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1.
Ann Intern Med ; 174(11): JC122, 2021 11.
Artigo em Inglês | MEDLINE | ID: mdl-34724408

RESUMO

SOURCE CITATION: Greenhawt M, Abrams EM, Shaker M, et al. The risk of allergic reaction to SARS-CoV-2 vaccines and recommended evaluation and management: a systematic review, meta-analysis, GRADE assessment, and international consensus approach. J Allergy Clin Immunol Pract. 2021;9:3546-67. 34153517.


Assuntos
COVID-19 , Hipersensibilidade , Vacinas contra COVID-19 , Consenso , Humanos , Hipersensibilidade/diagnóstico , Hipersensibilidade/prevenção & controle , SARS-CoV-2
2.
Ann Intern Med ; 174(9): JC107, 2021 09.
Artigo em Inglês | MEDLINE | ID: mdl-34487439

RESUMO

SOURCE CITATION: Tsang NN, So HC, Ng KY, et al. Diagnostic performance of different sampling approaches for SARS-CoV-2 RT-PCR testing: a systematic review and meta-analysis. Lancet Infect Dis. 2021. [Epub ahead of print.] 33857405.


Assuntos
COVID-19 , Faringe , Humanos , Nasofaringe , Reação em Cadeia da Polimerase Via Transcriptase Reversa , SARS-CoV-2
3.
Lancet Microbe ; 2(9): e481-e484, 2021 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-34337584

RESUMO

Although the development and increasingly widespread availability of effective and safe vaccines provides the greatest hope for the future recovery from the increasingly devastating COVID-19 pandemic, there are other preventive efforts that offer an immediate route to decreasing morbidity and mortality. Genomic surveillance is emerging as a vital necessity to achieve effective mitigation and containment. Since SARS-CoV-2 variants have already been detected, it is crucial to obtain reliable evidence about whether they are more contagious, virulent, or more resistant to the available COVID-19 vaccines well before they spread throughout the world. Genomic surveillance leverages applications of next-generation sequencing, creates the availability of whole genome data, and advances phylogenetic methods. These methods offer novel means to detect variants that are phenotypically or antigenically different. Genomic surveillance will facilitate greater early anticipation as well as initiation of effective strategies to mitigate and contain outbreaks of SARS-CoV-2 variants and other novel viruses.

5.
Am J Manag Care ; 27(7): e218-e220, 2021 07 01.
Artigo em Inglês | MEDLINE | ID: mdl-34314121

RESUMO

As of May 2021, the United States remains the world leader with 33 million of 165 million cases worldwide (20%) and 590,000 of 3.4 million deaths worldwide (17%) from COVID-19. Achieving herd immunity by disease spread and vaccination may result in 2 million to 4 million total US deaths. The future perfect of the vaccine should not be the enemy of the present good, which is masking. Masking, especially when combined with social distancing, crowd avoidance, frequent hand and face washing, increased testing capabilities, and contact tracing, is likely to prevent at least as many premature deaths as the widespread utilization of an effective and safe vaccine. Worldwide, masking is the oldest and simplest engineered control to prevent transmission of respiratory pathogens. Masking has been a cornerstone of infection control in hospitals, operating rooms, and clinics for more than a century. Unfortunately, since the epidemic began in the United States, masking has become politicized. All countries, but especially the United States, must adopt masking as an urgent necessity and a component of coordinated public health strategies to combat the COVID-19 pandemic. Any economic advantages of pandemic politics are short-lived and shortsighted in comparison with public health strategies of proven benefit that can prevent needless and mostly avoidable premature deaths from COVID-19. During the worst epidemic in more than 100 years, most Americans (75%) trust their health care providers. As competent and compassionate health care professionals, we recommend that effective strategies, especially masking, and not pandemic politics, should inform all rational clinical and public health decision-making.


Assuntos
COVID-19/prevenção & controle , Controle de Infecções/estatística & dados numéricos , Máscaras/estatística & dados numéricos , Distanciamento Físico , COVID-19/epidemiologia , Busca de Comunicante/estatística & dados numéricos , Humanos , Estados Unidos
7.
Contemp Clin Trials Commun ; 20: 100663, 2020 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-33043163

RESUMO

From December 2019 to May 22, 2020 the emerging and ever-increasing pandemic of coronavirus 19 (COVID-19) had no effective and safe treatment. Not surprisingly, remdesivir attracted worldwide attention. In a trial published online ahead of print, of 1063 patients, 541 were assigned at random to remdesivir and 522 to placebo. The primary prespecified endpoint was mean recovery time and patients assigned to remdesivir had a mean recovery time of 11 days versus 15 days for those assigned a random to placebo. (p < 0.001). With respect to mortality, the prespecfied secondary endpoint, 34/538 patients in remdesivir and 54/521 in placebo died after 28 days, yielding a possible 31% reduction that approached but did not achieve statistical significance (p = 0.059). The only other published trial of remdesivir randomized 237 patients in China. In that trial, 178 patients were assigned at random to remdesivir compared to 79 assigned to placebo. Those assigned at random to remdesivir experienced a possible but nonsignificant 23% faster time to clinical improvement of 21 days compared with 23 for those assigned to placebo [hazard ratio 1.23 [95% CI, 0·87-1.75)]. With respect to mortality there was no suggestion of any benefit. In fact, the mortality rate in those receiving remdesivir was 15% (22/150) compared with 13% (10/77) for those assigned to placebo. Ongoing randomized trials should be designed, conducted and analyzed to provide the necessary reliable data on mortality to resolve the remaining clinical uncertainties.

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