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1.
JMIR Research Protocols ; 11(5):e35706, 2022.
Article in English | MEDLINE | ID: covidwho-1834187

ABSTRACT

BACKGROUND: The SARS-CoV-2 pandemic has resulted in an unprecedented level of worldwide testing for epidemiologic and diagnostic purposes, and due to the extreme need for tests, the gold-standard Reverse Transcription Polymerase Chain Reaction (RT-PCR) testing capacity has been unable to meet the overall worldwide testing demand. Consequently, although the current literature has shown the sensitivity of rapid antigen tests (RATs) to be inferior to RT-PCR, RATs have been implemented on a large scale without solid data on performance. OBJECTIVE: This study will compare analytical and clinical sensitivities and specificities of 50 lateral flow- or laboratory-based RATs and 3 strand invasion-based amplification (SIBA)-RT-PCR tests from 30 manufacturers to RT-PCR testing of samples obtained from the deep oropharynx. In addition, the study will compare sensitivities and specificities of the included RATs as well as RT-PCR on clinical samples obtained from the deep oropharynx, the anterior nasal cavity, saliva, the deep nasopharynx, and expired air to RT-PCR on deep oropharyngeal samples. METHODS: In the prospective part of the study, 200 individuals found SARS-CoV-2 positive and 200 individuals found SARS-CoV-2 negative by routine RT-PCR testing will be retested with each RAT, applying RT-PCR as the reference method. In the retrospective part of the study, 304 deep oropharyngeal cavity swabs divided into 4 groups based on RT-PCR quantification cycle (Cq) levels will be tested with each RAT. RESULTS: The results will be reported in several papers with different aims. The first paper will report retrospective (analytical sensitivity, overall and stratified into different Cq range groups) and prospective (clinical sensitivity) data for RATs, with RT-PCR as the reference method. The second paper will report results for RAT based on anatomical sampling location. The third paper will compare different anatomical sampling locations by RT-PCR testing. The fourth paper will focus on RATs that rely on central laboratory testing. Tests from 4 different manufacturers will be compared for analytical performance data on retrospective deep oropharyngeal swab samples. The fifth paper will report the results of 4 RATs applied both as professional use and as self-tests. The last paper will report the results from 2 breath tests in the study. A comparison of sensitivity and specificity between RATs will be conducted using the McNemar test for paired samples and the chi-squared test for unpaired samples. Comparison of the positive predictive value (PPV) and negative predictive value (NPV) between RATs will be performed by the bootstrap test, and 95% CIs for sensitivity, specificity, PPV, and NPV will be calculated as bootstrap CIs. CONCLUSIONS: The study will compare the sensitivities of a large number of RATs for SARS-CoV-2 to with those of RT-PCR and will address whether lateral flow-based RATs differ significantly from laboratory-based RATs. The anatomical test locations for both RATs and RT-PCR will also be compared. TRIAL REGISTRATION: ClinicalTrials.gov NCT04913116;https://clinicaltrials.gov/ct2/show/NCT04913116. International registered report identifier (irrid): Derr1-10.2196/35706.

2.
Ugeskrift for Laeger ; 184(9):28, 2022.
Article in Danish | MEDLINE | ID: covidwho-1728455

ABSTRACT

Children and adolescents infected with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) are usually asymptomatic or have mild coronavirus disease (COVID-19) with low rates of hospitalization and death. Multisystem inflammatory syndrome in children (MIS-C) is a rare and severe complication of SARS-CoV-2 infection. This paper reviews an excerpt of the literature on disease burden and complications following COVID-19 in children and adolescents aged 0-17 years, in addition to the effects and adverse drug reactions of BNT162b2 and mRNA-1273 vaccinations among children and adolescents aged 5-17 years.

3.
Infect Dis Now ; 2022 Feb 08.
Article in English | MEDLINE | ID: covidwho-1670546

ABSTRACT

OBJECTIVES: Diagnosis of COVID-19 is essential to prevent the spread of SARS-CoV-2. Nasopharyngeal swabs (NPS) remain the gold standard in screening, although associated with false negative results (up to 30%). We developed a 3D simulator of the nasal and pharyngeal cavities for the learning and improvement of NPS collection. PATIENTS AND METHODS: Simulator training sessions were carried out in 11 centers in France. A questionnaire assessing the simulator was administered at the end of the sessions. The study population included both healthcare workers (HCW) and volunteers from the general population. RESULTS: Out of 589 participants, overall satisfaction was scored 9.0 [8.9-9.1] on a scale of 0 to 10 with excellent results in the 16 evaluation items of each category (HCWs and general population, NPS novices and experienced). The simulator was considered very realistic (95%), easy to use (97%), useful to understand the anatomy (89%) and NPS sampling technique (93%). This educational tool was considered essential (93%). Participants felt their future NPS would be more reliable (72%), less painful (70%), easier to perform (88%) and that they would be carried out more serenely (90%). The mean number of NPS conducted on the simulator to feel at ease was two; technical fluency with the simulator can thus be acquired quickly. CONCLUSION: Our simulator, whose 3D printing can be reproduced freely using a permanent open access link, is an essential educational tool to standardize the learning and improvement of NPS collection. It should enhance virus detection and thus contribute to better pandemic control.

