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164 | Postacute COVID 19 An Overview and Approach to Classification As the coronavirus disease 2019 COVID 19 pandemic has progressed a large volume of literature has developed delineating the clinical manifestations of acute infection Recent reports have also started to describe persistent symptoms extending beyond the period of initial illness or hospitalization Anecdotes of different signs and symptoms occurring after acute infection have also arisen in the lay press Here we describe the current existing medical literature on the emerging concept of postacute COVID 19 and suggest an approach to classifying different manifestations of the syndrome We also review long term clinical manifestations observed in patients who recovered from infection due to other epidemic coronaviruses and briefly discuss potential mechanisms driving the phenomenon of postacute COVID 19 | 1 |
7 | Short term and Long term Rates of Postacute Sequelae of SARS CoV 2 Infection A Systematic Review Short term and long term persistent postacute sequelae of COVID 19 PASC have not been systematically evaluated The incidence and evolution of PASC are dependent on time from infection organ systems and tissue affected vaccination status variant of the virus and geographic region To estimate organ system specific frequency and evolution of PASC PubMed MEDLINE Scopus the World Health Organization Global Literature on Coronavirus Disease and CoronaCentral databases were searched from December 2019 through March 2021 A total of 2100 studies were identified from databases and through cited references Studies providing data on PASC in children and adults were included The Preferred Reporting Items for Systematic Reviews and Meta analyses PRISMA guidelines for abstracting data were followed and performed independently by 2 reviewers Quality was assessed using the Newcastle Ottawa Scale for cohort studies The main outcome was frequency of PASC diagnosed by 1 laboratory investigation 2 radiologic pathology and 3 clinical signs and symptoms PASC were classified by organ system ie neurologic cardiovascular respiratory digestive dermatologic and ear nose and throat as well as mental health constitutional symptoms and functional mobility From a total of 2100 studies identified 57 studies with 250 351 survivors of COVID 19 met inclusion criteria The mean SD age of survivors was 54 4 8 9 years 140 196 56 were male and 197 777 79 were hospitalized during acute COVID 19 High income countries contributed 45 studies 79 The median IQR proportion of COVID 19 survivors experiencing at least 1 PASC was 54 0 45 0 69 0 13 studies at 1 month short term 55 0 34 8 65 5 38 studies at 2 to 5 months intermediate term and 54 0 31 0 67 0 9 studies at 6 or more months long term Most prevalent pulmonary sequelae neurologic disorders mental health disorders functional mobility impairments and general and constitutional symptoms were chest imaging abnormality median IQR 62 2 45 8 76 5 difficulty concentrating median IQR 23 8 20 4 25 9 generalized anxiety disorder median IQR 29 6 14 0 44 0 general functional impairments median IQR 44 0 23 4 62 6 and fatigue or muscle weakness median IQR 37 5 25 4 54 5 respectively Other frequently reported symptoms included cardiac dermatologic digestive and ear nose and throat disorders In this systematic review more than half of COVID 19 survivors experienced PASC 6 months after recovery The most common PASC involved functional mobility impairments pulmonary abnormalities and mental health disorders These long term PASC effects occur on a scale that could overwhelm existing health care capacity particularly in low and middle income countries | 1 |
582 | Reporting and methodological quality of COVID 19 systematic reviews needs to be improved an evidence mapping To assess the reporting and methodological quality of COVID 19 systematic reviews and to analyze trends and gaps in the quality clinical topics author countries and populations of the reviews using an evidence mapping approach A structured search for systematic reviews concerning COVID 19 was performed using PubMed Embase Cochrane Library Campbell Library Web of Science CBM WanFang Data CNKI and CQVIP from inception until June 2020 The quality of each review was assessed using the Assessment of Multiple Systematic Reviews 2 AMSTAR 2 checklist and the Preferred Reporting Items for Systematic Reviews and Meta Analyses PRISMA checklist In total 243 systematic reviews met the inclusion criteria over 50 of which 128 52 7 were from 14 developing countries with China contributing the most reviews 76 31 3 In terms of methodological quality of the studies 30 12 3 were of moderate quality 63 25 9 were of low quality and 150 61 7 were of critically low quality In terms of reporting quality the median interquartile range PRISMA score was 14 10 18 Regarding the topics of the reviews 24 9 9 focused on the prevalence of COVID 19 69 28 4 focused on the clinical manifestations 30 12 3 focused on etiology 43 17 7 focused on diagnosis 65 26 7 focused on treatment 104 42 8 focused on prognosis and 25 10 3 focused on prevention These studies mainly focused on general patients with COVID 19 161 66 3 followed by children 22 9 1 and pregnant patients 18 7 4 This study systematically evaluated the methodological and reporting quality of systematic reviews of COVID 19 summarizing and analyzing trends in their clinical topics author countries and study populations | 0 |
639 | Mass Spectrometry based Proteomics and Glycoproteomics in COVID 19 Biomarkers Identification A Mini review The first corona pandemic coronavirus disease 2019 COVID 19 caused a huge health crisis and incalculable damage worldwide Knowledge of how to cure the disease is urgently needed Emerging immune escaping mutants of the virus suggested that it may be potentially persistent in human society as a regular health threat as the flu virus Therefore it is imperative to identify appropriate biomarkers to indicate pathological and physiological states and more importantly clinic outcomes Proteins are the performers of life functions and their abundance and modification status can directly reflect the immune status Protein glycosylation serves a great impact in modulating protein function The use of both unmodified and glycosylated proteins as biomarkers has also been proved feasible in the studies of SARS Zika virus influenza etc In recent years mass spectrometry based glycoproteomics as well as proteomics approaches advanced significantly due to the evolution of mass spectrometry We focus on the current development of the mass spectrometry based strategy for COVID 19 biomarkers investigation Potential application of glycoproteomics approaches and challenges in biomarkers identification are also discussed | 0 |
284 | The Neurological Manifestations of Post Acute Sequelae of SARS CoV 2 infection Coronavirus disease 2019 COVID 19 caused by the severe acute respiratory syndrome coronavirus 2 SARS CoV 2 is a global health challenge This review aims to summarize the incidence risk factors possible pathophysiology and proposed management of neurological manifestations of post acute sequelae of SARS CoV 2 infection PASC or neuro PASC based on the published literature The National Institutes of Health has noted that PASC is a multi organ disorder ranging from mild symptoms to an incapacitating state that can last for weeks or longer following recovery from initial infection with SARS CoV 2 Various pathophysiological mechanisms have been proposed as the culprit for the development of PASC These include but are not limited to direct or indirect invasion of the virus into the brain immune dysregulation hormonal disturbances elevated cytokine levels due to immune reaction leading to chronic inflammation direct tissue damage to other organs and persistent low grade infection A multidisciplinary approach for the treatment of neuro PASC will be required to diagnose and address these symptoms Tailored rehabilitation and novel cognitive therapy protocols are as important as pharmacological treatments to treat neuro PASC effectively With recognizing the growing numbers of COVID 19 patients suffering from neuro PASC there is an urgent need to identify affected individuals early to provide the most appropriate and efficient treatments Awareness among the general population and health care professionals about PASC is rising and more efforts are needed to understand and treat this new emerging challenge In this review we summarize the relevant scientific literature about neuro PASC | 1 |
2 | Longest reported case of symptomatic COVID 19 reporting positive for over 230 days in an immunocompromised patient in the United States Coronavirus 2019 COVID 19 pneumonia was first noted in Wuhan China Since the start of the pandemic there have been millions of cases diagnosed The average time from onset of symptoms to testing negative SARS CoV 2 via reverse transcription polymerase chain reaction is roughly 25 days In patients who continually test positive for COVID 19 it is essential to determine precisely which risk factors contribute to the increase in viral shedding duration We present a case about a 62 year old man who has persistently tested positive for COVID 19 for more than 230 days We followed his treatment course in which he had been hospitalized multiple times since the onset of symptoms back in April 2020 We have determined that patients with immunosuppression especially those taking corticosteroids are at increased risk of prolonged viral shedding It is essential to continually monitor these immunocompromised patients as they required a greater time period in order to have an appropriate immune response in which antibodies are created | 1 |
197 | Post COVID 19 precautions based on lessons learned from past pandemics a review In view of the spread of the contagious coronavirus disease COVID 19 globally the present review focuses on the details of past pandemic diseases along with comparisons and lessons learned A general awareness of COVID 19 infection is addressed and it is compared with the Spanish flu pandemic Based on the successes failures and lessons learned in the past governmental efforts must be undertaken to empower citizens by providing accurate information and implementing post COVID 19 precautions that need to be taken now to stop the spread and recurrence of the virus locally and to restore health and economic normalcy A detailed literature survey of past pandemics is undertaken in order to extract the successes failures and lessons learned from previous breakouts The comparison of past pandemics will enable us to determine post COVID 19 precautions that should be followed Separate tables are prepared to highlight the lessons learned and measures to be taken Both general precautions and preventive measures for pregnant women are compiled The literature shows a continuous struggle of humans with disease outbreaks with the most adverse impact of the Spanish flu killing 20 50 million people Precautions need to be taken including social distancing compulsory mask wearing avoiding public gatherings and washing hands regularly The lessons from earlier pandemics show that they were equally devastating and vaccines were not available at the time of outbreaks Vaccines developed for polio H1N1 measles and other viral diseases have proven to save countless lives Living with COVID 19 and evolving the work culture of protecting oneself and protecting others also has to be adopted COVID 19 has become an everyday topic of discussion throughout the world indicating the increasing number of COVID 19 cases deaths and recoveries The lessons learned from past pandemics such as social distancing wearing masks avoiding public gatherings and adherence to guidelines along with personal hygiene are the key measures that must be taken in order to live with COVID 19 Precautions for the elderly and pregnant women advised by medical authorities are to be strictly adhered to These will help in reducing COVID 19 cases and in turn will reduce the pressure on hospitals to serve those in need India has learned lessons from the past and the present pandemic and will move towards growth through its self reliance | 1 |
628 | Why lockdown and distance learning during the COVID 19 pandemic are likely to increase the social class achievement gap The COVID 19 pandemic has forced teachers and parents to quickly adapt to a new educational context distance learning Teachers developed online academic material while parents taught the exercises and lessons provided by teachers to their children at home Considering that the use of digital tools in education has dramatically increased during this crisis and it is set to continue there is a pressing need to understand the impact of distance learning Taking a multidisciplinary view we argue that by making the learning process rely more than ever on families rather than on teachers and by getting students to work predominantly via digital resources school closures exacerbate social class academic disparities To address this burning issue we propose an agenda for future research and outline recommendations to help parents teachers and policymakers to limit the impact of the lockdown on social class based academic inequality | 0 |
454 | The OM 85 bacterial lysate inhibits SARS CoV 2 infection of epithelial cells by downregulating SARS CoV 2 receptor expression Treatments for coronavirus disease of 2019 COVID 19 which is caused by severe acute respiratory syndrome coronavirus 2 SARS CoV 2 are urgently needed but remain limited SARS CoV 2 infects cells through interactions of its spike S protein with ACE2 and TMPRSS2 on host cells Multiple cells and organs are targeted particularly airway epithelial cells OM 85 a standardized lysate of human airway bacteria with strong immunomodulating properties and an impeccable safety profile is widely used to prevent recurrent respiratory infections We found that airway OM 85 administration inhibits Ace2 and Tmprss2 transcription in the mouse lung suggesting that OM 85 might hinder SARS CoV 2 host cell interactions To investigate whether and how OM 85 treatment protects non human primate and human epithelial cells against SARS CoV 2 ACE2 and TMPRSS2 mRNA and protein expression cell binding of SARS CoV 2 S1 protein cell entry of SARS CoV 2 S protein pseudotyped lentiviral particles and SARS CoV 2 cell infection were measured in kidney lung and intestinal epithelial cell lines primary human bronchial epithelial cells and ACE2 transfected HEK293T cells treated with OM 85 in vitro OM 85 significantly downregulated ACE2 and TMPRSS2 transcription and surface ACE2 protein expression in epithelial cell lines and primary bronchial epithelial cells OM 85 also strongly inhibited SARS CoV 2 S1 protein binding to SARS CoV 2 S protein pseudotyped lentivirus entry into and SARS CoV 2 infection of epithelial cells These effects of OM 85 appeared to depend on SARS CoV 2 receptor downregulation OM 85 inhibits SARS CoV 2 epithelial cell infection in vitro by downregulating SARS CoV 2 receptor expression Further studies are warranted to assess whether OM 85 may prevent and or reduce the severity of COVID 19 | 0 |
245 | Long COVID An overview Long COVID is the collective term to denote persistence of symptoms in those who have recovered from SARS CoV 2 infection WE searched the pubmed and scopus databases for original articles and reviews Based on the search result in this review article we are analyzing various aspects of Long COVID Fatigue cough chest tightness breathlessness palpitations myalgia and difficulty to focus are symptoms reported in long COVID It could be related to organ damage post viral syndrome post critical care syndrome and others Clinical evaluation should focus on identifying the pathophysiology followed by appropriate remedial measures In people with symptoms suggestive of long COVID but without known history of previous SARS CoV 2 infection serology may help confirm the diagnosis This review will helps the clinicians to manage various aspects of Long COVID | 1 |
340 | Persistent clinical features in paediatric patients after SARS CoV 2 virological recovery a retrospective population based cohort study from a single centre in Latvia The COVID 19 related state of emergency in Latvia was declared on 12 March 2020 Consequently Childrens Clinical University Hospital in Riga Latvia established a postacute outpatient service for individuals after recovery from COVID 19 Although information regarding the epidemiology and clinical features of COVID 19 in children has accumulated relevant reports about persistent symptoms after recovery are lacking We aimed to determine data on COVID 19 persistent symptoms after recovery in children in Latvia Persistent symptoms have been reported in 9 out of 30 children | 1 |
615 | Suicide prevention and COVID 19 Suicide prevention during Covid 19 has become a global priority because the current pandemic has led to societal difficulties threatening the fabric of our lifestyle with increased morbidity and mortality Modelling studies published since the COVID 19 pandemic was declared in March 2020 estimate that suicide rates will increase by anywhere between 1 to 145 globally in response to the pandemic and action needs to be taken A narrative literature review on high quality evidence sources limited to human studies and publications written in English language only has been used to examine the relationship of COVID 19 and existing mental illness or history of mental illness suicide prevention strategies and changes in overall suicide rates A total of 39 papers are summarised and grouped using the headings aetiological factors proposed interventions to increase access and national policies to provide a framework for suicide prevention during pandemics such as COVID 19 This review indicates that 1 investing in active labour market programmes will result in a decreased suicide rate during times of high unemployment 2 People in low paid and casual jobs require specific support because they are most financially vulnerable during a pandemic related crisis 3 Women require specific support during a pandemic because of the type of employment they have and because they often carry a greater proportion of the domestic burden and are at increased risk of domestic violence during lockdown and crisis 4 Mental health and substance misuse services need to be appropriately funded and prioritised during and post pandemic due to the associated increase in substance misuse during a pandemic causing worsening mental health and increased risk of suicide 5 National Suicide Prevention Strategies should be developed by all countries and should anticipate response to a range of disasters including a pandemic 6 Suicide prevention is everybodys business and National Suicide Prevention Strategies should adopt a whole systems approach including mental health services primary care social care NGOs and other community stakeholders 7 Suicide is preventable 8 It is essential to prioritise suicide prevention strategies in the COVID and post COVID period to ensure that lives are saved Increase in suicide is not inevitable and suicide prevention during pandemics and post COVID 19 pandemics requires a collaborative whole system approach We require real time data to inform dynamic action planning | 0 |
