Changes in Treatment of Patients with Incident End-Stage Kidney Disease During the Novel Coronavirus Disease 2019 Pandemic

Background: The COVID-19 pandemic caused major disruptions to care for patients with advanced CKD. Methods: We investigated the incidence of documented ESKD, ESKD treatment modalities, changes in eGFR at dialysis initiation, and use of incident central venous catheters (CVCs) by epidemiologic week during the first half of 2020 compared to 2017-2019 historical trends, using Centers for Medicare & Medicaid Services data. We used Poisson and logistic regression for analyses of incidence and binary outcomes, respectively. Results: Incidence of documented ESKD dropped dramatically in 2020 compared with the expected incidence, particularly during epidemiologic weeks 15-18 (April; incidence rate ratio [IRR] 0.75, 95% CI 0.73-0.78). The decrease was most pronounced for individuals aged ≥75 years (IRR 0.69, 0.66-0.73). Preemptive kidney transplantation decreased markedly during weeks 15-18 (IRR 0.56, 0.46-0.67). Mean eGFR at dialysis initiation decreased by 0.33 mL/min/1.73 m2 in weeks 19-22; non-Hispanic Black patients exhibited the largest decrease, at 0.61 mL/min/1.73 m2. The odds of initiating dialysis with eGFR <10 ml/min/1.73 m2 were highest during weeks 19-22 (May; OR 1.14, 1.05-1.17), corresponding to an absolute increase of 2.9%. The odds of initiating peritoneal dialysis (versus hemodialysis) were 24% higher (OR 1.24, 1.14-1.34) in weeks 11-14, an absolute increase of 2.3%. Initiation with a CVC increased by 3.3% (OR 1.30, 1.20-1.41). Conclusions: During the first wave of the COVID-19 pandemic, the number of patients starting treatment for ESKD fell to a level not observed since 2011. Changes in documented ESKD incidence and other aspects of ESKD-related care may reflect differential access to care early in the pandemic.

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The impact of COVID-19 pandemic on the treatment of acute appendicitis in China

International Journal of Colorectal Disease ◽

10.1007/s00384-021-04031-4 ◽

2021 ◽

Author(s):

ZhiXue Zheng ◽

Jing Tao Bi ◽

Ya Qi Liu ◽

Xuan Cai

Keyword(s):

Acute Appendicitis ◽

White Blood Cells ◽

Onset Time ◽

The Novel ◽

C Reactive Protein ◽

Reactive Protein ◽

Number Of Patients ◽

Hospital Visits ◽

Novel Coronavirus ◽

The Impact

Abstract Objective This research aims to analyze the impact of the novel coronavirus pandemic on the hospital visits of patients with acute appendicitis. Methods The retrospective analysis was designed to look at the treatment of acute appendicitis in the Department of General Surgery in Beijing Jishuitan Hospital before and during the COVID-19 pandemic (2019–2020). Data was analyzed by the numbers of patients, sex, age, onset time, fever or not, laboratory examination, imaging test, and treatment. And we analyzed the differences between the “pre-COVID group” and “during-COVID group”. Results Compared with the year 2019, the number of acute appendicitis patients has diminished substantially during the COVID-19 pandemic (2020), but the number elevated with the control of the pandemic. Even if we did not find the differences of the treatment before and during the pandemic (P = 0.932), the onset time to emergency was significantly longer (P < 0.001), and more patients had showed fever (P < 0.001) during the COVID-19 pandemic. And the total number of white blood cells and C reactive protein level were significantly higher in 2020 than those in 2019 (P = 0.006, 0.003). And the same result was found in patients with appendiceal fecalith (P = 0.047). Conclusion During the pandemic of the new coronavirus pneumonia, the number of patients with acute appendix treatment dropped significantly, mainly because it took longer than before, and the condition was more severe. It can be seen that the new coronary pneumonia has a great impact on the patients’ medical treatment behavior, and the active prevention and treatment of the new coronavirus pneumonia is currently an important and urgent issue.

