Your browser doesn't support javascript.
loading
Mostrar: 20 | 50 | 100
Resultados 1 - 20 de 6.668
Filtrar
1.
J Infect Chemother ; 27(1): 117-119, 2021 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-32994136

RESUMEN

The novel coronavirus disease 2019 (COVID-19) is diagnosed by positive result of reverse transcription polymerase chain reaction (RT-PCR) for the novel coronavirus. We concluded that cycle threshold value (Ct-value) of real-time RT-PCR (rRT-PCR) assay could decrease as patients recover. Results of rRT-PCR assay could remain positive among asymptomatic patients for longer than 2 weeks. The discharge criteria of COVID-19 patients using a negative result of rRT-PCR should be reconsidered.


Asunto(s)
Infecciones por Coronavirus/diagnóstico , Neumonía Viral/diagnóstico , Reacción en Cadena de la Polimerasa de Transcriptasa Inversa/métodos , Adolescente , Adulto , Anciano de 80 o más Años , Enfermedades Asintomáticas , Betacoronavirus/aislamiento & purificación , Técnicas de Laboratorio Clínico/métodos , Infecciones por Coronavirus/virología , Femenino , Humanos , Masculino , Persona de Mediana Edad , Nasofaringe/virología , Pandemias , Alta del Paciente , Neumonía Viral/virología , Índice de Severidad de la Enfermedad , Carga Viral , Adulto Joven
2.
Ann Lab Med ; 41(2): 129-138, 2021 Mar 01.
Artículo en Inglés | MEDLINE | ID: mdl-33063674

RESUMEN

Since its first report in December 2019, coronavirus disease 2019 (COVID-19), caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), has rapidly emerged as a pandemic affecting nearly all countries worldwide. As the COVID-19 pandemic progresses, the need to identify genetic risk factors for susceptibility to this serious illness has emerged. Host genetic factors, along with other risk factors may help determine susceptibility to respiratory tract infections. It is hypothesized that the ACE2 gene, encoding angiotensin-converting enzyme 2 (ACE2), is a genetic risk factor for SARS-CoV-2 infection and is required by the virus to enter cells. Together with ACE2, transmembrane protease serine 2 (TMPRSS2) and dipeptidyl peptidase-4 (DPP4) also play an important role in disease severity. Evaluating the role of genetic variants in determining the direction of respiratory infections will help identify potential drug target candidates for further study in COVID-19 patients. We have summarized the latest reports demonstrating that ACE2 variants, their expression, and epigenetic factors may influence an individual's susceptibility to SARS-CoV-2 infection and disease outcome.


Asunto(s)
Betacoronavirus/genética , Infecciones por Coronavirus/patología , Variación Genética , Neumonía Viral/patología , Betacoronavirus/aislamiento & purificación , Infecciones por Coronavirus/virología , Dipeptidil Peptidasa 4/genética , Dipeptidil Peptidasa 4/metabolismo , Susceptibilidad a Enfermedades , Expresión Génica , Humanos , Pandemias , Peptidil-Dipeptidasa A/química , Peptidil-Dipeptidasa A/genética , Peptidil-Dipeptidasa A/metabolismo , Neumonía Viral/virología , Serina Endopeptidasas/genética , Serina Endopeptidasas/metabolismo , Índice de Severidad de la Enfermedad
3.
Ann Lab Med ; 41(2): 225-229, 2021 Mar 01.
Artículo en Inglés | MEDLINE | ID: mdl-33063685

RESUMEN

In response to the ongoing coronavirus disease 2019 (COVID-19) pandemic, an online laboratory surveillance system was established to monitor severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) real-time reverse transcription-PCR (rRT-PCR) testing capacities and results. SARS-CoV-2 rRT-PCR testing data were collected from 97 clinical laboratories, including 84 medical institutions and 13 independent clinical laboratories in Korea. We assessed the testing capacities to utilize SARS-CoV-2 rRT-PCR based on surveillance data obtained from February 7th to June 4th, 2020 and evaluated positive result characteristics according to the reagents used and sample types. A total of 1,890,319 SARS-CoV-2 rRT-PCR testing were performed, 2.3% of which were positive. Strong correlations were observed between the envelope (E) gene and RNA-dependent RNA polymerase (RdRp)/nucleocapsid (N) genes threshold cycle (Ct) values for each reagent. No statistically significant differences in gene Ct values were observed between the paired upper and lower respiratory tract samples, except in the N gene for nasopharyngeal swab and sputum samples. Our study showed that clinical laboratories in Korea have rapidly expanded their testing capacities in response to the COVID-19 outbreak, with a peak daily capacity of 34,193 tests. Rapid expansion in testing capacity is a critical component of the national response to the ongoing pandemic.


