Review J Ultrasound Med
. 2020 Jul;39(7):1459-1462. doi: 10.1002/jum.15284. Epub 2020 Apr 7.
Is There a Role for Lung Ultrasound During the COVID-19 Pandemic?
Gino Soldati 1, Andrea Smargiassi 2, Riccardo Inchingolo 2, Danilo Buonsenso 3, Tiziano Perrone 4 5, Domenica Federica Briganti 4 5, Stefano Perlini 4 5, Elena Torri 6, Alberto Mariani 7, Elisa Eleonora Mossolani 8, Francesco Tursi 9, Federico Mento 10, Libertario Demi 10
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PMID: 32198775 PMCID: PMC7228238 DOI: 10.1002/jum.15284
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Cited by 13 articles12 references2 figures
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2
Gastrointest Endosc
. 2020 Jul;92(1):192-197. doi: 10.1016/j.gie.2020.03.019. Epub 2020 Mar 14.
Coronavirus (COVID-19) Outbreak: What the Department of Endoscopy Should Know
Alessandro Repici 1, Roberta Maselli 2, Matteo Colombo 3, Roberto Gabbiadini 3, Marco Spadaccini 3, Andrea Anderloni 2, Silvia Carrara 2, Alessandro Fugazza 2, Milena Di Leo 3, Piera Alessia Galtieri 2, Gaia Pellegatta 2, Elisa Chiara Ferrara 2, Elena Azzolini 4, Michele Lagioia 4
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PMID: 32179106 PMCID: PMC7102667 DOI: 10.1016/j.gie.2020.03.019
Free PMC article
Abstract
Italy recorded its first case of confirmed acute respiratory illness because of coronavirus on February 18, 2020, soon after the initial reports in China. Since that time, Italy and nations throughout the world have adopted very stringent and severe measures to protect populations from spread of infection. Despite these measures, the number of infected people is growing exponentially, with a significant number of patients developing acute respiratory insufficiency. Endoscopy departments face significant risk for diffusion of respiratory diseases that can be spread via an airborne route, including aspiration of oral and fecal material via endoscopes. The purpose of this article is to discuss the measures, with specific focus on personal protection equipment and dress code modalities, implemented in our hospital to prevent further dissemination of COVID-19 infection.

Copyright © 2020 American Society for Gastrointestinal Endoscopy. Published by Elsevier Inc. All rights reserved.

Comment in
Separated pathways in the endoscopy unit for COVID-19 patients.
Cortegoso Valdivia P, Le Grazie M, Gaiani F, Decembrino F, De' Angelis GL.
Gastrointest Endosc. 2020 Jul;92(1):239. doi: 10.1016/j.gie.2020.03.3841. Epub 2020 Mar 27.
PMID: 32229132 Free PMC article. No abstract available.
Cited by 46 articles18 references3 figures
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3
Meta-Analysis Lancet
. 2020 Jun 27;395(10242):1973-1987. doi: 10.1016/S0140-6736(20)31142-9. Epub 2020 Jun 1.
Physical Distancing, Face Masks, and Eye Protection to Prevent Person-To-Person Transmission of SARS-CoV-2 and COVID-19: A Systematic Review and Meta-Analysis
Derek K Chu 1, Elie A Akl 2, Stephanie Duda 3, Karla Solo 3, Sally Yaacoub 4, Holger J Schünemann 5, COVID-19 Systematic Urgent Review Group Effort (SURGE) study authors
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PMID: 32497510 PMCID: PMC7263814 DOI: 10.1016/S0140-6736(20)31142-9
Free PMC article
Abstract
Background: Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) causes COVID-19 and is spread person-to-person through close contact. We aimed to investigate the effects of physical distance, face masks, and eye protection on virus transmission in health-care and non-health-care (eg, community) settings.

Methods: We did a systematic review and meta-analysis to investigate the optimum distance for avoiding person-to-person virus transmission and to assess the use of face masks and eye protection to prevent transmission of viruses. We obtained data for SARS-CoV-2 and the betacoronaviruses that cause severe acute respiratory syndrome, and Middle East respiratory syndrome from 21 standard WHO-specific and COVID-19-specific sources. We searched these data sources from database inception to May 3, 2020, with no restriction by language, for comparative studies and for contextual factors of acceptability, feasibility, resource use, and equity. We screened records, extracted data, and assessed risk of bias in duplicate. We did frequentist and Bayesian meta-analyses and random-effects meta-regressions. We rated the certainty of evidence according to Cochrane methods and the GRADE approach. This study is registered with PROSPERO, CRD42020177047.

Findings: Our search identified 172 observational studies across 16 countries and six continents, with no randomised controlled trials and 44 relevant comparative studies in health-care and non-health-care settings (n=25 697 patients). Transmission of viruses was lower with physical distancing of 1 m or more, compared with a distance of less than 1 m (n=10 736, pooled adjusted odds ratio [aOR] 0·18, 95% CI 0·09 to 0·38; risk difference [RD] -10·2%, 95% CI -11·5 to -7·5; moderate certainty); protection was increased as distance was lengthened (change in relative risk [RR] 2·02 per m; pinteraction=0·041; moderate certainty). Face mask use could result in a large reduction in risk of infection (n=2647; aOR 0·15, 95% CI 0·07 to 0·34, RD -14·3%, -15·9 to -10·7; low certainty), with stronger associations with N95 or similar respirators compared with disposable surgical masks or similar (eg, reusable 12-16-layer cotton masks; pinteraction=0·090; posterior probability >95%, low certainty). Eye protection also was associated with less infection (n=3713; aOR 0·22, 95% CI 0·12 to 0·39, RD -10·6%, 95% CI -12·5 to -7·7; low certainty). Unadjusted studies and subgroup and sensitivity analyses showed similar findings.

Interpretation: The findings of this systematic review and meta-analysis support physical distancing of 1 m or more and provide quantitative estimates for models and contact tracing to inform policy. Optimum use of face masks, respirators, and eye protection in public and health-care settings should be informed by these findings and contextual factors. Robust randomised trials are needed to better inform the evidence for these interventions, but this systematic appraisal of currently best available evidence might inform interim guidance.

Funding: World Health Organization.

© 2020 World Health Organization. Published by Elsevier Ltd. This is an Open Access article published under the CC BY 3.0 IGO license which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. In any use of this article, there should be no suggestion that WHO endorses any specific organisation, products or services. The use of the WHO logo is not permitted. This notice should be preserved along with the article's original URL.

Comment in
Physical distancing, face masks, and eye protection for prevention of COVID-19.
MacIntyre CR, Wang Q.
Lancet. 2020 Jun 27;395(10242):1950-1951. doi: 10.1016/S0140-6736(20)31183-1. Epub 2020 Jun 1.
PMID: 32497511 Free PMC article. No abstract available.
Cited by 4 articles87 references6 figures
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Case Reports Am J Perinatol
. 2020 Jun;37(8):861-865. doi: 10.1055/s-0040-1710050. Epub 2020 Apr 18.
Severe COVID-19 During Pregnancy and Possible Vertical Transmission
Maria Claudia Alzamora 1, Tania Paredes 2, David Caceres 3, Camille M Webb 4 5, Luis M Valdez 5 6, Mauricio La Rosa 1 7
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PMID: 32305046 DOI: 10.1055/s-0040-1710050
Abstract
There are few cases of pregnant women with novel corona virus 2019 (COVID-19) in the literature, most of them with a mild illness course. There is limited evidence about in utero infection and early positive neonatal testing. A 41-year-old G3P2 with a history of previous cesarean deliveries and diabetes mellitus presented with a 4-day history of malaise, low-grade fever, and progressive shortness of breath. A nasopharyngeal swab was positive for COVID-19, COVID-19 serology was negative. The patient developed respiratory failure requiring mechanical ventilation on day 5 of disease onset. The patient underwent a cesarean delivery, and neonatal isolation was implemented immediately after birth, without delayed cord clamping or skin-to-skin contact. The neonatal nasopharyngeal swab, 16 hours after delivery, was positive for severe acute respiratory syndrome-coronavirus 2 (SARS-CoV-2) real-time polymerase chain reaction (RT-PCR), and immunoglobulin (Ig)-M and IgG for SARS-CoV-2 were negative. Maternal IgM and IgG were positive on postpartum day 4 (day 9 after symptom onset). We report a severe presentation of COVID-19 during pregnancy. To our knowledge, this is the earliest reported positive PCR in the neonate, raising the concern for vertical transmission. We suggest pregnant women should be considered as a high-risk group and minimize exposures for these reasons. KEY POINTS: · We report a severe presentation of COVID-19 in pregnancy requiring invasive ventilatory support.. · This is a case of positive RT-PCR in first day of life, suggesting possible vertical transmission.. · There were no detectable maternal antibodies for COVID-19 until after delivery..

Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Conflict of interest statement
None declared.

Comment in
Vertical Transmission of SARS-CoV-2: What is the Optimal Definition?
Blumberg DA, Underwood MA, Hedriana HL, Lakshminrusimha S.
Am J Perinatol. 2020 Jun;37(8):769-772. doi: 10.1055/s-0040-1712457. Epub 2020 Jun 5.
PMID: 32503058 No abstract available.
Cited by 8 articles
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5
J Infect Dis
. 2020 Jun 29;222(2):183-188. doi: 10.1093/infdis/jiaa229.
Longitudinal Change of Severe Acute Respiratory Syndrome Coronavirus 2 Antibodies in Patients With Coronavirus Disease 2019
Guoxin Zhang 1, Shuke Nie 1, Zhaohui Zhang 1, Zhentao Zhang 1
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PMID: 32358956 PMCID: PMC7197530 DOI: 10.1093/infdis/jiaa229
Free PMC article
Abstract
Background: A novel coronavirus, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), has recently emerged and caused the rapid spread of coronavirus disease 2019 (COVID-19) worldwide.

Methods: We did a retrospective study and included COVID-19 patients admitted to Renmin Hospital of Wuhan University between 1 February and 29 February 2020. Antibody assay was conducted to detect COVID-19 envelope protein E and nucleocapsid protein N antigen.

Results: One hundred twelve patients were recruited with symptoms of fever, cough, fatigue, myalgia, and diarrhea. All patients underwent antibody tests. Fifty-eight (51.79%) were positive for both immunoglobulin M (IgM) and immunoglobulin G (IgG), 7 (6.25%) were negative for both antibodies, 1 (0.89%) was positive for only IgM, and 46 (41.07%) were positive for only IgG. IgM antibody appeared within a week post-disease onset, lasted for 1 month, and gradually decreased, whereas IgG antibody was produced 10 days after infection and lasted for a longer time. However, no significant difference in levels of IgM and IgG antibodies between positive and negative patients of nucleic acid test after treatment was found.

Conclusions: Our results indicate that serological tests could be a powerful approach for the early diagnosis of COVID-19.

Keywords: SARS-CoV-2; COVID-19; antibody; humoral immunity; serological test.

© The Author(s) 2020. Published by Oxford University Press for the Infectious Diseases Society of America. All rights reserved. For permissions, e-mail: journals.permissions@oup.com.

Cited by 1 article
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Am J Perinatol
. 2020 Jun;37(8):813-824. doi: 10.1055/s-0040-1709688. Epub 2020 Apr 8.
Neonatal Resuscitation and Postresuscitation Care of Infants Born to Mothers With Suspected or Confirmed SARS-CoV-2 Infection
Praveen Chandrasekharan 1, Maximo Vento 2, Daniele Trevisanuto 3, Elizabeth Partridge 4, Mark A Underwood 5, Jean Wiedeman 4, Anup Katheria 6, Satyan Lakshminrusimha 5
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PMID: 32268381 DOI: 10.1055/s-0040-1709688
Abstract
The first case of novel coronavirus disease of 2019 (COVID-19) caused by severe acute respiratory syndrome-coronavirus 2 (SARS-CoV-2) was reported in November2019. The rapid progression to a global pandemic of COVID-19 has had profound medical, social, and economic consequences. Pregnant women and newborns represent a vulnerable population. However, the precise impact of this novel virus on the fetus and neonate remains uncertain. Appropriate protection of health care workers and newly born infants during and after delivery by a COVID-19 mother is essential. There is some disagreement among expert organizations on an optimal approach based on resource availability, surge volume, and potential risk of transmission. The manuscript outlines the precautions and steps to be taken before, during, and after resuscitation of a newborn born to a COVID-19 mother, including three optional variations of current standards involving shared-decision making with parents for perinatal management, resuscitation of the newborn, disposition, nutrition, and postdischarge care. The availability of resources may also drive the application of these guidelines. More evidence and research are needed to assess the risk of vertical and horizontal transmission of SARS-CoV-2 and its impact on fetal and neonatal outcomes. KEY POINTS: · The risk of vertical transmission is unclear; transmission from family members/providers to neonates is possible.. · Optimal personal-protective-equipment (airborne vs. droplet/contact precautions) for providers is crucial to prevent transmission.. · Parents should be engaged in shared decision-making with options for rooming in, skin-to-skin contact, and breastfeeding..

Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Conflict of interest statement
None declared.

Cited by 4 articles
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7
Review J Clin Hypertens (Greenwich)
. 2020 Jun;22(6):943-948. doi: 10.1111/jch.13912. Epub 2020 May 29.
COVID-19 and Diabetes: Is There Enough Evidence?
Marijana Tadic 1, Cesare Cuspidi 2 3, Carla Sala 4
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PMID: 32472662 PMCID: PMC7300807 DOI: 10.1111/jch.13912
Free PMC article
Abstract
The pandemic of COVID-19, a disease caused by a novel coronavirus SARS-CoV-2, is associated with significant morbidity and mortality. Recent data showed that hypertension, diabetes mellitus, cardiovascular diseases, and chronic obstructive pulmonary disease were the most prevalent comorbidities in COVID-19 patients. Additionally, data indicate that hypertension, diabetes, and cardiovascular diseases are important risk factors for progression and unfavorable outcome in COVID-19 patients. There is only limited amount of data regarding follow-up of these patients, and they provided conflicting results. The main limitation is a small number of participants and particularly those who experienced primary composite outcome (admission in intensive care unit, use of mechanical ventilation, or death). Additionally, the limited number of patients was essential obstacle for performing analysis that would include many confounding factors such as advanced age, smoking status, and obesity and potentially change conclusion. So far, there is no study that demonstrated independent predictive value of diabetes on mortality in COVID-19 patients, but there are many speculations about the association between diabetes and susceptibility to novel coronavirus, as well as its impact on progression and prognosis of COVID-19. The aim of this review article was to summarize the current knowledge about the relationship between diabetes and COVID-19 and its role in outcome in these patients.

Keywords: COVID-19; coronavirus; diabetes; outcome; risk factors.

© 2020 Wiley Periodicals LLC.

Conflict of interest statement
No conflict of interest.

26 references
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8
J Intern Med
. 2020 Jul;288(1):128-138. doi: 10.1111/joim.13063. Epub 2020 Apr 20.
Early Antiviral Treatment Contributes to Alleviate the Severity and Improve the Prognosis of Patients With Novel Coronavirus Disease (COVID-19)
J Wu 1 2, W Li 3, X Shi 1, Z Chen 2, B Jiang 4, J Liu 5, D Wang 6, C Liu 7, Y Meng 8, L Cui 2, J Yu 1, H Cao 1 9, L Li 1
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PMID: 32220033 DOI: 10.1111/joim.13063
Abstract
Background: At present, the severity of patients infected with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has been a focal point.

Methods: To assess the factors associated with severity and prognosis of patients infected with SARS-CoV-2, we retrospectively investigated the clinical, imaging and laboratory characteristics of confirmed 280 cases of novel coronavirus disease (COVID-19) from 20 January to 20 February 2020.

Results: The median age of patients in the mild group was 37.55 years, whilst that in the severe group was 63.04 years. The proportion of patients aged over 65 years in the severe group was significantly higher than that of the mild group (59.04% vs. 10.15%, P < 0.05). 85.54% of severe patients had diabetes or cardiovascular diseases, which was significantly higher than that of the mild group (51.81% vs. 7.11%, P = 0.025; 33.73% vs. 3.05%, P = 0.042). Patients in the mild group experienced earlier initiation of antiviral treatment (1.19 ± 0.45 vs. 2.65 ± 1.06 days in the severe group, P < 0.001). Our study showed that comorbidity, time from illness onset to antiviral treatment and age >=65 were three major risk factors for COVID-19 progression, whilst comorbidity and time from illness onset to antiviral treatment were two major risk factors for COVID-19 recovery.

Conclusions: The elderly and patients with underlying diseases are more likely to experience a severe progression of COVID-19. It is recommended that timely antiviral treatment should be initiated to slow the disease progression and improve the prognosis.

Keywords: antiviral treatment; coronavirus disease-19 (COVID-19); disease progression; prognosis; severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2).

© 2020 The Association for the Publication of the Journal of Internal Medicine.

Cited by 11 articles28 references
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Practice Guideline Indian Pediatr
. 2020 Jun 15;57(6):536-548. doi: 10.1007/s13312-020-1852-4. Epub 2020 Apr 1.
Perinatal-Neonatal Management of COVID-19 Infection - Guidelines of the Federation of Obstetric and Gynaecological Societies of India (FOGSI), National Neonatology Forum of India (NNF), and Indian Academy of Pediatrics (IAP)
Deepak Chawla 1, Dinesh Chirla 2, Samir Dalwai 3, Ashok K Deorari 4, Atul Ganatra 5, Alpesh Gandhi 6, Nandkishor S Kabra 7, Praveen Kumar 8, Pratima Mittal 9, Bakul Jayant Parekh 10, M Jeeva Sankar 4, Tanu Singhal 11, Sindhu Sivanandan 12, Parikshit Tank 13, Federation of Obstetric and Gynaecological Societies of India (FOGSI), National Neonatology Forum of India (NNF) and Indian Academy of Pediatrics (IAP)
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PMID: 32238615 PMCID: PMC7340735 DOI: 10.1007/s13312-020-1852-4
Free PMC article
Abstract
Justification: During the current rapidly evolving pandemic of COVID-19 infection, pregnant women with suspected or confirmed COVID-19 and their newborn infants form a special vulnerable group that needs immediate attention. Unlike other elective medical and surgical problems for which care can be deferred during the pandemic, pregnancies and childbirths continue. Perinatal period poses unique challenges and care of the mother-baby dyads requires special resources for prevention of transmission, diagnosis of infection and providing clinical care during labor, resuscitation and postnatal period.

Process: The GRADE approach recommended by the World Health Organization was used to develop the guideline. A Guideline Development Group (GDG) comprising of obstetricians, neonatologists and pediatricians was constituted. The GDG drafted a list of questions which are likely to be faced by clinicians involved in obstetric and neonatal care. An e-survey was carried out amongst a wider group of clinicians to invite more questions and prioritize. Literature search was carried out in PubMed and websites of relevant international and national professional organizations. Existing guidelines, systematic reviews, clinical trials, narrative reviews and other descriptive reports were reviewed. For the practice questions, the evidence was extracted into evidence profiles. The context, resources required, values and preferences were considered for developing the recommendations.

Objectives: To provide recommendations for prevention of transmission, diagnosis of infection and providing clinical care during labor, resuscitation and postnatal period.

Recommendations: A set of twenty recommendations are provided under the following broad headings: 1) pregnant women with travel history, clinical suspicion or confirmed COVID-19 infection; 2) neonatal care; 3) prevention and infection control; 4) diagnosis; 5) general questions.

Cited by 4 articles44 references
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10
Review Korean J Radiol
. 2019 Sep;20(9):1368-1380. doi: 10.3348/kjr.2019.0057.
A Stepwise Diagnostic Approach to Cystic Lung Diseases for Radiologists
Kyu Chong Lee 1, Eun Young Kang 2, Hwan Seok Yong 1, Cherry Kim 3, Ki Yeol Lee 3, Sung Ho Hwang 4, Yu Whan Oh 4
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PMID: 31464115 PMCID: PMC6715565 DOI: 10.3348/kjr.2019.0057
Free PMC article
Abstract
Lung cysts are commonly seen on computed tomography (CT), and cystic lung diseases show a wide disease spectrum. Thus, correct diagnosis of cystic lung diseases is a challenge for radiologists. As the first diagnostic step, cysts should be distinguished from cavities, bullae, pneumatocele, emphysema, honeycombing, and cystic bronchiectasis. Second, cysts can be categorized as single/localized versus multiple/diffuse. Solitary/localized cysts include incidental cysts and congenital cystic diseases. Multiple/diffuse cysts can be further categorized according to the presence or absence of associated radiologic findings. Multiple/diffuse cysts without associated findings include lymphangioleiomyomatosis and Birt-Hogg-Dubé syndrome. Multiple/diffuse cysts may be associated with ground-glass opacity or small nodules. Multiple/diffuse cysts with nodules include Langerhans cell histiocytosis, cystic metastasis, and amyloidosis. Multiple/diffuse cysts with ground-glass opacity include pneumocystis pneumonia, desquamative interstitial pneumonia, and lymphocytic interstitial pneumonia. This stepwise radiologic diagnostic approach can be helpful in reaching a correct diagnosis for various cystic lung diseases.

Keywords: Birt-Hogg-Dubé syndrome; Computed tomography; Histiocytosis; Langerhans cell; Lung diseases; Lymphangioleiomyomatosis.

Copyright © 2019 The Korean Society of Radiology.

Conflict of interest statement
The authors have no potential conflicts of interest to disclose.

Cited by 1 article44 references13 figures
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11
Review J Clin Microbiol
. 2019 Aug 26;57(9):e00373-19. doi: 10.1128/JCM.00373-19. Print 2019 Sep.
Cost-Effective Respiratory Virus Testing
B A Pinsky 1 2, R T Hayden 3
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PMID: 31142607 PMCID: PMC6711893 DOI: 10.1128/JCM.00373-19
Free PMC article
Abstract
The timely and accurate diagnosis of respiratory virus infections has the potential to optimize downstream (posttesting) use of limited health care resources, including antibiotics, antivirals, ancillary testing, and inpatient and emergency department beds. Cost-effective algorithms for respiratory virus testing must take into consideration numerous factors, including which patients should be tested, what testing should be performed (for example, antigen testing versus reverse transcription-PCR testing or influenza A/B testing versus testing with a comprehensive respiratory virus panel), and the turnaround time necessary to achieve the desired posttesting outcomes. Despite the clinical impact of respiratory virus infections, the cost-effectiveness of respiratory virus testing is incompletely understood. In this article, we review the literature pertaining to the cost-effectiveness of respiratory virus testing in pediatric and adult patient populations, in emergency department, outpatient, and inpatient clinical settings. Furthermore, we consider the cost-effectiveness of a variety of testing methods, including rapid antigen tests, direct fluorescent antibody assays, and nucleic acid amplification tests.

Keywords: respiratory viruses.

Copyright © 2019 Pinsky and Hayden.

Cited by 2 articles94 references1 figure
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Am J Perinatol
. 2020 Jun;37(8):845-849. doi: 10.1055/s-0040-1710512. Epub 2020 May 7.
COVID-19 in Newborns and Infants-Low Risk of Severe Disease: Silver Lining or Dark Cloud?
Munmun Rawat 1, Praveen Chandrasekharan 1, Mark D Hicar 1, Satyan Lakshminrusimha 2
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PMID: 32380565 DOI: 10.1055/s-0040-1710512
Abstract
One hundred years after the 1918 influenza pandemic, we now face another pandemic with the severe acute respiratory syndrome-novel coronavirus-2 (SARS-CoV-2). There is considerable variability in the incidence of infection and severe disease following exposure to SARS-CoV-2. Data from China and the United States suggest a low prevalence of neonates, infants, and children, with those affected not suffering from severe disease. In this article, we speculate different theories why this novel agent is sparing neonates, infants, and young children. The low severity of SARS-CoV-2 infection in this population is associated with a high incidence of asymptomatic or mildly symptomatic infection making them efficient carriers. KEY POINTS: · There is a low prevalence of novel coronavirus disease in neonates, infants, and children.. · The fetal hemoglobin may play a protective role against coronavirus in neonates.. · Immature angiotensin converting enzyme (ACE2) interferes with coronavirus entry into the cells..

Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Conflict of interest statement
None declared.

Cited by 1 article
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13
Vaccine
. 2019 Feb 28;37(10):1284-1292. doi: 10.1016/j.vaccine.2019.01.055. Epub 2019 Feb 7.
Evaluation of Correlates of Protection Against Influenza A(H3N2) and A(H1N1)pdm09 Infection: Applications to the Hospitalized Patient Population
Joshua G Petrie 1, Emily T Martin 2, Rachel Truscon 2, Emileigh Johnson 2, Caroline K Cheng 2, E J McSpadden 2, Ryan E Malosh 2, Adam S Lauring 3, Lois E Lamerato 4, Maryna C Eichelberger 5, Jill M Ferdinands 6, Arnold S Monto 2
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PMID: 30738647 PMCID: PMC6595494 DOI: 10.1016/j.vaccine.2019.01.055
Free PMC article
Abstract
Background: Influenza vaccines are important for prevention of influenza-associated hospitalization. However, the effectiveness of influenza vaccines can vary by year and influenza type and subtype and mechanisms underlying this variation are incompletely understood. Assessments of serologic correlates of protection can support interpretation of influenza vaccine effectiveness in hospitalized populations.

