1
|
Çiçek Ç, Topan A. The Effect of Stress Ball Use Applied by Emergency Nurses During Swabbing Procedure on the Pain and Fear Levels of Children Admitted to the Pediatric Emergency Service With the Suspicion of COVID-19: A Randomized Controlled Trial. J Emerg Nurs 2024; 50:126-134. [PMID: 37855792 DOI: 10.1016/j.jen.2023.09.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2023] [Revised: 09/12/2023] [Accepted: 09/14/2023] [Indexed: 10/20/2023]
Abstract
INTRODUCTION This study aimed to determine the effect of stress ball use during the swabbing procedure on the pain and fear levels of children admitted to the pediatric emergency department with the suspicion of coronavirus disease 2019. Children with suspected coronavirus disease 2019 were recruited by convenience sampling from the pediatric emergency department of a university hospital in a city in Turkey. METHODS This study used a random controlled experimental design and had a calculated sample size of 60. There were 30 participants in both the control and experimental groups. The stress ball intervention was applied to the children in the experimental group during the swabbing process, and no intervention was made to the children in the control group during the procedure. The pain and fear levels of the children in the control and experimental groups were measured during the swabbing process. "Descriptive Characteristics Form for Parents and Children," "Wong-Baker Faces Pain Rating Scale," "Children's Fear Scale," and "Stress Ball" were used in data collection. Chi-square, Mann-Whitney U, and Friedman tests were used in the analysis. RESULTS Although there was no statistically significant difference between the groups in terms of pain and fear level mean scores before the procedure, a statistically significant difference was found between the groups during and after the procedures (P < .05). DISCUSSION Giving a stress ball to children aged 4 to 10 years during the swabbing procedure was determined to reduce the pain and fear levels during and after the procedures. It is recommended that stress ball use be applied during the swabbing procedure for children.
Collapse
|
2
|
Hu D, Wang T, Uddin J, Greene WK, Hu D, Ma B. Development of a high-sensitivity and short-duration fluorescence in situ hybridization method for viral mRNA detection in HEK 293T cells. Front Cell Infect Microbiol 2022; 12:960938. [PMID: 36268226 PMCID: PMC9577401 DOI: 10.3389/fcimb.2022.960938] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2022] [Accepted: 09/20/2022] [Indexed: 11/26/2022] Open
Abstract
Coronavirus disease 2019 (COVID-19) is an extremely contagious illness caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Early disease recognition of COVID-19 is crucial not only for prompt diagnosis and treatment of the patients, but also for effective public health surveillance and response. The reverse transcription-polymerase chain reaction (RT-PCR) is the most common method for the detection of SARS-CoV-2 viral mRNA and is regarded as the gold standard test for COVID-19. However, this test and those for antibodies (IgM and IgG) and antigens have certain limitations (e.g., by yielding false-negative and false-positive results). We have developed an RNA fluorescence in situ hybridization (FISH) method for high-sensitivity detection of SARS-CoV-2 mRNAs in HEK 293T cell cultures as a model. After transfection of HEK 293T cells with plasmids, Spike (S)/envelope (E) proteins and their mRNAs were clearly detected inside the cells. In addition, hybridization time could be reduced to 2 hours for faster detection when probe concentration was increased. Our approach might thus significantly improve the sensitivity and specificity of SARS-CoV-2 detection and be widely applied for the high-sensitivity single-molecular detection of other RNA viruses (e.g., Middle East respiratory syndrome coronavirus (MERS-CoV), Hepatitis A virus, all influenza viruses, and human immunodeficiency virus (HIV)) in various types of samples including tissue, body fluid, blood, and water. RNA FISH can also be utilized for the detection of DNA viruses (e.g., Monkeypox virus, human papillomavirus (HPV), and cytomegalovirus (CMV)) by detection of their mRNAs inside cells or body fluid.
Collapse
Affiliation(s)
- Dailun Hu
- Clinical College, Hebei Medical University, Shijiazhuang, China
| | - Tao Wang
- Telethon Kids Institute, Perth Children’s Hospital, Nedlands, WA, Australia
- Medical School, University of Western Australia, Nedlands, WA, Australia
| | - Jasim Uddin
- School of Veterinary Medicine, Murdoch University, Murdoch, WA, Australia
| | - Wayne K. Greene
- Medical, Molecular and Forensic Sciences, Murdoch University, Murdoch, WA, Australia
| | - Dakang Hu
- Department of Laboratory Medicine, Taizhou Municipal Hospital, Taizhou, China
- *Correspondence: Dakang Hu, ; Bin Ma,
| | - Bin Ma
- Medical, Molecular and Forensic Sciences, Murdoch University, Murdoch, WA, Australia
- *Correspondence: Dakang Hu, ; Bin Ma,
| |
Collapse
|
3
|
Guazzoni E, Castelli A, Polizzi A, Galanzino G, Piralla A, Giardina F, Baldanti F, Jannelli E, Caliogna L, Pasta G, Mosconi M, Grassi FA. Detection of SARS-CoV-2 in Cancellous Bone of Patients with COVID-19 Disease Undergoing Orthopedic Surgery: Laboratory Findings and Clinical Applications. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:10621. [PMID: 36078337 PMCID: PMC9517848 DOI: 10.3390/ijerph191710621] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/25/2022] [Revised: 08/20/2022] [Accepted: 08/21/2022] [Indexed: 06/15/2023]
Abstract
An emerging issue for orthopedic surgeons is how to manage patients with active or previous COVID-19 disease, avoiding any major risks for the surgeons and the O.R. personnel. This monocentric prospective observational study aims to assess the prevalence of SARS-CoV-2 viral RT-PCR RNA in cancellous bone samples in patients with active or previous COVID-19 disease. We collected data about 30 consecutive patients from our institution from January 2021 to March 2021 with active or previous COVID-19 disease. The presence of SARS-CoV-2 in the samples was determined using two different PCR-based assays. Eighteen of the thirty patients included in the study had a positive nasopharyngeal swab at the time of surgery. Twelve patients had a negative nasopharyngeal swab with a mean days since negativization of 138 ± 104 days, ranging from 23 to 331 days. Mean days of positivity to the nasal swab were 17 ± 17. Twenty-nine out of thirty (96.7%) samples were negative for the presence of SARS-CoV-2 RNA. In one sample, low SARS-CoV-2 load (Cycle threshold (Ct) 36.6.) was detected but not confirmed using an additional confirmatory assay. The conducted study demonstrates the absence of the viral genome within the analyzed cancellous bone. We think that the use of personal protection equipment (PPE) to only protect from aerosol produced during surgery, both in active and recovered patients, is not strictly necessary. We think that the use of PPE should not be employed by surgeons and the O.R. personnel to protect themselves from aerosols produced from the respiratory tract. Moreover, we think that our results could represent a valid basis for further studies related to the possibility of bone donation in patients that suffered and recovered from COVID-19.
Collapse
Affiliation(s)
- Edoardo Guazzoni
- Department of Orthopaedics and Traumatology, IRCCS Fondazione Policlinico San Matteo, University of Pavia, 27100 Pavia, Italy
| | - Alberto Castelli
- Department of Orthopaedics and Traumatology, IRCCS Fondazione Policlinico San Matteo, University of Pavia, 27100 Pavia, Italy
| | - Alberto Polizzi
- Department of Orthopaedics and Traumatology, IRCCS Fondazione Policlinico San Matteo, University of Pavia, 27100 Pavia, Italy
| | - Giacomo Galanzino
- Department of Orthopaedics and Traumatology, IRCCS Fondazione Policlinico San Matteo, University of Pavia, 27100 Pavia, Italy
| | - Antonio Piralla
- Microbiology and Virology Department, IRCCS Fondazione Policlinico San Matteo, 27100 Pavia, Italy
| | - Federica Giardina
- Microbiology and Virology Department, IRCCS Fondazione Policlinico San Matteo, 27100 Pavia, Italy
| | - Fausto Baldanti
- Microbiology and Virology Department, IRCCS Fondazione Policlinico San Matteo, 27100 Pavia, Italy
- Department of Clinical, Surgical, Diagnostic and Pediatric Sciences, University of Pavia, 27100 Pavia, Italy
| | - Eugenio Jannelli
- Multidisciplinary Department of Medico-Surgical and Dentistry Specialties, Luigi Vanvitelli, University of Campania, 80138 Naples, Italy
| | - Laura Caliogna
- Department of Orthopaedics and Traumatology, IRCCS Fondazione Policlinico San Matteo, University of Pavia, 27100 Pavia, Italy
| | - Gianluigi Pasta
- Department of Orthopaedics and Traumatology, IRCCS Fondazione Policlinico San Matteo, University of Pavia, 27100 Pavia, Italy
| | - Mario Mosconi
- Department of Orthopaedics and Traumatology, IRCCS Fondazione Policlinico San Matteo, University of Pavia, 27100 Pavia, Italy
| | - Federico Alberto Grassi
- Department of Orthopaedics and Traumatology, IRCCS Fondazione Policlinico San Matteo, University of Pavia, 27100 Pavia, Italy
| |
Collapse
|
4
|
Investigation of SARS-CoV-2 in Postmortem Ocular Tissues and Evaluation of Its Effects on Corneal Donation. Cornea 2022; 41:1265-1270. [DOI: 10.1097/ico.0000000000003093] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2022] [Accepted: 05/23/2022] [Indexed: 11/25/2022]
|
5
|
Shankar P, Singh J, Joshi A, Malhotra AG, Shrivas A, Goel G, Gupta P, Yadav J, Saigal S, Singh S, Purwar S. Organ Involvement in COVID-19: A Molecular Investigation of Autopsied Patients. Microorganisms 2022; 10:microorganisms10071333. [PMID: 35889052 PMCID: PMC9318581 DOI: 10.3390/microorganisms10071333] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2022] [Revised: 06/16/2022] [Accepted: 06/17/2022] [Indexed: 02/07/2023] Open
Abstract
Precise reasons for severe manifestation of SARS-CoV-2 remain unanswered, and efforts have been focused on respiratory system management. Demonstration of unequivocal presence of SARS-CoV-2 in vital body organs by cadaver autopsy was the only way to prove multi-organ involvement. Hence, the primary objective of the study was to determine presence of the SARS-CoV-2 in various organs of patients succumbing to SARS-CoV-2 infection. A total of 246 samples from different organs of 21 patients who died due to severe COVID-19 illness were investigated by qRT-PCR, and SARS-CoV-2 was detected in 181 (73.57%) samples and highest positivity of SARS-CoV-2 being (expectedly) found in nasopharynx (90.4%) followed by bilateral lungs (87.30%), peritoneal fluid (80%), pancreas (72.72%), bilateral kidneys (68.42%), liver (65%) and even in brain (47.2%). The deceased patients were categorized to three subgroups based upon the extent of organs in which SARS-CoV-2 was detected by qRT-PCR (high intensity ≥80%, intermediate intensity = 65-80% and low intensity ≤65% organs involvement). It was conclusively established that SARS-CoV-2 has the property of invasion beyond lungs and even crosses the blood-brain barrier, resulting in multi-system disease; this is probably the reason behind cytokine storm, though it is not clear whether organ damage is due to direct injury caused by the virus or result of inflammatory assault. Significant inverse correlation was found between the Ct value of lung samples and number of organs involved, implying that higher viral load in lungs is directly proportionate to involvement of extrapulmonary organs and patients with higher viral load in respiratory secretions should be monitored more closely for any warning signs and the treatment strategies should also address involvement of other organs for better outcome, because lungs, though the primary site of infection, are not the only organ system responsible for pathogenesis of systemic illness.
