Your browser doesn't support javascript.
Mostrar: 20 | 50 | 100
Resultados 1 - 20 de 6.265
Filtrar
Añadir filtros

Intervalo de año
2.
Epidemiol Health ; 42: e2020064, 2020.
Artículo en Inglés | MEDLINE | ID: covidwho-878558

RESUMEN

OBJECTIVES: During the 6 months since the first coronavirus disease 2019 (COVID-19) patient was diagnosed in Korea on January 20, 2020, various prevention and control measures have been implemented according to the COVID-19 epidemic pattern. Therefore, this study aimed to estimate the reproductive numbers (R) for each epidemic stage to analyze the effects of the preventive measures and to predict the COVID-19 transmission trends. METHODS: We estimated the transmission rates for each epidemic stage by fitting a COVID-19 transmission model, based on a deterministic mathematical model, to the data on confirmed cases. The effects of preventive measures such as social distancing by time period were analyzed, and the size and trends of future COVID-19 outbreaks were estimated. RESULTS: The value of R was 3.53 from February18, 2020 to February 28, 2020, and the mean R reduced to 0.45 from March 14, 2020 to April 29, 2020, but it significantly increased to 2.69 from April 30, 2020 to May13, 2020 and it was maintained at 1.03 from May 14, 2020 to July 23, 2020. CONCLUSIONS: According to the estimated R, it had fallen to below 1 and was maintained at that level owing to the isolation of infected persons by the public health authorities and social distancing measures followed by the general public. Then, the estimated R increased rapidly as the contact among individuals increased during the long holiday period from April 30, 2020 to May 5, 2020. Thereafter, the value of R dropped, with the continued use of preventive measures but remained higher than 1.00, indicating that the COVID-19 outbreak can be prolonged and develop into a severe outbreak at any time.


Asunto(s)
Infecciones por Coronavirus/prevención & control , Pandemias/prevención & control , Neumonía Viral/prevención & control , Distancia Social , Número Básico de Reproducción , Infecciones por Coronavirus/epidemiología , Humanos , Modelos Teóricos , Neumonía Viral/epidemiología , República de Corea/epidemiología
3.
Colomb Med (Cali) ; 51(2): e4277, 2020 Jun 30.
Artículo en Inglés | MEDLINE | ID: covidwho-875102

RESUMEN

Currently, there are several mathematical models that have been developed to understand the dynamics of COVID-19 infection. However, the difference in the sociocultural contexts between countries requires the specific adjustment of these estimates to each scenario. This article analyses the main elements used for the construction of models from epidemiological patterns, to describe the interaction, explain the dynamics of infection and recovery, and to predict possible scenarios that may arise with the introduction of public health measures such as social distancing and quarantines, specifically in the case of the pandemic unleashed by the new SARS-CoV-2/COVID-19 virus. Comment: Mathematical models are highly relevant for making objective and effective decisions to control and eradicate the disease. These models used for COVID-19 have supported and will continue to provide information for the selection and implementation of programs and public policies that prevent associated complications, reduce the speed of the virus spread and minimize the occurrence of severe cases of the disease that may collapse health systems.


Asunto(s)
Infecciones por Coronavirus/epidemiología , Política de Salud , Modelos Teóricos , Neumonía Viral/epidemiología , Infecciones por Coronavirus/prevención & control , Prestación de Atención de Salud/organización & administración , Humanos , Pandemias/prevención & control , Neumonía Viral/prevención & control , Salud Pública , Cuarentena , Aislamiento Social
4.
MMWR Morb Mortal Wkly Rep ; 69(41): 1485-1491, 2020 Oct 16.
Artículo en Inglés | MEDLINE | ID: covidwho-874994

