ABSTRACT
BackgroundBecause infectious diseases, such as COVID-19, do not have specific boundaries, all countries must prioritize and use the necessary capabilities to prevent, detect, and respond quickly to public health emergencies. In this context, we aimed to review most recent GHS index annual report to observe the regional and global level of health security against COVID-19 outbreak, as well as their relationship with case fatality rate, among 210 countries and territories worldwide. MethodsWe reviewed and analyzed October 2019 GHS index co-leaders joint report, to review health security capacities on the basis of the GHS index in the context of six categories. we prioritized not only the capacities of 210 countries and territories around the world using the GHS Index, but also the existence of functional, tested, proven capabilities for stopping outbreaks at the source. Data were collected from global databases including Worldometer, WHO, and Disease Control and Prevention Center (CDC). FindingsThis study recruited data on 210 countries and territories, of which up to 14 April 2020, 72 countries (34.28%) with more than 1000 total COVID-19 cases were presents. In "most prepared group", number of total COVID-19 diagnostic tests had a significant positive relation with GHS index (r=0.713; p=0.006). Case fatality rate was directly associated with the detection index (r=0.304; p=0.023) in "more prepared group". In "Lower-middle-income economies" group, case fatality rate positively related to detection, response and risk environment indices. ImplementationWith the exception of a very small number, countries that were ranked as most prepared countries, they were more likely to be affected by the COVID-19 outbreak of the virus and its health consequences, and needed to seriously reconsider their capabilities and health security in the context of detection, prevention, rapid response, health system facilities, and risk environment against disease outbreak Research in contextO_ST_ABSEvidence before this studyC_ST_ABSGiven the very rapid spread of the COVID-19 disease in a very short time, limited and few studies have shown weakness and strength in national and international capacity to deal with health emergencies. We systematically searched the Scopus, ISI web of science and PubMed from Jan 2019 to April 2020, using the search terms "health security" OR "emergency preparedness" AND "COVID-19" OR "SARS-CoV-2/nCoV-2019". Our search returned only limited number of published evidences (n=37), of which only one was assessed the operational readiness among 182 countries based on the International Health Regulations (IHR) annual report 1. Added value of this studyGiven a very limited and insufficient on the regional, as well as global preparedness capacities to combat health emergencies, such as COVID-19 disease, we used most recent GHS index annual report (October 2019), to observe the regional and global level of health security in the context of detection, prevention, rapid response, health system facilities, and risk environment against COVID-19 outbreak among 210 countries and territories around the world. We found information about only 195 countries in the recent used report and imputed the data for the rest 15 countries and territories that facing COVID-19 outbreak. Implications of all the available evidenceOur results showed that, with the exception of a very small number of countries that were ranked as most prepared countries, they were more likely to be affected by the COVID-19 outbreak of the virus and its health consequences, and needed to seriously reconsider their capabilities and health security in the context of detection, prevention, rapid response, health system facilities, and risk environment against disease outbreak.
ABSTRACT
This review compared coronavirus disease 2019 (COVID-19) laboratory findings, comorbidities, and clinical outcomes in patients from the general population versus medical staff to aid diagnosis of COVID-19 in a more timely, efficient, and accurate way. Electronic databases were searched up to 23rdMarch, 2020. The initial search yielded 6,527 studies. Following screening, 24 studies were included [18 studies (11,564 cases) of confirmed COVID-19 cases in the general public, and 6 studies (394 cases) in medical staff] in this review. Significant differences were observed in white blood cell counts (p < 0.001), lymphocyte counts (p < 0.001), platelet counts (p = 0.04), procalcitonin levels (p < 0.001), lactate dehydrogenase levels (p < 0.001), and creatinine levels (p = 0.03) when comparing infected medical staff with the general public. The mortality rate was higher in the general population than in medical staff (8% versus 2%). This review showed that during the early stages of COVID-19, laboratory findings alone may not be significant predictors of infection and may just accompany increasing C-reactive protein levels, erythrocyte sedimentation rates, and lactate dehydrogenase levels. In the symptomatic stage, the lymphocyte and platelet counts tended to decrease. Elevated D-dimer fibrin degradation product was associated with poor prognosis.
ABSTRACT
STUDY DESIGN: This study was performed to investigate the diagnostic values of some inflammatory biomarkers in abdominal pain. METHODS: Patients over 18 years of age with acute recent abdominal pain who presented to the Emergency Department were evaluated. Serum and urinary samples were taken and evaluated for serum and urine S100A8/A9 and serum amyloid A. All patients were referred to a surgeon and were followed up until the final diagnosis. In the end, the final diagnosis was compared with the levels of biomarkers. RESULTS: Of a total of 181 patients, 71 underwent surgery and 110 patients did not need surgery after they were clinically diagnosed. Mean levels of serum and urine S100A8/A9 had a significant difference between two groups, but serum amyloid A did not show. The diagnostic accuracy of serum S100A8/A9, urine S100A8/A9, and serum amyloid A was 86%, 79%, and 50%, respectively, in anticipation of the need or no need for surgery in acute abdominal pain. CONCLUSIONS: Our study showed that in acute abdominal pain, serum and urine S100A8/A9 can be useful indicators of the need for surgery, but serum amyloid A had a low and nonsignificant diagnostic accuracy.
