scholarly journals 549. Clinical Characteristics and Outcomes of Patients with COVID-19 treated with Convalescent Plasma in Miami, Florida

2020 ◽  
Vol 7 (Supplement_1) ◽  
pp. S340-S341
Author(s):  
Shweta Anjan ◽  
Dimitra Skiada ◽  
Miriam Andrea Duque Cuartas ◽  
Douglas Salguero ◽  
David P Serota ◽  
...  
Keyword(s):  
Treatment Options ◽  
Disease Outbreaks ◽  
Nasopharyngeal Swab ◽  
Rt Pcr ◽  
Health Crisis ◽  
Infectious Disease Outbreaks ◽  
Reactive Protein ◽  
High Acuity ◽  
Us Fda ◽  
Oxygen Requirements

Abstract Background The Coronavirus disease of 2019 (COVID-19) global health crisis caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has resulted in unprecedented mortality, impacted society, and strained healthcare systems, yet sufficient data regarding treatment options are lacking. Convalescent plasma, used since 1895 for infectious disease outbreaks, offers promise as a treatment option for COVID-19. Methods This is a retrospective study of patients diagnosed by a nasopharyngeal swab SARS-CoV-2 reverse transcriptase–polymerase chain reaction (RT-PCR), who received convalescent plasma between April to June 2020 at two large hospitals in Miami, Florida, as part of the US FDA Expanded Access Program for COVID-19 convalescent plasma (CCP). Results A total of 23 patients received CCP, 13 (57%) had severe COVID-19 disease, while 8 (35%) had critical or critical with multiorgan dysfunction. Median time of follow up was 26 (range, 7–79) days. Overall, 11 (48%) survived to discharge, 6 (26%) died, while 6 (26%) are currently hospitalized. All deaths reported were due to septic shock from secondary infections. 15 (65%) showed improvement in oxygen requirements 7 days post CCP transfusion. Measured inflammatory markers, c-reactive protein, lactate dehydrogenase, ferritin and d-dimer improved 7 days post transfusion in 13 (57%) patients. No adverse events due to the transfusion were reported. 10 (43.4%) patients had a negative SARS-CoV-2 RT-PCR at a median of 14.5 (range, 4–31) days after receiving convalescent plasma. Conclusion Administration of convalescent plasma was found to be safe, with favorable outcomes in this small cohort of relatively high acuity patients. Larger studies including control arms are needed to establish the efficacy of convalescent plasma on clinical and virologic outcomes for patients with COVID-19. Table Disclosures All Authors: No reported disclosures

scholarly journals Chlorpheniramine maleate nasal spray in COVID-19 patients: Case Series

2021 ◽  
Author(s):  
Joselit Torres ◽  
Camille C. Go ◽  
Farah A. Chohan ◽  
Genesis Camacho L. ◽  
Marcos A. Sanchez-Gonzalez ◽  
...  
Keyword(s):  
Nasal Spray ◽  
Influenza A ◽  
Case Series ◽  
Medical Community ◽  
Nasopharyngeal Swab ◽  
Upper Respiratory Tract ◽  
Rt Pcr ◽  
Chlorpheniramine Maleate ◽  
Health Crisis ◽  
Adjunct Treatment

Abstract The pandemic of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) posted a devastating global health crisis for almost a year already. Very little is known about this virus that scientists, physicians and the medical community struggled to find treatments of this novel virus. The vaccine that can potentially combat this virus is still an unknown reality hence, the repurposing of existing medical treatments such as chlorpheniramine maleate (CPM) could be a possible treatment and is being widely utilized. CPM is a safe and effective antihistamine with potent antiviral activity against various strains of influenza A/B, thus highlighting its great antiviral potential. We tested the virucidal potential of chlorpheniramine maleate (CPM) in a nasal spray composition currently in development as an anti-allergy medication. The coronavirus disease 2019 (COVID-19) has a droplet mode transmission with a notably high viral load in the upper respiratory tract, especially the nose. Several studies had already postulated that the nose is possibly the primary route of entry of SARS-CoV-2 owing to the high expression of Angiotensin 2 converting enzyme receptors. We hypothesize that utilizing (CPM) nasal spray as an adjunct treatment to COVID-19 positive patients and reduce their clinical course and hasten their time to negativization via RT-PCR via nasopharyngeal swab. We present a series of four symptomatic patients with mild-moderate risks. CPM nasal spray was added to their current supportive treatment. All four patients showed rapid improvement of their clinical symptoms with a shorter than average time to negativization on repeat nasopharyngeal swab via RT-PCR. No safety issues were encountered during the course of treatment. Given its years of excellent safety profile with remarkable clinical results as shown in this case series, we conclude that CPM nasal spray may be a potential adjunct treatment option in patients with mild to moderate COVID-19 symptoms.