RESUMEN

Frequent hand hygiene, including handwashing with soap and water or using a hand sanitizer containing ≥60% alcohol when soap and water are not readily available, is one of several critical prevention measures recommended to reduce the spread of SARS-CoV-2, the virus that causes coronavirus disease 2019 (COVID-19).* Previous studies identified demographic factors associated with handwashing among U.S. adults during the COVID-19 pandemic (1,2); however, demographic factors associated with hand sanitizing and experiences and beliefs associated with hand hygiene have not been well characterized. To evaluate these factors, an Internet-based survey was conducted among U.S. adults aged ≥18 years during June 24-30, 2020. Overall, 85.2% of respondents reported always or often engaging in hand hygiene following contact with high-touch public surfaces such as shopping carts, gas pumps, and automatic teller machines (ATMs).† Respondents who were male (versus female) and of younger age reported lower handwashing and hand sanitizing rates, as did respondents who reported lower concern about their own infection with SARS-CoV-2§ and respondents without personal experience with COVID-19. Focused health promotion efforts to increase hand hygiene adherence should include increasing visibility and accessibility of handwashing and hand sanitizing materials in public settings, along with targeted communication to males and younger adults with focused messages that address COVID-19 risk perception.


Asunto(s)
Infecciones por Coronavirus/prevención & control , Higiene de las Manos/estadística & datos numéricos , Conocimientos, Actitudes y Práctica en Salud , Pandemias/prevención & control , Neumonía Viral/prevención & control , Adolescente , Adulto , Factores de Edad , Anciano , Grupos de Población Continentales/psicología , Grupos de Población Continentales/estadística & datos numéricos , Infecciones por Coronavirus/epidemiología , Infecciones por Coronavirus/etnología , Grupos Étnicos/psicología , Grupos Étnicos/estadística & datos numéricos , Femenino , Conocimientos, Actitudes y Práctica en Salud/etnología , Humanos , Masculino , Persona de Mediana Edad , Neumonía Viral/epidemiología , Neumonía Viral/etnología , Factores Sexuales , Encuestas y Cuestionarios , Estados Unidos/epidemiología , Adulto Joven
5.
Front Immunol ; 11: 1836, 2020.
Artículo en Inglés | MEDLINE | ID: covidwho-868937

RESUMEN

Examining CD8+ and CD4+ T cell responses after primary Yellow Fever vaccination in a cohort of 210 volunteers, we have identified and tetramer-validated 92 CD8+ and 50 CD4+ T cell epitopes, many inducing strong and prevalent (i.e., immunodominant) T cell responses. Restricted by 40 and 14 HLA-class I and II allotypes, respectively, these responses have wide population coverage and might be of considerable academic, diagnostic and therapeutic interest. The broad coverage of epitopes and HLA overcame the otherwise confounding effects of HLA diversity and non-HLA background providing the first evidence of T cell immunodomination in humans. Also, double-staining of CD4+ T cells with tetramers representing the same HLA-binding core, albeit with different flanking regions, demonstrated an extensive diversification of the specificities of many CD4+ T cell responses. We suggest that this could reduce the risk of pathogen escape, and that multi-tetramer staining is required to reveal the true magnitude and diversity of CD4+ T cell responses. Our T cell epitope discovery approach uses a combination of (1) overlapping peptides representing the entire Yellow Fever virus proteome to search for peptides containing CD4+ and/or CD8+ T cell epitopes, (2) predictors of peptide-HLA binding to suggest epitopes and their restricting HLA allotypes, (3) generation of peptide-HLA tetramers to identify T cell epitopes, and (4) analysis of ex vivo T cell responses to validate the same. This approach is systematic, exhaustive, and can be done in any individual of any HLA haplotype. It is all-inclusive in the sense that it includes all protein antigens and peptide epitopes, and encompasses both CD4+ and CD8+ T cell epitopes. It is efficient and, importantly, reduces the false discovery rate. The unbiased nature of the T cell epitope discovery approach presented here should support the refinement of future peptide-HLA class I and II predictors and tetramer technologies, which eventually should cover all HLA class I and II isotypes. We believe that future investigations of emerging pathogens (e.g., SARS-CoV-2) should include population-wide T cell epitope discovery using blood samples from patients, convalescents and/or long-term survivors, who might all hold important information on T cell epitopes and responses.


