# pos

id: cord-276132-tv5y1eqc
pos: NNP
token:
  www.latimes.com/science/story/2020-03-31/coronavirusdeath-rate-estimates-show-risk-rising-sharply-with-age

lemma:
  www.latimes.com/science/story/2020-03-31/coronavirusdeath-rate-estimates-show-risk-rising-sharply-with-age


# ent

id: cord-284734-qioy7eso
type: PROTEIN
entity:
  autoantibodies complement products lipoprotein immune complexes cryoglobulin myeloma protein ADAMTS 13 protein


id: cord-263763-a8wgvgz2
type: CELL_TYPE
entity:
  white blood cell WBC 18 11 10 3 μL lymphocyte 1 05 10 3 μL lymphocyte count 5 8 eosinophil 0 01 10 3 μL C reactive protein


id: cord-295041-5vpawtef
type: PROTEIN
entity:
  granulocyte colony stimulating factor granulocyte monocyte colony stimulating factor C X C motif chemokine ligand


id: cord-285748-us5do6c2
type: ORG
entity:
  the European Society of Hypertension International Society of Hypertension and European Society of Cardiology


id: cord-347926-63w578b2
type: ORG
entity:
  Ningbo Clinical Research Center for Children s Health and Diseases Project of Ningbo Reproductive Medicine Center


id: cord-300866-cso6l6ze
type: DISEASE
entity:
  hypertension cerebral arteriosclerosis intracranial vascular malformation cerebral amyloid vascular disease


id: cord-284545-vn60yd46
type: GGP
entity:
  hepatitis B 1 5 malignancy 1 5 respiratory illnesses 1 4 renal disorders 0 8 and immunodeficiencies 0 01 10


id: cord-344217-kci4uw7u
type: PROTEIN
entity:
  genera alpha coronavirus beta coronavirus gamma coronavirus and delta coronavirus 1 Beta coronaviruses


id: cord-344217-kci4uw7u
type: PROTEIN
entity:
  SARS coronavirus Human coronavirus NL63employs the severe acute respiratory syndrome coronavirus receptor


# bib

id: cord-011297-4um9w2dx
title: New-Onset Refractory Status Epilepticus with Underlying Autoimmune Etiology: a Case Report
author: Brunker, Lucille
date: 2019-11-28
url: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7223986/
doi: 10.1007/s42399-019-00185-z
abstract:
  Management of new-onset refractory status epilepticus and the approach to burst suppression variable is often challenging. We present the unusual case of a previously healthy 18-year-old male with new-onset status epilepticus admitted to the neurologic intensive care unit for 70 days. Despite treatment with multiple anti-epileptic drugs in addition to IV anesthetics, burst suppression was initially unsustainable and the patient remained in super-refractory status epilepticus. Extensive evaluation revealed an underlying autoimmune-mediated etiology with positivity for glutamic acid decarboxylase-65 antibody. Clinical response with a goal of 1–2 bursts per screen on EEG monitor was eventually achieved after a course of rituximab and plasma exchange therapy as well as a 7-day barbiturate coma with a regimen of clobazam, lacosamide, Keppra, and oxcarbazepine followed by a slow taper of phenobarbital and the addition of fosphenytoin. Remarkably, the patient was subsequently discharged to a rehabilitation facility with complete neurologic recovery. We discuss treatment strategies for new-onset refractory status epilepticus and highlight the role of rapid initiation of burst suppression with high-dose IV anesthetics to ensure neuroprotection while the underlying etiology is addressed with immune-modulating therapy.


id: cord-028923-gzqd5g0k
title: Sedation with ketamine and fentanyl combination improves patient outcomes in intensive care units
author: Vitug, Sarah
date: 2020-07-10
url: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7347421/
doi: 10.1007/s42399-020-00275-3
abstract:
  Psychological manifestations such as depression and suicidal ideation are commonly caused by poorly controlled pain, anxiety, and sleep deprivation in intensive care unit (ICU) patients. We are concerned that previous analgesic and sedative techniques administered as single-medication approaches are outdated and inadequate. It is imperative that ICU practitioners are knowledgeable in multimodal approaches to pain and sedation in high acuity settings. We have shown that appropriate combinations of ketamine and fentanyl are effective, and if further supplementation is needed, we utilize additional pharmacological agents in low doses and regional techniques that ultimately lower the overall opioid consumption. We acknowledge that a variety of medication supplementations tailored to the patient’s clinical needs and nature of surgery improves a patient’s outcome in ICU and overall quality of life.


id: cord-029137-mck5cmn7
author: Krasnanova, Veronika
date: 2020-07-13
url: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7357261/
doi: 10.1007/s42399-020-00395-w
title:
  Tigecycline Therapy for Multi-drug-Resistant Pseudomonas aeruginosa Sepsis Associated with Multi-organ Failure in an Infant with Persistent Arterial Duct. Case Report

abstract:
  Sepsis is the leading cause of death in infants and children worldwide. The growing drug resistance in nosocomial gram-negative bacteria has resulted in treatment challenges. One of the most common multi-drug-resistant bacteria is Pseudomonas aeruginosa. Resistance to antibiotics used in Pseudomonas aeruginosa infections limits the therapeutic options. We present a tigecycline administration in a 5-month-old infant with patent arterial duct, heart failure, and respiratory failure due to respiratory syncytial virus bronchiolitis with subsequent respiratory distress syndrome and severe sepsis caused by multi-drug-resistant Pseudomonas aeruginosa. Despite combined antibiotic therapy with meropenem, amikacin, and colistin, inflammatory markers increased. Because of life-threatening condition, tigecycline was added to the therapy and was administered intravenously twice daily. Within 48 h, inflammatory markers started to decrease and tigecycline therapy continued for 13 days without adverse effects. Tigecycline used in combination with other antibiotics might be a valuable therapeutic approach in the management of multi-drug-resistant bacteria infections in pediatric patients when conventional antibiotics have failed. Further studies are needed to evaluate the efficacy and safety of tigecycline administration in critically ill pediatric patients.


id: cord-035099-8yk0dzxf
title: Geriatric Rehabilitation and COVID-19: a Case Report
author: Brika, Marine
date: 2020-11-09
txt: ./txt/cord-035099-8yk0dzxf.txt
cache: ./cache/cord-035099-8yk0dzxf.txt
extension: .txt
mime: text/plain
url: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7652377/
doi: 10.1007/s42399-020-00613-5
summary:
  The assessment process of this patient has been supported by an innovative multi-systemic tool developed in view of the COVID-19 clinical consequences and a systemic evaluation of motor functions by the Frail''BESTest. Aged adults who survive COVID-19 could present several frailty criteria following respiratory distress and may sometimes need to spend several days in an intensive care unit. Considering the physiotherapeutic diagnosis of Mr. P, as well as the agespecific lung physiology of the patient [26] , some cardiopulmonary rehabilitation exercises allowing both the maintenance of ventilator functions and the improvement of hematosis can be proposed. The four assessments performed by the specific COVID-19 evaluation showed an overall improvement of the patient in several functions. In our opinion, it is important to understand that the issue is not only to rescue a patient from their acute respiratory problem, but more so to prevent the functional dependency associated with the infection''s consequences, especially in intensive care units where chronic diseases are frequently acquired.

abstract:
  The COVID-19 infection has particularly affected older adults. Clinical observations in this population highlight major respiratory impairment associated with the development or aggravation of the patient’s frailty state. Mr. P is a 93-year-old frail patient, hospitalized after a COVID-19 infection. The assessment process of this patient has been supported by an innovative multi-systemic tool developed in view of the COVID-19 clinical consequences and a systemic evaluation of motor functions by the Frail’BESTest. This process allowed a mixed clinical picture associated with significant respiratory distress (linked with acute respiratory distress syndrome) and an evident motor frailty. The care plan was developed accordingly, and four assessments were done in the same manner until Mr. P returned home. This case report allows us to see a holistic COVID-19 clinical picture, showing the different axes of clinical reasoning to enhance the rehabilitation process. Furthermore, this case report illustrates the importance of rehabilitation in the COVID-19 context.


id: cord-254631-80sg4uvd
title: Posterior Reversible Encephalopathy Syndrome in COVID-19 Disease: a Case-Report
author: Llansó, Laura
date: 2020-08-26
txt: ./txt/cord-254631-80sg4uvd.txt
cache: ./cache/cord-254631-80sg4uvd.txt
extension: .txt
mime: text/plain
url: https://doi.org/10.1007/s42399-020-00470-2
doi: 10.1007/s42399-020-00470-2
summary:
  Posterior reversible encephalopathy syndrome (PRES) is a clinical syndrome that can include headache, altered consciousness, visual disturbances, and seizures, usually related to autoregulatory cerebral failure and hypertension. We present a case of a 66-year-old woman with severe pneumonia by SARS-CoV-2 who developed a posterior reversible encephalopathy syndrome with a typical clinical and radiological presentation, after being treated with anti-interleukin treatment (anakinra and tocilizumab) following local guidelines. We report a case of posterior reversible encephalopathy syndrome in a patient with COVID-19 disease, possibly related to anti-IL-1 or anti-IL-6, suggesting that anti-interleukin treatments may cause this syndrome, at least in patients with predisposing conditions such as infections and hydroelectrolytic disorders. Considering the infectious background, the immunomodulatory treatments, modest hypertension in the hours before the symptoms, and the distribution of the lesions on the CT scan, the most likely diagnosis is posterior reversible encephalopathy syndrome (PRES) [1] [2] [3] [4] [5] . Posterior reversible encephalopathy syndrome: associated clinical and radiologic findings

abstract:
  Posterior reversible encephalopathy syndrome (PRES) is a clinical syndrome that can include headache, altered consciousness, visual disturbances, and seizures, usually related to autoregulatory cerebral failure and hypertension. The neuroimaging is essential to diagnosis, showing white matter vasogenic edema in posterior areas. We present a case of a 66-year-old woman with severe pneumonia by SARS-CoV-2 who developed a posterior reversible encephalopathy syndrome with a typical clinical and radiological presentation, after being treated with anti-interleukin treatment (anakinra and tocilizumab) following local guidelines. We report a case of posterior reversible encephalopathy syndrome in a patient with COVID-19 disease, possibly related to anti-IL-1 or anti-IL-6, suggesting that anti-interleukin treatments may cause this syndrome, at least in patients with predisposing conditions such as infections and hydroelectrolytic disorders.


id: cord-255047-0kr4y753
author: Goletti, Orlando
date: 2020-08-17
url: https://doi.org/10.1007/s42399-020-00444-4
doi: 10.1007/s42399-020-00444-4
title:
  Factors Affecting Mortality in 1022 COVID-19 Patients Referred to an Emergency Department in Bergamo during the Peak of the Pandemic

abstract:
  The unexpected outbreak of COVID-19 in the area of Bergamo and the general crisis of personnel and devices has been managed as well as possible during the maximum peak of epidemic; Humanitas Gavazzeni Hospital implemented its facilities and organization in order to optimize the treatment of patients. The number of beds in the Intensive Care Unit (ICU) was doubled (from 16 to 33), and more than 220 beds were dedicated to the COVID-19 patients. This paper analyzes the factors affecting mortality in 1022 COVID-19 patients who referred to Humanitas Gavazzeni between February 25 and March 26, 2020. A total of 274 (34.9%) fatal events were registered: 202 among those admitted to the Intensive Care Unit (ICU) and COVID department and 72 among those treated in Acute Admission Unit Level II (AAUl-2) who died before hospital admission. This paper studies 274 dead cases by analyzing patient’s characteristics, physiological and laboratory parameters, symptoms, and the scores of severity of the disease. Patients who had fatal events in the AAUL-2 showed the worst parameters of risk. The most important differences regarded the Apache II score, Glasgow Coma Score (GCS), CRP (C-reactive protein), pH, creatinine, RR (respiratory rate), and asthenia.


