Is SARS-CoV-2 transmitted by asymptomatic and pre-symptomatic infected individuals?

2021 ◽  
Vol 54 ◽  
Author(s):  
Abigail F. Melicor ◽  
Katrina Loren R. Rey ◽  
Leonila F. Dans
Keyword(s):  
Case Reports ◽  
Case Series ◽  
The Philippines ◽  
World Health ◽  
Current Evidence ◽  
Wide Confidence Interval ◽  
Cross Sectional ◽  
Viral Shedding ◽  
Asymptomatic Patients ◽  
Health Organization

KEY FINDINGSAsymptomatic and pre-symptomatic transmission of SARS-CoV-2 may occur.• Manifestations of COVID-19 are highly varied and may include asymptomatic cases, who do not manifest with anysigns and symptoms despite testing positive for COVID-19 by viral nucleic acid tests. Pre-symptomatic cases areinfected individuals who are still in their incubation period, hence do not exhibit any symptoms yet but eventuallydevelop symptoms.• As of June 2020, only 586 (2.8%) of the 20,990 active cases in the Philippines were classified as asymptomatic,but it is unclear whether cases are pre-symptomatic or carriers (true asymptomatic).• Based on 36 observational studies (case reports, case series, cross-sectional and cohort studies) and 9 statisticalmodeling analysis, asymptomatic and pre-symptomatic transmission of SARS-CoV-2 may occur. However, 3studies reported no transmission from pre-symptomatic and asymptomatic cases.• Studies on viral load comparing symptomatic cases with pre-symptomatic and asymptomatic cases reportedcontradicting results. The duration of viral shedding was significantly longer for symptomatic patients comparedto asymptomatic patients but similar for asymptomatic and pre-symptomatic patients.• Therewas no difference in the transmission rates of symptomatic and asymptomatic cases. However,the estimatedinfectivity and probability of transmission was higherfor symptomatic cases compared to asymptomatic cases, butresults were imprecise due to a wide confidence interval.• The World Health Organization (WHO) and Centers for Disease Control and Prevention (CDC) recognize thepossibility of pre-symptomatic and asymptomatic transmission. According to WHO, current evidence suggestsasymptomatic cases are less likely to transmit the virus than symptomatic cases.

scholarly journals Is Non-Chlamydial Non-Gonococcal Urethritis Associated with Significant Clinical Complications in Men? A Systematic Review

2020 ◽  
Vol 14 (1) ◽  
pp. 1-13 ◽  
Author(s):  
Cassandra E.L. Fairhead ◽  
Alexander Hampson ◽  
Louis Dwyer-Hemmings ◽  
Nikhil Vasdev
Keyword(s):  
Systematic Review ◽  
Reactive Arthritis ◽  
Case Reports ◽  
Case Series ◽  
Current Evidence ◽  
Future Research ◽  
Qualitative Synthesis ◽  
Cross Sectional ◽  
Gonococcal Urethritis ◽  
Clinical Complications

Background: It is estimated that between 50 and 89% of non-gonococcal urethritis is not caused by Chlamydia trachomatis. Associations between non-chlamydial non-gonococcal urethritis (NCNGU) with balanoposthitis, epididymo-orchitis and reactive arthritis have been suggested, but evidence to support these often-theoretical relationships is sparse and further investigation is called for. Concerns over increasing antimicrobial resistance has rendered the need for clarity over this question ever more pressing in recent years. A review of the current evidence on the complications of NCNGU in men is therefore urgently warranted. Objective: This systematic review summarizes and evaluates the available evidence that NCNGU, whether symptomatic or asymptomatic, causes the significant complications that are already well-recognized to be associated with non-gonococcal urethritis. These significant complications are epididymo-orchitis, balanoposthitis, and sexually-acquired reactive arthritis (Reiter's syndrome) including arthritis or conjunctivitis. Summary: We conducted a systematic review and qualitative synthesis using the Preferred Reporting Items for Systematic Reviews and Meta-Analysis framework. Five databases (PubMed, EMBASE, Cumulative Index to Nursing and Allied Health Literature, PsycINFO, and British Nursing Index) were searched. We included studies that measured clinical outcome after diagnosis of NCNGU in men. Bias was assessed using variations of the Newcastle-Ottawa scale. Data were extracted and entered into a pre-written data abstraction proforma. Seven peer-review studies were included. This included 2 retrospective cohort studies, 1 case series, 2 case reports and 2 cross-sectional studies. The studies described and analyzed 3 types of complication: balanitis, posthitis and/or meatitis; reactive arthritis and/or conjunctivitis; and epididymitis. All studies reported one or more complications. Key Messages: This review identifies an important avenue for future research: while the available evidence suggests that NCNGU has the potential to cause significant complications in men, with the strongest evidence existing for balanitis, posthitis and/or meatitis, the nature and significance of these relationships is far from clear. The findings of this review suggest that prospective, adequately powered research into whether there is a causal link between NCNGU and significant clinical complications in men would be highly worthwhile. The findings of this review raise important questions about the utility of the term NCNGU in research and clinical practice.