599 | Evidence informed interventions and best practices for supporting women experiencing or at risk of homelessness a scoping review with gender and equity analysis While much of the literature on homelessness is centred on the experience of men women make up over one quarter of Canadas homeless population Research has shown that women experiencing homelessness are often hidden i e provisionally housed and have different pathways into homelessness and different needs as compared to men The objective of this research is to identify evidence based interventions and best practices to better support women experiencing or at risk of homelessness We conducted a scoping review with a gender and equity analysis This involved searching MEDLINE CINAHL PsycINFO and other databases for systematic reviews and randomized trials supplementing our search through reference scanning and grey literature followed by a qualitative synthesis of the evidence that examined gender and equity considerations Of the 4102 articles identified on homelessness interventions only 4 systematic reviews and 9 randomized trials were exclusively conducted on women or published disaggregated data enabling a gender analysis Interventions with the strongest evidence included post shelter advocacy counselling for women experiencing homelessness due to intimate partner violence as well as case management and permanent housing subsidies e g tenant based rental assistance vouchers which were shown to reduce homelessness food insecurity exposure to violence and psychosocial distress as well as promote school stability and child well being Much of the evidence on interventions to better support women experiencing homelessness focusses on those accessing domestic violence or family shelters Since many more women are experiencing or at risk of hidden homelessness population based strategies are also needed to reduce gender inequity and exposure to violence which are among the main structural drivers of homelessness among women | 0 |
142 | Long COVID in children and adolescents To identify the prevalence and also the full spectrum of symptoms complaints of children and adolescents who are suffering from long COVID Furthermore we investigated the risk factors of long COVID in children and adolescents All consecutive children and adolescents who were referred to the hospitals anywhere in Fars province Iran from 19 February 2020 until 20 November 2020 were included All patients had a confirmed diagnosis of COVID 19 In a phone call to patients parents at least 3 months after their discharge from the hospital we obtained their current status and information if their parents agreed to participate In total 58 children and adolescents fulfilled the inclusion criteria Twenty six 44 8 children adolescents reported symptoms complaints of long COVID These symptoms included fatigue in 12 21 shortness of breath in 7 12 exercise intolerance in 7 12 weakness in 6 10 and walking intolerance in 5 9 individuals Older age muscle pain on admission and intensive care unit admission were significantly associated with long COVID Long COVID is a frequent condition in children and adolescents The scientific community should investigate and explore the pathophysiology of long COVID to ensure that these patients receive appropriate treatments for their condition | 1 |
207 | Dermatologic manifestations of COVID 19 associated multisystem inflammatory syndrome in children Multisystem inflammatory syndrome in children MIS C affects a small percentage of pediatric patients infected with COVID 19 and is characterized by fever laboratory evidence of inflammation multisystem involvement and severe illness necessitating hospitalization Skin findings are often present in these patients and when initially compared with Kawasaki disease they likely represent distinct phenomena and overall remain poorly characterized In this retrospective review of 34 case reports and series we identified cutaneous manifestations documented in 417 of 736 patients 57 with MIS C associated with COVID 19 Rash was the sole descriptor of skin findings in nearly half of patients Case reports and smaller case series provided more detail outlining a broad range of lesion morphologies polymorphic maculopapular morbilliform erythrodermic urticarial reticular petechial purpuric in variable anatomic distribution More thorough descriptions of dermatologic manifestations in patients with MIS C are warranted to better characterize this syndrome as they may lend important insight into pathogenic mechanisms of disease | 1 |
637 | Elementary Laboratory Assays as Biomarkers of Ageing Support for Treatment of COVID 19 Youth working age and the elderly On a timeline chronological age CA and biological age BA may dissociate nosological entities manifest themselves at different BAs In determining which disease corresponds to a given age decade statistical registries of causes of death are unreliable and this does not change with SARS CoV 2 infection Beyond adolescence ageing metrics involve estimations of changes in fitness including prediction models to estimate the number of remaining years left to live A substantial disparity in biomarker levels and health status of ageing can be observed the difference in CA and BA in the large cohorts under consideration is glaring Here we focus more closely on ageing and senescence metrics in order to make information available for risk analysis non the least with COVID 19 including the most recent risk factors of ABO blood type and 3p21 31 chromosome cluster impacting on C5a and SC5b 9 plasma levels From the multitude of routine medical laboratory assays a potentially meaningful set of assays aimed to best reflect the stage of individual senescence hence risk factors the observational prospective SENIORLABOR study of 1 467 healthy elderly performed since 2009 and similar approaches since 1958 can be instantiated as a network to combine a set of elementary laboratory assays quantifying senescence | 0 |
222 | Screening of Potential Cardiac Involvement in Competitive Athletes Recovering From COVID 19 An Expert Consensus Statement As our understanding of the complications of coronavirus disease 2019 COVID 19 evolve subclinical cardiac pathology such as myocarditis pericarditis and right ventricular dysfunction in the absence of significant clinical symptoms represents a concern The potential implications of these findings in athletes are significant given the concern that exercise during the acute phase of viral myocarditis may exacerbate myocardial injury and precipitate malignant ventricular arrhythmias Such concerns have led to the development and publication of expert consensus documents aimed at providing guidance for the evaluation of athletes after contracting COVID 19 in order to permit safe return to play Cardiac imaging is at the center of these evaluations This review seeks to evaluate the current evidence regarding COVID 19 associated cardiovascular disease and how multimodality imaging may be useful in the screening and clinical evaluation of athletes with suspected cardiovascular complications of infection Guidance is provided with diagnostic red flags that raise the suspicion of pathology Specific emphasis is placed on the unique challenges posed in distinguishing athletic cardiac remodeling from subclinical cardiac disease The strengths and limitations of different imaging modalities are discussed and an approach to return to play decision making for athletes post COVID 19 as informed by multimodality imaging is provided | 1 |
481 | Clinical review of cerebral venous thrombosis in the context of COVID 19 vaccinations Evaluation management and scientific questions Vaccine induced immune mediated thrombocytopenia or VITT is a recent and rare phenomenon of thrombosis with thrombocytopenia frequently including cerebral venous thromboses CVT that has been described following vaccination with adenovirus vaccines ChAdOx1 nCOV 19 AstraZeneca and Ad26 COV2 S Johnson and Johnson Janssen J J The evaluation and management of suspected cases of CVT post COVID 19 vaccination are critical skills for a broad range of healthcare providers A collaborative comprehensive review of literature was conducted among a global group of expert neurologists and hematologists Strategies for rapid evaluation and treatment of the CVT in the context of possible VITT exist including inflammatory marker measurements PF4 assays and non heparin anticoagulation | 0 |
292 | Post COVID 19 functional status Relation to age smoking hospitalization and previous comorbidities Recently a new Post COVID 19 Functional Status PCFS scale is recommended in the current COVID 19 pandemic It is proposed that it could be used to display direct retrieval and the functional sequelae of COVID 19 The aim of the study was to assess the PCFS and to evaluate if age gender smoking hospitalization and comorbidities have any effect on functional limitations in recovered COVID 19 patients A total of 444 registered confirmed COVID 19 patients were included They were interviewed in our follow up clinics and filled an Arabic translated PCFS scale as well as their demographic and clinical data Eighty percent of COVID 19 recovered cases have diverse degrees of functional restrictions ranging from negligible 63 1 slight 14 4 moderate 2 to severe 0 5 based on PCFS Furthermore there was a substantial variance between the score of PCFS with age i P i 0 003 gender i P i 0 014 the duration since the onset of the symptoms of COVID 19 i P i 0 001 need for oxygen supplementation i P i 0 001 need for intensive care unit ICU admittance i P i 0 003 previous periodic influenza vaccination i P i 0 001 smoking status i P i 0 001 and finally the presence of any comorbid disorder i P i 0 001 Most of the COVID 19 recovered cases have diverse degrees of functional restrictions ranging from negligible to severe based on PCFS These restrictions were affected by age gender periodic influenza vaccination smoking duration since symptoms onset need for oxygen or ICU admittance and finally the presence of coexisting comorbidity | 1 |
352 | Investigations into the efficacy of a novel extubation aerosol shield a cough model study Physicians have had to perform numerous extubation procedures during the prolonged coronavirus disease 2019 COVID 19 pandemic Future pandemics caused by unknown pathogen may also present a risk of exposure to infectious droplets and aerosols This study evaluated the ability of a newly developed aerosol barrier Extubation Aerosol EA Shield to provide maximum protection from aerosol exposure during extubation via an aerosolised particle count and high quality visualisation assessments We employed a cough model having parameters similar to humans and used micron oil aerosol as well as titanium dioxide as aerosol tracers Aerosol barrier techniques employing a face mask group M and EA Shield group H were compared The primary outcome was the difference in the number of particles contacting the physicians face before and after extubation The maximum distances of aerosol dispersal after extubation were measured as the secondary outcomes All aerosolised particles of the two tracers were significantly smaller in group H than in group M p 0 05 In addition the sagittal and axial maximum distances and sagittal areas of aerosol dispersal for 3 5 and 10 s after extubation were significantly smaller in group H than in group M p 0 05 This model indicates that EA Shield could be highly effective in reducing aerosol exposure during extubation Therefore we recommend using it as an aerosol barrier when an infectious aerosol risk is suspected | 0 |
563 | Knowledge awareness and practices of Pakistani professionals amid COVID 19 outbreak End of the year 2019 marks an unprecedented outbreak of a pandemic named COVID 19 caused by the SARS CoV 2 It was first discovered in China and later spread to the whole world currently inflicting almost 200 countries After China few other countries have emerged as potential epicenters of this disease including the US Italy Spain and Pakistan as indicated by the World Health Organization WHO Since proper preventive and curative measures in the form of a vaccine or medication are currently unavailable throughout the world the only remedy devised to stop the spread of this virus is self isolation Such a measure necessitates ample awareness and understanding among people to avoid actions that lead to the spread of this virus Pakistan is the fifth most populous country in the world 212 2 million and has a record of contagious outbreaks in the past Therefore it is key to evaluate the general understanding regarding the cause spread and control of this disease in Pakistani population and acquire data to anticipate the possible spread and persistence of this disease to design relevant preventive measures We have attempted to collect such data from professionals who are susceptible to acquiring the infection due to an unavoidable exposure Keeping in view the current lock down we have relied on an internet based collection of data by filling a self designed questionnaire that is responded to by 1132 Descriptive and Frequency Analysis were performed on the responses received using MS Excel and SPSS software A total of 1132 individuals responded to the questionnaire among which include academic 45 8 non academic 20 8 healthcare 7 8 security 5 9 and other 19 7 professionals The questionnaire addressed the level of basic information regarding the cause spread cure and prevention of this disease among professionals in an attempt to provide directions for awareness campaigns at different levels in Pakistan and provide a model for similar outbreaks in the future To our expectations almost after a month of the coronavirus outbreak in Pakistan above 50 to up to 90 of the recorded responses against every question showed ample understanding regarding the cause spread and control of the disease which is an indicator of effective public awareness campaigns throughout the country largely based on media drive | 0 |
161 | Patient Led Research Collaborative embedding patients in the Long COVID narrative A large subset of patients with coronavirus disease 2019 COVID 19 are experiencing symptoms well beyond the claimed 2 week recovery period for mild cases These long term sequelae have come to be known as Long COVID Originating out of a dedicated online support group a team of patients formed the Patient Led Research Collaborative and conducted the first research on Long COVID experience and symptoms This article discusses the history and value of patient centric and patient led research the formation of Patient Led Research Collaborative as well as key findings to date and calls for the following the acknowledgement of Long COVID as an illness an accurate estimate of the prevalence of Long COVID publicly available basic symptom management care and research to not be limited to those with positive polymerase chain reaction and antibody tests and aggressive research and investigation into the pathophysiology of symptoms | 1 |
607 | Hesitancy Toward a COVID 19 Vaccine The scientific community has come together in a mass mobilization to combat the public health risks of COVID 19 including efforts to develop a vaccine However the success of any vaccine depends on the share of the population that gets vaccinated We designed a survey experiment in which a nationally representative sample of 3 133 adults in the USA stated their intentions to vaccinate themselves and their children for COVID 19 The factors that we varied across treatments were the stated severity and infectiousness of COVID 19 and the stated source of the risk information White House or the Centers for Disease Control We find that 20 of people in the USA intend to decline the vaccine We find no statistically significant effect on vaccine intentions from the severity of COVID 19 In contrast we find that the degree of infectiousness of the coronavirus influences vaccine intentions and that inconsistent risk messages from public health experts and elected officials may reduce vaccine uptake However the most important determinants of COVID 19 vaccine hesitancy seem to be distrust of the vaccine safety including uncertainty due to vaccine novelty as well as general vaccine avoidance as implied by not having had a flu shot in the last two years | 0 |
632 | COVID 19 and violence against children A review of early studies Throughout the course of the COVID 19 pandemic researchers across the globe have attempted to understand how the health and socioeconomic crisis brought about by the coronavirus is affecting childrens exposure to violence Since containment measures have disrupted many data collection and research efforts studies have had to rely on existing data or design new approaches to gathering relevant information This article reviews the literature that has been produced on childrens exposure to violence during the pandemic to understand emerging patterns and critically appraise methodologies to help inform the design of future studies The article concludes with recommendations for future research The study entailed a search of working papers technical reports and journal articles The search used a combination of search terms to identify relevant articles and reports published between March 1 and December 31 2020 The sources were assessed according to scope and study design The review identified 48 recent working papers technical reports and journal articles on the impact of COVID 19 on violence against children In terms of scope and methods the review led to three main findings 1 Studies have focused on physical or psychological violence at home and less attention has been paid to other forms of violence against children 2 most studies have relied on administrative records while other data sources such as surveys or big data were less commonly employed and 3 different definitions and study designs were used to gather data directly resulting in findings that are hardly generalizable With respect to childrens experience of violence the review led to four main findings 1 Studies found a decrease in police reports and referrals to child protective services 2 mixed results were found with respect to the number of calls to police or domestic violence helplines 3 articles showed an increase in child abuse related injuries treated in hospitals and 4 surveys reported an increase in family violence This review underscores the persistent challenges affecting the availability and quality of data on violence against children including the absence of standards for measuring this sensitive issue as well as the limited availability of baseline data Future research on COVID 19 and violence against children should address some of the gaps identified in this review | 0 |
138 | Functional neuroimaging using F 18 FDG PET CT in amnestic mild cognitive impairment A preliminary study People with amnestic mild cognitive impairment aMCI are at a higher risk of developing Alzheimers Dementia AD than their cognitively normal peers Decreased glucose metabolism with F 18 fluorodeoxyglucose FDG positron emission tomography PET is a downstream marker of neuronal injury and neurodegeneration The risk of developing AD is higher in patients with aMCI who have a pattern of AD related glucose metabolic changes on FDG PET than those who do not have these changes We evaluated the utility of visual and statistical parametric mapping SPM supported reading of the FDG PET scans of patients clinically classified as aMCI for identification of predementia patterns and for prediction of their progression to AD PTAD A total of 35 patients diagnosed as aMCI mini mental state examination MMSE score 25 at the cognitive disorders and memory CDM clinic of speciality neurology centers were referred for a resting FDG PET study All patients had a detailed neurological neuropsychological and magnetic resonance imaging MRI evaluation prior to referral Mean age of patients was 67 9 8 7 standard deviation SD years male female M F 26 9 Twenty healthy age matched controls were included in the study for SPM http www fil ion ucl ac uk spm Scans were interpreted visually and using SPM Each scan was classified as high intermediate or low likelihood for PTAD On visual analysis four scans were classified as high likelihood of PTAD and reveled hypometabolism in AD related territories Seven patients had hypometabolism in at least one AD related territory and were classified as intermediate likelihood for PTAD Two patients had hypometabolism in other than AD territories while 22 patients did not show any significant hypometabolism on their FDG PET scans and were classified as low likelihood for PTAD SPM analysis of these cases confirmed the areas hypometabolism in all 13 patients compared to a normal subgroup P 0 05 On follow up of 24 months all four cases with high likelihood scans had progression of cognitive deficits and were confirmed as AD in the CDM clinic while none of the others showed cognitive decline A pattern of AD hypometabolism on the FDG PET study is useful for predicting PTAD A longer follow up of patients with hypometabolism in single AD territories is needed to predict their clinical behavior | 1 |