Collapse
Affiliation(s)
- Prem Shankar
- Department of Microbiology, All India Institute of Medical Sciences, Bhopal 462020, India
| | - Jitendra Singh
- Department of Translational Medicine, All India Institute of Medical Sciences, Bhopal 462020, India
| | - Ankur Joshi
- Department of Community and Family Medicine, All India Institute of Medical Sciences, Bhopal 462020, India
| | - Anvita Gupta Malhotra
- Department of Microbiology, All India Institute of Medical Sciences, Bhopal 462020, India
| | - Arti Shrivas
- Department of Microbiology, All India Institute of Medical Sciences, Bhopal 462020, India
| | - Garima Goel
- Department of Pathology & Laboratory Medicine, All India Institute of Medical Sciences, Bhopal 462020, India
| | - Priyal Gupta
- Department of Microbiology, All India Institute of Medical Sciences, Bhopal 462020, India
| | - Jayanthi Yadav
- Department of Forensic Medicine, All India Institute of Medical Sciences, Bhopal 462020, India
| | - Saurabh Saigal
- Anaesthesia and Critical Care, All India Institute of Medical Sciences, Bhopal 462020, India
| | - Sarman Singh
- Department of Microbiology, All India Institute of Medical Sciences, Bhopal 462020, India
- Department of Biomedical Sciences, Indian Institute of Science Education and Research (IISER), Bhopal 462066, India
| | - Shashank Purwar
- Department of Microbiology, All India Institute of Medical Sciences, Bhopal 462020, India
| |
Collapse
|
6
|
Shen S, Li W, Wei H, Zhao L, Ye R, Ma K, Xiao P, Jia N, Zhou J, Cui X, Gong J, Cao W. A Chess and Card Room-Induced COVID-19 Outbreak and Its Agent-Based Simulation in Yangzhou, China. Front Public Health 2022; 10:915716. [PMID: 35784212 PMCID: PMC9247329 DOI: 10.3389/fpubh.2022.915716] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2022] [Accepted: 05/06/2022] [Indexed: 01/13/2023] Open
Abstract
Objective To evaluate epidemiological characteristics of the COVID-19 outbreak that resurged in Yangzhou and to simulate the impact of different control measures at different regional scales. Methods We collected personal information from 570 laboratory-confirmed cases in Yangzhou from 28 July to 26 August 2021, and built a modified susceptible-exposed-infected-removed (SEIR) model and an agent-based model. Results The SEIR model showed that for passengers from medium-high risk areas, pre-travel nucleic acid testing within 3 days could limit the total number of infected people in Yangzhou to 50; among elderly persons, a 60% increase in vaccination rates could reduce the estimated infections by 253. The agent-based model showed that when the population density of the chess and card room dropped by 40%, the number of infected people would decrease by 54 within 7 days. A ventilation increase in the chess and card room from 25 to 50% could reduce the total number of infections by 33 within 7 days; increasing the ventilation from 25 to 75% could reduce the total number of infections by 63 within 7 days. Conclusions The SEIR model and agent-based model were used to simulate the impact of different control measures at different regional scales successfully. It is possible to provide references for epidemic prevention and control work.
Collapse
Affiliation(s)
- Shijing Shen
- State Key Laboratory of Pathogen and Biosecurity, Beijing Institute of Microbiology and Epidemiology, Beijing, China
- School of Public Health and Health Management, Gannan Medical University, Ganzhou, China
| | - Wenning Li
- National Engineering Research Center for Geoinformatics, Aerospace Information Research Institute, Chinese Academy of Sciences, Beijing, China
- University of Chinese Academy of Sciences, Beijing, China
| | - Hua Wei
- State Key Laboratory of Pathogen and Biosecurity, Beijing Institute of Microbiology and Epidemiology, Beijing, China
- Institute of EcoHealth, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, China
| | - Lin Zhao
- Institute of EcoHealth, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, China
| | - Runze Ye
- Institute of EcoHealth, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, China
| | - Ke Ma
- State Key Laboratory of Pathogen and Biosecurity, Beijing Institute of Microbiology and Epidemiology, Beijing, China
| | - Peng Xiao
- State Key Laboratory of Pathogen and Biosecurity, Beijing Institute of Microbiology and Epidemiology, Beijing, China
| | - Na Jia
- State Key Laboratory of Pathogen and Biosecurity, Beijing Institute of Microbiology and Epidemiology, Beijing, China
| | - Jieping Zhou
- National Engineering Research Center for Geoinformatics, Aerospace Information Research Institute, Chinese Academy of Sciences, Beijing, China
| | - Xiaoming Cui
- State Key Laboratory of Pathogen and Biosecurity, Beijing Institute of Microbiology and Epidemiology, Beijing, China
- *Correspondence: Xiaoming Cui
| | - Jianhua Gong
- National Engineering Research Center for Geoinformatics, Aerospace Information Research Institute, Chinese Academy of Sciences, Beijing, China
- University of Chinese Academy of Sciences, Beijing, China
- Jianhua Gong
| | - Wuchun Cao
- State Key Laboratory of Pathogen and Biosecurity, Beijing Institute of Microbiology and Epidemiology, Beijing, China
- Wuchun Cao
| |
Collapse
|
7
|
Diagnostic Techniques for COVID-19: A Mini-review of Early Diagnostic Methods. JOURNAL OF ANALYSIS AND TESTING 2021; 5:314-326. [PMID: 34631199 PMCID: PMC8488931 DOI: 10.1007/s41664-021-00198-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2021] [Accepted: 08/25/2021] [Indexed: 12/26/2022]
Abstract
The outbreak of severe pneumonia at the end of 2019 was proved to be caused by the SARS-CoV-2 virus spreading out the world. And COVID-19 spread rapidly through a terrible transmission way by human-to-human, which led to many suspected cases waiting to be diagnosed and huge daily samples needed to be tested by an effective and rapid detection method. With an increasing number of COVID-19 infections, medical pressure is severe. Therefore, more efficient and accurate diagnosis methods were keen urgently established. In this review, we summarized several methods that can rapidly and sensitively identify COVID-19; some of them are widely used as the diagnostic techniques for SARS-CoV-2 in various countries, some diagnostic technologies refer to SARS (Severe Acute Respiratory Syndrome) or/and MERS (Middle East Respiratory Syndrome) detection, which may provide potential diagnosis ideas.
Collapse
|
8
|
Cuong HQ, Hai ND, Linh HT, Hieu NT, Anh NH, Ton T, Dong TC, Thao VT, Tuoi DTH, Tuan ND, Loan HTK, Long NT, Thang CM, Thao NTT, Lan PT. The Production of Standardized Samples with Known Concentrations for Severe Acute Respiratory Syndrome Coronavirus 2 RT-qPCR Testing Validation for Developing Countries in the Period of the Pandemic Era. BIOMED RESEARCH INTERNATIONAL 2021; 2021:5516344. [PMID: 34368349 PMCID: PMC8337105 DOI: 10.1155/2021/5516344] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/20/2021] [Revised: 07/11/2021] [Accepted: 07/19/2021] [Indexed: 11/22/2022]
Abstract
BACKGROUND Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has caused a pandemic of pneumonia spreading around the world, leading to serious threats to public health and attracting enormous attention. There is an urgent need for sensitive diagnostic testing implementation to control and manage SARS-CoV-2 in public health laboratories. The quantitative reverse transcription PCR (RT-qPCR) assay is the gold standard method, but the sensitivity and specificity of SARS-CoV-2 testing are dependent on a number of factors. METHODS We synthesized RNA based on the genes published to estimate the concentration of inactivated virus samples in a biosafety level 3 laboratory. The limit of detection (LOD), linearity, accuracy, and precision were evaluated according to the bioanalytical method validation guidelines. RESULTS We found that the LOD reached around 3 copies/reaction. Furthermore, intra-assay precision, accuracy, and linearity met the accepted criterion with an RSD for copies of less than 25%, and linear regression met the accepted R 2 of 0.98. CONCLUSIONS We suggest that synthesized RNA based on the database of the NCBI gene bank for estimating the concentration of inactivated virus samples provides a potential opportunity for reliable testing to diagnose coronavirus disease 2019 (COVID-19) as well as limit the spread of the disease. This method may be relatively quick and inexpensive, and it may be useful for developing countries during the pandemic era. In the long term, it is also applicable for evaluation, verification, validation, and external quality assessment.