id: cord-255357-oar2pttf
title: Kawasaki Disease and Invasive Pneumococcal Infection
author: Kijima, Emi
date: 2020-06-17
txt: ./txt/cord-255357-oar2pttf.txt
cache: ./cache/cord-255357-oar2pttf.txt
extension: .txt
mime: text/plain
url: https://www.ncbi.nlm.nih.gov/pubmed/32838143/
doi: 10.1007/s42399-020-00350-9
abstract: nan
summary:
  title: Kawasaki Disease and Invasive Pneumococcal Infection In the morning, she developed five out of six major KD symptoms (except for lip findings), and intravenous immunoglobulin (2 g/kg; IVIG) and oral aspirin (30 mg/kg/day) were started according to the definite diagnosis of KD with a Kobayashi score of 4 [2] . The blood culture became positive for GPC in the evening, and intravenous ampicillin (ABPC) was added to cover enterococcus infection, empirically. The follow-up blood culture performed on the same day was found to be negative later. In our case, KD was unresponsive to IVIG in spite of proper antibiotic treatment for IPD, and KD was well responsive to PSL instead. Furthermore, when once induced, KD requires specific treatment for itself, even if the triggering infection such as IPD as in our case is controlled by proper antibiotic therapy. Kawasaki disease associated with pneumococcal infection. Impact of D-dimer on the resistance to intravenous immunoglobulin therapy in Kawasaki disease GSL


id: cord-261222-762nqkbg
author: Sachdeva, Sonali
date: 2020-10-12
url: https://www.ncbi.nlm.nih.gov/pubmed/33073173/
doi: 10.1007/s42399-020-00575-8
title:
  Admission Hyperglycemia in Non-diabetics Predicts Mortality and Disease Severity in COVID-19: a Pooled Analysis and Meta-summary of Literature

abstract:
  In the latter part of 2019, a cluster of unexplained pneumonia cases were reported in Wuhan, China. In less than a year, SARS-CoV-2 has infected over 27 million people and claimed more than 800,000 deaths worldwide. Diabetes is a highly prevalent chronic metabolic disease, and recent reports have suggested a possible existence of COVID-19 related new-onset diabetes. Hyperglycemia induces an inflammatory state in the body, which coupled with coronavirus associated immune response is a possible explanation for clinical worsening of patients. We present a summary and pooled analysis of available evidence to ascertain the relationship between hyperglycemia in undiagnosed diabetics and outcomes of COVID-19 disease. Our results showed that hyperglycemia in non-diabetics was associated with higher risk of severe/critical illness (OR 1.837 (95% CI 1.368–2.465, P < 0.001) and mortality (2.822, 95% CI 1.587–5.019, P < 0.001) compared with those with normal values of blood glucose. The management of hyperglycemia in COVID-19 poses significant challenges in clinical practice, and the need to develop strategies for optimal glucose control in these patients cannot be overlooked.


id: cord-262945-zfcz0hpd
title: Thrombosis and Bleeding as Presentation of COVID-19 Infection with Polycythemia Vera. A Case Report
author: Chow, Lai Chee
date: 2020-10-04
url: https://doi.org/10.1007/s42399-020-00537-0
doi: 10.1007/s42399-020-00537-0
abstract:
  Coronavirus disease (COVID-19) has a wide spectrum of clinical manifestations. In this case report, we describe our first case of COVID-19 pneumonia that was complicated by cerebral venous thrombosis and bleeding in a patient with polycythemia vera. Madam A, a 72-year-old lady with polycythemia vera, ischemic stroke, hemorrhoids, diabetes mellitus, hypertension, and dyslipidemia was admitted to the hospital for COVID-19 pneumonia. She was treated with hydroxychloroquine and lopinavir/ritonavir as per hospital protocol. She continued taking hydroxyurea and aspirin for her treatment of polycythemia vera. Subsequently, she developed rectal bleeding when her platelet count was 1247 × 10(3)/μl, even though she was not on an anticoagulant. Her aspirin was withheld. One week later, she was readmitted to the hospital for cerebral venous thrombosis and her D-dimer was 2.02 μg/ml. She was commenced on a therapeutic dose of low molecular weight heparin. Following that, her D-dimer level showed a decreasing trend and normalized upon her discharge. Patients with polycythemia vera are prone to develop thrombotic and bleeding complications. Management of this group of patients has become more complex with COVID-19 infection. It is crucial for us to decide when to start an anticoagulant especially when there is a history of recent bleeding. We need to balance the risks of further bleeding versus potentially fatal thrombotic events. Studies have shown that D-dimer can be used as a clinical marker to predict thrombotic events in COVID-19 infection. Patients with COVID-19 infection and polycythemia vera will benefit from both pharmacological thromboprophylaxis and close monitoring for bleeding.


id: cord-263763-a8wgvgz2
author: Çelik, Ersin
date: 2020-07-02
txt: ./txt/cord-263763-a8wgvgz2.txt
cache: ./cache/cord-263763-a8wgvgz2.txt
extension: .txt
mime: text/plain
url: https://www.ncbi.nlm.nih.gov/pubmed/32838156/
doi: 10.1007/s42399-020-00377-y
summary:
  Here, we present our approach to a 54-year-old male patient who had coronary artery bypass (CABG) surgery diagnosed as high probability coronavirus disease 2019 (COVID-19) in early postoperative period. We aimed to present our approach to high probability COVID-19 pneumonia which developed on early postoperative period in our patient after coronary artery bypass grafting (CABG) operation, which was not reported in the literature before. After consultations applied by chest physicians and infectious disease departments of our hospital, COVID-19 was evaluated as a high probability due to the laboratory tests, radiological findings, and clinical course. Having considered our patient as high risk, without waiting for the RT-PCR result, we started the specific treatment for COVID-19 immediately, by evaluating clinical, laboratory, and radiology findings. Correlation of chest CT and RT-PCR testing in coronavirus disease 2019 (COVID-19) in China: a report of 1024 cases

title:
  Treatment Approach to Coronavirus Disease (COVID-19) Seen Early After Open Heart Surgery. Case Report

abstract:
  SARS-CoV-2 was reported for the first time in China on December 31, 2019, as the cause of some pneumonia cases characterized by fever, cough, dyspnea, myalgia, and fatigue. Here, we present our approach to a 54-year-old male patient who had coronary artery bypass (CABG) surgery diagnosed as high probability coronavirus disease 2019 (COVID-19) in early postoperative period.


id: cord-265293-l9omunq4
author: Schönegger, Carmen Maria
date: 2020-10-24
txt: ./txt/cord-265293-l9omunq4.txt
cache: ./cache/cord-265293-l9omunq4.txt
extension: .txt
mime: text/plain
url: https://www.ncbi.nlm.nih.gov/pubmed/33134844/
doi: 10.1007/s42399-020-00606-4
summary:
  title: Smell and Taste Disorders in COVID-19 Patients: Objective Testing and Magnetic Resonance Imaging in Five Cases Those with objectifiable alteration in taste or smell were subjected to MRI with contrast agent to investigate possible involvement of the central nervous system. We encourage medical professionals to conduct specialized examinations and MRIs in the acute stage of disease, which guarantees an optimum patient care. The study was conducted on five patients reporting impairment of taste and smell with confirmed SARS-CoV-2 infection in East Tyrol. In case objective testing revealed alterations in taste or smell, patients were subjected to MRI in a timely manner. Three weeks after the first olfactory and gustatory examination, a follow-up testing was conducted with the three patients who also had a second MRI. The first MRI images showed slight alterations in one patient, which could be associated with a SARS-CoV-2 infection. Magnetic resonance imaging alteration of the brain in a patient with coronavirus disease 2019 (COVID-19) and anosmia

title:
  Smell and Taste Disorders in COVID-19 Patients: Objective Testing and Magnetic Resonance Imaging in Five Cases

abstract:
  Smell and taste disorders are acknowledged as characteristic symptoms for SARS-CoV-2 infection by now. These symptoms have been linked to a neuroinvasive course of disease. In this study, we investigated five consecutive COVID-19 patients with a prolonged course of dysosmia and dysgeusia. Those with objectifiable alteration in taste or smell were subjected to MRI with contrast agent to investigate possible involvement of the central nervous system. We found dysosmia and dysgeusia to be mostly objectifiable, but no evidence for neuroinvasiveness could be detected by MRI in the late stage of the disease. Alterations in taste and smell could be objectified in most patients. Nevertheless, no evidence for a neuroinvasive potential could be identified by MRI, at least in the late stage of disease. We encourage medical professionals to conduct specialized examinations and MRIs in the acute stage of disease, which guarantees an optimum patient care.


id: cord-268617-1t7yaoct
title: COVID-19 and Gynecological Cancers: A Summary of International Recommendations
author: Ismaili, Nabil
date: 2020-08-31
url: https://www.ncbi.nlm.nih.gov/pubmed/32904733/
doi: 10.1007/s42399-020-00475-x
abstract:
  Morocco and the rest of the world are experiencing a pandemic of a new coronavirus known as COVID-19 or SARS-CoV-2 (severe acute respiratory syndrome coronavirus 2). On August 24, 2020, the spread of the virus in Morocco had caused more than 52,000 cases and 880 deaths. Cancer patients are more susceptible to develop an infection than people without cancer because of their immunosuppression caused by the disease and treatments (surgery and chemotherapy). Therefore, these patients are at higher risk of infection with COVID-19 and a much higher risk of developing more serious forms. Given this epidemiological context, the establishment of guidelines for patients with gynecological cancers, requiring multidisciplinary management during the global COVID-19 pandemic, is crucial to limit their infection while maintaining their chances for a cure. In this paper, we summarize the international COVID-19 recommendations on the prioritization of surgical cases, the perioperative protective measures, the precautions to be taken in the brachytherapy unit, the COVID-19 screening, and finally the therapeutic indications of gynecological cancers by tumor location.


id: cord-269425-e9iyso7n
title: Immune Thrombocytopenia Secondary to COVID-19: a Systematic Review
author: Bhattacharjee, Sukrita
date: 2020-09-19
txt: ./txt/cord-269425-e9iyso7n.txt
cache: ./cache/cord-269425-e9iyso7n.txt
extension: .txt
mime: text/plain
url: https://www.ncbi.nlm.nih.gov/pubmed/32984764/
doi: 10.1007/s42399-020-00521-8
summary:
  A systematic review was done to analyze the clinical profile and outcomes in a total of 45 cases of new-onset ITP in COVID-19 patients described in literature until date. Diagnosis of ITP in patients with moderate-to-severe COVID-19 poses a major diagnostic as well as therapeutic challenge to clinicians owing to presence of multiple concomitant conditions including HLH, DIC, sepsis, antibiotic use, heparin prophylaxis, and thromboembolic events. The following data were extracted from the included studies: age of the patient at presentation, gender, COVID-19 illness severity, comorbidities, medication use, nadir platelet count, onset of COVID-19 symptoms to diagnosis of ITP, bleeding manifestations of ITP, time to recovery from start of treatment, and clinical outcomes. Bone marrow study in these few selected cases of ITP would reveal low number of megakaryocytes, as seen in one patient of this review, who presented with severe thrombocytopenia (count 2 × 10 9 /μL) [7] .

abstract:
  Immune thrombocytopenia, often known as immune thrombocytopenic purpura (ITP), has emerged as an important complication of COVID-19. A systematic review was done to analyze the clinical profile and outcomes in a total of 45 cases of new-onset ITP in COVID-19 patients described in literature until date. A comprehensive approach is essential for diagnosing COVID-19-associated ITP after excluding several concomitant factors that can cause thrombocytopenia in COVID-19. Majority of ITP cases (71%) were found to be elderly (> 50 years) and 75% cases had moderate-to-severe COVID-19. Three patients (7%) were in the pediatric age group. Reports of ITP in asymptomatic COVID-19 patients (7%) underscore the need for COVID-19 testing in newly diagnosed patients with ITP irrespective of COVID-19 symptoms amid this pandemic. ITP onset occurred in 20% cases 3 weeks after onset of COVID-19 symptoms, with many reports after clinical recovery. SARS-CoV-2-mediated immune thrombocytopenia can be attributed to the underlying immune dysregulation, susceptibility mutations in SOCS 1, and other mechanisms, including molecular mimicry, cryptic antigen expression, and epitope spreading. No bleeding manifestations were reported in 31% cases at diagnosis. Severe life-threatening bleeding was uncommon. One case of mortality was attributed to intracranial hemorrhage. Secondary Evans syndrome was diagnosed in one case. Good initial response to short course of glucocorticoids and intravenous immunoglobulin has been found with the exception of delayed lag response in one case. Thrombopoietin receptor agonist usage as a second-line agent has been noted in few cases for short duration with no adverse events. In the relatively short follow-up period, four relapses of ITP were found.


