scholarly journals Abdominal symptoms as an initial manifestation of COVID-19 infection: Report of two cases

2020 ◽  
Author(s):  
PATRÍCIA YOKOO ◽  
Eduardo Kaiser Ururahy Nunes Fonseca ◽  
Marcelo Oranges Filho ◽  
Rodrigo Caruso Chate ◽  
Gilberto Szarf ◽  
...  
Keyword(s):  
Emergency Department ◽  
Respiratory Symptoms ◽  
Early Stage ◽  
The Novel ◽  
Initial Finding ◽  
Initial Manifestation ◽  
Abdominal Symptoms ◽  
Novel Coronavirus ◽  
Lung Base

Abstract The novel coronavirus (COVID-19) pandemic started in December 2019 in Wuhan (Hubei, China) and spread rapidly; therefore, it is essential to detect the disease at an early stage and immediately isolate the infected patients [1]. The most common symptoms of COVID-19 infection include fever, asthenia, cough and dyspnea [2]. However, some patients are asymptomatic from the respiratory symptoms, and may only present abdominal manifestations as an initial finding, what creates a diagnostic challenge.We describe two cases with diagnostic confirmations of COVID-19 who showed up at the Emergency Department with abdominal symptoms before presenting respiratory manifestations, and who had their initial suspicion based on the findings of the thoracoabdominal transition, demonstrating the importance of an adequate assessment of the lung base images.

scholarly journals The Impact of Armed Conflict on the Epidemiological Situation of COVID-19 in Libya, Syria and Yemen

2021 ◽  
Vol 9 ◽  
Author(s):  
Mohamed A. Daw
Keyword(s):  
Armed Conflict ◽  
Early Stage ◽  
Armed Conflicts ◽  
Cumulative Number ◽  
The Novel ◽  
Global Pandemic ◽  
Large Numbers ◽  
Public Data ◽  
Novel Coronavirus ◽  
The Impact

Background: Since the Arab uprising in 2011, Libya, Syria and Yemen have gone through major internal armed conflicts. This resulted in large numbers of deaths, injuries, and population displacements, with collapse of the healthcare systems. Furthermore, the situation was complicated by the emergence of COVID-19 as a global pandemic, which made the populations of these countries struggle under unusual conditions to deal with both the pandemic and the ongoing wars. This study aimed to determine the impact of the armed conflicts on the epidemiology of the novel coronavirus (SARS-CoV-2) within these war-torn countries and highlight the strategies needed to combat the spread of the pandemic and its consequences.Methods: Official and public data concerning the dynamics of the armed conflicts and the spread of SARS-COV-2 in Libya, Syria and Yemen were collected from all available sources, starting from the emergence of COVID-19 in each country until the end of December 2020. Datasets were analyzed by a set of statistical techniques and the weekly resolved data were used to probe the link between the intensity levels of the conflict and the prevalence of COVID-19.Results: The data indicated that there was an increase in the intensity of the violence at an early stage from March to August 2020, when it approximately doubled in the three countries, particularly in Libya. During that period, few cases of COVID-19 were reported, ranging from 5 to 53 cases/day. From September to December 2020, a significant decline in the intensity of the armed conflicts was accompanied by steep upsurges in the rate of COVID-19 cases, which reached up to 500 cases/day. The accumulative cases vary from one country to another during the armed conflict. The highest cumulative number of cases were reported in Libya, Syria and Yemen.Conclusions: Our analysis demonstrates that the armed conflict provided an opportunity for SARS-CoV-2 to spread. The early weeks of the pandemic coincided with the most intense period of the armed conflicts, and few cases were officially reported. This indicates undercounting and hidden spread during the early stage of the pandemic. The pandemic then spread dramatically as the armed conflict declined, reaching its greatest spread by December 2020. Full-blown transmission of the COVID-19 pandemic in these countries is expected. Therefore, urgent national and international strategies should be implemented to combat the pandemic and its consequences.