scholarly journals WHO guidance on ethics in outbreaks and the COVID-19 pandemic: a critical appraisal

2021 ◽  
pp. medethics-2020-106959
Author(s):  
Abha Saxena ◽  
Paul André Bouvier ◽  
Ehsan Shamsi-Gooshki ◽  
Johannes Köhler ◽  
Lisa J Schwartz
Keyword(s):  
Ebola Virus ◽  
Ethical Issues ◽  
Virus Disease ◽  
Disease Outbreaks ◽  
Guidance Document ◽  
Health Crisis ◽  
Infectious Disease Outbreaks ◽  
Ethical Implications ◽  
Political Crises ◽  
Starting Point

In 2016, following pandemic influenza threats and the 2014–2016 Ebola virus disease outbreaks, the WHO developed a guidance document for managing ethical issues in infectious disease outbreaks. In this article, we analyse some ethical issues that have had a predominant role in decision making in response to the current COVID-19 pandemic but were absent or not addressed in the same ways in the 2016 guidance document. A pandemic results in a health crisis and social and political crises both nationally and globally. The ethical implications of these global effects should be properly identified so that appropriate actions can be taken globally and not just in national isolation. Our analysis, which is a starting point to test the broader relevance of the 2016 WHO document that remains the only available guidance document applicable globally, concludes that the WHO guidance should be updated to provide reasoned and thoughtful comprehensive ethics advice for the sound management of the current and future pandemics.

scholarly journals Electoral Governance and Human Rights Amid Pandemics in Africa: Key lessons from the Early COVID-19 Experience

2021 ◽  
pp. 1-28
Author(s):  
Mansha Mohee
Keyword(s):  
Human Rights ◽  
Disease Outbreaks ◽  
African Countries ◽  
Initial State ◽  
Health Crisis ◽  
The Rule Of Law ◽  
Infectious Disease Outbreaks ◽  
The Face ◽  
State Responses

Abstract Over 25 African countries had planned elections for 2020. In the face of the onset of the COVID-19 pandemic in March, states resorted to one of two courses of action: adherence to planned electoral timelines in the shadow of the outbreak, which largely led to record low voter turnouts and hastened the spread of the virus; or adjourning elections with ill-defined election programming, constitutional tensions and unrest over delayed polls. The global health crisis not only frustrated the organization of the electoral process but set severe challenges to democracy, the rule of law and human rights in the region at a time of landmark elections, notably in Ethiopia, Burundi and Malawi. This article analyses initial state responses in electoral administration in light of international electoral norms, and interrogates the role of national and regional mechanisms in securing safe, inclusive, timely, free and fair elections amid new infectious disease outbreaks.

scholarly journals Best practice assessment of disease modelling for infectious disease outbreaks

2018 ◽  
Vol 146 (10) ◽  
pp. 1207-1215 ◽  
Author(s):  
Z. F. Dembek ◽  
T. Chekol ◽  
A. Wu
Keyword(s):  
Public Health ◽  
Infectious Disease ◽  
Large Population ◽  
Disease Outbreaks ◽  
Disease Modelling ◽  
Severe Illness ◽  
Health Practitioner ◽  
Epidemiological Models ◽  
Health Crisis ◽  
Infectious Disease Outbreaks

AbstractDuring emerging disease outbreaks, public health, emergency management officials and decision-makers increasingly rely on epidemiological models to forecast outbreak progression and determine the best response to health crisis needs. Outbreak response strategies derived from such modelling may include pharmaceutical distribution, immunisation campaigns, social distancing, prophylactic pharmaceuticals, medical care, bed surge, security and other requirements. Infectious disease modelling estimates are unavoidably subject to multiple interpretations, and full understanding of a model's limitations may be lost when provided from the disease modeller to public health practitioner to government policymaker. We review epidemiological models created for diseases which are of greatest concern for public health protection. Such diseases, whether transmitted from person-to-person (Ebola, influenza, smallpox), via direct exposure (anthrax), or food and waterborne exposure (cholera, typhoid) may cause severe illness and death in a large population. We examine disease-specific models to determine best practices characterising infectious disease outbreaks and facilitating emergency response and implementation of public health policy and disease control measures.

scholarly journals Viral Load, Detection Rate and Sensitivity of Nasopharyngeal and Oropharyngeal Swab Sampling for Diagnosis of COVID-19

2021 ◽  
pp. 35-50
Author(s):  
Eyzawiah Hassan ◽  
Nuralia Akma Mohamad Mustafa ◽  
Nor Azirah Salahuddin ◽  
Siti Asmat Md Arepen
Keyword(s):  
Viral Load ◽  
Nasopharyngeal Swab ◽  
Screening Methods ◽  
Rt Pcr ◽  
Pcr Assay ◽  
Health Crisis ◽  
Load Detection ◽  
Negative Results ◽  
Positive Rate ◽  
Oropharyngeal Swab