Collapse
Affiliation(s)
- Hoang Quoc Cuong
- Microbiology and Immunology Department, Planning Division, Medical Testing and Calibration Centers, Medical Analysis Department, Pasteur Institute in Ho Chi Minh City, Vietnam
| | - Nguyen Duc Hai
- Microbiology and Immunology Department, Planning Division, Medical Testing and Calibration Centers, Medical Analysis Department, Pasteur Institute in Ho Chi Minh City, Vietnam
| | - Hoang Thuy Linh
- Microbiology and Immunology Department, Planning Division, Medical Testing and Calibration Centers, Medical Analysis Department, Pasteur Institute in Ho Chi Minh City, Vietnam
| | - Nguyen Trung Hieu
- Microbiology and Immunology Department, Planning Division, Medical Testing and Calibration Centers, Medical Analysis Department, Pasteur Institute in Ho Chi Minh City, Vietnam
| | - Nguyen Hoang Anh
- Microbiology and Immunology Department, Planning Division, Medical Testing and Calibration Centers, Medical Analysis Department, Pasteur Institute in Ho Chi Minh City, Vietnam
| | - Tran Ton
- Microbiology and Immunology Department, Planning Division, Medical Testing and Calibration Centers, Medical Analysis Department, Pasteur Institute in Ho Chi Minh City, Vietnam
| | - Tran Cat Dong
- Faculty of Pharmacy, University of Medicine and Pharmacy at Ho Chi Minh City, Vietnam
| | - Vu Thanh Thao
- Faculty of Pharmacy, University of Medicine and Pharmacy at Ho Chi Minh City, Vietnam
| | - Do Thi Hong Tuoi
- Faculty of Pharmacy, University of Medicine and Pharmacy at Ho Chi Minh City, Vietnam
| | - Nguyen Duc Tuan
- Faculty of Pharmacy, University of Medicine and Pharmacy at Ho Chi Minh City, Vietnam
| | - Huynh Thi Kim Loan
- Microbiology and Immunology Department, Planning Division, Medical Testing and Calibration Centers, Medical Analysis Department, Pasteur Institute in Ho Chi Minh City, Vietnam
| | - Nguyen Thanh Long
- Microbiology and Immunology Department, Planning Division, Medical Testing and Calibration Centers, Medical Analysis Department, Pasteur Institute in Ho Chi Minh City, Vietnam
| | - Cao Minh Thang
- Microbiology and Immunology Department, Planning Division, Medical Testing and Calibration Centers, Medical Analysis Department, Pasteur Institute in Ho Chi Minh City, Vietnam
| | - Nguyen Thi Thanh Thao
- Microbiology and Immunology Department, Planning Division, Medical Testing and Calibration Centers, Medical Analysis Department, Pasteur Institute in Ho Chi Minh City, Vietnam
| | - Phan Trong Lan
- Microbiology and Immunology Department, Planning Division, Medical Testing and Calibration Centers, Medical Analysis Department, Pasteur Institute in Ho Chi Minh City, Vietnam
| |
Collapse
|
9
|
Malguria N, Yen LH, Lin T, Hussein A, Fishman EK. Role of Chest CT in COVID-19. J Clin Imaging Sci 2021; 11:30. [PMID: 34221639 PMCID: PMC8247924 DOI: 10.25259/jcis_138_2020] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2020] [Accepted: 04/19/2021] [Indexed: 01/08/2023] Open
Abstract
In December 2019, a disease attributed to a new severe acute respiratory syndrome coronavirus 2, and named coronavirus disease 2019 (COVID-19), broke out in Wuhan, China and has spread rapidly throughout the world. CT has been advocated in selected indications as a tool toward rapid and early diagnosis. The CT patterns of COVID-19 include ground glass opacities GGO, consolidation, and crazy paving. Additional signs include a “rounded morphology” of lesions, vascular enlargement sign, nodules, and fibrous stripe. Signs of healing and organization include subpleural bands, a reticular pattern, reversed halo sign and traction bronchiectasis. Cavitation and tree in bud signs are absent and pleural effusions are rare. There is a high incidence of pulmonary embolism associated with COVID-19. CT findings in COVID-19 appear to follow a predictable timeline with maximal involvement approximately 6–11 days after symptom onset. The stages of evolution include early stage (days 0–4) with GGO being the predominant abnormality, progressive stage (days 5–8) with increasing crazy paving; and peak stage (days 9–13) with predominance of consolidation and absorption phase (after day 14) with gradual absorption of consolidation with residual GGO and subpleural bands. CT findings in COVID-19 have a high sensitivity and low specificity, determined to be 98% and 25% in a retrospective study of 1014 patients. The low specificity of CT for the diagnosis of COVID-19 pneumonia is due to the overlap of CT findings with other viral pneumonias and other infections, lung involvement in connective tissue disorders, drug reaction, pulmonary edema, and hemorrhage.
Collapse
Affiliation(s)
- Nagina Malguria
- Department of Radiology, Johns Hopkins Hospital, Baltimore, Maryland, United States
| | - Li-Hsiang Yen
- Department of Radiology, University of Rochester, Rochester, New York, United States
| | - Tony Lin
- Department of Radiology, Johns Hopkins Hospital, Baltimore, Maryland, United States
| | - Amira Hussein
- Department of Radiology, University of Rochester, Rochester, New York, United States
| | - Elliot K Fishman
- Department of Radiology, Johns Hopkins Hospital, Baltimore, Maryland, United States
| |
Collapse
|
10
|
Ran HL, Zhou XT, Liu WJ, Gao GF. Keep Eyes on COVID-19: Ophthalmic Symptoms and Potential Transmission of SARS-CoV-2 through the Oculus. INFECTIOUS DISEASES & IMMUNITY 2021; 1:103-107. [PMID: 38630078 PMCID: PMC8291037 DOI: 10.1097/id9.0000000000000011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/10/2021] [Indexed: 12/15/2022]
Abstract
In December 2019, a new coronavirus disease 2019 (COVID-19) emerged and rapidly spread globally, posing a worldwide health emergency. The pathogen causing this pandemic was identified as severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2). It is well known that SARS-CoV-2 transmits via respiratory droplets and close contact with infected individuals or contaminated items. In addition to these two major transmission routes, other modes of transmission have not been confirmed. Considering that some COVID-19 patients have presented with ocular discomforts and positive SARS-CoV-2 RNA in ocular surfaces, as well as the discovery of the SARS-CoV-2 receptors, angiotensin-converting enzyme 2, and transmembrane protease, serine 2, in the oculus, the ocular surface is now thought to be a possible alternative route of SARS-CoV-2 transmission and a replication site. This review summarizes the evidence connecting COVID-19 with ocular tissues, ocular symptoms during SARS-CoV-2 infection, the potential role of the conjunctiva in SARS-CoV-2 transmission, and the physiopathological mechanisms. Appropriate precautions in ophthalmology departments, including innovative complete and effective patient management plans, protective personal equipment, hand hygiene, and strict personal distance intervals, are essential to effectively minimize the spread of SARS-CoV-2 and control the pandemic.
Collapse
Affiliation(s)
- Hong Li Ran
- School of Ophthalmology and Optometry, Wenzhou Medical University, Wenzhou 325027, China
- National Institute for Viral Disease Control and Prevention, Chinese Center for Disease Control and Prevention (China CDC), Beijing 100052, China
| | - Xiang Tian Zhou
- School of Ophthalmology and Optometry, Wenzhou Medical University, Wenzhou 325027, China
| | - William J. Liu
- School of Ophthalmology and Optometry, Wenzhou Medical University, Wenzhou 325027, China
- National Institute for Viral Disease Control and Prevention, Chinese Center for Disease Control and Prevention (China CDC), Beijing 100052, China
| | - George F. Gao
- School of Ophthalmology and Optometry, Wenzhou Medical University, Wenzhou 325027, China
- National Institute for Viral Disease Control and Prevention, Chinese Center for Disease Control and Prevention (China CDC), Beijing 100052, China
| |
Collapse
|
11
|
Keaney D, Whelan S, Finn K, Lucey B. Misdiagnosis of SARS-CoV-2: A Critical Review of the Influence of Sampling and Clinical Detection Methods. Med Sci (Basel) 2021; 9:36. [PMID: 34070530 PMCID: PMC8162574 DOI: 10.3390/medsci9020036] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2021] [Revised: 05/20/2021] [Accepted: 05/21/2021] [Indexed: 01/08/2023] Open
Abstract
SARS-CoV-2 infection has generated the biggest pandemic since the influenza outbreak of 1918-1919. One clear difference between these pandemics has been the ability to test for the presence of the virus or for evidence of infection. This review examined the performance characteristics of sample types via PCR detection of the virus, of antibody testing, of rapid viral antigen detection kits and computerised tomography (CT) scanning. It was found that combined detection approaches, such as the incorporation of CT scans, may reduce the levels of false negatives obtained by PCR detection in both symptomatic and asymptomatic patients, while sputum and oral throat washing sample types should take precedence over swabbing when available. Rt-PCR assays for detection of the virus remain the gold-standard method for SARS-CoV-2 diagnosis and can be used effectively on pooled samples for widespread screening. The novel Oxford antibody assay was found to have the highest sensitivity and specificity of four currently available commercial antibody kits but should only be used during a specific timeframe post-symptom onset. Further research into transmission modes between symptomatic and asymptomatic patients is needed. Analysis of the performance characteristics of different sampling and detection methods for SARS-CoV-2 showed that timing of sampling and testing methods used can greatly influence the rate of false-positive and false-negative test results, thereby influencing viral spread.
Collapse
Affiliation(s)
- Daniel Keaney
- Department of Biological Sciences, Munster Technological University, Bishopstown, T12 P928 Cork, Ireland; (D.K.); (S.W.); (B.L.)
| | - Shane Whelan
- Department of Biological Sciences, Munster Technological University, Bishopstown, T12 P928 Cork, Ireland; (D.K.); (S.W.); (B.L.)
| | - Karen Finn
- Department of Biopharmaceutical and Medical Science, Galway-Mayo Institute of Technology, Old Dublin Road, H91 DCH9 Galway, Ireland
| | - Brigid Lucey
- Department of Biological Sciences, Munster Technological University, Bishopstown, T12 P928 Cork, Ireland; (D.K.); (S.W.); (B.L.)
| |
Collapse
|
12
|
Mahmoud H, Radwan A, El Rashidy A, Hefny HM, Ali AH, Mounir A. Assessment of Coronavirus in the Conjunctival Tears in Pediatric Patients with Asymptomatic COVID-19 Infection in Sohag Government, Egypt. Open Ophthalmol J 2021. [DOI: 10.2174/1874364102115010083] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Objective:
The present study aims to evaluate coronavirus shedding in the tears of asymptomatic pediatric COVID-19 positive patients.
Methods:
A prospective interventional study that included a total of 145 pediatric asymptomatic COVID-19 patients hospitalized from 17th May 2020 to 16th July 2020 in Sohag Tropical Hospital. On admission, all of them were COVID-19 positive detected through nasopharyngeal swab. They were in intimate contact with positive symptomatic COVID-19 patients before testing and admission. Reverse Transcriptase Polymerase chain reaction (RT-PCR) was done for tears samples at an interval of 5 days after admission and twice before discharge.