571 | Asymptomatic COVID 19 infection diagnosis transmission population characteristics A novel coronavirus first discovered in late December 2019 has spread to many countries around the world An increasing number of asymptomatic patients have been reported and their ability to spread the virus has been proven This brings major challenges to the control of the transmission The discovery and control of asymptomatic patients with COVID 19 are the key issues in future epidemic prevention and recovery In this narrative review we summarise the existing knowledge about asymptomatic patients and put forward detection methods that are suitable for finding such patients Besides we compared the characteristics and transmissibility of asymptomatic patients in different populations in order to find the best screening diagnosis and control measures for different populations Comprehensive preventive advice is also provided to prevent the spread of infection from asymptomatic patients | 0 |
200 | A Review of Prolonged Post COVID 19 Symptoms and Their Implications on Dental Management The available data regarding the short and long term consequences of COVID 19 is still insufficient This narrative review aims to provide information on the prolonged COVID 19 symptoms in recovered patients and their implications during dental management Additionally this manuscript highlights the oral manifestations of COVID 19 and its management A systematic search was conducted in PubMed Embase Cochrane Library and Web of Science databases WHO and CDC websites and grey literature was searched through Google Scholar Clinical articles clinical trials case reports cohort and cross sectional studies were included reporting prolonged post COVID 19 symptoms Although COVID 19 is an infectious disease primarily affecting the lungs its multi organ involvement is responsible for several prolonged symptoms including oral implications In recovered patients with prolonged COVID 19 symptoms considerations for providing dental treatment has to be made as they can present with assortment of symptoms These prolonged post COVID 19 symptoms can affect the delivery of the required dental treatment Hence the recommendations proposed in this narrative review can be a useful starting point to aid dental teams providing adequate care for such recovered patients | 1 |
117 | Cellular Tropism of SARS CoV 2 across Human Tissues and Age related Expression of ACE2 and TMPRSS2 in Immune inflammatory Stromal Cells Recently emerging evidence has indicated that COVID 19 represents a major threat to older populations but the underlying mechanisms remain unclear The pathogen causing COVID 19 is acute respiratory syndrome coronavirus 2 SARS CoV 2 SARS CoV 2 infection depends on the key entry factors angiotensin converting enzyme 2 ACE2 and transmembrane serine protease 2 TMPRSS2 Recognizing the importance of ACE2 and TMPRSS2 for the cellular tropism of SARS CoV 2 we analyzed and presented the landscape of cell type identities for ACE2 sup sup TMPRSS2 sup sup cells across different human tissues and the age related alterations in ACE2 and TMPRSS2 expression across different cell types Additionally most of the post acute COVID 19 sequelae could attribute to the ACE2 expressing organ systems Therefore these SARS CoV 2 tropism data should be an essential resource for guiding clinical treatment and pathological studies which should draw attention toward the prioritization of COVID 19 research in the future Notably we discovered the age related expression of ACE2 and TMPRSS2 in the immune inflammatory stromal cells implying the potential interplay between COVID 19 stromal cells and aging In this study we developed a novel and practical analysis framework for mapping the cellular tropism of SARS CoV 2 This approach was built to aid the identification of viral specific cell types and age related alterations of viral tropism highlighting the power of single cell RNA sequencing scRNA seq to address viral pathogenesis systematically With the rapid accumulation of scRNA seq data and the continuously increasing insight into viral entry factors we anticipate that this scRNA seq based approach will attract broader interest in the virus research communities | 1 |
103 | Post infectious and post acute sequelae of critically ill adults with COVID 19 Data on the post acute and post infectious complications of patients who have recovered from severe coronavirus disease 2019 COVID 19 are limited While studies report that approximately 5 15 of COVID 19 hospitalized patients require intensive care and mechanical ventilation a substantially higher number need non invasive ventilation and are subject to prolonged hospitalizations with long periods of immobility and isolation The purpose of this study is to describe the post infectious sequelae of severe viral illness and the post acute complications of intensive care treatments in critically ill patients who have recovered from severe COVID 19 infection We performed a retrospective chart review of adult patients initially hospitalized with confirmed COVID 19 infection who recovered and were transferred to a general medical ward or discharged home between March 15 2020 and May 15 2020 dates inclusive after an intensive care unit ICU or high dependency unit HDU admission in a designated COVID 19 hospital in the United Arab Emirates Demographic data underlying comorbidities treatment complications and outcomes were collected Descriptive statistical analyses were performed Of 71 patients transferred out of ICU n 38 54 and HDU n 33 46 mean age was 48 years SD 9 95 96 men 54 under age 50 Mean ICU stay was 12 4 days SD 5 29 HDU stay was 13 4 days SD 4 53 Pre existing conditions were not significantly associated with developing post acute complications Odds Ratio OR 1 1 95 confidence interval CI 0 41 2 93 p 1 00 Fifty nine percent of patients had complications myopathy swallowing impairments and pressure ulcers were most common Delirium and confusion were diagnosed in 18 n 13 all were admitted to the ICU and required mechanical ventilation Of note of all patients studied 59 2 n 42 71 had at least 1 complication 32 4 n 23 had at least 2 complications and 19 7 n 14 suffered 3 or more sequelae Complications were significantly more common in ICU patients n 33 38 87 compared to HDU patients n 9 33 27 OR 17 6 95 CI 5 23 59 21 p 0 05 In a subset of critically ill patients who recovered from severe COVID 19 infection there was considerable short term post infectious and post acute disability Long term follow up of COVID 19 survivors is warranted | 1 |
612 | Weight Related Behaviors of Children with Obesity during the COVID 19 Pandemic b i Background i b During the coronavirus disease 2019 COVID 19 pandemic children and families have had to adapt their daily lives The purpose of this study was to describe changes in the weight related behaviors of children with obesity after the onset of the COVID 19 pandemic b i Methods i b Semistructured interviews i n i 51 were conducted from April to June 2020 with parents of children with obesity Families were participants in a randomized trial testing a clinic community pediatric obesity treatment model During interviews families described their experience during the COVID 19 pandemic with a particular emphasis on childrens diet physical activity sleep and screen time behaviors Rapid qualitative analysis methods were used to identify themes around changes in childrens weight related behaviors b i Results i b The mean child age was 9 7 2 8 years and the majority of children were Black 46 or Hispanic 39 and from low income families 62 Most parent participants were mothers 88 There were differences in the perceived physical activity level of children with some parents attributing increases in activity or maintenance of activity level to increased outdoor time whereas others reported a decline due to lack of outdoor time school and structured activities Key dietary changes included increased snacking and more meals prepared and consumed at home There was a shift in sleep schedules with children going to bed and waking up later and an increase in leisure based screen time Parents played a role in promoting activity and managing childrens screen time b i Conclusions i b The COVID 19 pandemic has created unique lifestyle challenges and opportunities for lifestyle modification Clinical Trials ID NCT03339440 | 0 |
180 | COVID and Cardiovascular Disease What We Know in 2021 Coronavirus disease 2019 COVID 19 has been the cause of significant global morbidity and mortality Here we review the literature to date of the short term and long term consequences of Severe Acute Respiratory Syndrome Coronavirus 2 SARS CoV 2 infection on the heart Early case reports described a spectrum of cardiovascular manifestations of COVID 19 including myocarditis stress cardiomyopathy myocardial infarction and arrhythmia However in most cases myocardial injury in COVID 19 appears to be predominantly mediated by the severity of critical illness rather than direct injury to myocardium from viral particles While cardiac magnetic resonance imaging remains a powerful tool for diagnosing acute myocarditis it should be used judiciously in light of low baseline prevalence of myocarditis Guiding an athletic patient through return to play RTP after COVID 19 infection is a challenging process More recent data show RTP has been a safe endeavor using a screening protocol Long COVID or post acute sequelae of SARS CoV 2 infection has also been described The reported symptoms span a large breadth of cardiopulmonary and neurologic complaints including fatigue palpitations chest pain breathlessness brain fog and dysautonomia including postural tachycardia syndrome POTS Management of POTS dysautonomia primarily centers on education exercise and salt and fluid repletion Our understanding of the impact of COVID 19 on the cardiovascular system is constantly evolving As we enter a new age of survivorship additional research is needed to catalogue the burden of persistent cardiopulmonary symptoms Research is also needed to learn how acute management may alter the likelihood and prevalence of this chronic syndrome | 1 |
485 | Connectedness Self Esteem and Prosocial Behaviors Protect Adolescent Mental Health Following Social Isolation A Systematic Review Societal trends and COVID 19 quarantines have increased the number of adolescents experiencing social isolation placing them at heightened risk for mental health issues The aim of this review is to explore protective factors that might mitigate psychological harm in the presence of social isolation A systematic literature review was conducted using Finks step by step process Four library databases were searched and results were reported using PRISMA Of the 246 studies reviewed 12 studies were retained following the quality assessment The sample includes 14 064 participants from USA Australia and Europe ranging from 10 19 years old Social connectedness ie family connectedness school connectedness social support self esteem and prosocial behaviors were the most common protective factors to social isolation Additional factors such as self efficacy optimism and ethnic identity are discussed Implications for future research are recommended including the need to explore spiritual biological and sociocultural factors influencing social connectedness and mental health in adolescents | 0 |
48 | Autonomic dysfunction in long COVID rationale physiology and management strategies The SARS CoV 2 COVID 19 pandemic has caused unprecedented morbidity mortality and global disruption Following the initial surge of infections focus shifted to managing the longer term sequelae of illness in survivors Post acute COVID known colloquially as long COVID is emerging as a prevalent syndrome It encompasses a plethora of debilitating symptoms including breathlessness chest pain palpitations and orthostatic intolerance which can last for weeks or more following mild illness We describe a series of individuals with symptoms of long COVID and we posit that this condition may be related to a virus or immune mediated disruption of the autonomic nervous system resulting in orthostatic intolerance syndromes We suggest that all physicians should be equipped to recognise such cases appreciate the symptom burden and provide supportive management We present our rationale for an underlying impaired autonomic physiology post COVID 19 and suggest means of management | 1 |
251 | Clinical Profile and Short Term Outcome of Children With SARS CoV 2 Related Multisystem Inflammatory Syndrome MIS C Treated With Pulse Methylprednisolone To study the clinical profile and outcome of children with MIS C treated with methylprednisolone pulse therapy and or intravenous immunoglobulin IVIG This prospective observational study included children satisfying CDC MIS C criteria admitted from September to November 2020 Primary outcome was persistence of fever beyond 36 hours after start of immunomodulation therapy Secondary outcomes included duration of ICU stay mortality need for repeat immunomodulation time to normalization of CRP and persistence of coronary abnormalities at 2 weeks Study population included 32 patients with MIS C with median IQR age of 7 5 5 9 5 years The proportion of children with gastrointestinal symptoms was 27 84 cardiac was 29 91 and coronary artery dilatation was 11 34 Pulse methylprednisolone and intravenous immunoglobulin were used as first line therapy in 26 81 and 6 19 patients respec tively Treatment failure was observed in 2 26 patients in methylprednisolone group and 2 6 patients in IVIG group C reactive protein levels less than 60mg L by day 3 was seen in 17 74 in methylprednisolone group and 2 25 in IVIG group P 0 014 There was no mortality At 2 weeks follow up coronary artery dilatation persisted in 4 in methylprednisolone group and 1 in IVIG group In patients with SARS CoV 2 related MIS C methylprednisolone pulse therapy was associated with favorable short term outcomes | 1 |
471 | Physician leaders cross boundary use of social media what are the implications in the current COVID 19 environment The purpose of this study is to better understand social media SM factors that physician leaders need to consider as they adapt their cross boundary practices to engage with colleagues and patients Firstly this study explores why SM is being used by physicians to cross horizontal physician to physician and stakeholder physician to patient boundaries prior to COVID 19 Secondly based on the studies reviewed this study provides insights on the practical SM implications for physician leaders working in the COVID 19 environment to actively enhance their practices reduce public confusion and improve patient care thus informing health care practices A systematic literature review was used to conduct a structured transparent overview of peer reviewed articles that describe physicians use of cross boundary SM across several disciplines e g health information science As a baseline assessment prior to COVID 19 the review synthesized 47 articles identified and selected from six databases and Novanet This study used NVivo 12 to thematical code the articles leading to the emergence of four broad factors that influence SM use A key reason noted in the literature for physicians use of SM to cross horizontal boundaries is to share knowledge Regarding stakeholder boundaries the most cited reasons are to improve patients health and encourage behavioural changes Insights garnered on the practical SM implications include the need for physicians to be stronger leaders in presenting trustworthy and consistent facts about health information to the public and fellow peers As role models for the effective use of SM tools physician leaders can mentor and coach their colleagues and counterparts As this was a literature review the authors did not collect primary data to further explore this rapidly changing and dynamic SM world Next steps could include a survey to determine firstly how physicians currently use SM in this COVID 19 environment and secondly how they could leverage it for their work Findings from this survey will help us better understand the role of physician leaders as health care influencers and how they could better create trust and inform the Canadian public in the health information that is being conveyed Physician leaders can play a key role in positively influencing institutional support for ethical and safe SM use and engagement practices Physicians need to participate in developing regulations and guidelines that are fundamentally to physician leaders SM use Central to this research would be the need to understand how physicians cross boundary practices have changed during and potentially post COVID 19 Physician leaders also need to monitor information sources for credibility and ensure that these sources are protected As role models for the effective use of SM tools physician leaders can mentor and coach their colleagues and counterparts in this area Although there have been studies of how physicians use SM fewer studies explore why physician leaders cross boundaries horizontal and stakeholder using SM Important insights are gained in physician leaders practical use of SM Key themes that emerged included organizational and individual information professional and regulations and guideline factors These factors strengthen physician leaders understanding of areas of foci to enhance their cross boundary interactions There is an urgency to study the complexity of SM and the effectiveness of regulations and guidelines for physicians who are being required at an accelerated rate to strengthen and increase their cross boundary practices | 0 |
218 | Persistent pulmonary pathology after COVID 19 is associated with high viral load weak antibody response and high levels of matrix metalloproteinase 9 The association between pulmonary sequelae and markers of disease severity as well as pro fibrotic mediators were studied in 108 patients 3 months after hospital admission for COVID 19 The COPD assessment test CAT score spirometry diffusion capacity of the lungs DL sub CO sub and chest CT were performed at 23 Norwegian hospitals included in the NOR SOLIDARITY trial an open labelled randomised clinical trial investigating the efficacy of remdesivir and hydroxychloroquine HCQ Thirty eight percent had a CAT score 10 DL sub CO sub was below the lower limit of normal in 29 6 Ground glass opacities were present in 39 8 on chest CT parenchymal bands were found in 41 7 At admission low pO sub 2 sub F sub i sub O sub 2 sub ratio ICU treatment high viral load and low antibody levels were predictors of a poorer pulmonary outcome after 3 months High levels of matrix metalloproteinase MMP 9 during hospitalisation and at 3 months were associated with persistent CT findings Except for a negative effect of remdesivir on CAT score we found no effect of remdesivir or HCQ on long term pulmonary outcomes Three months after hospital admission for COVID 19 a high prevalence of respiratory symptoms reduced DL sub CO sub and persistent CT findings was observed Low pO sub 2 sub F sub i sub O sub 2 sub ratio ICU admission high viral load low antibody levels and high levels of MMP 9 were associated with a worse pulmonary outcome | 1 |