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Hypercoagulation and Antithrombotic Treatment in Coronavirus 2019: A New Challenge

Thrombosis and Haemostasis ◽

10.1055/s-0040-1710317 ◽

2020 ◽

Vol 120 (06) ◽

pp. 949-956 ◽

Cited By ~ 58

Author(s):

Francesco Violi ◽

Daniele Pastori ◽

Roberto Cangemi ◽

Pasquale Pignatelli ◽

Lorenzo Loffredo

Keyword(s):

Multiorgan Failure ◽

Laboratory Data ◽

Clinical Severity ◽

The Novel ◽

Antithrombotic Treatment ◽

Clotting System ◽

Thrombotic Risk ◽

Number Of Patients ◽

Coronary Ischemia ◽

Novel Coronavirus

AbstractThe novel coronavirus 2019 (COVID-19) is clinically characterized by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), which is responsible for a high number of patients needing mechanical ventilation or intensive care units treatment and for the elevated mortality risk. A link between COVID-19 and multiorgan failure may be dependent on the fact that most COVID-19 patients are complicated by pneumonia, which is known to be associated with early changes of clotting and platelet activation and artery dysfunction; these changes may implicate in thrombotic-related events such as myocardial infarction and ischemic stroke. Recent data showed that myocardial injury compatible with coronary ischemia may be detectable in SARS-CoV-2 patients and laboratory data exploring clotting system suggest the presence of a hypercoagulation state. Thus, we performed a systematic review of COVID-19 literature reporting measures of clotting activation to assess if changes are detectable in this setting and their relationship with clinical severity. Furthermore, we discussed the biologic plausibility of the thrombotic risk in SARS-CoV-2 and the potential use of an antithrombotic treatment.

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SARS-CoV-2 Infection as a Cause of Acute Pancreatitis in a Child—A Case Report

Pediatric Reports ◽

10.3390/pediatric13040065 ◽

2021 ◽

Vol 13 (4) ◽

pp. 552-557

Author(s):

Natalia Kopiczko ◽

Kamila Kwiatek-Średzińska ◽

Mirosława Uścinowicz ◽

Monika Kowalczuk-Krystoń ◽

Dariusz Marek Lebensztejn

Keyword(s):

Acute Pancreatitis ◽

Abdominal Pain ◽

Case Report ◽

The Novel ◽

Gastrointestinal Manifestations ◽

Number Of Patients ◽

Growing Body ◽

Novel Coronavirus ◽

Mild Acute Pancreatitis ◽

First Time

The novel coronavirus disease (COVID-19) was detected for the first time in China in December 2019. Soon after it was declared a pandemic. Main symptoms include fever, dyspnea, cough, muscle pain, headache, anosmia and ageusia, however a growing body of evidence shows that other organs can be affected. Gastrointestinal manifestations have been observed in a considerable number of patients and include abdominal pain, diarrhea and vomiting. The involvement of liver as well as pancreas has been also described, however there are only a few cases of acute pancreatitis reported in patients with COVID-19. Therefore, we present a case of 6-year-old child with mild acute pancreatitis and COVID-19 pneumonia.

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The Novel Coronavirus in Pediatric and Geriatric Population- What We Know

The Open Dentistry Journal ◽

10.2174/1874210602115010300 ◽

2021 ◽

Vol 15 (1) ◽

pp. 300-304

Author(s):

Amit Reche ◽

Anjali Nandanwar ◽

Aniket Hedaoo ◽

Kumar G. Chhbra ◽

Punit Fulzele ◽

...

Keyword(s):

Older Adults ◽

Lung Diseases ◽

Heart Diseases ◽

Treatment Modalities ◽

Renal Diseases ◽

The Novel ◽

Geriatric Population ◽

Pulmonary Pathology ◽

Coronavirus Infection ◽

Novel Coronavirus

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2)is a virus responsible for the coronavirus infection that is currently causing a severe outbreak of the disease in the world, infecting and killing thousands to lacs of people. The pediatric and geriatric population is no exception to this. Children and older adults have less immunity, which makes them more susceptible to infection than other populations. But still the number of cases of Children where less as compared to adults and those having underlying pulmonary pathology or immunocompromising conditions are more vulnerable to infection. Some studies have shown that this virus causes more death in the older age population as compared to adults or children. Patients having any systemic conditions like diabetes, raised blood pressure, heart diseases, lung diseases and chronic renal diseases were more vulnerable to this infection. In this article, we will outline the epidemiology, symptoms, diagnosis, and treatment modalities of the novel coronavirus-2019(COVID 19) infection in humans, with more focusing on infection in children as well as in older adults.

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Changes in Provision of Psychotherapy in the Early Weeks of the COVID-19 Lockdown in Austria

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph17113815 ◽

2020 ◽

Vol 17 (11) ◽

pp. 3815 ◽

Cited By ~ 10

Author(s):

Thomas Probst ◽

Peter Stippl ◽

Christoph Pieh

Keyword(s):