Asunto(s)
Betacoronavirus/genética , Servicios de Laboratorio Clínico/estadística & datos numéricos , Infecciones por Coronavirus/diagnóstico , Neumonía Viral/diagnóstico , Betacoronavirus/aislamiento & purificación , Infecciones por Coronavirus/virología , Humanos , Laboratorios de Hospital , Pandemias , Neumonía Viral/virología , ARN Replicasa/genética , ARN Viral/genética , ARN Viral/metabolismo , Reacción en Cadena en Tiempo Real de la Polimerasa , República de Corea , Proteínas del Envoltorio Viral/genética , Proteínas Virales/genética
4.
Methods Mol Biol ; 2225: 25-38, 2021.
Artículo en Inglés | MEDLINE | ID: mdl-33108655

RESUMEN

Various systems exist for the robust production of recombinant proteins. However, only a few systems are optimal for human vaccine protein production. Plant-based transient protein expression systems offer an advantageous alternative to costly mammalian cell culture-based systems and can perform posttranslational modifications due to the presence of an endomembrane system that is largely similar to that of the animal cell. Technological advances in expression vectors for transient expression in the last two decades have produced new plant expression systems with the flexibility and speed that cannot be matched by those based on mammalian or insect cell culture. The rapid and high-level protein production capability of transient expression systems makes them the optimal system to quickly and versatilely develop and produce vaccines against viruses such as 2019-nCoV that have sudden and unpredictable outbreaks. Here, expression of antiviral subunit vaccines in Nicotiana benthamiana plants via transient expression is demonstrated.


Asunto(s)
Betacoronavirus/efectos de los fármacos , Infecciones por Coronavirus/prevención & control , Pandemias/prevención & control , Plantas/inmunología , Neumonía Viral/prevención & control , Vacunas de Subunidad/administración & dosificación , Vacunas de Subunidad/biosíntesis , Betacoronavirus/inmunología , Betacoronavirus/aislamiento & purificación , Infecciones por Coronavirus/inmunología , Infecciones por Coronavirus/transmisión , Infecciones por Coronavirus/virología , Vectores Genéticos , Humanos , Plantas/genética , Neumonía Viral/inmunología , Neumonía Viral/transmisión , Neumonía Viral/virología
5.
Front Biosci (Elite Ed) ; 13: 117-139, 2021 01 01.
Artículo en Inglés | MEDLINE | ID: mdl-33048778

RESUMEN

Coronavirus disease (COVID-19) is caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), a member of the human coronavirus (HCoV) family that targets the lower part of the respiratory tract and causes severe acute respiratory syndrome (SARS). In a short span of time, this infection has led to a global pandemic and has become a significant threat to the existence of present human society. Currently, there are no treatments for this infection and the measures established across various countries such as social distancing, usage of mask to prevent entry of the virus into the respiratory tract, quarantine, and containment together have reduced the prevalence of this disease and mortality in highly susceptible individuals. Here, we examine the structure, replication cycle, phylogeny and genomic organization of this virus and discuss the role of spike (S) protein of the virus, an important structure that interacts with the host ACE2 receptor facilitating viral entry. Further, we explore the epidemiology, symptoms of the disease, describe the reverse transcriptase-polymerase chain reaction (RT-PCR) that establishes the diagnosis of the disease and also review its unique diagnostic features in the chest CT-Scan. Finally, we review the current approaches to develop therapies and vaccines as a measure for disease prevention and control.


Asunto(s)
Betacoronavirus/aislamiento & purificación , Infecciones por Coronavirus/epidemiología , Pandemias , Neumonía Viral/epidemiología , Técnicas de Laboratorio Clínico/métodos , Infecciones por Coronavirus/diagnóstico , Infecciones por Coronavirus/terapia , Infecciones por Coronavirus/virología , Humanos , Neumonía Viral/diagnóstico , Neumonía Viral/terapia , Neumonía Viral/virología
6.
BMC Infect Dis ; 20(1): 807, 2020 Nov 05.
Artículo en Inglés | MEDLINE | ID: mdl-33153445

RESUMEN

BACKGROUND: The COVID-19 spread worldwide quickly. Exploring the epidemiological characteristics could provide a basis for responding to imported cases abroad and to formulate prevention and control strategies in areas where COVID-19 is still spreading rapidly. METHODS: The number of confirmed cases, daily growth, incidence and length of time from the first reported case to the end of the local cases (i.e., non-overseas imported cases) were compared by spatial (geographical) and temporal classification and visualization of the development and changes of the epidemic situation by layers through maps. RESULTS: In the first wave, a total of 539 cases were reported in Sichuan, with an incidence rate of 0.6462/100,000. The closer to Hubei the population centres were, the more pronounced the epidemic was. The peak in Sichuan Province occurred in the second week. Eight weeks after the Wuhan lockdown, the health crisis had eased. The longest epidemic length at the city level in China (except Wuhan, Taiwan, and Hong Kong) was 53 days, with a median of 23 days. Spatial autocorrelation analysis of China showed positive spatial correlation (Moran's Index > 0, p < 0.05). Most countries outside China began to experience a rapid rise in infection rates 4 weeks after their first case. Some European countries experienced that rise earlier than the USA. The pandemic in Germany, Spain, Italy, and China took 28, 29, 34, and 18 days, respectively, to reach the peak of daily infections, after their daily increase of up to 20 cases. During this time, countries in the African region and Southeast Asian region were at an early stage of infections, those in the Eastern Mediterranean region and region of the Americas were in a rapid growth phase. CONCLUSIONS: After the closure of the outbreak city, appropriate isolation and control measures in the next 8 weeks were key to control the outbreak, which reduced the peak value and length of the outbreak. Some countries with improved epidemic situations need to develop a continuous "local strategy at entry checkpoints" to to fend off imported COVID-19.