325 | Symptoms complications and management of long COVID a review Globally there are now over 160 million confirmed cases of COVID 19 and more than 3 million deaths While the majority of infected individuals recover a significant proportion continue to experience symptoms and complications after their acute illness Patients with long COVID experience a wide range of physical and mental psychological symptoms Pooled prevalence data showed the 10 most prevalent reported symptoms were fatigue shortness of breath muscle pain joint pain headache cough chest pain altered smell altered taste and diarrhoea Other common symptoms were cognitive impairment memory loss anxiety and sleep disorders Beyond symptoms and complications people with long COVID often reported impaired quality of life mental health and employment issues These individuals may require multidisciplinary care involving the long term monitoring of symptoms to identify potential complications physical rehabilitation mental health and social services support Resilient healthcare systems are needed to ensure efficient and effective responses to future health challenges | 1 |
357 | Thromboprophylaxis in COVID 19 Rationale and considerations The Corona Virus Disease 2019 COVID 19 pandemic is associated with a very high incidence of thrombotic complications The exact mechanisms for this excess risk for clots have not been elucidated although one of the often quoted pathophysiological entity is immunothrombosis Recognition of thrombotic complications early on in this pandemic led to an over explosion of studies which looked at the benefits of anticoagulation to mitigate this risk In this review we examine the rationale for thromboprophylaxis in COVID 19 with particular reference to dosing and discuss what may guide the decision making process to consider anticoagulation In addition we explore the rationale for thrombosis prevention measures in special populations including outpatient setting pregnant females children those with high body mass index and those on extracorporeal membrane oxygenation | 0 |
684 | Detection of N6 methyladenosine in SARS CoV 2 RNA by methylated RNA immunoprecipitation sequencing MeRIP Seq i N i sup i 6 i sup methylation of adenosine m6A is the most abundant internal mRNA modification and is an important post transcriptional regulator of gene expression Here we describe a protocol for methylated RNA immunoprecipitation sequencing MeRIP Seq to detect and quantify m6A modifications in severe acute respiratory syndrome coronavirus 2 SARS CoV 2 RNA The protocol is optimized for low viral RNA levels and is readily adaptable for other applications | 0 |
264 | Long Term Symptoms Among Adults Tested for SARS CoV 2 United States January 2020 April 2021 Long term symptoms often associated with COVID 19 post COVID conditions or long COVID are an emerging public health concern that is not well understood Prevalence of post COVID conditions has been reported among persons who have had COVID 19 range 5 80 with differences possibly related to different study populations case definitions and data sources 1 Few studies of post COVID conditions have comparisons with the general population of adults with negative test results for SARS CoV 2 the virus that causes COVID 19 limiting ability to assess background symptom prevalence 1 CDC used a nonprobability based Internet panel established by Porter Novelli Public Services to administer a survey to a nationwide sample of U S adults aged 18 years to compare the prevalence of long term symptoms those lasting 4 weeks since onset among persons who self reported ever receiving a positive SARS CoV 2 test result with the prevalence of similar symptoms among persons who reported always receiving a negative test result The weighted prevalence of ever testing positive for SARS CoV 2 was 22 2 95 confidence interval CI 20 6 23 8 Approximately two thirds of respondents who had received a positive test result experienced long term symptoms often associated with SARS CoV 2 infection Compared with respondents who received a negative test result those who received a positive test result reported a significantly higher prevalence of any long term symptom 65 9 versus 42 9 fatigue 22 5 versus 12 0 change in sense of smell or taste 17 3 versus 1 7 shortness of breath 15 5 versus 5 2 cough 14 5 versus 4 9 headache 13 8 versus 9 9 and persistence 4 weeks of at least one initially occurring symptom 76 2 versus 69 6 Compared with respondents who received a negative test result a larger proportion of those who received a positive test result reported believing that receiving a COVID 19 vaccine made their long term symptoms better 28 7 versus 15 7 Efforts to address post COVID conditions should include helping health care professionals recognize the most common post COVID conditions and optimize care for patients with persisting symptoms including messaging on potential benefits of COVID 19 vaccination | 1 |
416 | Review Mental health impacts of the COVID 19 pandemic on children and youth a systematic review The COVID 19 pandemic has posed an unprecedented threat to global mental health Children and adolescents may be more susceptible to mental health impacts related to their vulnerable developmental stage fear of infection home confinement suspension of regular school and extracurricular activities physical distancing mandates and larger scale threats such as global financial recessions and associated impacts Our objective was to review existing evidence of the COVID 19 pandemics global impact on the mental health of children and adolescents 19 years of age and to identify personal and contextual factors that may enhance risk or confer protection in relation to mental health outcomes We conducted a search of peer reviewed and preprint research published in English from January 1 2020 to February 22 2021 We included studies collecting primary data on COVID 19 related mental health impacts on children and adolescents We graded the strength of included articles using the Oxford Centre for Evidence Based Medicine rating scheme Our search and review yielded 116 articles presenting data on a total of 127 923 children and adolescents 50 984 child and adolescent proxy reports e g parents healthcare practitioners and 3 000 chart reviews A high prevalence of COVID 19 related fear was noted among children and adolescents as well as more depressive and anxious symptoms compared with prepandemic estimates Older adolescents girls and children and adolescents living with neurodiversities and or chronic physical conditions were more likely to experience negative mental health outcomes Many studies reported mental health deterioration among children and adolescents due to COVID 19 pandemic control measures Physical exercise access to entertainment positive familial relationships and social support were associated with better mental health outcomes This review highlights the urgent need for practitioners and policymakers to attend to and collaborate with children and adolescents especially those in higher risk subgroups to mitigate short and long term pandemic associated mental health effects | 0 |
617 | Applications of CRISPR as a potential therapeutic Genetic disorders and congenital abnormalities are present in 2 5 of births all over the world and can cause up to 50 of all early childhood deaths The establishment of sophisticated and controlled techniques for customizing DNA manipulation is significant for the therapeutic role in such disorders and further research on them One such technique is CRISPR that is significant towards optimizing genome editing and therapies metabolic fluxes as well as artificial genetic systems CRISPR Cas9 is a molecular appliance that is applied in the areas of genetic and protein engineering The CRISPR CAS system is an integral element of prokaryotic adaptive immunity that allows prokaryotic cells to identify and kill any foreign DNA The Gene editing property of CRISPR finds various applications like diagnostics and therapeutics in cancer neurodegenerative disorders genetic diseases blindness etc This review discusses applications of CRISPR as a therapeutic in various disorders including several genetic diseases including sickle cell anemia blindness thalassemia cystic fibrosis hereditary tyrosinemia type I duchenne muscular dystrophy mitochondrial disorders Cancer Huntingtons disease and viral infections like HIV COVID etc along with the prospects concerning them CRISPR based therapy is also being researched and defined for COVID 19 The related mechanism of CRISPR has been discussed alongside highlighting challenges involved in therapeutic applications of CRISPR | 0 |
341 | Sensors for the detection of ammonia as a potential biomarker for health screening The presence of ammonia within the body has long been linked to complications stemming from the liver kidneys and stomach These complications can be the result of serious conditions such as chronic kidney disease CKD peptic ulcers and recently COVID 19 Limited liver and kidney function leads to increased blood urea nitrogen BUN within the body resulting in elevated levels of ammonia in the mouth nose and skin Similarly peptic ulcers commonly from H pylori result in ammonia production from urea within the stomach The presence of these biomarkers enables a potential screening protocol to be considered for frequent non invasive monitoring of these conditions Unfortunately detection of ammonia in these mediums is rather challenging due to relatively small concentrations and an abundance of interferents Currently there are no options available for non invasive screening of these conditions continuously and in real time Here we demonstrate the selective detection of ammonia using a vapor phase thermodynamic sensing platform capable of being employed as part of a health screening protocol The results show that our detection system has the remarkable ability to selectively detect trace levels of ammonia in the vapor phase using a single catalyst Additionally detection was demonstrated in the presence of interferents such as carbon dioxide CO sub 2 sub and acetone common in human breath These results show that our thermodynamic sensors are well suited to selectively detect ammonia at levels that could potentially be useful for health screening applications | 1 |
505 | COVID 19 Pandemic and Water Sanitation and Hygiene Impacts Challenges and Mitigation Strategies In order to protect public health during the outbreaks of infectious diseases including the pandemic COVID 19 provision of Water Sanitation and Hygiene WASH services is important The challenges of inaccessible WASH services along with the pandemic COVID 19 in low income countries can lead to a devastating problem A systematic search of published articles was identified using PubMed Web of Science and Google Scholar on relevant studies of COVID 19 and WASH services Published articles were identified using abstracts and titles of the articles followed by assessed for eligibility and screening of the full text reports of relevant studies Electronic database search identified 798 articles from which 28 full text articles were included in the systematic review A lack of access to WASH services in households schools health care facilities and other public spaces were the main identified COVID 19 related public health risks A lack of adequate data and financial shortages were the challenges for mitigating the problems of COVI 19 and WASH services This systematical review identified the impacts and challenges of COVID 19 in the provision of WASH services The results implied that COVID 19 has significant impacts on WASH services that can affect the health of the public Therefore strengthening and ensuring access to WASH services are important for preventing COVID 19 and realizing human rights Community engagement also can be used to support for prevention and control of COVID 19 Countries need to be expand their investment in WASH services as an important mechanism for mitigating COVID 19 | 0 |
314 | Post COVID syndrome A case series and comprehensive review The existence of a variety of symptoms with a duration beyond the acute phase of COVID 19 is referred to as post COVID syndrome PCS We aimed to report a series of patients with PCS attending a Post COVID Unit and offer a comprehensive review on the topic Adult patients with previously confirmed SARS CoV 2 infection and PCS were systematically assessed through a semi structured and validated survey Total IgG IgA and IgM serum antibodies to SARS CoV 2 were evaluated by an electrochemiluminescence immunoassay A systematic review of the literature and meta analysis were conducted following PRISMA guidelines Univariate and multivariate methods were used to analyze data Out of a total of 100 consecutive patients 53 were women the median of age was 49 years IQR 37 8 55 3 the median of post COVID time after the first symptoms was 219 days IQR 143 258 and 65 patients were hospitalized during acute COVID 19 Musculoskeletal digestive i e diarrhea and neurological symptoms including depression by Zung scale were the most frequent observed in PCS patients A previous hospitalization was not associated with PCS manifestation Arthralgia and diarrhea persisted in more than 40 of PCS patients The median of anti SARS CoV 2 antibodies was 866 2 U mL IQR 238 2 1681 Despite this variability 98 patients were seropositive Based on autonomic symptoms by COMPASS 31 two clusters were obtained with different clinical characteristics Levels of anti SARS CoV 2 antibodies were not different between clusters A total of 40 articles 11 196 patients were included in the meta analysis Fatigue muscle weakness dyspnea pain and discomfort anxiety depression and impaired concentration were presented in more than 20 of patients reported In conclusion PCS is mainly characterized by musculoskeletal pulmonary digestive and neurological involvement including depression PCS is independent of severity of acute illness and humoral response Long term antibody responses to SARS CoV 2 infection and a high inter individual variability were confirmed Future studies should evaluate the mechanisms by which SARS CoV 2 may cause PCS and the best therapeutic options | 1 |
29 | Complaints and clinical findings six months after COVID 19 outpatient follow up at the University Medical Center Freiburg Increasing evidence suggests that some patients suffer from persistent symptoms for months after recovery from acute COVID 19 However the clinical phenotype and its pathogenesis remain unclear We here present data on complaints and results of a diagnostic workup of patients presenting to the post COVID clinic at the University Medical Center Freiburg Retrospective data analysis of persistently symptomatic patients presenting to our clinic at least 6 months after onset of acute COVID 19 All patients were assessed by a doctor and routine laboratory analysis was carried out Quality of life was assessed using SF 36 questionnaire In case of specific persisting symptoms further organ specific diagnostic evaluation was performed and patients were referred to respective departments specialists 132 Patients 58 male 74 female mean age 53 8 years presented to our clinic at least 6 months after COVID 19 79 60 had been treated as outpatients and 53 40 as inpatients Most common complaints were persistent fatigue 82 and dyspnea on exertion 61 Further common complaints were impairments of concentration 54 insomnia 43 and impairments of smell or taste 35 Quality of life was reduced in all sections of the SF 36 questionnaire yielding a reduced working capacity Significant pathological findings in laboratory echocardiographic and radiological work up were rare Impairments in lung function tests were more common in previously hospitalized patients Patients presenting 6 months after onset of acute COVID 19 suffer from a diverse spectrum of symptoms with impaired quality of life also referred to as Long COVID or Post Acute Sequelae of SARS CoV 2 infection PASC Further research is needed to determine the frequency of these post COVID syndromes and their pathogenesis natural course and treatment options Evaluation and management should be multi disciplinary | 1 |
88 | Update to post acute sequelae of SARS CoV 2 infection Caring for the long haulers An estimated 10 of COVID 19 survivors continue to experience symptoms several weeks to months after the appearance of initial symptoms a condition termed post acute sequelae of SARS CoV 2 infection PASC These patients also called long haulers most commonly report protracted symptoms of fatigue cough dyspnea chest tightness difficulty concentrating arthralgia olfactory dysfunction and headache While age comorbid medical conditions and COVID 19 severity are suspected risk factors for PASC young and previously healthy individuals with mild COVID 19 are also at risk Recognition of symptoms evaluation supportive treatment and attention to medical comorbidities are the cornerstones of medical management | 1 |
565 | Stop COVID Cohort An Observational Study of 3480 Patients Admitted to the Sechenov University Hospital Network in Moscow City for Suspected Coronavirus Disease 2019 COVID 19 Infection The epidemiology clinical course and outcomes of patients with coronavirus disease 2019 COVID 19 in the Russian population are unknown Information on the differences between laboratory confirmed and clinically diagnosed COVID 19 in real life settings is lacking We extracted data from the medical records of adult patients who were consecutively admitted for suspected COVID 19 infection in Moscow between 8 April and 28 May 2020 Of the 4261 patients hospitalized for suspected COVID 19 outcomes were available for 3480 patients median age 56 years interquartile range 45 66 The most common comorbidities were hypertension obesity chronic cardiovascular disease and diabetes Half of the patients n 1728 had a positive reverse transcriptase polymerase chain reaction RT PCR while 1748 had a negative RT PCR but had clinical symptoms and characteristic computed tomography signs suggestive of COVID 19 No significant differences in frequency of symptoms laboratory test results and risk factors for in hospital mortality were found between those exclusively clinically diagnosed or with positive severe acute respiratory syndrome coronavirus 2 SARS CoV 2 RT PCR In a multivariable logistic regression model the following were associated with in hospital mortality older age per 1 year increase odds ratio 1 05 95 confidence interval 1 03 1 06 male sex 1 71 1 24 2 37 chronic kidney disease 2 99 1 89 4 64 diabetes 2 1 1 46 2 99 chronic cardiovascular disease 1 78 1 24 2 57 and dementia 2 73 1 34 5 47 Age male sex and chronic comorbidities were risk factors for in hospital mortality The combination of clinical features was sufficient to diagnose COVID 19 infection indicating that laboratory testing is not critical in real life clinical practice | 0 |
553 | Long term impact of COVID 19 associated acute respiratory distress syndrome To determine the health status exercise capacity and health related quality of life HRQoL of COVID 19 associated acute respiratory distress syndrome ARDS survivors 8 months after diagnosis All eligible patients were interviewed and underwent a physical examination chest X ray and 6 min walk test 6MWT Scales to evaluate post traumatic stress disorder depression anxiety and HRQoL were applied Of 1295 patients 365 suffered ARDS and 166 survived to hospital discharge Five died after discharge and 48 were lost to follow up Of the 113 remaining patients 81 had persistent symptoms More than 50 of patients completed less than 80 of the theoretical distance on the 6MWT 50 had an abnormal X ray and 93 of patients developed psychiatric disorders Mean SF 36 scores were worse than in the general population After multivariate regression analysis female sex non Caucasian race and Charlson index 2 were independent risk factors for a worse mental health component summary score on the SF 36 and age was associated with a better prognosis Female sex and chronic obstructive pulmonary disease were independently associated with a worse physical component summary score COVID 19 associated ARDS survivors have long term consequences in health status exercise capacity and HRQoL Strategies addressed to prevent these sequelae are needed | 0 |
