An Update on SARS-COV-2/COVID-19 with Particular Reference on Its Clinical Pathology, Pathogenesis, Immunopathology and Mitigation Strategies – A Review

Coronavirus Disease 2019 (COVID-19), caused by a novel coronavirus named Severe Acute Respiratory Syndrome - Coronavirus-2 (SARS-CoV-2), emerged in early December 2019 in China and attained a pandemic situation worldwide by its rapid spread to nearly 167 countries with 287.239 confirmed cases and 11.921 human deaths with a case fatality rate (CFR) of around 4 per cent. Bats were considered as the reservoir host, and the search of a probable intermediate host is still going on. Animals have anticipated culprit of SARS-CoV-2 as of now. The disease is mainly manifested by pneumonia and related respiratory signs and symptoms, but the involvement of the gastrointestinal system and nervous system is also suggested. The severe form of the disease associated with death is mainly reported in older and immune-compromised patients with pre-existing disease history. Death in severe cases is attributed to respiratory failure associated with hyperinflammation. Cytokine storm syndrome associated with rampant inflammation in response to SARS-CoV-2 infection is considered as the leading killer of COVID-19 patients. COVID-19 patients were reported with higher levels of many pro-inflammatory cytokines and chemokines like IFN-g, IL-1b, IP-10, and MCP-1. Furthermore, severe cases of COVID-19 revealed higher levels of TNF-α, G-CSF, and MIP-1A. Blood profile of the COVID-19 patients exhibits lymphopenia, leucopenia, thrombocytopenia and RNAaemia along with increased levels of aspartate aminotransferase. SARS-CoV-2 infection in pregnant women does not lead to fetus mortalities unlike other zoonotic coronaviruses like SARS-CoV and MERS-CoV, with no evidence of intrauterine transmission to neonates. Rapid and confirmatory diagnostics have been developed, and high efforts are being made to develop effective vaccines and therapeutics. In the absence of any virus-specific therapeutic, internationally health care authorities are recommending adoption of effective prevention and control measures to counter and contain this pandemic virus. This paper is an overview of this virus and the disease with a particular focus on SARS-COV-2 / COVID-19 clinical pathology, pathogenesis and immunopathology along with a few recent research developments.

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COVID -19 in Geriatric Population

Journal of Pharmaceutical Research International ◽

10.9734/jpri/2021/v33i46b32967 ◽

2021 ◽

pp. 499-504

Author(s):

Pratiksha S. Thakare ◽

Samruddhi Gujar ◽

Shakib Sheikh ◽

Vrushali Dighikar

Keyword(s):

Immune System ◽

Case Fatality ◽

Clinical Pathology ◽

The United States ◽

Severe Form ◽

Mitigation Strategies ◽

Geriatric Population ◽

Control And Prevention ◽

Coronavirus Infection ◽

Prevention Center

The causative factors of Coronavirus disease mainly the viruses. Through news we aware that pneumonia cases seen recently in Wuhan city, China. Due to unknown causes. Coronaviruses that cause illness such as a common cold. The Coronavirus infection identified with respiratory symptoms and pneumonia, the severe form of coronavirus infection mainly associated with death and low immune system patients. It is very important for us to more focus on geriatric people because in our countries, geriatric group people facing health problems at this present situation. According to articles Clinical Pathology, Pathogenesis, Immunopathology, and Mitigation Strategies, in that said geriatric people and low immune system patient with symptoms related history are more prone to COVID infection. But according to recent information by WHO all people are at risk of coronavirus but mostly geriatric people facing more risk of developing a severe respiratory infection. Geriatric people easily get coronavirus syndrome due to physical changes that occur as increasing age. There were 95% of these deaths seen in geriatric people above 60 years older. Above 50% of all fatal conditions occurred in geriatric people between 60- 80 years ago. There having disease control and prevention center, which indicate that rates of hospitalizations, intensive care unit admissions and mortality reported among COVID-19 cases in the United States are substantially higher among patients older than 45 years compared with younger patients, with case-fatality rates exceeding 1.4% among patients aged 55 to 64 years and exceeding 2.7% among those aged 65 to 74 years.