Methods: We enrolled adults hospitalized for treatment of acute respiratory illnesses during the 2014-2015 and 2015-2016 influenza seasons whose symptoms began <10 days prior to enrollment. Influenza infection status was determined by RT-PCR. Influenza vaccination status was defined by self-report and medical record/registry documentation. Serum specimens collected at hospital admission were tested in hemagglutination-inhibition (HAI) and neuraminidase-inhibition (NAI) assays. We evaluated how well antibody measured in these specimens represented pre-infection immune status, and measured associations between antibody and influenza vaccination and infection.

Results: Serum specimens were retrieved for 315 participants enrolled during the 2014-2015 season and 339 participants during the 2015-2016 season. Specimens were collected within 3 days of illness onset from 65% of participants. Geometric mean titers (GMTs) did not vary by the number of days from illness onset to specimen collection among influenza positive participants suggesting that measured antibody was representative of pre-infection immune status rather than a de novo response to infection. In both seasons, vaccinated participants had higher HAI and NAI GMTs than unvaccinated. HAI titers against the 2014-2015 A(H3N2) vaccine strain did not correlate with protection from infection with antigenically-drifted A(H3N2) viruses that circulated that season. In contrast, higher HAI titers against the A(H1N1)pdm09 vaccine strain were associated with reduced odds of A(H1N1)pdm09 infection in 2015-2016.

Conclusions: Serum collected shortly after illness onset at hospital admission can be used to assess correlates of protection against influenza infection. Broader implementation of similar studies would provide an opportunity to understand the successes and shortcomings of current influenza vaccines.

Keywords: Correlates of protection; Hemagglutinin; Influenza; Influenza vaccine; Inpatient; Neuraminidase; Serology.

Copyright © 2019 Elsevier Ltd. All rights reserved.

Conflict of interest statement
Potential conflicts of interest

E.T.M has received grant support from Merck and Pfizer for work unrelated to this report. L.E.L. has received grant support from AstraZeneca, Merck, Pfizer, eMaxHealth Inc., Policy Analysis Inc., Analytica Inc. and Xcenda Inc. for work unrelated to this report. A.S.M. has received grant support from Sanofi Pasteur and consultancy fees from Sanofi, GSK and Novavax for work unrelated to this report. All authors reported no potential conflicts.

Cited by 2 articles4 figures
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14
Meta-Analysis Expert Rev Vaccines
. 2019 Nov;18(11):1211-1217. doi: 10.1080/14760584.2019.1690459. Epub 2019 Dec 10.
The Association of Influenza Infection and Vaccine With Myocardial Infarction: Systematic Review and Meta-Analysis of Self-Controlled Case Series
Daniel Caldeira 1 2 3, Bárbara Rodrigues 2, Cláudio David 1 2 3, João Costa 2 3, Fausto J Pinto 1, Joaquim J Ferreira 2 3
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PMID: 31693865 DOI: 10.1080/14760584.2019.1690459
Abstract
Introduction: Influenza vaccination may be beneficial in coronary disease patients; however the infection and vaccination are associated with acute inflammation, a trigger of cardiovascular events. We aimed to review the risk of myocardial infarction (MI) associated with Influenza infection and the safety of vaccination in self-controlled case series (SCCS).Methods: We performed a systematic review with meta-analysis of SCCS studies to evaluate the risk of MI associated with Influenza infection/vaccination. Database search was performed in August/2018. The data were reported using the incident rate ratio (IRR) and 95% confidence interval (95%CI).Results: three studies for Influenza infection and two studies for Influenza vaccination were eligible. The risk of MI following an Influenza infection was significantly increased in the first 3 days (IRR 5.79; 95%CI: 3.59-9.38) and between 4-7 days (IRR 4.52; 95%CI: 2.80-7.32). In the first 4 weeks following the Influenza vaccination, there was a significant decrease of MI risk (IRR 0.84, 95%CI: 0.78-0.91).Conclusions: Short-term MI risk in Influenza infection is significantly increased, with a low-to-moderate confidence in the pooled evidence. The Influenza vaccine was safe regarding the short-term risk for MI, and the risk reduction is possibly related to a healthy period bias.

Keywords: Influenza; Pneumonia; coronary artery disease; inflammation; ischemia; ischemic heart disease; respiratory infection; vaccine.

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15
Review Am J Perinatol
. 2020 Jun;37(8):780-791. doi: 10.1055/s-0040-1710522. Epub 2020 May 2.
COVID-19 and Neonatal Respiratory Care: Current Evidence and Practical Approach
Wissam Shalish 1, Satyanarayana Lakshminrusimha 2, Paolo Manzoni 3, Martin Keszler 4, Guilherme M Sant'Anna 1
Affiliations expand
PMID: 32359226 DOI: 10.1055/s-0040-1710522
Abstract
The novel coronavirus disease 2019 (COVID-19) pandemic has urged the development and implementation of guidelines and protocols on diagnosis, management, infection control strategies, and discharge planning. However, very little is currently known about neonatal COVID-19 and severe acute respiratory syndrome-coronavirus-2 (SARS-CoV-2) infections. Thus, many questions arise with regard to respiratory care after birth, necessary protection to health care workers (HCW) in the delivery room and neonatal intensive care unit (NICU), and safety of bag and mask ventilation, noninvasive respiratory support, deep suctioning, endotracheal intubation, and mechanical ventilation. Indeed, these questions have created tremendous confusion amongst neonatal HCW. In this manuscript, we comprehensively reviewed the current evidence regarding COVID-19 perinatal transmission, respiratory outcomes of neonates born to mothers with COVID-19 and infants with documented SARS-CoV-2 infection, and the evidence for using different respiratory support modalities and aerosol-generating procedures in this specific population. The results demonstrated that to date, neonatal COVID-19 infection is uncommon, generally acquired postnatally, and associated with favorable respiratory outcomes. The reason why infants display a milder spectrum of disease remains unclear. Nonetheless, the risk of severe or critical illness in young patients exists. Currently, the recommended respiratory approach for infants with suspected or confirmed infection is not evidence based but should include all routinely used types of support, with the addition of viral filters, proper personal protective equipment, and placement of infants in isolation rooms, ideally with negative pressure. As information is changing rapidly, clinicians should frequently watch out for updates on the subject. KEY POINTS: · Novel coronavirus disease 2019 (COVID-19) pandemic urged development of guidelines.. · Neonatal COVID-19 disease is uncommon.. · Respiratory outcomes in neonates seems favorable.. · Current neonatal respiratory care should continue.. · Clinicians should watch frequently for updates..

Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Conflict of interest statement
None declared.

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16
Review Am J Perinatol
. 2020 Jun;37(8):773-779. doi: 10.1055/s-0040-1710051. Epub 2020 Apr 17.
Considerations for Obstetric Care During the COVID-19 Pandemic
Sarah K Dotters-Katz 1, Brenna L Hughes 1
Affiliations expand
PMID: 32303077 DOI: 10.1055/s-0040-1710051
Abstract
The novel coronavirus disease 2019 (COVID-19) is a growing pandemic that is impacting daily life across the globe. Though disease is often mild, in high-risk populations, severe disease often leads to intubation, intensive care admission (ICU) admission, and in many cases death. The implications for pregnancy remain largely unknown. Early data suggest that COVID-19 may not pose increased risk in the pregnant population. Vertical transmission has not been confirmed. Because no treatment, no vaccine and no herd immunity exist, social distancing is the best mechanism available to protect patients and health care workers from infection. This review will discuss what is known about the virus as it relates to pregnancy and then consider management considerations based on these data. KEY POINTS: · COVID-19 severity in pregnancy is unclear.. · Social distancing is the best protective mechanism.. · No clear evidence of vertical transmission exists.. · Mother/baby separation avoids transmission..

Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Conflict of interest statement
None declared.

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17
Vaccine
. 2019 Feb 4;37(6):808-816. doi: 10.1016/j.vaccine.2018.12.053. Epub 2019 Jan 9.
Intradermal Vaccination With a Pseudomonas Aeruginosa Vaccine Adjuvanted With a Mutant Bacterial ADP-ribosylating Enterotoxin Protects Against Acute Pneumonia
Sarah M Baker 1, Derek Pociask 2, John D Clements 1, James B McLachlan 1, Lisa A Morici 3
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PMID: 30638799 DOI: 10.1016/j.vaccine.2018.12.053
Abstract
Respiratory infections are a leading cause of morbidity and mortality globally. This is partially due to a lack of effective vaccines and a clear understanding of how vaccination route and formulation influence protective immunity in mucosal tissues such as the lung. Pseudomonas aeruginosa is an opportunistic pathogen capable of causing acute pulmonary infections and is a leading cause of hospital-acquired and ventilator-associated pneumonia. With multidrug-resistant P. aeruginosa infections on the rise, the need for a vaccine against this pathogen is critical. Growing evidence suggests that a successful P. aeruginosa vaccine may require mucosal antibody and Th1- and Th17-type CD4+ T cells to prevent pulmonary infection. Intradermal immunization with adjuvants, such as the bacterial ADP-Ribosylating Enterotoxin Adjuvant (BARE) double mutant of E. coli heat-labile toxin (dmLT), can direct protective immune responses to mucosal tissues, including the lungs. We reasoned that intradermal immunization with P. aeruginosa outer membrane proteins (OMPs) adjuvanted with dmLT could drive neutralizing antibodies and migration of CD4+ T cells to the lungs and protect against P. aeruginosa pneumonia in a murine model. Here we show that mice immunized with OMPs and dmLT had significantly more antigen-specific IgG and Th1- and Th17-type CD4+ memory T cells in the pulmonary environment compared to control groups of mice. Furthermore, OMPs and dmLT immunized mice were significantly protected against an otherwise lethal lung infection. Protection was associated with early IFN-γ and IL-17 production in the lungs of immunized mice. These results indicate that intradermal immunization with dmLT can drive protective immunity to the lung mucosa and may be a viable vaccination strategy for a multitude of respiratory pathogens.

Keywords: Bacteria; Intradermal; Lung; Pseudomonas aeruginosa; Vaccine; dmLT.

Copyright © 2019 Elsevier Ltd. All rights reserved.

Cited by 3 articles
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18
Review J Epidemiol Community Health
. 2020 Aug;74(8):620-623. doi: 10.1136/jech-2020-214297. Epub 2020 May 8.
Importance of Collecting Data on Socioeconomic Determinants From the Early Stage of the COVID-19 Outbreak Onwards
Saman Khalatbari-Soltani 1 2, Robert C Cumming 3 4, Cyrille Delpierre 5 6, Michelle Kelly-Irving 5 6 7
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PMID: 32385126 PMCID: PMC7298202 DOI: 10.1136/jech-2020-214297
Free PMC article
Abstract
Disadvantaged socioeconomic position (SEP) is widely associated with disease and mortality, and there is no reason to think this will not be the case for the newly emerged coronavirus disease 2019 (COVID-19) that has reached a pandemic level. Individuals with a more disadvantaged SEP are more likely to be affected by most of the known risk factors of COVID-19. SEP has been previously established as a potential determinant of infectious diseases in general. We hypothesise that SEP plays an important role in the COVID-19 pandemic either directly or indirectly via occupation, living conditions, health-related behaviours, presence of comorbidities and immune functioning. However, the influence of socioeconomic factors on COVID-19 transmission, severity and outcomes is not yet known and is subject to scrutiny and investigation. Here we briefly review the extent to which SEP has been considered as one of the potential risk factors of COVID-19. From 29 eligible studies that reported the characteristics of patients with COVID-19 and their potential risk factors, only one study reported the occupational position of patients with mild or severe disease. This brief overview of the literature highlights that important socioeconomic characteristics are being overlooked when data are collected. As COVID-19 spreads worldwide, it is crucial to collect and report data on socioeconomic determinants as well as race/ethnicity to identify high-risk populations. A systematic recording of socioeconomic characteristics of patients with COVID-19 will be beneficial to identify most vulnerable groups, to identify how SEP relates to COVID-19 and to develop equitable public health prevention measures, guidelines and interventions.

Keywords: Ageing; Cancer; Epidemiology; Health inequalities; Inequalities; Life course epidemiology; Longitudinal studies; Social epidemiology; Social inequalities; Stress.

© Author(s) (or their employer(s)) 2020. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.