Mental Health ◽

Health Care ◽

Mental Health Care ◽

Online Survey ◽

Personal Contact ◽

The Novel ◽

Central Measure ◽

Number Of Patients ◽

Novel Coronavirus

Reducing personal contacts is a central measure against the spreading of the novel coronavirus disease (COVID-19). This troubles mental health, but also mental health care as treatments usually take place in personal contact and switching to remote treatments might be necessary in times of COVID-19. The present study investigated the question how the provision of psychotherapy changed in the early weeks of the COVID-19 lockdown in Austria and whether there were differences between the four therapeutic orientations eligible in Austria (psychodynamic, humanistic, systemic, behavioral). Psychotherapists (N = 1547) completed an online survey. They entered their number of patients treated on average per week (in personal contact, via telephone, via Internet) in the early weeks of the COVID-19 lockdown in Austria as well as (retrospectively) in the months before. The number of patients treated on average per week in personal contact decreased (on average 81%; p < 0.001), whereas the number of patients treated on average per week via telephone and via Internet increased (on average 979% and 1561%; both p < 0.001). Yet, the decrease of psychotherapies through personal contact was not compensated for by increases of remote psychotherapies (p < 0.001). No differences between the four therapeutic orientations emerged. Results imply an undersupply of psychotherapy in the COVID-19 lockdown and that further changes are necessary to cover the increased need for timely psychotherapy in times of COVID-19.

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“Door to Treatment” Outcomes of Cancer Patients during the COVID-19 Pandemic

Chemotherapy ◽

10.1159/000511884 ◽

2020 ◽

pp. 1-6

Author(s):

Naziye Ak ◽

Sezai Vatansever

Keyword(s):

Cancer Patients ◽

Treatment Time ◽

Index Case ◽

Neoadjuvant Treatment ◽

The Novel ◽

Newly Diagnosed ◽

Intravenous Treatment ◽

Number Of Patients ◽

Significant Difference ◽

Novel Coronavirus

Background: The novel coronavirus disease 2019 has become a worldwide threat. We aimed to explore reflections of these unexpected changes to newly diagnosed cancer patients. Method: We searched the 2 months after the index case of our country. The first admission day and the first day of intravenous treatment of newly diagnosed patients were recorded. Results: In the 60 days measured during the pandemic, the total number of patients on polyclinics was 159/weekdays, and the total applied chemotherapy cycles were 276/week. For comparison, the total numbers in the previous year were 267/weekday and 363/week for polyclinic and applied chemotherapy cycles, respectively. The total number of newly admitted patients in 2020 was 283. For comparison, the number of new patients in the same 60-day period in 2019 was 495. Patients who were admitted for adjuvant treatment required a median of 8 days for the first course, those who were admitted for neoadjuvant treatment required 12 days, and metastatic patients required 14 days; there were no significant differences between treatment types (p = 0.233). However, the median treatment time was 11.5 and 17 days, in 2020 and in 2019, respectively. A significant difference was observed between the 2 groups (p < 0.001). Conclusion: The effective shift of workers and accurate regulations have not resulted in apparent delays in patient care. While a decrease in the number of patients has detected, faster healthcare service was introduced to newly diagnosed patients. The reason for the decrease in the number of patients should be investigated with new studies.

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Possible Role of Adenosine in COVID-19 Pathogenesis and Therapeutic Opportunities

Frontiers in Pharmacology ◽

10.3389/fphar.2020.594487 ◽

2020 ◽

Vol 11 ◽

Author(s):

Jonathan D. Geiger ◽

Nabab Khan ◽

Madhuvika Murugan ◽

Detlev Boison

Keyword(s):

Respiratory Distress Syndrome ◽

Respiratory Distress ◽

Distress Syndrome ◽

Adenosine Kinase ◽

Nucleoside Transporter ◽

The Novel ◽

Equilibrative Nucleoside Transporter ◽

Novel Coronavirus ◽

End Stage

The outbreak of the novel coronavirus disease 2019 (COVID-19) caused by Severe Acute Respiratory Syndrome CoronaVirus-2 (SARS-CoV-2) requires urgent clinical interventions. Crucial clinical needs are: 1) prevention of infection and spread of the virus within lung epithelia and between people, 2) attenuation of excessive lung injury in Advanced Respiratory Distress Syndrome, which develops during the end stage of the disease, and 3) prevention of thrombosis associated with SARS-CoV-2 infection. Adenosine and the key adenosine regulators adenosine deaminase (ADA), adenosine kinase (ADK), and equilibrative nucleoside transporter 1 may play a role in COVID-19 pathogenesis. Here, we highlight 1) the non-enzymatic role of ADA by which it might out-compete the virus (SARS-CoV-2) for binding to the CD26 receptor, 2) the enzymatic roles of ADK and ADA to increase adenosine levels and ameliorate Advanced Respiratory Distress Syndrome, and 3) inhibition of adenosine transporters to reduce platelet activation, thrombosis and improve COVID-19 outcomes. Depending on the stage of exposure to and infection by SARS-CoV-2, enhancing adenosine levels by targeting key adenosine regulators such as ADA, ADK and equilibrative nucleoside transporter 1 might find therapeutic use against COVID-19 and warrants further investigation.