Asunto(s)
Linfocitos T CD4-Positivos/inmunología , Linfocitos T CD8-positivos/inmunología , Epítopos de Linfocito T/inmunología , Vacunación , Vacuna contra la Fiebre Amarilla/inmunología , Fiebre Amarilla/prevención & control , Virus de la Fiebre Amarilla/inmunología , Betacoronavirus/inmunología , Estudios de Cohortes , Infecciones por Coronavirus/prevención & control , Infecciones por Coronavirus/virología , Voluntarios Sanos , Antígenos de Histocompatibilidad Clase I/inmunología , Antígenos de Histocompatibilidad Clase II/inmunología , Humanos , Inmunogenicidad Vacunal , Pandemias/prevención & control , Neumonía Viral/prevención & control , Neumonía Viral/virología , Fiebre Amarilla/virología
6.
Codas ; 32(4): e20200222, 2020.
Artículo en Portugués, Inglés | MEDLINE | ID: covidwho-868751

RESUMEN

PURPOSE: to describe de functional development of swallowing in Intensive Care Unit (ICU) patients with COVID-19, who were submitted to a swallowing intervention. METHODS: participants of the study were 77 patients (both gender, mean age 53.4±15.9; score on the Glasgow Coma Scale ≥14 and stable respiratory condition). The functional scale of swallowing used for assessment was the American Speech-Language-Hearing Association National Outcome Measurement System (ASHA NOMS). RESULTS: the results indicate that there was a significant recovery of the functional swallowing patterns when comparing the measurements pre and post swallowing intervention. CONCLUSION: 83% of the patients needed up to 3 swallowing interventions to recover a safe swallowing pattern.


Asunto(s)
Infecciones por Coronavirus/prevención & control , Deglución/fisiología , Unidades de Cuidados Intensivos/estadística & datos numéricos , Neumonía Viral/prevención & control , Adulto , Anciano , Betacoronavirus , Coronavirus , Infecciones por Coronavirus/epidemiología , Brotes de Enfermedades/prevención & control , Humanos , Persona de Mediana Edad , Pandemias , Neumonía Viral/epidemiología , Estados Unidos/epidemiología
8.
Epidemiol Infect ; 148: e226, 2020 09 28.
Artículo en Inglés | MEDLINE | ID: covidwho-867334

RESUMEN

Data on the possibility of transmission of Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) during the provision of chronic haemodialysis, which often entails many person-to-person contacts, are lacking. We report a follow-up of the in-centre contacts of three positive chronic haemodialysis patients. Under strict preventive measures, only one patient out of 21 patient-contacts and 29 personnel-contacts tested positive within 2 weeks after the last contact. This patient, case #3, most likely became infected during unprotected, organised group transportation to the dialysis centre.


Asunto(s)
Infecciones por Coronavirus/transmisión , Neumonía Viral/transmisión , Anciano , Betacoronavirus/fisiología , Trazado de Contacto , Infecciones por Coronavirus/epidemiología , Infecciones por Coronavirus/prevención & control , Femenino , Unidades de Hemodiálisis en Hospital , Humanos , Masculino , Pandemias/prevención & control , Aislamiento de Pacientes , Equipo de Protección Personal , Neumonía Viral/epidemiología , Neumonía Viral/prevención & control , Eslovenia/epidemiología , Transportes
9.
Rev. Asoc. Odontol. Argent ; 108(2): 88-94, mayo-ago. 2020. tab
Artículo en Español | LILACS (Américas) | ID: covidwho-864469

RESUMEN

La pandemia de enfermedad por coronavirus de 2019 (Covid-19) se ha convertido en un importante desafío de salud pública para todos los países. Las medidas de control de infecciones son necesarias para disminuir la circulación del virus y evitar que se siga propagando mundialmente. Debido a las características de los entornos odontológicos, el riesgo de infección cruzada entre los pacientes y los odontólogos es alto. Es por esto que se requieren protocolos de control de infecciones estrictos y efectivos. Elaborar estrategias de gestión del riesgo en salud en odontología permitirá brindar un entorno de seguridad para el paciente, el profesional y su equipo (AU)


