scholarly journals 68 Consecutive patients assessed for COVID-19 infection; experience from a UK regional infectious disease unit

2020 ◽  
Author(s):  
Nicholas Easom ◽  
Peter Moss ◽  
Gavin Barlow ◽  
Anda Samson ◽  
Thomas Taynton ◽  
...  
Keyword(s):  
Infectious Diseases ◽  
Influenza A ◽  
Laboratory Data ◽  
Case Series ◽  
Clinical Intervention ◽  
Respiratory Illness ◽  
Antimicrobial Treatment ◽  
Major Activity ◽  
Novel Coronavirus ◽  
The Uk

AbstractClinical assessment of possible infection with SARS-CoV-2, the novel coronavirus responsible for the outbreak of COVID-19 respiratory illness, has been a major activity of infectious diseases services in the UK and elsewhere since the first report of cases in December 2019. We report our case series of 68 patients, reviewed by Infectious Diseases Consultants at a Regional Infectious Diseases Unit in the UK. We prospectively evaluated our service between the 29th Jan 2020 and 24th Feb 2020.Demographic, clinical, epidemiological and laboratory data were collected. We have compared clinical features and subsequent diagnosis between well patients not requiring admission for clinical reasons or antimicrobials with those assessed as needing either admission or antimicrobial treatment.Final microbiological diagnoses included SARS-CoV-2 (COVID-19), Mycoplasma pneumonia, influenza A, RSV, non SARS/MERS coronaviruses, rhinovirus/enterovirus. 9/68 were treated with antimicrobials, 15/68 were admitted to a negative pressure room of whom 5/68 were admitted solely due to an inability to isolate at home. Patients requiring either admission on clinical grounds or antimicrobials (14/68) were similar to those not requiring admission or antimicrobials, with modestly more fever and shortness of breath in the clinically admitted / antimicrobial group. The most commonly prescribed antimicrobials were doxycycline, moxifloxacin and oseltamivir.The majority of patients had mild illness which did not require a clinical intervention to manage. This finding supports a community testing approach supported by clinicians to review the proportion of more unwell patients.

scholarly journals Venovenous ECMO treatment, outcomes, and complications in adults according to large case series: A systematic review

2020 ◽  
pp. 039139882097540
Author(s):  
Jun Hyun Kim ◽  
Marina Pieri ◽  
Giovanni Landoni ◽  
Anna Mara Scandroglio ◽  
Maria Grazia Calabrò ◽  
...  
Keyword(s):  
Systematic Review ◽  
Treatment Outcomes ◽  
Influenza A ◽  
Influenza Pandemic ◽  
Case Series ◽  
H1n1 Influenza ◽  
Novel Coronavirus ◽  
Ecmo Treatment ◽  
Vv Ecmo ◽  
Large Case

Background: Venovenous extracorporeal membrane oxygenation (VV ECMO) has gained popularity for the treatment of refractory respiratory failure during and after the 2009 influenza pandemic, and still represents a precious therapeutic resource for severe novel coronavirus 2019 infection. However, most of the published studies are small case series, and only two randomized trials exist in literature. Aim: Aim of this systematic review is to describe trends in VV ECMO treatment outcomes according to large studies only. Methods: We searched and included studies with more than 100 VV ECMO cases dated up to August 1st, 2019. Results: Thirty-three studies published in the period 2011–2019 met inclusion criteria, for a total of 12,860 patients (age 46.3 ± 17.4 years). ARDS was mainly by pneumonia, in 3126 (37%) cases; further 401(7%) patients had H1N1 Influenza A infection. Cannulation-related complications occurred in 502 (7%) cases. Weighted mean (95% confidence interval) of VV ECMO duration was 8.9 (8.7–9.1) days, and ICU stay was 23.6 (22.4–24.8) days. Mortality at the longest follow up available was 40%. Data collection in 70% of the studies had a duration of >5 years. Conclusion: This study reveals the characteristics of large case VV ECMO studies.