id: cord-270645-tzctvs9q
title: Air Pollution and the Novel Covid-19 Disease: a Putative Disease Risk Factor
author: Martelletti, Luigi
date: 2020-04-15
txt: ./txt/cord-270645-tzctvs9q.txt
cache: ./cache/cord-270645-tzctvs9q.txt
extension: .txt
mime: text/plain
url: https://www.ncbi.nlm.nih.gov/pubmed/32296757/
doi: 10.1007/s42399-020-00274-4
abstract: nan
summary:
  This study analyzed the correlation between the increment of the API (Air Pollution Index) and the rate of fatality due to SARS across 5 regions in China. In 2017, Ciencewicki and Jaspers conducted an epidemiological analysis regarding air pollution and respiratory viral infections which noted positive correlation between the high level of particulate matter (PM) in some urban areas and mortality due to cardiovascular and respiratory conditions. A recent study from the SIMA (Società Italiana di Medicina Ambientale) reported that the specificity of the high spread of the contagious virus in some areas of Northern Italy is likely to be linked to air pollution conditions. The above studies show that air pollutants, such as particulate matter, nitrogen dioxide, and carbon monoxide, are most likely direct to facilitate the longevity of virus particles in favorable climate conditions. Air pollution and case fatality of SARS in the People''s Republic of China: an ecologic study


id: cord-273459-3686wv7v
title: Analysis and Estimation of COVID-19 Spreading in Russia Based on ARIMA Model
author: Fang, Lanlan
date: 2020-10-09
url: https://doi.org/10.1007/s42399-020-00555-y
doi: 10.1007/s42399-020-00555-y
abstract:
  Russia has been currently in the “hard-hit” area of the COVID-19 outbreak, with more than 396,000 confirmed cases as of May 30. It is necessary to analyze and predict its epidemic situation to help formulate effective public health policies. Autoregressive integrated moving average (ARIMA) models were developed to predict the cumulative confirmed, dead, and recovered cases, respectively. R 3.6.2 software was used to fit the data from January 31 to May 20, 2020, and predict the data for the next 30 days. The COVID-19 epidemic in Russia was divided into two stages and reached its peak in May. The epidemic began to stabilize on May 19. The case fatality rate has been at an extremely low level. ARIMA (2,2,1), ARIMA (3,2,0), and ARIMA (0,2,1) were the models of cumulative confirmed, dead, and recovered cases, respectively. After testing, the mean absolute percentage error (MAPE) of three models were 0.6, 3.9, and 2.4, respectively. This paper indicates that Russia’s health system capacity can effectively respond to the COVID-19 pandemic. Three ARIMA models have a good fitting effect and can be used for short-term prediction of the COVID-19 trend, providing a theoretical basis for Russia to formulate new intervention policies.


id: cord-273829-t5cuop5c
title: rRT-PCR Results of a Covid-19 Diagnosed Geriatric Patient
author: Görgülü, Özkan
date: 2020-10-17
txt: ./txt/cord-273829-t5cuop5c.txt
cache: ./cache/cord-273829-t5cuop5c.txt
extension: .txt
mime: text/plain
url: https://doi.org/10.1007/s42399-020-00590-9
doi: 10.1007/s42399-020-00590-9
summary:
  Therefore, the COVID-19 pandemic control and filiation evaluation with the rRT-PCR test may produce false negative results. Patient with positive Covid-19 IgM Rapid Test performed on May 19, 2020, was subjected to the rRT-PCR test, repeated twice on the 19th of May which also resulted in positive. The nucleic acid test functions as the gold standard method for confirming the SARS-COV-2 infection; however, some recent studies have detected false negative results of real-time reverse transcriptase polymerase chain reaction (rRT-PCR) [4] . Similar to our case, there are case reports of reverse transcription-polymerase chain reaction (RT-PCR) test initially false negative and later positive in the literature [11] . Therefore, it can be argued that COVID-19 pandemic control and filiation evaluation with the rRT-PCR test may produce false negative results. A case report of COVID-19 with false negative RT-PCR test: necessity of chest CT

abstract:
  In this study, we aimed to present a geriatric patient with the diagnosis of COVID-19 and with contradictory results in rRT-PCR examinations in short time intervals. A 69-year-old male patient was admitted to the emergency room on the 18th day of May 2020, with the complaints of fever, sweating, myalgia, dry cough that continued for 5 days, and the lack of taste that started on the day he applied to the emergency room. Comorbidity factors include diabetes mellitus, bronchial asthma, and hypertension. The patient has a history of 36 years of smoking 1.5 packs per day. High laboratory findings during hospitalization: monocytes, creatinine, CRP (C-reactive protein). In the thorax CT, in the parenchyma areas of both lungs, there are increases in attenuation with multilobe distributions (more visible at the level of the upper lobes) in the form of ground-glass opacities. May 19, 2020, was subjected to the rRT-PCR test, repeated twice on the 19th of May which also resulted in positive. Despite rRT-PCR tests, which were negative on 27th of May and positive on 28th of May, the patient, whose symptoms disappeared, and general condition improved, was discharged on June 1, 2020, with the recommendation for home isolation. In our case, unlike the incubation period only, we encountered a negative rRT-PCR result on the 8th day after diagnosis. Therefore, the COVID-19 pandemic control and filiation evaluation with the rRT-PCR test may produce false negative results.


id: cord-276132-tv5y1eqc
title: COVID-19: The Impact in Oncology Care
author: Ray, Upasana
date: 2020-10-23
txt: ./txt/cord-276132-tv5y1eqc.txt
cache: ./cache/cord-276132-tv5y1eqc.txt
extension: .txt
mime: text/plain
url: https://www.ncbi.nlm.nih.gov/pubmed/33134842/
doi: 10.1007/s42399-020-00592-7
summary:
  The COVID-19 pandemic has imposed a critical challenge to the current oncology care and practices including late diagnoses, delayed anti-cancer treatment, and static clinical trials. Delaying anti-cancer treatment in the ongoing pandemic cannot be recommended as a sensible choice to reduce the associated infection risk in patients. The American Society of Clinical Oncology (ASCO) recommends that in cancer patients diagnosed with the infection, the immunosuppressive therapies should be withheld until the symptoms resolve like complete remission of fever without use of antipyretics along with a negative COVID-19 test. Nevertheless, contact limitation and physical distancing guidelines continue to be an important part of the cancer treatment strategies during the pandemic in order to protect the patients, health-care personnel and non-COVID-19 patients being treated in the same organization. A practical approach to the management of cancer patients during the novel coronavirus disease 2019 (COVID-19) pandemic: an international collaborative group Clinical characteristics of COVID-19-infected cancer patients: a retrospective case study in three hospitals within Wuhan

abstract:
  The COVID-19 pandemic has imposed a critical challenge to the current oncology care and practices including late diagnoses, delayed anti-cancer treatment, and static clinical trials. With the increasing risk of cancer patients acquiring infection during receiving the essential care, the debate ensues on how to balance the risk factors and benefits out of the oncologic emergencies in cancer patients. In this review article, we have focused on the current global re-organization of the integrity and effectiveness of the treatment modalities depending on the patient and cancer-specific urgencies while minimizing exposure to the infection. In this review, we addressed how the worldwide oncology community is united to share therapy schemes and the best possible guidelines to help cancer patients, and to strategize and execute therapy/trial protocols. This review provides collective knowledge on the current re-structuring of the general framework that prioritizes cancer care with the available exploitation of the reduced resources and most importantly the unparalleled levels of companionship as a large health care community towards the need to offer the best possible care to the patients.


id: cord-284545-vn60yd46
title: Comorbidity and its Impact on Patients with COVID-19
author: Sanyaolu, Adekunle
date: 2020-06-25
url: https://doi.org/10.1007/s42399-020-00363-4
doi: 10.1007/s42399-020-00363-4
abstract:
  A novel human coronavirus, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), was identified in Wuhan, China, in December 2019. Since then, the virus has made its way across the globe to affect over 180 countries. SARS-CoV-2 has infected humans in all age groups, of all ethnicities, both males and females while spreading through communities at an alarming rate. Given the nature of this virus, there is much still to be learned; however, we know that the clinical manifestations range from a common cold to more severe diseases such as bronchitis, pneumonia, severe acute respiratory distress syndrome (ARDS), multi-organ failure, and even death. It is believed that COVID-19, in those with underlying health conditions or comorbidities, has an increasingly rapid and severe progression, often leading to death. This paper examined the comorbid conditions, the progression of the disease, and mortality rates in patients of all ages, infected with the ongoing COVID-19 disease. An electronic literature review search was performed, and applicable data was then collected from peer-reviewed articles published from January to April 20, 2020. From what is known at the moment, patients with COVID-19 disease who have comorbidities, such as hypertension or diabetes mellitus, are more likely to develop a more severe course and progression of the disease. Furthermore, older patients, especially those 65 years old and above who have comorbidities and are infected, have an increased admission rate into the intensive care unit (ICU) and mortality from the COVID-19 disease. Patients with comorbidities should take all necessary precautions to avoid getting infected with SARS CoV-2, as they usually have the worst prognosis.


id: cord-284734-qioy7eso
title: Efficacy of Plasmapheresis and Immunoglobulin Replacement Therapy (IVIG) on Patients with COVID-19
author: Pourahmad, Ramtin
date: 2020-07-31
txt: ./txt/cord-284734-qioy7eso.txt
cache: ./cache/cord-284734-qioy7eso.txt
extension: .txt
mime: text/plain
url: https://doi.org/10.1007/s42399-020-00438-2
doi: 10.1007/s42399-020-00438-2
summary:
  According to recent observations about different modalities in treatment of patients infected with COVID-19, plasmapheresis and intravenous immunoglobulin (IVIg) have been reported to be an effective empirical therapeutic option to control the infection. According to the medical experiences in the treatment of patients infected with other members of coronavirus family such as SARS-CoV and MERS-CoV, plasmapheresis and intravenous immunoglobulin (IVIg) have been reported to be an effective empirical therapeutic option to control the infection [1] [2] [3] [4] [5] [6] [7] . As the world confronting a pandemic due to SARS-CoV-2, immunoglobulin replacement therapy (IVIG) could be an ideal option for prevention and treatment of COVID-19 disease. According to the reports, China has used immunoglobulin replacement therapy on several COVID-19 patients during the outbreak of this novel coronavirus which showed promising results [46] . The use of convalescent plasma therapy and remdesivir in the successful management of a critically ill obstetric patient with novel coronavirus 2019 infection: a case report.

abstract:
  Since the rapidly evolving outbreak of COVID-19, several empirical therapeutic options have been recommended including the use of antivirals, steroids, and vaccines. According to recent observations about different modalities in treatment of patients infected with COVID-19, plasmapheresis and intravenous immunoglobulin (IVIg) have been reported to be an effective empirical therapeutic option to control the infection. In this review, we aimed to provide an overview on the possible application of plasmapheresis and intravenous immunoglobulin in patients with COVID-19.


id: cord-284785-mkjogy6h
title: Labile PT-INR in a Covid-19 Patient Under Long-term Vitamin K Antagonist Therapy: a Case Report
author: Trevisan, Caterina
date: 2020-08-19
txt: ./txt/cord-284785-mkjogy6h.txt
cache: ./cache/cord-284785-mkjogy6h.txt
extension: .txt
mime: text/plain
url: https://www.ncbi.nlm.nih.gov/pubmed/32839751/
doi: 10.1007/s42399-020-00460-4
summary:
  The patient''s medical history included moderate cognitive impairment, atrial fibrillation under oral anticoagulation (warfarin 2.5 mg and 3.75 mg on alternate days, showing stable PT-INR values since October 2018), and arterial hypertension. On April 20, blood analyses revealed hemoglobin 117 g/l, PT-INR 2.15, and a slight alteration of liver function with AST 55 U/l (normal range: 5-32). The temporal relationship between COVID-19 onset and PT-INR elevation in a patient whose PT-INR values were stable in the 18 months before the hospitalization supports the hypothesis that this infection may impact on the coagulative pattern not only pro-thrombotically [4, 5] but also by increasing hemorrhagic risk. This confirms that special attention should be paid to COVID-19 patients under long-term anticoagulation with vitamin K antagonist and a shift to heparin treatment until illness resolution may be a safe option in these individuals [7] .