4.
27th International Conference on Theory and Application of Cryptology and Information Security, ASIACRYPT 2021 ; 13091 LNCS:665-695, 2021.
Article in English | Scopus | ID: covidwho-1602788

ABSTRACT

Contact tracing is among the most important interventions to mitigate the spread of any pandemic, usually in the form of manual contact tracing. Smartphone-facilitated digital contact tracing may help to increase tracing capabilities and extend the coverage to those contacts one does not know in person. Most implemented protocols use local Bluetooth Low Energy (BLE) communication to detect contagion-relevant proximity, together with cryptographic protections, as necessary to improve the privacy of the users of such a system. However, current decentralized protocols, including DP3T [T+20], do not sufficiently protect infected users from having their status revealed to their contacts, which raises fear of stigmatization. We alleviate this by proposing a new and practical solution with stronger privacy guarantees against active adversaries. It is based on the upload-what-you-observed paradigm, includes a separation of duties on the server side, and a mechanism to ensure that users cannot deduce which encounter caused a warning with high time resolution. Finally, we present a simulation-based security notion of digital contact tracing in the real–ideal setting, and prove the security of our protocol in this framework. © 2021, International Association for Cryptologic Research.

6.
The Polar Record ; 57, 2021.
Article in English | ProQuest Central | ID: covidwho-1475216

ABSTRACT

Climate warming is occurring most rapidly in the Arctic, which is both a sentinel and a driver of further global change. Ecosystems and human societies are already affected by warming. Permafrost thaws and species are on the move, bringing pathogens and vectors to virgin areas. During a five-year project, the CLINF – a Nordic Center of Excellence, funded by the Nordic Council of Ministers, has worked with the One Health concept, integrating environmental data with human and animal disease data in predictive models and creating maps of dynamic processes affecting the spread of infectious diseases. It is shown that tularemia outbreaks can be predicted even at a regional level with a manageable level of uncertainty. To decrease uncertainty, rapid development of new and harmonised technologies and databases is needed from currently highly heterogeneous data sources. A major source of uncertainty for the future of contaminants and infectious diseases in the Arctic, however, is associated with which paths the majority of the globe chooses to follow in the future. Diplomacy is one of the most powerful tools Arctic nations have to influence these choices of other nations, supported by Arctic science and One Health approaches that recognise the interconnection between people, animals, plants and their shared environment at the local, regional, national and global levels as essential for achieving a sustainable development for both the Arctic and the globe.

7.
Investigative Ophthalmology and Visual Science ; 62(11), 2021.
Article in English | EMBASE | ID: covidwho-1445096

ABSTRACT

Purpose: Ophthalmic diagnostic devices require patient and operator to be physically close during the exam. Goal of this study is to develop and release protective measures to increase patient and operator protection during COVID-19. Methods: We applied recommendations by the World Health Organization (WHO), the Center of Disease Control (CDC) and the Environmental Protection Agency (EPA) to the situation in the ophthalmic exam room, and developed, released, distributed, and communicated the resulting protective measures. We report the number of website visits, document downloads, and parts distributed from March 2020 through February 2021. Results: Detailed instructions on remote control of ophthalmic devices using remote desktop software or extension on monitors were published, viewed 4,450 and downloaded 1,014 times. Custom breath shields separating operator and patient were developed and a total of 82,827 have been shipped, free of charge or at-cost. Third party order information for single-use plastic bags and dental barrier film that fit ophthalmic devices and can cover high touch surfaces has been published on a dedicated web page. All cleaning instructions have been published in one place (viewed 25,819 times, downloaded 11,781 times). Highly accelerated lifetime tests were performed to confirm that frequent cleaning and disinfection of the HFA bowl with a spray of atomized isopropyl alcohol will not damage or alter the performance of the bowl. Updated disinfection instructions have been published and downloaded 8,318 times. An additional highly accelerated lifetime test has shown that the bowl inside the HFA can be disinfected using UV-C radiation without damaging the functionality of the perimeter. Conclusions: In response to the COVID-19 pandemic, we have provided improved cleaning instructions for the HFA family of bowl perimeters, have developed and distributed over 80,000 breath shields, have identified protective coverings for high-touch areas, and have developed and communicated different ways to operate existing devices remotely. While we have not been able to quantify the effectiveness of the individual measures, it is our assumption that implementing these measures which are based on recommendations by the WHO, the CDC, and the EPA, have increased patient and operator protection.