The Covid-19 pandemic has become a major public health challenge all over the world. Infection control measures are necessary to prevent the virus from spreading further and to help to control the situation worldwide. Due to the characteristics of the dental environment, the risk of cross infection is high between patients and dentists. It is important to develop strict infection control protocols to provide a safety environment for the patient and the dental staff (AU)


Asunto(s)
Humanos , Infecciones por Coronavirus/prevención & control , Control de Infección Dental/métodos , Personal de Odontología , Pandemias , Seguridad del Paciente , Gestión de Riesgos , Control de Enfermedades Transmisibles/métodos , Protocolos Clínicos , Consultorios Odontológicos/normas
10.
JMIR Public Health Surveill ; 6(3): e18965, 2020 09 18.
Artículo en Inglés | MEDLINE | ID: covidwho-862937

RESUMEN

BACKGROUND: Throughout March 2020, leaders in countries across the world were making crucial decisions about how and when to implement public health interventions to combat the coronavirus disease (COVID-19). They urgently needed tools to help them to explore what will work best in their specific circumstances of epidemic size and spread, and feasible intervention scenarios. OBJECTIVE: We sought to rapidly develop a flexible, freely available simulation model for use by modelers and researchers to allow investigation of how various public health interventions implemented at various time points might change the shape of the COVID-19 epidemic curve. METHODS: "COVOID" (COVID-19 Open-Source Infection Dynamics) is a stochastic individual contact model (ICM), which extends the ICMs provided by the open-source EpiModel package for the R statistical computing environment. To demonstrate its use and inform urgent decisions on March 30, 2020, we modeled similar intervention scenarios to those reported by other investigators using various model types, as well as novel scenarios. The scenarios involved isolation of cases, moderate social distancing, and stricter population "lockdowns" enacted over varying time periods in a hypothetical population of 100,000 people. On April 30, 2020, we simulated the epidemic curve for the three contiguous local areas (population 287,344) in eastern Sydney, Australia that recorded 5.3% of Australian cases of COVID-19 through to April 30, 2020, under five different intervention scenarios and compared the modeled predictions with the observed epidemic curve for these areas. RESULTS: COVOID allocates each member of a population to one of seven compartments. The number of times individuals in the various compartments interact with each other and their probability of transmitting infection at each interaction can be varied to simulate the effects of interventions. Using COVOID on March 30, 2020, we were able to replicate the epidemic response patterns to specific social distancing intervention scenarios reported by others. The simulated curve for three local areas of Sydney from March 1 to April 30, 2020, was similar to the observed epidemic curve in terms of peak numbers of cases, total numbers of cases, and duration under a scenario representing the public health measures that were actually enacted, including case isolation and ramp-up of testing and social distancing measures. CONCLUSIONS: COVOID allows rapid modeling of many potential intervention scenarios, can be tailored to diverse settings, and requires only standard computing infrastructure. It replicates the epidemic curves produced by other models that require highly detailed population-level data, and its predicted epidemic curve, using parameters simulating the public health measures that were enacted, was similar in form to that actually observed in Sydney, Australia. Our team and collaborators are currently developing an extended open-source COVOID package comprising of a suite of tools to explore intervention scenarios using several categories of models.


Asunto(s)
Trazado de Contacto , Infecciones por Coronavirus/prevención & control , Modelos Biológicos , Pandemias/prevención & control , Neumonía Viral/prevención & control , Salud Pública , Aislamiento Social , Australia , Betacoronavirus , Coronavirus , Infecciones por Coronavirus/epidemiología , Infecciones por Coronavirus/transmisión , Infecciones por Coronavirus/virología , Epidemias , Humanos , Neumonía Viral/epidemiología , Neumonía Viral/transmisión , Neumonía Viral/virología , Cuarentena
11.
Infect Control Hosp Epidemiol ; 41(9): 1003-1010, 2020 09.
Artículo en Inglés | MEDLINE | ID: covidwho-862242