Conflict of interest statement
Competing interests: None declared.

Cited by 1 article27 references
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19
Antimicrob Resist Infect Control
. 2019 Oct 28;8:164. doi: 10.1186/s13756-019-0631-2. eCollection 2019.
Debate on the Compositions of Influenza B in Northern Hemisphere Seasonal Influenza Vaccines
Guozhong He 1, Pengfei Yang 2, Qingli Yan 2, Chenglong Xiong 3 4
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PMID: 31673353 PMCID: PMC6819444 DOI: 10.1186/s13756-019-0631-2
Free PMC article
Abstract
Background: Annual influenza vaccination is the most effective way to prevent influenza. Influenza vaccines have traditionally included the hemagglutinins (HA) and neuraminidases (NA) from the two A viruses (H1N1 and H3N2) and either B Yamagata or B Victoria. Mismatches between circulating isolates of influenza B and the vaccines are very common. Taking 2017/2018 winter in northern hemisphere as an example, this study was designed to find out the reasons for mismatch between the trivalent influenza vaccine (TIV) and most of the epidemic isolates at that time, and to discuss if there are some optimized programs for seasonal influenza vaccines.

Methods: HA and NA sequences of the seasonal isolates circulating from December 1, 2017 to February 28, 2018, and in the previously other 7 winters in northern hemisphere from Global Initiative on Sharing All Influenza Data (GISAID) and the influenza database of National Center for Biotechnology Information (NCBI). Phylogenetic trees and genetic distances were constructed or calculated by using MAFFT and MEGA 6.0 software.

Results: Influenza B composition in the TIV recommendation mismatched most of circulating viruses in 2017/2018 winter; the vaccine strain was from the B/Victoria lineage, while most of epidemic isolates were from the B/Yamagata lineage. The epidemic lineage of influenza B reached its peak a little late in the previous winter might be responsible for this mismatch. During 2010-2018, the mean genetic distances between epidemic isolates of influenza A (H1N1 and H3N2) and the vaccines were no higher than 0.02375 ± 0.00341 in both HA and NA. However, concerning influenza B virus, when forecasting done well, the mean genetic distances between epidemic isolates and the vaccines were no higher than 0.02368 ± 0.00272; otherwise, the distances could reach 0.13695 ± 0.00238.

Conclusion: When applying quadrivalent influenza vaccines (QIVs) for vaccination, the recommendations of compositions for influenza B could be altered and assessed once in 3 or 4 years; when economic burden was considered intensively and TIVs were utilized, the recommended compositions for influenza B could be announced in April or May, rather than in February or March as now.

Keywords: Influenza B; Northern hemisphere; Seasonal influenza; Vaccine.

© The Author(s). 2019.

Conflict of interest statement
Competing interestsWe declare that we have no conflicts of interest.

35 references2 figures
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20
Eur J Intern Med
. 2019 May;63:42-45. doi: 10.1016/j.ejim.2019.02.010. Epub 2019 Feb 19.
Reactive Thrombocytosis in Acute Infectious Diseases: Prevalence, Characteristics and Timing
Ami Schattner 1, Jaber Kadi 2, Ina Dubin 2
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PMID: 30795883 DOI: 10.1016/j.ejim.2019.02.010
Abstract
Background: Reactive thrombocytosis is known to occur in infectious, inflammatory and neoplastic diseases. However, the characteristics of its association with acute infections (ID) has not been systematically studied.

Setting: A department of internal medicine in a general teaching hospital.

Methods: Retrospective chart review of admitted patients with a confirmed diagnosis of community-acquired pneumonia (CAP), urinary tract infection (UTI) or skin and soft tissue infection (SSTI). Key clinical and laboratory data were retrieved and patients with platelet counts >400 × 109/L who had no alternative cause of thrombocytosis were studied longitudinally and compared to patients with acute infections who had no thrombocytosis.

Results: Thirty two of 421 patients with acute infections (ID) had infection-associated thrombocytosis (7.6%): 11/125 patients with CAP (8.8%), 13/205 patients with UTI (6.3%) and 8/91 (8.8%) patients with SSTI. Their median ages (77-78 years), gender (48% males), admission temperature, Hb, and WBC were not significantly different from ID patients without thrombocytosis. However, patients with thrombocytosis had longer hospital stays (P = 0.001), more bacteremias (P = 0.048) and in 4/32 (12/5% vs. 2%) significantly increased combined mortality or suppurative complications (P = 0.0006). The ESR (median 70 vs. 40 mm/h, P = 0.000) and CRP (median 214 vs. 114 mg/dL, P < 0.0001) were found to be increased in ID-associated thrombocytosis patients, similarly for each ID. Platelets increase was already found on admission in 18 patients (56%), was mild in most cases (median 492.5 × 109/L, range 401-917 × 109/L) and resolved after recovery in all survivors. The median time to thrombocytosis was 1 day in patients with CAP, 4 days in UTI and 7.5 days in SSTI. No thrombotic complications were found.

Conclusions: Approximately 8% of patients with acute ID examined had thrombocytosis which was mostly mild, transient, and not usually indicative of an infectious complication. However, these patients had enhanced acute-phase response, increased length of hospital stay, more bacteremia and increased mortality/suppurative complications albeit affecting a minority of patients.

Keywords: Erysipelas/cellulitis; Hematology; Infectious diseases; Pneumonia, community-acquired; Thrombocytosis; Urinary tract infection.

Copyright © 2019. Published by Elsevier B.V.

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21
Comparative Study J Clin Microbiol
. 2019 Aug 26;57(9):e00027-19. doi: 10.1128/JCM.00027-19. Print 2019 Sep.
Comparison of Respiratory Specimen Collection Methods for Detection of Influenza Virus Infection by Reverse Transcription-PCR: A Literature Review
Sarah Spencer 1 2, Mark G Thompson 3, Brendan Flannery 3, Alicia Fry 3
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PMID: 31217267 PMCID: PMC6711916 DOI: 10.1128/JCM.00027-19
Free PMC article
Abstract
The detection of influenza virus in respiratory specimens from ill individuals is the most commonly used method to identify influenza virus infection. A number of respiratory specimen types may be used, including swabs, brush, aspirate, and wash, and specimens may be collected from numerous sites, including the anterior and posterior nasopharynx, oropharynx, and nares. Traditionally, respiratory specimens from the nasopharynx have been considered to have the highest sensitivity for viral detection. However, as molecular assays such as reverse transcription-PCR (RT-PCR) have increased the sensitivity of viral detection from respiratory specimens, the use of less-invasive and easier-to-obtain specimens has increased for the detection of influenza virus. This review presents and evaluates the sensitivities of respiratory specimen methods used in epidemiologic studies that used RT-PCR to detect influenza virus in respiratory specimens from ill patients. This literature review suggested that a combination of two less-invasive swabbing methods, such as nasal and oropharyngeal swabs, had about the same sensitivity as did nasopharyngeal specimens for influenza virus detection by RT-PCR. By combining two less-invasive collection methods, it may be possible to reduce barriers to enrollment without compromising influenza virus detection sensitivity.

Keywords: RT-PCR; influenza; respiratory specimen.

Copyright © 2019 American Society for Microbiology.

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22
J Gen Intern Med
. 2019 Jun;34(6):846-854. doi: 10.1007/s11606-018-4467-x. Epub 2018 May 8.
Behavioral Economics Interventions to Improve Outpatient Antibiotic Prescribing for Acute Respiratory Infections: A Cost-Effectiveness Analysis
Cynthia L Gong 1, Kenneth M Zangwill 2, Joel W Hay 3, Daniella Meeker 3 4, Jason N Doctor 3
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PMID: 29740788 PMCID: PMC6544688 DOI: 10.1007/s11606-018-4467-x
Free PMC article
Abstract
Background: Behavioral economics interventions have been shown to effectively reduce the rates of inappropriate antibiotic prescriptions for acute respiratory infections (ARIs).

Objective: To determine the cost-effectiveness of three behavioral economic interventions designed to reduce inappropriate antibiotic prescriptions for ARIs.

Design: Thirty-year Markov model from the US societal perspective with inputs derived from the literature and CDC surveillance data.

Subjects: Forty-five-year-old adults with signs and symptoms of ARI presenting to a healthcare provider.

Interventions: (1) Provider education on guidelines for the appropriate treatment of ARIs; (2) Suggested Alternatives, which utilizes computerized clinical decision support to suggest non-antibiotic treatment choices in lieu of antibiotics; (3) Accountable Justification, which mandates free-text justification into the patient's electronic health record when antibiotics are prescribed; and (4) Peer Comparison, which sends a periodic email to prescribers about his/her rate of inappropriate antibiotic prescribing relative to clinician colleagues.

Main measures: Discounted costs, quality-adjusted life years (QALYs), and incremental cost-effectiveness ratios.

Key results: Each intervention has lower costs but higher QALYs compared to provider education. Total costs for each intervention were $178.21, $173.22, $172.82, and $172.52, and total QALYs were 14.68, 14.73, 14.74, and 14.74 for the control, Suggested Alternatives, Accountable Justification, and Peer Comparison groups, respectively. Results were most sensitive to the quality-of-life of the uninfected state, and the likelihood and costs for antibiotic-associated adverse events.

Conclusions: Behavioral economics interventions can be cost-effective strategies for reducing inappropriate antibiotic prescriptions by reducing healthcare resource utilization.

Trial registration: ClinicalTrials.gov NCT01454947.

Keywords: cost-effectiveness; healthcare administration; infectious disease; physician behavior.

Conflict of interest statement
The authors declare no conflicts of interest.

Comment in
So Many Nudges, So Little Time: Can Cost-effectiveness Tell Us When It Is Worthwhile to Try to Change Provider Behavior?
Atkins D.
J Gen Intern Med. 2019 Jun;34(6):783-784. doi: 10.1007/s11606-019-04871-5.
PMID: 30877456 Free PMC article. No abstract available.
Cited by 2 articles4 figures
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23
Review Expert Rev Clin Immunol
. 2019 Nov;15(11):1171-1183. doi: 10.1080/1744666X.2020.1679626. Epub 2019 Oct 22.
Endotype-driven Precision Medicine in Chronic Rhinosinusitis
Hongfei Lou 1, Chengshuo Wang 1, Luo Zhang 1 2 3
Affiliations expand
PMID: 31600458 DOI: 10.1080/1744666X.2020.1679626
Abstract
Introduction: Chronic rhinosinusitis (CRS) is a heterogeneous disease spectrum with variable phenotypes and endotypes that are not well characterized. Conventional treatment options are insufficient; recent research in precision medicine focuses on providing endotype-driven care based on underlying mechanisms.Areas covered: A comprehensive overview of CRS phenotypes and endotypes is provided. Biomarkers have been identified to predict prognosis and guide personalized pharmacotherapy, surgery, and innovative treatments. For CRS with nasal polyps (CRSwNP), type 2-targeting biologics, such as anti-IgE, anti-IL4Rα, and anti-IL5 antibodies, have been explored in clinical trials.Expert opinion: In addition to differences in immunopathogenic mechanisms and responses to medical and surgical interventions, CRS endotypes vary according to geography and ethnicity and their distributions change over time. Endotype-driven integrated care is a promising approach. Our current understanding of type 2 inflammation is well ahead of that of other endotypes. Biomarkers of type 2 inflammation show good predictive ability for corticosteroid responsiveness and disease recurrence. Type 2-targeted treatments are effective for CRSwNP based on clinical trials. The identification of patient subsets and effective biomarkers is important for optimizing biotherapeutic strategies. Further studies should focus on non-type 2 inflammation-targeted treatment approaches and the safety of biologics for routine clinical use.

Keywords: Biologics; biomarker; chronic rhinosinusitis; corticosteroids; endotype; nasal polyps; recurrence; type 2 inflammation.

