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Alothman AA, Ebrahim MT, Gadelrab HF. Challenges, practices, and impact of COVID-19 among mothers of children with autism spectrum disorder in cities and remote areas in Saudi Arabia. Res Dev Disabil 2024; 148:104718. [PMID: 38484423 DOI: 10.1016/j.ridd.2024.104718] [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] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/01/2023] [Revised: 03/06/2024] [Accepted: 03/07/2024] [Indexed: 04/21/2024]
Abstract
BACKGROUND Mothers of children with autism spectrum disorder (ASD) across Saudi Arabia have experienced tremendous challenges during the COVID-19 pandemic. However, the challenges may be different for mothers living in a city compared to those living more remotely. AIMS We investigated challenges and practices related to COVID-19 and their impact among Saudi mothers of children with ASD in cities and remote areas during the pandemic. METHODS A sample of 99 mothers (60 in cities and 39 remote) who had a child with ASD was surveyed using an electronic questionnaire. RESULTS Mothers who lived in remote areas reported more challenges, while mothers in cities reported adopting more new practices with children than remote mothers. Regression analyses revealed that place of residence and age of the child were significant predictors of the challenges experienced by mothers of children with ASD. RECOMMENDATIONS Intervention services, community-based education programs, and electronic media are recommended for use with mothers in Saudi Arabia to increase awareness of COVID-19, improve practices, and minimize challenges in protecting their children with ASD.
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Affiliation(s)
| | - Mona Tawakkul Ebrahim
- Department of Educational Sciences, College of Education, Majmaah University, Majmaah 11952, Saudi Arabia
| | - Hesham Fathy Gadelrab
- Department of Psychology, College of Social Sciences, Kuwait University, Kuwait; Department of Educational Psychology, College of Education, Mansoura University, Egypt
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2
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Machii R, Takahashi H, Miyazawa J, Nakayama T. Cancer screening in Japan 2 years after the COVID-19 pandemic: Changes in participation, 2017-2021. Prev Med Rep 2024; 39:102649. [PMID: 38375089 PMCID: PMC10875236 DOI: 10.1016/j.pmedr.2024.102649] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2023] [Revised: 02/06/2024] [Accepted: 02/07/2024] [Indexed: 02/21/2024] Open
Abstract
Objectives The impact of the coronavirus disease (COVID-19) pandemic on cancer screening has become a global concern; compared with pre-pandemic levels, the number of individuals who underwent population-based cancer screening in Japan decreased by 10-30% in fiscal year (FY)2020. Therefore, it is important to monitor subsequent changes in the number of participants. Methods This descriptive study analysed data from a national database to determine changes from 2017 to 2021 in the number of people screened for gastric cancer (upper gastrointestinal [UGI] series or endoscopy), colorectal cancer (faecal immunochemical test), lung cancer (chest X-ray), breast cancer (mammography), and cervical cancer (Pap smear). Results Compared with the pre-pandemic period (FY 2017-2019), the number of participants in screening programmes in FY2021 decreased maximally for the gastric cancer UGI series (2.8 million to 2.2 million; -23.3 %), followed by those for lung cancer (7.9 million to 7.3 million; -8.2 %), colorectal cancer (8.4 million to 7.8 million; -7.3 %), breast cancer (3.1 million to 3.0 million; -4.5 %), and cervical cancer (4.3 million to 4.1 million; -3.2 %). Conversely, the number of people screened for endoscopic gastric cancer screening increased (1.0 million to 1.2 million; +13.1 %). Conclusions The number of participants, which decreased sharply immediately after the onset of the COVID-19 pandemic, recovered only slightly in FY2021 and did not return to pre-pandemic levels yet, except for endoscopic gastric cancer screening. Therefore, the impact of this decline in participation in cancer-detection programmes and changes in mortality should be monitored carefully.
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Affiliation(s)
- Ryoko Machii
- Division of Screening Assessment and Management, Institute for Cancer Control, National Cancer Center, 5-1-1 Tsukiji, Chuo-ku, Tokyo 104-0045, Japan
| | - Hirokazu Takahashi
- Division of Screening Assessment and Management, Institute for Cancer Control, National Cancer Center, 5-1-1 Tsukiji, Chuo-ku, Tokyo 104-0045, Japan
| | - Jin Miyazawa
- Division of Screening Assessment and Management, Institute for Cancer Control, National Cancer Center, 5-1-1 Tsukiji, Chuo-ku, Tokyo 104-0045, Japan
| | - Tomio Nakayama
- Division of Screening Assessment and Management, Institute for Cancer Control, National Cancer Center, 5-1-1 Tsukiji, Chuo-ku, Tokyo 104-0045, Japan
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3
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Woo S, Yang H, Kim Y, Lim H, Song HJ, Park KH. Sedentary Time and Fast-Food Consumption Associated With Weight Gain During COVID-19 Lockdown in Children and Adolescents With Overweight or Obesity. J Korean Med Sci 2022; 37:e103. [PMID: 35347907 PMCID: PMC8960937 DOI: 10.3346/jkms.2022.37.e103] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/10/2021] [Accepted: 03/10/2022] [Indexed: 11/20/2022] Open
Abstract
BACKGROUND The coronavirus disease pandemic is predicted to have adverse health effects on children and adolescents who are overweight or obese due to restricted school activity and stay-at-home orders. The purpose of this observational study was to determine the factors associated with weight gain in children and adolescents with overweight and obesity during coronavirus disease 2019 (COVID-19) lockdown. METHODS Ninety-seven participants (sex- and age-specific body mass index (BMI) ≥ 85th percentile) were included. A baseline examination was conducted pre-COVID-19 (August 2019 to January 2020), and re-examination was performed post-lockdown (June to September 2020) and the results were compared. Correlation and regression analyses were conducted to investigate the association among changes in cardiometabolic markers and lifestyle behaviors with changes in BMI z-score. RESULTS During the COVID-19 pandemic, an increase in BMI z-score (2.56 [2.01-2.94] to 2.62 [2.03-3.18]) was noticed in children and adolescents with obesity. Changes in cardiometabolic markers including liver enzymes, triglycerides (r = 0.398), leptin (r = 0.578), and adiponectin (r = -0.326), as well as muscular strength (r = -0.212), were correlated with the increase in BMI z-score. According to a multivariate regression analysis, changes in sedentary time (B = 0.016; 95% confidence interval [CI], 0.001-0.032) and fast-food consumption (B = 0.067; 95% CI, 0.013-0.122) were the lifestyle variables associated with BMI z-score increase. CONCLUSION Changes in lifestyle behaviors including fast-food consumption and sedentary time during the COVID-19 pandemic may be associated with weight gain. In order to prevent health-related risks in children and adolescents with obesity during the pandemic, it is important to maintain the level of physical activity and healthy dietary habits.
