751
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Federico A. Experiencing COVID19 pandemic and neurology: learning by the recent reports and by old literary or scientific descriptions. Neurol Sci 2020; 41:1323-1327. [PMID: 32430624 PMCID: PMC7235549 DOI: 10.1007/s10072-020-04471-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Affiliation(s)
- Antonio Federico
- Department of Medicine, Surgery and Neurosciences, Medical School, University of Siena, viale Bracci 2, 53100, Siena, Italy.
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752
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Romano M, Ruggiero A, Squeglia F, Maga G, Berisio R. A Structural View of SARS-CoV-2 RNA Replication Machinery: RNA Synthesis, Proofreading and Final Capping. Cells 2020; 9:E1267. [PMID: 32443810 PMCID: PMC7291026 DOI: 10.3390/cells9051267] [Citation(s) in RCA: 300] [Impact Index Per Article: 75.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2020] [Revised: 05/14/2020] [Accepted: 05/19/2020] [Indexed: 01/18/2023] Open
Abstract
The current coronavirus disease-2019 (COVID-19) pandemic is due to the novel coronavirus SARS-CoV-2. The scientific community has mounted a strong response by accelerating research and innovation, and has quickly set the foundation for understanding the molecular determinants of the disease for the development of targeted therapeutic interventions. The replication of the viral genome within the infected cells is a key stage of the SARS-CoV-2 life cycle. It is a complex process involving the action of several viral and host proteins in order to perform RNA polymerization, proofreading and final capping. This review provides an update of the structural and functional data on the key actors of the replicatory machinery of SARS-CoV-2, to fill the gaps in the currently available structural data, which is mainly obtained through homology modeling. Moreover, learning from similar viruses, we collect data from the literature to reconstruct the pattern of interactions among the protein actors of the SARS-CoV-2 RNA polymerase machinery. Here, an important role is played by co-factors such as Nsp8 and Nsp10, not only as allosteric activators but also as molecular connectors that hold the entire machinery together to enhance the efficiency of RNA replication.
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Affiliation(s)
- Maria Romano
- Institute of Biostructures and Bioimaging, IBB, CNR, 80134 Naples, Italy; (M.R.); (A.R.); (F.S.)
| | - Alessia Ruggiero
- Institute of Biostructures and Bioimaging, IBB, CNR, 80134 Naples, Italy; (M.R.); (A.R.); (F.S.)
| | - Flavia Squeglia
- Institute of Biostructures and Bioimaging, IBB, CNR, 80134 Naples, Italy; (M.R.); (A.R.); (F.S.)
| | - Giovanni Maga
- Institute of Molecular Genetics, IGM, CNR, 27100 Pavia, Italy;
| | - Rita Berisio
- Institute of Biostructures and Bioimaging, IBB, CNR, 80134 Naples, Italy; (M.R.); (A.R.); (F.S.)
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753
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Abstract
Background: The outbreak of COVID-19 in China in early 2020 provides a rich data source for exploring the ecological determinants of this new infection, which may be of relevance as the pandemic develops. Objectives: Assessing the spread of the COVID-19 across China, in relation to associations between cases and ecological factors including population density, temperature, solar radiation and precipitation. Methods: Open-access COVID-19 case data include 18,069 geo-located cases in China during January and February 2020, which were mapped onto a 0.25° latitude/longitude grid together with population and weather data (temperature, solar radiation and precipitation). Of 15,539 grid cells, 559 (3.6%) contained at least one case, and these were used to construct a Poisson regression model of cell-weeks. Weather parameters were taken for the preceding week given the established 5–7 day incubation period for COVID-19. The dependent variable in the Poisson model was incident cases per cell-week and exposure was cell population, allowing for clustering of cells over weeks, to give incidence rate ratios. Results: The overall COVID-19 incidence rate in cells with confirmed cases was 0.12 per 1,000. There was a single confirmed case in 113/559 (20.2%) of cells, while two grid cells recorded over 1,000 confirmed cases. Weekly means of maximum daily temperature varied from −28.0°C to 30.1°C, minimum daily temperature from −42.4°C to 23.0°C, maximum solar radiation from 0.04 to 2.74 MJm−2 and total precipitation from 0 to 72.6 mm. Adjusted incidence rate ratios suggested brighter, warmer and drier conditions were associated with lower incidence. Conclusion: Though not demonstrating cause and effect, there were appreciable associations between weather and COVID-19 incidence during the epidemic in China. This does not mean the pandemic will go away with summer weather but demonstrates the importance of using weather conditions in understanding and forecasting the spread of COVID-19.
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Affiliation(s)
- Peter Byass
- Department of Epidemiology and Global Health, Umeå University, Umeå, Sweden.,Aberdeen Centre for Health Data Science (ACHDS), Institute of Applied Health Sciences, School of Medicine, Medical Sciences and Nutrition, University of Aberdeen, Aberdeen, Scotland.,MRC/Wits Rural Public Health and Health Transitions Research Unit (Agincourt), School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
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754
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Fogarty H, Townsend L, Ni Cheallaigh C, Bergin C, Martin-Loeches I, Browne P, Bacon CL, Gaule R, Gillett A, Byrne M, Ryan K, O'Connell N, O'Sullivan JM, Conlon N, O'Donnell JS. COVID19 coagulopathy in Caucasian patients. Br J Haematol 2020; 189:1044-1049. [PMID: 32330308 PMCID: PMC7264579 DOI: 10.1111/bjh.16749] [Citation(s) in RCA: 258] [Impact Index Per Article: 64.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2020] [Accepted: 04/22/2020] [Indexed: 01/30/2023]
Abstract
Although the pathophysiology underlying severe COVID19 remains poorly understood, accumulating data suggest that a lung‐centric coagulopathy may play an important role. Elevated D‐dimer levels which correlated inversely with overall survival were recently reported in Chinese cohort studies. Critically however, ethnicity has major effects on thrombotic risk, with a 3–4‐fold lower risk in Chinese compared to Caucasians and a significantly higher risk in African‐Americans. In this study, we investigated COVID19 coagulopathy in Caucasian patients. Our findings confirm that severe COVID19 infection is associated with a significant coagulopathy that correlates with disease severity. Importantly however, Caucasian COVID19 patients on low molecular weight heparin thromboprophylaxis rarely develop overt disseminated intravascular coagulation (DIC). In rare COVID19 cases where DIC does develop, it tends to be restricted to late‐stage disease. Collectively, these data suggest that the diffuse bilateral pulmonary inflammation observed in COVID19 is associated with a novel pulmonary‐specific vasculopathy termed pulmonary intravascular coagulopathy (PIC) as distinct to DIC. Given that thrombotic risk is significantly impacted by race, coupled with the accumulating evidence that coagulopathy is important in COVID19 pathogenesis, our findings raise the intriguing possibility that pulmonary vasculopathy may contribute to the unexplained differences that are beginning to emerge highlighting racial susceptibility to COVID19 mortality.