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24
N Engl J Med
. 2020 Jul 2;383(1):85-88. doi: 10.1056/NEJMc2009567. Epub 2020 Apr 29.
Covid-19 in Immune-Mediated Inflammatory Diseases - Case Series From New York
Rebecca Haberman 1, Jordan Axelrad 1, Alan Chen 2, Rochelle Castillo 1, Di Yan 1, Peter Izmirly 1, Andrea Neimann 1, Samrachana Adhikari 2, David Hudesman 3, Jose U Scher 3
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PMID: 32348641 PMCID: PMC7204427 DOI: 10.1056/NEJMc2009567
Free PMC article
Cited by 6 articles5 references
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25
Am J Perinatol
. 2020 Jun;37(8):800-808. doi: 10.1055/s-0040-1712121. Epub 2020 May 12.
Telehealth for High-Risk Pregnancies in the Setting of the COVID-19 Pandemic
Aleha Aziz 1, Noelia Zork 1, Janice J Aubey 1, Caitlin D Baptiste 1, Mary E D'Alton 1, Ukachi N Emeruwa 1, Karin M Fuchs 1, Dena Goffman 1, Cynthia Gyamfi-Bannerman 1, Jennifer H Haythe 2, Anita P LaSala 1, Nigel Madden 1, Eliza C Miller 3, Russell S Miller 1, Catherine Monk 1 4 5, Leslie Moroz 1, Samsiya Ona 1, Laurence E Ring 6, Jean-Ju Sheen 1, Erica S Spiegel 1, Lynn L Simpson 1, Hope S Yates 1, Alexander M Friedman 1
Affiliations expand
PMID: 32396948 DOI: 10.1055/s-0040-1712121
Abstract
As New York City became an international epicenter of the novel coronavirus disease 2019 (COVID-19) pandemic, telehealth was rapidly integrated into prenatal care at Columbia University Irving Medical Center, an academic hospital system in Manhattan. Goals of implementation were to consolidate in-person prenatal screening, surveillance, and examinations into fewer in-person visits while maintaining patient access to ongoing antenatal care and subspecialty consultations via telehealth virtual visits. The rationale for this change was to minimize patient travel and thus risk for COVID-19 exposure. Because a large portion of obstetric patients had underlying medical or fetal conditions placing them at increased risk for adverse outcomes, prenatal care telehealth regimens were tailored for increased surveillance and/or counseling. Based on the incorporation of telehealth into prenatal care for high-risk patients, specific recommendations are made for the following conditions, clinical scenarios, and services: (1) hypertensive disorders of pregnancy including preeclampsia, gestational hypertension, and chronic hypertension; (2) pregestational and gestational diabetes mellitus; (3) maternal cardiovascular disease; (4) maternal neurologic conditions; (5) history of preterm birth and poor obstetrical history including prior stillbirth; (6) fetal conditions such as intrauterine growth restriction, congenital anomalies, and multiple gestations including monochorionic placentation; (7) genetic counseling; (8) mental health services; (9) obstetric anesthesia consultations; and (10) postpartum care. While telehealth virtual visits do not fully replace in-person encounters during prenatal care, they do offer a means of reducing potential patient and provider exposure to COVID-19 while providing consolidated in-person testing and services. KEY POINTS: · Telehealth for prenatal care is feasible.. · Telehealth may reduce coronavirus exposure during prenatal care.. · Telehealth should be tailored for high risk prenatal patients..

Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Conflict of interest statement
M.E.D. has had a leadership role in the American College of Obstetricians and Gynecologists II's Safe Motherhood Initiative which has received unrestricted funding from Merck for Mothers. The other authors did not report any potential conflicts of interest.

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26
Review Expert Rev Clin Immunol
. 2019 Nov;15(11):1155-1170. doi: 10.1080/1744666X.2020.1672538. Epub 2019 Oct 19.
Allergen-induced Asthma, Chronic Rhinosinusitis and Transforming Growth factor-β Superfamily Signaling: Mechanisms and Functional Consequences
Harsha H Kariyawasam 1 2 3, Simon B Gane 2 3
Affiliations expand
PMID: 31549888 DOI: 10.1080/1744666X.2020.1672538
Abstract
Introduction: Often co-associated, asthma and chronic rhinosinusitis (CRS) are complex heterogeneous disease syndromes. Severity in both is related to tissue inflammation and abnormal repair (termed remodeling). Understanding signaling factors that can modulate, integrate the activation, and regulation of such key processes together is increasingly important. The transforming growth factor (TGF)-β superfamily of ligands comprise a versatile system of immunomodulatory molecules that are gaining recognition as having an essential function in the immunopathogenesis of asthma. Early data suggest an important role in CRS as well. Abnormal or dysregulated signaling may contribute to disease pathogenesis and severity.Areas covered: The essential biology of this complex family of growth factors in relation to the excess inflammation and remodeling that occurs in allergic asthma and CRS is reviewed. The need to understand the integration of signaling pathways together is highlighted. Studies in human airway tissue are evaluated and only selected key animal models relevant to human disease discussed given the highly context-dependent signaling and function of these ligands.Expert opinion: Abnormal or dysregulated TGF-β superfamily signaling may be central to the excess inflammation and tissue remodeling in asthma, and possibly CRS. Therefore, the TGF-β superfamily signaling pathways represent an emerging and attractive therapeutic target.

Keywords: Asthma; TGF-β superfamily; chronic rhinosinusitis; immune dysregulation; immunopathogenesis; inflammation; remodeling.

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27
J Clin Microbiol
. 2019 Aug 26;57(9):e00614-19. doi: 10.1128/JCM.00614-19. Print 2019 Sep.
Same-Day Tools, Including Xpert Ultra and IRISA-TB, for Rapid Diagnosis of Pleural Tuberculosis: A Prospective Observational Study
Richard Meldau 1, Philippa Randall 1, Anil Pooran 1, Jason Limberis 1, Edson Makambwa 1, Muhammed Dhansay 1, Aliasgar Esmail 1, Keertan Dheda 2 3
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PMID: 31270183 PMCID: PMC6711909 DOI: 10.1128/JCM.00614-19
Free PMC article
Abstract
The diagnosis of pleural tuberculosis (TB) is problematic. The comparative performance of newer same-day tools for pleural TB, including Xpert MTB/RIF Ultra (ULTRA), has hitherto not been comprehensively studied. Adenosine deaminase (ADA), IRISA-TB (interferon gamma ultrasensitive rapid immunosuspension assay), Xpert MTB/RIF, and ULTRA performance outcomes were evaluated in pleural fluid samples from 149 patients with suspected pleural TB. The reference standard was culture positivity (fluid, biopsy specimen, or sputum) and/or pleural biopsy histopathology (termed definite TB). Those designated as having non-TB were negative by microbiological testing and were not initiated on anti-TB treatment. To determine the effect of sample concentration, 65 samples underwent pelleting by centrifugation, followed by conventional Xpert MTB/RIF and ULTRA. Of the 149 patients, 49 had definite TB, 16 had probable TB (not definite but treated for TB), and 84 had non-TB. ULTRA sensitivity and specificity (95% confidence intervals [CI]) were similar to those of Xpert MTB/RIF [sensitivity, 37.5% (25.3 to 51.2) versus 28.6% (15.9 to 41.2), respectively; specificity, 98.8% (96.5 to 100) versus 98.8% (96.5 to 100), respectively]. Centrifugation did not significantly improve ULTRA sensitivity (29.5% versus 31.3%, respectively). Adenosine deaminase and IRISA-TB sensitivity were 84.4% (73.9 to 95.0) and 89.8% (81.3 to 98.3), respectively. However, IRISA-TB demonstrated significantly better specificity (96.4% versus 87.5% [P = 0.034]), positive predictive value (93.6% versus 80.9 [P = 0.028]), and positive likelihood ratio (25.1 versus 6.8 [P = 0.032]) than ADA. In summary, Xpert ULTRA has poor sensitivity for the diagnosis of pleural TB. Alternative assays (ADA and IRISA-TB) are significantly more sensitive, with IRISA-TB demonstrating a higher specificity and rule-in value than ADA in this high-TB-burden setting where HIV is endemic.

Keywords: IRISA-TB; Mycobacterium tuberculosis; ULTRA; Xpert MTB/RIF; adenosine deaminase; interferon gamma.

Copyright © 2019 Meldau et al.

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28
Mov Disord
. 2020 Jun;35(6):912-914. doi: 10.1002/mds.28088. Epub 2020 May 8.
Parkinson's Disease and COVID-19: Perceptions and Implications in Patients and Caregivers
Shweta Prasad 1 2, Vikram Venkappayya Holla 2, Koti Neeraja 2, Bharath Kumar Surisetti 2, Nitish Kamble 2, Ravi Yadav 2, Pramod Kumar Pal 2
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PMID: 32304118 PMCID: PMC7264599 DOI: 10.1002/mds.28088
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Cited by 1 article3 references
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29
Int J Nurs Stud
. 2020 Aug;108:103629. doi: 10.1016/j.ijnurstu.2020.103629. Epub 2020 Apr 30.
A Rapid Systematic Review of the Efficacy of Face Masks and Respirators Against Coronaviruses and Other Respiratory Transmissible Viruses for the Community, Healthcare Workers and Sick Patients
C Raina MacIntyre 1, Abrar Ahmad Chughtai 2
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PMID: 32512240 PMCID: PMC7191274 DOI: 10.1016/j.ijnurstu.2020.103629
Free PMC article
Abstract
Background: The pandemic of COVID-19 is growing, and a shortage of masks and respirators has been reported globally. Policies of health organizations for healthcare workers are inconsistent, with a change in policy in the US for universal face mask use. The aim of this study was to review the evidence around the efficacy of masks and respirators for healthcare workers, sick patients and the general public.

Methods: A systematic review of randomized controlled clinical trials on use of respiratory protection by healthcare workers, sick patients and community members was conducted. Articles were searched on Medline and Embase using key search terms.

Results: A total of 19 randomised controlled trials were included in this study - 8 in community settings, 6 in healthcare settings and 5 as source control. Most of these randomised controlled trials used different interventions and outcome measures. In the community, masks appeared to be effective with and without hand hygiene, and both together are more protective. Randomised controlled trials in health care workers showed that respirators, if worn continually during a shift, were effective but not if worn intermittently. Medical masks were not effective, and cloth masks even less effective. When used by sick patients randomised controlled trials suggested protection of well contacts.

Conclusion: The study suggests that community mask use by well people could be beneficial, particularly for COVID-19, where transmission may be pre-symptomatic. The studies of masks as source control also suggest a benefit, and may be important during the COVID-19 pandemic in universal community face mask use as well as in health care settings. Trials in healthcare workers support the use of respirators continuously during a shift. This may prevent health worker infections and deaths from COVID-19, as aerosolisation in the hospital setting has been documented.

Keywords: COVID19; Coronavirus; Coronavirus disease; Mask; Personal protective equipment; Respirators.

Copyright © 2020. Published by Elsevier Ltd.

Cited by 3 articles53 references1 figure
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30
J Infect Dis
. 2020 Jun 29;222(2):198-202. doi: 10.1093/infdis/jiaa252.
T-Cell Subset Counts in Peripheral Blood Can Be Used as Discriminatory Biomarkers for Diagnosis and Severity Prediction of Coronavirus Disease 2019
Mei Jiang 1, Yang Guo 1, Qing Luo 1, ZiKun Huang 1, Rui Zhao 1, ShuYuan Liu 1, AiPing Le 2, JunMing Li 1, LaGen Wan 1
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PMID: 32379887 PMCID: PMC7239156 DOI: 10.1093/infdis/jiaa252
Free PMC article
Abstract
This study evaluated the significance of lymphocyte subset detection in peripheral blood in the diagnosis and prognosis of coronavirus disease 2019 (COVID-19). Our results revealed that CD3+ T cells, CD4+ T cells, CD8+ T cells, and natural killer cells were significantly decreased in patients with COVID-19. These patients had a relatively slight decrease in CD4+ T cells but a severe decrease in CD8+ T cells. The significantly elevated CD4/CD8 ratio was observed in COVID-19 patients. T-cell subset counts were related to the severity and prognosis of COVID-19, suggesting that the counts of CD8+ T and CD4+ T cells can be used as diagnostic markers of COVID-19 and predictors of disease severity.

Keywords: SARS-CoV2; diagnosis; lymphocyte subsets; prognosis.

© The Author(s) 2020. Published by Oxford University Press for the Infectious Diseases Society of America. All rights reserved. For permissions, e-mail: journals.permissions@oup.com.

Cited by 1 article
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31
Review Nervenarzt
. 2020 Jul;91(7):604-610. doi: 10.1007/s00115-020-00939-4.
[Psychopharmacotherapy During the COVID-19 Pandemic]
[Article in German]
J Seifert 1, J Heck 2 3, G Eckermann 4, M Singer 5, S Bleich 2, R Grohmann 6, S Toto 2
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PMID: 32488413 PMCID: PMC7265158 DOI: 10.1007/s00115-020-00939-4
Free PMC article
Abstract in English , German
In view of the current coronavirus disease 2019 (COVID-19) pandemic, patient care, including that of psychiatric patients, is facing unprecedented challenges. Treatment strategies for mental illness include psychotherapy and psychopharmacological interventions. The latter are associated with a multitude of adverse drug reactions (ADR); however, they may currently represent the preferred treatment due to restrictions regarding patient care (i.e. social distancing). Direct contact to patients may have to be reduced in favor of telephone calls or video conferences, so that new techniques in diagnosing and treating patients have to be established to guarantee patient safety. Patients should be extensively informed about relevant ADRs and physicians should actively ask patients about the timely recognition of ADRs. The use of psychotropic drugs may lead to an increased risk of developing ADRs, which are considered to be particularly unfavorable if they occur simultaneously with an acute infection or may even lead to an increased risk of infection. These include respiratory depression, agranulocytosis, intoxication by inhibition of metabolizing enzymes and venous thromboembolism, each of which may be associated with potentially fatal consequences; however, physicians should simultaneously ensure adequate efficacy of treatment, since the ongoing crisis may lead to a worsening of preexisting mental illnesses and to a surge in first onset of psychiatric disorders.