scholarly journals Emergency department preparation for COVID-19: accelerated care units

2020 ◽  
Vol 37 (7) ◽  
pp. 402-406 ◽  
Author(s):  
Jeanne Noble ◽  
Nida Felicija Degesys ◽  
Elizabeth Kwan ◽  
Edward Grom ◽  
Cortlyn Brown ◽  
...  
Keyword(s):  
Emergency Department ◽  
San Francisco ◽  
Negative Pressure ◽  
Potential Model ◽  
Adaptive Leadership ◽  
Protective Equipment ◽  
The Novel ◽  
Leadership Challenges ◽  
Novel Coronavirus ◽  
Rapid Deployment

By 11 February 2020 when the WHO named the novel coronavirus (SARS-CoV-2) and the disease it causes (COVID-19), it was evident that the virus was spreading rapidly outside of China. Although San Francisco did not confirm its first locally transmitted cases until the first week of March, our ED and health system began preparing for a potential COVID-19 surge in late February 2020.In this manuscript, we detail how the above responses were instrumental in the rapid deployment of two military-grade negative-pressure medical tents, named accelerated care units (ACU). We describe engagement of our workforce, logistics of creating new care areas, ensuring safety through personal protective equipment access and conservation, and the adaptive leadership challenges that this process posed.We know of no other comprehensive examples of how EDs have prepared for COVID-19 in the peer-reviewed literature. Many other EDs both in and outside of California have requested access to the details of how we operationalised our ACUs to facilitate their own planning. This demonstrates the urgent need to disseminate this information to our colleagues. Below we describe the process of developing and launching our ACUs as a potential model for other EDs around the country.

scholarly journals The basic reproduction number and prediction of the epidemic size of the novel coronavirus (COVID-19) in Shahroud, Iran

2020 ◽  
Vol 148 ◽  
Author(s):  
A. Khosravi ◽  
R. Chaman ◽  
M. Rohani-Rasaf ◽  
F. Zare ◽  
S. Mehravaran ◽  
...  
Keyword(s):  
Basic Reproduction Number ◽  
Reproduction Number ◽  
Early Stage ◽  
Screening Tests ◽  
The Novel ◽  
Epidemic Size ◽  
Serial Interval ◽  
Novel Coronavirus ◽  
Interval Distribution ◽  
The Basic Reproduction Number

Abstract The aim of this study was to estimate the basic reproduction number (R0) of COVID-19 in the early stage of the epidemic and predict the expected number of new cases in Shahroud in Northeastern Iran. The R0 of COVID-19 was estimated using the serial interval distribution and the number of incidence cases. The 30-day probable incidence and cumulative incidence were predicted using the assumption that daily incidence follows a Poisson distribution determined by daily infectiousness. Data analysis was done using ‘earlyR’ and ‘projections’ packages in R software. The maximum-likelihood value of R0 was 2.7 (95% confidence interval (CI): 2.1−3.4) for the COVID-19 epidemic in the early 14 days and decreased to 1.13 (95% CI 1.03–1.25) by the end of day 42. The expected average number of new cases in Shahroud was 9.0 ± 3.8 cases/day, which means an estimated total of 271 (95% CI: 178–383) new cases for the period between 02 April to 03 May 2020. By day 67 (27 April), the effective reproduction number (Rt), which had a descending trend and was around 1, reduced to 0.70. Based on the Rt for the last 21 days (days 46–67 of the epidemic), the prediction for 27 April to 26 May is a mean daily cases of 2.9 ± 2.0 with 87 (48–136) new cases. In order to maintain R below 1, we strongly recommend enforcing and continuing the current preventive measures, restricting travel and providing screening tests for a larger proportion of the population.

scholarly journals Who Should Get Vaccinated First? An effective Network Information-driven Priority Vaccination Strategy