scholarly journals Prices, Availability and Affordability of Medicines with Value-Added Tax Exemption: A Cross-Sectional Survey in the Philippines

2020 ◽  
Vol 17 (14) ◽  
pp. 5242 ◽  
Author(s):  
Krizzia Lambojon ◽  
Jie Chang ◽  
Amna Saeed ◽  
Khezar Hayat ◽  
Pengchao Li ◽  
...  
Keyword(s):  
Value Added ◽  
Access To Medicines ◽  
The Philippines ◽  
Unit Price ◽  
World Health ◽  
Value Added Tax ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Universal Healthcare ◽  
Health Organization

Background: Developing countries, such as the Philippines, started implementing policies to improve access to medicines, which is a vital step toward universal healthcare coverage. This study aimed to evaluate the prices, availability and affordability of prescribed medicines for diabetes, hypercholesterolemia and hypertension with the exemption of 12% value-added tax in the Philippines. Methods: The prices and availability of 50 medicines were collected in August 2019 from 36 public and 42 private medicine outlets in six regions of the Philippines, following a modified methodology developed by the World Health Organization and Health Action International. Availability is reported as the percentage of outlets in which the surveyed medicine was found at the time of visit. Medicine prices are expressed as median unit prices (MUPs) in Philippine Peso. Affordability is calculated based on the number of days’ wages required for the lowest-paid unskilled government worker to purchase a monthly treatment. Results: The mean availability of surveyed medicines was low in both public and private sectors, with 1.3% for originator brands (OBs) and 25.0% for lowest-priced generics (LPGs) in public outlets, and 34.7% and 35.4% in private outlets, respectively. The MUP of medicines were higher in private outlets, and OBs have higher unit price compared to the generic equivalents. Treatments with OBs were unaffordable, except for gliclazide, but the affordability of most LPGs is generally good. Conclusion: Access to medicines in both sectors was affected by low availability. High prices of OBs influenced the affordability of medicines even with tax exemption. A review of policies and regulations should be initiated for a better access to medicines in the Philippines.

scholarly journals Angka Kasus Kekerasan dalam Rumah Tangga di Kota Manado Tahun 2018-2019

e-CliniC ◽  
2021 ◽  
Vol 9 (1) ◽  
Author(s):  
Rebennia Tumewu ◽  
Djemi Tomuka ◽  
Erwin G. Kristanto
Keyword(s):  
Domestic Violence ◽  
World Health Organization ◽  
Physical Violence ◽  
Case Reports ◽  
Secondary Data ◽  
World Health ◽  
Or Education ◽  
Cross Sectional ◽  
British Crime Survey ◽  
Health Organization