RESUMEN

BACKGROUND: SARS-CoV-2 has been implicated in the largest recorded coronavirus outbreak to date. Initially, most COVID-19 cases were in China, but the virus has spread to more than 184 countries worldwide, and the United States currently has more cases than any other country. OBJECTIVE: With person-to-person spread expanding in the United States, we describe hospital preparedness for managing suspected and confirmed COVID-19 patients. DESIGN: Cross-sectional survey focused on various elements of respiratory disease preparedness. SETTING: Critical access hospitals (CAHs) and acute-care hospitals (ACHs) in Idaho. METHODS: The electronic survey was sent to infection preventionists (IPs) and nurse administrators in 44 hospitals in Idaho. RESULTS: Overall, 32 (73%) hospitals responded to the survey. Participating facilities reported their preparedness with respect to existing, formalized structures for managing infectious disease incidents-specifically COVID-19-as well as availability of resources, such as isolation rooms and personal protective equipment, for safely managing suspected and confirmed COVID-19 cases. CONCLUSIONS: Hospitals covered by the survey had varying levels of preparedness for managing COVID-19 cases, with differences across the various categories of interest in this study. Although the study reveals strengths, including in application of emergency management and infection control frameworks, it also suggests that other areas, such as consistent implementation of federal guidelines and requirements for infection prevention, are potential areas for strengthening preparedness for SARS-CoV-2 and other respiratory pathogens with pandemic potential.


Asunto(s)
Betacoronavirus , Infecciones por Coronavirus/prevención & control , Recursos en Salud/provisión & distribución , Hospitales/estadística & datos numéricos , Control de Infecciones/estadística & datos numéricos , Pandemias/prevención & control , Neumonía Viral/prevención & control , Estudios Transversales , Encuestas de Atención de la Salud , Humanos , Idaho , Control de Infecciones/instrumentación , Control de Infecciones/métodos , Equipo de Protección Personal/provisión & distribución , Cuarentena/métodos , Cuarentena/estadística & datos numéricos
12.
Infect Control Hosp Epidemiol ; 41(9): 1075-1076, 2020 Sep.
Artículo en Inglés | MEDLINE | ID: covidwho-862233
13.
ACS Chem Biol ; 15(9): 2331-2337, 2020 09 18.
Artículo en Inglés | MEDLINE | ID: covidwho-860112

RESUMEN

We report on using the synthetic aminoadamantane-CH2-aryl derivatives 1-6 as sensitive probes for blocking M2 S31N and influenza A virus (IAV) M2 wild-type (WT) channels as well as virus replication in cell culture. The binding kinetics measured using electrophysiology (EP) for M2 S31N channel are very dependent on the length between the adamantane moiety and the first ring of the aryl headgroup realized in 2 and 3 and the girth and length of the adamantane adduct realized in 4 and 5. Study of 1-6 shows that, according to molecular dynamics (MD) simulations and molecular mechanics Poisson-Boltzmann surface area (MM/PBSA) calculations, all bind in the M2 S31N channel with the adamantyl group positioned between V27 and G34 and the aryl group projecting out of the channel with the phenyl (or isoxazole in 6) embedded in the V27 cluster. In this outward binding configuration, an elongation of the ligand by only one methylene in rimantadine 2 or using diamantane or triamantane instead of adamantane in 4 and 5, respectively, causes incomplete entry and facilitates exit, abolishing effective block compared to the amantadine derivatives 1 and 6. In the active M2 S31N blockers 1 and 6, the phenyl and isoxazolyl head groups achieve a deeper binding position and high kon/low koff and high kon/high koff rate constants, compared to inactive 2-5, which have much lower kon and higher koff. Compounds 1-5 block the M2 WT channel by binding in the longer area from V27-H37, in the inward orientation, with high kon and low koff rate constants. Infection of cell cultures by influenza virus containing M2 WT or M2 S31N is inhibited by 1-5 or 1-4 and 6, respectively. While 1 and 6 block infection through the M2 block mechanism in the S31N variant, 2-4 may block M2 S31N virus replication in cell culture through the lysosomotropic effect, just as chloroquine is thought to inhibit SARS-CoV-2 infection.