Results:
Of the 145 asymptomatic pediatric COVID-19 positive patients, no one showed ocular or systemic manifestations. They were silent carriers. Ten were positive for tears sample on admission. They became negative for nasopharyngeal and tear samples before discharge.
Conclusion:
Pediatric positive COVID-19 patients can shed coronavirus through their tears. Even among asymptomatic patients, transmission through tears is possible.
Collapse
|
13
|
Roshanshad A, Ashraf MA, Roshanshad R, Kharmandar A, Zomorodian SA, Ashraf H. Ocular Manifestations of Patients with Coronavirus Disease 2019: A Comprehensive Review. J Ophthalmic Vis Res 2021; 16:234-247. [PMID: 34055261 PMCID: PMC8126735 DOI: 10.18502/jovr.v16i2.9087] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2020] [Accepted: 01/10/2021] [Indexed: 12/19/2022] Open
Abstract
Apart from conjunctival involvement which is the most well-known ocular manifestation of coronavirus infectious disease 2019 (COVID-19), there are multiple reports of the involvement of other ocular structures by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). We comprehensively reviewed PubMed, Scopus, Embase, and Google Scholar for available evidence regarding COVID-19 various ocular manifestations, with special focus on less known and unusual ocular findings. We then categorized the findings based on the parts of the eye which was involved. In anterior sections of the eye, the involvement of the eyelid (tarsadenitis), conjunctiva and cornea (follicular conjunctivitis, pseudomembranous conjunctivitis, and keratoconjunctivitis), episclera (nodular episcleritis), uvea (anterior uveitis) were reported. Also, third, fourth, and sixth nerve palsy, retinal vasculitis, retinal optical coherence tomography (OCT) changes (hyper-reflective lesions and increased retinal nerve fiber layer thickness [RNFLT]), optic neuritis, papillophlebitis, Miller Fisher syndrome, posterior reversible leukoencephalopathy (PRES), ophthalmic artery and central retinal artery occlusion, and polyneuritis cranialis were reported in different studies. Postmortem evaluation of COVID-19 patients detected no viral RNA in different anterior and posterior segments of the eyes. However, another study revealed a 21.4% positivity of the retinal biopsies of dead patients. The results of this study can help ophthalmologists to be vigilant when they see these findings in a suspected case of COVID-19. In addition, wearing face masks and protective goggles or eye shields are recommended, especially in high risk contacts.
Collapse
Affiliation(s)
- Amirhossein Roshanshad
- Student Research Committee, Shiraz University of Medical Sciences, Shiraz, Iran
- Poostchi Ophthalmology Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Mohammad Ali Ashraf
- Student Research Committee, Shiraz University of Medical Sciences, Shiraz, Iran
- Poostchi Ophthalmology Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Romina Roshanshad
- Student Research Committee, Shiraz University of Medical Sciences, Shiraz, Iran
- Poostchi Ophthalmology Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Ali Kharmandar
- Non-communicable Disease Research Center, Fasa University of Medical Sciences, Fasa, Iran
- Health Policy Research Center, Institute of Health, Shiraz University of Medical Sciences, Shiraz, Iran
| | | | - Hossein Ashraf
- Poostchi Ophthalmology Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| |
Collapse
|
14
|
Kocamış Ö, Örnek K, Aşıkgarip N, Hızmalı L, Sezgin FM, Şahin Y. Evaluation of Nasopharyngeal and Conjunctival Swab Samples of Hospitalised Patients with Confirmed COVID-19. Ocul Immunol Inflamm 2021; 29:634-637. [PMID: 33661070 DOI: 10.1080/09273948.2020.1838558] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
PURPOSE To evaluate the results of conjunctival and nasopharyngeal swab tests in patients with confirmed COVID-19. METHODS This prospective study included 45 patients who were hospitalized for confirmed COVID-19. Nasopharyngeal swab samples were obtained from the patients before hospitalization. Only one eye of each patient was randomly selected for-conjunctival sampling. All participants underwent a complete slit-lamp examination. Conjunctival and nasopharyngeal swab samples were analyzed by reversetranscriptase-polymerase-chain reaction (RT-PCR). RESULTS Twenty seven (60%) of the patients were male and 18 (40%) were female. Conjunctival swab was positive in only one (2.22%) patient. None of the COVID-19 patients showed ocular changes and symptoms. There were no abnormalities of the ocular surface, anterior chamber or posterior segment at slit-lamp examination. CONCLUSIONS The RT-PCR was not high positive in the conjunctiva as in nasopharyngeal swabs. Ocular changes were not common in COVID-19 patients.
Collapse
Affiliation(s)
- Özkan Kocamış
- Department of Opthalmology, Kırşehir Ahi Evran University School of Medicine, Kırşehir, Turkey
| | - Kemal Örnek
- Department of Opthalmology, Kırşehir Ahi Evran University School of Medicine, Kırşehir, Turkey
| | - Nazife Aşıkgarip
- Department of Opthalmology, Kırşehir Ahi Evran Training and Research Hospital, Kırşehir, Turkey
| | - Lokman Hızmalı
- Department of Infectious Disease and Clinical Microbiology, Kırşehir Ahi Evran University School of Medicine, Kırşehir, Turkey
| | - Fikriye Milletli Sezgin
- Department of Medical Microbiology, Kırşehir Ahi Evran University School of Medicine, Kırşehir, Turkey
| | - Yahya Şahin
- Department of Emergency Medicine, Kırşehir Ahi Evran University School of Medicine, Kırşehir, Turkey
| |
Collapse
|
15
|
Arevalo-Rodriguez I, Seron P, Buitrago-García D, Ciapponi A, Muriel A, Zambrano-Achig P, Del Campo R, Galán-Montemayor JC, Simancas-Racines D, Perez-Molina JA, Khan KS, Zamora J. Recommendations for SARS-CoV-2/COVID-19 testing: a scoping review of current guidance. BMJ Open 2021; 11:e043004. [PMID: 33408209 PMCID: PMC7789202 DOI: 10.1136/bmjopen-2020-043004] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/22/2020] [Revised: 10/15/2020] [Accepted: 12/22/2020] [Indexed: 01/19/2023] Open
Abstract
BACKGROUND Testing used in screening, diagnosis and follow-up of COVID-19 has been a subject of debate. Several organisations have developed formal advice about testing for COVID-19 to assist in the control of the disease. We collated, delineated and appraised current worldwide recommendations about the role and applications of tests to control SARS-CoV-2/COVID-19. METHODS We searched for documents providing recommendations for COVID-19 testing in PubMed, EMBASE, LILACS, the Coronavirus Open Access Project living evidence database and relevant websites such as TRIP database, ECRI Guidelines Trust, the GIN database, from inception to 21 September 2020. Two reviewers applied the eligibility criteria to potentially relevant citations without language or geographical restrictions. We extracted data in duplicate, including assessment of methodological quality using the Appraisal of Guidelines for Research and Evaluation-II tool. RESULTS We included 47 relevant documents and 327 recommendations about testing. Regarding the quality of the documents, we found that the domains with the lowest scores were 'Editorial independence' (Median=4%) and 'Applicability' (Median=6%). Only six documents obtained at least 50% score for the 'Rigour of development' domain. An important number of recommendations focused on the diagnosis of suspected cases (48%) and deisolation measures (11%). The most frequently recommended test was the reverse transcription-PCR (RT-PCR) assay (87 recommendations) and the chest CT (38 recommendations). There were 22 areas of agreement among guidance developers, including the use of RT-PCR for SARS-Cov-2 confirmation, the limited role of bronchoscopy, the use chest CT and chest X-rays for grading severity and the co-assessment for other respiratory pathogens. CONCLUSION This first scoping review of recommendations for COVID-19 testing showed many limitations in the methodological quality of included guidance documents that could affect the confidence of clinicians in their implementation. Future guidance documents should incorporate a minimum set of key methodological characteristics to enhance their applicability for decision making.
Collapse
Affiliation(s)
- Ingrid Arevalo-Rodriguez
- Clinical Biostatistics Unit, Hospital Universitario Ramón y Cajal, IRYCIS, CIBER of Epidemiology and Public Health, Madrid, Spain
| | - Pamela Seron
- Department of Internal Medicine, Faculty of Medicine, Universidad de La Frontera, Temuco, Chile
| | - Diana Buitrago-García
- Institute of Social and Preventive Medicine (ISPM), University of Bern, Switzerland, Bern, Switzerland
| | - Agustin Ciapponi
- Instituto de Efectividad Clínica y Sanitaria (IECS-CONICET), Buenos Aires, Argentina
| | - Alfonso Muriel
- Clinical Biostatistics Unit, Hospital Universitario Ramón y Cajal, CIBER of Epidemiology and Public Health, Madrid, Spain
| | - Paula Zambrano-Achig
- Centro de investigación en Salud Pública y Epidemiología Clínica (CISPEC). Facultad de Ciencias de la Salud "Eugenio Espejo", Universidad UTE, Quito, Ecuador
| | - Rosa Del Campo
- Department of Microbiology, Ramón y Cajal University Hospital, Ramón y Cajal Health Research Institute (IRYCIS), Madrid, Spain
| | - Juan Carlos Galán-Montemayor
- Department of Microbiology, Ramón y Cajal University Hospital. Ramón y Cajal Health Research Institute (IRYCIS), CIBER of Epidemiology and Public Health (CIBERESP), Madrid, Spain
| | - Daniel Simancas-Racines
- Centro de investigación en Salud Pública y Epidemiología Clínica (CISPEC). Facultad de Ciencias de la Salud "Eugenio Espejo", Universidad UTE, Quito, Ecuador
| | - Jose A Perez-Molina
- Infectious Diseases Department, National Referral Centre for Tropical Diseases, Hospital Universitario Ramón y Cajal, IRYCIS, Madrid, Spain
| | - Khalid Saeed Khan
- Department of Preventive Medicine and Public Health, Faculty of Medicine, University of Granada, CIBER of Epidemiology and Public Health, Granada, Spain
| | - Javier Zamora
- Clinical Biostatistics Unit, Hospital Universitario Ramón y Cajal, CIBER of Epidemiology and Public Health, Madrid, Spain
- Institute of Applied Health Research, University of Birmingham, Birmingham, UK
| |
Collapse
|
16
|
Li M, Yang Y, He T, Wei R, Shen Y, Qi T, Han T, Song Z, Zhu Z, Ma X, Zhao J, Lin Y, Shen Y, Yang W, Zhao K, Lu H, Zhou X. Detection of SARS-CoV-2 in the ocular surface in different phases of COVID-19 patients in Shanghai, China. ANNALS OF TRANSLATIONAL MEDICINE 2021; 9:100. [PMID: 33569402 PMCID: PMC7867919 DOI: 10.21037/atm-20-6026] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
Background To investigate the temporal pattern of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) presence on ocular surfaces using conjunctival swabs in coronavirus disease 2019 (COVID-19) patients. Methods This study included 59 patients (32 newly admitted and 27 hospitalized for ≥2 weeks) with a COVID-19-confirmed diagnosis at the Shanghai Public Health Clinical Center from March 3, 2020, to March 21, 2020. Conjunctival swab samples were collected from both eyes of all the 59 patients and were tested by reverse transcription polymerase chain reaction (RT-PCR) assay. The range of sampling time lies widely between 1 and 50 days since symptom onset. Results Among the 32 newly admitted patients, positive RT-PCR results for SARS-CoV-2 in conjunctival swab samples were reported in 2 patients (one eye for each) without ocular discomfort, but 1 positive case had conjunctival congestion. The positive results were detected on Day 5 for 1 patient and Day 7 for the other, but repeated tests after 1 week were negative for both patients. All 27 patients who had been hospitalized for ≥2 weeks had negative test results. The mean time from symptom onset to sampling of 2 positive cases was significantly less than that of 57 negative cases (P<0.001). Conclusions SARS-CoV-2 on the ocular surface can be detected in the early phase of COVID-19. The risk of ocular transmission remains and might be higher in the early phase.