Abstract: Domestic violence is universal and can occur regardless of age, profession, economic level or education of the victims. According to World Health Organization, 1 in 3 women in the world had experienced physical or sexual violence. In addition, according to the British Crime Survey, 1/3 of victims of domestic violence were male. This study was aimed to obtain the number of domestic violence cases in Manado during 2018-2019. This was a retrospective and descriptive study with a cross-sectional design using secondary data of domestic violence case reports at Polresta Manado regarding domestic violence in Manado 2018-2019. The results showed that there were 111 cases of domestic violence in 2018-2019 in Manado. Most cases occurred at Sario District (14 cases; 13%) dominated by physical violence (78 cases; 70%), committed by male perpetrators (101 cases; 91%), husbands of the victims (101 cases; 91%), and age group of 15-24 years (43 cases; 39%). In conclusion, there was a fluctuation in the number of domestic violence cases; an increase of 51.3% comparing to the number of cases in 2012-2013 and a decrease of 27.4% comparing to the number of cases in 2015-2016.Keywords: domestic violence Abstrak: Kekerasan dalam rumah tangga (KDRT) merupakan hal yang universal dan dapat terjadi tanpa memandang usia, profesi, tingkat ekonomi, maupun pendidikan dari korban. Menurut data WHO (World Health Organization), 1 dari 3 perempuan di dunia pernah mengalami kekerasan fisik maupun seksual. Selain itu, menurut British Crime Survey, 1/3 korban KDRT ialah laki-laki.  Penelitian ini bertujuan untuk mendapatkan angka kasus KDRT di Kota Manado tahun 2018-2019. Jenis penelitian ialah deskriptif retrospektif dengan desain potong lintang. Data sekunder yaitu laporan kasus KDRT di Polresta Manado mengenai KDRT di Kota Manado pada tahun 2018-2019. Hasil penelitian mendapatkan, kasus KDRT pada tahun 2018-2019 di Kota Manado berjumlah 111 kasus, paling banyak terjadi di Kecamatan Sario (14 kasus; 13%), didominasi oleh jenis kekerasan fisik (78 kasus; 70%), pelaku berjenis kelamin laki-laki (101 kasus; 91%), yang merupakan suami korban (101 kasus; 91%), dan paling sering dialami oleh kelompok usia 15-24 tahun (43 kasus; 39%). Simpulan penelitian ini ialah terdapat fluktuasi angka kasus KDRT dibandingkan jumlah kasus pada tahun 2012-2013 yaitu terjadi peningkatan sebanyak 51,3% dan terjadi penurunan 27,4% bila dibandingkan dengan jumlah kasus pada tahun 2015-2016.Kata kunci: kekerasan dalam rumah tangga (KDRT)

scholarly journals Transplant Drugs against SARS, MERS and COVID-19

2020 ◽  
Vol 1 (2) ◽  
pp. 71-84
Author(s):  
René Hage ◽  
Carolin Steinack ◽  
Fiorenza Gautschi ◽  
Macé M. Schuurmans
Keyword(s):  
Treatment Option ◽  
Calcineurin Inhibitor ◽  
Virus Disease ◽  
Case Reports ◽  
Calcineurin Inhibitors ◽  
World Health ◽  
Current Evidence ◽  
Pubmed Database ◽  
Health Organization ◽  
Meta Analyses

There is an urgent need to develop drugs and vaccines to counteract the effects of the new coronavirus SARS-CoV-2 and adequately treat the corona virus disease (COVID-19). As these drugs are still under investigation, research also focuses on existing medication with proven effectiveness in other coronaviral diseases. The advantages of existing therapeutic drugs that are currently approved (for other indications) are the known safety profile, general availability and relatively lower costs involved in extending the purpose to a new disease. Calcineurin inhibitors (CNI) are drugs that have shown effectiveness in several coronaviral diseases, and are well-known and widely used drugs in transplant medicine. The aim of this narrative review is to present the current evidence of CNI in coronaviral diseases, the biophysiology of CNI and to suggest possible ways to study CNI as a new treatment option for COVID-19. We searched original papers, observational studies, case reports, and meta-analyses published between 2000 and 2020 in English in the PubMed database and Google Scholar using the keywords: (coronavirus), (treatment), (MERS), (SARS), (COVID-19), (tacrolimus), (ciclosporin), (cyclosporin) AND (calcineurin inhibitor). We excluded studies in patients with clear indications for immunosuppressive therapy. Additionally, we searched in the preprint servers and the World Health Organization bulletin. Ten studies were identified and included. Calcineurin inhibitor therapy has been suggested to be effective for coronaviral diseases in different settings. The results are summarized in a table. CNI should be investigated as a first treatment option based on evidence of direct antiviral effects and its properties preventing severe systemic hyperinflammation, as has been observed in COVID-19 with predominantly pulmonary immunopathological changes.