442 | Non COVID fatalities in the COVID era A paradigm shift in the face of a pandemic lessons learnt or not The rapid spread of the coronavirus pandemic and the associated high morbidity and mortality led to sudden lock down forcing the elderly and others in the high risk group into isolation Elective health care services including diagnostics therapeutics and elective surgical services were put on hold leading to delays seriously affecting cancer and non cancer related services In spite of lessons learnt during the first wave similar issues have persisted during the second wave increasing the pressure on an already fragile infrastructure Information related to surgical patients admitted since lock down March to August 2020 as an emergency was collected on a structured proforma and analysed Data was gathered from prospectively kept patient admission lists and Electronic Discharge summaries All the patients who were directly or indirectly affected with poor outcomes including delayed diagnosis and treatment were identified and included in the analysis A total of 185 patients were admitted as an emergency during this period Of these Eight patients admitted under surgical care were included in the study Four out of eight patients were diagnosed with advanced cancer and the remainder presented with complications of benign pathologies Of the four patients with advanced cancer three patients had advanced colorectal and the fourth had advanced ovarian cancer All four patients either presented late or had delayed access to investigations Three out four patients with benign disease presented with complications due to cancellation of elective and semi urgent services One patient who was COVID positive and presented with bowel perforation died after a prolonged hospital stay There is definite evidence of unfavourable patient outcomes in non COVID patients as a result of the COVID pandemic As COVID is unlikely to whither down in the very near future and highs and lows are expected rapid and safe reintroduction of elective health care services affected by COVID is the call of the hour In addition more efforts should be directed towards increasing awareness amongst patients regarding the importance of reporting red flag symptoms and encouraging them to access health care services | 0 |
499 | Mild SARS CoV 2 Infections and Neutralizing Antibody Titers Recent evidence suggests that neutralizing antibodies nAbs to severe acute respiratory syndrome coronavirus 2 may persist over time however knowledge regarding pediatric subjects is limited A single center prospective observational study was conducted on 57 family clusters of coronavirus disease 2019 including children of neonatal and pediatric age attending the University Hospital of Padua Italy For each patient blood samples were collected for both the quantification of nAbs through a plaque reduction neutralizing test and the detection of antinucleocapsid spike protein immunoglobulin G and or immunoglobulin M We analyzed 283 blood samples collected from 152 confirmed coronavirus disease 2019 cases 82 parents and 70 children or older siblings of median age of 8 years interquartile range 4 13 presenting asymptomatic or with mildly symptomatic disease Despite the decrease of immunoglobulin G over time nAbs were found to persist up to 7 to 8 months in children whereas adults recorded a modest declining trend Interestingly children aged 6 years and in particular those aged 3 years developed higher long lasting levels of nAbs compared with older siblings and or adults Mild and asymptomatic severe acute respiratory syndrome coronavirus 2 infections in family clusters elicited higher nAbs among children | 0 |
660 | SARS CoV 2 The Path of Prevention and Control The 2019 coronavirus pandemic COVID 19 continues to expand worldwide Although the number of cases and the death rate among children and adolescents are reported to be low compared to adults limited data have been reported We urgently need to find the treatment and vaccine to stop the epidemic Vaccine development is in progress but any approved and effective vaccine for COVID 19 will take at least 12 to 18 months The World Health Organization WHO the Center for Disease Control and Prevention CDC and the Food and Agriculture Organization FAO have issued instructions and strategies for controlling COVID 19 outbreak to the general public physicians travelers and injured patients to follow so that the transmission to a healthy population can be prevented In this review we summarize demographic data clinical characteristics complications and outcomes and finally prevention and control strategies for this serious pandemic | 0 |
460 | Longitudinal changes in physical activity during and after the first national lockdown due to the COVID 19 pandemic in England Recent studies have shown reduced physical activity at early stages of the COVID 19 pandemic However there is a lack of investigation on longitudinal changes in physical activity beyond lockdowns and stay at home orders Moreover it is unclear if there is heterogeneity in physical activity growth trajectories This study aimed to explore longitudinal patterns of physical activity and factors associated with them Data were from the UCL COVID 19 Social Study The analytical sample consisted of 35 915 adults in England who were followed up for 22 weeks from 24th March to 23rd August 2020 Data were analysed using growth mixture models Our analyses identified six classes of growth trajectories including three stable classes showing little change over time 62 4 in total two classes showing decreasing physical activity 28 6 and one class showing increasing physical activity over time 9 A range of factors were found to be associated the class membership of physical activity trajectories such as age gender education income employment status and health There is substantial heterogeneity in longitudinal changes in physical activity during the COVID 19 pandemic However a substantial proportion of our sample showed persistent physical inactivity or decreasing physical activity Given the well established link between physical activity and health persistent or increased physical inactivity is likely to have both immediate and long term implications for peoples physical and mental health as well as general wellbeing More efforts are needed to promote physical activity during the pandemic and beyond | 0 |
548 | Role of ACE2 in pregnancy and potential implications for COVID 19 susceptibility In times of coronavirus disease 2019 COVID 19 the impact of severe acute respiratory syndrome SARS coronavirus CoV 2 infection on pregnancy is still unclear The presence of angiotensin converting enzyme ACE 2 ACE2 the main receptor for SARS CoV 2 in human placentas indicates that this organ can be vulnerable for viral infection during pregnancy However for this to happen additional molecular processes are critical to allow viral entry in cells its replication and disease manifestation particularly in the placenta and or feto maternal circulation Beyond the risk of vertical transmission COVID 19 is also proposed to deplete ACE2 protein and its biological actions in the placenta It is postulated that such effects may impair essential processes during placentation and maternal hemodynamic adaptations in COVID 19 pregnancy features also observed in several disorders of pregnancy This review gathers information indicating risks and protective features related to ACE2 changes in COVID 19 pregnancies First we describe the mechanisms of SARS CoV 2 infection having ACE2 as a main entry door and current evidence of viral infection in the placenta Further we discuss the central role of ACE2 in physiological systems such as the renin angiotensin system RAS and the kallikrein kinin system KKS both active during placentation and hemodynamic adaptations of pregnancy Significant knowledge gaps are also identified and should be urgently filled to better understand the fate of ACE2 in COVID 19 pregnancies and the potential associated risks Emerging knowledge will be able to improve the early stratification of high risk pregnancies with COVID 19 exposure as well as to guide better management and follow up of these mothers and their children | 0 |
638 | Redefining the Relationship Palliative Care in Critical Perinatal and Neonatal Cardiac Patients Patients with perinatal and neonatal congenital heart disease CHD represent a unique population with higher morbidity and mortality compared to other neonatal patient groups Despite an overall improvement in long term survival they often require chronic care of complex medical illnesses after hospital discharge placing a high burden of responsibility on their families Emerging literature reflects high levels of depression and anxiety which plague parents starting as early as the time of prenatal diagnosis In the current era of the global COVID 19 pandemic the additive nature of significant stressors for both medical providers and families can have catastrophic consequences on communication and coping Due to the high prognostic uncertainty of CHD data suggests that early pediatric palliative care PC consultation may improve shared decision making communication and coping while minimizing unnecessary medical interventions However barriers to pediatric PC persist largely due to the perception that PC consultation is indicative of giving up This review serves to highlight the evolving landscape of perinatal and neonatal CHD and the need for earlier and longitudinal integration of pediatric PC in order to provide high quality interdisciplinary care to patients and families | 0 |
348 | Current advances in transfusion medicine 2020 A critical review of selected topics by the AABB Clinical Transfusion Medicine Committee The AABB Clinical Transfusion Medicine Committee CTMC compiles an annual synopsis of the published literature covering important developments in the field of transfusion medicine TM which has been made available as a manuscript published in Transfusion since 2018 CTMC committee members reviewed original manuscripts including TM related topics published electronically ahead or in print from December 2019 to December 2020 The selection of topics and manuscripts was discussed at committee meetings and chosen based on relevance and originality Next committee members worked in pairs to create a synopsis of each topic which was then reviewed by two additional committee members The first and senior authors of this manuscript assembled the final manuscript Although this synopsis is extensive it is not exhaustive and some papers may have been excluded or missed The following topics are included COVID 19 effects on the blood supply and regulatory landscape COVID convalescent plasma adult transfusion practices whole blood molecular immunohematology pediatric TM cellular therapy and apheresis medicine This synopsis provides easy access to relevant topics and may be useful as an educational tool | 0 |
588 | Rheumatological complications of Covid 19 COVID 19 has caused unprecedented hardships in the 21st century with more than 150 million infections Various immunological phenomena have been described during the course of the infection and this infection has also triggered autoimmunity Rheumatological illnesses have been described following resolution of the acute infection hence we sought to conduct a review of the rheumatological complications of COVID 19 We conducted a literature search for articles relating to sequelae of COVID 19 from Jan 2020 to 30th April 2021 We found a number of reports of inflammatory arthritis after SARS CoV 2 infection SLE and renal disease have been described and vasculitis also appears to be a common complication Rhabdomyolysis and myositis has also been reported in a number of patients We also found some evidence of large vessel vasculitis in long COVID patients This review highlights a number of important complications such as inflammatory arthritis lupus like disease myostis and vasculitis following SARS CoV 2 infection | 0 |
539 | Impact that the COVID 19 pandemic on routine childhood vaccinations and challenges ahead A narrative review To document the decline in vaccination coverage in the first months of 2020 as an indirect effect of the COVID 19 pandemic We performed a literature review in medical databases Overall 143 articles were initially retrieved out of which 48 were selected and included in the review Our review retrieved similar data in many countries worldwide and globally preliminary data from the first 4 months of 2020 indicate a decline in diphtheria tetanus pertussis coverage generally considered the marker of vaccination coverage across countries World Health Organization recommends maintaining vaccination services prioritising primary series vaccinations especially for measles rubella or poliomyelitis but it also lets each country decide whether to maintain the immunisation services evaluating the current epidemiology of vaccine preventable diseases and the COVID 19 local transmission scenario Successively recovering of vaccinations should be planned Moreover during the pandemic influenza vaccination should be promoted as a central public health measure Future challenges will be to maintain the vaccination programmes especially in children younger than 2 years old and adolescents to plan the recovery of vaccinations for subjects who postponed them during the lockdown and to early identify any vaccine preventable disease outbreak | 0 |
459 | COVID 19 and the labour market outcomes of disabled people in the UK The economic impact of COVID 19 has exacerbated inequalities in society but disability has been neglected This paper contributes to this knowledge gap by providing a comprehensive analysis of the differential labour market impact of COVID 19 by disability in the UK Using data from the Labour Force Survey before and during the pandemic it estimates disability gaps in pre pandemic risk factors as well as changes in labour market inequality nearly one year on Disabled workers are found to face higher COVID 19 related economic and health risks including being more likely to work in shutdown industries and in occupations with greater proximity to others and exposure to disease However established measures of inequality including the disability employment and pay gap suggest limited impact of COVID 19 in 2020 Nevertheless the increase in the probability of being temporarily away from work even among otherwise comparable workers is 40 higher for disabled workers and consistent with disproportionate use of the governments job retention scheme While the reasons for this are likely to be complex there is a risk that it will contribute to future disability related labour market inequality | 0 |
381 | The use of biological agents in pregnant women affected by autoimmune disorders Why we need more research of this neglected area Women of childbearing age are largely affected by several autoimmune disorders the estimates range between 1 5 and 10 per 10 000 The increasing number of effective biological agents has dramatically revolutionized the treatment of these clinical conditions ameliorating the patients quality of life The use of these agents by women during pregnancy is growing to ensure the disease activity control and avoid adverse health outcomes However for many newer biological agents the degree of information concerning their use in pregnancy is often incomplete to perform a conclusive risk assessment on fetal and maternal health given the exclusion of this specific population from pharmacological clinical trials More recently the COVID 19 pandemic has confirmed the unacceptable inequities of pharmacological research and medical treatment for pregnant and lactating women exacerbating the need for filling the gaps of quantitative and qualitative pharmacology data in this sensitive population ere we summarize i what is already known about safety and effectiveness of biological agents in this understudied population with specific focus on pregnancy related health outcomes and what we are going to learn from the on going studies among pregnant women treated with biological agents ii the methodological and ethical considerations that characterize the pharmacological research in pregnancy also discussing emerging evidence on the use of therapeutic drug monitoring TDM in this clinical setting | 0 |
143 | Could Cognitive Behavioural Therapy Be an Effective Treatment for Long COVID and Post COVID 19 Fatigue Syndrome Lessons from the Qure Study for Q Fever Fatigue Syndrome An increasing number of young and previously fit and healthy people who did not require hospitalisation continue to have symptoms months after mild cases of COVID 19 Rehabilitation clinics are already offering cognitive behavioural therapy CBT as an effective treatment for long COVID and post COVID 19 fatigue syndrome based on the claims that it is effective for myalgic encephalomyelitis chronic fatigue syndrome ME CFS the most common post infectious syndrome as no study into the efficacy of CBT for post COVID 19 fatigue syndrome has been published Re analyses of these studies however showed that CBT did not lead to objective improvements in heterogeneous groups of ME CFS patients nor did it restore the ability to work The group of patients with long COVID and post COVID 19 fatigue syndrome on the other hand is homogeneous We therefore analysed the Dutch Qure study as it studied the efficacy of CBT in a homogeneous group of patients who developed Q fever fatigue syndrome which affects up to 30 of patients after the largest reported outbreak of Q fever to see if CBT might potentially be an effective treatment for long haulers after COVID 19 infection Our reanalysis found that the Qure study suffered from many serious methodological problems which included relying on one subjective primary outcome in a study without a control group for the non blinded CBT treatment group using a post hoc definition of improvement waiting 2 years before publishing their objective actometer results and ignoring the null effect of said results Moreover only 10 of participants achieved a clinically meaningful subjective improvement in fatigue as a result of CBT according to the studys own figures Consequently CBT has no subjective clinically meaningful effect in nine out of every ten patients that are treated with it Additionally the subjective improvement in fatigue was not matched by an improvement in disability even though the disability was fatigue related according to the researchers On top of this CBT did not lead to an objective improvement in physical performance Therefore it cannot be said that CBT is an effective treatment for Q fever fatigue syndrome either It seems therefore unlikely that CBT will reduce disability or lead to objective improvement in long COVID or in post COVID 19 fatigue syndrome | 1 |
285 | Multisystem inflammatory syndrome in children MIS C and the coronavirus pandemic Current knowledge and implications for public health The coronavirus disease 2019 COVID 19 pandemic has caused widespread mortality and morbidity Though children are largely spared from severe illness a novel childhood hyperinflammatory syndrome presumed to be associated with and subsequent to severe acute respiratory syndrome coronavirus 2 SARS CoV 2 infection has emerged with potentially severe outcomes Multisystem inflammatory disorder in children MIS C most commonly affects young school aged children and is characterized by persistent fever systemic hyperinflammation and multisystem organ dysfunction While uncommon and generally treatable MIS C presents potentially life altering medical sequelae complicated by a dearth of information regarding its etiology pathophysiology and long term outcomes The severity of MIS C may warrant the need for increased awareness and continued COVID 19 mitigation efforts particularly until potential factors conferring a predisposition to MIS C can be clarified through additional research Well informed guidelines will be critical as the school year progresses In this article current knowledge on MIS C is reviewed and the potential implications of this novel syndrome are discussed from a public health perspective | 1 |