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Affiliation(s)
- Helen Fogarty
- Irish Centre for Vascular Biology, School of Pharmacy and Biomolecular Sciences, Royal College of Surgeons in Ireland, Dublin, Ireland.,National Coagulation Centre, St James's Hospital, Dublin, Ireland.,National Children's Research Centre, Our Lady's Children's Hospital Crumlin, Dublin, Ireland
| | - Liam Townsend
- Department of Infectious Diseases, St James's Hospital, Trinity College Dublin, Dublin, Ireland
| | - Cliona Ni Cheallaigh
- Department of Infectious Diseases, St James's Hospital, Trinity College Dublin, Dublin, Ireland
| | - Colm Bergin
- Department of Infectious Diseases, St James's Hospital, Trinity College Dublin, Dublin, Ireland
| | - Ignacio Martin-Loeches
- Irish Centre for Vascular Biology, School of Pharmacy and Biomolecular Sciences, Royal College of Surgeons in Ireland, Dublin, Ireland.,Department of Critical Care, St James's Hospital, Trinity College Dublin, Dublin, Ireland
| | - Paul Browne
- St James's Hospital, Trinity College Dublin, Dublin, Ireland
| | | | - Richard Gaule
- St James's Hospital, Trinity College Dublin, Dublin, Ireland
| | | | - Mary Byrne
- National Coagulation Centre, St James's Hospital, Dublin, Ireland
| | - Kevin Ryan
- National Coagulation Centre, St James's Hospital, Dublin, Ireland
| | - Niamh O'Connell
- National Coagulation Centre, St James's Hospital, Dublin, Ireland
| | - Jamie M O'Sullivan
- Irish Centre for Vascular Biology, School of Pharmacy and Biomolecular Sciences, Royal College of Surgeons in Ireland, Dublin, Ireland
| | - Niall Conlon
- Department of Immunology, St James's Hospital, Trinity College Dublin, Dublin, Ireland
| | - James S O'Donnell
- Irish Centre for Vascular Biology, School of Pharmacy and Biomolecular Sciences, Royal College of Surgeons in Ireland, Dublin, Ireland.,National Coagulation Centre, St James's Hospital, Dublin, Ireland.,National Children's Research Centre, Our Lady's Children's Hospital Crumlin, Dublin, Ireland.,St James's Hospital, Trinity College Dublin, Dublin, Ireland
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755
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Abstract
Regrettably, after a first moment of appreciation and praise of the citizens for healthcare personnel facing COVID 19 pandemia, numerous episodes of actions taken against them on the issue of their legal liability followed. Impelling is to start an argumentation on this problem that aims to establish a shared conduct in dealing with them. The authors propose a basis for discussion on which to begin a constructive debate.
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Affiliation(s)
| | - Guido Viel
- Department of Cardiac, Thoracic, Vascular Sciences and Public Health, University of Padova, Italy
| | - Rossana Cecchi
- Department of Medicine and Surgery, University of Parma, Italy.
| | - Massimo Montisci
- Department of Cardiac, Thoracic and Vascular Sciences, University of Padova, Italy
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756
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Friedlaender A, Kim C, Addeo A. Rethinking the Optimal Duration of Immune Checkpoint Inhibitors in Non-small Cell Lung Cancer Throughout the COVID-19 Pandemic. Front Oncol 2020; 10:862. [PMID: 32574277 PMCID: PMC7239024 DOI: 10.3389/fonc.2020.00862] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2020] [Accepted: 05/01/2020] [Indexed: 01/14/2023] Open
Abstract
Immune checkpoint inhibitors (ICPIs) have revolutionized the management and prognosis of fit patients with advanced non-small cell lung cancer (NSCLC). Recently, the publication of 5-year survival rates has cemented the role of ICPIs in NSCLC. An ongoing challenge is to determine the optimal treatment duration to find the balance between efficacy, toxicity and cost. From the onset of ICPI trials, different durations were used, ranging from treatment until progression or toxicity, to fixed durations of 2 years. Subsequently, exploratory analyses from a 1-year fixed duration trial failed to change practice. There are, to date, no adequately powered prospective trials addressing this important question. With today's severe acute respiratory syndrome coronavirus 2 (SARS-COV-2) pandemic, more than ever, the question resurfaces with added factors tilting the already shaky therapeutic balance. Here, we will discuss current data regarding ICPI treatment duration and incorporate this into the context of the ongoing pandemic. We conclude with a discussion of pragmatic approaches, should physicians be unable to continue standard therapy.
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Affiliation(s)
- Alex Friedlaender
- Department of Oncology, University Hospital of Geneva (HUG), Geneva, Switzerland
| | - Chul Kim
- Georgetown Lombardi Comprehensive Cancer Center, Georgetown University, Washington, DC, United States
| | - Alfredo Addeo
- Department of Oncology, University Hospital of Geneva (HUG), Geneva, Switzerland
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757
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Sugrue M, O'Keeffe D, Sugrue R, MacLean L, Varzgalis M. A cloth mask for under-resourced healthcare settings in the COVID19 pandemic. Ir J Med Sci 2020; 189:1155-7. [PMID: 32394153 DOI: 10.1007/s11845-020-02241-3] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2020] [Accepted: 04/16/2020] [Indexed: 01/09/2023]
Abstract
Introduction COVID19 pandemic poses a global threat, with many unknowns. The potential for resource limited countries to suffer huge mortality is of major concern. Prevention and risk reduction strategies are paramount in the current absence of effective treatment or a vaccine. There is a global shortage of personal protective equipment. Aims This short paper describes the rationale for and development of a cloth homemade mask and has a step by step video. Results The template is reproducible around the world and is both washable and cheap. Conclusion This article describes a simple way to make a cloth mask, suitable if medical masks are not available.
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758
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Hakeem R, Sheikh MA. Beyond transmission: Dire need for integration of nutrition interventions in COVID-19 pandemic-response strategies in Developing Countries like Pakistan. Pak J Med Sci 2020; 36:S85-S89. [PMID: 32582320 PMCID: PMC7306946 DOI: 10.12669/pjms.36.covid19-s4.2784] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
Synergistic associations between infection and nutrition are well known. Impact of nutrition interventions on the outcomes have been scientifically assessed and reported. The role of nutrition in limiting the infection related morbidity and mortality does not appear to be a debatable question but nutrition interventions do not appear to be an essential part of current COVID-19 management strategies. Given the nature of pandemic and lack of organism-specific evidence, variability in nutrition interventions and lack of nutrition interventions is not unexpected. However, delay in realization of the crucial need of nutrition interventions to limit the immediate and long term outcomes at personal and community level may aggravate health related issues that can have long term impact on quality of life and economy. Due to existing undernutrition and lack of nutrition related awareness and competence, need for timely and appropriate interventions is much more critical for developing countries. This manuscript highlights the need and feasibility of various nutrition interventions to assure optimum quality of life during and after COVID-19 pandemic. Available evidence provides enough guidance for nutrition interventions that are safe and promise to accrue various degrees of benefits with almost no likelihood of harm. Nutrition interventions suggested by author are: 1) population level efforts for promoting better use of existing resources; 2) quicker augmentation of nutrition status of high risk people and non-hospitalized cases by use of supplement and individualized guidance and 3) nutritional support of sever case by timely and adequate enteral and parenteral feeding.