Keywords: Adverse drug reactions (ADR); Drug safety; Infection; Psychiatry; Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2).

29 references1 figure
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32
Am J Perinatol
. 2020 Jun;37(8):854-856. doi: 10.1055/s-0040-1709689. Epub 2020 Apr 10.
Protecting Labor and Delivery Personnel From COVID-19 During the Second Stage of Labor
Anna Palatnik 1, Jennifer J McIntosh 1
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PMID: 32276282 DOI: 10.1055/s-0040-1709689
Abstract
The novel coronavirus disease 2019 (COVID-19) is spreading fast and is affecting the clinical workers at much higher risk than the general population. Little is known about COVID-19 effect on pregnant women; however, the emerging evidence suggests they may be at high risk of asymptomatic disease. In light of projected shortage of personal protective equipment (PPE), there is an aggressive attempt at conservation. In obstetrics, the guidelines on PPE use are controversial and differ among hospitals, globally, as well as nationally. The centers for disease control and prevention (CDC) recommend using N95 respirators, which are respirators that offer a higher level of protection instead of a facemask for when performing or present for an aerosol-generating procedures (AGP). However, the second stage of labor is not considered an AGP. The second stage of labor can last up to 4 hours. During that time, labor and delivery personnel is in close contact to patients, who are exerting extreme effort during and frequently blow out their breath, cough, shout, and vomit, all of which put the health care team at risk, considering that COVID-19 transmission occurs through aerosol generated by coughing and sneezing. The CDC and the American College of Obstetricians and Gynecologists (ACOG) do not provide clarification on the use of N95 during the second stage. We recommend that labor and delivery personnel have the utmost caution and be granted the protection they need to protect themselves and other patients. This includes providing labor and delivery personnel full PPE including N95 for the second stage of labor. This is critical to ensure the adequate protection for health care workers and to prevent spread to other health care workers and patients. KEY POINTS: · Second stage of labor exposes providers to aerosol.. · COVID-19 risk during second stage of labor is high.. · N95 should be used during second stage of labor..

Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Conflict of interest statement
None declared.

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33
Review Antibiotics (Basel)
. 2020 Jul 5;9(7):E380. doi: 10.3390/antibiotics9070380.
Current Concepts in Community and Ventilator Associated Lower Respiratory Tract Infections in ICU Patients
Ignacio Martin-Loeches 1 2 3
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PMID: 32635601 DOI: 10.3390/antibiotics9070380
Free article
Abstract
It is widely known that pneumonia (either community acquired or hospital acquired, as like ventilator associated pneumonia (VAP)), is the most frequent type of severe infection and continues to pose a significant burden on healthcare services worldwide. Despite new diagnostic developments, most pneumonia cases continue to be difficult to diagnose clinically, partly due to acquired antibiotic resistance and the lack of a 'gold standard' method of diagnosis. In other words, the lack of a rapid, accurate diagnostic test, as well as the uncertainty of the initial etiologic diagnosis and the risk stratification, results in empirical antibiotic treatments. There are significant changes in the aetiology of patients with ventilator associated lower respiratory tract infections (VA-LRTI), which are characterised by a higher incidence of multi drug resistant organisms. Evidence suggests that when patients with VA-LRTI develop organ failure, the associated mortality can be exceptionally high with frequent complications, including acute respiratory distress syndrome, acute kidney injury, and septic shock. Appropriate antibiotic treatments must consider that the present cardiovascular failure seen in patients has a different association with the patient's mortality. Unlike patients with less severe clinical presentations, who have a higher chance of survival when the appropriate antibiotics are administered promptly, for patients with a severe subtype of the disease, the appropriateness of antibiotic treatment will impact the patient's outcome to a lesser extent. The present review highlights certain factors detectable at the time of admission that could indicate patients who are at a high risk of bacteraemia and who, therefore, merit more intense therapy and stratified care.

Keywords: VA-LRTI; VAP; pneumonia; sepsis.

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34
Euro Surveill
. 2019 Mar;24(12):1900170. doi: 10.2807/1560-7917.ES.2019.24.12.1900170.
Influenza A(H3N2) Virus Exhibiting Reduced Susceptibility to Baloxavir Due to a Polymerase Acidic Subunit I38T Substitution Detected From a Hospitalised Child Without Prior Baloxavir Treatment, Japan, January 2019
Emi Takashita 1, Chiharu Kawakami 2, Rie Ogawa 1, Hiroko Morita 1, Seiichiro Fujisaki 1, Masayuki Shirakura 1, Hideka Miura 1, Kazuya Nakamura 1, Noriko Kishida 1, Tomoko Kuwahara 1, Akira Ota 3, Hayato Togashi 3, Ayako Saito 4, Keiko Mitamura 5, Takashi Abe 6, Masataka Ichikawa 7, Masahiko Yamazaki 8, Shinji Watanabe 1, Takato Odagiri 1
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PMID: 30914078 PMCID: PMC6440584 DOI: 10.2807/1560-7917.ES.2019.24.12.1900170
Free PMC article
Abstract
In January 2019, two influenza A(H3N2) viruses carrying an I38T substitution in the polymerase acidic subunit (PA), which confers reduced susceptibility to baloxavir, were detected from epidemiologically unrelated hospitalised children in Japan. The viruses exhibited reduced susceptibility to baloxavir but were susceptible to neuraminidase inhibitors. Only one of the two children had been treated with baloxavir. An epidemiological analysis suggests possible transmission of the PA I38T mutant A(H3N2) virus among humans.

Keywords: Influenza virus; baloxavir acid; baloxavir marboxil; cap-dependent endonuclease inhibitor; drug resistance.

Conflict of interest statement
Conflict of interest: None declared.

Cited by 12 articles9 references
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35
Antimicrob Agents Chemother
. 2019 Sep 23;63(10):e00907-19. doi: 10.1128/AAC.00907-19. Print 2019 Oct.
Population Pharmacokinetics of the Antituberculosis Agent Pretomanid
David H Salinger 1, Vishak Subramoney 1, Daniel Everitt 2, Jerry R Nedelman 3
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PMID: 31405856 PMCID: PMC6761531 DOI: 10.1128/AAC.00907-19
Free PMC article
Abstract
A population pharmacokinetic (PopPK) model for pretomanid was developed using data from 14 studies in the pretomanid development program: six phase 1 studies, six phase 2 studies, and two phase 3 studies. The final analysis data set contained 17,725 observations from 1,054 subjects, including healthy subjects and subjects with drug-sensitive, multidrug-resistant, or extensively drug-resistant pulmonary tuberculosis dosed pretomanid in monotherapy or combination therapy for up to 6 months. Pretomanid pharmacokinetic behavior was described by a one-compartment model that at a given dose was linear in its absorption and clearance processes but where the rate of absorption and extent of bioavailability changed with dose. Clearance and volume of distribution scaled allometrically with weight. Apparent clearance in females was 18% less than in males. Among HIV-positive subjects, absent the effect of CYP3A4-inducing antiretrovirals, apparent clearance was 6% higher. Some effects of total bilirubin and albumin were found, but the impacts on exposure were small. Bioavailability in the fasted condition was about half that in the fed condition. Relative bioavailability decreased with increasing dose in the fasted condition, but not for doses of ≤200 mg in the fed condition. HIV-positive subjects taking efavirenz and lopinavir/ritonavir had exposures that were reduced by 46 and 17%, respectively. There was little evidence for noteworthy effects of regimen partners on pretomanid. Standard diagnostics indicated that the model described the voluminous, diverse data well, so that the model could be used to generate exposure metrics for exposure/response analyses to be reported elsewhere.

Keywords: Mycobacterium tuberculosis; antibiotic resistance; multidrug resistance; tuberculosis.

Copyright © 2019 Salinger et al.

Cited by 1 article24 references2 figures
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36
Observational Study Am J Perinatol
. 2020 Jun;37(8):869-872. doi: 10.1055/s-0040-1710541. Epub 2020 May 2.
Neonatal Late Onset Infection With Severe Acute Respiratory Syndrome Coronavirus 2
Danilo Buonsenso 1, Simonetta Costa # 1, Maurizio Sanguinetti 2, Paola Cattani 2, Brunella Posteraro 2, Simona Marchetti 2, Brigida Carducci 1, Antonio Lanzone 1, Enrica Tamburrini 2, Giovanni Vento 1, Piero Valentini 1
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PMID: 32359227 DOI: 10.1055/s-0040-1710541
Abstract
Objective: To date, no information on late-onset infection in newborns to mother with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) contracted in pregnancy are available. This study aimed to evaluate postdischarge SARS-CoV-2 status of newborns to mothers with COVID-19 in pregnancy that, at birth, were negative to SARS-CoV-2.

Study design: This is an observational study of neonates born to mothers with coronavirus disease 2019 (COVID-19).

Results: Seven pregnant women with documented SARS-CoV-2 infection have been evaluated in our institution. One woman had a spontaneous abortion at 8 weeks of gestational age, four women recovered and are still in follow-up, and two women delivered. Two newborns were enrolled in the study. At birth and 3 days of life, newborns were negative to SARS-CoV-2. At 2-week follow-up, one newborn tested positive although asymptomatic.

Conclusion: Our findings highlight the importance of follow-up of newborns to mothers with COVID-19 in pregnancy, since they remain at risk of contracting the infection in the early period of life and long-term consequences are still unknown.

Key points: · Newborns to mothers with coronavirus disease 2019 (COVID-19) in pregnancy can acquire the infection later after birth.. · Newborns to mothers with COVID-19 in pregnancy need a long-term follow-up, even if they tested negative at birth.. · Specific guidelines for the long-term follow-up of newborns to mothers with COVID-19 in pregnancy are needed..

Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Conflict of interest statement
None declared.

Cited by 1 article
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37
Am J Perinatol
. 2020 Jun;37(8):829-836. doi: 10.1055/s-0040-1710308. Epub 2020 Apr 28.
General Guidelines in the Management of an Obstetrical Patient on the Labor and Delivery Unit During the COVID-19 Pandemic
Angela J Stephens 1, John R Barton 2, Nana-Ama Ankumah Bentum 1, Sean C Blackwell 1, Baha M Sibai 1
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PMID: 32344441 DOI: 10.1055/s-0040-1710308
Abstract
Novel coronavirus disease 2019 (COVID-19) is a respiratory tract infection that was first identified in China. Since its emergence in December 2019, the virus has rapidly spread, transcending geographic barriers. The World Health Organization and the Centers for Disease Control and Prevention have declared COVID-19 as a public health crisis. Data regarding COVID-19 in pregnancy is limited, consisting of case reports and small cohort studies. However, obstetric patients are not immune from the current COVID-19 pandemic, and obstetric care will inevitably be impacted by the current epidemic. As such, clinical protocols and practice on labor and delivery units must adapt to optimize the safety of patients and health care workers and to better conserve health care resources. In this commentary, we provide suggestions to meet these goals without impacting maternal or neonatal outcomes. KEY POINTS: • Novel coronavirus disease 2019 (COVID-19) is a pandemic.• COVID-19 impacts care of obstetric patients.• Health care should be adapted for the COVID-19 pandemic.

Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Conflict of interest statement
None declared.