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Weil’s Disease Death Investigation and Outbreak Control Measures Instituted in the Field Area of a Family Health Center in Thiruvananthapuram, Kerala—A Case Report

Indian Journal of Clinical Medicine ◽

10.1177/26339447211067580 ◽

2022 ◽

pp. 263394472110675

Author(s):

Pranav V. Vasisht

Keyword(s):

Family Health ◽

Case Fatality ◽

Severe Form ◽

Control Measures ◽

Case Presentation ◽

Depth Interview ◽

Care Guidelines ◽

Death Investigation ◽

Field Area ◽

Infectious Disorder

Introduction: Weil syndrome, a rare infectious disorder, is a severe form of the bacterial infection caused by Leptospira bacteria known as leptospirosis. Weil syndrome is characterized by dysfunction of the kidneys and liver, abnormal enlargement of the liver (hepatomegaly), persistent yellowing of the skin, mucous membranes, whites of the eyes (jaundice), and/or alterations in consciousness. In most cases, Weil syndrome occurs among individuals who are exposed to affected animals. Case Presentation and Summary: The investigation of death was done by a team consisting of doctor, junior health inspector, and ASHA workers of the area. We did a qualitative approach of in-depth interview of the wife and daughter-in-law of the deceased for data collection. The patient’s name and other details are not revealed for anonymity. No particular statistical analyses are used for this case reporting. The CARE guidelines were followed for writing this report. Conclusion: Leptospirosis is a disease of outbreak potential and has high case fatality rate. Timely identification of cases and institution of preventive measures is very important in preventing outbreaks. The surveys conducted in the area did not reveal any signs of an imminent or ongoing outbreak of leptospirosis.

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COVID-19 Pandemic: Public Health Risk Assessment and Risk Mitigation Strategies

Journal of Personalized Medicine ◽

10.3390/jpm11121243 ◽

2021 ◽

Vol 11 (12) ◽

pp. 1243

Author(s):

Dae-Young Kim ◽

Surendra Krushna Shinde ◽

Saifullah Lone ◽

Ramasubba Reddy Palem ◽

Gajanan Sampatrao Ghodake

Keyword(s):

Public Health ◽

Risk Assessment ◽

Risk Mitigation ◽

Case Fatality ◽

Mitigation Strategies ◽

Control Measures ◽

Mitigation Measures ◽

Average Case ◽

Diverse Range ◽

Health Crisis

A newly emerged respiratory viral disease called severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) is also known as pandemic coronavirus disease (COVID-19). This pandemic has resulted an unprecedented global health crisis and devastating impact on several sectors of human lives and economies. Fortunately, the average case fatality ratio for SARS-CoV-2 is below 2%, much lower than that estimated for MERS (34%) and SARS (11%). However, COVID-19 has a much higher transmissibility rate, as evident from the constant increase in the count of infections worldwide. This article explores the reasons behind how COVID-19 was able to cause a global pandemic crisis. The current outbreak scenario and causes of rapid global spread are examined using recent developments in the literature, epidemiological features relevant to public health awareness, and critical perspective of risk assessment and mitigation strategies. Effective pandemic risk mitigation measures have been established and amended against COVID-19 diseases, but there is still much scope for upgrading execution and coordination among authorities in terms of organizational leadership’s commitment and diverse range of safety measures, including administrative control measures, engineering control measures, and personal protective equipment (PPE). The significance of containment interventions against the COVID-19 pandemic is now well established; however, there is a need for its effective execution across the globe, and for the improvement of the performance of risk mitigation practices and suppression of future pandemic crises.

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High COVID-19 transmission potential associated with re-opening universities can be mitigated with layered interventions

Nature Communications ◽

10.1038/s41467-021-25169-3 ◽

2021 ◽

Vol 12 (1) ◽

Author(s):

Ellen Brooks-Pollock ◽

Hannah Christensen ◽

Adam Trickey ◽

Gibran Hemani ◽

Emily Nixon ◽

...

Keyword(s):

Prediction Interval ◽

Mitigation Strategies ◽

Control Measures ◽

Transmission Model ◽

Model Parameters ◽

Infection Rates ◽

First Year Students ◽

Transmission Potential ◽

Plausible Model ◽

Effective Option

AbstractControlling COVID-19 transmission in universities poses challenges due to the complex social networks and potential for asymptomatic spread. We developed a stochastic transmission model based on realistic mixing patterns and evaluated alternative mitigation strategies. We predict, for plausible model parameters, that if asymptomatic cases are half as infectious as symptomatic cases, then 15% (98% Prediction Interval: 6–35%) of students could be infected during the first term without additional control measures. First year students are the main drivers of transmission with the highest infection rates, largely due to communal residences. In isolation, reducing face-to-face teaching is the most effective intervention considered, however layering multiple interventions could reduce infection rates by 75%. Fortnightly or more frequent mass testing is required to impact transmission and was not the most effective option considered. Our findings suggest that additional outbreak control measures should be considered for university settings.