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Affiliation(s)
- Rubina Hakeem
- Prof. Dr. Rubina Hakeem, Ph.D. (UK) RD (UK). Fellow of Association for Nutrition (FAfN), UK Principal, RLAK Govt. College of Home Economics, Karachi, Pakistan
| | - Muhammad Adil Sheikh
- Muhammad Adil Sheikh, Clinical Assistant Professor Division of Hospital Medicine Department of Internal Medicine University of Michigan Ann Arbor, Michigan. US
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759
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Merindol N, Pépin G, Marchand C, Rheault M, Peterson C, Poirier A, Houle C, Germain H, Danylo A. SARS-CoV-2 detection by direct rRT-PCR without RNA extraction. J Clin Virol 2020; 128:104423. [PMID: 32416598 DOI: 10.1016/j.jcv.2020.104423] [Citation(s) in RCA: 76] [Impact Index Per Article: 19.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2020] [Accepted: 05/03/2020] [Indexed: 12/15/2022]
Abstract
Rapid and reliable screening of SARS-CoV-2 is fundamental to assess viral spread and limit the pandemic we are facing. In this study, we compared direct rRT-PCR method (without RNA extraction) using SeeGene AllplexTM 2019-nCoV rRT-PCR with the RealStar® SARS-CoV-2 rRT-PCR kit (Altona Diagnostics). Furthermore, we assessed the impact of swab storage media composition on PCR efficiency. We show that SeeGene and Altona's assays provide similar efficiency. Importantly, we provide evidence that RNA extraction can be successfully bypassed when samples are stored in UTM medium or in molecular water but not when samples are stored in saline solution and in Hanks medium.
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760
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MacIntyre CR, Chughtai AA. A rapid systematic review of the efficacy of face masks and respirators against coronaviruses and other respiratory transmissible viruses for the community, healthcare workers and sick patients. Int J Nurs Stud. 2020;108:103629. [PMID: 32512240 PMCID: PMC7191274 DOI: 10.1016/j.ijnurstu.2020.103629] [Citation(s) in RCA: 175] [Impact Index Per Article: 43.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2020] [Revised: 04/18/2020] [Accepted: 04/21/2020] [Indexed: 12/15/2022]
Abstract
Background The pandemic of COVID-19 is growing, and a shortage of masks and respirators has been reported globally. Policies of health organizations for healthcare workers are inconsistent, with a change in policy in the US for universal face mask use. The aim of this study was to review the evidence around the efficacy of masks and respirators for healthcare workers, sick patients and the general public. Methods A systematic review of randomized controlled clinical trials on use of respiratory protection by healthcare workers, sick patients and community members was conducted. Articles were searched on Medline and Embase using key search terms. Results A total of 19 randomised controlled trials were included in this study – 8 in community settings, 6 in healthcare settings and 5 as source control. Most of these randomised controlled trials used different interventions and outcome measures. In the community, masks appeared to be effective with and without hand hygiene, and both together are more protective. Randomised controlled trials in health care workers showed that respirators, if worn continually during a shift, were effective but not if worn intermittently. Medical masks were not effective, and cloth masks even less effective. When used by sick patients randomised controlled trials suggested protection of well contacts. Conclusion The study suggests that community mask use by well people could be beneficial, particularly for COVID-19, where transmission may be pre-symptomatic. The studies of masks as source control also suggest a benefit, and may be important during the COVID-19 pandemic in universal community face mask use as well as in health care settings. Trials in healthcare workers support the use of respirators continuously during a shift. This may prevent health worker infections and deaths from COVID-19, as aerosolisation in the hospital setting has been documented.
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761
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Vouri SM, Thai TN, Winterstein AG. An evaluation of co-use of chloroquine or hydroxychloroquine plus azithromycin on cardiac outcomes: A pharmacoepidemiological study to inform use during the COVID19 pandemic. Res Social Adm Pharm 2021; 17:2012-7. [PMID: 32409150 DOI: 10.1016/j.sapharm.2020.04.031] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2020] [Accepted: 04/28/2020] [Indexed: 12/27/2022]
Abstract
Background Chloroquine or hydroxychloroquine (chloroquine) plus azithromycin is considered as therapy for COVID-19. With benefit evaluations underway, safety concerns due to potential additive effects on QTc prolongation should be addressed. Objective We compared risk of cardiac adverse events between combinations of chloroquine and azithromycin and chloroquine and amoxicillin. Methods We conducted a retrospective cohort study using the IBM MarketScan Commercial Claims and Medicare Supplemental Databases, 2005-2018. We included autoimmune disease patients aged ≥18 years initiating azithromycin or amoxicillin for ≥5 days during chloroquine treatment. Patients had continuous insurance coverage ≥6 months before combination use until 5 days thereafter or inpatient death. Two outcomes were sudden cardiac arrest/ventricular arrhythmias (SCA/VA) and cardiac symptoms. We followed patients for up to 5 days to estimate hazard ratios (HR). Covariates were adjusted using stabilized inverse probability treatment weighting. Results We identified two SVC/VA events among >145,000 combination users. The adjusted incidence of cardiac symptoms among azithromycin and amoxicillin users was 276 vs 254 per 10,000 person-years with an adjusted HR of 1.10 (95%CI, 0.62-1.95). Conclusion Combination use of chloroquine and azithromycin at routine doses did not show pronounced increases in arrhythmias in this real-world population, though small sample size and outcome rates limit conclusions.
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762
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Hamroush A, Qureshi M, Shah S. Increased risk of ocular injury seen during lockdown due to COVID-19. Cont Lens Anterior Eye 2020; 43:216. [PMID: 32359967 PMCID: PMC7184015 DOI: 10.1016/j.clae.2020.04.007] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2020] [Revised: 04/19/2020] [Accepted: 04/19/2020] [Indexed: 11/18/2022]
Affiliation(s)
- Ahmed Hamroush
- Ahmed Hamroush, ST7 Ophthalmology, Birmingham and Midland Eye Centre., Birmingham, United Kingdom.
| | - Madyan Qureshi
- Madyan Qureshi ST4 Ophthalmology, Birmingham and Midland Eye Centre, Birmingham, United Kingdom.
| | - Sunil Shah
- Prof. Sunil Shah Consultant Ophthalmologist, Birmingham and Midland Eye Centre, Birmingham, United Kingdom.
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763
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Dousa KM, Malavade SS, Furin J, Gripshover B, Hatszegi M, Hojat L, Saade E, Salata RA. SARS-CoV-2 infection in a patient on chronic hydroxychloroquine therapy: Implications for prophylaxis. IDCases 2020; 20:e00778. [PMID: 32341910 PMCID: PMC7185003 DOI: 10.1016/j.idcr.2020.e00778] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2020] [Revised: 04/21/2020] [Accepted: 04/22/2020] [Indexed: 12/27/2022] Open
Abstract
People exposed to COVID-19 have a risk of developing disease, and health care workers are at risk at a time when they are badly needed during a health care crisis. Hydroxychloroquine and chloroquine have been used as treatment and are being considered as prophylaxis. Our patient developed COVID-19 while on hydroxychloroquine and although more work is needed, this calls into question the role of these medications as preventive therapy.
