The incidence of the novel coronavirus SARS-CoV-2 among asymptomatic patients: A systematic review

Abstract Background The novel Coronavirus SARS CoV-2 (COVID-19) outbreak was complicated by the lack of diagnostic testing kits. In early March 2020, leadership at Beaumont Hospital, Royal Oak Michigan (Beaumont) identified the need to develop high capacity testing modalities with appropriate sensitivity and specificity and rapid turnaround time. We describe the molecular diagnostic testing experience since initial rollout on March 16, 2020 at Beaumont, and results of repeat testing during the peak of the COVID-19 pandemic in MI. Methods Beaumont is an 1100 bed hospital in Southeast MI. In March, testing was initially performed with the EUA Luminex NxTAG CoV Extended Panel until March 28, 2020 when testing was converted to the EUA Cepheid Xpert Xpress SARS-CoV-2 for quicker turnaround times. Each assay was validated with a combination of patient samples and contrived specimens. Results During the initial week of testing there was > 20 % specimen positivity. As the prevalence grew the positivity rate reached 68% by the end of March (Figure 1). Many state and hospital initiatives were implemented during the outbreak, including social distancing and screening of asymptomatic patients to increase case-finding and prevent transmission. We also adopted a process for clinical review of symptomatic patients who initially tested negative for SARS-CoV-2 by a group of infectious disease physicians (Figure 2). This process was expanded to include other trained clinicians who were redeployed from other departments in the hospital. Repeat testing was performed to allow consideration of discontinuation of isolation precautions. During the surge of community cases from March 16 to April 30, 2020, we identified patients with negative PCR tests who subsequently had repeat testing based on clinical evaluation, with 7.1% (39/551) returning positive for SARS- CoV2. Of the patients who expired due to COVID-19 during this period, 4.3% (9/206) initially tested negative before ultimately testing positive. Figure 1 BH RO testing Epicurve Figure 2: Screening tool for repeat COVID19 testing and precautions Conclusion Many state and hospital initiatives helped us flatten the curve for COVID-19. Our hospital testing experience indicate that repeat testing may be warranted for those patients with clinical features suggestive of COVID-19. We will further analyze these cases and clinical features that prompted repeat testing. Disclosures All Authors: No reported disclosures

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Contact Tracing Applications Against COVID-19: A Systematic Review (Preprint)

10.2196/preprints.30262 ◽

2021 ◽

Author(s):

Ahmad Nabeel ◽

Salman AlSabah ◽

Eliana Al Haddad ◽

Hutan Ashrafian

Keyword(s):

Systematic Review ◽

Critical Mass ◽

Population Level ◽

Ease Of Use ◽

Contact Tracing ◽

The Novel ◽

Scientific Databases ◽

Manual Methods ◽

Novel Coronavirus ◽

Transmission Of Disease

BACKGROUND The novel coronavirus 2019 (COVID-19) pandemic has triggered public anxiety around the world. So far, the evidence suggests that prevention on a public scale is the most effective health measure for thwarting the progress of COVID-19. Another critical aspect of preventing COVID-19 is contact tracing. OBJECTIVE We aimed to investigate the effectiveness of contact tracing applications currently available in the context of the COVID-19 pandemic. METHODS We undertook a systematic review and narrative synthesis of all literature relating to contact tracing applications in the context of COVID-19. We searched 3 major scientific databases. Only articles that were published in English and were available as full-text articles were selected for review. Data were extracted and narrative syntheses conducted. RESULTS Five studies relating to COVID-19 were included in the review. Our results suggest that digitalized contact tracing methods can be beneficial for impeding the progress of COVID-19. Three key themes were generated from this systematic review. First, the critical mass of application adoption must be attained at the population level before the sensitivity and positive predictive value of the solution can be increased. Second, usability factors such as access, ease of use and the elimination of barriers are essential in driving this uptake. Third, privacy must be ensured where possible as it is the single most significant barrier against achieving critical mass. CONCLUSIONS The COVID-19 pandemic has claimed more than 2 million lives globally, with over 100 million confirmed cases. Contact tracing can rapidly identify potentially infected individuals before the emergence of severe or critical symptoms, and it can also prevent the subsequent transmission of disease from secondary cases when implemented efficiently. Contact tracing methods have proved to be beneficial for impeding the progress of COVID-19 as compared to older, more labor intensive manual methods.