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Affiliation(s)
- Sarah Woo
- Department of Medical Sciences, College of Medicine, Hallym University, Chuncheon, Korea
| | - Heonil Yang
- Department of Family Medicine, Hallym University Sacred Heart Hospital, Hallym University, Anyang, Korea
| | - YoonMyung Kim
- University College, Yonsei University International Campus, Incheon, Korea
| | - Hyunjung Lim
- Department of Medical Nutrition, Kyung Hee University, Yongin, Korea
| | - Hong Ji Song
- Department of Family Medicine, Hallym University Sacred Heart Hospital, Hallym University, Anyang, Korea
| | - Kyung Hee Park
- Department of Family Medicine, Hallym University Sacred Heart Hospital, Hallym University, Anyang, Korea.
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Ajirak M, Heiselman C, Fuchs A, Heiligenstein M, Herrera K, Garretto D, Djurić PM. Bayesian Nonparametric Dimensionality Reduction of Categorical Data for Predicting Severity of COVID-19 in Pregnant Women. Proc Eur Signal Process Conf EUSIPCO 2021; 2021:1980-4. [PMID: 35291722 DOI: 10.23919/eusipco54536.2021.9616021] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
The coronavirus disease (COVID-19) has rapidly spread throughout the world and while pregnant women present the same adverse outcome rates, they are underrepresented in clinical research. We collected clinical data of 155 test-positive COVID-19 pregnant women at Stony Brook University Hospital. Many of these collected data are of multivariate categorical type, where the number of possible outcomes grows exponentially as the dimension of data increases. We modeled the data within the unsupervised Bayesian framework and mapped them into a lower dimensional space using latent Gaussian processes. The latent features in the lower dimensional space were further used for predicting if a pregnant woman would be admitted to a hospital due to COVID-19 or would remain with mild symptoms. We compared the prediction accuracy with the dummy/one-hot encoding of categorical data and found that the latent Gaussian process had better accuracy.
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Lopez S, Finuf KD, Marziliano A, Sinvani L, Burns EA. Palliative Care Consultation in Hospitalized Patients With COVID-19: A Retrospective Study of Characteristics, Outcomes, and Unmet Needs. J Pain Symptom Manage 2021; 62:267-276. [PMID: 33359040 PMCID: PMC7844404 DOI: 10.1016/j.jpainsymman.2020.12.015] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/30/2020] [Revised: 12/14/2020] [Accepted: 12/16/2020] [Indexed: 12/23/2022]
Abstract
CONTEXT Few studies have described the characteristics and palliative care needs in hospitalized patients with coronavirus disease 2019 (COVID-19). OBJECTIVES Describing characteristics, consultation demands, patients' needs, and outcomes of hospitalized patients with COVID-19 who received a palliative care evaluation. METHODS Retrospective chart review of patients (aged 18+ years) with COVID-19 admitted to an academic quaternary center and seen by the geriatrics and palliative medicine team from March 1st to May 11th, 2020. Socio-demographics, operational metrics, severity of illness, goals of care-advanced care planning documentation, and outcomes were analyzed. RESULTS Three hundred seventy-six (17.6%) out of 2138 COVID-19 admissions were seen by the consultation team. Compared with prepandemic situation (September 1st, 2019, to February 29th, 2020), overall new consults (205 vs. 371, P < 0.001) significantly increased, particularly in the intensive care unit (ICU; 9.5% vs. 36.9%, P < 0.001). For the COVID-19 population, median age was 78 years (interquartile range, 70-87; range, 36-102); 56% were male. LACE score, D-dimer, and C-reactive protein suggested severe disease and increased risk of mortality. Seventy-five percent of consults were for goals of care-advanced care planning, and 9.6% for symptoms. During the index admission, 7.1% had documented advanced directives, and 69.7% became do not resuscitate. Of all deaths, 55.5% were in the ICU, and 87.2% were aged ≥65 years. Underserved minority patients had a disproportionate mortality. Overall consultation mortality (38.3% vs. 70.4%, P < 0.001) and ICU mortality (55.2% vs. 78.1%, P < 0.001) significantly increased compared with those before COVID-19. CONCLUSION During this pandemic, understanding inpatient specialized palliative care needs and the vulnerable populations driving these causes may encourage health-care agencies and local, state, and federal governments to support the dedicated palliative care workforce.