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Robust Estimation of Infection Fatality Rates during the Early Phase of a Pandemic

10.1101/2020.04.08.20057729 ◽

2020 ◽

Cited By ~ 1

Author(s):

Perikles Simon

Keyword(s):

Robust Estimation ◽

Case Fatality ◽

Mitigation Strategies ◽

Global Burden ◽

Data Sets ◽

Serological Testing ◽

Time Data ◽

Age Cohorts ◽

Spanish Influenza ◽

And Control

AbstractDuring a pandemic, robust estimation of case fatality rates (CFRs) is essential to plan and control suppression and mitigation strategies. At present, estimates for the CFR of COVID-19 caused by SARS-CoV-2 infection vary considerably. Expert consensus of 0.1–1% covers in practical terms a range from normal seasonable Influenza to Spanish Influenza. In the following, I deduce a formula for an adjusted Infection Fatality Rate (IFR) to assess mortality in a period following a positive test adjusted for selection bias.Official datasets on cases and deaths were combined with data sets on number of tests. After data curation and quality control, a total of IFR (n=819) was calculated for 21 countries for periods of up to 26 days between registration of a case and death.Estimates for IRFs increased with length of period, but levelled off at >9days with a median for all 21 countries of 0.11 (95%-CI: 0.073–0.15). An epidemiologically derived IFR of 0.040 % (95%-CI: 0.029%– 0.055%) was determined for Iceland and was very close to the calculated IFR of 0.057% (95%-CI: 0.042– 0.078), but 2.7–6-fold lower than CFRs. IFRs, but not CFRs, were positively associated with increased proportions of elderly in age-cohorts (n=21, spearman’s ρ=.73, p =.02).Real-time data on molecular and serological testing may further displace classical diagnosis of disease and its related death. I will critically discuss, why, how and under which conditions the IFR, provides a more solid early estimate of the global burden of a pandemic than the CFR.

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COVID-19: A HEALTH PERSPECTIVE

Journal of Business & Economic Analysis ◽

10.1142/s2737566821500018 ◽

2021 ◽

Vol 04 (01) ◽

pp. 57-81

Author(s):

SHEENA WONG ◽

GOH JING EN ◽

DAVID KOH

Keyword(s):

Public Health ◽

Severe Pneumonia ◽

Unknown Origin ◽

Mitigation Strategies ◽

Diagnostic Methods ◽

Control Measures ◽

Infection Control Measures ◽

Rapid Characterization ◽

Silver Lining

A severe pneumonia of an unknown origin was reported in Wuhan, China in December 2019. The disease, now known as coronavirus disease 2019 (COVID-19), has evolved into a public health emergency of international concern and wreaked worldwide havoc. An unprecedented and vigorous scientific response has allowed the accelerated discovery of the virus and reliable diagnostic methods; a rapid characterization of the disease and its impacts so as to better apply precautionary and public health measures; and resulted in remarkable progress in the development of mitigation strategies, including the development of vaccines at breakneck speed. This paper provides a health perspective of the virus and the pandemic it caused, based on available best evidence. Controversies surrounding the origin of the virus, its incubation period and infectivity, presentation and course of the disease, testing, as well as treatments and vaccinations are highlighted. The pandemic response, including infection control measures, and considerations on mental and economic health, alongside physical health is discussed. Moving forward, it is important that the global community is aware and better informed. More resources are needed to strengthen public health systems and healthcare infrastructure and delivery. This virus has the potential to persist and become endemic and seasonal in communities. Thus, non-pharmaceutical interventions (e.g. wearing masks, frequent hand washing, etc.) might become the new normal in a post-pandemic world. The silver lining in the COVID-19 cloud may be the lessons it provides, so that we may be better prepared to respond to an inevitable next pandemic.