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38
Review Postgrad Med J
. 2020 Jul;96(1137):392-398. doi: 10.1136/postgradmedj-2020-137979. Epub 2020 Jun 10.
COVID-19: To Be or Not to Be; That Is the Diagnostic Question
Jamie J Coleman 1 2, Kaveh Manavi 2 3, Ella J Marson 4 2, Adam H Botkai 4 2, Elizabeth Sapey 2 3
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PMID: 32522844 PMCID: PMC7306267 DOI: 10.1136/postgradmedj-2020-137979
Free PMC article
Abstract
Since the first cases in December 2019, the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has rapidly spread across the globe, resulting in the COVID-19 pandemic. Early clinical experiences have demonstrated the wide spectrum of SARS-CoV-2 presentations, including various reports of atypical presentations of COVID-19 and possible mimic conditions.This article summarises the current evidence surrounding atypical presentations of COVID-19 including neurological, cardiovascular, gastrointestinal, otorhinolaryngology and geriatric features. A case from our hospital of pneumocystis pneumonia initially suspected to be COVID-19 forms the basis for a discussion surrounding mimic conditions of COVID-19. The dual-process model of clinical reasoning is used to analyse the thought processes used to make a diagnosis of COVID-19, including consideration of the variety of differential diagnoses.While SARS-CoV-2 is likely to remain on the differential diagnostic list for a plethora of presentations for the foreseeable future, clinicians should be cautious of ignoring other potential diagnoses due to availability bias. An awareness of atypical presentations allows SARS-CoV-2 to be a differential so that it can be appropriately investigated. A knowledge of infectious mimics prevents COVID-19 from overshadowing other diagnoses, hence preventing delayed diagnosis or even misdiagnosis and consequent adverse outcomes for patients.

Keywords: infectious diseases; respiratory infections.

© Author(s) (or their employer(s)) 2020. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.

Conflict of interest statement
Competing interests: None declared.

54 references3 figures
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39
Euro Surveill
. 2019 Mar;24(10):1800174. doi: 10.2807/1560-7917.ES.2019.24.10.1800174.
Influenza C Virus in Pre-School Children With Respiratory Infections: Retrospective Analysis of Data From the National Influenza Surveillance System in Germany, 2012 to 2014
Annemarie Fritsch 1, Brunhilde Schweiger 1, Barbara Biere 1
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PMID: 30862333 PMCID: PMC6415498 DOI: 10.2807/1560-7917.ES.2019.24.10.1800174
Free PMC article
Abstract
IntroductionRecent data on influenza C virus indicate a possible higher clinical impact in specified patient populations than previously thought.AimWe aimed to investigate influenza C virus circulation in Germany.MethodsA total of 1,588 samples from 0 to 4 year-old children presenting as outpatients with influenza-like illness (ILI) or acute respiratory infection were analysed retrospectively. The samples represented a subset of all samples from the German national surveillance system for influenza in this age group in 2012-14. The presence of influenza C virus was investigated by real-time PCR. For positive samples, information on symptoms as well as other respiratory virus co-infections was considered. Retrieved influenza C viral sequences were phylogenetically characterised.ResultsInfluenza C viral RNA was detected in 20 (1.3% of) samples, including 16 during the 2012/13 season. The majority (18/20) of influenza C-positive patients had ILI according to the European Union definition, one patient had pneumonia. Viruses belonged to the C/Sao Paulo and C/Kanagawa lineages. Most (11/20) samples were co-infected with other respiratory viruses.ConclusionOur data are the first on influenza C virus circulation in Germany and notably from a European national surveillance system. The low detection frequency and the identified virus variants confirm earlier observations outside a surveillance system. More virus detections during the 2012/13 season indicate a variable circulation intensity in the different years studied. Influenza C virus can be considered for ILI patients. Future studies addressing its clinical impact, especially in patients with severe disease are needed.

Keywords: Germany; Real-Time PCR; air-borne infections; epidemiology; hemagglutinin esterase; influenza virus; laboratory surveillance; molecular methods; respiratory infections; sentinel surveillance; viral infections.

Conflict of interest statement
Conflict of interest: None declared.

Cited by 1 article34 references3 figures
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40
Case Reports Am J Perinatol
. 2020 Jun;37(8):866-868. doi: 10.1055/s-0040-1709993. Epub 2020 Apr 24.
Successful Treatment of Preterm Labor in Association With Acute COVID-19 Infection
Paul C Browne 1, Jennifer B Linfert 1, Emilio Perez-Jorge 2
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PMID: 32330970 DOI: 10.1055/s-0040-1709993
Abstract
Novel coronavirus disease 2019 (COVID-19) infection occurring during pregnancy is associated with an increased risk of preterm delivery. This case report describes successful treatment of preterm labor during acute COVID-19 infection. Standard treatment for preterm labor may allow patients with acute COVID-19 infection to recover without the need for preterm delivery. KEY POINTS: · Acute COVID-19 infection is associated with a high rate of preterm delivery.. · Standard treatment for preterm labor such as intravenous magnesium sulfate, antepartum steroid therapy and antibiotic prophylaxis for group B streptococcus infection were effective in this patient.. · In the absence of maternal or fetal compromise, acute COVID-19 infection is not an indication for early elective delivery..

Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Conflict of interest statement
None declared.

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41
Editorial J Bronchology Interv Pulmonol
. 2020 Jul;27(3):160-162. doi: 10.1097/LBR.0000000000000682.
Bronchoscopy in the Age of COVID-19
David E Ost 1
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PMID: 32205711 PMCID: PMC7141585 DOI: 10.1097/LBR.0000000000000682
Free PMC article
Conflict of interest statement
Disclosure: There is no conflict of interest or other disclosures.

Cited by 1 article13 references
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42
Curr Clin Pharmacol
. 2019;14(2):157-164. doi: 10.2174/1574884714666181214101917.
Protective Effect of Selenium-L-methionine on Radiation-induced Acute Pneumonitis and Lung Fibrosis in Rat
Peyman Amini 1, Sedighe Kolivand 2, Hana Saffar 3, Saeed Rezapoor 1, Elahe Motevaseli 4, Masoud Najafi 5, Farzad Nouruzi 6, Dheyauldeen Shabeeb 7 8, Ahmed Eleojo Musa 7 9
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PMID: 30556505 PMCID: PMC7040518 DOI: 10.2174/1574884714666181214101917
Free PMC article
Abstract
Background: In this study, we aimed to detect the changes in the level of interleukin (IL)-4 and IL-13 cytokines and their downstream genes including interleukin-13 receptor subunit alpha-2 (IL13Ra2), interleukin-4 receptor subunit alpha-1 (IL4Ra1), dual oxidase 1 (DUOX1) and dual oxidase 2 (DUOX2). The protective effects of Selenium-L-methionine on radiation-induced histopathological damages and changes in the level of these cytokines and genes were detected.

Methods: Four groups of 20 rats (5 rats in each) namely, control; Selenium-L-methionine, radiation and radiation plus Selenium-L-methionine were used in this study. 4 mg/kg of Selenium-Lmethionine was administered 1 day before irradiation and five consecutive days after irradiation. Irradiation was done using a dose of 15 Gy 60Co gamma rays at 109 cGy/min. All rats were sacrificed 10 weeks after irradiation for detecting changes in IL-4 and IL-13 cytokines, the expressions of IL13Ra2, IL4Ra1, Duox1 and Duox2 and histopathological changes.

Results: The level of IL-4 but not IL-13 increased after irradiation. This was associated with increased expression of IL4Ra1, Duox1 and Duox2, in addition to changes in morphological properties. Selenium-L-methionine could attenuate all injury markers following lung irradiation.

Conclusion: Selenium-L-methionine can protect lung tissues against toxic effects of ionizing radiation. It is possible that the modulation of immune responses and redox interactions are involved in the radioprotective effect of this agent.

Keywords: IL-4. IL-13; Selenium-L-methionine; interleukin; lung; pneumonitis; radiation; radiotherapy..

Copyright© Bentham Science Publishers; For any queries, please email at epub@benthamscience.net.

Cited by 5 articles42 references5 figures
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43
Antiviral Res
. 2019 Nov;171:104566. doi: 10.1016/j.antiviral.2019.104566. Epub 2019 Jul 23.
Responses of Human Mast Cells and Epithelial Cells Following Exposure to Influenza A Virus
Kurtis Ng 1, Javeria Raheem 1, Chris D St Laurent 1, Candy Tsang Marcet 1, Harissios Vliagoftis 1, A Dean Befus 2, Tae Chul Moon 3
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PMID: 31348951 DOI: 10.1016/j.antiviral.2019.104566
Abstract
As a part of innate immune defense, the role of mast cells during viral replication has been incompletely understood. In this study, we characterized and compared the responses of the human mast cell line, LAD2, and human lung epithelial cell line, Calu-3, against three influenza A virus strains; A/PR/8/34 (H1N1), A/WS/33 (H1N1) and A/HK/8/68 (H3N2). We found that there were strain-dependent mast cell responses, and different profiles of cytokine, chemokine and antiviral gene expression between the two cell types. All three strains did not induce histamine or β-hexosaminidase release in LAD2. A/HK/8/68 induced release of prostaglandin D2 in LAD2, whereas A/PR/8/34 and A/WS/33 did not. We found that, among those examined, only CCL4 (by A/PR/8/34) was statistically significantly released from LAD2 cells. Furthermore, there was increased mRNA expression of viral recognition receptors (RIG-I and MDA5) and antiviral protein, viperin, but levels and kinetics of the expression were different among the cell types, as well as by the strains examined. Our findings highlight the variability in innate response to different strains of influenza A virus in two human cell types, indicating that further investigation is needed to understand better the role of mast cells and epithelial cells in innate immunity against influenza A viruses.

Keywords: Epithelial cells; Host response; Influenza A virus; Mast cells.

Copyright © 2019 Elsevier B.V. All rights reserved.

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44
Observational Study Vaccine
. 2019 Feb 28;37(10):1293-1298. doi: 10.1016/j.vaccine.2019.01.054. Epub 2019 Feb 2.
A Population-Based Study of Maternal and Infant Factors Influencing Influenza Vaccination Among Young Children Born in Colorado From 2008 to 2016
Suchitra Rao 1, Musheng Alishahi 2, Lauren De Crescenzo 2, Amanda F Dempsey 3
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PMID: 30723065 DOI: 10.1016/j.vaccine.2019.01.054
Abstract
Introduction: Influenza causes significant morbidity among young children, and vaccination remains the best strategy to prevent disease. Understanding factors influencing early influenza vaccination uptake are important to identify strategies to increase vaccination rates.

Objective: To assess maternal and neonatal factors associated with influenza vaccination among first-born children within the first two years of life.

Methods: We conducted a retrospective population-based cohort study linking Colorado Birth Registry data and state immunization data of all live births between 2008 and 2016. The cohort was limited to singleton, first births. Multivariable logistic regression was used to assess associations between maternal and neonatal factors and influenza vaccination.

Results: Among 126,763 births meeting criteria for inclusion, 50.2% were vaccinated against influenza by two years of age. Mothers of unvaccinated children were older (27 vs 26 years, p < 0.0001), married (67.8% vs 66.8%, p < 0.0001), with a college education (38.8% vs 37.2%, p < 0.0001). Influenza vaccination rates declined over time by birth year (30.5% in 2009 vs 6.8% in 2013, p < 0.0001). Children admitted to the NICU receiving oxygen with 72 h of birth were 20% less likely to be vaccinated (RR = 0.8, 95% CI: 0.67-0.96) after adjusting for maternal age, race/ethnicity, education and preterm birth. Conversely, premature births were associated with an increase in influenza vaccination by age two years (RR = 1.1, 95%CI: 1.05, 1.15).

Conclusions: Among a large population-based cohort of mother-infant pairs in Colorado using birth and immunization registry data, there were statistically significant differences in maternal factors between unvaccinated and vaccinated children with influenza in the first 2 years of life, but the differences were too small to be clinically significant. Children admitted to the NICU were 20% less likely to be vaccinated, highlighting the need to target influenza vaccination in this population once eligible. Ongoing studies are needed to explore factors associated with early influenza vaccination.

Keywords: Birth registry; Immunization registry; Influenza vaccination; Vaccine uptake.

Copyright © 2019 Elsevier Ltd. All rights reserved.

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45
Metabolism
. 2020 Jul;108:154262. doi: 10.1016/j.metabol.2020.154262. Epub 2020 May 16.
Severe Obesity, Increasing Age and Male Sex Are Independently Associated With Worse In-Hospital Outcomes, and Higher In-Hospital Mortality, in a Cohort of Patients With COVID-19 in the Bronx, New York
Leonidas Palaiodimos 1, Damianos G Kokkinidis 2, Weijia Li 2, Dimitrios Karamanis 3, Jennifer Ognibene 4, Shitij Arora 5, William N Southern 5, Christos S Mantzoros 6
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PMID: 32422233 PMCID: PMC7228874 DOI: 10.1016/j.metabol.2020.154262
Free PMC article
Abstract
Background & aims: New York is the current epicenter of Coronavirus disease 2019 (COVID-19) pandemic. The underrepresented minorities, where the prevalence of obesity is higher, appear to be affected disproportionately. Our objectives were to assess the characteristics and early outcomes of patients hospitalized with COVID-19 in the Bronx and investigate whether obesity is associated with worse outcomes independently from age, gender and other comorbidities.