Asunto(s)
Adamantano/farmacología , Virus de la Influenza A/efectos de los fármacos , Gripe Humana/prevención & control , Canales Iónicos/antagonistas & inhibidores , Sondas Moleculares/química , Proteínas de la Matriz Viral/antagonistas & inhibidores , Adamantano/análogos & derivados , Adamantano/química , Adamantano/metabolismo , Betacoronavirus/efectos de los fármacos , Sitios de Unión , Células Cultivadas , Cloroquina/farmacología , Infecciones por Coronavirus/tratamiento farmacológico , Infecciones por Coronavirus/prevención & control , Variación Genética , Humanos , Virus de la Influenza A/química , Virus de la Influenza A/genética , Gripe Humana/tratamiento farmacológico , Cinética , Sondas Moleculares/metabolismo , Pandemias/prevención & control , Neumonía Viral/tratamiento farmacológico , Neumonía Viral/prevención & control , Unión Proteica , Relación Estructura-Actividad , Replicación Viral/efectos de los fármacos
15.
Zhongguo Yi Liao Qi Xie Za Zhi ; 44(5): 453-456, 2020 Oct 08.
Artículo en Chino | MEDLINE | ID: covidwho-854259

RESUMEN

OBJECTIVE: To explore the preventing infection measures of new coronavirus disease 2019(COVID-19) patients during mechanical ventilation, and to provide reference for the safe application of mechanical ventilation. METHODS: Retrieved from PubMed, Ovid and other databases, and combined with the application experience of mechanical ventilation were collected to explore the preventing infection measures of COVID-19 patients during mechanical ventilation. RESULTS: This paper put forward the preventing infection measures of external circuit, internal circuit, outer surface, filter and special parts in ventilator. The preventing infection measures of sputum suction and nebulization were summarized. CONCLUSIONS: The preventing infection measures of COVID-19 patients during mechanical ventilation are successfully completed, which can provide suggestions for the application and maintenance of mechanical ventilation.


Asunto(s)
Infecciones por Coronavirus/prevención & control , Control de Infecciones/métodos , Pandemias/prevención & control , Neumonía Viral/prevención & control , Respiración Artificial , Betacoronavirus , Infecciones por Coronavirus/terapia , Humanos , Neumonía Viral/terapia , Ventiladores Mecánicos
16.
Z Gastroenterol ; 58(10): 982-1002, 2020 Oct.
Artículo en Inglés | MEDLINE | ID: covidwho-851352

RESUMEN

The COVID-19 pandemic is a global outbreak of new onset infections with the SARS-CoV-2 virus. To date, more than 3.4 million people have been infected throughout the world. In Germany, approximately 450,000 patients suffer from inflammatory bowel disease; these patients generally require continuous expert care and support. Against the background of a rapidly accumulating knowledge base on SARS-CoV-2, 68 expert authors of the current DGVS guidelines for Crohn's disease and ulcerative colitis took part in a virtual meeting to compile up-to-date, practice-orientated recommendations aimed at improving the care of patients with IBD. These recommendations address the risk of infection, including the risk for specific patient groups, the possible course of the disease, and consequences for pharmacological and surgical therapies of the underlying disease, as well as general measures for infection prevention and adjuvant prophylactic and therapeutic options.


Asunto(s)
Colitis Ulcerosa , Infecciones por Coronavirus , Enfermedad de Crohn , Enfermedades Inflamatorias del Intestino , Neumonía Viral , Guías de Práctica Clínica como Asunto , Betacoronavirus , Colitis Ulcerosa/diagnóstico , Colitis Ulcerosa/terapia , Infecciones por Coronavirus/epidemiología , Infecciones por Coronavirus/prevención & control , Enfermedad de Crohn/diagnóstico , Enfermedad de Crohn/terapia , Alemania , Humanos , Enfermedades Inflamatorias del Intestino/diagnóstico , Enfermedades Inflamatorias del Intestino/terapia , Pandemias , Neumonía Viral/epidemiología , Neumonía Viral/prevención & control
17.
Bone Joint J ; 102-B(9): 1256-1260, 2020 Sep.
Artículo en Inglés | MEDLINE | ID: covidwho-844475