Asunto(s)
Betacoronavirus , Infecciones por Coronavirus/epidemiología , Salud Global , Neumonía Viral/epidemiología , China/epidemiología , Infecciones por Coronavirus/virología , Humanos , Incidencia , Pandemias , Neumonía Viral/virología , Prevalencia , Análisis Espacial , Factores de Tiempo
7.
Int J Mol Sci ; 21(21)2020 Nov 04.
Artículo en Inglés | MEDLINE | ID: mdl-33158276

RESUMEN

Binding to the host receptor is a critical initial step for the coronavirus SARS-CoV-2 spike protein to enter into target cells and trigger virus transmission. A detailed dynamic and energetic view of the binding mechanisms underlying virus entry is not fully understood and the consensus around the molecular origins behind binding preferences of SARS-CoV-2 for binding with the angiotensin-converting enzyme 2 (ACE2) host receptor is yet to be established. In this work, we performed a comprehensive computational investigation in which sequence analysis and modeling of coevolutionary networks are combined with atomistic molecular simulations and comparative binding free energy analysis of the SARS-CoV and SARS-CoV-2 spike protein receptor binding domains with the ACE2 host receptor. Different from other computational studies, we systematically examine the molecular and energetic determinants of the binding mechanisms between SARS-CoV-2 and ACE2 proteins through the lens of coevolution, conformational dynamics, and allosteric interactions that conspire to drive binding interactions and signal transmission. Conformational dynamics analysis revealed the important differences in mobility of the binding interfaces for the SARS-CoV-2 spike protein that are not confined to several binding hotspots, but instead are broadly distributed across many interface residues. Through coevolutionary network analysis and dynamics-based alanine scanning, we established linkages between the binding energy hotspots and potential regulators and carriers of signal communication in the virus-host receptor complexes. The results of this study detailed a binding mechanism in which the energetics of the SARS-CoV-2 association with ACE2 may be determined by cumulative changes of a number of residues distributed across the entire binding interface. The central findings of this study are consistent with structural and biochemical data and highlight drug discovery challenges of inhibiting large and adaptive protein-protein interfaces responsible for virus entry and infection transmission.


Asunto(s)
Betacoronavirus/metabolismo , Infecciones por Coronavirus/metabolismo , Peptidil-Dipeptidasa A/metabolismo , Neumonía Viral/metabolismo , Glicoproteína de la Espiga del Coronavirus/metabolismo , Secuencia de Aminoácidos , Sitios de Unión , Infecciones por Coronavirus/enzimología , Infecciones por Coronavirus/virología , Interacciones Microbiota-Huesped , Humanos , Pandemias , Neumonía Viral/enzimología , Neumonía Viral/virología , Unión Proteica , Dominios Proteicos , Receptores Virales/metabolismo , Transducción de Señal , Internalización del Virus
8.
BMC Infect Dis ; 20(1): 811, 2020 Nov 06.
Artículo en Inglés | MEDLINE | ID: mdl-33158425

RESUMEN

BACKGROUND: Covid-19 is causing a pandemic and forces physicians to restructure their work. We want to share our experience in the outpatient management of potentially-infected patients with special consideration of altered national test strategies during the crisis. METHODS: We analysed patients with respiratory symptoms reporting to our three rural general practitioner (GP) offices in North Rhine-Westphalia, Germany, from 27.01-20.04.2020 (n = 489 from a total of 6090 patients). A history of symptoms was taken at the doorstep following a specific questionnaire. Patients with respiratory symptoms were examined in a separated isolation area, while the others were allowed to enter the office. We applied the first recommended algorithm of the German Robert Koch Institute (RKI) to test suspected patients and compared our results with an adapted, more liberal version of the RKI, which is currently applied in Germany. RESULTS: Eighty patients (16.36%, mean age: 47.03 years+ - 18.08) were sent to a nasopharyngeal smear. Five patients (6.25%) proved to be positive, four of whom had established risk factors for COVID-19. Overall, the most common symptoms were cough (83.75%), sore throat (71.25%), as well as myalgia and fatigue (66.25%). The most common diagnoses were rhinopharyngitis (37.22%) and acute bronchitis (30.27%). A sore throat was more common in positively-tested patients (80% vs. 12%). Applying the first RKI test strategy yielded 6.25% of positive tests (n = 80), while the more liberal later RKI recommendation would have achieved 1.36% positive tests from 369 patients. No positive test was missed by applying the conservative strategy. None of our employees called in sick during this period, which emphasises the efficacy and safety of our screening methods. CONCLUSION: A clinical distinction between ordinary respiratory infections and COVID-19 is not possible in a low-prevalence population. Our model to prevent unprotected physical contact, screen patients in front of the office with protective equipment, and examine respiratory infections in separated areas works in the GP setting without overt health risks for employees. Thus, this approach should be used as a GP standard to uphold patient care without major health risks for the personnel. Large multi-centre studies are necessary to work out the most suitable test strategy.