9.
COVID-19 and Co-production in Health and Social Care Vol 2: Volume 2: Co-production Methods and Working Together at a Distance ; : 27-34, 2021.
Article in English | Scopus | ID: covidwho-1391366
10.
Apmis ; 23:23, 2021.
Article in English | MEDLINE | ID: covidwho-1209186

ABSTRACT

In the efforts to dampen the COVID-19 pandemic, governments are compelled to outweigh disease control efforts to the possible negative consequences of closing large parts of society. Although Denmark and Sweden are alike in political organization and health care, national responses to the 2020 COVID-19 epidemic differed noticeably. Denmark initiated a hard lock down followed by an outbreak control strategy (the so-called "hammer and dance" strategy), while Sweden's strategy was based on advising on social distancing, while keeping society open (a so-called mitigative strategy). The objective of this study is to describe national epidemic control strategies in Denmark and Sweden in 2020, and compare the epidemic dynamics in the two countries, with respect to number of COVID-19 cases, admissions to intensive care and mortality. Data on epidemic control efforts and COVID-associated morbidity/mortality were downloaded from official government and epidemic surveillance webpages and comparatively described using basic statistics. Overall, we found "the hammer" resulted in better epidemic control during 2020 with less COVID-19-associated admissions to intensive care and lower mortality.

11.
Transplant International ; 33(SUPPL 2):18, 2020.
Article in English | EMBASE | ID: covidwho-1093815

ABSTRACT

Introduction: To date, 23 lung transplant recipients have been described with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infections worldwide. Eight had severe coronavirus disease 2019 (COVID-19), but none were placed on extracorporeal membrane oxygenation (ECMO) support. We aimed to describe our experience. Methods: Lung transplant recipients who were admitted to our hospital with SARS-CoV-2 infections from the beginning of the pandemia until May 25th, 2020 were included. Clinical charts were retrospectively retrieved and data analysed. Results: Four patients (3 males, 75%) with a median age of 58.5 years (47-66) were admitted for SARS-CoV-2 infections in our center. Three patients had double-lung transplantation for chronic thromboembolic pulmonary hypertension, idiopathic pulmonary fibrosis and cystic fibrosis. One patient had singlelung transplantation for non-specific interstitial pneumonia. SARS-CoV-2 infections were diagnosed by nasopharyngeal swabs in all patients within one month post-transplant (n=2), or after 13 months (n=1) and 15 years (n=1). Dyspnea was present in all patients. Worsening of symptoms occurred in three patients after a median of 8 days (1 to 8) after diagnosis. Imaging showed a highly variable degree of infiltrations. Mechanical ventilation was required in three patients. They all underwent prone positioning. Veno-venous ECMO was required in two patients. In all patients, immunosuppression consisted of prednisone and tacrolimus, while mycophenolate mofetil was stopped. Treatment with hydroxychloroquine was attempted in the first three patients. At last follow-up, one patient was discharged home and one was weaned from mechanical ventilation. Both ECMO supported patients died from multiple organ failure, despite ECMO could be weaned in one patient. Conclusion: A highly variable course of COVID-19 disease was observed in four patients after lung transplantation. More data is needed to better understand prognostic factors and management of this patient cohort.

12.
PubMed; 2020.
Preprint in English | PubMed | ID: ppcovidwho-1973

ABSTRACT

Protein-ligand docking is an in silico tool used to screen potential drug compounds for their ability to bind to a given protein receptor within a drug-discovery campaign. Experimental drug screening is expensive and time consuming, and it is desirable to carry out large scale docking calculations in a high-throughput manner to narrow the experimental search space. Few of the existing computational docking tools were designed with high performance computing in mind. Therefore, optimizations to maximize use of high-performance computational resources available at leadership-class computing facilities enables these facilities to be leveraged for drug discovery. Here we present the porting, optimization, and validation of the AutoDock-GPU program for the Summit supercomputer, and its application to initial compound screening efforts to target proteins of the SARS-CoV-2 virus responsible for the current COVID-19 pandemic.

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