abstract:
  The COronaVIrus Disease-19 (COVID-19) has been associated with thromboembolic complications, but evidence on its impact on hemorrhagic risk are still scarce. We describe a case of COVID-19 with hemorrhagic complication in the post-acute phase of the disease. The patient was a 93-year-old woman admitted to a post-acute care unit for COVID-19 patients in northern Italy. The patient’s medical history included moderate cognitive impairment, atrial fibrillation under oral anticoagulation (warfarin 2.5 mg and 3.75 mg on alternate days, showing stable PT-INR values since October 2018), and arterial hypertension. The patient was affected by COVID-19, treated with supportive therapy. In the post-acute phase of the disease, the patient presented with melena and showed a marked elevation of PT-INR of 25.1. She was treated with venous infusion of three-factor prothrombin complex concentrate and vitamin K until PT-INR reduction. After 5 days, blood analyses revealed normal hemoglobin, PT-INR 2.15, and a slight alteration of liver function. This case supports a strong impact of the infection on the coagulative pattern not only pro-thrombotically but also by increasing hemorrhagic risk. Special attention should therefore be paid to COVID-19 patients under anticoagulation with vitamin K antagonist and a shift to heparin treatment until illness resolution may be a safe option in these individuals.


id: cord-285748-us5do6c2
title: SARS-CoV-2-Related Kidney Injury: Current Concern and Challenges
author: Cheng, Yongqian
date: 2020-09-23
txt: ./txt/cord-285748-us5do6c2.txt
cache: ./cache/cord-285748-us5do6c2.txt
extension: .txt
mime: text/plain
url: https://doi.org/10.1007/s42399-020-00529-0
doi: 10.1007/s42399-020-00529-0
summary:
  Currently, the diagnosis and treatment of SARS-CoV-2 infection in patients with chronic kidney disease (CKD) are still unclear. Here, we review the recent findings of characteristics of COVID-19 in CKD patients and highlight the possible mechanisms of kidney injury caused by SARS-CoV-2 infection. Controversial results also exist like another study [18] indicating that SARS-CoV-2 infection was not found significantly correlated with incremental acute renal injury or aggravate chronic kidney failure in the COVID-19 patients. Therefore, SARS-CoV-2 infection in kidney transplant patients from this study showed that such cases may be severe enough requiring intensive care admission and these patients are in high risk of disease progression and death. Another study based on single-cell analysis by Lin and colleagues [28] also found that ACE2 was enriched in proximal tubular cells which may indicate that the kidney is more susceptible to SARS-CoV-2 infection.

abstract:
  Coronavirus disease 2019 (COVID-19) not only causes pulmonary inflammation but also causes multiple organ damages, including the kidney. ACE2, as one of the receptors for SARS-CoV-2 intrusion, is widely distributed in kidney tissues. Currently, the diagnosis and treatment of SARS-CoV-2 infection in patients with chronic kidney disease (CKD) are still unclear. Here, we review the recent findings of characteristics of COVID-19 in CKD patients and highlight the possible mechanisms of kidney injury caused by SARS-CoV-2 infection. We then discuss the emerging therapeutic approaches aimed at reducing kidney damage and protecting kidney function including virus removal, immunotherapy, supporting treatment, special blood purification therapy, etc. Problems unresolved and challenges ahead are also discussed.


id: cord-288732-k763ejqb
title: COVID-19, Brachytherapy, and Gynecologic Cancers: a Moroccan Experience
author: ElMajjaoui, Sanaa
date: 2020-07-15
txt: ./txt/cord-288732-k763ejqb.txt
cache: ./cache/cord-288732-k763ejqb.txt
extension: .txt
mime: text/plain
url: https://www.ncbi.nlm.nih.gov/pubmed/32838167/
doi: 10.1007/s42399-020-00402-0
summary:
  More recently, the American Brachytherapy Society published some clarifications in this regard and international expert consensus recommendations of radiation therapy for gynecologic malignancies during the COVID-19 pandemic were published (https://www.americanbrachytherapy.org/about-abs/abs-news/abs-statement-on-coronavirus/, Gynecol Oncol 15, 2020). In the majority of cases, the treatment is based on EBRT (exclusive in early stages and with concurrent chemotherapy in locally advanced stages), followed by intracavitary brachytherapy (ICBT) which constitutes a cornerstone in its management [4] . For patients over 70 years of age or with significant comorbidities (chronic respiratory or cardiac pathology, immunosuppression, etc.) who have small tumors or responding well to external beam radiotherapy (EBRT), a more shortened schedule of 9 Gy per fraction in 2 fractions at 1 week apart may be considered. Efficacy and toxicity of concomitant cisplatin with external beam pelvic radiotherapy and two high-dose-rate brachytherapy insertions for the treatment of locally advanced cervical cancer

abstract:
  The treatment of gynecological cancers is the main activity of brachytherapy units. However, during COVID-19 pandemic, precautions should be done in order to reduce the spread of the virus while maintaining all chances to recovery for all patients (Radiother Oncol 148, 227-228, 2020). Despite the extent of the pandemic in our country, limited data are available to establish recommendations with a sufficient level of evidence (Radiother Oncol 148, 227-228, 2020). More recently, the American Brachytherapy Society published some clarifications in this regard and international expert consensus recommendations of radiation therapy for gynecologic malignancies during the COVID-19 pandemic were published (https://www.americanbrachytherapy.org/about-abs/abs-news/abs-statement-on-coronavirus/, Gynecol Oncol 15, 2020). In this commentary, we sought to share the procedures adopted for the management of gynecological cancer patients during COVID-19 pandemic in our brachytherapy unit.


id: cord-289115-bntcn0m6
author: Thangaraju, Pugazhenthan
date: 2020-09-10
url: https://www.ncbi.nlm.nih.gov/pubmed/32935079/
doi: 10.1007/s42399-020-00510-x
title:
  Role of Dupilumab in Approved Indications of COVID-19 Patient: an Efficacy-Based Nonsystematic Critical Analysis

abstract:
  With many drugs being tried in the management and treatment of COVID-19, dupilumab is one such monoclonal antibody that has come under the limelight for its possible role as an adjunct therapy in COVID-19 position. There are isolated case reports and series that document a milder course of COVID-19 infection in patients who have already been on dupilumab therapy for treatment of conditions such as atopic dermatitis and chronic rhino-sinusitis with nasal polyp. There is also an ongoing debate regarding the continuation of biologicals in the COVID patient. In this article, a non-systematic critical analysis of dupilumab was performed to delve into this hypothesis further.


id: cord-292997-xbomgwzx
title: Takotsubo Syndrome in Patients with COVID-19: a Systematic Review of Published Cases
author: Singh, Sandeep
date: 2020-10-06
url: https://doi.org/10.1007/s42399-020-00557-w
doi: 10.1007/s42399-020-00557-w
abstract:
  Takotsubo syndrome (TTS) is caused by catecholamine surge, which is also observed in COVID-19 disease due to the cytokine storm. We performed a systematic literature search using PubMed/Medline, SCOPUS, Web of Science, and Google Scholar databases to identify COVID-19-associated TTS case reports and evaluated patient-level demographics, clinical attributes, and outcomes. There are 12 cases reported of TTS associated with COVID-19 infection with mean age of 70.8 ± 15.2 years (range 43–87 years) with elderly (66.6% > 60 years) female (66.6%) majority. The time interval from the first symptom to TTS was 8.3 ± 3.6 days (range 3–14 days). Out of 12 cases, 7 reported apical ballooning, 4 reported basal segment hypo/akinesia, and 1 reported median TTS. Out of 12 cases, during hospitalization, data on left ventricular ejection fraction (LVEF) was reported in only 9 of the cases. The mean LVEF was 40.6 ± 9.9% (male, 46.7 ± 5.7%, and female, 37.7 ± 10.6%). Troponin was measured in all 12 cases and was elevated in 11 (91.6%) without stenosis on coronary angiography except one. Out of 11 cases, 6 developed cardiac complications with 1 case each of cardiac tamponade, heart failure, myocarditis, hypertensive crisis, and cardiogenic shock in 2. Five patients required intubation, 1 patient required continuous positive airway pressure, and 1 patient required venovenous extracorporeal membrane oxygenation. The outcome was reported in terms of recovery in 11 (91.6%) out of 12 cases, and a successful recovery was noted in 10 (90.9%) cases. COVID-19-related TTS has a higher prevalence in older women. Despite a lower prevalence of cardiac comorbidities in COVID-19 patients, direct myocardial injury, inflammation, and stress may contribute to TTS with a high complication rate.


id: cord-295041-5vpawtef
title: SARS-CoV-2, an Underestimated Pathogen of the Nervous System
author: Jakhmola, Shweta
date: 2020-09-28
txt: ./txt/cord-295041-5vpawtef.txt
cache: ./cache/cord-295041-5vpawtef.txt
extension: .txt
mime: text/plain
url: https://doi.org/10.1007/s42399-020-00522-7
doi: 10.1007/s42399-020-00522-7
summary:
  Numerous clinical studies have reported neurological symptoms in COVID-19 patients since the spread of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), apart from the atypical signs of pneumonia. Angiotensin-converting enzyme-2 (ACE-2), a potential receptor for SARS-CoV-2 entry, is expressed on various brain cells and cerebral parts, i.e., subfornical organ, paraventricular nucleus, nucleus of the tractus solitarius, and rostral ventrolateral medulla, as well as in non-cardiovascular areas such as the motor cortex and raphe. The resident CNS cells like astrocytes and microglia also express ACE-2, thus highlighting the vulnerability of the nervous system to SARS-CoV-2 infection. Furthermore, the presence of SARS-CoV-2 in cerebrospinal fluid (CSF) of COVID-19 patients is confirmed through genome sequencing [4] ; however, experimental evidence is needed to validate virusmediated neurological damage. Furthermore, the interaction of SARS-CoV-2 and ACE-2-expressing neuronal/glial cells may facilitate virus entry into the nervous system through different routes.

abstract:
  Numerous clinical studies have reported neurological symptoms in COVID-19 patients since the spread of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), apart from the atypical signs of pneumonia. Angiotensin-converting enzyme-2 (ACE-2), a potential receptor for SARS-CoV-2 entry, is expressed on various brain cells and cerebral parts, i.e., subfornical organ, paraventricular nucleus, nucleus of the tractus solitarius, and rostral ventrolateral medulla, as well as in non-cardiovascular areas such as the motor cortex and raphe. The resident CNS cells like astrocytes and microglia also express ACE-2, thus highlighting the vulnerability of the nervous system to SARS-CoV-2 infection. Additionally, transmembrane serine protease 2 (TMPRSS2) and furin facilitate virus entry into the host. Besides, the probable routes of virus entry into the nervous system include the hematogenic pathway, through the vagus, the olfactory nerve, or the enteric nervous system. However, the trajectory of SARS-CoV-2 to the brain needs investigation. Furthermore, a Th17-mediated cytokine storm is seen in COVID-19 cases with higher levels of IL-1β/2/7/8/9/10/17, GM-CSF, IFN-γ, TNF-α, CXCL-10, MCP1, and MIP1α/β. Some cytokines can cross the blood-brain barrier and activate the brain’s immune cells to produce neural cytokines, leading to neuronal dysfunctions. Nonetheless, most of the neurological conditions developed due to viral infections may not have effective and registered treatments. Although, some antivirals may inhibit the virus-mediated pathogenesis and prove to be suitable in COVID-19 treatment. Therefore, clinicians’ and researchers’ collective expertise may unravel the potential of SARS-CoV-2 infection to prevent short-term and long-term CNS damage.