Asunto(s)
Atención Ambulatoria/métodos , Betacoronavirus , Infecciones por Coronavirus/terapia , Médicos Generales , Neumonía Viral/terapia , Servicios de Salud Rural , Adulto , Anciano , Infecciones por Coronavirus/fisiopatología , Infecciones por Coronavirus/virología , Femenino , Alemania/epidemiología , Humanos , Masculino , Persona de Mediana Edad , Pandemias , Neumonía Viral/fisiopatología , Neumonía Viral/virología , Prevalencia , Factores de Riesgo , Encuestas y Cuestionarios
9.
PLoS One ; 15(11): e0240784, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-33166287

RESUMEN

Fatigue is a common symptom in those presenting with symptomatic COVID-19 infection. However, it is unknown if COVID-19 results in persistent fatigue in those recovered from acute infection. We examined the prevalence of fatigue in individuals recovered from the acute phase of COVID-19 illness using the Chalder Fatigue Score (CFQ-11). We further examined potential predictors of fatigue following COVID-19 infection, evaluating indicators of COVID-19 severity, markers of peripheral immune activation and circulating pro-inflammatory cytokines. Of 128 participants (49.5 ± 15 years; 54% female), more than half reported persistent fatigue (67/128; 52.3%) at median of 10 weeks after initial COVID-19 symptoms. There was no association between COVID-19 severity (need for inpatient admission, supplemental oxygen or critical care) and fatigue following COVID-19. Additionally, there was no association between routine laboratory markers of inflammation and cell turnover (leukocyte, neutrophil or lymphocyte counts, neutrophil-to-lymphocyte ratio, lactate dehydrogenase, C-reactive protein) or pro-inflammatory molecules (IL-6 or sCD25) and fatigue post COVID-19. Female gender and those with a pre-existing diagnosis of depression/anxiety were over-represented in those with fatigue. Our findings demonstrate a significant burden of post-viral fatigue in individuals with previous SARS-CoV-2 infection after the acute phase of COVID-19 illness. This study highlights the importance of assessing those recovering from COVID-19 for symptoms of severe fatigue, irrespective of severity of initial illness, and may identify a group worthy of further study and early intervention.


Asunto(s)
Infecciones por Coronavirus/patología , Fatiga/etiología , Neumonía Viral/patología , Adulto , Anciano , Betacoronavirus/aislamiento & purificación , Infecciones por Coronavirus/complicaciones , Infecciones por Coronavirus/virología , Fatiga/epidemiología , Femenino , Humanos , Subunidad alfa del Receptor de Interleucina-2/sangre , Interleucina-6/sangre , Masculino , Persona de Mediana Edad , Pandemias , Neumonía Viral/complicaciones , Neumonía Viral/virología , Prevalencia , Índice de Severidad de la Enfermedad
10.
PLoS One ; 15(11): e0241468, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-33166301

RESUMEN

In March of this year, COVID-19 was declared a pandemic, and it continues to threaten public health. This global health crisis imposes limitations on daily movements, which have deteriorated every sector in our society. Understanding public reactions to the virus and the non-pharmaceutical interventions should be of great help to fight COVID-19 in a strategic way. We aim to provide tangible evidence of the human mobility trends by comparing the day-by-day variations across the U.S. from January 2020 to early April 2020. Large-scale public mobility at an aggregated level is observed by leveraging mobile device location data and the measures related to social distancing. Our study captures spatial and temporal heterogeneity as well as the sociodemographic variations and teleworking trends regarding the pandemic propagation and the non-pharmaceutical mobility interventions. All metrics adapted capture decreased public movements after the national emergency declaration. The population staying home has increased in all states before the stay-at-home mandates implemented and becomes more stable after the order with a smaller range of fluctuation. The public had been taking active responses, voluntarily staying home more, to the in-state confirmed cases while the stay-at-home orders stabilize the variations. As the estimated teleworking rates also continue to incline throughout the study period, the teleworking trend can be another driving factor for the growing stay-at-home population. We confirm that there exists overall mobility heterogeneity between the income or population density groups. The study suggests that public mobility trends are in line with the government message urging to stay home. We anticipate our data-driven analysis offers integrated perspectives and serves as evidence to raise public awareness and, consequently, reinforce the importance of social distancing while assisting policymakers.


Asunto(s)
Infecciones por Coronavirus/patología , Movimiento , Neumonía Viral/patología , Betacoronavirus/aislamiento & purificación , Uso del Teléfono Celular/estadística & datos numéricos , Infecciones por Coronavirus/epidemiología , Infecciones por Coronavirus/virología , Procesamiento Automatizado de Datos , Humanos , Pandemias , Neumonía Viral/epidemiología , Neumonía Viral/virología , Análisis Espacio-Temporal , Estados Unidos/epidemiología
11.
PLoS One ; 15(11): e0241954, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-33166336

RESUMEN

Evidence-based models may assist Mexican government officials and health authorities in determining the safest plans to respond to the coronavirus disease 2019 (COVID-19) pandemic in the most-affected region of the country, the Mexico City Metropolitan Area. This study aims to present the potential impacts of COVID-19 in this region and to model possible benefits of mitigation efforts. The COVID-19 Hospital Impact Model for Epidemics was used to estimate the probable evolution of COVID-19 in three scenarios: (i) no social distancing, (ii) social distancing in place at 50% effectiveness, and (iii) social distancing in place at 60% effectiveness. Projections of the number of inpatient hospitalizations, intensive care unit admissions, and patients requiring ventilators were made for each scenario. Using the model described, it was predicted that peak case volume at 0% mitigation was to occur on April 30, 2020 at 11,553,566 infected individuals. Peak case volume at 50% mitigation was predicted to occur on June 1, 2020 with 5,970,093 infected individuals and on June 21, 2020 for 60% mitigation with 4,128,574 infected individuals. Occupancy rates in hospitals during peak periods at 0%, 50%, and 60% mitigation would be 875.9%, 322.8%, and 203.5%, respectively, when all inpatient beds are included. Under these scenarios, peak daily hospital admissions would be 40,438, 13,820, and 8,650. Additionally, 60% mitigation would result in a decrease in peak intensive care beds from 94,706 to 23,116 beds and a decrease in peak ventilator need from 67,889 to 17,087 units. Mitigating the spread of COVID-19 through social distancing could have a dramatic impact on reducing the number of infected people and minimize hospital overcrowding. These evidence-based models may enable careful resource utilization and encourage targeted public health responses.