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Affiliation(s)
- Khalid M. Dousa
- Division of Infectious Diseases and HIV Medicine, University Hospitals Cleveland Medical Center, Case Western Reserve University, Cleveland, OH, USA
| | - Sharad S. Malavade
- Division of Infectious Diseases and HIV Medicine, University Hospitals Cleveland Medical Center, Case Western Reserve University, Cleveland, OH, USA
| | - Jennifer Furin
- Division of Infectious Diseases and HIV Medicine, University Hospitals Cleveland Medical Center, Case Western Reserve University, Cleveland, OH, USA
| | - Barbara Gripshover
- Division of Infectious Diseases and HIV Medicine, University Hospitals Cleveland Medical Center, Case Western Reserve University, Cleveland, OH, USA
| | - Marjorie Hatszegi
- Division of Infectious Diseases and HIV Medicine, University Hospitals Cleveland Medical Center, Case Western Reserve University, Cleveland, OH, USA
- Roe Green Center for Travel Medicine and Global Health, University Hospitals Cleveland Medical Center, Cleveland, OH, USA
| | - Leila Hojat
- Division of Infectious Diseases and HIV Medicine, University Hospitals Cleveland Medical Center, Case Western Reserve University, Cleveland, OH, USA
| | - Elie Saade
- Division of Infectious Diseases and HIV Medicine, University Hospitals Cleveland Medical Center, Case Western Reserve University, Cleveland, OH, USA
| | - Robert A. Salata
- Division of Infectious Diseases and HIV Medicine, University Hospitals Cleveland Medical Center, Case Western Reserve University, Cleveland, OH, USA
- Roe Green Center for Travel Medicine and Global Health, University Hospitals Cleveland Medical Center, Cleveland, OH, USA
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764
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Abstract
Purpose of Review With real-time communication crucial to both healthcare professionals (HCPs) and the public in infectious diseases (ID), social media networking sites has become even more important. Twitter is the most popular form of social media used for ID communication. We will review the power of Twitter in ID. Recent Findings Twitter allows for real-time sharing of educational resources at ID scientific conferences, enabling individuals that are not able to attend conferences to follow conferences anytime anywhere and stimulate discussion around topics of interest with experts from across the globe. Further, Twitter chats are a valuable tool for stewardship, with different accounts periodically hosting chats on various stewardship topics. Several studies have also demonstrated the strong relationship between dissemination and citation impact of publications with the help of Twitter. There is great value in engaging with non-ID people on Twitter via dissemination of ID knowledge to other disciplines. Lastly, when used appropriately, Twitter is a useful site for distributing vaccine information, whether informally (by advocates and physicians) or formally (by government entities) and allows one to keep up with ongoing ID outbreaks in real time. Summary Twitter has transformed how we communicate in healthcare. Particularly in ID, where bacteria and viruses can enter/exit borders anytime anywhere, global real-time information about outbreaks and antimicrobial resistance for clinicians and the public is critical. Twitter has no hierarchy or barriers, is a conduit for global collaboration, and is a way for HCPs and the public to "social"ize on healthcare topics, if used appropriately.
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Affiliation(s)
- Ravina Kullar
- Expert Stewardship, Inc, 320 Superior Ave, Newport Beach, CA 92663 USA
| | - Debra A. Goff
- The Ohio State University College of Pharmacy, The Ohio State University Wexner Medical Center, Columbus, OH USA
| | | | - Tara C. Smith
- Kent State University College of Public Health, Kent, OH USA
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765
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Parrinello G, Missale F, Sampieri C, Carobbio ALC, Peretti G. Safe management of laryngectomized patients during the COVID-19 pandemic. Oral Oncol 2020; 107:104742. [PMID: 32353792 PMCID: PMC7180359 DOI: 10.1016/j.oraloncology.2020.104742] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2020] [Revised: 04/21/2020] [Accepted: 04/22/2020] [Indexed: 12/15/2022]
Affiliation(s)
- Giampiero Parrinello
- IRCCS Ospedale Policlinico San Martino, Genoa, Italy; Department of Surgical Sciences and Integrated Diagnostics (DISC), University of Genoa, Genoa, Italy
| | - Francesco Missale
- IRCCS Ospedale Policlinico San Martino, Genoa, Italy; Department of Molecular and Translational Medicine, University of Brescia, Brescia, Italy.
| | - Claudio Sampieri
- IRCCS Ospedale Policlinico San Martino, Genoa, Italy; Department of Surgical Sciences and Integrated Diagnostics (DISC), University of Genoa, Genoa, Italy
| | - Andrea Luigi Camillo Carobbio
- IRCCS Ospedale Policlinico San Martino, Genoa, Italy; Department of Surgical Sciences and Integrated Diagnostics (DISC), University of Genoa, Genoa, Italy
| | - Giorgio Peretti
- IRCCS Ospedale Policlinico San Martino, Genoa, Italy; Department of Surgical Sciences and Integrated Diagnostics (DISC), University of Genoa, Genoa, Italy
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766
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Abdessater M, Rouprêt M, Misrai V, Matillon X, Gondran-Tellier B, Freton L, Vallée M, Dominique I, Felber M, Khene ZE, Fortier E, Lannes F, Michiels C, Grevez T, Szabla N, Boustany J, Bardet F, Kaulanjan K, Seizilles de Mazancourt E, Ploussard G, Pinar U, Pradere B. COVID19 pandemic impacts on anxiety of French urologist in training: Outcomes from a national survey. Prog Urol 2020; 30:448-455. [PMID: 32376208 PMCID: PMC7177119 DOI: 10.1016/j.purol.2020.04.015] [Citation(s) in RCA: 35] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2020] [Revised: 04/14/2020] [Accepted: 04/15/2020] [Indexed: 12/20/2022]
Abstract
INTRODUCTION The COVID-19 outbreak in France is disturbing our health system. Urologists in training who are already known to have burnout, are in the front line to face this disease. The aim of our study was to assess the psychological impact of COVID-19 pandemic on young French urologists in training. MATERIAL AND METHODS A self-administered anonymous questionnaire evaluating the pandemic added stress, and its negative impact on work and training quality, was e-mailed to the members of the French Association of Urologists in Training (AFUF). The association includes all French junior and senior residents. The survey lasted 3 days. Multivariable analyses using logistic regression was performed to identify the predictive factors. RESULTS Two hundred and seventy-five (55.5%) of the 495 AFUF members responded to the questionnaire. More than 90% of responders felt more stressed by the pandemic. Fellows and senior residents were more likely to feel that the crisis had an important impact on their work quality (OR=1.76, IC95=[1.01-3.13]), even more when COVID 19 patients were present in their department (OR=2.31, IC95=[1.20-4.65]). Past medical history of respiratory disease (OR=2.57, IC95=[1.31-5.98]) and taking in charge COVID19 patients (OR=1.85, IC95=[0.98-3.59]) were additional risk factors. CONCLUSION COVID19 pandemic has a negative impact on young French urologists in training and on their work and training quality. Managing their psychosocial well-being during this time is as important as managing their physical health. LEVEL OF EVIDENCE 3.