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COVID-19 in Sudan

The Journal of Infection in Developing Countries ◽

10.3855/jidc.14520 ◽

2021 ◽

Vol 15 (02) ◽

pp. 204-208

Author(s):

Ayman Ahmed ◽

Nouh Saad Mohamed ◽

Sarah Misbah EL-Sadig ◽

Lamis Ahmed Fahal ◽

Ziad Bakri Abelrahim ◽

...

Keyword(s):

Health Systems ◽

Case Fatality Rate ◽

Case Fatality ◽

Control Measures ◽

Religious Practices ◽

Mass Gathering ◽

Fatality Rate ◽

High Case Fatality Rate ◽

The Government ◽

And Control

The steadily growing COVID-19 pandemic is challenging health systems worldwide including Sudan. In Sudan, the first COVID-19 case was reported on 13th March 2020, and up to 11 November 2020 there were 14,401 confirmed cases of which 9,535 cases recovered and the rest 3,750 cases were under treatment. Additionally, 1,116 deaths were reported, indicating a relatively high case fatality rate of 7.7%. Several preventive and control measures were implemented by the government of Sudan and health partners, including the partial lockdown of the country, promoting social distancing, and suspending mass gathering such as festivals and performing religious practices in groups. However, new cases still emerging every day and this could be attributed to the noncompliance of the individuals to the advocated preventive measurements.

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Mass SARS-CoV-2 Testing in a Dormitory-Style Correctional Facility in Arkansas

American Journal of Public Health ◽

10.2105/ajph.2020.306117 ◽

2021 ◽

pp. e1-e10

Author(s):

Lindsay K. Tompkins ◽

Jayleen K. L. Gunn ◽

Blake Cherney ◽

Jason E. Ham ◽

Roberta Horth ◽

...

Keyword(s):

Infection Prevention ◽

Close Contact ◽

Correctional Facility ◽

Mitigation Strategies ◽

Control Measures ◽

Infection Prevention And Control ◽

Strict Enforcement ◽

Prevention And Control Measures ◽

And Control ◽

Respiratory Specimens

Objectives. To assess SARS-CoV-2 transmission within a correctional facility and recommend mitigation strategies. Methods. From April 29 to May 15, 2020, we established the point prevalence of COVID-19 among incarcerated persons and staff within a correctional facility in Arkansas. Participants provided respiratory specimens for SARS-CoV-2 testing and completed questionnaires on symptoms and factors associated with transmission. Results. Of 1647 incarcerated persons and 128 staff tested, 30.5% of incarcerated persons (range by housing unit = 0.0%–58.2%) and 2.3% of staff tested positive for SARS-CoV-2. Among those who tested positive and responded to symptom questions (431 incarcerated persons, 3 staff), 81.2% and 33.3% were asymptomatic, respectively. Most incarcerated persons (58.0%) reported wearing cloth face coverings 8 hours or less per day, and 63.3% reported close contact with someone other than their bunkmate. Conclusions. If testing remained limited to symptomatic individuals, fewer cases would have been detected or detection would have been delayed, allowing transmission to continue. Rapid implementation of mass testing and strict enforcement of infection prevention and control measures may be needed to mitigate spread of SARS-CoV-2 in this setting. (Am J Public Health. Published online ahead of print March 18, 2021: e1–e10. https://doi.org/10.2105/AJPH.2020.306117 )

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Serology surveillance of anti-SARS-CoV-2 antibodies among asymptomatic healthcare workers in Malaysian healthcare facilities designated for COVID-19 care

10.21203/rs.3.rs-37132/v1 ◽

2020 ◽

Author(s):

Yuan Liang Woon ◽

Yee Leng Lee ◽

Yoong Min Chong ◽

Nor Aliya Ayub ◽

Swarna Lata Krishnabahawan ◽

...

Keyword(s):