The rapid spread of the COVID-19 pandemic has led to a major public health crisis. Accurate screening methods for COVID-19 infection is essential and crucial for case detection, isolation, prevention and control of the current pandemic. At present, nasopharyngeal and oropharyngeal swabs are typically used as the method of choice for the diagnosis of SARS-CoV-2 infection. We carried out a review on the accuracy of the two different sampling sites, the nasopharyngeal and oropharyngeal swab sampling, focusing on the viral load, detection of positive cases and sensitivity in real-time polymerase chain reaction (RT-PCR) assay in diagnosing COVID-19. A total of 25 articles related to the topic were selected out of 5221 articles searched online using Scopus, PubMed and Medline, Embase, Web of Science, and Google scholar with the keywords  COVID-19, SARS-CoV-2, nasopharyngeal swab, oropharyngeal swab, nasal swab and throat swab. All full text original articles were obtained and reviewed. Nasopharyngeal swab had significantly higher SARS-CoV-2 load than oropharyngeal swab (mean Ct value ranging from 24.3-37.8, higher detection of positive rate (highest rate 62.5%) and sensitivity (highest sensitivity 98.3%, P<0.05) in RT-PCR assay compared to oropharyngeal swab. Based on the scientific literature review, both nasopharyngeal and oropharyngeal swabs were reported to have 30% probability of yielding false negative results; thus clinically suspicious patients with negative results should be viewed with concern. In conclusion, although several methods of COVID-19 screening and type of specimen are available, nasopharyngeal swab is the best option for large scale screening as it yields significantly higher viral load, higher detection of positive rate among cases and higher sensitivity in RT-PCR assay compared to oropharyngeal swab in detecting SARS-CoV-2.

scholarly journals COVID-19 and Global Health Security: Overview of the Global Health Security Alliance, COVID-19 Response, African Countries’ Approaches, and Ethics

2020 ◽  
pp. 1-5
Author(s):  
Belete Yimer ◽  
Wassachew Ashebir ◽  
Awraris Wolde ◽  
Muluken Teshome
Keyword(s):  
Infectious Disease ◽  
Global Health ◽  
Disease Outbreaks ◽  
Global Health Security ◽  
Health Security ◽  
Health Crisis ◽  
Infectious Disease Outbreaks ◽  
Wide Range ◽  
The World ◽  
Pandemic Response

ABSTRACT Public health emergencies can arise from a wide range of causes, one of which includes outbreaks of contagion. The world has continued to be threatened by various infectious outbreaks of different types that have global consequences. While all pandemics are unique in their level of transmission and breadth of impact, the 2019 coronavirus disease (COVID-19) pandemic is the deepest global crisis of the 21st century, which has affected nearly every country globally. Yet, going forward, there will be a continued need for global health security resources to protect people around the world against increasing infectious disease outbreaks frequency and intensity. Pandemic response policies and processes all need to be trusted for effective and ethical pandemic response. As the world can learn during the past few years about frequent infectious disease outbreaks, (these) diseases respect no borders, and, therefore, our spirit of solidarity must respect no borders in our efforts to stop the ongoing COVID-19 pandemic and be better prepared to respond effectively to a health crisis in the future.

scholarly journals Effects and Safety of Convalescent Plasma Administration in a Group of Polish Pediatric Patients with COVID-19: A Case Series

Life ◽  
2021 ◽  
Vol 11 (3) ◽  
pp. 247
Author(s):  
Paweł Małecki ◽  
Kamil Faltin ◽  
Anna Mania ◽  
Katarzyna Mazur-Melewska ◽  
Agnieszka Cwalińska ◽  
...  
Keyword(s):  
Pediatric Patients ◽  
Case Series ◽  
Nasopharyngeal Swab ◽  
Rt Pcr ◽  
C Reactive Protein ◽  
Virus Elimination ◽  
Reactive Protein ◽  
Promising Treatment ◽  
Pcr Method ◽  
The Mean

Despite the enormous advances in knowledge about the SARS-CoV-2 infection, the optimal treatment for COVID-19 is still not well defined. The use of convalescent plasma seems to be a promising method of treatment but requires further evaluation. Although it is usually mild, in children with underlying chronic diseases, the course of SARS-CoV-2 infection may be very severe. We described a series of 13 pediatric patients (mean age 10.4 years, median 12) treated with convalescent plasma as a method of COVID-19 therapy. Medical history, with particular emphasis on comorbidities, clinical course, laboratory parameters, supportive treatment and virus elimination time, were analyzed. The mean hospitalization time was 22.6 days (median 20). The most common abnormalities included increased levels of C-reactive protein, D-dimer, and lymphopenia. Median time from symptom onset to convalescent plasma transfusion was 10.6 days (median 7 days). Six patients (46.2%) had a viral clearance on RT-PCR method from a nasopharyngeal swab within 3 days of transfusion, while in the remaining patients the mean elimination time was 12.1 days (median 6 days). Clinical improvement was achieved in all patients; no adverse effects were found in any of the cases. Convalescent plasma may be a promising treatment for COVID-19 in children.