Asunto(s)
Infecciones por Coronavirus/prevención & control , Prestación de Atención de Salud , Política de Salud , Pandemias/prevención & control , Neumonía Viral/prevención & control , Betacoronavirus/aislamiento & purificación , Infecciones por Coronavirus/patología , Infecciones por Coronavirus/virología , Hospitalización , Humanos , México , Modelos Teóricos , Neumonía Viral/patología , Neumonía Viral/virología
12.
PLoS One ; 15(11): e0241743, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-33166344

RESUMEN

The Coronavirus Disease 2019 (COVID-19) has fast spread to over 200 countries and regions worldwide since its outbreak, while in March, Europe became the emerging epicentre. In this study, we aimed to model the epidemic trends and estimate the essential epidemic features of COVID-19 in Italy, Spain, Germany, and France at the initial stage. The numbers of daily confirmed cases and total confirmed cases were extracted from the Coronavirus disease (COVID-19) situation reports of WHO. We applied an extended Susceptible-Exposed-Infectious-Removed (SEIR) model to fit the epidemic trend and estimated corresponding epidemic features. The transmission rate estimates were 1.67 (95% credible interval (CrI), 1.64-1.71), 2.83 (2.72-2.85), 1.91 (1.84-1.98), and 1.89 (1.82-1.96) for Italy, Spain, Germany, and France, corresponding to the basic reproduction numbers (R0) 3.44 (3.35-3.54), 6.25 (5.97-6.55), 4.03 (3.84-4.23), and 4.00 (3.82-4.19), respectively. We found Spain had the lowest ascertainment rate of 0.22 (0.19-0.25), followed by France, Germany, and Italy of 0.45 (0.40-0.50), 0.46 (0.40-0.52), and 0.59 (0.55-0.64). The peaks of daily new confirmed cases would reach on April 16, April 5, April 21, and April 19 for Italy, Spain, Germany, and France if no action was taken by the authorities. Given the high transmissibility and high covertness of COVID-19, strict countermeasures, such as national lockdown and social distancing, were essential to be implemented to reduce the spread of the disease.


Asunto(s)
Infecciones por Coronavirus/diagnóstico , Modelos Teóricos , Neumonía Viral/diagnóstico , Betacoronavirus/aislamiento & purificación , Infecciones por Coronavirus/epidemiología , Infecciones por Coronavirus/virología , Brotes de Enfermedades , Francia/epidemiología , Alemania/epidemiología , Humanos , Italia/epidemiología , Pandemias , Neumonía Viral/epidemiología , Neumonía Viral/virología , España/epidemiología
13.
PLoS One ; 15(11): e0241947, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-33166346

RESUMEN

BACKGROUND: A recent cluster of pneumonia cases in Wuhan, China, has been caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). We propose the protocol described below to perform an individual-patient data (IPD) network meta-analysis (NMA) in order to evaluate the efficacies of different antiviral drugs to treat patients with coronavirus disease 2019 (COVID-19). MATERIALS AND METHODS: We will search the Medline, EMBASE, Cochrane Library, SinoMed, CNKI and VIP databases from their inceptions through July 2020. There will be no restrictions on language, publication year, or publication type. Randomized clinical trials (RCTs) and prospective cohort studies with antiviral treatments for COVID-19 will be considered. Two reviewers will independently select studies and collect data. Risk-of-bias assessments will be completed using the Cochrane risk-of-bias scale. Primary outcome will be the COVID-19 recovery rate. We will combine aggregated data from IPD with the NMA in a single model, compare the effects of different antiviral drugs on patient-relevant efficacy, and rank the results to decide which is the most effective. TRIAL REGISTRATION: PROSPERO registration number: CRD42020167038.


Asunto(s)
Antivirales/uso terapéutico , Infecciones por Coronavirus/tratamiento farmacológico , Neumonía Viral/tratamiento farmacológico , Betacoronavirus/aislamiento & purificación , Infecciones por Coronavirus/mortalidad , Infecciones por Coronavirus/patología , Infecciones por Coronavirus/virología , Bases de Datos Factuales , Humanos , Metaanálisis en Red , Pandemias , Neumonía Viral/mortalidad , Neumonía Viral/patología , Neumonía Viral/virología , Ensayos Clínicos Controlados Aleatorios como Asunto , Riesgo , Resultado del Tratamiento
14.
PLoS One ; 15(11): e0242124, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-33166369