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Affiliation(s)
- M Abdessater
- Sorbonne Université, GRC n(o) 5, Predictive onco-urology, AP-HP, Hôpital Pitié-Salpêtrière, Urology, 75013 Paris, France
| | - M Rouprêt
- Sorbonne Université, GRC n(o) 5, Predictive onco-urology, AP-HP, Hôpital Pitié-Salpêtrière, Urology, 75013 Paris, France.
| | - V Misrai
- Clinique Pasteur, 31300 Toulouse, France
| | - X Matillon
- Department of Urology and Transplantation, Edouard Herriot Hospital, Hospices Civils de Lyon, Lyon, France
| | - B Gondran-Tellier
- Department of Urology, La Conception University Hospital, Assistance-Publique Marseille, Marseille, France
| | - L Freton
- Department of Urology, University Hospital of Rennes, Rennes, France
| | - M Vallée
- Department of Urology, Poitiers University Hospital, Poitiers, France
| | - I Dominique
- Department of Urology, Groupe Hospitalier Diaconesses Croix Saint-Simon, Paris, France
| | - M Felber
- Sorbonne Université, GRC n(o) 5, Predictive onco-urology, AP-HP, Hôpital Pitié-Salpêtrière, Urology, 75013 Paris, France
| | - Z-E Khene
- Department of Urology, University Hospital of Rennes, Rennes, France
| | - E Fortier
- Department of Urology, Montpellier University Hospital, Montpellier, France
| | - F Lannes
- Department of Urology, La Conception University Hospital, Assistance-Publique Marseille, Marseille, France
| | - C Michiels
- Department of Urology, Bordeaux University Hospital, Bordeaux, France
| | - T Grevez
- Department of Urology, CHRU Tours, Francois Rabelais University, Tours, France
| | - N Szabla
- Department of Urology and Transplantation, Caen University Hospital, Caen, France
| | - J Boustany
- Department of Urology and Renal Transplantation, Henri Mondor University Hospital, Créteil, France
| | - F Bardet
- Department of Urology, Dijon University Hospital, Dijon, France
| | - K Kaulanjan
- Department of Urology, CHU Pointe-à-Pitre, Pointe-à-Pitre, Guadeloupe
| | - E Seizilles de Mazancourt
- Department of Urology and Transplantation, Edouard Herriot Hospital, Hospices Civils de Lyon, Lyon, France
| | - G Ploussard
- Department of Urology, Ramsay Santé, Clinique La Croix du Sud, Quint Fonsegrives, France
| | - U Pinar
- Sorbonne Université, GRC n(o) 5, Predictive onco-urology, AP-HP, Hôpital Pitié-Salpêtrière, Urology, 75013 Paris, France
| | - B Pradere
- Department of Urology, CHRU Tours, Francois Rabelais University, Tours, France; Department of Urology, Comprehensive Cancer Center, Medical University of Vienna, Vienna, Austria
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767
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Agyapong VIO. Coronavirus Disease 2019 Pandemic: Health System and Community Response to a Text Message (Text4Hope) Program Supporting Mental Health in Alberta. Disaster Med Public Health Prep 2020; 14:e5-6. [PMID: 32317038 DOI: 10.1017/dmp.2020.114] [Citation(s) in RCA: 50] [Impact Index Per Article: 12.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
In an effort to support the mental health of Albertans during the coronavirus disease 2019 (COVID-19) pandemic, Alberta Health Services launched a supportive text message (Text4Mood) program on March 23, 2020. The program was simultaneously approved for funding by the 6 regional health foundations and launched within 1 week of conception. Residents of Alberta can subscribe to the program by texting “COVID19HOPE” to a sort code number. Each subscriber receives free daily supportive text messages, for 3 months, crafted by a team of clinical psychologists, psychiatrists, mental health therapist, and mental health service users. Within 1 week of the launch of Text4Hope, 32 805 subscribers had signed up to the program, and there have been expressions of interests from other jurisdictions to implement a similar program to support the mental health of those in quarantine, isolation, or lockdown.
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768
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Miles BA, Schiff B, Ganly I, Ow T, Cohen E, Genden E, Culliney B, Mehrotra B, Savona S, Wong RJ, Haigentz M, Caruana S, Givi B, Patel K, Hu K. Tracheostomy during SARS-CoV-2 pandemic: Recommendations from the New York Head and Neck Society. Head Neck 2020; 42:1282-1290. [PMID: 32304119 PMCID: PMC7264578 DOI: 10.1002/hed.26166] [Citation(s) in RCA: 64] [Impact Index Per Article: 16.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2020] [Accepted: 04/08/2020] [Indexed: 12/15/2022] Open
Abstract
The rapid spread of SARS‐CoV‐2 in 2019 and 2020 has resulted in a worldwide pandemic characterized by severe pulmonary inflammation, effusions, and rapid respiratory compromise. The result of this pandemic is a large and increasing number of patients requiring endotracheal intubation and prolonged ventilator support. The rapid rise in endotracheal intubations coupled with prolonged ventilation requirements will certainly lead to an increase in tracheostomy procedures in the coming weeks and months. Performing tracheostomy in the setting of active SARS‐CoV‐2, when necessary, poses a unique situation, with unique risks and benefits for both the patient and the health care providers. The New York Head and Neck Society has collaborated on this document to provide guidance on the performance of tracheostomies during the SARS‐CoV‐2 pandemic.
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Affiliation(s)
- Brett A Miles
- Department of Otolaryngology Head and Neck Surgery, Head and Neck Oncology Division, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Bradley Schiff
- Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, New York, USA
| | - Ian Ganly
- Memorial Sloan Kettering Cancer Center, Weill Cornell Medical College, New York, New York, USA
| | - Thomas Ow
- Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, New York, USA
| | - Erik Cohen
- Morristown Medical Center, Leonard B. Kahn Head and Neck Cancer Institute, Morristown, New Jersey, USA
| | - Eric Genden
- Department of Otolaryngology Head and Neck Surgery, Head and Neck Oncology Division, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Bruce Culliney
- Department of Otolaryngology Head and Neck Surgery, Head and Neck Oncology Division, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Bhoomi Mehrotra
- Department of Hematology Oncology, Head and Neck Oncology, Cancer Institute at St. Francis Hospital, New York, New York, USA
| | - Steven Savona
- Northwell Cancer Institute, Monter Cancer Center, Lake Success, New York, USA
| | - Richard J Wong
- Memorial Sloan Kettering Cancer Center, Weill Cornell Medical College, New York, New York, USA
| | - Missak Haigentz
- Morristown Medical Center, Leonard B. Kahn Head and Neck Cancer Institute, Morristown, New Jersey, USA
| | - Salvatore Caruana
- Department of Otolaryngology Head and Neck Surgery, Head and Neck Oncology Division, Columbia University, New York, New York, USA
| | - Babak Givi
- Department of Otolaryngology Head and Neck Surgery, Head and Neck Oncology Division, NYU Langone Health, New York, New York, USA
| | - Kepal Patel
- Department of Otolaryngology Head and Neck Surgery, Head and Neck Oncology Division, NYU Langone Health, New York, New York, USA
| | - Kenneth Hu
- Department of Hematology Oncology, Division Head and Neck Oncology, NYU Langone Health, New York, New York, USA
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769
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Hamidian Jahromi A, Mazloom S, Ballard DH. COVID-19: The time for action is just now; It's still not too late. Travel Med Infect Dis 2020; 37:101676. [PMID: 32305632 PMCID: PMC7162786 DOI: 10.1016/j.tmaid.2020.101676] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2020] [Accepted: 04/14/2020] [Indexed: 02/07/2023]
Affiliation(s)
- Alireza Hamidian Jahromi
- Department of Plastic Surgery, University of Tennessee Health Science Center, 910 Madison Ave, Room 315, Memphis, TN, 38163, USA.