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COVID-19, MERS and SARS with Concomitant Liver Injury—Systematic Review of the Existing Literature

Journal of Clinical Medicine ◽

10.3390/jcm9051420 ◽

2020 ◽

Vol 9 (5) ◽

pp. 1420 ◽

Cited By ~ 14

Author(s):

Michał Kukla ◽

Karolina Skonieczna-Żydecka ◽

Katarzyna Kotfis ◽

Dominika Maciejewska ◽

Igor Łoniewski ◽

...

Keyword(s):

Systematic Review ◽

Liver Injury ◽

Clinical Course ◽

Meta Analysis ◽

Gastrointestinal Symptoms ◽

Intensive Care Treatment ◽

The Novel ◽

Massive Necrosis ◽

Novel Coronavirus ◽

Elevated Transaminases

The novel coronavirus SARS-CoV-2 (severe acute respiratory syndrome coronavirus 2) infection has been predominantly linked to respiratory distress syndrome, but gastrointestinal symptoms and hepatic injury have also been reported. The mechanism of liver injury is poorly understood and may result as a consequence of viral hepatitis, systemic inflammatory response, gut barrier and microbiome alterations, intensive care treatment or drug toxicity. The incidence of hepatopathy among patients with coronavirus disease 2019 (COVID-19) is unclear, but studies have reported liver injury in patients with SARS and Middle East respiratory syndrome (MERS). We aimed to systematically review data on the prevalence of hepatic impairments and their clinical course in SARS and MERS Coronaviridae infections. A systematic literature search (PubMed/Embase/Cinahl/Web of Science) according to preferred reporting items for systematic review and meta-analysis protocols (PRISMA) was conducted from database inception until 17/03/2020 for studies that evaluated the incidence of hepatic abnormalities in SARS CoV-1, SARS CoV-2 and MERS infected patients with reported liver-related parameters. A total of forty-three studies were included. Liver anomalies were predominantly mild to moderately elevated transaminases, hypoalbuminemia and prolongation of prothrombin time. Histopathology varied between non-specific inflammation, mild steatosis, congestion and massive necrosis. More studies to elucidate the mechanism and importance of liver injury on the clinical course and prognosis in patients with novel SARS-CoV-2 infection are warranted.

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Impact of COVID-19 on community health: A systematic review of a population of 82 million

Journal of Advances in Internal Medicine ◽

10.3126/jaim.v9i1.29159 ◽

2020 ◽

Vol 9 (1) ◽

pp. 4-11

Author(s):

Brijesh Sathian ◽

Mohammad Asim ◽

Ahammed Mekkodathil ◽

Edwin R. Van Teijlingen ◽

Supram Hosuru Subramanya ◽

...

Keyword(s):

Public Health ◽

Systematic Review ◽

Community Health ◽

South Asian ◽

Personal Hygiene ◽

The Novel ◽

Asian Countries ◽

Current Systematic Review ◽

Novel Coronavirus ◽

The Impact

The novel coronavirus disease 2019 (COVID-19) outbreak, caused by the pathogenic severe acute respiratory syndrome-2 (SARS-CoV-2) virus, is exponentially spreading across the globe. As there is paucity of published literature, the influence of COVID-19 on community health remains unclear. Therefore, we aimed to conduct a systematic review of the literature on the impact of COVID-19 on community health. The current systematic review was performed utilizing electronic databases, i.e., PubMed, MEDLINE, and EMBASE. We searched for the keywords "COVID-19" AND "community health" between January 1, 2020, until May 10, 2020. Although, limited evidence is available regarding quarantine to prevent COVID‐19, most studies considered quarantine as an essential public health measure to minimize rate of infection and mortality. Under these circumstances, people should focus on maintaining personal hygiene, proper nutrition, and extreme social distancing to reduce the risk of COVID-19. Besides, that there is a need to provide professional psychological support to reduce mental ill-health. We have highlighted two different public health approaches in South Asian countries, namely Nepal and India.