Collapse
Affiliation(s)
- Meiyan Li
- Department of Ophthalmology and Optometry, Eye and ENT Hospital, Fudan University, Shanghai, China; NHC Key Laboratory of Myopia (Fudan University), Shanghai, China; Shanghai Research Center of Ophthalmology and Optometry, Shanghai, China
| | - Yaling Yang
- Department of Ophthalmology, Shanghai Public Health Clinical Center, Shanghai, China
| | - Taiwen He
- Department of Ophthalmology, Shanghai Public Health Clinical Center, Shanghai, China
| | - Ruoyan Wei
- Department of Ophthalmology and Optometry, Eye and ENT Hospital, Fudan University, Shanghai, China; NHC Key Laboratory of Myopia (Fudan University), Shanghai, China; Shanghai Research Center of Ophthalmology and Optometry, Shanghai, China
| | - Yinzhong Shen
- Department of Infectious Diseases and Immunology, Shanghai Public Health Clinical Center, Shanghai, China
| | - Tangkai Qi
- Department of Infectious Diseases and Immunology, Shanghai Public Health Clinical Center, Shanghai, China
| | - Tian Han
- Department of Ophthalmology and Optometry, Eye and ENT Hospital, Fudan University, Shanghai, China; NHC Key Laboratory of Myopia (Fudan University), Shanghai, China; Shanghai Research Center of Ophthalmology and Optometry, Shanghai, China
| | - Zhigang Song
- Department of Pathogen Diagnosis and Biosafety, Shanghai Public Health Clinical Center, Shanghai, China
| | - Zhaoqin Zhu
- Department of Laboratory Medicine, Shanghai Public Health Clinical Center, Shanghai, China
| | - Xiaopeng Ma
- Shanghai Research Institute of Acupuncture and Meridian, Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Jing Zhao
- Department of Ophthalmology and Optometry, Eye and ENT Hospital, Fudan University, Shanghai, China; NHC Key Laboratory of Myopia (Fudan University), Shanghai, China; Shanghai Research Center of Ophthalmology and Optometry, Shanghai, China
| | - Yixiao Lin
- Department of Infectious Diseases and Immunology, Shanghai Public Health Clinical Center, Shanghai, China
| | - Yang Shen
- Department of Ophthalmology and Optometry, Eye and ENT Hospital, Fudan University, Shanghai, China; NHC Key Laboratory of Myopia (Fudan University), Shanghai, China; Shanghai Research Center of Ophthalmology and Optometry, Shanghai, China
| | - Weiming Yang
- Department of Ophthalmology, Children's Hospital of Fudan University, Shanghai, China
| | - Keqing Zhao
- Department of Otolaryngology, Eye and ENT Hospital, Fudan University, Shanghai, China
| | - Hongzhou Lu
- Department of Infectious Diseases and Immunology, Shanghai Public Health Clinical Center, Shanghai, China
| | - Xingtao Zhou
- Department of Ophthalmology and Optometry, Eye and ENT Hospital, Fudan University, Shanghai, China; NHC Key Laboratory of Myopia (Fudan University), Shanghai, China; Shanghai Research Center of Ophthalmology and Optometry, Shanghai, China
| |
Collapse
|
17
|
Arevalo-Rodriguez I, Buitrago-Garcia D, Simancas-Racines D, Zambrano-Achig P, Del Campo R, Ciapponi A, Sued O, Martinez-García L, Rutjes AW, Low N, Bossuyt PM, Perez-Molina JA, Zamora J. False-negative results of initial RT-PCR assays for COVID-19: A systematic review. PLoS One 2020; 15:e0242958. [PMID: 33301459 PMCID: PMC7728293 DOI: 10.1371/journal.pone.0242958] [Citation(s) in RCA: 350] [Impact Index Per Article: 87.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2020] [Accepted: 11/12/2020] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND A false-negative case of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection is defined as a person with suspected infection and an initial negative result by reverse transcription-polymerase chain reaction (RT-PCR) test, with a positive result on a subsequent test. False-negative cases have important implications for isolation and risk of transmission of infected people and for the management of coronavirus disease 2019 (COVID-19). We aimed to review and critically appraise evidence about the rate of RT-PCR false-negatives at initial testing for COVID-19. METHODS We searched MEDLINE, EMBASE, LILACS, as well as COVID-19 repositories, including the EPPI-Centre living systematic map of evidence about COVID-19 and the Coronavirus Open Access Project living evidence database. Two authors independently screened and selected studies according to the eligibility criteria and collected data from the included studies. The risk of bias was assessed using the Quality Assessment of Diagnostic Accuracy Studies (QUADAS-2) tool. We calculated the proportion of false-negative test results using a multilevel mixed-effect logistic regression model. The certainty of the evidence about false-negative cases was rated using the GRADE approach for tests and strategies. All information in this article is current up to July 17, 2020. RESULTS We included 34 studies enrolling 12,057 COVID-19 confirmed cases. All studies were affected by several risks of bias and applicability concerns. The pooled estimate of false-negative proportion was highly affected by unexplained heterogeneity (tau-squared = 1.39; 90% prediction interval from 0.02 to 0.54). The certainty of the evidence was judged as very low due to the risk of bias, indirectness, and inconsistency issues. CONCLUSIONS There is substantial and largely unexplained heterogeneity in the proportion of false-negative RT-PCR results. The collected evidence has several limitations, including risk of bias issues, high heterogeneity, and concerns about its applicability. Nonetheless, our findings reinforce the need for repeated testing in patients with suspicion of SARS-Cov-2 infection given that up to 54% of COVID-19 patients may have an initial false-negative RT-PCR (very low certainty of evidence). SYSTEMATIC REVIEW REGISTRATION Protocol available on the OSF website: https://tinyurl.com/vvbgqya.
Collapse
Affiliation(s)
- Ingrid Arevalo-Rodriguez
- Clinical Biostatistics Unit, Hospital Universitario Ramón y Cajal- IRYCIS, Madrid, Spain
- CIBER of Epidemiology and Public Health, Madrid, Spain
| | - Diana Buitrago-Garcia
- Institute of Social and Preventive Medicine (ISPM), University of Bern, Bern, Switzerland
- Graduate School for Health Sciences, University of Bern, Bern, Switzerland
| | - Daniel Simancas-Racines
- Centro de Investigación en Salud Pública y Epidemiología Clínica (CISPEC), Facultad de Ciencias de la Salud “Eugenio Espejo”, Universidad UTE, Quito, Ecuador
| | - Paula Zambrano-Achig
- Department of Microbiology, Ramón y Cajal University Hospital, Ramón y Cajal Health Research Institute (IRYCIS), Madrid, Spain
| | - Rosa Del Campo
- Department of Microbiology, Ramón y Cajal University Hospital, Ramón y Cajal Health Research Institute (IRYCIS), Madrid, Spain
| | - Agustin Ciapponi
- Instituto de Efectividad Clínica y Sanitaria (IECS-CONICET), Buenos Aires, Argentina
| | - Omar Sued
- Fundación Huésped, Buenos Aires, Argentina
| | - Laura Martinez-García
- CIBER of Epidemiology and Public Health, Madrid, Spain
- Department of Microbiology, Ramón y Cajal University Hospital, Ramón y Cajal Health Research Institute (IRYCIS), Madrid, Spain
| | - Anne W. Rutjes
- Institute of Social and Preventive Medicine (ISPM), University of Bern, Bern, Switzerland
- Graduate School for Health Sciences, University of Bern, Bern, Switzerland
| | - Nicola Low
- Institute of Social and Preventive Medicine (ISPM), University of Bern, Bern, Switzerland
- Graduate School for Health Sciences, University of Bern, Bern, Switzerland
| | - Patrick M. Bossuyt
- Department of Clinical Epidemiology, Biostatistics and Bioinformatics, Amsterdam University Medical Centres, University of Amsterdam, Amsterdam, The Netherlands
| | - Jose A. Perez-Molina
- Infectious Diseases Department, National Referral Centre for Tropical Diseases, Hospital Universitario Ramón y Cajal, Madrid, Spain
- Instituto Ramón y Cajal de Investigación Sanitaria, Madrid, Spain
| | - Javier Zamora
- Clinical Biostatistics Unit, Hospital Universitario Ramón y Cajal- IRYCIS, Madrid, Spain
- CIBER of Epidemiology and Public Health, Madrid, Spain
- Institute of Applied Health Research, University of Birmingham, Birmingham, United Kingdom
| |
Collapse
|
18
|
Arevalo-Rodriguez I, Buitrago-Garcia D, Simancas-Racines D, Zambrano-Achig P, Del Campo R, Ciapponi A, Sued O, Martinez-García L, Rutjes AW, Low N, Bossuyt PM, Perez-Molina JA, Zamora J. False-negative results of initial RT-PCR assays for COVID-19: A systematic review. PLoS One 2020; 15:e0242958. [PMID: 33301459 DOI: 10.1101/2020.04.16.20066787] [Citation(s) in RCA: 80] [Impact Index Per Article: 20.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2020] [Accepted: 11/12/2020] [Indexed: 05/23/2023] Open
Abstract
BACKGROUND A false-negative case of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection is defined as a person with suspected infection and an initial negative result by reverse transcription-polymerase chain reaction (RT-PCR) test, with a positive result on a subsequent test. False-negative cases have important implications for isolation and risk of transmission of infected people and for the management of coronavirus disease 2019 (COVID-19). We aimed to review and critically appraise evidence about the rate of RT-PCR false-negatives at initial testing for COVID-19. METHODS We searched MEDLINE, EMBASE, LILACS, as well as COVID-19 repositories, including the EPPI-Centre living systematic map of evidence about COVID-19 and the Coronavirus Open Access Project living evidence database. Two authors independently screened and selected studies according to the eligibility criteria and collected data from the included studies. The risk of bias was assessed using the Quality Assessment of Diagnostic Accuracy Studies (QUADAS-2) tool. We calculated the proportion of false-negative test results using a multilevel mixed-effect logistic regression model. The certainty of the evidence about false-negative cases was rated using the GRADE approach for tests and strategies. All information in this article is current up to July 17, 2020. RESULTS We included 34 studies enrolling 12,057 COVID-19 confirmed cases. All studies were affected by several risks of bias and applicability concerns. The pooled estimate of false-negative proportion was highly affected by unexplained heterogeneity (tau-squared = 1.39; 90% prediction interval from 0.02 to 0.54). The certainty of the evidence was judged as very low due to the risk of bias, indirectness, and inconsistency issues. CONCLUSIONS There is substantial and largely unexplained heterogeneity in the proportion of false-negative RT-PCR results. The collected evidence has several limitations, including risk of bias issues, high heterogeneity, and concerns about its applicability. Nonetheless, our findings reinforce the need for repeated testing in patients with suspicion of SARS-Cov-2 infection given that up to 54% of COVID-19 patients may have an initial false-negative RT-PCR (very low certainty of evidence). SYSTEMATIC REVIEW REGISTRATION Protocol available on the OSF website: https://tinyurl.com/vvbgqya.