2021 ◽  
Author(s):  
Dong Liu ◽  
Chi Kong Tse ◽  
Rosa H. M. Chan ◽  
Choujun Zhan
Keyword(s):  
Large Scale ◽  
Early Stage ◽  
Vaccination Strategy ◽  
Cumulative Number ◽  
The Novel ◽  
Vaccination Programs ◽  
Network Information ◽  
Network Properties ◽  
Effective Network ◽  
Novel Coronavirus

Abstract Approval of emergency use of the Novel Coronavirus Disease 2019 (COVID-19) vaccines in many countries has brought hope to ending the COVID-19 pandemic sooner. Considering the limited vaccine supply in the early stage of COVID-19 vaccination programs in most countries, a highly relevant question to ask is: who should get vaccinated first? In this article we propose a network information- driven vaccination strategy where a small number of people in a network (population) are categorized, according to a few key network properties, into priority groups. Using a network-based SEIR model for simulating the pandemic progression, the network information-driven vaccination strategy is compared with a random vaccination strategy. Results for both large-scale synthesized networks and real social networks have demonstrated that the network information-driven vaccination strategy can significantly reduce the cumulative number of infected individuals and lead to a more rapid containment of the pandemic. The results provide insight for policymakers in designing an effective early-stage vaccination plan.

scholarly journals Case Report: Disposition of Symptomatic Probable COVID-19

2020 ◽  
Vol 4 (3) ◽  
pp. 336-339
Author(s):  
Aleq Jaffery ◽  
John Slakey ◽  
David Zodda ◽  
Douglas Finefrock
Keyword(s):  
Emergency Department ◽  
Case Report ◽  
Distress Syndrome ◽  
Healthcare Providers ◽  
The Novel ◽  
Moderate Risk ◽  
Risk Of Progression ◽  
Novel Coronavirus ◽  
Tools And Techniques

Introduction: The novel coronavirus disease 2019 (COVID-19) presents a challenge for healthcare providers in terms of diagnosis, management, and triage of cases requiring admission. Case Report: A 47-year-old male with symptoms suspicious for COVID-19, pulse oximetry of 93% on room air, and multifocal pneumonia was risk stratified and safely discharged from the emergency department (ED) despite having moderate risk of progression to acute respiratory distress syndrome. He had resolution of his symptoms verified by telephone follow-up. Conclusion: Various risk-stratifying tools and techniques can aid clinicians in identifying COVID-19 patients who can be safely discharged from the ED.

scholarly journals Immunopathogenesis of COVID-19 and early immunomodulators

2020 ◽  
Vol 63 (7) ◽  
pp. 239-250 ◽  
Author(s):  
Kyung-Yil Lee ◽  
Jung-Woo Rhim ◽  
Jin-Han Kang
Keyword(s):  
Lung Injury ◽  
Early Stage ◽  
Severe Pneumonia ◽  
Biochemical Properties ◽  
Etiologic Agent ◽  
Host Immune System ◽  
The Novel ◽  
Immune Mediated ◽  
Novel Coronavirus ◽  
Current Guidelines

The novel coronavirus disease 2019 (COVID-19) is spreading globally. Although its etiologic agent is discovered as severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2), there are many unsolved issues in COVID-19 and other infectious diseases. The causes of different clinical phenotypes and incubation periods among individuals, species specificity, and cytokine storm with lymphopenia as well as the mechanism of damage to organ cells are unknown. It has been suggested that in viral pneumonia, virus itself is not a direct cause of acute lung injury; rather, aberrant immune reactions of the host to the insults from viral infection are responsible. According to its epidemiological and clinical characteristics, SARS-CoV-2 may be a virus with low virulence in nature that has adapted to the human species. Current immunological concepts have limited ability to explain such unsolved issues, and a presumed immunopathogenesis of COVID-19 is presented under the proteinhomeostasis-system hypothesis. Every disease, including COVID-19, has etiological substances controlled by the host immune system according to size and biochemical properties. Patients with severe pneumonia caused by SARS-CoV-2 show more severe hypercytokinemia with corresponding lymphocytopenia than patients with mild pneumonia; thus, early immunomodulator treatment, including corticosteroids, has been considered. However, current guidelines recommend their use only for patients with advanced pneumonia or acute respiratory distress syndrome. Since the immunopathogenesis of pneumonia may be the same for all patients regardless of age or severity and the critical immune-mediated lung injury may begin in the early stage of the disease, early immunomodulator treatment, including corticosteroids and intravenous immunoglobulin, can help reduce morbidity and possibly mortality rates of older patients with underlying conditions.