scholarly journals COVID-19 in the light of current clinical eye research

2021 ◽  
pp. 112067212199891
Author(s):  
Mashael Al-Namaeh
Keyword(s):  
Observational Studies ◽  
Geriatric Patients ◽  
Case Reports ◽  
Case Series ◽  
World Health ◽  
Wuhan City ◽  
Pubmed Search ◽  
Chinese Province ◽  
Novel Coronavirus ◽  
Health Organization

COVID-19 is a disease caused by a SARS-CoV-2 virus infection first reported in Wuhan city, Chinese province of Hubei, in December 2019. Previously known as 2019 Novel Coronavirus (2019-nCoV) respiratory disease, COVID-19 was declared official name by the World Health Organization (WHO) as COVID-19 in February 2020. By July 2nd, 2020 10,818,005 confirmed cases with 519,467 COVID-19 deaths worldwide. The aim of this review article is to inform the audience of what is available in the current literature on how COVID-19 affects the eyes in adults, children, and elderly. PubMed search was used between December 2019 and July 2nd, 2020. Randomized trials, observational studies, case series or case reports, and letters of research, letters to editors were selected for confirmed cases of COVID-19. According to current scientific literature since the outbreak in December 2019 there have been 218 papers written. Conjunctivitis and keratoconjunctvitis have been reported in adults with COVID-19. Further studies are needed in children and geriatric patients.

scholarly journals Coronavirus Disease and Abdominal Pain: Mechanism, Diagnostic, and Treatment

2021 ◽  
Vol 9 (F) ◽  
Author(s):  
Aleksandra Bozhinovska
Keyword(s):  
Abdominal Pain ◽  
World Health Organization ◽  
Case Reports ◽  
Case Series ◽  
World Health ◽  
Publication Date ◽  
Gi Symptoms ◽  
The World ◽  
Methods Of Synthesis ◽  
Health Organization

BACKGROUND: On March 11, 2020, the General Director of the World Health Organization has announced that according to the organization, the level of spread and severity of symptoms of coronavirus disease (COVID-19) is becoming alarming and because of that, it can be characterized as a pandemic. The assessment of the World Health Organization stimulated more urgent and belligerent actions from the governments as the number of case reports and studies on COVID-19 symptoms and treatment increased dramatically. AIM: In this paper, the aim is to make a review of the studies and case reports/series that indicate that abdominal pain is one of the manifestations of COVID-19. METHODS: A search was performed on two electronic databases: PubMed Central and Google Scholar, using the key words “COVID-19 and abdominal pain.” Case reports and case series in adults and children were included regardless of the language, region, or the publication date. The methods of synthesis and comparison were also used. RESULTS: In general, it can be noted that the manifestation of the COVID-19 infection on the digestive tract and the consequences on the same are not fully examined. CONCLUSION: The conclusion of the analyzed papers is that clinical practitioners in COVID-19 pandemic should carefully distinguish abdominal pain and other GI symptoms from COVID-19 manifestations and should exclude acute surgical condition.

scholarly journals Clinical Presentation of Patients Infected with Coronavirus Disease 19: A Systematic Review

2020 ◽  
Vol 13 ◽  
pp. 117863372095207
Author(s):  
Tadesse Sheleme ◽  
Firomsa Bekele ◽  
Tasissa Ayela
Keyword(s):  
Systematic Review ◽  
English Language ◽  
Clinical Symptoms ◽  
Case Series ◽  
World Health ◽  
Cross Sectional ◽  
Sputum Production ◽  
Novel Coronavirus ◽  
Health Organization ◽  
Study Designs