RESUMEN

BACKGROUND: In December 2019, the COVID-19 outbreak began in China and quickly spread throughout the world and was reclassified as a pandemic in March 2020. The first case of COVID-19 was declared in Togo on March 5. Two months later, few data were available to describe the circulation of the new coronavirus in the country. OBJECTIVE: This survey aimed to estimate the prevalence of SARS-CoV-2 in high-risk populations in Lomé. MATERIALS AND METHODS: From April 23, 2020, to May 8, 2020, we recruited a sample of participants from five sectors: health care, air transport, police, road transport and informal. We collected oropharyngeal swabs for direct detection through real-time reverse transcription polymerase chain reaction (rRT-PCR) and blood for antibody detection by serological tests. The overall prevalence (current and past) of infection was defined by positivity for both tests. RESULTS: A total of 955 participants with a median age of 36 (IQR 32-43) were included, and 71.6% (n = 684) were men. Approximately 22.1% (n = 212) were from the air transport sector, 20.5% (n = 196) were from the police sector, and 38.7% (n = 370) were from the health sector. Seven participants (0.7%, 95% CI: 0.3-1.6%) had a positive rRT-PCR test result at the time of recruitment, and nine (0.9%, 95% CI: 0.4-1.8%) were seropositive for IgM or IgG against SARS-CoV-2. We found an overall prevalence of 1.6% (n = 15), 95% CI: 0.9-2.6%. CONCLUSION: The prevalence of SARS-CoV-2 infection among high-risk populations in Lomé was relatively low and could be explained by the various measures taken by the Togolese government. Therefore, we recommend targeted screening.


Asunto(s)
Infecciones por Coronavirus/patología , Neumonía Viral/patología , Adulto , Anticuerpos Antivirales/sangre , Betacoronavirus/genética , Betacoronavirus/aislamiento & purificación , Infecciones por Coronavirus/epidemiología , Infecciones por Coronavirus/virología , Estudios Transversales , Femenino , Humanos , Inmunoensayo , Masculino , Persona de Mediana Edad , Pandemias , Neumonía Viral/epidemiología , Neumonía Viral/virología , Prevalencia , ARN Viral/genética , ARN Viral/metabolismo , Reacción en Cadena en Tiempo Real de la Polimerasa , Factores de Riesgo , Togo/epidemiología
15.
PLoS One ; 15(11): e0241959, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-33166373

RESUMEN

The coronavirus disease 2019 (Covid-19) pandemic, caused by SARS-CoV-2, has resulted in a global testing supply shortage. In response, pooled testing has emerged as a promising strategy that can immediately increase testing capacity. In pooled sample testing, multiple samples are combined (or pooled) together and tested as a single unit. If the pool is positive, the individual samples can then be individually tested to identify the positive case(s). Here, we provide support for the adoption of sample pooling with the point-of-care Cepheid Xpert® Xpress SARS-CoV-2 molecular assay. Corroborating previous findings, the limit of detection of this assay was comparable to laboratory-developed reverse-transcription quantitative PCR SARS-CoV-2 tests, with observed detection below 100 copies/mL. The Xpert® Xpress assay detected SARS-CoV-2 after samples with minimum viral loads of 461 copies/mL were pooled in groups of six. Based on these data, we recommend the adoption of pooled testing with the Xpert® Xpress SARS-CoV-2 assay where warranted based on public health needs. The suggested number of samples per pool, or the pooling depth, is unique for each point-of-care testing site and can be determined by the positive test rates. To statistically determine appropriate pooling depth, we have calculated the pooling efficiency for numerous combinations of pool sizes and test rates. This information is included as a supplemental dataset that we encourage public health authorities to use as a guide to make recommendations that will maximize testing capacity and resource conservation.


Asunto(s)
Betacoronavirus/genética , Infecciones por Coronavirus/diagnóstico , Neumonía Viral/diagnóstico , ARN Viral/metabolismo , Reacción en Cadena de la Polimerasa de Transcriptasa Inversa/métodos , Betacoronavirus/aislamiento & purificación , Infecciones por Coronavirus/virología , Humanos , Pandemias , Neumonía Viral/virología , Pruebas en el Punto de Atención , ARN Viral/genética , Juego de Reactivos para Diagnóstico , Manejo de Especímenes , Carga Viral
16.
PLoS One ; 15(11): e0242045, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-33166991

RESUMEN

Coronavirus Disease 2019 (COVID-19) has recently become a public emergency and a worldwide pandemic. However, the information on the risk factors associated with the mortality of COVID-19 and of their prognostic potential is limited. In this retrospective study, the clinical characteristics, treatment and outcome data were collected and analyzed from 676 COVID-19 patients stratified into 140 non-survivors and 536 survivors. We found that the levels of Dimerized plasmin fragment D (D-dimer), C-reactive protein (CRP), lactate dehydrogenase (LDH), procalcitonin (PCT) were significantly higher in non-survivals on admission (non-survivors vs. survivors: D-Dimer ≥ 0.5 mg/L, 83.2% vs. 44.9%, P<0.01; CRP ≥10 mg/L, 50.4% vs. 6.0%, P<0.01; LDH ≥ 250 U/L, 73.8% vs. 20.1%, P<0.01; PCT ≥ 0.5 ng/ml, 27.7% vs. 1.8%, P<0.01). Moreover, dynamic tracking showed D-dimer kept increasing in non-survivors, while CRP, LDH and PCT remained relatively stable after admission. D-dimer has the highest C-index to predict in-hospital mortality, and patients with D-dimer levels ≥0.5 mg/L had a higher incidence of mortality (Hazard Ratio: 4.39, P<0.01). Our study suggested D-dimer could be a potent marker to predict the mortality of COVID-19, which may be helpful for the management of patients.