| | - Samira Mazloom
- Gemological Institute of America (GIA), Manhattan, NY, 10036, USA
| | - David H Ballard
- Mallinckrodt Institute of Radiology, Washington University School of Medicine, 510 S. Kings Highway Blvd, St. Louis, Missouri, 63110, USA
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770
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Abstract
The COVID-19 pandemic has dramatically altered how otolaryngologists contemplate and assume their roles in health care delivery. The ethical implications of this pandemic upon our practice are formidable and distinct from other surgical fields. The salient ethical issues of public health stewardship and safety, distributive justice, and nonabandonment are distilled for the practicing otolaryngologist.
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Affiliation(s)
- Andrew G Shuman
- Center for Bioethics and Social Sciences in Medicine, University of Michigan Medical School, Ann Arbor, Michigan, USA.,Department of Otolaryngology-Head and Neck Surgery, University of Michigan Medical School, Ann Arbor, Michigan, USA
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771
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Yarmarkovich M, Warrington JM, Farrel A, Maris JM. A SARS-CoV-2 Vaccination Strategy Focused on Population-Scale Immunity. SSRN 2020:3575161. [PMID: 32714112 PMCID: PMC7366814 DOI: 10.2139/ssrn.3575161] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/13/2020] [Revised: 06/05/2020] [Indexed: 11/15/2022]
Abstract
Here we propose a vaccination strategy for SARS-CoV-2 based on identification of both highly conserved regions of the virus and newly acquired adaptations that are presented by MHC class I and II across the vast majority of the population, are highly dissimilar from the human proteome, and are predicted B cell epitopes. We present 65 peptide sequences that we expect to result in a safe and effective vaccine which can be rapidly tested in DNA, mRNA, or synthetic peptide constructs. These include epitopes that are contained within evolutionarily divergent regions of the spike protein reported to increase infectivity through increased binding to the ACE2 receptor, and within a novel furin cleavage site thought to increase membrane fusion. This vaccination strategy specifically targets unique vulnerabilities of SARS-CoV-2 and should engage a robust adaptive immune response in the vast majority of the human population.
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Affiliation(s)
- Mark Yarmarkovich
- Division of Oncology and Center for Childhood Cancer Research; Children’s Hospital of Philadelphia; Philadelphia, PA, 19104; USA
| | - John M. Warrington
- Division of Oncology and Center for Childhood Cancer Research; Children’s Hospital of Philadelphia; Philadelphia, PA, 19104; USA
| | - Alvin Farrel
- Department of Biomedical and Health Informatics, Children’s Hospital of Philadelphia; Philadelphia, PA, 19104
| | - John M. Maris
- Division of Oncology and Center for Childhood Cancer Research; Children’s Hospital of Philadelphia; Philadelphia, PA, 19104; USA
- Perelman School of Medicine at the University of Pennsylvania; Philadelphia, PA, 19104
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772
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Ramakrishna R, Zadeh G, Sheehan JP, Aghi MK. Inpatient and outpatient case prioritization for patients with neuro-oncologic disease amid the COVID-19 pandemic: general guidance for neuro-oncology practitioners from the AANS/CNS Tumor Section and Society for Neuro-Oncology. J Neurooncol 2020; 147:525-9. [PMID: 32274630 DOI: 10.1007/s11060-020-03488-7] [Citation(s) in RCA: 51] [Impact Index Per Article: 12.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2020] [Accepted: 04/07/2020] [Indexed: 11/05/2022]
Abstract
The Coronavirus pandemic has created unprecedented strain on medical resources at health care institutions around the world. At many institutions, this has resulted in efforts to prioritize cases with an attempt to balance the acuity of medical needs with available resources. Here, we provide a framework for institutions and governments to help adjudicate treatment allocations to patients with neuro-oncologic disease.
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773
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Picot S, Marty A, Bienvenu AL, Blumberg LH, Dupouy-Camet J, Carnevale P, Kano S, Jones MK, Daniel-Ribeiro CT, Mas-Coma S. Coalition: Advocacy for prospective clinical trials to test the post-exposure potential of hydroxychloroquine against COVID-19. One Health. 2020;9:100131. [PMID: 32292817 PMCID: PMC7128742 DOI: 10.1016/j.onehlt.2020.100131] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
Abstract
Our coalition of public health experts, doctors, and scientists worldwide want to draw attention to the need for high-quality evaluation protocols of the potential beneficial effect of hydroxychloroquine (HCQ) as a post-exposure drug for exposed people. In the absence of an approved, recognized effective pre or post-exposure prophylactic drug or vaccine for COVID-19, nor of any approved and validated therapeutic drug, coupled with social and political pressure raised by publicity both regarding the potential beneficial effect of hydroxychloroquine (HCQ) as well as potential risks from HCQ, we urge the immediate proper clinical trials. Specifically, we mean using HCQ for post-exposure of people with close contact with patients with positive COVID19 rtPCR, including home and medical caregivers. We have reviewed the mechanisms of antiviral effect of HCQ, the risk-benefit ratio taking into consideration the PK/PD of HCQ and the thresholds of efficacy. We have studied its use as an antimalarial, an antiviral, and an immunomodulating drug and concluded that the use of HCQ at doses matching that of the standard treatment of Systemic Lupus erythematous, which has proven safety and efficacy in terms of HCQ blood and tissue concentration adapted to bodyweight (2,3), at 6 mg/kg/day 1 (loading dose) followed by 5 mg/kg/ day, with a maximum limit of 600 mg/day in all cases should swiftly be clinically evaluated as a post-exposure drug for exposed people.
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774
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Moftakhar L, Seif M. The Exponentially Increasing Rate of Patients Infected with COVID-19 in Iran. Arch Iran Med 2020; 23:235-238. [PMID: 32271595 DOI: 10.34172/aim.2020.03] [Citation(s) in RCA: 26] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/25/2020] [Accepted: 03/27/2020] [Indexed: 12/19/2022]
Abstract
BACKGROUND Coronavirus, the cause of severe acute respiratory syndrome (COVID-19), is rapidly spreading around the world. Since the number of corona positive patients is increasing sharply in Iran, this study aimed to forecast the number of newly infected patients in the coming days in Iran. METHODS The data used in this study were obtained from daily reports of the Iranian Ministry of Health and the datasets provided by the Johns Hopkins University including the number of new infected cases from February 19, 2020 to March 21, 2020. The autoregressive integrated moving average (ARIMA) model was applied to predict the number of patients during the next thirty days. RESULTS The ARIMA model forecasted an exponential increase in the number of newly detected patients. The result of this study also show that if the spreading pattern continues the same as before, the number of daily new cases would be 3574 by April 20. CONCLUSION Since this disease is highly contagious, health politicians need to make decisions to prevent its spread; otherwise, even the most advanced and capable health care systems would face problems for treating all infected patients and a substantial number of deaths will become inevitable.