RESUMEN

AIMS: The risk to patients and healthcare workers of resuming elective orthopaedic surgery following the peak of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic has been difficult to quantify. This has prompted governing bodies to adopt a cautious approach that may be impractical and financially unsustainable. The lack of evidence has made it impossible for surgeons to give patients an informed perspective of the consequences of elective surgery in the presence of SARS-CoV-2. This study aims to determine, for the UK population, the probability of a patient being admitted with an undetected SARS-CoV-2 infection and their resulting risk of death; taking into consideration the current disease prevalence, reverse transcription-polymerase chain reaction (RT-PCR) testing, and preassessment pathway. METHODS: The probability of SARS-CoV-2 infection with a false negative test was calculated using a lower-end RT-PCR sensitivity of 71%, specificity of 95%, and the UK disease prevalence of 0.24% reported in May 2020. Subsequently, a case fatality rate of 20.5% was applied as a worst-case scenario. RESULTS: The probability of SARS-CoV-2 infection with a false negative preoperative test was 0.07% (around 1 in 1,400). The risk of a patient with an undetected infection being admitted for surgery and subsequently dying from the coronavirus disease 2019 (COVID-19) is estimated at approximately 1 in 7,000. However, if an estimate of the current global infection fatality rate (1.04%) is applied, the risk of death would be around 1 in 140,000, at most. This calculation does not take into account the risk of nosocomial infection. Conversely, it does not factor in that patients will also be clinically assessed and asked to self-isolate prior to surgery. CONCLUSION: Our estimation suggests that the risk of patients being inadvertently admitted with an undetected SARS-CoV-2 infection for elective orthopaedic surgery is relatively low. Accordingly, the risk of death following elective orthopaedic surgery is low, even when applying the worst-case fatality rate. Cite this article: Bone Joint J 2020;102-B(9):1256-1260.


Asunto(s)
Enfermedades Asintomáticas , Causas de Muerte , Infecciones por Coronavirus/epidemiología , Procedimientos Quirúrgicos Electivos/efectos adversos , Pandemias/estadística & datos numéricos , Neumonía Viral/epidemiología , Complicaciones Posoperatorias/mortalidad , Teorema de Bayes , Técnicas de Laboratorio Clínico , Estudios de Cohortes , Infecciones por Coronavirus/diagnóstico , Infecciones por Coronavirus/prevención & control , Procedimientos Quirúrgicos Electivos/mortalidad , Reacciones Falso Negativas , Femenino , Humanos , Incidencia , Masculino , Pandemias/prevención & control , Neumonía Viral/prevención & control , Complicaciones Posoperatorias/fisiopatología , Medición de Riesgo , Tasa de Supervivencia , Resultado del Tratamiento , Reino Unido
18.
JCO Glob Oncol ; 6: 1428-1438, 2020 09.
Artículo en Inglés | MEDLINE | ID: covidwho-844422

RESUMEN

PURPOSE: The COVID-19 pandemic affected health care systems globally and resulted in the interruption of usual care in many health care facilities, exposing vulnerable patients with cancer to significant risks. Our study aimed to evaluate the impact of this pandemic on cancer care worldwide. METHODS: We conducted a cross-sectional study using a validated web-based questionnaire of 51 items. The questionnaire obtained information on the capacity and services offered at these centers, magnitude of disruption of care, reasons for disruption, challenges faced, interventions implemented, and the estimation of patient harm during the pandemic. RESULTS: A total of 356 centers from 54 countries across six continents participated between April 21 and May 8, 2020. These centers serve 716,979 new patients with cancer a year. Most of them (88.2%) reported facing challenges in delivering care during the pandemic. Although 55.34% reduced services as part of a preemptive strategy, other common reasons included an overwhelmed system (19.94%), lack of personal protective equipment (19.10%), staff shortage (17.98%), and restricted access to medications (9.83%). Missing at least one cycle of therapy by > 10% of patients was reported in 46.31% of the centers. Participants reported patient exposure to harm from interruption of cancer-specific care (36.52%) and noncancer-related care (39.04%), with some centers estimating that up to 80% of their patients were exposed to harm. CONCLUSION: The detrimental impact of the COVID-19 pandemic on cancer care is widespread, with varying magnitude among centers worldwide. Additional research to assess this impact at the patient level is required.