Clinical Signs ◽

Signs And Symptoms ◽

Healthcare Setting ◽

Public Hospitals ◽

Control Measures ◽

Infection Prevention And Control ◽

Personal Protection Equipment ◽

Strict Adherence ◽

The Past ◽

Increased Risk

Abstract IntroductionHealthcare workers (HCW) are presumed to be at increased risk of severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) infection due to occupational exposure to infected patients. We aim to determine the prevalence of anti-SARS-CoV-2 antibodies among asymptomatic HCW.MethodsWe prospectively recruited HCW from the National Public Health Laboratory and two COVID-19 designated public hospitals in Klang Valley, Malaysia between April 13th and May 12th, 2020. Quota sampling was applied to ensure adequate representation of the HCW involved in provision of care for patients directly and indirectly. All participants had worked in the respective healthcare facility for at least 30 days prior study enrollment. HCW who were previously confirmed with COVID-19 infection or listed as “patient under investigation” were excluded. A self-administered questionnaire was used to capture sociodemographic information, history of contact with COVID-19 cases within the past month, clinical signs and symptoms and adherence to universal precautions. Blood samples were taken to test for anti-SARS-CoV-2 antibodies by surrogate virus neutralization test.ResultsA total of 400 HCW were recruited, comprising 154 (38.5%) nurses, 103 (25.8%) medical doctors, 47 (11.8%) laboratory technologists and others (23.9%). The mean age was 35±7.8 years, with females predominant (74%). A majority (68.9%) reported direct contact with COVID-19 patients, body fluids of COVID-19 patients and/or contaminated objects and surfaces in the past month within their respective workplaces. Nearly all claimed to adhere to personal protection equipment (PPE) guidelines (97%-100% adherence) and hand hygiene practice (91%-96% adherence). None (95% CI: 0, 0.0095) of the participants had anti-SARS-CoV-2 antibodies detected, despite 135 (33.8%) reporting respiratory symptoms one month prior to study recruitment. One hundred and fifteen (29%) participants claimed to have contact with known COVID-19 persons outside of the workplace.ConclusionOur finding of zero seroprevalence among asymptomatic HCW suggests a low risk of asymptomatic COVID-19 infection in our healthcare setting; which is at expected levels for a country with an incidence of 26 per 100,000. The adequacy of PPE equipment and strict adherence to infection prevention and control measures offers considerable protection during contact with COVID-19 cases and should be ensured to prevent future nosocomial transmission.

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Conquering hypertension in Vietnam—solutions at grassroots level: study protocol of a cluster randomized controlled trial

Trials ◽

10.1186/s13063-020-04917-8 ◽

2020 ◽

Vol 21 (1) ◽

Author(s):

Duc A. Ha ◽

Oanh T. Tran ◽

Hoa L. Nguyen ◽

Germán Chiriboga ◽

Robert J. Goldberg ◽

...

Keyword(s):

Health Care Providers ◽

Controlled Trial ◽

Clinical Care ◽

Intervention Group ◽

Practice Change ◽

Control Measures ◽

Care Providers ◽

Effective Prevention ◽

Multi Media ◽

Cluster Randomized

Abstract Background Vietnam has been experiencing an epidemiologic transition to that of a lower-middle income country with an increasing prevalence of non-communicable diseases. The key risk factors for cardiovascular disease (CVD) are either on the rise or at alarming levels in Vietnam, particularly hypertension (HTN). Inasmuch, the burden of CVD will continue to increase in the Vietnamese population unless effective prevention and control measures are put in place. The objectives of the proposed project are to evaluate the implementation and effectiveness of two multi-faceted community and clinic-based strategies on the control of elevated blood pressure (BP) among adults in Vietnam via a cluster randomized trial design. Methods Sixteen communities will be randomized to either an intervention (8 communities) or a comparison group (8 communities). Eligible and consenting adult study participants with HTN (n = 680) will be assigned to intervention/comparison status based on the community in which they reside. Both comparison and intervention groups will receive a multi-level intervention modeled after the Vietnam National Hypertension Program including education and practice change modules for health care providers, accessible reading materials for patients, and a multi-media community awareness program. In addition, the intervention group only will receive three carefully selected enhancements integrated into routine clinical care: (1) expanded community health worker services, (2) home BP self-monitoring, and (3) a “storytelling intervention,” which consists of interactive, literacy-appropriate, and culturally sensitive multi-media storytelling modules for motivating behavior change through the power of patients speaking in their own voices. The storytelling intervention will be delivered by DVDs with serial installments at baseline and at 3, 6, and 9 months after trial enrollment. Changes in BP will be assessed in both groups at several follow-up time points. Implementation outcomes will be assessed as well. Discussion Results from this full-scale trial will provide health policymakers with practical evidence on how to combat a key risk factor for CVD using a feasible, sustainable, and cost-effective intervention that could be used as a national program for controlling HTN in Vietnam. Trial registration ClinicalTrials.gov NCT03590691. Registered on July 17, 2018. Protocol version: 6. Date: August 15, 2019.

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