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Affiliation(s)
- Santiago Lopez
- Division of Geriatrics and Palliative Medicine, Department of Medicine, Zucker School of Medicine at Hofstra Northwell, Manhasset, New York, USA.
| | - Kayla D Finuf
- The Feinstein Institute for Medical Research, Center for Health Innovation and Outcomes Research (CHIOR), Department of Medicine, Northwell Health, Manhasset, New York, USA
| | - Allison Marziliano
- The Feinstein Institute for Medical Research, Center for Health Innovation and Outcomes Research (CHIOR), Department of Medicine, Northwell Health, Manhasset, New York, USA
| | - Liron Sinvani
- Division of Geriatrics and Palliative Medicine, Department of Medicine, Zucker School of Medicine at Hofstra Northwell, Manhasset, New York, USA; The Feinstein Institute for Medical Research, Center for Health Innovation and Outcomes Research (CHIOR), Department of Medicine, Northwell Health, Manhasset, New York, USA
| | - Edith A Burns
- Division of Geriatrics and Palliative Medicine, Department of Medicine, Zucker School of Medicine at Hofstra Northwell, Manhasset, New York, USA; The Feinstein Institute for Medical Research, Center for Health Innovation and Outcomes Research (CHIOR), Department of Medicine, Northwell Health, Manhasset, New York, USA
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Qureshi AI, Baskett WI, Huang W, Shyu D, Myers D, Lobanova I, Naqvi SH, Thompson VS, Shyu CR. Effect of Race and Ethnicity on In-Hospital Mortality in Patients with COVID-19. Ethn Dis 2021; 31:389-398. [PMID: 34295125 PMCID: PMC8288468 DOI: 10.18865/ed.31.3.389] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
Objective To identify differences in short-term outcomes of patients with coronavirus disease 2019 (COVID-19) according to various racial/ethnic groups. Design Analysis of Cerner de-identified COVID-19 dataset. Setting A total of 62 health care facilities. Participants The cohort included 49,277 adult COVID-19 patients who were hospitalized from December 1, 2019 to November 13, 2020. Main Outcome Measures The primary outcome of interest was in-hospital mortality. The secondary outcome was non-routine discharge (discharge to destinations other than home, such as short-term hospitals or other facilities including intermediate care and skilled nursing homes). Methods We compared patients' age, gender, individual components of Charlson and Elixhauser comorbidities, medical complications, use of do-not-resuscitate, use of palliative care, and socioeconomic status between various racial and/or ethnic groups. We further compared the rates of in-hospital mortality and non-routine discharges between various racial and/or ethnic groups. Results Compared with White patients, in-hospital mortality was significantly higher among African American (OR 1.5; 95%CI:1.3-1.6, P<.001), Hispanic (OR1.4; 95%CI:1.3-1.6, P<.001), and Asian or Pacific Islander (OR 1.5; 95%CI: 1.1-1.9, P=.002) patients after adjustment for age and gender, Elixhauser comorbidities, do-not-resuscitate status, palliative care use, and socioeconomic status. Conclusions Our study found that, among hospitalized patients with COVID-2019, African American, Hispanic, and Asian or Pacific Islander patients had increased mortality compared with White patients after adjusting for sociodemographic factors, comorbidities, and do-not-resuscitate/palliative care status. Our findings add additional perspective to other recent studies.
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Affiliation(s)
- Adnan I Qureshi
- Zeenat Qureshi Stroke Institutes and Department of Neurology, University of Missouri, Columbia, MO
| | - William I. Baskett
- Institute for Data Science and Informatics, University of Missouri, Columbia, MO
| | - Wei Huang
- Zeenat Qureshi Stroke Institutes and Department of Neurology, University of Missouri, Columbia, MO
| | - Daniel Shyu
- Department of Medicine, University of Missouri, Columbia, MO
| | - Danny Myers
- Tiger Institute for Health Innovation, Cerner Corporation, Columbia, MO
| | - Iryna Lobanova
- Zeenat Qureshi Stroke Institutes and Department of Neurology, University of Missouri, Columbia, MO
| | - S. Hasan Naqvi
- Department of Internal Medicine, University of Missouri, Columbia, MO
| | - Vetta S. Thompson
- Brown School of Public Health Program, Washington University, St. Louis, MO
| | - Chi-Ren Shyu
- Institute for Data Science and Informatics, University of Missouri, Columbia, MO
- Department of Medicine, University of Missouri, Columbia, MO
- Department of Electrical Engineering and Computer Science, University of Missouri, Columbia, MO
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Kassania SH, Kassanib PH, Wesolowskic MJ, Schneidera KA, Detersa R. Automatic Detection of Coronavirus Disease (COVID-19) in X-ray and CT Images: A Machine Learning Based Approach. Biocybern Biomed Eng 2021; 41:867-879. [PMID: 34108787 PMCID: PMC8179118 DOI: 10.1016/j.bbe.2021.05.013] [Citation(s) in RCA: 91] [Impact Index Per Article: 30.3] [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] [Received: 04/22/2020] [Accepted: 05/13/2021] [Indexed: 12/23/2022]
Abstract
The newly identified Coronavirus pneumonia, subsequently termed COVID-19, is highly transmittable and pathogenic with no clinically approved antiviral drug or vaccine available for treatment. The most common symptoms of COVID-19 are dry cough, sore throat, and fever. Symptoms can progress to a severe form of pneumonia with critical complications, including septic shock, pulmonary edema, acute respiratory distress syndrome and multi-organ failure. While medical imaging is not currently recommended in Canada for primary diagnosis of COVID-19, computer-aided diagnosis systems could assist in the early detection of COVID-19 abnormalities and help to monitor the progression of the disease, potentially reduce mortality rates. In this study, we compare popular deep learning-based feature extraction frameworks for automatic COVID-19 classification. To obtain the most accurate feature, which is an essential component of learning, MobileNet, DenseNet, Xception, ResNet, InceptionV3, InceptionResNetV2, VGGNet, NASNet were chosen amongst a pool of deep convolutional neural networks. The extracted features were then fed into several machine learning classifiers to classify subjects as either a case of COVID-19 or a control. This approach avoided task-specific data pre-processing methods to support a better generalization ability for unseen data. The performance of the proposed method was validated on a publicly available COVID-19 dataset of chest X-ray and CT images. The DenseNet121 feature extractor with Bagging tree classifier achieved the best performance with 99% classification accuracy. The second-best learner was a hybrid of the a ResNet50 feature extractor trained by LightGBM with an accuracy of 98.