Background: The coronavirus disease-19 has been labeled a pandemic by World Health Organization. By virtue of its highly contagious attribution, this virus has spread across over the world and the numbers are still rapidly increasing. Increasing numbers of confirmed cases and mortality rates of coronavirus disease 2019 are occurring in several countries. The aim of this systematic review was to summarize clinical presentations of this newly emerging coronavirus disease. Methods: A systematic review of published articles was conducted using databases such as PubMed, Scopus, and Google Scholar. A search was conducted on 18 to 25 April 2020. Search terms included “novel coronavirus,” “2019 novel coronavirus,” “Coronavirus disease 2019,” “COVID-19,” “severe acute respiratory syndrome coronavirus 2.” The studies published in the English language and their full texts available were included. The eligible study designs were cross-sectional, case-control, cohort, and case series. Results: Thirty (30) studies which contain 4829 participants were included in this review. From included studies, the age of infected patients were found in range 0.25 to 94 years. The main clinical symptoms of COVID-19 patients were fever (77.6%), cough (64.8%), fatigue (27.2%), dyspnea (21.2%) and sputum production (18.0%). Conclusion: This systematic review identified that fever, cough, fatigue, and dyspnea were the most common reported clinical features of coronavirus disease 19. Understanding of the clinical spectrum and impact of this novel disease is important for all individuals, especially for healthcare workers to manage and prevent it.

High-dose or multi-day praziquantel for imported schistosomiasis? A systematic review

2019 ◽  
Vol 26 (7) ◽  
Author(s):  
Giulia Cucchetto ◽  
Dora Buonfrate ◽  
Valentina Marchese ◽  
Paola Rodari ◽  
Anna Ferrari ◽  
...  
Keyword(s):  
Systematic Review ◽  
Clinical Trials ◽  
World Health Organization ◽  
Case Reports ◽  
Case Series ◽  
Sub Saharan Africa ◽  
World Health ◽  
The World ◽  
Endemic Areas ◽  
Health Organization

Abstract Background Schistosomiasis affects more than 260 million people worldwide, mostly in sub-Saharan Africa, where more than 280 000 deaths per year are estimated. In the past few years, the increasing flow of migrants from endemic areas and the upward number of international travels have caused the emergence of the disease also in non-endemic areas. A single course of praziquantel (PZQ) 40 mg/kg is the first-line treatment recommended by the World Health Organization, mainly based on clinical trials conducted in endemic countries. No trials have been performed in non-endemic areas. Methods We carried out a systematic review of case reports and case series published between 1956 and August 2017 on cases of chronic schistosomiasis (infection acquired >3 months before) diagnosed in non-endemic areas and treated with PZQ. Primary outcome was to assess the number of different therapeutic regimens deployed and their frequency of use, calculated as the number of reports for each regimen over the total number of included cases. Results The final database included 99 case reports and 51 case series, for a total of 1433 patients. In 57 of the 150 records (38%) the administered treatment was different from the one recommended by the World Health Organization. The proportion of ‘alternative’ regimens included increased doses of PZQ (up to 80 mg/kg) and/or prolonged duration of treatment and/or doses repeated some days/weeks apart. About 50% of the records regarding Western short-term travellers reported a non-standard treatment. Conclusion This is the first complete catalogue of the published experience with PZQ outside of endemic areas in the situation where reinfection is not an issue. We found a wide heterogeneity of the therapeutic regimens reported. Multicenter clinical trials conducted in non-endemic areas and guidelines specifically addressing the treatment of imported cases of chronic schistosomiasis are needed.

scholarly journals Extra-Pulmonary Manifestations of Coronavirus Disease 2019: A Multi System Disease

2021 ◽  
Vol 7 (1) ◽  
pp. 14-20
Author(s):  
Vijayasree Biruduraju ◽  
◽  
Ankita R. Chawla ◽  
Keyword(s):  
World Health Organization ◽  
Case Reports ◽  
Case Series ◽  
Pulmonary Complications ◽  
World Health ◽  
Organ Systems ◽  
Pulmonary Manifestations ◽  
The World ◽  
Extra Pulmonary ◽  
Health Organization