Asunto(s)
Infecciones por Coronavirus/mortalidad , Productos de Degradación de Fibrina-Fibrinógeno/análisis , Neumonía Viral/mortalidad , Adulto , Anciano , Betacoronavirus/aislamiento & purificación , Proteína C-Reactiva/análisis , Infecciones por Coronavirus/patología , Infecciones por Coronavirus/virología , Femenino , Humanos , Estimación de Kaplan-Meier , L-Lactato Deshidrogenasa/análisis , Masculino , Persona de Mediana Edad , Pandemias , Neumonía Viral/patología , Neumonía Viral/virología , Polipéptido alfa Relacionado con Calcitonina/análisis , Modelos de Riesgos Proporcionales , Estudios Retrospectivos , Factores de Riesgo
17.
BMC Infect Dis ; 20(1): 818, 2020 Nov 10.
Artículo en Inglés | MEDLINE | ID: mdl-33167900

RESUMEN

BACKGROUND: To explore the kinetic changes in virology, specific antibody response and imaging during the clinical course of COVID-19. METHODS: This observational study enrolled 20 patients with COVID-19, who were hospitalized between January 20-April 6, 2020, in the two COVID-19 designated hospitals of Zhoushan, Zhejiang and Rushan, Shandong, China, The laboratory findings, imaging, serum response to viral infection, and viral RNA level in the throat and stool samples were assessed from onset to recovery phase in patients with COVID-19. RESULTS: SARS-COV-2 RNA was positive as early as day four. It remained positive until day 55 post-onset in the sputum-throat swabs and became negative in most cases (55%) within 14 days after onset. Lymphocytopenia occurred in 40% (8/20) of patients during the peak infection period and returned to normal at week five. The most severe inflammation in the lungs appeared in week 2 or 3 after onset, and this was completely absorbed between week 6 and 8 in 85.7% of patients. All patients had detectable antibodies to the receptor binding domain (RBD), and 95% of these patients had IgG to viral N proteins. The antibody titer peaked at week four. Anti-S IgM was positive in 7 of 20 patients after week three. CONCLUSIONS: All COVID-19 patients in this study were self-limiting and recovered well though it may take as long as 6-8 weeks. Our findings on the kinetic changes in imaging, serum response to viral infection and viral RNA level may help understand pathogenesis and define clinical course of COVID-19.


Asunto(s)
Anticuerpos Antivirales/sangre , Betacoronavirus/inmunología , Técnicas de Laboratorio Clínico , Infecciones por Coronavirus/diagnóstico por imagen , Infecciones por Coronavirus/inmunología , Pulmón/diagnóstico por imagen , Neumonía Viral/diagnóstico por imagen , Neumonía Viral/inmunología , Adolescente , Adulto , Anciano , Betacoronavirus/genética , Niño , China/epidemiología , Infecciones por Coronavirus/diagnóstico , Infecciones por Coronavirus/epidemiología , Infecciones por Coronavirus/virología , Femenino , Humanos , Inmunoglobulina G/sangre , Inmunoglobulina M/sangre , Masculino , Persona de Mediana Edad , Proteínas de la Nucleocápside/inmunología , Pandemias , Neumonía Viral/epidemiología , Neumonía Viral/virología , ARN Viral/genética , Reacción en Cadena en Tiempo Real de la Polimerasa , Reacción en Cadena de la Polimerasa de Transcriptasa Inversa , Esputo/virología , Tomografía Computarizada por Rayos X , Adulto Joven
18.
Antimicrob Resist Infect Control ; 9(1): 185, 2020 11 10.
Artículo en Inglés | MEDLINE | ID: mdl-33168097

RESUMEN

BACKGROUND: Prehospital professionals such as emergency physicians or paramedics must be able to choose and adequately don and doff personal protective equipment (PPE) in order to avoid COVID-19 infection. Our aim was to evaluate the impact of a gamified e-learning module on adequacy of PPE in student paramedics. METHODS: This was a web-based, randomized 1:1, parallel-group, triple-blind controlled trial. Student paramedics from three Swiss schools were invited to participate. They were informed they would be presented with both an e-learning module and an abridged version of the current regional prehospital COVID-19 guidelines, albeit not in which order. After a set of 22 questions designed to assess baseline knowledge, the control group was shown the guidelines before answering a set of 14 post-intervention questions. The e-learning group was shown the gamified e-learning module right after the guidelines, and before answering post-intervention questions. The primary outcome was the difference in the percentage of adequate choices of PPE before and after the intervention. RESULTS: The participation rate was of 71% (98/138). A total of 90 answer sets was analyzed. Adequate choice of PPE increased significantly both in the control (50% [33;83] vs 25% [25;50], P = .013) and in the e-learning group (67% [50;83] vs 25% [25;50], P = .001) following the intervention. Though the median of the difference was higher in the e-learning group, there was no statistically significant superiority over the control (33% [0;58] vs 17% [- 17;42], P = .087). The e-learning module was of greatest benefit in the subgroup of student paramedics who were actively working in an ambulance company (42% [8;58] vs 25% [- 17;42], P = 0.021). There was no significant effect in student paramedics who were not actively working in an ambulance service (0% [- 25;33] vs 17% [- 8;50], P = .584). CONCLUSIONS: The use of a gamified e-learning module increases the rate of adequate choice of PPE only among student paramedics actively working in an ambulance service. In this subgroup, combining this teaching modality with other interventions might help spare PPE and efficiently protect against COVID-19 infection.