id: cord-295500-j84v1k1o
title: Chinese and British Hospitalised Patients with COVID-19—a Comparative Case Series Analysis
author: Conway, J.
date: 2020-07-18
url: https://www.ncbi.nlm.nih.gov/pubmed/32838171/
doi: 10.1007/s42399-020-00414-w
abstract:
  The COVID-19 pandemic initially started in China then spread to Europe. It is not known whether COVID-19 affects patients differently across the two continents. We aimed to describe our cohort of patients admitted to a single British centre with COVID-19 in comparison to a Chinese cohort of similar size and admitted over a similar time period to Chinese centres. We present a comparison of 62 Chinese and 71 British cases hospitalised for COVID-19. Cases in both sites were confirmed by a positive RT-PCR of nasopharyngeal swabs. Comparison analysis highlighted some differences between both populations. The most striking difference is the significantly older age of the British population (72% of the British ≥ 66 years compared to only 3% of the Chinese patients, difference of 69%, 95% confidence interval (CI) 68.3% to 69.7%, respectively) and the associated significant premorbid conditions (85% of patients vs 32%, difference of 53%, 95% CI 52 to 54%, respectively). Gastrointestinal and general symptoms were more common clinical presentation in the British while respiratory symptoms were more prominent in the Chinese cohort. Mortality was significantly higher in the British cohort 14% compared to none in the Chinese cohort (difference of 14%, 95% CI 13.7 to 14.3%). We conclude that COVID-19 does present differently in these two cohorts, but the apparent differences in the clinical presentations could be explained by the inherent differences in the demographics and case mix between both countries.


id: cord-298980-yt52bgc7
author: Ferrara, Francesco
date: 2020-06-26
url: https://doi.org/10.1007/s42399-020-00375-0
doi: 10.1007/s42399-020-00375-0
abstract: nan
title:
  Worldwide Recommendations and Therapies for Multiple Sclerosis: Are They Safe in the COVID-19 Pandemic Period?


id: cord-300320-07tdrd4w
title: Systematic and Statistical Review of Coronavirus Disease 19 Treatment Trials
author: Siordia, Juan A.
date: 2020-07-15
txt: ./txt/cord-300320-07tdrd4w.txt
cache: ./cache/cord-300320-07tdrd4w.txt
extension: .txt
mime: text/plain
url: https://www.ncbi.nlm.nih.gov/pubmed/32838169/
doi: 10.1007/s42399-020-00399-6
summary:
  Medications assessed included lopinavir/ritonavir, arbidol, hydroxychloroquine, tocilizumab, favipiravir, heparin, and dexamethasone. Review of literature showed no significant clinical improvement with lopinavir/ritonavir, arbidol, hydroxychloroquine, or remdesivir. Medical therapies investigated included lopinavir/ritonavir, arbidol, hydroxychloroquine, remdesivir, favipiravir, heparin, glucocorticoids, interferon, ivermectin, and convalescent plasma. Key words included COVID-19, SARS-CoV2, randomized, This article is part of the Topical Collection on Covid-19 controlled, human, retrospective, prospective, trial, chloroquine, hydroxychloroquine, lopinavir, ritonavir, arbidol, umifenovir, tocilizumab, favipiravir, steroids, dexamethasone, glucocorticoids, interferon, ivermectin, remdesivir, azithromycin, heparin, and low-molecular weight heparin. Lopinavir/ritonavir, arbidol, hydroxychloroquine, favipiravir, remdesivir, and heparin are medications that have been tested in human controlled trials for COVID-19 treatment. In human trials, arbidol shows no significant positive-negative conversion rate or recovery time compared to standard therapy or lopinavir/ritonavir [4, 9] . Combining T, treatment group (remdesivir); C, control group all the hydroxychloroquine human trials showed no benefit with reducing COVID-19 viral shedding time.

abstract:
  The following systematic review and meta-analysis compile the current data regarding human controlled COVID-19 treatment trials. An electronic search of the literature compiled studies pertaining to human controlled treatment trials with COVID-19. Medications assessed included lopinavir/ritonavir, arbidol, hydroxychloroquine, tocilizumab, favipiravir, heparin, and dexamethasone. Statistical analyses were performed for common viral clearance endpoints whenever possible. Lopinavir/ritonavir showed no significant effect on viral clearance for COVID-19 cases (OR 0.95 [95% CI 0.50–1.83]). Hydroxychloroquine also showed no significant effect on COVID-19 viral clearance rates (OR 2.16 [95% CI 0.80–5.84]). Arbidol showed no 7-day (OR 1.63 [95% CI 0.76–3.50]) or 14-day viral (OR 5.37 [95% CI 0.35–83.30]) clearance difference compared to lopinavir/ritonavir. Review of literature showed no significant clinical improvement with lopinavir/ritonavir, arbidol, hydroxychloroquine, or remdesivir. Tocilizumab showed mixed results regarding survival. Favipiravir showed quicker symptom improvement compared to lopinavir/ritonavir and arbidol. Heparin and dexamethasone showed improvement with severe COVID-19 cases requiring supplemental oxygenation. Current medications do not show significant effect on COVID-19 viral clearance rates. Tocilizumab showed mixed results regarding survival. Favipiravir shows favorable results compared to other tested medications. Heparin and dexamethasone show benefit especially for severe COVID-19 cases.


id: cord-300866-cso6l6ze
title: Clinical Features of COVID-19 in a Young Man with Massive Cerebral Hemorrhage—Case Report
author: Bao, Yi
date: 2020-05-23
url: https://www.ncbi.nlm.nih.gov/pubmed/32838132/
doi: 10.1007/s42399-020-00315-y
abstract:
  COVID-19 is currently a pandemic in the world, can invade multiple systems, and has a high morbidity and mortality. So far, no cases of acute cerebrovascular disease have been reported. This article reports the clinical features of a COVID-19 patient whose first symptom was cerebral hemorrhage. More importantly, after the craniotomy, the patient had high fever and it was difficult to retreat. After cerebrospinal fluid testing, it was determined that an intracranial infection had occurred. After anti-infection and plasma infusion of the recovered person, the patient’s symptoms gradually improved. This case suggests that COVID-19 may infringe on cerebral blood vessels and cause cerebral hemorrhage. Transfusion of plasma from rehabilitation patients is effective for critically ill patients.


id: cord-303731-yrlzxtbw
title: Management of Dysphagia in Nursing Homes During the COVID-19 Pandemic: Strategies and Experiences
author: Fong, Raymond
date: 2020-08-18
url: https://www.ncbi.nlm.nih.gov/pubmed/32838197/
doi: 10.1007/s42399-020-00464-0
abstract:
  The global 2019 novel coronavirus disease (COVID-19) pandemic has had devastating effects not only on healthcare systems worldwide but also on different aspects of the care provided to nursing home residents. Dysphagia management is a crucial component of the care provided to many nursing home residents. This article presents the dysphagia management strategies applied in Hong Kong during the COVID-19 pandemic and the related experiences. A two-tier protection system was implemented wherein residents were categorised according to their contact and hospitalisation histories. The provided swallowing management and personal protective equipment level differed between the two tiers. The article also discusses the referral and prioritisation of clinical services for residents requiring swallowing management, as well as the adaptations of swallowing assessment and management during the pandemic. The possible effects of COVID-19 on mealtime arrangements in nursing homes, the implications of the pandemic on the use of personal protective equipment and the use of telepractice in nursing homes were also discussed. This article has summarised the actions taken in this regard and may serve as a reference to clinicians who are responsible for swallowing assessments and dysphagia management in nursing homes.


id: cord-303959-e1654g5j
author: Vitiello, Antonio
date: 2020-08-27
url: https://doi.org/10.1007/s42399-020-00487-7
doi: 10.1007/s42399-020-00487-7
title:
  COVID-19 Patients with Pulmonary Fibrotic Tissue: Clinical Pharmacological Rational of Antifibrotic Therapy

abstract:
  In December 2019, the first data emerged from Wuhan, China, of a serious acute respiratory disease caused by a new coronavirus, SARS-CoV-2 (COVID-19). In a short time, the health emergency became a global pandemic. To date, there are about 18.8 million infected people and about 700,000 deaths. There are currently no effective vaccines, and treatments are mostly experimental. The symptoms associated with COVID-19 are different, ranging from mild upper respiratory tract symptoms to severe acute respiratory distress syndrome (SARS). Data from previous coronavirus outbreaks such as SARS-CoV (2003 outbreak) and emerging epidemiological data from the current global COVID-19 pandemic suggest that there could be substantial tissue fibrotic consequences following SARS-CoV-2 infection, responsible for severe and in some cases fatal lung lesions. Some data show that even patients cured of viral infection have lung fibrotic tissue residues responsible for incorrect respiratory function even after healing. The role of antifibrotic drug therapy in patients with ongoing SARS-CoV-2 infection or in patients cured of residual pulmonary fibrosis is still to be defined and unclear; the scientific rationale for initiating, continuing, or discontinuing therapy is poorly defined. In this article, we describe the advantages of antifibrotic therapy in patients with ongoing SARS-CoV-2 viral infection to prevent the worsening and aggravation of the clinical situation, and the advantages it could have in the role of preventing pulmonary fibrosis after SARS-CoV-2 infection, and in accelerating the complete healing process.


id: cord-310084-taaz6mhs
title: Acute Ischemic and Hemorrhagic Stroke and COVID-19: Case Series
author: Fatehi, Poya
date: 2020-10-01
url: https://doi.org/10.1007/s42399-020-00559-8
doi: 10.1007/s42399-020-00559-8
abstract:
  The coronavirus COVID-19 pandemic is the defining global health crisis of our time and the greatest challenge we have faced since the World Wars; it can attack several systems in the body and has high complications and mortality. COVID-19 can cause venous and arterial thromboembolism due to immobility, high inflammation, extensive intravascular blood coagulation, and hypoxia. In this study, we report 5 cases of adults with COVID-19, hospitalized in Tohid Hospital, Sanandaj, Iran. Three patients were male and two were female. The youngest patient was 20 years old and the oldest was 55 years old. All patients had at least one family member with coronavirus. Fever, chills, muscular pain, cough, and tachypnea were present in all patients. Red blood cell (RBC) was observed in all patients at a low level. Computed tomography (CT) scans of all patients showed abnormal findings in different areas of the brain. These cases indicate that COVID-19 may damage blood vessels in the brain and lead to stroke.


id: cord-312730-4ejjmab4
title: The SARS-CoV-2 Outbreak: an Epidemiological and Clinical Perspective
author: Wong, Rebecca S. Y.
date: 2020-09-29
txt: ./txt/cord-312730-4ejjmab4.txt
cache: ./cache/cord-312730-4ejjmab4.txt
extension: .txt
mime: text/plain
url: https://www.ncbi.nlm.nih.gov/pubmed/33015553/
doi: 10.1007/s42399-020-00546-z
summary:
  The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) outbreak started with the detection of an increasing number of pneumonia cases of unknown origin in Wuhan, China, since December 2019. In response to the rapidly growing number of confirmed cases and deaths, some measures taken by the Chinese authorities include the quarantine of millions of its citizens with the unprecedented lockdown of many cities, in an attempt to contain the virus and slow down the spread of the disease [3] . One study in China reported a young 22-year-old male who spread SARS-CoV-2 infection to his contacts (1 relative and 6 classmates, all of which were youngsters from 16 to 23 years) just after a few-hour contact during the incubation period, when he was totally asymptomatic [18] , suggesting that the disease is highly infectious during the incubation period.

abstract:
  The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) outbreak started with the detection of an increasing number of pneumonia cases of unknown origin in Wuhan, China, since December 2019. The disease caused by SAS-CoV-2 was subsequently named coronavirus disease 2019 (COVID-19). Currently, the ongoing COVID-19 pandemic poses a global health concern with more than 28.9 million confirmed cases, taking away the lives of more than 900,000 people worldwide. To prevent further spread of the disease, an understanding of the clinical characteristics and how the disease spread is essential, especially for an emerging disease like COVID-19. Individuals who are infected with SARS-CoV-2 show diverse clinical features, and the disease severity can range from asymptomatic to death. The disease has been shown to affect not just the respiratory system but also other systems of the body. This review will discuss the pulmonary and extra-pulmonary clinical manifestations of COVID-19 in general, as well as the clinical characteristics in different groups of patients such as children, the elderly, pregnant women, patients with comorbidities and those with a compromised immunity. It will also critically examine existing evidence from relevant studies and discuss the SARS-CoV-2 outbreak from an epidemiological perspective. With the easing of control measures in many countries after months of lockdown, it is important to revisit the lessons learnt from research, as the world enters a new normal with the coexistence of SARS-CoV-2.