Collapse
Affiliation(s)
- Ingrid Arevalo-Rodriguez
- Clinical Biostatistics Unit, Hospital Universitario Ramón y Cajal- IRYCIS, Madrid, Spain
- CIBER of Epidemiology and Public Health, Madrid, Spain
| | - Diana Buitrago-Garcia
- Institute of Social and Preventive Medicine (ISPM), University of Bern, Bern, Switzerland
- Graduate School for Health Sciences, University of Bern, Bern, Switzerland
| | - Daniel Simancas-Racines
- Centro de Investigación en Salud Pública y Epidemiología Clínica (CISPEC), Facultad de Ciencias de la Salud "Eugenio Espejo", Universidad UTE, Quito, Ecuador
| | - Paula Zambrano-Achig
- Department of Microbiology, Ramón y Cajal University Hospital, Ramón y Cajal Health Research Institute (IRYCIS), Madrid, Spain
| | - Rosa Del Campo
- Department of Microbiology, Ramón y Cajal University Hospital, Ramón y Cajal Health Research Institute (IRYCIS), Madrid, Spain
| | - Agustin Ciapponi
- Instituto de Efectividad Clínica y Sanitaria (IECS-CONICET), Buenos Aires, Argentina
| | - Omar Sued
- Fundación Huésped, Buenos Aires, Argentina
| | - Laura Martinez-García
- CIBER of Epidemiology and Public Health, Madrid, Spain
- Department of Microbiology, Ramón y Cajal University Hospital, Ramón y Cajal Health Research Institute (IRYCIS), Madrid, Spain
| | - Anne W Rutjes
- Institute of Social and Preventive Medicine (ISPM), University of Bern, Bern, Switzerland
- Graduate School for Health Sciences, University of Bern, Bern, Switzerland
| | - Nicola Low
- Institute of Social and Preventive Medicine (ISPM), University of Bern, Bern, Switzerland
- Graduate School for Health Sciences, University of Bern, Bern, Switzerland
| | - Patrick M Bossuyt
- Department of Clinical Epidemiology, Biostatistics and Bioinformatics, Amsterdam University Medical Centres, University of Amsterdam, Amsterdam, The Netherlands
| | - Jose A Perez-Molina
- Infectious Diseases Department, National Referral Centre for Tropical Diseases, Hospital Universitario Ramón y Cajal, Madrid, Spain
- Instituto Ramón y Cajal de Investigación Sanitaria, Madrid, Spain
| | - Javier Zamora
- Clinical Biostatistics Unit, Hospital Universitario Ramón y Cajal- IRYCIS, Madrid, Spain
- CIBER of Epidemiology and Public Health, Madrid, Spain
- Institute of Applied Health Research, University of Birmingham, Birmingham, United Kingdom
| |
Collapse
|
19
|
Regmi K, Lwin CM. Impact of non-pharmaceutical interventions for reducing transmission of COVID-19: a systematic review and meta-analysis protocol. BMJ Open 2020; 10:e041383. [PMID: 33093038 PMCID: PMC7582337 DOI: 10.1136/bmjopen-2020-041383] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/06/2020] [Revised: 09/24/2020] [Accepted: 10/05/2020] [Indexed: 12/26/2022] Open
Abstract
INTRODUCTION Implementing non-pharmaceutical interventions (NPIs) protect the public from COVID-19. However, the impact of NPIs has been inconsistent and remains unclear. This study, therefore, aims to measure the impact of major NPIs (social distancing, social isolation and quarantine) on reducing COVID-19 transmission. METHODS AND ANALYSIS We will conduct a systematic review and meta-analysis research of both randomised and non-randomised controlled trials. We will undertake a systematic search of: MEDLINE, Embase, Allied & Complementary Medicine, COVID-19 Research, WHO database on COVID-19, ClinicalTrails.Gov for clinical trials on COVID-19, Cochrane Resources on Coronavirus (COVID-19), Oxford COVID-19 Evidence Service and Google Scholar for published and unpublished literatures on COVID-19 including preprint engines such as medRxiv, bioRxiv, Litcovid and SSRN for unpublished studies on COVID-19 and will be reported in accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analyses. Outcomes of interest for impact analysis will include the reduction of COVID-19 transmission, avoiding crowds and restricting movement, isolating ill and psychological impacts. The Preferred Reporting Items for Systematic Review and Meta-Analysis Protocols checklist has been used for this protocol. For quality of included studies, we will use the Cochrane Collaboration's tool for assessing risk of bias for randomised controlled trials and the Newcastle-Ottawa Scale for observational studies. The Grading of Recommendations Assessment, Development and Evaluation approach will grade the certainty of the evidence for all outcome measures across studies. Random-effects model for meta-analysis will measure the effect size of NPIs or the strengths of relationships. For quantitative data, risk ratio or OR, absolute risk difference (for dichotomous outcome data), or mean difference or standardised mean difference (for continuous data) and their 95% CIs will be calculated. Where statistical pooling is not possible, a narrative synthesis will be conducted for the included studies. To assess the heterogeneity of effects, I2 together with the observed effects will be evaluated to provide the true effects in the analysis. ETHICS AND DISSEMINATION Formal ethical approval from an institutional review board or research ethics committee is not required as primary data will not be collected. The final results of this study will be published in an open-access peer-reviewed journal, and abstract will be presented at suitable national/international conferences or workshops. We will also share important information with public health authorities as well as with the WHO. In addition, we may post the submitted manuscript under review to medRxiv, or other relevant preprint servers. TRIAL REGISTRATION NUMBER CRD42020207338.
Collapse
Affiliation(s)
- Krishna Regmi
- Institute for Health Research, Faculty of Health and Social Sciences, University of Bedfordshire, Luton, UK
| | - Cho Mar Lwin
- Department of Rheumatology, University of Medicine Mandalay, Mandalay, Myanmar
| |
Collapse
|
20
|
Ling XC, Kang EYC, Lin JY, Chen HC, Lai CC, Ma DHK, Wu WC. Ocular manifestation, comorbidities, and detection of severe acute respiratory syndrome-coronavirus 2 from conjunctiva in coronavirus disease 2019: A systematic review and meta-analysis. Taiwan J Ophthalmol 2020; 10:153-166. [PMID: 33110745 PMCID: PMC7585479 DOI: 10.4103/tjo.tjo_53_20] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2020] [Accepted: 07/31/2020] [Indexed: 01/08/2023] Open
Abstract
The coronavirus disease 2019 (COVID 19) pandemic has presented major challenges to ophthalmologists. Reports have shown that ocular manifestations can be the first presenting symptoms of COVID 19 infection and conjunctiva may be a portal of entry for the severe acute respiratory syndrome (SARS) associated coronavirus 2 (SARS CoV 2). The purpose of this article is to provide general guidance for ophthalmologists to understand the prevalence of ocular presentation in COVID 19 patients and to reduce the risk of transmission during practice. Relevant studies published in the period of November 1, 2019, and July 15, 2020, regarding ocular manifestations of COVID 19 and detection of SARS CoV 2 in the eye were included in this systematic review and meta analysis. The pooled prevalence of the ocular manifestations has been estimated at 7% (95% confidence interval [CI]: 0.03–0.10) among COVID 19 patients. The pooled detection rate of SARS CoV 2 from conjunctiva was low (1%, 95% CI: 0.00–0.03). Conjunctival symptoms were the most common ocular manifestations in COVID 19, but the positive detection rate of the SARS CoV 2 virus by reverse transcription–polymerase chain reaction of conjunctival tears or secretions remained low. No study has shown a definite transmission of COVID 19 through ocular mucosa or secretions. In summary, ocular manifestations in COVID 19 patients commonly comprise ocular surface symptoms. Although a low prevalence of ocular symptoms was encountered among patients infected by SARS CoV 2, it is imperative for all ophthalmologists to understand the full spectrum of COVID 19 symptoms or signs including those of the eyes as well as to adopt appropriate protective measures during clinical practice.