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Affiliation(s)
- Leila Moftakhar
- Student Research Committee, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Mozhgan Seif
- Department of Epidemiology, School of Health, Shiraz University of Medical Sciences, Shiraz, Iran
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775
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Affiliation(s)
- Jean-Sébastien Hulot
- Université de Paris, Inserm, PARCC, 75015 Paris, France; CIC1418 and DMU CARTE, hôpital européen Georges-Pompidou, AP-HP, 56, rue Leblanc, 75015 Paris, France.
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776
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Bogdanos DP, Daniil Z, Zakynthinos E, Gourgoulianis K, Sakkas LI. When there is a pandemic there is no time to waste: should we have hydroxychloroquine in our armoury against COVID-19 infected patients? Mediterr J Rheumatol 2020; 31:94-97. [PMID: 32411941 PMCID: PMC7219635 DOI: 10.31138/mjr.31.1.94] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2020] [Accepted: 03/29/2020] [Indexed: 02/06/2023] Open
Abstract
The current use of chloroquine and/or hydroxychloroquine, a drug currently used to treat autoimmune rheumatic diseases, in treating severe acute respiratory syndrome caused by coronavirus 2 (SARSCoV-2) or COVID-19-infected patients with pneumonia is a matter of intense consideration. We wish to enter the ongoing debate as to whether this well-known drug must be given to Greek COVID-19-infected patients, especially those with pneumonia. Our arguments are based on the existing data and the capacity of the Greek health system to afford potent anti-viral treatments, which are under immense investigation. We propose several suggestions related to treatment of COVID-19 pneumonia with chloroquine/hydroxychloroquine that we think must be taken into consideration to fit the evolving situation of the pandemic in Greece.
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Affiliation(s)
| | | | - Epaminondas Zakynthinos
- Intensive Care Unit, Faculty of Medicine, School of Health Sciences, University of Thessaly, Larissa, Greece
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777
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Schoch-Spana M, Brunson EK, Gwon H, Regenberg A, Toner ES, Daugherty-Biddison EL. Influence of Community and Culture in the Ethical Allocation of Scarce Medical Resources in a Pandemic Situation: Deliberative Democracy Study. J Particip Med 2020; 12:e18272. [PMID: 33064107 PMCID: PMC7141421 DOI: 10.2196/18272] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2020] [Revised: 03/20/2020] [Accepted: 03/20/2020] [Indexed: 01/20/2023] Open
Abstract
BACKGROUND Stark gaps exist between projected health needs in a pandemic situation and the current capacity of health care and medical countermeasure systems. Existing pandemic ethics discussions have advocated to engage the public in scarcity dilemmas and attend the local contexts and cultural perspectives that shape responses to a global health threat. This public engagement study thus considers the role of community and culture in the ethical apportionment of scarce health resources, specifically ventilators, during an influenza pandemic. It builds upon a previous exploration of the values and preferences of Maryland residents regarding how a finite supply of mechanical ventilators ought to be allocated during a severe global outbreak of influenza. An important finding of this earlier research was that local history and place within the state engendered different ways of thinking about scarcity. OBJECTIVE Given the intrastate variation in the themes expressed by Maryland participants, the project team sought to examine interstate differences by implementing the same protocol elsewhere to answer the following questions. Does variation in ethical frames of reference exist within different regions of the United States? What practical implications does evidence of sameness and difference possess for pandemic planners and policymakers at local and national levels? METHODS Research using the same deliberative democracy process from the Maryland study was conducted in Central Texas in March 2018 among 30 diverse participants, half of whom identified as Hispanic or Latino. Deliberative democracy provides a moderated process through which community members can learn facts about a public policy matter from experts and explore their own and others' views. RESULTS Participants proposed that by evenly distributing supplies of ventilators and applying clear eligibility criteria consistently, health authorities could enable fair allocation of scarce lifesaving equipment. The strong identification, attachment, and obligation of persons toward their nuclear and extended families emerged as a distinctive regional and ethnic core value that has practical implications for the substance, administration, and communication of allocation frameworks. CONCLUSIONS Maryland and Central Texas residents expressed a common, overriding concern about the fairness of allocation decisions. Central Texas deliberants, however, more readily expounded upon family as a central consideration. In Central Texas, family is a principal, culturally inflected lens through which life and death matters are often viewed. Conveners of other pandemic-related public engagement exercises in the United States have advocated the benefits of transparency and inclusivity in developing an ethical allocation framework; this study demonstrates cultural competence as a further advantage.
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Affiliation(s)
- Monica Schoch-Spana
- Johns Hopkins Center for Health Security, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, United States
| | - Emily K Brunson
- Department of Anthropology, Texas State University, San Marcos, TX, United States
| | - Howard Gwon
- Department of Environmental Sciences, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, United States
| | - Alan Regenberg
- Johns Hopkins Berman Institute of Bioethics, Johns Hopkins University, Baltimore, MD, United States
| | - Eric S Toner
- Johns Hopkins Center for Health Security, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, United States
| | - Elizabeth L Daugherty-Biddison
- Division of Pulmonary and Critical Care Medicine, School of Medicine, Johns Hopkins University, Baltimore, MD, United States
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778
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Affiliation(s)
| | - Zubair Shah
- College of Science and Engineering, Hamad Bin Khalifa University (HBKU), Qatar
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779
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Dai WC, Zhang HW, Yu J, Xu HJ, Chen H, Luo SP, Zhang H, Liang LH, Wu XL, Lei Y, Lin F. CT Imaging and Differential Diagnosis of COVID-19. Can Assoc Radiol J 2020; 71:195-200. [PMID: 32129670 PMCID: PMC7140975 DOI: 10.1177/0846537120913033] [Citation(s) in RCA: 173] [Impact Index Per Article: 43.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
Since the beginning of 2020, coronavirus disease 2019 (COVID-19) has spread throughout China. This study explains the findings from lung computed tomography images of some patients with COVID-19 treated in this medical institution and discusses the difference between COVID-19 and other lung diseases.