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Affiliation(s)
| | | | | | | | - Ralph Detersa
- Department of Computer Science, University of Saskatchewan, Canada
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Sun QG, An XD, Xie P, Jiang B, Tian JX, Yang Q, Li XY, Luo M, Liu P, Zhao SH, Duan LY, Lang SP, Fan A, Luo PC, Lian FM, Huang XD, Tong XL. Traditional Chinese Medicine Decoctions Significantly Reduce the Mortality in Severe and Critically Ill Patients with COVID-19: A Retrospective Cohort Study. Am J Chin Med 2021; 49:1063-1092. [PMID: 34107858 DOI: 10.1142/s0192415x21500518] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
Coronavirus disease (COVID-19) is a new infectious disease associated with high mortality, and traditional Chinese medicine decoctions (TCMDs) have been widely used for the treatment of patients with COVID-19 in China; however, the impact of these decoctions on severe and critical COVID-19-related mortality has not been evaluated. Therefore, we aimed to address this gap. In this retrospective cohort study, we included inpatients diagnosed with severe/critical COVID-19 at the Tongren Hospital of Wuhan University and grouped them depending on the recipience of TCMDs (TCMD and non-TCMD groups). We conducted a propensity score-matched analysis to adjust the imbalanced variables and treatments and used logistic regression methods to explore the risk factors associated with in-hospital death. Among 282 patients with COVID-19 who were discharged or died, 186 patients (66.0%) received TCMD treatment (TCMD cohort) and 96 (34.0%) did not (non-TCMD cohort). After propensity score matching at a 1:1 ratio, 94 TCMD users were matched to 94 non-users, and there were no significant differences in baseline clinical variables between the two groups of patients. The all-cause mortality was significantly lower in the TCMD group than in the non-TCMD group, and this trend remained valid even after matching (21.3% [20/94] vs. 39.4% [37/94]). Multivariable logistic regression model showed that disease severity (odds ratio: 0.010; 95% CI: 0.003, 0.037; [Formula: see text]¡ 0.001) was associated with increased odds of death and that TCMD treatment significantly decreased the odds of in-hospital death (odds ratio: 0.115; 95% CI: 0.035, 0.383; [Formula: see text]¡ 0.001), which was related to the duration of TCMD treatment. Our findings show that TCMD treatment may reduce the mortality in patients with severe/critical COVID-19.
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Affiliation(s)
- Qin-Guo Sun
- Department of Traditional Chinese Medicine, Wuhan Third Hospital, Tongren Hospital of Wuhan University, Wuhan 430060, P. R. China
| | - Xue-Dong An
- Department of Endocrine, Guang'anmen Hospital, Chinese Academy of Traditional Chinese Medicine, Beijing 100053, P. R. China
| | - Ping Xie
- Department of Traditional Chinese Medicine, Wuhan Third Hospital, Tongren Hospital of Wuhan University, Wuhan 430060, P. R. China
| | - Bo Jiang
- Department of Traditional Chinese Medicine, Wuhan Third Hospital, Tongren Hospital of Wuhan University, Wuhan 430060, P. R. China
| | - Jia-Xing Tian
- Department of Endocrine, Guang'anmen Hospital, Chinese Academy of Traditional Chinese Medicine, Beijing 100053, P. R. China
| | - Qian Yang
- Department of Traditional Chinese Medicine, Wuhan Third Hospital, Tongren Hospital of Wuhan University, Wuhan 430060, P. R. China
| | - Xiu-Yang Li
- Department of Endocrine, Guang'anmen Hospital, Chinese Academy of Traditional Chinese Medicine, Beijing 100053, P. R. China
| | - Meng Luo
- Department of Traditional Chinese Medicine, Wuhan Third Hospital, Tongren Hospital of Wuhan University, Wuhan 430060, P. R. China
| | - Ping Liu
- Drug clinical trial institution, Guang'anmen Hospital, Chinese Academy of Traditional Chinese Medicine, Beijing 100053, P. R. China
| | - Sheng-Hui Zhao
- Department of Endocrine, Guang'anmen Hospital, Chinese Academy of Traditional Chinese Medicine, Beijing 100053, P. R. China
| | - Li-Yun Duan
- Department of Endocrine, Guang'anmen Hospital, Chinese Academy of Traditional Chinese Medicine, Beijing 100053, P. R. China
| | - Su-Ping Lang
- Data center, GCP ClinPlus Co., Ltd., Beijing 100160, P R. China
| | - An Fan
- Data center, GCP ClinPlus Co., Ltd., Beijing 100160, P R. China
| | - Peng-Cheng Luo