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Hypogeusia as the initial presenting symptom of COVID-19

BMJ Case Reports ◽

10.1136/bcr-2020-236080 ◽

2020 ◽

Vol 13 (5) ◽

pp. e236080 ◽

Cited By ~ 8

Author(s):

Lauren E Melley ◽

Eli Bress ◽

Erik Polan

Keyword(s):

Cardiopulmonary Arrest ◽

General Medicine ◽

Initial Symptom ◽

The Novel ◽

Severe Respiratory Distress ◽

Upper Respiratory Infection ◽

Respiratory Involvement ◽

Asymptomatic Patients ◽

Flavour Perception ◽

Novel Coronavirus

COVID-19 is the disease caused by the novel coronavirus, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), which first arose in Wuhan, China, in December 2019 and has since been declared a pandemic. The clinical sequelae vary from mild, self-limiting upper respiratory infection symptoms to severe respiratory distress, acute cardiopulmonary arrest and death. Otolaryngologists around the globe have reported a significant number of mild or otherwise asymptomatic patients with COVID-19 presenting with olfactory dysfunction. We present a case of COVID-19 resulting in intensive care unit (ICU) admission, presenting with the initial symptom of disrupted taste and flavour perception prior to respiratory involvement. After 4 days in the ICU and 6 days on the general medicine floor, our patient regained a majority of her sense of smell and was discharged with only lingering dysgeusia. In this paper, we review existing literature and the clinical course of SARS-CoV-2 in relation to the reported symptoms of hyposmia, hypogeusia and dysgeusia.

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The impact of the novel coronavirus disease (COVID-19) pandemic on drug overdose-related deaths in the United States and Canada: a systematic review of observational studies and analysis of public health surveillance data

Substance Abuse Treatment Prevention and Policy ◽

10.1186/s13011-021-00423-5 ◽

2021 ◽

Vol 16 (1) ◽

Author(s):

Sameer Imtiaz ◽

Frishta Nafeh ◽

Cayley Russell ◽

Farihah Ali ◽

Tara Elton-Marshall ◽

...

Keyword(s):

United States ◽

Systematic Review ◽

Drug Overdose ◽

Observational Studies ◽

Public Health Surveillance ◽

The United States ◽

Health Surveillance ◽

The Novel ◽

Novel Coronavirus ◽

The Impact

Abstract Background There are preliminary indications that the trajectory of drug overdose-related deaths in North America has been exacerbated due to the novel coronavirus disease pandemic (COVID-19). As such, the impact of COVID-19 on drug overdose-related deaths was examined through a systematic review of the literature and percentage change analyses of surveillance data. Methods Systematic searches in electronic databases were conducted, a topical issue brief and bibliography were reviewed, reference lists of included studies were searched and expert consultations were held to identify studies (Registration # CRD42021230223). Observational studies from the United States and Canada were eligible for inclusion if drug overdose-related deaths were assessed in quantitative or qualitative analyses onwards from at least March 2020. In addition, percentage changes comparing drug overdose-related deaths in the second annual quarter (Q2 2020 [April to June]) with the first annual quarter (Q1 2020 [January to March]) were generated using national and subnational data from public health surveillance systems and reports from jurisdictions in the United States and Canada. Results Nine studies were included in the systematic review, eight from the United States and one from Canada. The maximum outcome assessment period in the included studies extended until September 2020. Drug overdose-related deaths after the onset of COVID-19 were higher compared with the months leading up to the pandemic in 2020 and the comparative months in 2019. In additional percentage change analyses, drug overdose-related deaths increased by 2 to 60% in jurisdictions in the United States and by 58% in Canada when comparing Q2 2020 with Q1 2020. Conclusions Drug overdose-related deaths increased after the onset of COVID-19. The current situation necessitates a multi-pronged approach, encompassing expanded access to substance use disorder treatment, undisrupted access to harm reduction services, emphasis on risk reduction strategies, provision of a safe drug supply and decriminalization of drug use.

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From Covid-19 to Psychological Distress: A Systematic Review on Quarantine

10.20944/preprints202012.0135.v1 ◽

2020 ◽

Author(s):

Cavicchioli Marco ◽

Roberta Ferrucci ◽

Matteo Guidetti ◽

Maria Paola Canevini ◽

Gabriella Pravettoni ◽

...

Keyword(s):

Mental Health ◽

Systematic Review ◽

Psychological Distress ◽

Web Of Science ◽

Cochrane Collaboration ◽

The Novel ◽

Related Risk ◽

Prisma Statement ◽

Methodological Bias ◽

Novel Coronavirus

Background. The novel coronavirus (SARS-COV-2) and related syndrome (COVID-19) has required a worldwide measure of quarantine with severe consequences for millions of people. Methods. Since psychopathological consequences related to social restrictions have been reported, a systematic review according to Cochrane Collaboration guidelines and the PRISMA Statement was performed to quantify the effects of quarantine on mental health of adults. Major databases - Pubmed, Scopus, Embase, PsycInfo, and Web of Science- were researched for observational studies with data on mental health indexes related to quarantine or isolation for epidemic infections. Results. Twenty-one independent studies were included for 82,312 subjects. Conclusions. The results showed that at least 20% of people exposed to these conditions reported a psychological distress, with a prevalence of PTSD, depression and, less often, generalized anxiety. Important methodological bias weakens the conclusion of most studies, opening to the need of further research on mental health after quarantine and related risk/buffering factors.