339 | A national survey of community rehabilitation service provision for people with long Covid in Scotland b Background b Over 50 million cases of COVID 19 have been confirmed globally as of November 2020 Evidence is rapidly emerging on the epidemiology of COVID 19 and its impact on individuals and potential burden on health services and society Between 10 35 of people with COVID 19 may experience post acute long Covid This currently equates to between 8 129 and 28 453 people in Scotland Some of these people will require rehabilitation to support their recovery Currently we do not know how to optimally configure community rehabilitation services for people with long Covid b Methods b This national survey aimed to provide a detailed description of current community rehabilitation provision for people with long Covid in Scotland We developed piloted and conducted a national electronic survey of current community rehabilitation service provision for people presenting with long Covid symptomatology Our sample were the Allied Health Professions Directors of all 14 territorial NHS Health Boards in Scotland Fixed response and narrative data were analysed descriptively b Results b Responses were received from all respondents 14 14 enabling a national picture to be gained Almost all Health Boards 13 14 currently deliver rehabilitation for people with long Covid within pre existing services Fatigue 11 14 and respiratory conditions 9 14 were the two most common presenting problems of patients Most long Covid community rehabilitation services are delivered through a combination of face to face and digital contact 13 14 b Conclusions b Community rehabilitation for people with long Covid is an emerging reality This survey provides a national picture of current community rehabilitation for people with long Covid We do not know how community rehabilitation can be optimally delivered for this population This is vital as community rehabilitation services were already under pressure prior to the emergence of COVID 19 Further research is urgently required to investigate the implementation outcomes and cost effectiveness of differing models of community rehabilitation for this patient population | 1 |
441 | Image challenge left sided facial swelling in a patient with COVID 19 A 68 year old man with diabetes presented with shortness of breath left sided facial swelling and nasal discharge He had recently returned from India and PCR was positive for SARS CoV 2 Delta variant CT head and diffusion weighted MRI sinuses were performed and the patient underwent endoscopic sinus surgery before being transferred to a specialist skull base centre | 0 |
122 | Comparison of post COVID depression and major depressive disorder During the COVID 19 pandemic rates of depressive symptoms are markedly elevated particularly among survivors of infection Understanding whether such symptoms are distinct among those with prior SARS CoV 2 infection or simply a nonspecific reflection of elevated stress could help target interventions We analyzed data from multiple waves of a 50 state survey that included questions about COVID 19 infection as well as the Patient Health Questionnaire examining depressive and anxious symptoms We utilized multiple logistic regression to examine whether sociodemographic features associated with depression liability differed for those with or without prior COVID 19 and then whether depressive symptoms differed among those with or without prior COVID 19 Among 91 791 respondents in regression models age gender race education and income all exhibited an interaction with prior COVID 19 in risk for moderate or greater depressive symptoms p 0 0001 in all cases indicating differential risk in the two subgroups Among those with such symptoms levels of motoric symptoms and suicidality were significantly greater among those with prior COVID 19 illness Depression risk increased with greater interval following acute infection Our results suggest that major depressive symptoms observed among individuals with prior COVID 19 illness may not reflect typical depressive episodes and merit more focused neurobiological investigation | 1 |
22 | Post COVID 19 Syndrome The Persistent Symptoms at the Post viral Stage of the Disease A Systematic Review of the Current Data Whilst the entire world is battling the second wave of COVID 19 a substantial proportion of patients who have suffered from the condition in the past months are reporting symptoms that last for months after recovery i e long term COVID 19 symptoms We aimed to assess the current evidence on the long term symptoms in COVID 19 patients We did a systematic review on PubMed Web of Science EMBASE and Google Scholar from database inception to February 15 2021 for studies on long term COVID 19 symptoms We included all type of papers that reported at least one long term COVID 19 symptom We screened studies using a standardized data collection form and pooled data from published studies Cohort cross sectional case report cases series case control studies and review were graded using specific quality assessment tools Of 11 361 publications found following our initial search we assessed 218 full text articles of which 145 met all selection criteria We found that 20 70 of reports on long term COVID 19 symptoms were on abnormal lung functions 24 13 on neurologic complaints and olfactory dysfunctions and 55 17 on specific widespread symptoms mainly chronic fatigue and pain Despite the relatively high heterogeneity of the reviewed studies our findings highlighted that a noteworthy proportion of patients who have suffered from SARS CoV 2 infection present a post COVID syndrome The multifaceted understanding of all aspects of the COVID 19 pandemic including these long term symptoms will allow us to respond to all the global health challenges thus paving the way to a stronger public health | 1 |
64 | From frustration to enlightenment experiences of student exchange program awardees in Taiwan b Background b Studying abroad is one of the most exciting experiences for a college student who is running a student exchange program as it creates opportunities to learn work solve problems and ensure a secured life However Indonesians who are into student exchange programs face some difficulties in adjusting to their new environment They experience awkwardness in the use of advanced equipment from technology and cultural aspects This study investigates the experiences of two Indonesian students who participated for a semester at a Taiwanese university It aims to explore the Indonesian student exchange program awardees experiences by examining both the obstacles and benefits of attending the Taiwanese university b Methods b This study used qualitative data analysis Data were collected through a semi structured interview informal participant observations and a set of open and closed ended questions Two Indonesian undergraduate students who belonged to the same major year and university were recruited to act as ambassadors b Results b The two students reported facing some problems but felt more independent and became more adaptable They met with new people and explored new places and learned much in terms of teaching pedagogy and personal development from the 21 sup st sup century classroom pedagogy which was important for their future carrier in education Aside from being able to feel the 21 sup st sup century classroom environment they were able to learn the host language and culture which enriched their insights Five main findings emerged departure and journey difficulties in settling in inability to use technology facilities meeting new people and exploring new places and 21 sup st sup century classroom environment b Conclusions b Despite the challenges that are associated with being a student exchange awardee there are vast opportunities for self development and learning the ropes associated with teaching from the 21st century classroom pedagogy | 1 |
58 | Post COVID pulmonary fibrosis therapeutic efficacy using with mesenchymal stem cells How the lung heals COVID 19 is an acute respiratory infectious disease caused by SARS COV 2 Severe Acute Respiratory Syndrome Coronavirus that has become a global pandemic COVID 19 mainly causes the respiratory complications of Acute Respiratory Distress Syndrome ARDS cytokine storm and severe immune disruptions The assays depict that though people recuperate from COVID 19 there are still symptoms that persists in the body causing discomfort which is the consequence of the viral infection due to severe immune disruptions Upon various difficulties of post COVID 19 the pulmonary fibrosis is the stumbling block in the lungs causing severe damage In this review we have shown the effectiveness and importance of the Hepatocyte Growth Factor HGF secreted by Mesenchymal Stem Cell MSC therapy on selective stoppage of the Transforming Growth Factor Beta TGF β signalling pathway by causing immunomodulatory effects that ameliorate the pulmonary fibrosis through paracrine signalling However more pilot studies have to be carried out to determine the efficacy and outcomes of the re emerging complication | 1 |
306 | Immuno fibrotic drivers of impaired lung function in post acute sequelae of SARS CoV 2 infection PASC Subjects recovering from COVID 19 frequently experience persistent respiratory ailments however little is known about the underlying biological factors that may direct lung recovery and the extent to which these are affected by COVID 19 severity We performed a prospective cohort study of subjects with persistent symptoms after acute COVID 19 collecting clinical data pulmonary function tests and plasma samples used for multiplex profiling of inflammatory metabolic angiogenic and fibrotic factors Sixty one subjects were enrolled across two academic medical centers at a median of 9 weeks interquartile range 6 10 after COVID 19 illness n 13 subjects 21 mild non hospitalized n 30 49 hospitalized non critical and n 18 subjects 30 hospitalized intensive care ICU Fifty three subjects 85 had lingering symptoms most commonly dyspnea 69 and cough 58 Forced vital capacity FVC forced expiratory volume in 1 second FEV1 and diffusing capacity for carbon monoxide DLCO declined as COVID 19 severity increased P 0 05 but did not correlate with respiratory symptoms Partial least squares discriminant analysis of plasma biomarker profiles clustered subjects by past COVID 19 severity Lipocalin 2 LCN2 matrix metalloproteinase 7 MMP 7 and hepatocyte growth factor HGF identified by the model were significantly higher in the ICU group P 0 05 and inversely correlated with FVC and DLCO P 0 05 and were confirmed in a separate validation cohort n 53 Subjective respiratory symptoms are common after acute COVID 19 illness but do not correlate with COVID 19 severity or pulmonary function Host response profiles reflecting neutrophil activation LCN2 fibrosis signaling MMP 7 and alveolar repair HGF track with lung impairment and may be novel therapeutic or prognostic targets The study was funded in part by the NHLBI K08HL130557 to BDK and R01HL142818 to HJC the DeLuca Foundation Award AP a donation from Jack Levin to the Benign Hematology Program at Yale and Divisional Departmental funds from Duke University | 1 |
272 | Pulmonary rehabilitation in long COVID more than just natural recovery b In the light of missing randomised controlled trials some arguments suggest that pulmonary rehabilitation has beneficial effects beyond natural recovery b https bit ly 3ze2xvw | 1 |
680 | Advancements in detection of SARS CoV 2 infection for confronting COVID 19 pandemics As one of the major approaches in combating the COVID 19 pandemics the availability of specific and reliable assays for the SARS CoV 2 viral genome and its proteins is essential to identify the infection in suspected populations make diagnoses in symptomatic or asymptomatic individuals and determine clearance of the virus after the infection For these purposes use of the quantitative reverse transcriptase polymerase chain reaction qRT PCR for detection of the viral nucleic acid remains the most valuable in terms of its specificity fast turn around high throughput capacity and reliability It is critical to update the sequences of primers and probes to ensure the detection of newly emerged variants Various assays for increased levels of IgG or IgM antibodies are available for detecting ongoing or past infection vaccination responses and persistence and for identifying high titers of neutralizing antibodies in recovered individuals Viral genome sequencing is increasingly used for tracing infectious sources monitoring mutations and subtype classification and is less valuable in diagnosis because of its capacity and high cost Nanopore target sequencing with portable options is available for a quick process for sequencing data Emerging CRISPR Cas based assays such as SHERLOCK and AIOD CRISPR for viral genome detection may offer options for prompt and point of care detection Moreover aptamer based probes may be multifaceted for developing portable and high throughput assays with fluorescent or chemiluminescent probes for viral proteins In conclusion assays are available for viral genome and protein detection and the selection of specific assays depends on the purposes of prevention diagnosis and pandemic control or monitoring of vaccination efficacy | 0 |
544 | Cryoglobulins Identification classification and novel biomarkers of mysterious proteins Cryoglobulins consist of serum immunoglobulins that precipitate below 37 C and resolubilize upon warming The clinical triad of cryoglobulinemia usually includes purpura weakness and arthralgia Cryoglobulinemic syndrome clinically defined as a systemic vasculitis is associated with chronic infection with hepatitis C virus HCV and autoimmune disorders and can evolve into B cell malignancies While the current literature about HCV associated cryoglobulinemia is not very limited little is known about the immunologic and serologic profiles of affected patients Therefore comprehension of the pathogenetic mechanisms underlying cryoprecipitation could be very helpful Due to the persistence of viral antigenic stimulation biomarkers to use after the worsening progression of HCV infection to lymphoproliferative and or autoimmune diseases are widely needed Laboratory methods used to detect and characterize low concentrations of cryoprecipitates and immunotyping patterns could improve patient management The most critical factor affecting cryoglobulin testing is that the pre analytical phase is not fully completed at 37 C | 0 |
583 | Covid 19 Pandemic Resumption of Orthopedic Care and Medical Education Covid 19 is a respiratory disease caused by coronavirus 2 SARS CoV 2 first identified in Wuhan China December 2019 The disease rapidly crossed the barrier of countries continents and spread globally Non pharmaceutical measures such as social distancing face mask frequent hand washing and use of sanitizer remained the best available option to prevent the spread of disease OPD IPD admissions elective O Ts were curtailed Orthopedic care was only limited to emergency and semi urgent procedures like necrotizing fasciitis open fracture and compartment syndrome These measures were taken to preserve infrastructure and manpower to manage covid 19 pandemic The children were thought to have a low susceptibility to covid 19 as compared to an adult Deferring the patient during pandemic has led to high orthopedic disease burden morbidity and disease related sequelae hence elective care must be resumed with modified hospital infrastructure Resumption of elective emergent orthopedic care should be slow phasic and strategic much similar to unlocking Cases must be stratified depending on covid status and severity Dedicated O Ts with neutral negative pressure and HEPA filter for covid positive and suspected patients are to be used All symptomatic and suspected patients should be investigated for covid 19 by RT PCR blood counts and CT scan Regional anaesthesia should be preferred to General anaesthesia Power drill saw burr pulse lavage should be minimized to avoid aerosol generation Postoperatively continuous surveillance and monitoring to be done for covid related symptoms Medical institutes rapidly shifted to the online mode of education Blended learning virtual physical and imparting skills have to be continued in post covid phase with equitable distribution of teaching hours to students of different years | 0 |
343 | Post acute sequelae of SARS CoV 2 infection Caring for the long haulers An estimated 10 of COVID 19 survivors continue to experience symptoms several weeks to months after the appearance of initial symptoms a condition termed post acute sequelae of SARS CoV 2 infection PASC These patients also called long haulers most commonly report protracted symptoms of fatigue cough dyspnea chest tightness difficulty concentrating arthralgia olfactory dysfunction and headache While age comorbid medical conditions and COVID 19 severity are risk factors young and previously healthy individuals with mild COVID 19 are also at risk Recognition of symptoms evaluation supportive treatment and attention to medical comorbidities are the cornerstones of medical management | 1 |
595 | Association of Blood Groups with the Severity and Outcome of COVID 19 Infection in Children The objective of this study was to find out the association of ABO blood groups with the severity and outcome of corona virus disease 2019 COVID 19 in children It included all laboratory confirmed cases of COVID 19 and post COVID multisystem inflammatory syndrome in children MIS C Kawasaki disease KD like illness admitted from March to September 2020 to The Childrens Hospital Lahore Out of 66 children 45 68 2 were COVID 19 and 21 31 8 MIS C KD temporally associated with SARS C0V 2 The mean age was 7 9 4 2 years Majority of children had mild to moderate illness 38 57 6 while 23 34 8 had severe or critical disease Among all patients 24 36 4 had some underlying comorbidity Blood group A was significantly associated with severe and critical disease p 0 030 COVID 19 in children had generally a good outcome but children with blood group A were more susceptible to severe critical disease Key Words Coronavirus disease 2019 ABO blood groups Children Severity Outcome | 0 |
100 | Is there a post COVID syndrome For critically ill COVID 19 patients surviving the acute phase of the disease could possibly only mean having overcome the first stage of a long and challenging path Physical cognitive and psychological consequences seem to be realistic however do residual symptoms in patients who have returned to microbiological normalization constitute a post COVID syndrome and which symptoms are principally possible in this context and are able to cause such a syndrome It is no novelty that critically ill patients often still sustain functional limitations over a long period after discharge from hospital in many cases even over many years In most cases of COVID 19 it is too early for the diagnosis of a post COVID syndrome For this the symptoms would have to have lasted over a period of at least 6 months therefore only a post infection fatigue can currently be spoken of On top of this even if patients recover physically they could be at particular risk of suffering from long term mental health problems or perceive a reduced quality of life Such findings exist not only after ARDS as many intensive care unit patients sustain long term disorders which is also known as post intensive care syndrome PICS To sum up there is sufficient evidence for the possible existence of a post COVID syndrome or for the justification to correspondingly designate these possible sequelae with persisting symptoms in this way In any case all efforts that enable a complete functional recovery and a return to a life after corona are justified | 1 |