Collapse
Affiliation(s)
- Xiao Chun Ling
- Department of Ophthalmology, Chang Gung Memorial Hospital, Linkou, Taiwan
| | | | - Jui-Yen Lin
- Department of Ophthalmology, Chang Gung Memorial Hospital, Linkou, Taiwan
| | - Hung-Chi Chen
- Department of Ophthalmology, Chang Gung Memorial Hospital, Linkou, Taiwan.,Department of Medicine, College of Medicine, Chang Gung University, Taoyuan, Taiwan
| | - Chi-Chun Lai
- Department of Medicine, College of Medicine, Chang Gung University, Taoyuan, Taiwan.,Department of Ophthalmology, Chang Gung Memorial Hospital, Keelung, Taiwan
| | - David Hui-Kang Ma
- Department of Ophthalmology, Chang Gung Memorial Hospital, Linkou, Taiwan.,Department of Chinese Medicine, College of Medicine, Chang Gung University, Taoyuan, Taiwan.,Department of Ophthalmology, Xiamen Chang Gung Hospital, Xiamen, Fujian, China
| | - Wei-Chi Wu
- Department of Ophthalmology, Chang Gung Memorial Hospital, Linkou, Taiwan.,Department of Medicine, College of Medicine, Chang Gung University, Taoyuan, Taiwan
| |
Collapse
|
21
|
Valente P, Iarossi G, Federici M, Petroni S, Palma P, Cotugno N, De Ioris MA, Campana A, Buzzonetti L. Ocular manifestations and viral shedding in tears of pediatric patients with coronavirus disease 2019: a preliminary report. J AAPOS 2020; 24:212-215. [PMID: 32531341 PMCID: PMC7282793 DOI: 10.1016/j.jaapos.2020.05.002] [Citation(s) in RCA: 49] [Impact Index Per Article: 12.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/17/2020] [Revised: 05/30/2020] [Accepted: 05/30/2020] [Indexed: 12/24/2022]
Abstract
PURPOSE To evaluate ocular manifestations and severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) prevalence in the tears of children with coronavirus disease 2019 (COVID-19). METHODS A total of 27 pediatric patients with confirmed COVID-19 infection hospitalized from March 16 to April 15, 2020, at the Bambino Gesù Children's Hospital were enrolled in the study. At admission, all patients showed ocular manifestations. Reverse transcriptase-polymerase chain reaction from nasopharyngeal and conjunctival swabs were performed every 2-3 days before discharge. RESULTS Of the 27 patients, 4 (15%) were asymptomatic, 15 (56%) showed respiratory symptoms, and 8 (30%) had gastrointestinal symptoms. At admission, nasopharyngeal swabs were positive for COVID-19 in all patients; on the second swabs, 7 children (26%) tested negative, and 20 remained positive for COVID-19. Ocular manifestations consistent with mild viral conjunctivitis were observed in 4 patients (15%). At first conjunctival swab, 3 patients (11%), 1 symptomatic and 2 asymptomatic for ocular infection, had positive findings for COVID-19; 2 became negative on the second test and 1 on the third. CONCLUSIONS In our study cohort, ocular manifestations of COVID-19 seem to have had a milder clinical course in pediatric patients than in adults. Despite the low prevalence and rapid regression of viral presence in the conjunctiva, SARS-CoV-2 transmission through tears may be possible, even in patients without apparent ocular involvement.
Collapse
Affiliation(s)
- Paola Valente
- Ophthalmology Department, Bambino Gesù IRCCS Pediatric Hospital, Rome, Italy.
| | - Giancarlo Iarossi
- Ophthalmology Department, Bambino Gesù IRCCS Pediatric Hospital, Rome, Italy
| | - Matteo Federici
- Ophthalmology Department, Bambino Gesù IRCCS Pediatric Hospital, Rome, Italy
| | - Sergio Petroni
- Ophthalmology Department, Bambino Gesù IRCCS Pediatric Hospital, Rome, Italy
| | - Paolo Palma
- Academic Department of Pediatrics (DPUO), Unit of Perinatal Infection and Congenital Infectious Diseases, Bambino Gesù IRCCS Pediatric Hospital, Rome, Italy
| | - Nicola Cotugno
- Academic Department of Pediatrics (DPUO), Unit of Perinatal Infection and Congenital Infectious Diseases, Bambino Gesù IRCCS Pediatric Hospital, Rome, Italy
| | - Maria A De Ioris
- Pediatric Department, Bambino Gesù IRCCS Pediatric Hospital, Rome, Italy
| | - Andrea Campana
- Pediatric Department, Bambino Gesù IRCCS Pediatric Hospital, Rome, Italy
| | - Luca Buzzonetti
- Ophthalmology Department, Bambino Gesù IRCCS Pediatric Hospital, Rome, Italy
| |
Collapse
|
22
|
Guo D, Xia J, Wang Y, Zhang X, Shen Y, Tong JP. Relapsing viral keratoconjunctivitis in COVID-19: a case report. Virol J 2020; 17:97. [PMID: 32641169 PMCID: PMC7341713 DOI: 10.1186/s12985-020-01370-6] [Citation(s) in RCA: 28] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2020] [Accepted: 06/23/2020] [Indexed: 01/01/2023] Open
Abstract
BACKGROUND Since the outbreak of Coronavirus Disease 2019 (COVID-19) in December 2019, many studies have reported the presence of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in the conjunctival sac of patients infected with this virus, with several patients displaying symptoms of viral conjunctivitis. However, to our best knowledge, there is no in-depth report on the course of patients with COVID-19 complicated by relapsing viral conjunctivitis or keratoconjunctivitis. CASE PRESENTATION A 53-year-old man confirmed with COVID-19 developed symptoms of viral conjunctivitis in the left eye approximately 10 days after the onset of COVID-19. The results of a nucleic acid test were positive for SARS-CoV-2 in the conjunctival sac of the left eye. The symptoms were relieved 6 days after treatment. However, the patient was subsequently diagnosed with viral keratoconjunctivitis in both eyes 5 days after the symptoms in the left eye were satisfactorily relieved. The disease progressed rapidly, with spot staining observed at the periphery of the corneal epithelium. Although SARS-CoV-2 could not be detected in conjunctival secretions, the levels of inflammatory factors, such as interleukin-6, were increased in both eyes. Both eyes were treated with glucocorticoids, and symptoms were controlled within 5 days. There was no recurrence. CONCLUSIONS In this case report, the pathogenesis, clinical manifestations, treatment, and outcome of a case with COVID-19 complicated by relapsing viral keratoconjunctivitis is described, and the involvement of topical cytokine surge in the pathogenesis of COVID-19 as it relates to viral keratoconjunctivitis is reported.
Collapse
Affiliation(s)
- Dongyu Guo
- Department of Ophthalmology, Zhejiang University School of Medicine First Affiliated Hospital, Hangzhou, 310003, Zhejiang, China
| | - Jianhua Xia
- Department of Ophthalmology, Zhejiang University School of Medicine First Affiliated Hospital, Hangzhou, 310003, Zhejiang, China
| | - Yang Wang
- Department of Ophthalmology, Zhejiang University School of Medicine First Affiliated Hospital, Hangzhou, 310003, Zhejiang, China
| | - Xuhong Zhang
- Department of Ophthalmology, Zhejiang University School of Medicine First Affiliated Hospital, Hangzhou, 310003, Zhejiang, China
| | - Ye Shen
- Department of Ophthalmology, Zhejiang University School of Medicine First Affiliated Hospital, Hangzhou, 310003, Zhejiang, China.
| | - Jian-Ping Tong
- Department of Ophthalmology, Zhejiang University School of Medicine First Affiliated Hospital, Hangzhou, 310003, Zhejiang, China.
| |
Collapse
|
23
|
Coronavirus disease 2019 (SARS-CoV-2) and colonization of ocular tissues and secretions: a systematic review. Eye (Lond) 2020; 34:1206-1211. [PMID: 32424327 PMCID: PMC7232062 DOI: 10.1038/s41433-020-0926-9] [Citation(s) in RCA: 74] [Impact Index Per Article: 18.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2020] [Revised: 04/16/2020] [Accepted: 04/22/2020] [Indexed: 12/14/2022] Open
Abstract
Coronavirus disease 19 (COVID-19) has been described to potentially be complicated by ocular involvement. However, scant information is available regarding severe acute respiratory syndrome-coronavirus-2 (SARS-CoV-2) and ocular structures tropism. We conducted a systematic review of articles referenced in PubMed, Cochrane Library, Web of Science and Chinese Clinical Trial Register (ChiCTR) from December 20, 2019 to April 6, 2020, providing information on the presence of SARS-CoV-2 in cornea, conjunctiva, lacrimal sac, and tears. We excluded ongoing clinical studies as for unobtainable conclusive results. Of 2422 articles, 11 met the inclusion criteria for analysis and were included in the study. None of the studies were multinational. Among the 11 selected papers there were three original articles, one review, four letters, two editorials, and one correspondence letter. Globally, 252 SARS-CoV-2 infected patients were included in our review. The prevalence of ocular conjunctivitis complicating the course of COVID-19 was demonstrated to be as high as 32% in one study only. Globally, three patients had conjunctivitis with a positive tear-PCR, 8 patients had positive tear-PCR in the absence of conjunctivitis, and 14 had conjunctivitis with negative tear-PCR. The majority of the available data regarding SARS-CoV-2 colonization of ocular and periocular tissues and secretions have to be considered controversial. However, it cannot be excluded that SARS-CoV-2 could both infect the eye and the surrounding structures. SARS-CoV-2 may use ocular structure as an additional transmission route, as demonstrated by the COVID-19 patients' conjunctival secretion and tears positivity to reverse transcriptase-PCR SARS-CoV-2-RNA assay.
Collapse
|
24
|
Yu Y, Shi Q, Zheng P, Gao L, Li H, Tao P, Gu B, Wang D, Chen H. Assessment of the quality of systematic reviews on COVID-19: A comparative study of previous coronavirus outbreaks. J Med Virol 2020; 92:883-890. [PMID: 32301508 PMCID: PMC7264505 DOI: 10.1002/jmv.25901] [Citation(s) in RCA: 24] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2020] [Accepted: 04/14/2020] [Indexed: 12/12/2022]
Abstract
Several systematic reviews (SRs) have been conducted on the COVID-19 outbreak, which together with the SRs on previous coronavirus outbreaks, form important sources of evidence for clinical decision and policy making. Here, we investigated the methodological quality of SRs on COVID-19, severe acute respiratory syndrome (SARS), and Middle East respiratory syndrome (MERS). Online searches were performed to obtain SRs on COVID-19, SARS, and MERS. The methodological quality of the included SRs was assessed using the AMSTAR-2 tool. Descriptive statistics were used to present the data. In total, of 49 SRs that were finally included in our study, 17, 16, and 16 SRs were specifically on COVID-19, MERS, and SARS, respectively. The growth rate of SRs on COVID-19 was the highest (4.54/month) presently. Of the included SRs, 6, 12, and 31 SRs were of moderate, low, and critically low quality, respectively. SRs on SARS showed the optimum quality among the SRs on the three diseases. Subgroup analyses showed that the SR topic (P < .001), the involvement of a methodologist (P < .001), and funding support (P = .046) were significantly associated with the methodological quality of the SR. According to the adherence scores, adherence to AMSTAR-2 items sequentially decreased in SRs on SARS, MERS, and COVID-19. The methodological quality of most SRs on coronavirus outbreaks is unsatisfactory, and those on COVID-19 have higher risks of poor quality, despite the rapid actions taken to conduct SRs. The quality of SRs should be improved in the future. Readers must exercise caution in accepting and using the results of these SRs.