Ophthalmic Manifestations of Neurologic, Rheumatologic, and Infectious Diseases in the Context of the novel Coronavirus Disease 2019 Pandemic: A Case Series

2021 ◽  
Keyword(s):  
Infectious Diseases ◽  
Clinical Manifestations ◽  
Case Series ◽  
Clinical Findings ◽  
The Novel ◽  
Altered Level ◽  
Multiple Systems ◽  
Ocular Manifestations ◽  
Ophthalmic Manifestations ◽  
Novel Coronavirus

The novel Coronavirus Disease 2019 (COVID-19) is known to present with a broad range of clinical manifestations. While symptoms such as fever, cough, dyspnea, myalgias, diarrhea, anosmia, and ageusia predominate, less common manifestations involving multiple systems have also been described. Some reported ocular manifestations include symptoms associated with keratoconjunctivitis, such as chemosis, ocular pain, photophobia, dry eye and tearing [1]. Neurological symptoms in addition to smell and taste dysfunction have been commonly described as well, and include headache, ataxia, dizziness, altered level of consciousness, and stroke [2]. Whether these neuro-ophthalmologic findings reflect direct involvement of these systems or a more generalized response to SARS-CoV-2 infection remains uncertain. Many other neurologic, rheumatologic, and infectious diseases also present with similar clinical findings as those described in COVID-19, further complicating the diagnostic picture. In this case series, we examine several patients presenting with unusual neuro-ophthalmological manifestations and discuss similarities of these findings with those seen in SARS-CoV-2 infection, and review current literature describing possible mechanisms underlying similar findings in patients with confirmed COVID-19.

scholarly journals Surveillance of influenza in the post-pandemic period in the Vojvodina, Serbia, October 2010 - May 2015

2017 ◽  
Vol 145 (7-8) ◽  
pp. 387-393
Author(s):  
Mioljub Ristic ◽  
Vesna Stojanovic ◽  
Vesna Milosevic ◽  
Jelena Radovanov ◽  
Tihomir Dugandzija ◽  
...  
Keyword(s):  
Influenza A ◽  
Laboratory Data ◽  
Weather Conditions ◽  
Respiratory Illness ◽  
Laboratory Method ◽  
World Health ◽  
School Age Children ◽  
Influenza Surveillance ◽  
Influenza B ◽  
Influenza A H1n1

Introduction/Objective. In August 2010, World Health Organization declared the beginning of the postpandemic phase of influenza surveillance. The aim of this study was to evaluate the epidemiological and virological characteristics of influenza and correlation between the influenza occurrence and weather conditions. Methods. We used surveillance reports of influenza and laboratory data from October 2010 to May 2015. Data for the analysis were collected through sentinel surveillance of influenza-like illness (ILI), severe acute respiratory illness (SARI), acute respiratory distress syndrome, and by virological surveillance. The nasal and throat swabs from all influenza cases were performed by the PCR laboratory method. Results. During the observed period, the highest rates of ILI were registered during the 2010/11 and 2012/13 seasons, with influenza A (H1N1)pdm09 and influenza B being predominant, respectively. The highest weekly age-specific rates of ILI were registered in school-age children (ages 5?14). Out of 1,466 samples collected, 720 (49.1%) were laboratory confirmed as influenza, and influenza A virus was more frequently detected than influenza B. Among confirmed cases of influenza, participation of patients with SARI or ILI was nearly equal (46% vs. 44.1%). There was a weak correlation observed between the decrease in temperature and rainfall and the increase in influenza detection (? = -0.04214 vs. ? = -0.01545, respectively, p > 0.05). Conclusion. There is a need for continuous surveillance in order to predict seasonal trends and prepare for a timely response to influenza outbreak.

scholarly journals Seasonality and immunity to laboratory-confirmed seasonal coronaviruses (HCoV-NL63, HCoV-OC43, and HCoV-229E): results from the Flu Watch cohort study

2020 ◽  
Vol 5 ◽  
pp. 52 ◽  
Author(s):  
Robert W. Aldridge ◽  
Dan Lewer ◽  
Sarah Beale ◽  
Anne M. Johnson ◽  
Maria Zambon ◽  
...  
Keyword(s):  
Cohort Study ◽  
Influenza Pandemic ◽  
Respiratory Illness ◽  
H1n1 Influenza ◽  
The Novel ◽  
Government Response ◽  
Four Seasons ◽  
2009 H1n1 ◽  
Novel Coronavirus ◽  
The Uk

