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 Nonepileptic Myoclonus in COVID-19: Case Report

2021 ◽  
pp. 194187442110043
Author(s):  
Henly Hewan ◽  
Annie Yang ◽  
Aparna Vaddiparti ◽  
Benison Keung
Keyword(s):  
Case Report ◽  
Critically Ill ◽  
Recovery Phase ◽  
Critically Ill Patient ◽  
High Dose ◽  
The Novel ◽  
Neurological Manifestations ◽  
Immune Mediated ◽  
Novel Coronavirus ◽  
Post Infectious

In late 2019, the novel coronavirus, SARS-CoV-2, and the disease it causes, COVID-19, was identified. Since then many different neurological manifestations of COVID-19 have been well reported. Movement abnormalities have been rarely described. We report here a critically ill patient with COVID-19 who developed generalized myoclonus during the recovery phase of the infection. Myoclonus was associated with cyclical fevers and decreased alertness. Movements were refractory to conventional anti-epileptic therapies. There was concern that myoclonus could be part of a post-infectious immune-mediated syndrome. The patient improved fully with a 4-day course of high-dose steroids. Our experience highlights a rare, generalized myoclonus syndrome associated with COVID-19 that may be immune-mediated and is responsive to treatment.

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.

Coronavirus disease 2019 (COVID-19): a new challenge in untreated wastewater

2020 ◽  
Vol 47 (8) ◽  
pp. 1005-1009 ◽  
Author(s):  
Akshay Kumar Chaudhry ◽  
Payal Sachdeva
Keyword(s):  
Human Health ◽  
Human Exposure ◽  
Etiologic Agent ◽  
Decision Makers ◽  
The Novel ◽  
Successful Management ◽  
Virus Shedding ◽  
Untreated Wastewater ◽  
Novel Coronavirus

COVID-19 outbreak was declared a pandemic by the WHO on 12 March 2020. As of 27 May 2020, WHO statistics exhibited that more than five million confirmed cases have been reported globally. Much remains unclear about the fate and impact of SARS-CoV-2, the novel coronavirus 2019, in wastewater. SARS-CoV-2 infection, the etiologic agent of the current COVID-19 pandemic, is followed by virus shedding in the stool. The quantification of SARS-CoV-2 in wastewater, therefore, enables monitoring of the prevalence of infections among the population through wastewater-based epidemiology. This review discusses the possible spread of the SARS-CoV-2 virus in wastewater and its impact on human health, if any. The information and resources outlined in this paper are based on recently published studies and provide information to decision-makers on the successful management of COVID-19 and reduce the risk of human exposure to COVID-19. Additionally, systems-based approaches to curtail COVID-19 spread are also discussed.

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 Cardiac Echocardiography in COVID-19 Infection

2020 ◽  
Vol 04 (01) ◽  
pp. 56-60
Author(s):  
Rohan Kapur ◽  
Naveen Garg ◽  
K. K. Kapur ◽  
Pranav Kapoor ◽  
Poonam Malhotra Kapoor
Keyword(s):  
Myocardial Infarction ◽  
Cardiac Involvement ◽  
Troponin I ◽  
Service Providers ◽  
The Novel ◽  
Cardiac Enzymes ◽  
Cardiac Evaluation ◽  
Novel Coronavirus ◽  
Cardiac Manifestations ◽  
Current Guidelines

AbstractThe novel COVID-19 disease mainly affects respiratory organs; however, involvement of cardiovascular system is also not uncommon. Cardiac involvement can manifest as myocarditis, heart failure, myocardial infarction, pulmonary embolism, or arrhythmias in COVID-19 patients. This novel Coronavirus enters into the cells of the human body by binding to ACE-2 receptors which are predominantly present on pneumocytes and cardiomyocytes. The damage to myocardium is manifested by the increase in cardiac enzymes such as troponin-I, CK-MB, and NT pro-BNP. Although echocardiogram is an important tool in the cardiac evaluation of COVID-19 patients, its indiscriminate use is discouraged, owing to the risk of transmission to echocardiography service providers, as well as possible risk of contaminating echocardiography equipment. In this article, we discuss the different mechanisms and cardiac manifestations of COVID-19. We also review the current guidelines for echocardiography evaluation of COVID-19 patients as well as current recommendations on safety of echocardiography personnel and equipment against contamination. We also include our experience of two cases in which COVID-19 affliction of heart was strongly suspected, and echocardiography clinched the diagnosis.

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 An atypical case: RT-PCR-negative, sero-positive covid-19 patient

Pneumologia ◽  
2020 ◽  
Vol 69 (2) ◽  
pp. 107-114
Author(s):  
William Suriady ◽  
Andika Chandra Putra ◽  
Wiwien Heru Wiyono ◽  
Mohammad Fahmi Alatas ◽  
Bettia Bermawi ◽  
...  
Keyword(s):  
False Negative ◽  
Severe Pneumonia ◽  
World Health ◽  
Diagnostic Process ◽  
The Novel ◽  
Rt Pcr ◽  
Atypical Case ◽  
Polymerase Chain ◽  
Novel Coronavirus ◽  
Health Organization

Abstract The novel coronavirus disease-2019 (COVID-19), caused by the severe acute respiratory syndrome-coronavirus-2 (SARS-CoV-2), has become a public health emergency of international concern. The first confirmed COVID-19 case in Indonesia was announced on 2 March 2020, and later on, 11,192 confirmed cases were reported as of 3 May. The World Health Organization has stated that performing a real-time reverse transcription–polymerase chain reaction (RT-PCR) specific for SARS-CoV-2 on specimens from the upper and the lower respiratory tracts, especially nasopharyngeal and oropharyngeal swabs, is the standard diagnostic procedure for COVID-19. In Indonesia, we also use other diagnostic tests, such as rapid antibody tests specific for SARS-CoV-2. Herein, we report an atypical case of COVID-19 and describe the diagnostic process, the clinical course, with progression to severe pneumonia on Week 3 of illness and the case management. We also try to highlight the possibility of false-negative RT-PCR tests.

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 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 How to Treat COVID-19 Patients at Home in the Italian Context: An Expert Opinion

2021 ◽  
Vol 13 (1) ◽  
pp. 251-258
Author(s):  
Davide Roberto Donno ◽  
Ignazio Grattagliano ◽  
Alessandro Rossi ◽  
Pierangelo Lora Aprile ◽  
Gerardo Medea ◽  
...  
Keyword(s):  
Psychological Impact ◽  
The Novel ◽  
Home Therapy ◽  
Home Management ◽  
Expert Opinions ◽  
Novel Coronavirus ◽  
Italian Context ◽  
The Impact ◽  
Current Guidelines ◽  
At Home

The impact of the coronavirus disease (COVID-19), caused by the novel coronavirus SARS-CoV-2, continues to be widespread, with more than 100 million cases diagnosed in more than 220 countries since the virus was first identified in January 2020. Although patients with mild to moderate forms of COVID-19 could be efficiently managed at home, thus reducing the pressure on the healthcare system and minimizing socio-psychological impact on patients, no trial has been proposed, conducted, or even published on COVID-19 home therapy to date. These expert opinions provide indications on the therapeutical at home management of COVID-19 patients, based on the evidence from the literature and on current guidelines.

Sign in / Sign up

Export Citation Format

Share Document