Asunto(s)
Betacoronavirus/fisiología , Infecciones por Coronavirus/prevención & control , Personal de Salud/educación , Pandemias/prevención & control , Equipo de Protección Personal , Neumonía Viral/prevención & control , Adulto , Técnicos Medios en Salud/educación , Técnicos Medios en Salud/normas , Betacoronavirus/genética , Infecciones por Coronavirus/epidemiología , Infecciones por Coronavirus/transmisión , Infecciones por Coronavirus/virología , Educación a Distancia/estadística & datos numéricos , Europa (Continente) , Femenino , Personal de Salud/normas , Humanos , Transmisión de Enfermedad Infecciosa de Paciente a Profesional , Internet , Conocimiento , Aprendizaje , Masculino , Equipo de Protección Personal/normas , Neumonía Viral/epidemiología , Neumonía Viral/transmisión , Neumonía Viral/virología , Estudiantes/psicología , Adulto Joven
19.
J Korean Med Sci ; 35(43): e391, 2020 Nov 09.
Artículo en Inglés | MEDLINE | ID: mdl-33169560

RESUMEN

Since mid-April 2020, cases of multisystem inflammatory syndrome in children (MIS-C) associated with coronavirus disease 2019 that mimics Kawasaki disease (KD) have been reported in Europe and North America. However, no cases have been reported in Korea. We describe an 11-year old boy with fever, abdominal pain, and diarrhea who developed hypotension requiring inotropes in intensive care unit. His blood test revealed elevated inflammatory markers, thrombocytopenia, hypoalbuminemia, and coagulopathy. Afterward, he developed signs of KD such as conjunctival injection, strawberry tongue, cracked lip, and coronary artery dilatation, and parenchymal consolidation without respiratory symptoms. Microbiological tests were all negative including severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) reverse transcription polymerase chain reaction. However, serum immunoglobulin G against SARS-CoV-2 was positive in repeated tests using enzyme-linked immunosorbent assay and fluorescent immunoassay. He was recovered well after intravenous immunoglobulin administration and discharged without complication on hospital day 13. We report the first Korean child who met all the criteria of MIS-C with features of incomplete KD or KD shock syndrome.


Asunto(s)
Infecciones por Coronavirus/patología , Neumonía Viral/patología , Síndrome de Respuesta Inflamatoria Sistémica/diagnóstico , Abdomen/diagnóstico por imagen , Anticuerpos Antivirales/sangre , Betacoronavirus/genética , Betacoronavirus/inmunología , Niño , Infecciones por Coronavirus/complicaciones , Infecciones por Coronavirus/virología , Humanos , Inmunoglobulinas Intravenosas/administración & dosificación , Masculino , Síndrome Mucocutáneo Linfonodular/patología , Pandemias , Neumonía Viral/complicaciones , Neumonía Viral/virología , Síndrome de Respuesta Inflamatoria Sistémica/complicaciones , Tórax/diagnóstico por imagen , Tomografía Computarizada por Rayos X , Ultrasonografía
20.
PLoS One ; 15(11): e0241949, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-33170871

RESUMEN

The ongoing COVID-19 pandemic has overwhelmingly demonstrated the need to accurately evaluate the effects of implementing new or altering existing nonpharmaceutical interventions. Since these interventions applied at the societal level cannot be evaluated through traditional experimental means, public health officials and other decision makers must rely on statistical and mathematical epidemiological models. Nonpharmaceutical interventions are typically focused on contacts between members of a population, and yet most epidemiological models rely on homogeneous mixing which has repeatedly been shown to be an unrealistic representation of contact patterns. An alternative approach is individual based models (IBMs), but these are often time intensive and computationally expensive to implement, requiring a high degree of expertise and computational resources. More often, decision makers need to know the effects of potential public policy decisions in a very short time window using limited resources. This paper presents a computation algorithm for an IBM designed to evaluate nonpharmaceutical interventions. By utilizing recursive relationships, our method can quickly compute the expected epidemiological outcomes even for large populations based on any arbitrary contact network. We utilize our methods to evaluate the effects of various mitigation measures in the District of Columbia, USA, at various times and to various degrees. Rcode for our method is provided in the supplementry material, thereby allowing others to utilize our approach for other regions.


Asunto(s)
Infecciones por Coronavirus/diagnóstico , Modelos Teóricos , Neumonía Viral/diagnóstico , Algoritmos , Betacoronavirus/aislamiento & purificación , Infecciones por Coronavirus/epidemiología , Infecciones por Coronavirus/prevención & control , Infecciones por Coronavirus/virología , Brotes de Enfermedades , District of Columbia/epidemiología , Humanos , Máscaras , Pandemias/prevención & control , Neumonía Viral/epidemiología , Neumonía Viral/prevención & control , Neumonía Viral/virología , Cuarentena
SELECCIÓN DE REFERENCIAS
DETALLE DE LA BÚSQUEDA