To Wear or Not to Wear: A Commentary on Mistrust in Public Comments to CDC Tweets about Mask-Wearing during COVID19

2021 ◽  
pp. 232948842110085
Author(s):  
Tatiana Batova
Keyword(s):  
Social Media ◽  
Disease Outbreaks ◽  
Health Crisis ◽  
The Public ◽  
Government Organizations ◽  
Infectious Disease Outbreaks ◽  
Multiple Factors ◽  
Building Trust ◽  
The U.S ◽  
Promising Avenue

Trust is an important component of crisis communication, and social media has been shown a promising avenue for building trust. Yet, mixed findings about how effectively government organizations utilize social media during health crises such as pandemics or infectious disease outbreaks require further research to better understand how trust is created and destroyed. This study investigates the factors that reflect mistrust in the public comments to the CDC tweets about mask-wearing during the 3 months after the first reported case of COVID19 in the U.S. The findings show that multiple factors representing mistrust were present in the public comments. What is more, the feeling of anger was growing in the comments as the health crisis progressed, which also could have been trust-damaging.

Targeting COVID-19 in Parkinson’s patients: Drugs repurposed.

2020 ◽  
Vol 27 ◽  
Author(s):  
Firoz Anwar ◽  
Salma Naqvi ◽  
Fahad A. Al-Abbasi ◽  
Nauroz Neelofar ◽  
Vikas Kumar ◽  
...  
Keyword(s):  
Day Treatment ◽  
Treatment Options ◽  
Developed Countries ◽  
Methyl Transferase ◽  
Comt Inhibitors ◽  
Mao B ◽  
Pharmacokinetic Properties ◽  
Us Fda ◽  
Approved Drugs ◽  
Fda Approved Drugs

: The last couple of months have witnessed the world in a state of virtual standstill. The SARS-CoV-2 virus has overtaken globe to economic and social lockdown. Many patients with COVID-19 have compromised immunity, especially in an aged population suffering from Parkinson disease (PD). Alteration in dopaminergic neurons or deficiency of dopamine in PD patients is the most common symptoms affecting 1% population above the age of 60 years. The compromised immune system and inflammatory manifestation in PD patients make them an easy target. The most common under trial drugs for COVID-19 are Remdesivir, Favipiravir, Chloroquine and Hydroxychloroquine, Azithromycin along with adjunct drugs like Amantadine with some monoclonal antibodies. : Presently, clinically US FDA approved drugs in PD includes Levodopa, catechol-O-methyl transferase (COMT) inhibitors, (Entacapone and Tolcapone), Dopamine agonists (Bromocriptine, Ropinirole, Pramipexole, and Rotigotine), Monoamine oxidase B (MAO-B) inhibitors (Selegiline and Rasagiline), Amantadine and Antimuscarinic drugs. The drugs have established mechanism of action on PD patients with known pharmacodynamics and pharmacokinetic properties along with dose and adverse effects. : Conclusion and relevance of this review focus on the drugs that can be tried for the PD patients with SAR CoV-2 infection, in particular, Amantadine approved by all developed countries a common drug possessing both antiviral properties by downregulation of CTSL, lysosomal pathway disturbance and change in pH necessary to uncoat the viral proteins and antiParkinson properties. The significant prognostic adverse effect of SARS-CoV-2 on PD and the present-day treatment options, clinical presentation and various mechanism is warrant need of the hour.

Scoring System for the Diagnosis of COVID-19

2020 ◽  
Vol 13 (1) ◽  
pp. 413-414 ◽  
Author(s):  
Mohamed Farouk Allam
Keyword(s):  
Scoring System ◽  
Clinical Symptoms ◽  
False Negative ◽  
Nasopharyngeal Swab ◽  
Rt Pcr ◽  
Pcr Assay ◽  
Negative Results ◽  
False Negative Results ◽  
Symptoms And Signs

Due to the international spread of COVID-19, the difficulty of collecting nasopharyngeal swab specimen from all suspected patients, the costs of RT-PCR and CT, and the false negative results of RT-PCR assay in 41% of COVID-19 patients, a scoring system is needed to classify the suspected patients in order to determine the need for follow-up, home isolation, quarantine or the conduction of further investigations. A scoring system is proposed as a diagnostic tool for suspected patients. It includes Epidemiological Evidence of Exposure, Clinical Symptoms and Signs, and Investigations (if available). This scoring system is simple, could be calculated in a few minutes, and incorporates the main possible data/findings of any patient.

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