- Department of Urology, Tongren Hospital of Wuhan University, Wuhan 430060, P. R. China
| | - Feng-Mei Lian
- Department of Endocrine, Guang'anmen Hospital, Chinese Academy of Traditional Chinese Medicine, Beijing 100053, P. R. China
| | - Xiao-Dong Huang
- Department of Gastrology, Wuhan Third Hospital, Tongren Hospital of Wuhan University, Wuhan 430060, P. R. China
| | - Xiao-Lin Tong
- Department of Endocrine, Guang'anmen Hospital, Chinese Academy of Traditional Chinese Medicine, Beijing 100053, P. R. China
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Kafan S, Tadbir Vajargah K, Sheikhvatan M, Tabrizi G, Salimzadeh A, Montazeri M, Majidi F, Maghuli N, Pazoki M. Predicting Risk Score for Mechanical Ventilation in Hospitalized Adult Patients Suffering from COVID-19. Anesth Pain Med 2021; 11:e112424. [PMID: 34336617 PMCID: PMC8314086 DOI: 10.5812/aapm.112424] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [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: 01/15/2021] [Revised: 03/08/2021] [Accepted: 03/12/2021] [Indexed: 12/29/2022] Open
Abstract
Background COVID-19 has become a pandemic since December 2019, causing millions of deaths worldwide. It has a wide spectrum of severity, ranging from mild infection to severe illness requiring mechanical ventilation. In the middle of a pandemic, when medical resources (including mechanical ventilators) are scarce, there should be a scoring system to provide the clinicians with the information needed for clinical decision-making and resource allocation. Objectives This study aimed to develop a scoring system based on the data obtained on admission, to predict the need for mechanical ventilation in COVID-19 patients. Methods This study included COVID-19 patients admitted to Sina Hospital, Tehran University of Medical Sciences from February 20 to May 29, 2020. Patients' data on admission were retrospectively recruited from Sina Hospital COVID-19 Registry (SHCo-19R). Multivariable logistic regression and receiver operating characteristic (ROC) curve analysis were performed to identify the predictive factors for mechanical ventilation. Results A total of 681 patients were included in the study; 74 patients (10.9%) needed mechanical ventilation during hospitalization, while 607 (89.1%) did not. Multivariate logistic analysis revealed that age (OR,1.049; 95% CI:1.008-1.091), history of diabetes mellitus (OR,3.216; 95% CI:1.134-9.120), respiratory rate (OR,1.051; 95% CI:1.005-1.100), oxygen saturation (OR,0.928; 95% CI:0.872-0.989), CRP (OR,1.013; 95% CI:1.001-1.024) and bicarbonate level (OR,0.886; 95% CI:0.790-0.995) were risk factors for mechanical ventilation during hospitalization. Conclusions A risk score has been developed based on the available data within the first hours of hospital admission to predict the need for mechanical ventilation. This risk score should be further validated to determine its applicability in other populations.
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Affiliation(s)
- Samira Kafan
- Department of Pulmonary Medicine, Sina Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Kiana Tadbir Vajargah
- Student's Scientific Research Center (SSRC), Tehran University of Medical Sciences, Tehran, Iran
- Corresponding Author: Student's Scientific Research Center (SSRC), Tehran University of Medical Sciences, Tehran, Iran.
| | - Mehrdad Sheikhvatan
- Heidelberg Medical Hospital, Heidelberg, Germany
- Research Development Center, Sina Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Gholamreza Tabrizi
- Research Development Center, Sina Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Ahmad Salimzadeh
- Rheumatology Research Center, Sina Hospital, Tehran University of Medical Science, Tehran, Iran
- Department of Internal Medicine, Sina Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Mahnaz Montazeri
- Department of Infectious Diseases, Sina Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Fazeleh Majidi
- Research Development Center, Sina Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Negin Maghuli
- Department of Internal Medicine, Sina Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Marzieh Pazoki
- Department of Pulmonary Medicine, Sina Hospital, Tehran University of Medical Sciences, Tehran, Iran
- Corresponding Author: Department of Pulmonary Medicine, Sina Hospital, Tehran University of Medical Sciences, Tehran, Iran.