Background: There is currently a pandemic caused by the novel coronavirus SARS-CoV-2. The intensity and duration of this first and second waves in the UK may be dependent on whether SARS-CoV-2 transmits more effectively in the winter than the summer and the UK Government response is partially built upon the assumption that those infected will develop immunity to reinfection in the short term. In this paper we examine evidence for seasonality and immunity to laboratory-confirmed seasonal coronavirus (HCoV) from a prospective cohort study in England. Methods: In this analysis of the Flu Watch cohort, we examine seasonal trends for PCR-confirmed coronavirus infections (HCoV-NL63, HCoV-OC43, and HCoV-229E) in all participants during winter seasons (2006-2007, 2007-2008, 2008-2009) and during the first wave of the 2009 H1N1 influenza pandemic (May-Sep 2009). We also included data from the pandemic and ‘post-pandemic’ winter seasons (2009-2010 and 2010-2011) to identify individuals with two confirmed HCoV infections and examine evidence for immunity against homologous reinfection. Results: We tested 1,104 swabs taken during respiratory illness and detected HCoV in 199 during the first four seasons. The rate of confirmed HCoV infection across all seasons was 390 (95% CI 338-448) per 100,000 person-weeks; highest in the Nov-Mar 2008/9 season at 674 (95%CI 537-835) per 100,000 person-weeks. The highest rate was in February at 759 (95% CI 580-975) per 100,000 person-weeks. Data collected during May-Sep 2009 showed there was small amounts of ongoing transmission, with four cases detected during this period. Eight participants had two confirmed infections, of which none had the same strain twice. Conclusion: Our results provide evidence that HCoV infection in England is most intense in winter, but that there is a small amount of ongoing transmission during summer periods. We found some evidence of immunity against homologous reinfection.

Use of a large general practice syndromic surveillance system to monitor the progress of the influenza A(H1N1) pandemic 2009 in the UK

2011 ◽  
Vol 140 (1) ◽  
pp. 100-105 ◽  
Author(s):  
S. E. HARCOURT ◽  
G. E. SMITH ◽  
A. J. ELLIOT ◽  
R. PEBODY ◽  
A. CHARLETT ◽  
...  
Keyword(s):  
Surveillance System ◽  
Influenza A ◽  
Geographical Area ◽  
Respiratory Illness ◽  
H1n1 Pandemic ◽  
Syndromic Surveillance System ◽  
Daily Data ◽  
Influenza A H1n1 ◽  
Using Data ◽  
The Uk

SUMMARYThe Health Protection Agency/QSurveillance national surveillance system utilizes QSurveillance® a recently developed general practitioner database covering over 23 million people in the UK. We describe the spread of the first wave of the influenza A(H1N1) pandemic 2009 using data on consultations for influenza-like illness (ILI), respiratory illness and prescribing for influenza from 3400 contributing general practices. Daily data, provided from 27 April 2009 to 28 January 2010, were used to give a timely overview for those managing the pandemic nationally and locally. The first wave particularly affected London and the West Midlands with a peak in ILI in week 30. Children aged between 1 and 15 years had consistently high consultation rates for ILI. Daily ILI rates were used for modelling national weekly case estimates. The system enabled the ‘real-time’ monitoring of the pandemic to a small geographical area, linking morbidity and prescribing for influenza and other respiratory illnesses.

Is COVID-19 Infection a Death Sentence in Patients Living with Haematological Malignancies? A Case Series

2021 ◽  
Author(s):  
Mudit Varshney ◽  
Amandeep Jaswal ◽  
Sahil Diwan ◽  
Santvana Kohli ◽  
Ruqaiya Bano ◽  
...  
Keyword(s):  
Poor Prognosis ◽  
Severe Disease ◽  
Case Series ◽  
Respiratory Illness ◽  
Chemotherapeutic Agents ◽  
Death Sentence ◽  
High Morbidity ◽  
Haematological Malignancies ◽  
Novel Coronavirus ◽  
High Index Of Suspicion