scholarly journals REVIEW ON PANDEMIC OUTBREAK OF CORONAVIRUS (COVID-19): VIROLOGY, AVAILABLE TREATMENT, PREVENTION, AND FUTURE PROJECTION

2020 ◽  
pp. 1-6
Author(s):  
Abhijit Mohan Kanavaje ◽  
Vipul Ajit Sansare
Keyword(s):  
Early Stage ◽  
Scale Up ◽  
Therapeutic Agents ◽  
Family Welfare ◽  
The Novel ◽  
Future Projection ◽  
Potential Threat ◽  
Treatment Regimens ◽  
Treatment And Prevention ◽  
Novel Coronavirus

Since the outbreak of the novel coronavirus disease COVID-19, caused by the SARS-CoV-2 virus, this disease has spread rapidly around the globe. On 11 March 2020, WHO declared Novel Coronavirus Disease (COVID-19) outbreak as a pandemic and reiterated the call for countries to take immediate actions and scale up the response to treat, detect and reduce transmission to save people’s lives. As of 3 April 2020, according to the Ministry of Health & Family Welfare (MoHFW), a total of 2301 COVID-19 cases (including 55 foreign nationals) have been reported in 29 states/union territories. These include 156 who have been cured/discharged,1 who has migrated, and 56 deaths in India. Considering the potential threat of a pandemic, scientists and physicians have been racing to understand this new virus and the pathophysiology of this disease to uncover possible treatment regimens and discover effective therapeutic agents and vaccines. The objective of this review article was to have a preliminary opinion about the disease, the ways of treatment, and prevention in this early stage of this outbreak.

scholarly journals Vaccines and Therapies in Development for SARS-CoV-2 Infections

2020 ◽  
Vol 9 (6) ◽  
pp. 1885 ◽  
Author(s):  
David Wu ◽  
Raghuram Koganti ◽  
Upendra P. Lambe ◽  
Tejabhiram Yadavalli ◽  
Shyam S. Nandi ◽  
...  
Keyword(s):  
Respiratory Symptoms ◽  
The Elderly ◽  
The Novel ◽  
Antiviral Therapies ◽  
Emerging Therapies ◽  
Novel Coronavirus

The current COVID-19 pandemic is caused by the novel coronavirus SARS-CoV-2. The virus causes severe respiratory symptoms which manifest disproportionately in the elderly. Currently, there are over 6.5 million cases and 380,000 deaths reported. Given the current severity of the outbreak, there is a great need for antiviral therapies and vaccines to treat and prevent COVID-19. In this review, we provide an overview of SARS-CoV-2 and discuss the emerging therapies and vaccines that show promise in combating COVID-19. We also highlight potential viral targets that could be exploited by researchers and drug manufacturers.

scholarly journals Divergent Trends in Emergency Department Presentations Amidst the Novel Coronavirus Disease 2019 Pandemic in Chicago, Illinois

2021 ◽  
Author(s):  
Sadiya S. Khan ◽  
Al'ona Furmanchuk ◽  
Laura E. Seegmiller ◽  
Faraz S. Ahmad ◽  
Bernard S. Black ◽  
...  
Keyword(s):  
Emergency Department ◽  
The Novel ◽  
Novel Coronavirus
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