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Kang SH, Kim SW, Kim AY, Cho KH, Park JW, Do JY. Association between Chronic Kidney Disease or Acute Kidney Injury and Clinical Outcomes in COVID-19 Patients. J Korean Med Sci 2020; 35:e434. [PMID: 33372426 PMCID: PMC7769703 DOI: 10.3346/jkms.2020.35.e434] [Citation(s) in RCA: 23] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/15/2020] [Accepted: 12/09/2020] [Indexed: 01/15/2023] Open
Abstract
BACKGROUND A population-based study would be useful to identify the association between chronic kidney disease (CKD) or acute kidney injury (AKI) and prognosis of coronavirus disease 2019 (COVID-19) patients. METHODS This retrospective study utilized the claim data from Korea. Patients who underwent COVID-19 testing and were confirmed to be positive were included and divided into the following three groups based on the presence of CKD or requirement of maintenance dialysis: Non-CKD (participants without CKD), non-dialysis CKD (ND-CKD), and dialysis-dependent CKD (DD-CKD) patients. We collected data on the development of severe clinical outcomes and death during follow-up. Severe clinical outcomes were defined as the use of inotropics, conventional oxygen therapy, high-flow nasal cannula, mechanical ventilation, or extracorporeal membrane oxygenation and the development of AKI, cardiac arrest, myocardial infarction, or acute heart failure after the diagnosis of COVID-19. AKI was defined as the initiation of renal replacement therapy after the diagnosis of COVID-19 in patients not requiring maintenance dialysis. Death was evaluated according to survival at the end of follow-up. RESULTS Altogether, 7,341 patients were included. The median duration of data collection was 19 (interquartile range, 11-28) days. On multivariate analyses, odds ratio (OR) for severe clinical outcomes in the ND-CKD group was 0.88 (95% confidence interval [CI], 0.64-1.20; P = 0.422) compared to the Non-CKD group. The DD-CKD group had ORs of 7.32 (95% CI, 2.14-33.90; P = 0.004) and 8.32 (95% CI, 2.37-39.21; P = 0.002) compared to the Non-CKD and ND-CKD groups, respectively. Hazard ratio (HR) for death in the ND-CKD group was 0.79 (95% CI, 0.49-1.26; P = 0.318) compared to the Non-CKD group. The DD-CKD group had HRs of 2.96 (95% CI, 1.09-8.06; P = 0.033) and 3.77 (95% CI, 1.29-11.06; P = 0.016) compared to the Non-CKD and ND-CKD groups, respectively. DD-CKD alone was associated with severe clinical outcomes and higher mortality. There was no significant difference in frequency of severe clinical outcomes or mortality rates between the Non-CKD and ND-CKD groups. In patients not requiring maintenance dialysis, AKI was associated with old age, male sex, and high Charlson's comorbidity index score but not with the presence of CKD. HRs for patients with AKI were 11.26 (95% CI, 7.26-17.45; P < 0.001) compared to those for patients without AKI in the multivariate analysis. AKI was associated with severe clinical outcomes and patient survival, rather than underlying CKD. CONCLUSION CKD requiring dialysis is associated with severe clinical outcomes and mortality in patients with COVID-19; however, the development of AKI is more strongly associated with severe clinical outcomes and mortality.
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Affiliation(s)
- Seok Hui Kang
- Division of Nephrology, Department of Internal Medicine, College of Medicine, Yeungnam University, Daegu, Korea
| | - Sang Won Kim
- Medical Research Center, College of Medicine, Yeungnam University Medical Center, Daegu, Korea
| | - A Young Kim
- Division of Nephrology, Department of Internal Medicine, College of Medicine, Yeungnam University, Daegu, Korea
| | - Kyu Hyang Cho
- Division of Nephrology, Department of Internal Medicine, College of Medicine, Yeungnam University, Daegu, Korea
| | - Jong Won Park
- Division of Nephrology, Department of Internal Medicine, College of Medicine, Yeungnam University, Daegu, Korea
| | - Jun Young Do
- Division of Nephrology, Department of Internal Medicine, College of Medicine, Yeungnam University, Daegu, Korea.
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Singh S, Bilal M, Pakhchanian H, Raiker R, Kochhar GS, Thompson CC. Impact of Obesity on Outcomes of Patients With Coronavirus Disease 2019 in the United States: A Multicenter Electronic Health Records Network Study. Gastroenterology 2020; 159:2221-2225.e6. [PMID: 32835663 PMCID: PMC7441935 DOI: 10.1053/j.gastro.2020.08.028] [Citation(s) in RCA: 25] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/16/2020] [Revised: 08/15/2020] [Accepted: 08/18/2020] [Indexed: 01/26/2023]
Affiliation(s)
- Shailendra Singh
- Division of Gastroenterology and Hepatology, West Virginia University, Morgantown, West Virginia.
| | - Mohammad Bilal
- Division of Gastroenterology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts
| | - Haig Pakhchanian
- George Washington University School of Medicine & Health Science, Washington, DC
| | - Rahul Raiker
- Department of Medicine, West Virginia University School of Medicine, Morgantown, West Virginia
| | - Gursimran S. Kochhar
- Division of Gastroenterology, Hepatology & Nutrition, Allegheny Health Network, Pittsburgh, Pennsylvania
| | - Christopher C. Thompson
- Harvard Medical School, Boston, Massachusetts,Division of Gastroenterology, Hepatology and Endoscopy, Brigham and Women’s Hospital, Harvard Medical School, Boston, Massachusetts,Correspondence Address correspondence to: Christopher C. Thompson, MSc, MD, FASGE, FACG, AGAF, Harvard Medical School, Brigham and Women’s Hospital, Division of Gastroenterology, Hepatology, and Endoscopy, 75 Francis Street, Thorn 1404, Boston, Massachusetts 02115. fax: (617) 525-8740
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12
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Bordea IR, Xhajanka E, Candrea S, Bran S, Onișor F, Inchingolo AD, Malcangi G, Pham VH, Inchingolo AM, Scarano A, Lorusso F, Isacco CG, Aityan SK, Ballini A, Dipalma G, Inchingolo F. Coronavirus (SARS-CoV-2) Pandemic: Future Challenges for Dental Practitioners. Microorganisms 2020; 8:E1704. [PMID: 33142764 PMCID: PMC7694165 DOI: 10.3390/microorganisms8111704] [Citation(s) in RCA: 33] [Impact Index Per Article: 8.3] [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] [Received: 09/24/2020] [Revised: 10/28/2020] [Accepted: 10/29/2020] [Indexed: 12/15/2022] Open
Abstract
In the context of the SARS-CoV-2 (Severe acute respiratory syndrome coronavirus 2) pandemic, the medical system has been subjected to many changes. Face-to-face treatments have been suspended for a period of time. After the lockdown, dentists have to be aware of the modalities to protect themselves and their patients in order not to get infected. Dental practitioners are potentially exposed to a high degree of contamination with SARS-CoV-2 while performing dental procedures that produce aerosols. It should also be noted that the airways, namely the oral cavity and nostrils, are the access pathways for SARS-CoV-2. In order to protect themselves and their patients, they have to use full personal protective equipment. Relevant data regarding this pandemic are under evaluation and are still under test. In this article, we made a synthesis about the way in which SARS-CoV-2 spreads, how to diagnose a novel corona virus infection, what the possible treatments are, and which protective personal equipment we can use to stop its spreading.