The year 2020 saw the rise of an influenza-like illness from SARS-nCoV2 (Severe Acute Respiratory Illness by novel Coronavirus 2), which causes myriad of symptoms in patients, ranging from mild upper respiratory symptoms to severe ARDS (Acute Respiratory Distress Syndrome). It is, however, known to cause high morbidity and mortality in patients with underlying comorbidities like diabetes, hypertension, kidney disease, obesity and malignancies. Amongst these, the subset with haematological malignancies has an especially poor prognosis possibly as a result of immune suppression, due to underlying bone marrow depression as well as effects of chemotherapeutic agents. These patients need frequent visits and admissions to the hospital for treatment, thus exposing them to the risk of acquiring the infection. Also, a high index of suspicion, with low threshold for testing is needed in view of possible atypical presentation and symptoms. These patients may also warrant an early ICU admission, as they tend to develop severe disease with ARDS more frequently, with an overall poor prognosis and high mortality rate. We hereby present a series of six patients with underlying haematological malignancies who were admitted in our ICU with a serious COVID-19 illness and a grave outcome.

scholarly journals Seasonality and immunity to laboratory-confirmed seasonal coronaviruses (HCoV-NL63, HCoV-OC43, and HCoV-229E): results from the Flu Watch cohort study

2020 ◽  
Vol 5 ◽  
pp. 52 ◽  
Author(s):  
Robert W. Aldridge ◽  
Dan Lewer ◽  
Sarah Beale ◽  
Anne M. Johnson ◽  
Maria Zambon ◽  
...  
Keyword(s):  
Cohort Study ◽  
Influenza Pandemic ◽  
Respiratory Illness ◽  
H1n1 Influenza ◽  
The Novel ◽  
Government Response ◽  
Four Seasons ◽  
2009 H1n1 ◽  
Novel Coronavirus ◽  
The Uk

Background: There is currently a pandemic caused by the novel coronavirus SARS-CoV-2. The intensity and duration of this first wave in the UK may be dependent on whether SARS-CoV-2 transmits more effectively in the winter than the summer and the UK Government response is partially built upon the assumption that those infected will develop immunity to reinfection in the short term. In this paper we examine evidence for seasonality and immunity to laboratory-confirmed seasonal coronavirus (HCoV) from a prospective cohort study in England. Methods: In this analysis of the Flu Watch cohort, we examine seasonal trends for PCR-confirmed coronavirus infections (HCoV-NL63, HCoV-OC43, and HCoV-229E) in all participants during winter seasons (2006-2007, 2007-2008, 2008-2009) and during the first wave of the 2009 H1N1 influenza pandemic (May-Sep 2009). We also included data from the pandemic and ‘post-pandemic’ winter seasons (2009-2010 and 2010-2011) to identify individuals with two confirmed HCoV infections and examine evidence for immunity against homologous reinfection. Results: We tested 1,104 swabs taken during respiratory illness and detected HCoV in 199 during the first four seasons. The rate of confirmed HCoV infection across all seasons was 390 (95% CI 338-448) per 100,000 person-weeks; highest in the Nov-Mar 2008/9 season at 674 (95%CI 537-835). The highest rate was in February at 759 (95% CI 580-975). Data collected during May-Sep 2009 showed there was small amounts of ongoing transmission, with four cases detected during this period. Eight participants had two confirmed infections, of which none had the same strain twice. Conclusion: Our results provide evidence that HCoV infection in England is most intense in winter, but that there is a small amount of ongoing transmission during summer periods. We found some evidence of immunity against homologous reinfection.

scholarly journals Influenza-attributable burden in United Kingdom primary care

2015 ◽  
Vol 144 (3) ◽  
pp. 537-547 ◽  
Author(s):  
D. M. FLEMING ◽  
R. J. TAYLOR ◽  
F. HAGUINET ◽  
C. SCHUCK-PAIM ◽  
J. LOGIE ◽  
...  
Keyword(s):  
Influenza Vaccination ◽  
Otitis Media ◽  
Influenza A ◽  
Cost Benefit ◽  
Respiratory Illness ◽  
Practice Research ◽  
Clinical Practice Research Datalink ◽  
Severe Influenza ◽  
The Uk ◽  
Health Service Costs