Introduction The outbreak of coronavirus disease 2019 (COVID-19), caused by the severe acute respiratory distress syndrome coronavirus 2 (SARS-CoV- 2), has been recently declared a pandemic by the World Health Organization. Apart from acute respiratory manifestations, SARS-CoV-2 may also adversely affect other organ systems. To date, however, there is a very limited understanding of the manifestations and management of COVID-19 related conditions outside of the pulmonary system. This study provides an overview of the current literature about the extra pulmonary manifestations of COVID-19 that may affect the renal, cardiovascular, gastrointestinal, hematological, hematopoietic, neurological, or reproductive systems. This study also describes the current understanding of the extra pulmonary manifestations caused by COVID-19 to improve the management and prognosis of patients with COVID-19. Materials and Methods A total number of 200 hospitalized patients with COVID-19 disease were retrospectively evaluated for extra-pulmonary manifestations findings or complications. These patients had undergone various imaging studies, blood examinations during the course of hospital stay. The data reviewed using the institutional PACS, database system over a period of four months (August to November 2020). Results Among the 200 patients (males and females), 175 of them had extra-pulmonary complications. Various extra-pulmonary findings such as acute kidney injury, renal failure, cytokinase strome, acute myocardial injury, congestive cardiac failure, pulmonary thromboembolism, gastrointestinal, neurological complications were observed. Inclusion and Exclusion Criteria All retrospective clinical studies, case series, and case reports with data on extra-pulmonary manifestations in COVID-19 that were published from the end of December 2019 till the end of February 2021 were included. Studies that did not mention extrapulmonary manifestations were excluded. Literature Search The review was based on publications available on PubMed and data collected by the World Health Organization (WHO). Search terms used were ‘novel coronavirus 2019 (2019-nCoV)’, ‘SARS- CoV-2’, or ‘COVID-19’ combined with ‘asymptomatic’, ‘gastrointestinal’, ‘cardiac’, ‘neurological’, ‘hepatic’, ‘hematological’, ‘renal’, ‘psychiatric’, ‘hematological’, and ‘atypical’.

Origin of Chordoid Glioma of the Third Ventricle

2006 ◽  
Vol 130 (4) ◽  
pp. 460-464 ◽  
Author(s):  
Norman E. Leeds ◽  
Frederick F. Lang ◽  
Teresa Ribalta ◽  
Raymond Sawaya ◽  
Gregory N. Fuller
Keyword(s):  
Case Reports ◽  
Third Ventricle ◽  
Case Series ◽  
Gross Anatomy ◽  
Individual Case ◽  
Gliomatosis Cerebri ◽  
World Health ◽  
The Third ◽  
Chordoid Glioma ◽  
Health Organization

Abstract Context.—Chordoid glioma is a relatively recently described unique glial neoplasm that has been formally codified by the World Health Organization in Pathology and Genetics of Tumours of the Nervous System, in which it is included along with astroblastoma and gliomatosis cerebri under the rubric “Tumors of Uncertain Origin.” Many examples of chordoid glioma come to clinical attention only at a relatively large size and occupy a large portion of the third ventricle. Accordingly, the anatomic origin of chordoid glioma has been unclear and debated. Objective.—To examine the regional anatomic origin of chordoid glioma. Data Sources.—The clinical, imaging, histologic, immunophenotypic, and ultrastructural data in previously published case series and individual case reports of chordoid glioma were reviewed in conjunction with the study of a new case of chordoid glioma that presented at a relatively small size, thereby facilitating neuroanatomic localization. Conclusions.—Chordoid glioma exhibits features of specialized ependymal differentiation on ultrastructural examination, and all examples reported in the literature to date have displayed a highly stereotypical suprasellar anatomic localization and an ovoid shape, as seen on neuroimaging studies and gross anatomy. Neuroanatomic, radiologic, and clinical evidence supports an anatomic origin for chordoid glioma from the vicinity of the lamina terminalis.

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