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Affiliation(s)
- Ioana Roxana Bordea
- Department of Oral Rehabilitation, Faculty of Dentistry, Iuliu Hațieganu University of Medicine and Pharmacy, 400012 Cluj-Napoca, Romania
| | - Edit Xhajanka
- President of Dental School, Medical University of Tirana, Rruga e Dibrës, 1001 Tirana, Albania;
| | - Sebastian Candrea
- Department of Pedodontics, County Hospital Cluj-Napoca, 400000 Cluj-Napoca, Romania
| | - Simion Bran
- Department of Maxilofacial Surgery and Implantology, Faculty of Dentistry, Iuliu Hațieganu University of Medicine and Pharmacy, 400012 Cluj-Napoca, Romania; (S.B.); (F.O.)
| | - Florin Onișor
- Department of Maxilofacial Surgery and Implantology, Faculty of Dentistry, Iuliu Hațieganu University of Medicine and Pharmacy, 400012 Cluj-Napoca, Romania; (S.B.); (F.O.)
| | - Alessio Danilo Inchingolo
- Department of Interdisciplinary Medicine (D.I.M.), University of Medicine Aldo Moro, 70121 Bari, Italy; (A.D.I.); (G.M.); (A.M.I.); (G.D.); (F.I.)
| | - Giuseppina Malcangi
- Department of Interdisciplinary Medicine (D.I.M.), University of Medicine Aldo Moro, 70121 Bari, Italy; (A.D.I.); (G.M.); (A.M.I.); (G.D.); (F.I.)
| | - Van H Pham
- Nam Khoa Laboratories and Pham Chau Trinh University of Medicine, Hoi An 70000, Vietnam;
| | - Angelo Michele Inchingolo
- Department of Interdisciplinary Medicine (D.I.M.), University of Medicine Aldo Moro, 70121 Bari, Italy; (A.D.I.); (G.M.); (A.M.I.); (G.D.); (F.I.)
| | - Antonio Scarano
- Department of Medical, Oral and Biotechnological Sciences, University of Chieti-Pescara, 66100 Chieti, Italy; (A.S.); (F.L.)
| | - Felice Lorusso
- Department of Medical, Oral and Biotechnological Sciences, University of Chieti-Pescara, 66100 Chieti, Italy; (A.S.); (F.L.)
| | - Ciro Gargiulo Isacco
- Director of Research at Human Stem Cells Research Center HSC, Ho Chi Minh 70000, Vietnam;
- Associate Professor of Embryology and Regenerative Medicine and Immunology at Pham Chau Trinh University of Medicine, Hoi An 70000, Vietnam
- Visiting Professor of Regenerative Medicine and Metabolic Disorders at Department of Interdisciplinary Medicine (D.I.M.), University of Medicine Aldo Moro, 70121 Bari, Italy
| | - Sergey K Aityan
- Director of Multidisciplinary Research Center, Lincoln University, Oakland, CA 94102, USA;
| | - Andrea Ballini
- Department of Biosciences, Biotechnologies and Biopharmaceutics, Campus Universitario “Ernesto Quagliariello” University of Bari “Aldo Moro”, 70125 Bari, Italy;
- Department of Precision Medicine, University of Campania“Luigi Vanvitelli”, 80138 Naples, Italy
| | - Gianna Dipalma
- Department of Interdisciplinary Medicine (D.I.M.), University of Medicine Aldo Moro, 70121 Bari, Italy; (A.D.I.); (G.M.); (A.M.I.); (G.D.); (F.I.)
| | - Francesco Inchingolo
- Department of Interdisciplinary Medicine (D.I.M.), University of Medicine Aldo Moro, 70121 Bari, Italy; (A.D.I.); (G.M.); (A.M.I.); (G.D.); (F.I.)
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Kwon DH, Do Y, Eun MY, Lee J, Park H, Sohn SI, Hong JH. Characteristics of Acute Stroke in Patients with Coronavirus Disease 2019 and Challenges in Stroke Management during an Epidemic. J Korean Med Sci 2020; 35:e324. [PMID: 32893524 PMCID: PMC7476797 DOI: 10.3346/jkms.2020.35.e324] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/24/2020] [Accepted: 08/23/2020] [Indexed: 12/16/2022] Open
Abstract
Coronavirus disease 2019 (COVID-19) is an ongoing pandemic infection associated with high morbidity and mortality. The Korean city of Daegu endured the first large COVID-19 outbreak outside of China. Since the report of the first confirmed case in Daegu on February 18, 2020, a total of 6,880 patients have been reported until May 29, 2020. We experienced five patients with ischemic stroke and COVID-19 during this period in four tertiary hospitals in Daegu. The D-dimer levels were high in all three patients in whom D-dimer blood testing was performed. Multiple embolic infarctions were observed in three patients and suspected in one. The mean time from stroke symptom onset to emergency room arrival was 22 hours. As a result, acute treatment for ischemic stroke was delayed. The present case series report raises the possibility that the coronavirus responsible for COVID-19 causes or worsens stroke, perhaps by inducing inflammation. The control of COVID-19 is very important; however, early and proper management of stroke should not be neglected during the epidemic.