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The Novel Coronavirus Disease (COVID-19): A PRISMA Systematic Review and Meta-Analysis of Clinical and Paraclinical Characteristics

BioMed Research International ◽

10.1155/2020/3149020 ◽

2020 ◽

Vol 2020 ◽

pp. 1-16 ◽

Cited By ~ 3

Author(s):

Hamidreza Hasani ◽

Shayan Mardi ◽

Sareh Shakerian ◽

Nooshin Taherzadeh-Ghahfarokhi ◽

Parham Mardi

Keyword(s):

Systematic Review ◽

Observational Studies ◽

Clinical Laboratory ◽

Meta Analysis ◽

Ct Scanning ◽

Imaging Features ◽

The Novel ◽

Laboratory Findings ◽

Global Concern ◽

Novel Coronavirus

An outbreak of pneumonia, caused by a novel coronavirus (SARS-CoV-2), was identified in China in December 2019. This virus expanded worldwide, causing global concern. Although clinical, laboratory, and imaging features of COVID-19 are characterized in some observational studies, we undertook a systematic review and meta-analysis to assess the frequency of these features. We did a systematic review and meta-analysis using three databases to identify clinical, laboratory, and computerized tomography (CT) scanning features of rRT-PCR confirmed cases of COVID-19. Data for 3420 patients from 30 observational studies were included. Overall, the results showed that fever (84.2%, 95% CI 82.6-85.7), cough (62%, 95% CI 60-64), and fatigue (39.4%, 95% CI 37.2-41.6%) are the most prevalent symptoms in COVID-19 patients. Increased CRP level, decreased lymphocyte count, and increased D-dimer level were the most common laboratory findings. Among COVID-19 patients, 92% had a positive CT finding, most prevalently ground-glass opacification (GGO) (60%, 95% CI 58-62) and peripheral distribution opacification (64%, 95% CI 60-69). These results demonstrate the clinical, paraclinical, and imaging features of COVID-19.

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Prevalence of Anxiety in Medical Students during the COVID-19 Pandemic: A Rapid Systematic Review with Meta-Analysis

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph17186603 ◽

2020 ◽

Vol 17 (18) ◽

pp. 6603 ◽

Cited By ~ 1

Author(s):

Isabel Lasheras ◽

Patricia Gracia-García ◽

Darren Lipnicki ◽

Juan Bueno-Notivol ◽

Raúl López-Antón ◽

...

Keyword(s):

Systematic Review ◽

Medical Students ◽

Meta Analysis ◽

Total Sample ◽

Significant Heterogeneity ◽

The Novel ◽

Cross Sectional ◽

Manual Search ◽

Novel Coronavirus ◽

Treatment Prognosis

The novel coronavirus disease (COVID-19) pandemic has brought a great deal of pressure for medical students, who typically show elevated anxiety rates. Our aim is to investigate the prevalence of anxiety in medical students during this pandemic. This systematic review and mini meta-analysis has been conducted following the PRISMA guidelines. Two researchers independently searched PubMed on 26 August 2020 for cross-sectional studies on medical students during the COVID-19 outbreak, with no language restrictions applied. We then performed a manual search to detect other potentially eligible investigations. To the 1361 records retrieved in the initial search, 4 more were added by manual search on medRxiv. Finally, eight studies were finally included for qualitative and quantitative analysis, which yielded an estimated prevalence of anxiety of 28% (95% CI: 22–34%), with significant heterogeneity between studies. The prevalence of anxiety in medical students is similar to that prior to the pandemic but correlates with several specific COVID-related stressors. While some preventive and risk factors have been previously identified in a non-pandemic context, knowledge and cognitions on COVID-19 transmission, treatment, prognosis and prevention negatively correlate with anxiety, emerging as a key preventive factor that may provide a rationale for why the levels of anxiety have remained stable in medical students during the pandemic while increasing in their non-medical peers and the general population. Other reasons for the invariability of anxiety rates in this population are discussed. A major limitation of our review is that Chinese students comprised 89% the total sample, which could compromise the external validity of our work

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