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Affiliation(s)
- Wei-Cai Dai
- Guangzhou Medical University, Guangzhou, China.,Imaging Department, Fifth People's Hospital of Longgang District, Shenzhen, China
| | - Han-Wen Zhang
- Department of Radiology, The First Affiliated Hospital of Shenzhen University, Health Science Center, Shenzhen Second People's Hospital, Shenzhen, China
| | - Juan Yu
- Department of Radiology, The First Affiliated Hospital of Shenzhen University, Health Science Center, Shenzhen Second People's Hospital, Shenzhen, China
| | - Hua-Jian Xu
- Department of Radiology, The First Affiliated Hospital of Shenzhen University, Health Science Center, Shenzhen Second People's Hospital, Shenzhen, China
| | - Huan Chen
- Department of Radiology, The First Affiliated Hospital of Shenzhen University, Health Science Center, Shenzhen Second People's Hospital, Shenzhen, China
| | - Si-Ping Luo
- Department of Radiology, The First Affiliated Hospital of Shenzhen University, Health Science Center, Shenzhen Second People's Hospital, Shenzhen, China
| | - Hong Zhang
- Department of Radiology, The First Affiliated Hospital of Shenzhen University, Health Science Center, Shenzhen Second People's Hospital, Shenzhen, China
| | - Li-Hong Liang
- Department of Radiology, The First Affiliated Hospital of Shenzhen University, Health Science Center, Shenzhen Second People's Hospital, Shenzhen, China
| | - Xiao-Liu Wu
- Department of Radiology, The First Affiliated Hospital of Shenzhen University, Health Science Center, Shenzhen Second People's Hospital, Shenzhen, China
| | - Yi Lei
- Department of Radiology, The First Affiliated Hospital of Shenzhen University, Health Science Center, Shenzhen Second People's Hospital, Shenzhen, China
| | - Fan Lin
- Department of Radiology, The First Affiliated Hospital of Shenzhen University, Health Science Center, Shenzhen Second People's Hospital, Shenzhen, China
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780
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Greek Rheumatology Society and Professional Association of Rheumatologists (ERE-EPERE). Recommendations Regarding COVID19 Infection in Rheumatic Patients in Greece. Mediterr J Rheumatol 2020; 31:6-7. [PMID: 32411928 DOI: 10.31138/mjr.31.1.6] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2020] [Accepted: 03/27/2020] [Indexed: 01/20/2023] Open
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781
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NATEGHIAN A, ANVARI S. Partial seizure due to COVID19 infection in an infant. Iran J Child Neurol 2020; 14:107-109. [PMID: 33193790 PMCID: PMC7660023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Subscribe] [Scholar Register] [Received: 04/25/2020] [Accepted: 08/23/2020] [Indexed: 11/16/2022]
Abstract
We live at the time of the coronavirus pandemic in the world (1, 2). The symptoms of COVID19 are similar in children and adults. However, children with confirmed COVID19 have generally shown mild symptoms (3). The symptoms in children include cold-like symptoms, such as fever, runny nose, and cough, vomiting, and diarrhea. In this study, we describe an eight-month-old boy with recurrent partial seizure and mild diarrhea. It was later revealed that he was COVID19 positive.
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Affiliation(s)
- Alireza NATEGHIAN
- Department of Pediatrics, Aliasghar children hospital, Iran University of Medical Science, Tehran, Iran
| | - Saeed ANVARI
- Department of Pediatrics, Division of Pediatric Neurology, Milad Hospital, Social Security Organisation, Tehran, Iran
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782
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Nanjundaswamy MH, Shiva L, Desai G, Ganjekar S, Kishore T, Ram U, Satyanarayana V, Thippeswamy H, Chandra PS. COVID-19-related anxiety and concerns expressed by pregnant and postpartum women-a survey among obstetricians. Arch Womens Ment Health 2020; 23:787-790. [PMID: 32839898 PMCID: PMC7445074 DOI: 10.1007/s00737-020-01060-w] [Citation(s) in RCA: 44] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/02/2020] [Accepted: 08/18/2020] [Indexed: 11/05/2022]
Abstract
This paper from India describes anxieties that pregnant and postpartum women reported to obstetricians during the COVID-19 pandemic. Of the 118 obstetricians who responded to an online survey, most had been contacted for concerns about hospital visits (72.65%), methods of protection (60.17%), the safety of the infant (52.14%), anxieties related to social media messages (40.68%) and contracting the infection (39.83%). Obstetricians felt the need for resources such as videos, websites and counselling skills to handle COVID-related anxiety among perinatal women.
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Affiliation(s)
- Madhuri H. Nanjundaswamy
- grid.416861.c0000 0001 1516 2246Department of Psychiatry, National Institute of Mental Health and Neurosciences (NIMHANS), Hosur Road, Bengaluru, 560029 India
| | - Lakshmi Shiva
- grid.416861.c0000 0001 1516 2246Department of Psychiatry, National Institute of Mental Health and Neurosciences (NIMHANS), Hosur Road, Bengaluru, 560029 India
| | - Geetha Desai
- grid.416861.c0000 0001 1516 2246Department of Psychiatry, National Institute of Mental Health and Neurosciences (NIMHANS), Hosur Road, Bengaluru, 560029 India
| | - Sundarnag Ganjekar
- grid.416861.c0000 0001 1516 2246Department of Psychiatry, National Institute of Mental Health and Neurosciences (NIMHANS), Hosur Road, Bengaluru, 560029 India
| | - Thomas Kishore
- grid.416861.c0000 0001 1516 2246Department of Clinical Psychology, National Institute of Mental Health and Neurosciences (NIMHANS), Bengaluru, 560029 India
| | - Uma Ram
- grid.502911.eConsultant Obstetrician, Seethapathy Clinic & Hospital, 128 Royapettah High Road, Chennai, India
| | - Veena Satyanarayana
- grid.416861.c0000 0001 1516 2246Department of Clinical Psychology, National Institute of Mental Health and Neurosciences (NIMHANS), Bengaluru, 560029 India
| | - Harish Thippeswamy
- grid.416861.c0000 0001 1516 2246Department of Psychiatry, National Institute of Mental Health and Neurosciences (NIMHANS), Hosur Road, Bengaluru, 560029 India
| | - Prabha S. Chandra
- grid.416861.c0000 0001 1516 2246Department of Psychiatry, National Institute of Mental Health and Neurosciences (NIMHANS), Hosur Road, Bengaluru, 560029 India
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783
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Silverman ME, Medeiros C, Burgos L. Early pregnancy mood before and during COVID-19 community restrictions among women of low socioeconomic status in New York City: a preliminary study. Arch Womens Ment Health 2020; 23:779-782. [PMID: 32844329 PMCID: PMC7447087 DOI: 10.1007/s00737-020-01061-9] [Citation(s) in RCA: 28] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/27/2020] [Accepted: 08/18/2020] [Indexed: 11/03/2022]
Abstract
To explore the mental health consequences of COVID-19-related social restrictions on pregnant women living in low socioeconomic status. Prenatal women appearing at the Mount Sinai Hospital Ambulatory Practice were screened for mood symptomatology from February 2, 2020, through June 12, 2020. An improvement in prenatal mood was observed following social restrictions compared to before the pandemic. The impact of COVID-19 remains largely unknown and may be useful towards understanding the needs of pregnant women living in poverty.
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Affiliation(s)
- Michael E. Silverman
- grid.416167.3Department of Psychiatry, Icahn School of Medicine at Mount Sinai, The Mount Sinai Hospital, New York, NY USA
| | - Cathryn Medeiros
- grid.416167.3Department of Social Work Services, The Mount Sinai Hospital, New York, NY USA
| | - Laudy Burgos
- grid.416167.3Department of Social Work Services, Icahn School of Medicine at Mount Sinai, The Mount Sinai Hospital, New York, NY USA
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