Asunto(s)
Instituciones Oncológicas/estadística & datos numéricos , Infecciones por Coronavirus/prevención & control , Accesibilidad a los Servicios de Salud/estadística & datos numéricos , Oncología Médica/estadística & datos numéricos , Neoplasias/terapia , Pandemias/prevención & control , Neumonía Viral/prevención & control , Betacoronavirus/patogenicidad , Instituciones Oncológicas/normas , Infecciones por Coronavirus/epidemiología , Infecciones por Coronavirus/transmisión , Infecciones por Coronavirus/virología , Estudios Transversales , Carga Global de Enfermedades , Accesibilidad a los Servicios de Salud/normas , Humanos , Control de Infecciones/normas , Cooperación Internacional , Oncología Médica/normas , Neumonía Viral/epidemiología , Neumonía Viral/transmisión , Neumonía Viral/virología , Encuestas y Cuestionarios/estadística & datos numéricos
19.
BMC Infect Dis ; 20(1): 745, 2020 Oct 12.
Artículo en Inglés | MEDLINE | ID: covidwho-843296

RESUMEN

BACKGROUND: Workers and residents in Care Homes are considered at special risk for the acquisition of SARS-CoV-2 infection, due to the infectivity and high mortality rate in the case of residents, compared to other containment areas. The role of presymptomatic people in transmission has been shown to be important and the early detection of these people is critical for the control of new outbreaks. Pooling strategies have proven to preserve SARS-CoV-2 testing resources. The aims of the present study, based in our local experience, were (a) to describe SARS-CoV-2 prevalence in institutionalized people in Galicia (Spain) during the Coronavirus pandemic and (b) to evaluate the expected performance of a pooling strategy using RT-PCR for the next rounds of screening of institutionalized people. METHODS: A total of 25,386 Nasopharyngeal swab samples from the total of the residents and workers at Care Homes in Galicia (March to May 2020) were individually tested using RT-PCR. Prevalence and quantification cycle (Cq) value distribution of positives was calculated. Besides, 26 pools of 20 samples and 14 pools of 5 samples were tested using RT-PCR as well (1 positive/pool). Pooling proof of concept was performed in two populations with 1.7 and 2% prevalence. RESULTS: Distribution of SARS-CoV-2 infection at Care Homes was uneven (0-60%). As the virus circulation global rate was low in our area (3.32%), the number of people at risk of acquiring the infection continues to be very high. In this work, we have successfully demonstrated that pooling of different groups of samples at low prevalence clusters, can be done with a small average delay on Cq values (5 and 2.85 cycles for pools of 20 and 5 samples, respectively). CONCLUSIONS: A new screening system with guaranteed protection is required for small clusters, previously covered with individual testing. Our proposal for Care Homes, once prevalence zero is achieved, would include successive rounds of testing using a pooling solution for transmission control preserving testing resources. Scale-up of this method may be of utility to confront larger clusters to avoid the viral circulation and keeping them operative.


Asunto(s)
Betacoronavirus/genética , Betacoronavirus/aislamiento & purificación , Técnicas de Laboratorio Clínico/métodos , Infecciones por Coronavirus/diagnóstico , Infecciones por Coronavirus/prevención & control , Casas de Salud/estadística & datos numéricos , Pandemias/prevención & control , Neumonía Viral/diagnóstico , Neumonía Viral/prevención & control , Infecciones por Coronavirus/transmisión , Infecciones por Coronavirus/virología , Brotes de Enfermedades/prevención & control , Brotes de Enfermedades/estadística & datos numéricos , Humanos , Neumonía Viral/transmisión , Neumonía Viral/virología , Reacción en Cadena de la Polimerasa de Transcriptasa Inversa , España/epidemiología
SELECCIÓN DE REFERENCIAS
DETALLE DE LA BÚSQUEDA