id: cord-317956-srbualjc
title: Sex Differences in Age and Comorbidities for COVID-19 Mortality in Urban New York City
author: Klang, Eyal
date: 2020-08-09
txt: ./txt/cord-317956-srbualjc.txt
cache: ./cache/cord-317956-srbualjc.txt
extension: .txt
mime: text/plain
url: https://www.ncbi.nlm.nih.gov/pubmed/32838184/
doi: 10.1007/s42399-020-00430-w
summary:
  The aim of this study was to compare age and comorbidities between women and men who died from COVID-19. We used a multivariable logistic regression model to identify independently significant variables associated with gender in patients who died from COVID-19. In the multivariable model, cardiovascular comorbidities were not significantly different between women and men. This study demonstrates that women who died of COVID-19 showed a similar cardiovascular disease profile as men. The present study was designed to compare age and comorbidities between women and men who died from COVID-19. Univariate analysis compared age and comorbidities between men and women who died from COVID-19. This study demonstrates that in patients who died from COVID-19, no significant difference was noted between cardiac morbidity and gender. Our study is limited to an assessment of gender differences among patients who have died from COVID-19 without considering the comorbidity rate of men versus women in the general population.

abstract:
  Previous studies demonstrated a higher COVID-19 fatality rate in men. The aim of this study was to compare age and comorbidities between women and men who died from COVID-19. We retrospectively analyzed data of COVID-19 patients hospitalized to a large academic hospital system in New York City between March 1 and May 9, 2020. We used a multivariable logistic regression model to identify independently significant variables associated with gender in patients who died from COVID-19. The model was adjusted for age and comorbidities known to be associated with COVID-19 mortality. We identified 6760 patients diagnosed with COVID-19. Of these patients, 3018/6760 (44.6%) were women. The mortality rate was higher for men (women 18.2% vs. men 20.6%, p = 0.039). Of the patients who died, women were on average 5 years older than men (woman 77.4 ± 12.7 vs. men 72.4 ± 13.0, p < 0.001). In the multivariable model, cardiovascular comorbidities were not significantly different between women and men. Chronic kidney disease (aOR for women 0.7, 95% CI 0.5–0.9) and smoking (aOR for women 0.7, 95% CI 0.5–0.9) were more common in men. Age decile (aOR for women 1.4, 95% CI 1.3–1.6) and obesity (aOR for women 2.3, 95% CI 1.8–3.0) were higher in women. This study demonstrates that women who died of COVID-19 showed a similar cardiovascular disease profile as men. Yet, they are 5 years older than men. Investigating the gender impacts of COVID-19 is an important part of understanding the disease behavior.


id: cord-318542-785hnh19
title: Systematic Review: Safety of Intravesical Therapy for Bladder Cancer in the Era of COVID-19
author: Leeson, Cale E.
date: 2020-08-18
url: https://www.ncbi.nlm.nih.gov/pubmed/32838196/
doi: 10.1007/s42399-020-00461-3
abstract:
  A novel coronavirus has emerged in late 2019 capable of causing a severe respiratory disease known as COVID-19. Its pathogenesis appears to be the initiation of an immune response and resulting cytokine storm that damages the healthy lung tissue of the host. Some epidemiological studies found bacillus Calmette-Guérin (BCG) vaccine can help to decrease morbidity and mortality of the viral infection. We aim to review and summarize what is known about COVID-19 and the current implications of intravesical BCG with regard to the disease.


id: cord-320612-vam0bli3
title: Management of a Hospital-Wide COVID-19 Outbreak Affecting Patients and Healthcare Workers
author: Höring, Steffen
date: 2020-10-26
txt: ./txt/cord-320612-vam0bli3.txt
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extension: .txt
mime: text/plain
url: https://doi.org/10.1007/s42399-020-00597-2
doi: 10.1007/s42399-020-00597-2
summary:
  Here, we report a large nosocomial outbreak of SARS-CoV-2 that occurred at a satellite hospital of the University Hospital Aachen, Germany, with 26 patients and 21 healthcare workers infected. Considering the numerous COVID-19 cases among patients and HCW, a hospital-wide screening was initiated on April 8 for all remaining SARS-CoV-2-negative patients and entire hospital staff. On the other hand, we analyzed the first cases among hospital staff, starting with the potential index nurse tested positive for SARS-CoV-2 on the 6th of April. By the time the outbreak emerged, the hospital policy already comprised preemptive infection control measures in order to prevent intrahospital spread of SARS-CoV-2. The second route of transmission addressed by our measures was infected HCW, who potentially spread SARS-CoV-2 to patients as well as to their co-workers. In the post-outbreak period, we have continued to screen all patients on their day of admission and all geriatric inpatients once weekly for SARS-CoV-2 in order to detect new cases timely.

abstract:
  To the best of our knowledge, here, we describe the first hospital-wide outbreak of SARS-CoV-2 that occurred in Germany in April 2020. We aim to share our experience in order to facilitate the management of nosocomial COVID-19 outbreaks in healthcare facilities. All patients and hospital workers were screened for SARS-CoV-2 repeatedly. An infection control team on the side was installed. Strict spatial separation of patients and intensified hygiene training of healthcare workers (HCW) were initiated. By the time of reporting, 26 patients and 21 hospital workers were infected with a cluster of cases in the geriatric department. Fourteen patients developed COVID-19 consistent symptoms and five patients with severe pre-existing medical conditions died. The outbreak was successfully contained after intensified infection control measures were implemented and no further cases among patients were detected over a period of 14 days. Strict application of standard infection control measures proved to be successful in the management of nosocomial SARS-CoV-2 outbreaks. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (10.1007/s42399-020-00597-2) contains supplementary material, which is available to authorized users.


id: cord-322596-vfmzk2el
title: Involvement of Spike Protein, Furin, and ACE2 in SARS-CoV-2-Related Cardiovascular Complications
author: Ming, Yi
date: 2020-07-11
url: https://www.ncbi.nlm.nih.gov/pubmed/32838164/
doi: 10.1007/s42399-020-00400-2
abstract:
  The novel coronavirus disease 2019 (COVID-19) is a global epidemic caused by severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2). SARS-CoV-2 has a similar structure to severe acute respiratory syndrome coronavirus-1(SARS-CoV-1). The S protein on the surface of the virus is cleaved by host proprotein convertases (PCs) to expose the active N-terminal S1 extracellular domain. Its receptors are angiotensin-converting enzyme 2 (ACE2), and the C-terminal S2 membrane anchoring protein is responsible for translocating the virus into the cell. Among patients with COVID-19, there is a higher prevalence of cardiovascular disease, and more than 7% of patients have suffered myocardial damage due to the infection, but the internal mechanism is still poorly understood. There is currently no specific and effective targeted treatment. Reduction of the patient’s morbidity and mortality is an urgent problem that needs to be solved clinically. By exploring the theoretical analysis of PCs and ACE2 in COVID-19 cardiovascular susceptibility, some insights on how to prevent and alleviate adverse cardiovascular prognosis have been provided in this study.


id: cord-323368-cf5axwcb
title: Re-reading the SARS-COV-2 Epidemic in Bergamo
author: Schena, Daniele
date: 2020-08-11
txt: ./txt/cord-323368-cf5axwcb.txt
cache: ./cache/cord-323368-cf5axwcb.txt
extension: .txt
mime: text/plain
url: https://doi.org/10.1007/s42399-020-00431-9
doi: 10.1007/s42399-020-00431-9
summary:
  Bergamo province was one of the hardest hit regions by the novel SARS-CoV-2 virus. Although many hypotheses have been formulated to explain the rapid outbreak of COVID-19 in Lombardy, none have yet considered the specific conditions that characterized the Bergamo hinterland. In recent months, several hypotheses have been offered to explain the rapid spread of the virus in Bergamo province and Lombardy, but all of them are focused on what happened in the hospitals (Codogno, Alzano Lombardo, and other emergency departments across the territory) involved in the SARS-CoV-2 epidemic. In particular, the management of two patients admitted in the Alzano Lombardo Hospital on the 23rd of February was thought to be critical for the epidemic outbreak. During the last week of February and first week of March, many events could be implied in the spread of SARS-CoV-2.

abstract:
  Bergamo province was one of the hardest hit regions by the novel SARS-CoV-2 virus. Since the beginning of the epidemic, more than 30,000 people have died as a result of the infection. Although many hypotheses have been formulated to explain the rapid outbreak of COVID-19 in Lombardy, none have yet considered the specific conditions that characterized the Bergamo hinterland. In this letter, we try to identify and investigate which elements could have helped the rapid spreading of the virus.


id: cord-329447-kjeqs6zh
author: Shen, Bingzheng
date: 2020-07-04
txt: ./txt/cord-329447-kjeqs6zh.txt
cache: ./cache/cord-329447-kjeqs6zh.txt
extension: .txt
mime: text/plain
url: https://www.ncbi.nlm.nih.gov/pubmed/32838157/
doi: 10.1007/s42399-020-00382-1
summary:
  A large comprehensive gymnasium was converted into Wuchang Fangcang Shelter Hospital in order to provide adequate medical beds and appropriate care for the confirmed patients with mild to moderate symptoms. Since more than 80% of COVID-19 patients were mild or moderate types [4] [5] [6] , a novel public health measure, Fangcang Shelter Hospitals, was conceived [7] . During this major public health emergency, pharmacists, as a member of the medical team, have been responsible for providing professional and superior pharmaceutical services. Relying on the 5G network and medical information systems, the team of pharmacists accomplished pharmaceutical services smoothly, helping to reduce the risk of occupational exposure in the Shelter Hospital. In the pharmaceutical services provided at Wuchang Fangcang Shelter Hospital, ACE-I and ARBs were not recommended, but now, the latest joint viewpoint from three U.S. heart groups states that patients with COVID-19 should take ACE inhibitors and ARBs [14] .

title:
  Wuchang Fangcang Shelter Hospital: Practices, Experiences, and Lessons Learned in Controlling COVID-19

abstract:
  In early January 2020, the outbreak of the new corona virus pneumonia (Corona Virus Disease 2019, COVID-19) occurred. Wuhan, the capital city of Hubei province, became the epicenter of the disease in China. The rapid growth of patients had exceeded the maximum affordability of local medical resources. A large comprehensive gymnasium was converted into Wuchang Fangcang Shelter Hospital in order to provide adequate medical beds and appropriate care for the confirmed patients with mild to moderate symptoms. For these hospitalized patients with COVID-19, medication became the mainstay of therapy. From 5th February to 10th March, a team of pharmacists successfully completed drug supplies and pharmaceutical services for 1124 patients and approximately 800 medical staff, and, while doing so, received zero complaint, and experienced zero disputes and zero pharmacist infection. This paper summarizes the development and construction of the pharmacy, human resource allocation of pharmacists, pharmacy administration, and pharmaceutical services. It aims to review a 34-day period of pharmaceutical practice and serve as a reference for other health professionals working on COVID-19 prevention and treatment in other regions. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (10.1007/s42399-020-00382-1) contains supplementary material, which is available to authorized users.


id: cord-330690-cupy89gl
author: Vierucci, Francesco
date: 2020-09-23
txt: ./txt/cord-330690-cupy89gl.txt
cache: ./cache/cord-330690-cupy89gl.txt
extension: .txt
mime: text/plain
url: https://www.ncbi.nlm.nih.gov/pubmed/32984767/
doi: 10.1007/s42399-020-00532-5
summary:
  During phase 1 (national lockdown period, March 9th-May 3rd, 2020) the Italian Ministry of Health recommended to avoid direct access to the emergency department (ED) in case of fever and/or cough or other respiratory symptoms, favoring home care or phone consultation for ill patients without compromised general conditions [10] . The aims of this study were to (1) evaluate the impact of COVID-19 pandemic on the activity of a secondary care Italian Pediatric Unit assessing, in particular, the characteristics of pediatric ED consultations performed in 2020 before and after the beginning of lockdown; (2) evaluate the prevalence of SARS-CoV-2 infection in children and adolescents referred to ED; and (3) compare pediatric ED activity during the same period of 2019 and 2020.