Collapse
Affiliation(s)
- Yang Yu
- The Department of Tumour Surgery, Lanzhou University Second Hospital, Lanzhou, China.,The Second Clinical Medical College, Lanzhou University, Lanzhou, China
| | - Qianling Shi
- The First Clinical Medical College, Lanzhou University, Lanzhou, China.,Evidence-Based Medicine Centre, School of Basic Medical Sciences, Lanzhou University, Lanzhou, China
| | - Peng Zheng
- The Department of Tumour Surgery, Lanzhou University Second Hospital, Lanzhou, China.,The Second Clinical Medical College, Lanzhou University, Lanzhou, China
| | - Lei Gao
- The Department of Tumour Surgery, Lanzhou University Second Hospital, Lanzhou, China.,The Second Clinical Medical College, Lanzhou University, Lanzhou, China
| | - Haiyuan Li
- The Department of Tumour Surgery, Lanzhou University Second Hospital, Lanzhou, China.,The Second Clinical Medical College, Lanzhou University, Lanzhou, China
| | - Pengxian Tao
- The Department of Tumour Surgery, Lanzhou University Second Hospital, Lanzhou, China.,The Second Clinical Medical College, Lanzhou University, Lanzhou, China
| | - Baohong Gu
- The Department of Tumour Surgery, Lanzhou University Second Hospital, Lanzhou, China.,The Second Clinical Medical College, Lanzhou University, Lanzhou, China
| | - Dengfeng Wang
- The Department of Tumour Surgery, Lanzhou University Second Hospital, Lanzhou, China.,The Second Clinical Medical College, Lanzhou University, Lanzhou, China
| | - Hao Chen
- The Department of Tumour Surgery, Lanzhou University Second Hospital, Lanzhou, China
| |
Collapse
|
25
|
UĞRAŞ DİKMEN A, KINA M, ÖZKAN S, İLHAN MN. COVID-19 Epidemiyolojisi: Pandemiden Ne Öğrendik. ACTA ACUST UNITED AC 2020. [DOI: 10.34084/bshr.715153] [Citation(s) in RCA: 23] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
|
26
|
Koh D, Cunningham AC. Counting Coronavirus Disease-2019 (COVID-19) Cases: Case Definitions, Screened
Populations and Testing Techniques Matter. ANNALS ACADEMY OF MEDICINE SINGAPORE 2020. [DOI: 10.47102/annals-acadmedsg.202038] [Citation(s) in RCA: 24] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
Abstract
While counting cases of disease appears straightforward, there are issues to consider
when enumerating disease counts during an epidemic. For example, for Coronavirus
Disease-2019 (COVID-19), how is a case defined? Hubei province in China changed
its case definition twice in a fortnight—from laboratory-confirmed cases to clinically confirmed cases without laboratory tests, and back to laboratory-confirmed cases. This
caused confusion in the reported number of cases. If a confirmed case requires laboratory testing, what is the population who are laboratory-tested? Due to limited laboratory testing capacity in the early phase of an emerging epidemic, only “suspected cases” are laboratory-tested in most countries. This will result in underdiagnosis of confirmed cases and also raises the question: how is a “suspect case” defined? With the passage of time and increased capability to perform laboratory tests, more people can be screened and the number of confirmed cases will increase. What are the technical considerations of laboratory testing? This includes specimen collection (variable collection methods), samples collected (upper or lower respiratory tract biospecimens), time of collection in relation to course of
disease, different laboratory test methods and kits (not all of which may be standardised or approved by authorities such as the Food and Drug Administration). Are approved laboratory facilities and trained manpower available, and how are test results interpreted and false-negatives excluded? These issues will affect the accuracy of disease counts, which in turn will have implications on how we mount an appropriate response to the outbreak.
Key words: Diagnosis, Laboratory testing, Outbreak, Pandemic, Screening
Collapse
Affiliation(s)
- David Koh
- PAPRSB Institute of Health Sciences, Universiti Brunei Darussalam, Brunei Darussalam. Saw Swee Hock School of Public Health, National University of Singapore, Singapore
| | | |
Collapse
|
27
|
Xia J, Tong J, Liu M, Shen Y, Guo D. Evaluation of coronavirus in tears and conjunctival secretions of patients with SARS-CoV-2 infection. J Med Virol 2020; 92:589-594. [PMID: 32100876 PMCID: PMC7228294 DOI: 10.1002/jmv.25725] [Citation(s) in RCA: 732] [Impact Index Per Article: 183.0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2020] [Accepted: 02/24/2020] [Indexed: 12/11/2022]
Abstract
Objective This study aimed to assess the presence of novel coronavirus in tears and conjunctival secretions of SARS–CoV‐2‐infected patients. Methods A prospective interventional case series study was performed, and 30 confirmed novel coronavirus pneumonia (NCP) patients were selected at the First Affiliated Hospital of Zhejiang University from 26 January 2020 to 9 February 2020. At an interval of 2 to 3 days, tear and conjunctival secretions were collected twice with disposable sampling swabs for reverse‐transcription polymerase chain reaction (RT‐PCR) assay. Results Twenty‐one common‐type and nine severe‐type NCP patients were enrolled. Two samples of tear and conjunctival secretions were obtained from the only one patient with conjunctivitis yielded positive RT‐PCR results. Fifty‐eight samples from other patents were all negative. Conclusion We speculate that SARS‐CoV‐2 may be detected in the tears and conjunctival secretions in NCP patients with conjunctivitis. SARS‐CoV‐2 may be detected in the tears and conjunctival secretions in NCP patients with conjunctivitis. SARS‐CoV‐2 was not detected in the conjunctival sac of NCP patients without conjunctivitis. The possibility of eye infection and the ocular route as a potential infection source should be considered and further examined, and scientific protection should be carried out.
Collapse
Affiliation(s)
- Jianhua Xia
- Department of Ophthalmology, Zhejiang University School of Medicine First Affiliated Hospital, Hangzhou, Zhejiang, China
| | - Jianping Tong
- Department of Ophthalmology, Zhejiang University School of Medicine First Affiliated Hospital, Hangzhou, Zhejiang, China
| | - Mengyun Liu
- Department of Ophthalmology, Zhejiang University School of Medicine First Affiliated Hospital, Hangzhou, Zhejiang, China
| | - Ye Shen
- Department of Ophthalmology, Zhejiang University School of Medicine First Affiliated Hospital, Hangzhou, Zhejiang, China
| | - Dongyu Guo
- Department of Ophthalmology, Zhejiang University School of Medicine First Affiliated Hospital, Hangzhou, Zhejiang, China
| |
Collapse
|
28
|
[Emergency response plan for the neonatal intensive care unit during epidemic of 2019 novel coronavirus]. ZHONGGUO DANG DAI ER KE ZA ZHI = CHINESE JOURNAL OF CONTEMPORARY PEDIATRICS 2020; 22:91-95. [PMID: 32051072 PMCID: PMC7390008 DOI: 10.7499/j.issn.1008-8830.2020.02.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 01/28/2020] [Indexed: 06/10/2023]
Abstract
2019 novel coronavirus (2019-nCoV) infection has been spreading in China since December 2019. Neonates are presumably the high-risk population susceptible to 2019-nCoV due to immature immune function. The neonatal intensive care unit (NICU) should be prepared for 2019-nCoV infections as far as possible. The emergency response plan enables the efficient response capability of NICU. During the epidemic of 2019-nCoV, the emergency response plan for the NICU should be based on the actual situation, including diagnosis, isolation, and treatment, as well as available equipment and staffing, and take into account the psychosocial needs of the families and neonatal care staff.
Collapse
|
29
|
Practical Guidance for Clinical Microbiology Laboratories: Viruses Causing Acute Respiratory Tract Infections. Clin Microbiol Rev 2018; 32:32/1/e00042-18. [PMID: 30541871 DOI: 10.1128/cmr.00042-18] [Citation(s) in RCA: 67] [Impact Index Per Article: 11.2] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Abstract
Respiratory viral infections are associated with a wide range of acute syndromes and infectious disease processes in children and adults worldwide. Many viruses are implicated in these infections, and these viruses are spread largely via respiratory means between humans but also occasionally from animals to humans. This article is an American Society for Microbiology (ASM)-sponsored Practical Guidance for Clinical Microbiology (PGCM) document identifying best practices for diagnosis and characterization of viruses that cause acute respiratory infections and replaces the most recent prior version of the ASM-sponsored Cumitech 21 document, Laboratory Diagnosis of Viral Respiratory Disease, published in 1986. The scope of the original document was quite broad, with an emphasis on clinical diagnosis of a wide variety of infectious agents and laboratory focus on antigen detection and viral culture. The new PGCM document is designed to be used by laboratorians in a wide variety of diagnostic and public health microbiology/virology laboratory settings worldwide. The article provides guidance to a rapidly changing field of diagnostics and outlines the epidemiology and clinical impact of acute respiratory viral infections, including preferred methods of specimen collection and current methods for diagnosis and characterization of viral pathogens causing acute respiratory tract infections. Compared to the case in 1986, molecular techniques are now the preferred diagnostic approaches for the detection of acute respiratory viruses, and they allow for automation, high-throughput workflows, and near-patient testing. These changes require quality assurance programs to prevent laboratory contamination as well as strong preanalytical screening approaches to utilize laboratory resources appropriately. Appropriate guidance from laboratorians to stakeholders will allow for appropriate specimen collection, as well as correct test ordering that will quickly identify highly transmissible emerging pathogens.
Collapse
|