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Affiliation(s)
- Doo Hyuk Kwon
- Department of Neurology, Keimyung University Daegu Dongsan Hospital, Keimyung University School of Medicine, Daegu, Korea
| | - Youngrok Do
- Department of Neurology, Daegu Catholic University Hospital, Catholic University of Daegu School of Medicine, Daegu, Korea
| | - Mi Yeon Eun
- Department of Neurology, Kyungpook National University Chilgok Hospital, School of Medicine, Kyungpook National University, Daegu, Korea
| | - Jun Lee
- Department of Neurology, Yeungnam University Hospital, Yeungnam University School of Medicine, Daegu, Korea
| | - Hyungjong Park
- Department of Neurology, Keimyung University Dongsan Hostpial, Keimyung University School of Medicine, Daegu, Korea
| | - Sung Il Sohn
- Department of Neurology, Keimyung University Dongsan Hostpial, Keimyung University School of Medicine, Daegu, Korea
| | - Jeong Ho Hong
- Department of Neurology, Keimyung University Daegu Dongsan Hospital, Keimyung University School of Medicine, Daegu, Korea
- Department of Neurology, Keimyung University Dongsan Hostpial, Keimyung University School of Medicine, Daegu, Korea.
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14
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Tajlil A, Ghaffari S, Pourafkari L, Mashayekhi S, Roshanravan N. Nicotine and smoking in the COVID-19 era. J Cardiovasc Thorac Res 2020; 12:136-139. [PMID: 32626554 PMCID: PMC7320997 DOI: 10.34172/jcvtr.2020.22] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [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: 05/03/2020] [Accepted: 05/23/2020] [Indexed: 01/08/2023] Open
Abstract
Introduction: The knowledge regarding the demographic characteristics of patients with Covid-19 and risk factors distribution is still evolving. Considering the role of cigarette smoking in the pathogenesis of lung diseases and the effect of nicotine on expression of the entry receptor for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), it is important to determine the implications of smoking in COVID-19.
Methods: In this brief report, by using the published articles in the literature, we aimed to compare the reported prevalence of smoking in patients with COVID-19 to the prevalence of smoking in the general population of the corresponding report. Binomial tests were conducted and a P value of less than 0.05 was considered statistically significant.
Results: Among the screened papers, we found 12 peer-reviewed articles in which epidemiological characteristics of COVID-19 patients, including smoking status, were stated. Based on the descriptive reports of characteristics of COVID-19 patients, we observed a significantly lower proportion of COVID-19 patients with smoking history compared to what is expected, given the population average for each study’s geographic area.
Conclusion: This analysis of available data showed a lower prevalence of smoking in COVID-19 patients in comparison to the regional average. Considering the limitations of the study, the results should be interpreted with great caution and be viewed just as a preliminary report to motivate related basic and clinical researches.
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Affiliation(s)
- Arezou Tajlil
- Cardiovascular Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Samad Ghaffari
- Cardiovascular Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
| | | | - Sina Mashayekhi
- Cardiovascular Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Neda Roshanravan
- Cardiovascular Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
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15
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Chavez S, Long B, Koyfman A, Liang SY. Coronavirus Disease (COVID-19): A primer for emergency physicians. Am J Emerg Med 2020; 44:220-229. [PMID: 32265065 PMCID: PMC7102516 DOI: 10.1016/j.ajem.2020.03.036] [Citation(s) in RCA: 142] [Impact Index Per Article: 35.5] [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: 03/22/2020] [Revised: 03/22/2020] [Accepted: 03/22/2020] [Indexed: 12/28/2022] Open
Abstract
Introduction Rapid worldwide spread of Coronavirus Disease 2019 (COVID-19) has resulted in a global pandemic. Objective This review article provides emergency physicians with an overview of the most current understanding of COVID-19 and recommendations on the evaluation and management of patients with suspected COVID-19. Discussion Severe Acute Respiratory Syndrome coronavirus 2 (SARS-CoV-2), the virus responsible for causing COVID-19, is primarily transmitted from person-to-person through close contact (approximately 6 ft) by respiratory droplets. Symptoms of COVID-19 are similar to other viral upper respiratory illnesses. Three major trajectories include mild disease with upper respiratory symptoms, non-severe pneumonia, and severe pneumonia complicated by acute respiratory distress syndrome (ARDS). Emergency physicians should focus on identifying patients at risk, isolating suspected patients, and informing hospital infection prevention and public health authorities. Patients with suspected COVID-19 should be asked to wear a facemask. Respiratory etiquette, hand washing, and personal protective equipment are recommended for all healthcare personnel caring for suspected cases. Disposition depends on patient symptoms, hemodynamic status, and patient ability to self-quarantine. Conclusion This narrative review provides clinicians with an updated approach to the evaluation and management of patients presenting to the emergency department with suspected COVID-19.
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Affiliation(s)
- Summer Chavez
- Department of Emergency Medicine, MedStar Georgetown University Hospital, 3800 Reservoir Road, NW, Washington, DC 20007, United States
| | - Brit Long
- Brooke Army Medical Center, Department of Emergency Medicine, 3841 Roger Brooke Dr, Fort Sam Houston, TX 78234, United States.
| | - Alex Koyfman
- The University of Texas Southwestern Medical Center, Department of Emergency Medicine, 5323 Harry Hines Boulevard, Dallas, TX 75390, United States
| | - Stephen Y Liang
- Divisions of Emergency Medicine and Infectious Diseases, Washington University School of Medicine, 660 S. Euclid Ave, St. Louis, MO 63110, United States.
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