title:
  How COVID-19 Pandemic Changed Children and Adolescents Use of the Emergency Department: the Experience of a Secondary Care Pediatric Unit in Central Italy

abstract:
  Italy was the first European country hit by SARS-CoV-2 infection, particularly northern regions. After the beginning of national lockdown (March 9th, 2020), we observed a significant decrease in pediatric emergency department consultations (daily pediatric visits; pre-lockdown, 16 (11–22); lockdown, 3 (1–3); phase 2, 3 (3–5), p < 0.0001). On the other hand, the percentage of children discharged right after pediatric visit significantly decreased from 80% in January to 50% in April. After March 9th, we registered a change in the diagnoses of emergency department visits, with an increase in the percentage of non-infectious acute conditions and a decrease in infectious diseases, with two cases of a noteworthy delayed access to hospital care. We performed a retrospective analysis of consultations requested to our pediatric unit for children and adolescents referred to the general Emergency Department of San Luca Hospital of Lucca (Tuscany, Central Italy) from January 1st to May 31st, 2020. We split data in two different time periods according to consultations performed before (January 1st–March 8th) and after the beginning of lockdown (March 9th–May 31st). Analyzing the number of children hospitalized from January to May 2020 in comparison with the same period in 2019, a decreased hospitalization became evident after March (March − 74.6%, April − 71.6%, May − 58.6%). Nasopharyngeal swabs done in 115 children showed only one case of COVID-19. Even if COVID-19 outbreak more seriously affected Northern Italy, utilization of pediatric emergency services significantly changed also in Central Italy with consequent reduced demand and increased appropriateness. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (10.1007/s42399-020-00532-5) contains supplementary material, which is available to authorized users.


id: cord-335095-epsi5qq7
title: Clinical Features of COVID-19 Patients in Xiaogan City
author: Feng, Gong
date: 2020-08-24
txt: ./txt/cord-335095-epsi5qq7.txt
cache: ./cache/cord-335095-epsi5qq7.txt
extension: .txt
mime: text/plain
url: https://www.ncbi.nlm.nih.gov/pubmed/32864573/
doi: 10.1007/s42399-020-00465-z
summary:
  Moreover, the smooth curve fitting graph reflected that the severity of COVID-19 was positively correlated with both age and CRP levels (all P value < 0.05). But the studies exploring the relationship between age, CRP levels, and the severity of COVID-19, especially by the means of smooth curve fitting, are lacking. Thus, we describe the clinical characteristics as well as laboratory findings of COVID-19 patients residing in Xiaogan City, so as to have an insight regarding the prevention as well as treatment of COVID-19, and simultaneously explore the relationship between age, CRP levels, and the severity of COVID-19, thereby exploring the indicators for predicting the severity of COVID-19. Compared with the initial COVID-19 patients observed in Wuhan, in terms of disease symptoms and severity, the patients from Xiaogan City, in our study, were relatively moderate, but we could not neglect asymptomatic or mild patients.

abstract:
  On February 6, 2020, Xiaogan City became the second most seriously affected city with coronavirus disease 2019 (COVID-19), outside Wuhan district, Hubei Province, China. The objectives are to study the clinical features of COVID-19 patients and assess the relationship between the severity of COVID-19, age, and C-reactive protein (CRP) levels. The retrospective data of 134 COVID-19 patients hospitalized in 3 hospitals of Xiaogan City, between February 1 and March 1, 2020, was collected. This study documented COVID-19 patients. Clinical data in terms of body temperature, history of travel, and direct contact with COVID-19 patients, and incubation period was collected. Out of the 134 patients, only 5 required intensive care. Moreover, 2 patients succumbed during this period. The median age of patients was 45 (33–56) years. The most common symptoms at the onset of disease were fever (66.4%), cough (33, 6%), and sore throat (14.7%). Amongst the medicines used, antiviral agents (92.3%) followed by the traditional Chinese medicine (89.5%) were most commonly used. In both the crude and adjusted (I to III) models, odds ratio and its 95% confidence interval for both age and CRP levels were > 1. Moreover, the smooth curve fitting graph reflected that the severity of COVID-19 was positively correlated with both age and CRP levels (all P value < 0.05). The signs and symptoms of COVID-19 patients were fairly moderate. The health care professionals treating the COVID-19 patients should be aware of the increased likelihood of progression to severe COVID-19 in elderly patients and those with high CRP levels.


id: cord-336689-z3ayolzb
title: Challenges and Opportunities of Preclinical Medical Education: COVID-19 Crisis and Beyond
author: Gaur, Uma
date: 2020-09-22
txt: ./txt/cord-336689-z3ayolzb.txt
cache: ./cache/cord-336689-z3ayolzb.txt
extension: .txt
mime: text/plain
url: https://www.ncbi.nlm.nih.gov/pubmed/32984766/
doi: 10.1007/s42399-020-00528-1
summary:
  We searched relevant literature in PubMed, Scopus, and Google Scholar using specific keywords, e.g., "COVID-19 pandemic," "preclinical medical education," "online learning," "remote learning," "challenges," and "opportunities." The pandemic has posed several challenges to premedical education (e.g., suspension of face-to-face teaching, lack of cadaveric dissections, and practical/laboratory sessions) but has provided many opportunities as well, such as the incorporation of online learning in the curriculum and upskilling and reskilling in new technologies. New strategies are emerging in the preclinical phase that integrates technology to make learning effective and appealing to students, [7] [8] [9] , making them more relevant and applicable for remote learning during the current COVID-19 pandemic. [40] also warned: "The COVID-19 pandemic will not be the last major infectious disease that puts learners at risk." However, many medical schools have successfully transitioned their teaching and learning environment to emergency remote learning, having monitored and examined student and staff readiness, and completed online formative and summative exams both in preclinical and clinical years.

abstract:
  COVID-19 pandemic has disrupted face-to-face teaching in medical schools globally. The use of remote learning as an emergency measure has affected students, faculty, support staff, and administrators. The aim of this narrative review paper is to examine the challenges and opportunities faced by medical schools in implementing remote learning for basic science teaching in response to the COVID-19 crisis. We searched relevant literature in PubMed, Scopus, and Google Scholar using specific keywords, e.g., “COVID-19 pandemic,” “preclinical medical education,” “online learning,” “remote learning,” “challenges,” and “opportunities.” The pandemic has posed several challenges to premedical education (e.g., suspension of face-to-face teaching, lack of cadaveric dissections, and practical/laboratory sessions) but has provided many opportunities as well, such as the incorporation of online learning in the curriculum and upskilling and reskilling in new technologies. To date, many medical schools have successfully transitioned their educational environment to emergency remote teaching and assessments. During COVID-19 crisis, the preclinical phase of medical curricula has successfully introduced the novel culture of “online home learning” using technology-oriented innovations, which may extend to post-COVID era to maintain teaching and learning in medical education. However, the lack of hands-on training in the preclinical years may have serious implications on the training of the current cohort of students, and they may struggle later in the clinical years. The use of emergent technology (e.g., artificial intelligence for adaptive learning, virtual simulation, and telehealth) for education is most likely to be indispensable components of the transformative change and post-COVID medical education.


id: cord-336790-29im4gxw
author: Violetis, Odyssefs A.
date: 2020-06-29
url: https://www.ncbi.nlm.nih.gov/pubmed/32838152/
doi: 10.1007/s42399-020-00380-3
title:
  COVID-19 Infection and Haematological Involvement: a Review of Epidemiology, Pathophysiology and Prognosis of Full Blood Count Findings

abstract:
  The unfolding COVID-19 pandemic began in December 2019 in Wuhan, Hubei Province. COVID-19 is a systemic infection affecting several systems including the haematopoietic system. Surveys illustrating the laboratory findings of these patients conclude that lymphocytopenia, neutrophilia and thrombocytopenia are prominent amongst them. Moreover, it has been reported a significant decrease in T lymphocyte subsets and an increase of inflammatory cytokines of hospitalized patients with COVID-19. Generally, thrombocytopenia is commonplace in critically ill patients and usually suggests serious organ malfunction. In view of this, this review investigates the correlation between these abnormalities and the prognosis and disease course. Full blood count is an easy, economic and widely available tool which may help to discriminate between patients with or without severe disease. Last but not least, this review examines potential pathophysiological mechanisms by the novel coronavirus which contribute to these haematological alterations aiding the clinicians to better understand this disease and provide more clinical treatment options.


id: cord-337026-osgi06o4
title: Conjunctivitis as a Sentinel of SARS-CoV-2 Infection: a Need of Revision for Mild Symptoms
author: Panoutsopoulos, Alexios A.
date: 2020-06-19
txt: ./txt/cord-337026-osgi06o4.txt
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extension: .txt
mime: text/plain
url: https://www.ncbi.nlm.nih.gov/pubmed/32838145/
doi: 10.1007/s42399-020-00360-7
summary:
  Given the uprising number of publications and case reports of COVID-19 patients showing conjunctivitis [61, 62] and the history of other coronaviruses that are found in tears, we have to consider the possibility of a separate, alternative viral mechanism through which the virus can enter the patient''s organism through epithelial cells of the eye [63] . The growing evidence on COVID-19 and its ocular implications and manifestations, in both animals and humans, is covered by many interesting reviews, all published 5 to 6 months after the novel coronavirus'' outbreak [64] [65] [66] [67] [68] , something that reveals the need to understand the virus from different perspectiveswhich at first may have seemed secondary in priority-in order to be able to reach a treatment.

abstract:
  COVID-19 has been declared a pandemic by the World Health Organization on March 11, and since then, more than 3 million cases and a quarter million deaths have occurred due to it. Lately, there is a growing evidence for an ophthalmologic symptom (conjunctivitis) to be connected with the disease. This seems to happen in early stages of the infection by SARS-CoV-2, and thus, it is of major importance to understand the mechanism through which the virus can facilitate such a symptom. Here, we are proposing a molecular mechanism through which the novel coronavirus could act in order to affect the eye and use it as another, secondary but alternative, point of entry to the host organism.


id: cord-338544-eph89g47
title: COVID-19: is it just a lung disease? A case-based review
author: Spuntarelli, Valerio
date: 2020-07-28
url: https://www.ncbi.nlm.nih.gov/pubmed/32838177/
doi: 10.1007/s42399-020-00418-6
abstract:
  Due to its extreme virulence, COVID-19 virus has rapidly spread, developing a severe pandemic. SARS-COV-2 mostly affected the respiratory tract, causing a severe acute lung failure. Although the infection of airways, COVID-19 can be associated with chronic and systemic damages still not so much known. The purpose of this research is to collect recent evidence in literature about systemic diseases caused by COVID-19. The format of the present article has features of a systematic case-based review (level of evidence), and it is structured as a case series report (patients of our COVID-19 Medicine Ward have been selected as cases). Data for this review have been selected systematically, taking evidence only from indexed journals and databases: PubMed, Scopus, MEDLINE, and Cochrane systems. Papers chosen included systematic reviews, case series, clinical cases, meta-analysis studies, and RCTs. We start collecting studies since 2003. The main keywords used were “COVID-19” “OR” “SARS” “OR” “SARS – COV 2” “AND” “systemic disease” / “nephropathy” / “cardiac pathology” / “central nervous system.” Clinical cases belong to our COVID-19 Medicine Ward. One of the most severe COVID-19 clinical presentations includes cardiovascular problems, like myocarditis, pericarditis, and acute hearth failure. Cytokine release syndrome caused by COVID-19 develops severe acute kidney failure. It is still unknown the way coronavirus damages the liver, brain, and reproductive system. Considering the majority of the new studies about this pathology, it issues that COVID-19 is considered to be a multi-organ disease.