661 | Mental health among healthcare workers and other vulnerable groups during the COVID 19 pandemic and other coronavirus outbreaks A rapid systematic review Although most countries and healthcare systems worldwide have been affected by the COVID 19 pandemic some groups of the population may be more vulnerable to detrimental effects of the pandemic on mental health than others The aim of this systematic review was to synthesise evidence currently available from systematic reviews on the impact of COVID 19 and other coronavirus outbreaks on mental health for groups of the population thought to be at increased risk of detrimental mental health impacts We conducted a systematic review of reviews on adults and children residing in a country affected by a coronavirus outbreak and belonging to a group considered to be at risk of experiencing mental health inequalities Data were collected on symptoms or diagnoses of any mental health condition quality of life suicide or attempted suicide The protocol for this systematic review was registered in the online PROSPERO database prior to commencing the review https www crd york ac uk prospero display_record php RecordID 194264 We included 25 systematic reviews Most reviews included primary studies of hospital workers from multiple countries Reviews reported variable estimates for the burden of symptoms of mental health problems among acute healthcare workers COVID 19 patients with physical comorbidities and children and adolescents No evaluations of interventions were identified Risk and protective factors mostly for healthcare workers showed the importance of personal factors the work environment and social networks for mental health This review of reviews based on primary studies conducted in the early months of the COVID 19 pandemic shows a lack of evidence on mental health interventions and mental health impacts on vulnerable groups in the population | 0 |
487 | The long term consequences of Corona Virus Disease 2019 patients receiving Chinese herbal medicine treatments in acute phase A protocol for systematic review and meta analysis In December 2019 the first case of Corona Virus Disease 2019 COVID 19 associated with severe acute respiratory syndrome coronavirus 2 viral infection was described in Wuhan Similar to SARS in 2003 COVID 19 also had a lasting impact Approximately 76 of patients discharged after hospitalization for COVID 19 had neurological manifestations which could persist for 6 months and some long term consequences such as the gradual loss of lung function due to pulmonary interstitial fibrosis could have comprehensive effects on daily quality of life for people who were initially believed to have recovered from COVID 19 Our comprehensive search strategy developed in consultation with a research librarian We will search these following electronic databases PubMed Cochrane Library Web of Science ScienceDirect Scopus Google Scholar Embase ProQuest China Science and Technology Journal Database VIP China National Knowledge Infrastructure WANFANG DATA WHO covid 19 website and Centers for Disease Control and the Prevention COVID 19 websites of the United States and China The bias of publication will be confirmed via the P value of Egger test The quality of studies will be evaluated by the Newcastle Ottawa Scale There are no ethical considerations associated with this study protocol for this systematic review which mainly focuses on the examination of secondary data On completion of this analysis we will prepare a manuscript for publication in a peer reviewed medical journal CRD42021258711 | 0 |
480 | Translating known drivers of COVID 19 disease severity to design better SARS CoV 2 vaccines The SARS CoV 2 pandemic has highlighted how an emergent disease can spread globally and how vaccines are once again the most important public health policy to combat infectious disease Despite promising initial protection the rise of new viral variants calls into question how effective current SARS CoV 2 vaccines will be moving forward Improving on vaccine platforms represents an opportunity to stay ahead of SARS CoV 2 and keep the human population protected Many researchers focus on modifying delivery platforms or altering the antigen s presented to improve the efficacy of the vaccines Identifying mechanisms of natural immunity that result in the control of infection and prevent poor clinical outcomes provides an alternative approach to the development of efficacious vaccines Early and current evidence shows that SARS CoV 2 infection is marked by potent lung inflammation and relatively diminished antiviral signaling which leads to impaired immune recognition and viral clearance essentially making SARS CoV 2 too hot to handle | 0 |
132 | The microvascular hypothesis underlying neurologic manifestations of long COVID 19 and possible therapeutic strategies With the ongoing distribution of the coronavirus disease COVID vaccines the pandemic of our age is ending leaving the world to deal with its well documented aftereffects Long COVID comprises a variety of symptoms of which the neurological component prevails The most permeating theory on the genesis of these symptoms builds upon the development of microvascular dysfunction similar to that seen in numerous vascular diseases such as diabetes This can occur through the peripheral activation of angiotensin converting enzyme 2 receptors or through exacerbations of pro inflammatory cytokines that can remain in circulation even after the infection diminishes Several drugs have been identified to act on the neurovascular unit to promote repair such as gliptins and others They also succeeded in improving neurologic outcome in diabetic patients The repurposing of such drugs for treatment of long COVID 19 can possibly shorten the time to recovery of long COVID 19 syndrome | 1 |
203 | Multiorgan impairment in low risk individuals with post COVID 19 syndrome a prospective community based study To assess medium term organ impairment in symptomatic individuals following recovery from acute SARS CoV 2 infection Baseline findings from a prospective observational cohort study Community based individuals from two UK centres between 1 April and 14 September 2020 Individuals 18 years with persistent symptoms following recovery from acute SARS CoV 2 infection and age matched healthy controls Assessment of symptoms by standardised questionnaires EQ 5D 5L Dyspnoea 12 and organ specific metrics by biochemical assessment and quantitative MRI Severe post COVID 19 syndrome defined as ongoing respiratory symptoms and or moderate functional impairment in activities of daily living single organ and multiorgan impairment heart lungs kidneys liver pancreas spleen by consensus definitions at baseline investigation 201 individuals mean age 45 range 21 71 years 71 female 88 white 32 healthcare workers completed the baseline assessment median of 141 days following SARS CoV 2 infection IQR 110 162 The study population was at low risk of COVID 19 mortality obesity 20 hypertension 7 type 2 diabetes 2 heart disease 5 with only 19 hospitalised with COVID 19 42 of individuals had 10 or more symptoms and 60 had severe post COVID 19 syndrome Fatigue 98 muscle aches 87 breathlessness 88 and headaches 83 were most frequently reported Mild organ impairment was present in the heart 26 lungs 11 kidneys 4 liver 28 pancreas 40 and spleen 4 with single organ and multiorgan impairment in 70 and 29 respectively Hospitalisation was associated with older age p 0 001 non white ethnicity p 0 016 increased liver volume p 0 0001 pancreatic inflammation p 0 01 and fat accumulation in the liver p 0 05 and pancreas p 0 01 Severe post COVID 19 syndrome was associated with radiological evidence of cardiac damage myocarditis p 0 05 In individuals at low risk of COVID 19 mortality with ongoing symptoms 70 have impairment in one or more organs 4 months after initial COVID 19 symptoms with implications for healthcare and public health which have assumed low risk in young people with no comorbidities NCT04369807 Pre results | 1 |
65 | Similar patterns of sup 18 sup F FDG brain PET hypometabolism in paediatric and adult patients with long COVID a paediatric case series Several weeks after COVID 19 infection some children report the persistence or recurrence of functional complaints This clinical presentation has been referred as long COVID in the adult population and an sup 18 sup F FDG brain PET hypometabolic pattern has recently been suggested as a biomarker Herein we present a retrospective analysis of 7 paediatric patients with suspected long COVID who were explored by sup 18 sup F FDG brain PET exam Metabolic brain findings were confronted to those obtained in adult patients with long COVID in comparison to their respective age matched control groups Review of clinical examination and whole brain voxel based analysis of sup 18 sup F FDG PET metabolism of the 7 children in comparison to 21 paediatric controls 35 adult patients with long COVID and 44 healthy adult subjects Despite lower initial severity at the acute stage of the infection paediatric patients demonstrated on average 5 months later a similar brain hypometabolic pattern as that found in adult long COVID patients involving bilateral medial temporal lobes brainstem and cerebellum p voxel 0 001 p cluster 0 05 FWE corrected and also the right olfactory gyrus after small volume correction p voxel 0 010 FWE corrected with partial PET recovery in two children at follow up These results provide arguments in favour of possible long COVID in children with a similar functional brain involvement to those found in adults regardless of age and initial severity | 1 |
16 | Headache as an acute and post COVID 19 symptom in COVID 19 survivors A meta analysis of the current literature Headache is identified as a common post COVID sequela experienced by COVID 19 survivors The aim of this pooled analysis was to synthesize the prevalence of post COVID headache in hospitalized and non hospitalized patients recovering from SARS CoV 2 infection MEDLINE CINAHL PubMed EMBASE and Web of Science databases as well as medRxiv and bioRxiv preprint servers were searched up to 31 May 2021 Studies or preprints providing data on post COVID headache were included The methodological quality of the studies was assessed using the Newcastle Ottawa Scale Random effects models were used for meta analytical pooled prevalence of post COVID headache Data synthesis was categorized at hospital admission symptoms onset and at 30 60 90 and 180 days afterwards From 9573 studies identified 28 peer reviewed studies and 7 preprints were included The sample was 28 438 COVID 19 survivors 12 307 females mean age 46 6 SD 17 45 years The methodological quality was high in 45 of the studies The overall prevalence of post COVID headache was 47 1 95 CI 35 8 58 6 at onset or hospital admission 10 2 95 CI 5 4 18 5 at 30 days 16 5 95 CI 5 6 39 7 at 60 days 10 6 95 CI 4 7 22 3 at 90 days and 8 4 95 CI 4 6 14 8 at 180 days after onset hospital discharge Headache as a symptom at the acute phase was more prevalent in non hospitalized 57 97 than in hospitalized 31 11 patients Time trend analysis showed a decreased prevalence from the acute symptoms onset to all post COVID follow up periods which was maintained afterwards This meta analysis found that the prevalence of post COVID headache ranged from 8 to 15 during the first 6 months after SARS CoV 2 infection | 1 |
626 | Care of Pediatric Patients with Diabetes During the Coronavirus Disease 2019 COVID 19 Pandemic This article summarizes clinical observations and management strategies in pediatric type 1 diabetes T1D during the coronavirus disease 2019 COVID 19 pandemic Despite initial fears that children with diabetes would similar to adults with diabetes be at risk for severe COVID 19 most pediatric patients with a history of T1D who developed COVID 19 had mild disease or were asymptomatic similar to their peers without diabetes The article also summarizes the use of telemedicine to provide ongoing care for pediatric patients with T1D during the COVID 19 pandemic Finally the article highlights important lessons learned about management of pediatric diabetes during the COVID 19 pandemic | 0 |
47 | The occurrence of long COVID a rapid review The long term effects of the severe acute respiratory syndrome SARS coronavirus 2 SARS CoV 2 are not well understood This rapid review was aimed at synthesizing evidence on the long term effects of the SARS CoV 2 infection among survivors We considered both randomised controlled trials and non randomised studies eligible for inclusion in this review The following databases were searched PubMed Scopus Cochrane library Google Scholar and the World Health Organization WHO COVID 19 database The reference lists of all the included studies were also searched Two authors independently screened the search outputs and reviewed full texts of potentially eligible articles Data extraction was done by one author and checked by a second author A meta analysis was not conducted due to heterogeneity among the included studies Results are presented narratively Eleven studies met our inclusion criteria All these studies were conducted in high income countries Study findings demonstrate that COVID 19 survivors can experience persistent symptoms after recovering from their initial illness especially among previously hospitalized persons The majority of symptoms reported were fatigue shortness of breath cough and sleep disorders Mental conditions such as depression and anxiety disorders were also reported In conclusion this study showed that COVID 19 survivors can experience persistent symptoms after recovering from their initial illness Therefore there is a need for a long term follow up of COVID 19 patients and rehabilitation services for survivors More research is needed in this area especially in Africa | 1 |
233 | Duration of post COVID 19 symptoms is associated with sustained SARS CoV 2 specific immune responses A subset of COVID 19 patients exhibit post acute sequelae of COVID 19 PASC but little is known about the immune signatures associated with these syndromes We investigated longitudinal peripheral blood samples in 50 individuals with previously confirmed SARS CoV 2 infection including 20 who experienced prolonged duration of COVID 19 symptoms lasting more than 30 days median 74 days compared with 30 who had symptom resolution within 20 days Individuals with prolonged symptom duration maintained antigen specific T cell response magnitudes to SARS CoV 2 spike protein in CD4 and circulating T follicular helper cell populations during late convalescence while those without persistent symptoms demonstrated an expected decline The prolonged group also displayed increased IgG avidity to SARS CoV 2 spike protein Significant correlations between symptom duration and both SARS CoV 2 specific T cells and antibodies were observed Activation and exhaustion markers were evaluated in multiple immune cell types revealing few phenotypic differences between prolonged and recovered groups suggesting that prolonged symptom duration is not due to persistent systemic inflammation These findings demonstrate that SARS CoV 2 specific immune responses are maintained in patients suffering from prolonged post COVID 19 symptom duration in contrast to those with resolved symptoms and may suggest the persistence of viral antigens as an underlying etiology | 1 |
652 | Obesity and immune status in children Childhood obesity with persistent chronic inflammation is a worldwide epidemic Obesity causes dysregulation throughout the immune system affecting the balance and levels of cytokines adipokines and innate and adaptive immune cells The present review focuses on the impact of obesity on immune function in children altering the baseline activation state of immune cells and affecting the ability of the host to combat pathogens and malignancy and respond appropriately to vaccination Obesity causes dysregulation of the immune system Single cell RNA sequencing of adipose tissue and resident immune cells is quantifying the impact of obesity on the frequency of immune cell subsets and their states The system wide alterations in immune function in obesity are most evident upon perturbation including the response to infection e g increased risk of severe COVID 19 in the ongoing pandemic vaccination and malignancy However mechanistic research in pediatric obesity is limited and this impacts our ability to care for these children We must better understand baseline and perturbed immune health in obese children to determine how to account for altered frequency and function of humoral and cellular immune components in acute infection during vaccine design and when considering therapeutic options for this complex medically vulnerable group | 0 |
642 | Development and optimization of heavy metal lead biosensors in biomedical and environmental applications The detrimental impact of the heavy metal lead Pb on human health has been studied for years The fact that Pb impairs human body has been established from countless painful and sad historical events Nowadays World Health Organization and many developmental countries have established regulations concerning the use of Pb Measuring the blood lead level BLL is so far the only way to officially evaluate the degree of Pb exposure but the so called safety value 10 μg dL in adults and 5 μg dL in children seems unreliable to represent the security checkpoint for children through daily intake of drinking water or physical contact with a lower contaminated level of Pb contents In general unsolved mysteries about the Pb toxicological mechanisms still remain In this review article we report on the methods to prevent Pb poison for further Pb toxicological research We establish high sensitivity Pb monitoring and also report on the use of fluorescent biosensors such as genetically encoded fluorescence resonance energy transfer based biosensors built for various large demands such as the detection of severe acute respiratory syndrome coronavirus 2 We also contribute to the development and optimization of the FRET based Pb biosensors Our well performed version of Met lead 1 44 M1 has achieved a limit of detection of 10 nM 2 ppb 0 2 μg dL and almost 5 fold in dynamic range DR supported for the real practical applications that is the in cell Pb sensing device for blood and blood related samples and the Pb environmental detections in vitro The perspective of our powerful Pb biosensor incorporated with a highly sensitive bio chip of the portable device for quick Pb measurements will be addressed for further manipulation | 0 |
113 | Clinical features and follow up of pediatric patients hospitalized for COVID 19 This report summarizes the clinical features and 1 month follow up observations for pediatric patients who were hospitalized with coronavirus disease 2019 COVID 19 in Wuhan Women and Childrens Hospital The 1 month follow up data included clinical manifestations and results from serum severe acute respiratory syndrome coronavirus 2 SARS CoV 2 IgG and IgM tests reverse transcription polymerase chain reaction RT PCR for SARS CoV 2 lung computed tomography CT scans and laboratory tests Between January 20 and March 15 2020 127 patients aged 0 15 years were hospitalized for COVID 19 treatment including 3 severe cases and 124 mild or moderate cases The main therapies included inhalation of aerosolized interferon α 122 127 and additional antiviral drugs 28 127 Among the 81 patients who had pneumonia at admission 35 with right lobe pneumonia had the longest hospital stay mean 14 5 7 days 17 with left lobe pneumonia had the highest creatine kinase 154 106 U L and creatine kinase myocardial band CK MB 43 48 U L levels and 29 with bilateral pneumonia had the highest white blood cell counts 8 3 4 10 sup 9 sup L Among the 46 patients who were successfully followed up 1 month after discharge two notable findings were right lobe pneumonia in 22 95 confidence interval CI 11 37 of patients and persistently elevated serum creatine kinase and CK MB levels The median duration of elevated CK MB was 45 days The mean concentrations of serum SARS CoV 2 IgG and IgM in 41 patients were 8 0 7 5 and 98 40 ng ml respectively At follow up four patients retested positive for SARS CoV 2 The involvement of different lung lobes in patients with COVID 19 was associated with variations in the persistence of pneumonia and elevation of CK MB levels and body temperature | 1 |