Methods: This retrospective study included the first 200 patients admitted to a tertiary medical center with COVID-19. The electronic medical records were reviewed at least three weeks after admission. The primary endpoint was in-hospital mortality.

Results: 200 patients were included (female sex: 102, African American: 102). The median BMI was 30 kg/m2. The median age was 64 years. Hypertension (76%), hyperlipidemia (46.2%), and diabetes (39.5%) were the three most common comorbidities. Fever (86%), cough (76.5%), and dyspnea (68%) were the three most common symptoms. 24% died during hospitalization (BMI < 25 kg/m2: 31.6%, BMI 25-34 kg/m2: 17.2%, BMI ≥ 35 kg/m2: 34.8%, p = 0.03). Increasing age (analyzed in quartiles), male sex, BMI ≥ 35 kg/m2 (reference: BMI 25-34 kg/m2), heart failure, CAD, and CKD or ESRD were found to have a significant univariate association with mortality. The multivariate analysis demonstrated that BMI ≥ 35 kg/m2 (reference: BMI 25-34 kg/m2, OR: 3.78; 95% CI: 1.45-9.83; p = 0.006), male sex (OR: 2.74; 95% CI: 1.25-5.98; p = 0.011) and increasing age (analyzed in quartiles, OR: 1.73; 95% CI: 1.13-2.63; p = 0.011) were independently associated with higher in-hospital mortality. Similarly, age, male sex, BMI ≥ 35 kg/m2 and current or prior smoking were significant predictors for increasing oxygenation requirements in the multivariate analysis, while male sex, age and BMI ≥ 35 kg/m2 were significant predictors in the multivariate analysis for the outcome of intubation.

Conclusions: In this cohort of hospitalized patients with COVID-19 in a minority-predominant population, severe obesity, increasing age, and male sex were independently associated with higher in-hospital mortality and in general worse in-hospital outcomes.

Keywords: Bronx; COVID-19; Coronavirus; Mortality; New York; Obesity; Pandemic; Risk factor; SARS-CoV-2.

Copyright © 2020 Elsevier Inc. All rights reserved.

Conflict of interest statement
Declaration of competing interest All authors declare no conflict of interests.

Cited by 5 articles28 references1 figure
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46
Review Clin Microbiol Rev
. 2020 Jun 24;33(4):e00028-20. doi: 10.1128/CMR.00028-20. Print 2020 Sep 16.
Coronavirus Disease 2019-COVID-19
Kuldeep Dhama 1, Sharun Khan 2, Ruchi Tiwari 3, Shubhankar Sircar 4, Sudipta Bhat 4, Yashpal Singh Malik 5, Karam Pal Singh 1, Wanpen Chaicumpa 6, D Katterine Bonilla-Aldana 7 8 9, Alfonso J Rodriguez-Morales 10 9 11
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PMID: 32580969 DOI: 10.1128/CMR.00028-20
Abstract
SUMMARYIn recent decades, several new diseases have emerged in different geographical areas, with pathogens including Ebola virus, Zika virus, Nipah virus, and coronaviruses (CoVs). Recently, a new type of viral infection emerged in Wuhan City, China, and initial genomic sequencing data of this virus do not match with previously sequenced CoVs, suggesting a novel CoV strain (2019-nCoV), which has now been termed severe acute respiratory syndrome CoV-2 (SARS-CoV-2). Although coronavirus disease 2019 (COVID-19) is suspected to originate from an animal host (zoonotic origin) followed by human-to-human transmission, the possibility of other routes should not be ruled out. Compared to diseases caused by previously known human CoVs, COVID-19 shows less severe pathogenesis but higher transmission competence, as is evident from the continuously increasing number of confirmed cases globally. Compared to other emerging viruses, such as Ebola virus, avian H7N9, SARS-CoV, and Middle East respiratory syndrome coronavirus (MERS-CoV), SARS-CoV-2 has shown relatively low pathogenicity and moderate transmissibility. Codon usage studies suggest that this novel virus has been transferred from an animal source, such as bats. Early diagnosis by real-time PCR and next-generation sequencing has facilitated the identification of the pathogen at an early stage. Since no antiviral drug or vaccine exists to treat or prevent SARS-CoV-2, potential therapeutic strategies that are currently being evaluated predominantly stem from previous experience with treating SARS-CoV, MERS-CoV, and other emerging viral diseases. In this review, we address epidemiological, diagnostic, clinical, and therapeutic aspects, including perspectives of vaccines and preventive measures that have already been globally recommended to counter this pandemic virus.

Keywords: COVID-19; One Health; SARS-CoV-2; diagnosis; emerging coronavirus; therapy; vaccines.

Copyright © 2020 American Society for Microbiology.

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47
Infect Immun
. 2020 Mar 23;88(4):e00855-19. doi: 10.1128/IAI.00855-19. Print 2020 Mar 23.
Cooperativity Between Stenotrophomonas Maltophilia and Pseudomonas Aeruginosa During Polymicrobial Airway Infections
Melissa S McDaniel 1 2, Trenton Schoeb 3, W Edward Swords 4 2
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PMID: 31932329 PMCID: PMC7093137 (available on 2020-09-23) DOI: 10.1128/IAI.00855-19
Free PMC article
Abstract
Stenotrophomonas maltophilia is a Gram-negative bacterium found ubiquitously in the environment that has historically been regarded as nonpathogenic. S. maltophilia is increasingly observed in patient sputa in cystic fibrosis (CF), and while existing epidemiology indicates that patients with S. maltophilia have poorer diagnoses, its clinical significance remains unclear. Moreover, as multidrug resistance is common among S. maltophilia isolates, treatment options for these infections may be limited. Here, we investigated the pathogenicity of S. maltophilia alone and during polymicrobial infection with Pseudomonas aeruginosa Colonization, persistence, and virulence of S. maltophilia were assessed in experimental respiratory infections of mice. The results of this study indicate that S. maltophilia transiently colonizes the lung accompanied by significant weight loss and immune cell infiltration and the expression of early inflammatory markers, including interleukin 6 (IL-6), IL-1α, and tumor necrosis factor alpha (TNF-α). Importantly, polymicrobial infection with P. aeruginosa elicited significantly higher S. maltophilia counts in bronchoalveolar lavages and lung tissue homogenates. This increase in bacterial load was directly correlated with the density of the P. aeruginosa population and required viable P. aeruginosa bacteria. Microscopic analysis of biofilms formed in vitro revealed that S. maltophilia formed well-integrated biofilms with P. aeruginosa, and these organisms colocalize in the lung during dual-species infection. Based on these results, we conclude that active cellular processes by P. aeruginosa afford a significant benefit to S. maltophilia during polymicrobial infections. Furthermore, these results indicate that S. maltophilia may have clinical significance in respiratory infections.

Keywords: Pseudomonas; Pseudomonas aeruginosa; Stenotrophomonas; Stenotrophomonas maltophilia; biofilm; biofilms; cystic fibrosis; inflammation; polymicrobial infection.

Copyright © 2020 American Society for Microbiology.

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48
Vaccine
. 2019 Feb 4;37(6):783-791. doi: 10.1016/j.vaccine.2018.12.047. Epub 2019 Jan 5.
Effectiveness of Trivalent Inactivated Influenza Vaccine Among Community-Dwelling Older Adults in Thailand: A Two-Year Prospective Cohort Study
Kriengkrai Prasert 1, Jayanton Patumanond 2, Prabda Praphasiri 3, Supakit Siriluk 4, Darunee Ditsungnoen 5, Malinee Chittaganpich 6, Fatimah S Dawood 7, Joshua A Mott 8, Kim A Lindblade 8
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PMID: 30616956 DOI: 10.1016/j.vaccine.2018.12.047
Free article
Abstract
Background: We conducted a two-year prospective cohort study to measure the effectiveness of trivalent inactivated influenza vaccine (IIV3) to prevent laboratory-confirmed influenza among community-dwelling Thai adults aged ≥65 years during 2015-16 and 2016-17 influenza seasons.

Methods: In 2015, we enrolled a cohort of 3220 participants. Trained health volunteers collected baseline data and followed participants for two years with weekly surveillance for new or worsened cough with self-collection of nasal swabs. Vaccine effectiveness (VE) was estimated as 100% × (1- rate ratio of rRT-PCR -confirmed influenza) among vaccinated versus unvaccinated participants. Propensity score stratification was used to reduce differences between vaccinated and unvaccinated participants associated with access to and receipt of IIV3.

Findings: During 2015-16 and 2016-17, 1666 (52%) and 1498 (48%) participants received IIV3, respectively. The overall incidence of influenza during the two seasons was 14.3/1000 person-years among vaccinated participants and 20.2/1000 person-years among unvaccinated participants. VE was -4% (95% confidence interval [CI], -83%-40%) during 2015-16 when there was poor antigenic match between the dominant circulating A/H3N2 viruses and the vaccine strain, and 50% (95% CI, 12-71%) during 2016-17 when circulating and vaccine strains were well-matched. Of all three influenza subtypes in both years, significant protection was observed only against Influenza A/H3N2 during 2016-17 (VE, 49%; 95% CI, 3-73%).

Interpretation: During a season with well-matched circulating and vaccine strains, IIV3 was moderately effective against laboratory-confirmed influenza among older adults in Thailand.

Keywords: Older adults; Seasonal influenza vaccine; Thailand; Vaccine effectiveness.

Published by Elsevier Ltd.

Cited by 2 articles
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49
Review Postgrad Med J
. 2020 Jul;96(1137):403-407. doi: 10.1136/postgradmedj-2020-137935. Epub 2020 Jun 10.
ACE2 and COVID-19 and the Resulting ARDS
Xiaoqing Zhang 1 2, Shuren Li 3, Shaoqian Niu 2
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PMID: 32522846 DOI: 10.1136/postgradmedj-2020-137935
Abstract
This article reviews the correlation between ACE2 and COVID-19 and the resulting acute respiratory distress syndrome (ARDS). ACE2 is a crucial component of the renin-angiotensin system (RAS). The classical ACE-angiotensin Ⅱ (Ang II)-angiotensin type 1 receptor (AT1R) axis and the ACE2-Ang(1-7)-Mas counter-regulatory axis play an essential role in RAS system. ACE2 antagonises the activation of the classical RAS ACE-Ang II-AT1R axis and protects against lung injury. Similar to severe acute respiratory syndrome-related coronavirus, 2019 novel coronavirus (2019-nCoV) also uses ACE2 for cell entry. ARDS is a clinical high-mortality disease which is probably due to the excessive activation of RAS caused by 2019-nCoV infection, and ACE2 has a protective effect on ARDS caused by COVID-19. Because of these protective effects of ACE2 on ARDS, the development of drugs enhancing ACE2 activity may become one of the most promising approaches for the treatment of COVID-19 in the near future. In the meantime, however, the use of RAS blockers such as ACE inhibitors and angiotensin II receptor blockers that inhibit the damaging (ACE-Ang II) arm of the RAS cascade in the lung may also be promising. Trial registration number: NCT04287686.

© Author(s) (or their employer(s)) 2020. No commercial re-use. See rights and permissions. Published by BMJ.

Conflict of interest statement
Competing interests: None declared.

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50
J Clin Virol
. 2020 Apr;125:104305. doi: 10.1016/j.jcv.2020.104305. Epub 2020 Feb 28.
Rapid Random Access Detection of the Novel SARS-coronavirus-2 (SARS-CoV-2, Previously 2019-nCoV) Using an Open Access Protocol for the Panther Fusion
Anne K Cordes 1, Albert Heim 2
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PMID: 32143123 PMCID: PMC7129486 DOI: 10.1016/j.jcv.2020.104305
Free PMC article
Abstract
•
Detection of SARS-CoV-2 within 3.5 h (sample-to-answer-time) by random access real time PCR.
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Adaption of an already published real time PCR for SARS-CoV-2 to a fully automatic, random access PCR system.
•
Detection of all SARS-CoV (from 2002, which may be soon labelled as SARS-CoV-1, and SARS-CoV-2) with a PCR for the highly conserved E gene region.
•
Differentiation of SARS-CoV-2 with a PCR for the RdRp Gene.

Keywords: 2019-nCoV; COVID-19; Coronavirus; Random access PCR; Rapid diagnosis; SARS-CoV-2.

Conflict of interest statement
Declaration of Competing Interest AH: Research grant and travel grant not related to the present work by Hologic Inc. AC: Travel grant and speaker honorarium not related to the present work by Hologic Inc.

Cited by 6 articles8 references
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