id: cord-339332-6lml531t
title: COVID-19 and its Modes of Transmission
author: Karia, Rutu
date: 2020-09-01
txt: ./txt/cord-339332-6lml531t.txt
cache: ./cache/cord-339332-6lml531t.txt
extension: .txt
mime: text/plain
url: https://www.ncbi.nlm.nih.gov/pubmed/32904860/
doi: 10.1007/s42399-020-00498-4
summary:
  The direct mode includes (1) transmission via aerosols formed via surgical and dental procedures and/or in the form of respiratory droplet nuclei; (2) other body fluids and secretions, for example, feces, saliva, urine, semen, and tears; and (3) mother-to-child. The direct mode includes (1) transmission via aerosols formed via surgical and dental procedures and/or in the form of respiratory droplet nuclei; (2) other body fluids and secretions, for example, feces, saliva, urine, semen, and tears; and (3) mother-to-child. The goal of this paper is to briefly review how SARS-CoV-2 is shown to transmit via various modes and propose measures to reduce the risk of spread within the population and operating personnel. Letter: the risk of COVID-19 infection during neurosurgical procedures: a review of severe acute respiratory distress syndrome coronavirus 2 (SARS-CoV-2) modes of transmission and proposed neurosurgery-specific measures for mitigation

abstract:
  The World Health Organization recognized SARS-CoV-2 as a public health concern and declared it as a pandemic on March 11, 2020. Over 12 million people have been affected across several countries since it was first recognized. SARS-CoV-2 is thought to commonly spread via respiratory droplets formed while talking, coughing, and sneezing of an infected patient. As several cases, with an absence of travel history to the majorly affected areas were identified, a strong possibility of community transmission could have been possible. Broadly, two modes of transmission of COVID-19 exist—direct and indirect. The direct mode includes (1) transmission via aerosols formed via surgical and dental procedures and/or in the form of respiratory droplet nuclei; (2) other body fluids and secretions, for example, feces, saliva, urine, semen, and tears; and (3) mother-to-child. Indirect transmission may occur via (1) fomites or surfaces (e.g., furniture and fixtures) present within the immediate environment of an infected patient and (2) objects used on the infected person (e.g., stethoscope or thermometer). As many of these modes may be underestimated, it is necessary to emphasize and illustrate them. The goal of this paper is to briefly review how SARS-CoV-2 is shown to transmit via various modes and propose measures to reduce the risk of spread within the population and operating personnel.


id: cord-340305-jtvn9tlm
title: A Minimalist Strategy Towards Temporarily Defining Protection for COVID-19
author: Cimolai, Nevio
date: 2020-09-19
url: https://doi.org/10.1007/s42399-020-00533-4
doi: 10.1007/s42399-020-00533-4
abstract:
  Until either efficacious therapy or vaccination for COVID-19 is achieved, there will be a need to regain world economic stability while yet controlling the pandemic with current approaches. For those infected thus far, there is a prevailing perspective that devising recognition for protective immunity will progressively allow segments of society to return to some functionality more than is existing. At this time, the best correlates with protection from natural coronavirus infections are systemic neutralizing antibody and mucosal IgA. Serum neutralizing antibody more easily fulfills the latter requisite, but current live virus methods for neutralization prevent large-scale application. It is conceivable that the exposure of previously infected individuals can allow for the definition of protective thresholds of neutralizing antibody. Thereafter, many other antibody assays will be able to screen for surrogate protection after correlations with protective neutralizing antibody are made. Specificity of common antibody tests would benefit from confirmatory blocking systems or confirmatory immunoblotting fingerprints with well-defined antigen(s). The opportunity for the scientific community to make these assessments is evident in the current context of the COVID-19 epidemic given the large numbers of infected individuals worldwide. Such information will also be vital to guide vaccine development and/or immunotherapy.


id: cord-341987-lsvifqyo
title: Novel Corona Virus Pandemic and Neonatal Care: It’s Too Early to Speculate on Impact!
author: Kalyanasundaram, Sridhar
date: 2020-08-03
url: https://doi.org/10.1007/s42399-020-00440-8
doi: 10.1007/s42399-020-00440-8
abstract:
  The entire world is reeling under the effects of the novel corona virus pandemic. As it is a new infection, our knowledge is evolving constantly. There is limited information about impact of corona virus on neonatal care in relation to newborns with confirmed or suspected COVID-19. In this article, we summarize the current approach to this infection in relation to newborn babies. We discuss the basic aspects of the infection, the approach of care to novel corona virus disease 2019 (COVID-19) in positive pregnant women, the likely presentation in newborns (as per current knowledge), and the approach to the management of neonates with infection or at risk of the infection. Children are less susceptible to COVID-19 infection and generally have a mild course. There is a lower risk of severe disease among pregnant women and neonates. It was recommended to follow the current protocols for management of symptomatic newborn with isolation precautions, antibiotics, and respiratory support.


id: cord-344217-kci4uw7u
author: Majid, Sabhiya
date: 2020-08-25
txt: ./txt/cord-344217-kci4uw7u.txt
cache: ./cache/cord-344217-kci4uw7u.txt
extension: .txt
mime: text/plain
url: https://doi.org/10.1007/s42399-020-00457-z
doi: 10.1007/s42399-020-00457-z
summary:
  Coronavirus disease 2019 (COVID-19), an ongoing global health emergency, is a highly transmittable and pathogenic viral infection caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Coronaviruses (CoVs) have emerged as a major public health concern having caused three zoonotic outbreaks; severe acute respiratory syndrome-CoV (SARS-CoV) in 2002–2003, Middle East respiratory syndrome-CoV (MERS-CoV) in 2012, and currently this devastating COVID-19. Beta coronaviruses are a subgroup of the coronavirus family, large enveloped positive-sense singlestranded RNA (+ssRNA) viruses able to infect a wide variety of mammals and avian species, causing mainly respiratory or enteric diseases [2] . The disease caused by SARS-CoV-2 has been named COVID-19, a highly transmittable and pathogenic respiratory infection, which has become a public health emergency of international concern as no clinically approved antiviral drug or vaccine is available-though few broad spectrum antiviral drugs and drug combinations in clinical trials have resulted in clinical recovery [23] [24] [25] [26] [27] .

title:
  Managing the COVID-19 Pandemic: Research Strategies Based on the Evolutionary and Molecular Characteristics of Coronaviruses

abstract:
  Coronavirus disease 2019 (COVID-19), an ongoing global health emergency, is a highly transmittable and pathogenic viral infection caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Emerging in Wuhan, China, in December 2019, it spread widely across the world causing panic—worst ever economic depression is visibly predictable. Coronaviruses (CoVs) have emerged as a major public health concern having caused three zoonotic outbreaks; severe acute respiratory syndrome-CoV (SARS-CoV) in 2002–2003, Middle East respiratory syndrome-CoV (MERS-CoV) in 2012, and currently this devastating COVID-19. Research strategies focused on understanding the evolutionary origin, transmission, and molecular basis of SARS-CoV-2 and its pathogenesis need to be urgently formulated to manage the current and possible future coronaviral outbreaks. Current response to the COVID-19 outbreak has been largely limited to monitoring/containment. Although frantic global efforts for developing safe and effective prophylactic and therapeutic agents are on, no licensed antiviral treatment or vaccine exists till date. In this review, research strategies for coping with COVID-19 based on evolutionary and molecular aspects of coronaviruses have been proposed.


id: cord-347926-63w578b2
title: COVID-19 in Children: Clinical Characteristics and Follow-Up Study
author: Ruan, Pei-sen
date: 2020-09-03
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url: https://www.ncbi.nlm.nih.gov/pubmed/32895639/
doi: 10.1007/s42399-020-00502-x
summary:
  We recorded patients'' epidemiological, clinical features, and follow-up data after discharging in order to improve the awareness and treatment of children with COVID-19. Since December 2019, multiple patients of pneumonia infected with the emergence of severe acute respiratory syndrome coronavirus 2 disease (COVID-19) had been detected in Wuhan city, China [1] . So, analysis of the clinical characteristics, epidemiological characteristics, and follow-up results after discharge of pediatric patients with confirmed COVID-19 in this area was aimed at improving the awareness and treatment of children with COVID-19. Diagnosis and discharge standards were performed according to the content of the "Diagnosis and treatment guidelines for 2019 novel coronavirus pneumonia (Trial Version 7) (In Chinese) [3] ." We observed and recorded the patient''s epidemiological characteristics, clinical manifestations, laboratory tests, radiography, treatment methods, and transfer return. Clinical and epidemiological features of 36 children with coronavirus disease 2019 (COVID-19) in Zhejiang, China: an observational cohort study

abstract:
  Since December 2019, the coronavirus disease 2019 (COVID-19) has spread globally. But the clinical symptoms and detailed follow-up of children with COVID-19 infection are lacking. Here, we conducted a retrospective study including children with confirmed COVID-19. We recorded patients’ epidemiological, clinical features, and follow-up data after discharging in order to improve the awareness and treatment of children with COVID-19.


id: cord-348121-c7jq240j
title: The “Pandemic” of Disinformation in COVID-19
author: Tagliabue, Fabio
date: 2020-08-01
url: https://doi.org/10.1007/s42399-020-00439-1
doi: 10.1007/s42399-020-00439-1
abstract:
  In recent years, mass media and social networks have played an important role in disseminating information regarding public health. During the COVID-19 epidemic, misinformation and fake news have represented an important issue generating confusion and insecurity among the population. In our analysis, we investigate the role of mass media as a critical element during the SARS-CoV-2 outbreak that has influenced the public perception of risk.


id: cord-351531-wo1ggmmn
title: Trans-thoracic Echocardiography in Prone Positioning COVID-19 Patients: a Small Case Series
author: Giustiniano, Enrico
date: 2020-09-15
url: https://www.ncbi.nlm.nih.gov/pubmed/32954211/
doi: 10.1007/s42399-020-00516-5
abstract:
  During SARS-CoV-2 pandemic, several subjects were treated in our intensive care unit (ICU) because of acute respiratory failure following COVID-19 pneumonia. Most of them required mechanical ventilation and someone in prone position (PP) too, because of acute respiratory distress syndrome (ARDS). During PP, trans-esophageal echocardiography (TEE) is not always easy, mainly due to the forced position of the neck of the patient. Moreover, during a pandemic, given the great number of patients needing treatment, TEE probes and monitoring devices are not widely available. Then, trans-thoracic echocardiography (TTE) plays a crucial role as it is non-invasive, repeatable, and available every time it is needed. Moreover, it can be safely performed also in prone position (TTEp). According to in-hospital protocol, TTEp was performed using the apical-four-chamber (A-4-C) view in 8 patients. We temporarily deflated the lower thoracic section of the air-mattress to place the probe between the mattress surface and the thorax of the patient. We collected both TEE and hemodynamics data. The main result of our retrospective analysis is that TTE can be performed in patients in prone positioning and is reliable and repeatable; the single apical-four-chamber view provides sufficient data to evaluate the cardiac performance in case of scarce availability of hemodynamic monitoring devices, like in a pandemic setting. TTE may be a helpful tool for cardiac performance evaluation and diagnosis not only in supine or anterolateral positioning like in echocardiographic lab, but also in subjects admitted to ICU due to ARDS needing of mechanical ventilation in prone positioning.


id: cord-352642-u513wnu1
author: Patrocínio de Jesus, Rita
date: 2020-10-02
txt: ./txt/cord-352642-u513wnu1.txt
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url: https://www.ncbi.nlm.nih.gov/pubmed/33043249/
doi: 10.1007/s42399-020-00548-x
summary:
  After reviewing this case in light of current evidence and debates surrounding SARS-CoV-2 RT-PCR results, we hypothesize that patients on corticosteroids may have particular viral shedding dynamics and should prompt a more conservative approach in regard to isolation discontinuation and monitoring. Since the identification of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) as the cause of the disease which was later named COVID-19, and as it progressed to the current worldwide pandemic, much investigation has been made regarding its clinical presentation, transmission route, and immunity. This could point either to a reactivation of the disease in a patient who first presented as asymptomatic or to a long incubation period (18 days from risk contact until developing symptoms, with a CT performed 3 days prior to the onset of symptoms showing an evolving disease, which is consistent with previous studies reporting typical radiological findings of COVID-19 in asymptomatic or presymptomatic patients [2] ).

title:
  Reactivation of SARS-CoV-2 after Asymptomatic Infection while on High-Dose Corticosteroids. Case Report

abstract:
  As SARS-CoV-2 and its related clinical syndrome (COVID-19) became a pandemic worldwide, questions regarding its clinical presentation, infectivity, and immune response have been the subject of investigation. We present a case of a patient previously considered recovered from nosocomially transmitted asymptomatic COVID-19 illness, who presented with new respiratory, radiological, and RT-PCR findings consistent with COVID-19, while on high-dose prednisolone due to a suspected secondary demyelinating disease. Importantly, it led to three subsequent cases within patient’s household after discharge from the hospital. After reviewing this case in light of current evidence and debates surrounding SARS-CoV-2 RT-PCR results, we hypothesize that patients on corticosteroids may have particular viral shedding dynamics and should prompt a more conservative approach in regard to isolation discontinuation and monitoring.