616 | How does COVID 19 affect intestinal microbiota There is a bidirectional interaction between the intestines and lungs the so called lung intestinal axis The review article reports on studies that deal with a possible influence of the intestinal microbiota on the immune response to a SARS CoV 2 infection Studies have shown that COVID 19 is accompanied by dysbiosis that persists even after successful virus conversion negative PCR One study found that the severity of COVID 19 is associated with the intestinal microbiota A dysbiosis could thus favor the so called cytokine storm There is indication that pre and probiotics could boost the immune response in both the guts and lungs | 0 |
152 | Role of the Renin Angiotensin Aldosterone and Kinin Kallikrein Systems in the Cardiovascular Complications of COVID 19 and Long COVID Severe Acute Respiratory Syndrome Coronavirus 2 SARS CoV 2 is the virus responsible for the COVID 19 pandemic Patients may present as asymptomatic or demonstrate mild to severe and life threatening symptoms Although COVID 19 has a respiratory focus there are major cardiovascular complications CVCs associated with infection The reported CVCs include myocarditis heart failure arrhythmias thromboembolism and blood pressure abnormalities These occur in part because of dysregulation of the Renin Angiotensin Aldosterone System RAAS and Kinin Kallikrein System KKS A major route by which SARS CoV 2 gains cellular entry is via the docking of the viral spike S protein to the membrane bound angiotensin converting enzyme 2 ACE2 The roles of ACE2 within the cardiovascular and immune systems are vital to ensure homeostasis The key routes for the development of CVCs and the recently described long COVID have been hypothesised as the direct consequences of the viral S protein ACE2 axis downregulation of ACE2 and the resulting damage inflicted by the immune response Here we review the impact of COVID 19 on the cardiovascular system the mechanisms by which dysregulation of the RAAS and KKS can occur following virus infection and the future implications for pharmacological therapies | 1 |
73 | Brain imaging before and after COVID 19 in UK Biobank There is strong evidence for brain related pathologies in COVID 19 some of which could be a consequence of viral neurotropism The vast majority of brain imaging studies so far have focused on qualitative gross pathology of moderate to severe cases often carried out on hospitalised patients It remains unknown however whether the impact of COVID 19 can be detected in milder cases in a quantitative and automated manner and whether this can reveal a possible mechanism for the spread of the disease UK Biobank scanned over 40 000 participants before the start of the COVID 19 pandemic making it possible to invite back in 2021 hundreds of previously imaged participants for a second imaging visit Here we studied the effects of the disease in the brain using multimodal data from 782 participants from the UK Biobank COVID 19 re imaging study with 394 participants having tested positive for SARS CoV 2 infection between their two scans We used structural and functional brain scans from before and after infection to compare longitudinal brain changes between these 394 COVID 19 patients and 388 controls who were matched for age sex ethnicity and interval between scans We identified significant effects of COVID 19 in the brain with a loss of grey matter in the left parahippocampal gyrus the left lateral orbitofrontal cortex and the left insula When looking over the entire cortical surface these results extended to the anterior cingulate cortex supramarginal gyrus and temporal pole We further compared COVID 19 patients who had been hospitalised n 15 with those who had not n 379 and while results were not significant we found comparatively similar findings to the COVID 19 vs control group comparison with in addition a greater loss of grey matter in the cingulate cortex central nucleus of the amygdala and hippocampal cornu ammonis all Z 3 Our findings thus consistently relate to loss of grey matter in limbic cortical areas directly linked to the primary olfactory and gustatory system Unlike in i post hoc i disease studies the availability of pre infection imaging data helps avoid the danger of pre existing risk factors or clinical conditions being mis interpreted as disease effects Since a possible entry point of the virus to the central nervous system might be via the olfactory mucosa and the olfactory bulb these brain imaging results might be the i in vivo i hallmark of the spread of the disease or the virus itself via olfactory and gustatory pathways | 1 |
125 | Epidemiologic and clinical characteristics of multisystem inflammatory syndrome in adults a rapid review Multisystem inflammatory disease in children MIS C is one of the severe presentations of the coronavirus disease 2019 COVID 19 that has been described in the literature since the beginning of the pandemic Although MIS C refers to children cases with similar clinical characteristics have been recently described in adults A description of the epidemiologic and clinical characteristics of multisystem inflammatory disease in adults MIS A is a starting point for better knowledge and understanding of this emerging disease We identified nine case reports of MIS A in the literature five from the United States two from France and two from the United Kingdom The case descriptions revealed similarities in clinical features including occurrence during post acute disease phase fever digestive symptoms cardiac involvement and elevated inflammatory markers All the patients were hospitalized three required admission to the intensive care unit and one died The most common treatments were intravenous immunoglobulin prednisolone and aspirin These findings suggest that MIS A is a severe complication of COVID 19 disease that can lead to death Further studies to improve our understanding of the pathogenesis of MIS A which will help improve treatment decisions and prevent sequelae or death | 1 |
432 | Adenoviral Vector DNA and SARS CoV 2 mRNA Based Covid 19 Vaccines Possible Integration into the Human Genome Are Adenoviral Genes Expressed in Vector based Vaccines Vigorous vaccination programs against SARS CoV 2 causing Covid 19 are the major chance to fight this dreadful pandemic The currently administered vaccines depend on adenovirus DNA vectors or on SARS CoV 2 mRNA that might become reverse transcribed into DNA however infrequently In some societies people have become sensitized against the potential short or long term side effects of foreign DNA being injected into humans In my laboratory the fate of foreign DNA in mammalian human cells and organisms has been investigated for many years In this review a summary of the results obtained will be presented This synopsis has been put in the evolutionary context of retrotransposon insertions into pre human genomes millions of years ago In addition studies on adenovirus vector based DNA on the fate of food ingested DNA as well as the long term persistence of SARS CoV 2 RNA DNA will be described Actual integration of viral DNA molecules and of adenovirus vector DNA will likely be chance events whose frequency and epigenetic consequences cannot with certainty be assessed The review also addresses problems of remaining adenoviral gene expression in adenoviral based vectors and their role in side effects of vaccines Eventually it will come down to weighing the possible risks of genomic insertions of vaccine associated foreign DNA and unknown levels of vector carried adenoviral gene expression versus protection against the dangers of Covid 19 A decision in favor of vaccination against life threatening disease appears prudent Informing the public about the complexities of biology will be a reliable guide when having to reach personal decisions about vaccinations | 0 |
631 | Exercise Is Medicine for Immune Function Implication for COVID 19 This review supports that physical activity improves immunosurveillance and has the potential to counter COVID 19 infection and symptomatology at three prevention levels At the primary prevention level several lines of evidence support that physical activity is an immune system adjuvant in combating infectious diseases Recent epidemiological studies indicate that regular physical activity is associated with a reduced risk for COVID 19 similar to what has been reported for other respiratory infections Although specific COVID 19 related studies are needed data from investigations with other types of infectious agents such as influenza support the potential role of physical activity in augmenting COVID 19 vaccine efficacy secondary prevention level There is a growing awareness that COVID 19 can cause sustained morbidity in some patients and physical training and rehabilitation tertiary prevention level can be directed toward improvement in physical fitness quality of life and immune health | 0 |
372 | Remote evaluations of violence against women and girls interventions a rapid scoping review of tools ethics and safety Although programmes and policies targeting violence against women and girls VAWG have increased in the past decade there is a paucity of evidence on the effectiveness of these interventions To expand this evidence base researchers increasingly employ remote data collection RDC including online surveys mobile applications and telephone interviews in their evaluations Although RDC allows for evaluations without in person interactions which are restricted during crises such as the COVID 19 pandemic information about these methods is necessary to understand their potential usefulness and limitations This scoping review examines remote evaluations of VAWG interventions to describe the landscape of RDC methods reflect on safety and ethical considerations and offer best practices for RDC in VAWG research Fourteen studies met eligibility criteria with seven five and two studies employing telephone interviews online surveys and mobile applications respectively Studies commonly stated that participants were asked to use a safe email or device but the method for verifying such safety was rarely specified Best practices around safety included creating a quick escape button for online data collection to use when another individual was present explaining to participants how to erase browsing history and application purchases and asking participants to specify a safe time for researchers to call Only eight studies established referral pathways for respondents as per best practice None of the eligible studies took place in low middle income countries LMICs or humanitarian settings likely reflecting the additional challenges to using RDC methods in lower resource settings Findings were used to create a best practice checklist for programme evaluators and Institutional Review Boards using RDC for VAWG interventions The authors found that opportunities exist for researchers to safely and effectively use RDC methodologies to gather VAWG data but that further study is needed to gauge the feasibility of these methods in LMICs and humanitarian settings | 0 |
410 | COVID 19 Disease Womens Predominant Non Heparin Vaccine Induced Thrombotic Thrombocytopenia and Kounis Syndrome A Passepartout Cytokine Storm Interplay Coronavirus disease 2019 COVID 19 and severe acute respiratory syndrome coronavirus 2 SARS CoV 2 constitute one of the deadliest pandemics in modern history demonstrating cardiovascular gastrointestinal hematologic mucocutaneous respiratory neurological renal and testicular manifestations and further complications COVID 19 induced excessive immune response accompanied with uncontrolled release of cytokines culminating in cytokine storm seem to be the common pathogenetic mechanism of these complications The aim of this narrative review is to elucidate the relation between anaphylaxis associated with profound hypotension or hypoxemia with pro inflammatory cytokine release COVID 19 relation with Kounis syndrome and post COVID 19 vaccination correlation with heparin induced thrombocytopenia with thrombosis HITT especially serious cerebral venous sinus thrombosis were also reviewed A current literature search in PubMed Embase and Google databases was performed to reveal the pathophysiology prevalence clinical manifestation correlation and treatment of COVID 19 anaphylaxis with profuse hypotension Kounis acute coronary syndrome and thrombotic events post vaccination The same key immunological pathophysiology mechanisms and cells seem to underlie COVID 19 cardiovascular complications and the anaphylaxis associated Kounis syndrome The myocardial injury in patients with COVID 19 has been attributed to coronary spasm plaque rupture and microthrombi formation hypoxic injury or cytokine storm disposing the same pathophysiology with the three clinical variants of Kounis syndrome COVID 19 interrelated vaccine excipients as polysorbate polyethelene glycol PEG and trometamol constitute potential allergenic substances Better acknowledgement of the pathophysiological mechanisms clinical similarities multiorgan complications of COVID 19 or other viral infections as dengue and human immunodeficiency viruses along with the action of inflammatory cells inducing the Kounis syndrome could identify better immunological approaches for prevention treatment of the COVID 19 pandemic as well as post COVID 19 vaccine adverse reactions | 0 |
133 | Evolving Phenotypes of non hospitalized Patients that Indicate Long Covid For some SARS CoV 2 survivors recovery from the acute phase of the infection has been grueling with lingering effects Many of the symptoms characterized as the post acute sequelae of COVID 19 PASC could have multiple causes or are similarly seen in non COVID patients Accurate identification of phenotypes will be important to guide future research and help the healthcare system focus its efforts and resources on adequately controlled age and gender specific sequelae of a COVID 19 infection In this retrospective electronic health records EHR cohort study we applied a computational framework for knowledge discovery from clinical data MLHO to identify phenotypes that positively associate with a past positive reverse transcription polymerase chain reaction RT PCR test for COVID 19 We evaluated the post test phenotypes in two temporal windows at 3 6 and 6 9 months after the test and by age and gender Data from longitudinal diagnosis records stored in EHRs from Mass General Brigham in the Boston metropolitan area was used for the analyses Statistical analyses were performed on data from March 2020 to June 2021 Study participants included over 96 thousand patients who had tested positive or negative for COVID 19 and were not hospitalized We identified 33 phenotypes among different age gender cohorts or time windows that were positively associated with past SARS CoV 2 infection All identified phenotypes were newly recorded in patientsâ medical records two months or longer after a COVID 19 RT PCR test in non hospitalized patients regardless of the test result Among these phenotypes a new diagnosis record for anosmia and dysgeusia OR 2 60 95 CI 1 94 3 46 alopecia OR 3 09 95 CI 2 53 3 76 chest pain OR 1 27 95 CI 1 09 1 48 chronic fatigue syndrome OR 2 60 95 CI 1 22 2 10 shortness of breath OR 1 41 95 CI 1 22 1 64 pneumonia OR 1 66 95 CI 1 28 2 16 and type 2 diabetes mellitus OR 1 41 95 CI 1 22 1 64 are some of the most significant indicators of a past COVID 19 infection Additionally more new phenotypes were found with increased confidence among the cohorts who were younger than 65 Our approach avoids a flood of false positive discoveries while offering a more robust probabilistic approach compared to the standard linear phenome wide association study PheWAS The findings of this study confirm many of the post COVID symptoms and suggest that a variety of new diagnoses including new diabetes mellitus and neurological disorder diagnoses are more common among those with a history of COVID 19 than those without the infection Additionally more than 63 percent of PASC phenotypes were observed in patients under 65 years of age pointing out the importance of vaccination to minimize the risk of debilitating post acute sequelae of COVID 19 among younger adults | 1 |
581 | Imaging Evaluation of Pulmonary and Non Ischaemic Cardiovascular Manifestations of COVID 19 Coronavirus Disease 2019 COVID 19 has been a pandemic challenge for the last year Cardiovascular disease is the most described comorbidity in COVID 19 patients and it is related to the disease severity and progression COVID 19 induces direct damage on cardiovascular system leading to arrhythmias and myocarditis and indirect damage due to endothelial dysfunction and systemic inflammation with a high inflammatory burden Indirect damage leads to myocarditis coagulation abnormalities and venous thromboembolism Takotsubo cardiomyopathy Kawasaki like disease and multisystem inflammatory syndrome in children Imaging can support the management assessment and prognostic evaluation of these patients Ultrasound is the most reliable and easy to use in emergency setting and in the ICU as a first approach The focused approach is useful in management of these patients due its ability to obtain quick and focused results This tool is useful to evaluate cardiovascular disease and its interplay with lungs However a detailed echocardiography evaluation is necessary in a complete assessment of cardiovascular involvement Computerized tomography is highly sensitive but it might not always be available Cardiovascular magnetic resonance and nuclear imaging may be helpful to evaluate COVID 19 related myocardial injury but further studies are needed This review deals with different modalities of imaging evaluation in the management of cardiovascular non ischaemic manifestations of COVID 19 comparing their use in emergency and in intensive care | 0 |
250 | A Clinic Blueprint for Post Coronavirus Disease 2019 RECOVERY Learning From the Past Looking to the Future The severe acute respiratory syndrome coronavirus 2 pandemic poses extraordinary challenges The tremendous number of coronavirus disease 2019 COVID 19 cases in the United States has resulted in a large population of survivors with prolonged postinfection symptoms The creation of multidisciplinary post COVID 19 clinics to address both persistent symptoms and potential long term complications requires an understanding of the acute disease and the emerging data regarding COVID 19 outcomes Experience with severe acute respiratory syndrome and Middle East respiratory syndrome post acute respiratory distress syndrome complications and post intensive care syndrome also informs anticipated sequelae and clinical program design Post COVID 19 clinical programs should be prepared to care for individuals previously hospitalized with COVID 19 including those who required critical care support nonhospitalized individuals with persistent respiratory symptoms following COVID 19 and individuals with preexisting lung disease complicated by COVID 19 Effective multidisciplinary collaboration models leverage lessons learned during the early phases of the pandemic to overcome the unique logistical challenges posed by pandemic circumstances Collaboration between physicians and researchers across disciplines will provide insight into survivorship that may shape the treatment of both acute disease and chronic complications In this review we discuss the aims general principles elements of design and challenges of a successful multidisciplinary model to address the needs of COVID 19 survivors | 1 |
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