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Current Status on Treatments and Clinical Trials for COVID-19 (Preprint)

10.2196/preprints.22701 ◽

2020 ◽

Author(s):

Guosheng Yin ◽

Chenyang Zhang ◽

Huaqing Jin

Keyword(s):

Clinical Trials ◽

Phase Ii ◽

Developmental Process ◽

Current Situation ◽

Current Status ◽

The Novel ◽

Fast Speed ◽

Death Toll ◽

Number Of Patients ◽

Novel Coronavirus

UNSTRUCTURED With the worldwide rapidly growing number of patients infected with the novel coronavirus (COVID-19), the death toll has also been climbing up at a fast speed. There is an urgent need to search for cures for COVID-19 patients. A large number of clinical trials have been launched to test some existing or new antiviral therapeutics and vaccines. In contrast to starting from the scratch, many trials are initiated directly in phase II or III with the hope to expedite the developmental process. We summarize the information on the registered trials for the top ten COVID-19 drugs, and give an overview on the current situation and trend of treatments and clinical trials. In particular, we review those trials that have already been finished and discuss lessons that can be learned from them.

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Turning Calamity into Opportunity: COVID-19 & Dental Practice

Journal of Dentistry and Oral Sciences ◽

10.37191/mapsci-2582-3736-2(3)-039 ◽

2020 ◽

Author(s):

Arpit Sikri

Keyword(s):

Treatment Options ◽

Treatment Modalities ◽

Effective Vaccine ◽

Dental Practice ◽

The Novel ◽

Global Challenge ◽

Novel Coronavirus ◽

The Impact ◽

Preventive Methods ◽

Viable Treatment

The novel coronavirus disease (COVID-19) pandemic, caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), remains a global challenge. Even after extensive research going on globally, an effective vaccine and other viable treatment options have eluded investigators. Therefore, guidelines by the higher authorities and following the precautions as well as protocols provide the best approach in controlling the spread of the disease. In this article, various treatment modalities, preventive methods, and transmission routes of COVID-19 are discussed along with the impact of COVID-19 in dental practice and remedial measures to fight against the same.

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Effect of Lockdown,Temperature,and Humidity on the Pattern of COVID-19 in Erbil Province,Kurdistan Region, Iraq

Diyala Journal of Medicine ◽

10.26505/djm.20025821123 ◽

2021 ◽

Vol 20 (2) ◽

pp. 56-67

Author(s):

Rundk Hwaiz ◽

◽

Katan Ali ◽

Namir Al-Tawil

Keyword(s):

Relative Humidity ◽

Air Temperature ◽

Death Rate ◽

Weather Conditions ◽

World Health ◽

The Novel ◽

Number Of Patients ◽

Temperature And Humidity ◽

Novel Coronavirus ◽

Health Organization

Background: COVID-19 was first reported in Erbil province in Iraq on March 19, 2020. The effect of lockdown on reducing the spread of the novel coronavirus and the effect of weather conditions (air temperature and humidity) on the daily reported number of cases and death rate of COVID-19 were investigated during April to July, 2020. Objective: To investigate the effect of lock down on reducing the spread of the novel coronavirus pandemic and the effect of weather conditions (air temperature and humidity) on the daily reported number of cases and death rate of COVID-19. Patients and Methods: The data collected during three different periods, the first (total lockdown), followed by the second period of lockdown relaxation, which was followed by the third period (interrupted relaxation of lockdown) that reported hundreds of new cases daily. The real-time PCR .assay was performed on suspected COVID-19 patients according to the protocol established by the World Health Organization. Results: Temperature and relative humidity were recorded in Erbil city in Iraq. Patients’ age ranged (2-70) years old. Out of (1469) patients confirmed positive with COVID-19, 57.7% of them were males, 31.3% were females, and the rest (11%) were children. The mean number of patients per day was 32.77 during the period of interrupted relaxation lockdown which was significantly higher than in the total-lock down period (3.88 patient), and the relaxation lockdown period (1.93 patient). The mortality rate per day was 0.77 during the period of interrupted relaxation lockdown was significantly higher than the rates (0.0%) of the other periods. Moreover, increasing the temperature increased the number of confirmed cases in July while, low relative humidity significantly increased the rate of reported cases. Conclusion: The increase in the number of reported cases of COVID-19, might be related to the interruption of lockdown. Moreover, the daily reported cases and mortality rates increased by increasing the temperature from April to June.

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