SUMMARYInfluenza is rarely laboratory-confirmed and the outpatient influenza burden is rarely studied due to a lack of suitable data. We used the Clinical Practice Research Datalink (CPRD) and surveillance data from Public Health England in a linear regression model to assess the number of persons consulting UK general practitioners (GP episodes) for respiratory illness, otitis media and antibiotic prescriptions attributable to influenza during 14 seasons, 1995–2009. In CPRD we ascertained influenza vaccination status in each season and risk status (conditions associated with severe influenza outcomes). Seasonal mean estimates of influenza-attributable GP episodes in the UK were 857 996 for respiratory disease including 68 777 for otitis media, with wide inter-seasonal variability. In an average season, 2·4%/0·5% of children aged <5 years and 1·3%/0·1% of seniors aged ⩾75 years had a GP episode for respiratory illness attributed to influenza A/B. Two-thirds of influenza-attributable GP episodes were estimated to result in prescription of antibiotics. These estimates are substantially greater than those derived from clinically reported influenza-like illness in surveillance programmes. Because health service costs of influenza are largely borne in general practice, these are important findings for cost-benefit assessment of influenza vaccination programmes.

scholarly journals Severe Acute Respiratory Illness Deaths in Sub-Saharan Africa and the Role of Influenza: A Case Series From 8 Countries

2015 ◽  
Vol 212 (6) ◽  
pp. 853-860 ◽  
Author(s):  
Meredith L. McMorrow ◽  
Emile Okitolonda Wemakoy ◽  
Joelle Kabamba Tshilobo ◽  
Gideon O. Emukule ◽  
Joshua A. Mott ◽  
...  
Keyword(s):  
Influenza A ◽  
Case Series ◽  
Respiratory Illness ◽  
Sub Saharan Africa ◽  
Acute Respiratory Illness ◽  
Sub Saharan ◽  
Severe Acute Respiratory Illness

scholarly journals Estimation of influenza activity in Vojvodina (Serbia) for five consecutive influenza seasons

2018 ◽  
Vol 75 (6) ◽  
pp. 589-597
Author(s):  
Mioljub Ristic ◽  
Mirjana Strbac ◽  
Snezana Medic ◽  
Vladimir Petrovic
Keyword(s):  
Influenza A ◽  
Influenza Season ◽  
Influenza Infection ◽  
Laboratory Data ◽  
Respiratory Illness ◽  
Case Definition ◽  
Influenza Surveillance ◽  
Influenza B ◽  
Case Definitions ◽  
Influenza A H1n1

Background/Aim. After pandemic 2009/10 influenza season, influenza A (H1N1)pdm09, A(H3N2) and B viruses have continued to circulate in the population. The aim of this study was to describe the epidemiological and virological characteristics of influenza and evaluate values of proposed case definitions of influenza like illness (ILI), severe acute respiratory illness (SARI) and acute respiratory distress syndrome (ARDS) for detecting laboratory-confirmed influenza cases in Vojvodina. Methods. We conducted a descriptive epidemiological study using surveillance reports and laboratory data from October 2010 to May 2015 (five surveillance seasons). Results. Out of 1,466 samples collected, 720 (49.1%) were laboratory confirmed as influenza. Influenza A infection was more frequently detected than influenza B infection. Using the case definition of ILI was a good predictor for influenza confirmation (p < 0.05) during 5 influenza seasons. The predominant age-range of patients with confirmed influenza A (42.2%) and B (43.0%) infections was 30 to 64, but the patients aged from 15 to 29 years were more likely to have influenza A (p = 0.0168). In the period from December to January, influenza A (17.8%) was more frequently registered than influenza B (7.6%). The highest number of deaths (19/38) and hospitalized patients (128/402) was registered during the last influenza season (2014/15). The immunosuppressed patients with confirmed influenza infection were more likely to have influenza B than influenza A (p = 0.0110). Conclusion. Our results indicate that influenza surveillance should be continued and expanded in order to fully assess the burden of the disease in given population.

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