Highest Coronavirus Disease 2019 Research Articles

COVID-19 site readiness initiative: Building clinical trial capacity for vaccine efficacy trials in Latin America in response to the pandemic

According to the World Health Organization, the American region has the highest coronavirus disease-2019 (COVID-19) cases and deaths since the start of the pandemic. This humanitarian tragedy presented the possibility of generating efficacy data from COVID-19 vaccine trials. The race to develop successful vaccines imposed a high demand for trained healthcare personnel and clinical sites where large scale randomized clinical trials could be conducted. This site readiness initiative, funded by the Bill and Melinda GatesFoundation (BMGF), was carried out to rapidly build site capacity for running COVID-19 vaccine trials in Latin America.Twenty-two sites across 7 countries were selected and received funding. Site selection was based on defined feasibility criteria which deemed these sites as suitable for running vaccine efficacy trials. Criteria for selection included investigator and core permanent staff experience, public health measures in place for COVID-19, import/export requirements for study drug and biological specimens, a clear and accelerated ethical and regulatory approval process for COVID-19 trials. Training was tailored and delivered according to the experience level of the investigator and site staff, and included GCP training, standard operating procedures (SOP) fundamentals, conducting vaccine trials, COVID-19 pathophysiology, and vaccine trials lessons learned. Most of the grant funds were utilized for space expansion and renovation (46 %) followed by purchase of equipment (36 %); the remaining 18 % was spent on human resources. By the end of this site readiness initiative project, which took approximately 4 months, 21 of 22 (95 %) sites had agreements in place or were in discussions with sponsors to conduct large scale COVID-19 vaccine trials.

Recognizing and Intervening on Elder Abuse, Neglect, and Exploitation in the Age of COVID-19

The rapid outbreak of coronavirus disease 2019 (COVID-19) caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has led to a global pandemic. Public health measures to prevent the spread of COVID-19, such as social distancing and self-quarantine, have drastically altered people’s lives and led to social isolation, financial instability, and disrupted access to healthcare and social services. Older adults have not only borne the brunt of the highest COVID-19 mortality rates, but recent studies also describe growing reports of elder mistreatment. It is necessary to attend to these age-related disparities during the remainder of the COVID-19 pandemic and future health crises. This symposium includes four presentations on researchers’ findings in elder mistreatment during the COVID-19 pandemic. Dr. E-Shien Chang will compare prevalence of elder mistreatment before and since the pandemic, and highlight associated risk and protective factors during the pandemic. Dr. Lena Makaroun will examine changes in elder mistreatment risk factors among caregivers during the pandemic. Dr. Pamela Teaster will present Adult Protective Services’ (APS) policy and practice changes in response to the pandemic to demonstrate the pandemic’s impact on service providers. Lastly, Dr. Pi-Ju (Marian) Liu will appraise elder mistreatment victims’ awareness of COVID-19 and their unmet needs during the pandemic. Following the four presentations, Dr. Pamela Teaster will moderate a discussion on how elder mistreatment is a growing concern, especially during the pandemic, and what service providers are doing to protect older adults.

Explaining the effective reproduction number of COVID-19 through mobility and enterprise statistics: Evidence from the first wave in Japan.

This study uses mobility statistics combined with business census data for the eight Japanese prefectures with the highest coronavirus disease-2019 (COVID-19) infection rates to study the effect of mobility reductions on the effective reproduction number (i.e., the average number of secondary cases caused by one infected person). Mobility statistics are a relatively new data source created by compiling smartphone location data; they can be effectively used for understanding pandemics if integrated with epidemiological findings and other economic data sets. Based on data for the first wave of infections in Japan, we found that reductions targeting the hospitality industry were slightly more effective than restrictions on general business activities. Specifically, we found that to hold back the pandemic (that is, to reduce the effective reproduction number to one or less for all days), a 20%–35% reduction in weekly mobility is required, depending on the region. A lesser goal, 80% of days with one or less observed transmission, can be achieved with a 6%–30% reduction in weekly mobility. These are the results if other potential causes of spread are ignored; for a fuller picture, more careful observations, expanded data sets, and advanced statistical modeling are needed.

A Study of the Clinico-epidemiological Profile of COVID-19 Patients Admitted in a Tertiary Care Hospital in India

Introduction: India is the second country with the highest Coronavirus Disease-2019 (COVID-19) case burden in the world. In India, Maharashtra state has the highest number of cases. Aim: To study the clinico-epidemiological profile of COVID-19 patients admitted in a COVID-19 designated tertiary care centre in Pune, Maharashtra, India. Materials and Methods: The authors retrospectively investigated epidemiological, demographic, clinical, laboratory, radiological and treatment data of 413 Real Time-Polymerase Chain Reaction (RT-PCR) confirmed COVID-19 patients from 14thApril 2020 to 30th June 2020. The data was analysed using the Mann-Whitney U test for continuous variables with non-normal distribution. Also, the multivariate logistic regression was used for analysis. Results: Among the 413 laboratory confirmed COVID-19 patients, 249 (60.29 %) were males, majority {87 (21.07%)} of the patients belonged to the age group of 51-60 years. The most common co-morbid condition found was diabetes mellitus {102 (24.69%)}. The most common symptoms were fever {185 (44.79%)} and cough {146 (35.35%)} followed by breathlessness {134 (32.45%)}. History of close contact with a confirmed COVID-19 case was present in 205 (49.64%) patients. The mean time from the onset of symptoms to hospital admission was 3.75 (SD±2.64) days. There was a strong association between increasing age and the need for intensive care. Total 63 (80.77%) out of 78 patients above 60 years of age had abnormal Chest X-Ray (CXR) findings during hospitalisation. Furthermore, the maximum number of deaths i.e., 31 patients (58.49%, n=53) occurred in the age group of more than 60 years of age. Conclusion: The findings suggest that increased value of serum Lactate Dehydrogenase (LDH) and Urea can be used as predictors for mortality rate. Patients aged more than 60 years are more prone for severe disease with Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) pneumonia and this subset of patients requires urgent medical attention.

Infection Control Practices and Outcomes of Endoscopy Units in the Lombardy Region of Italy: A Survey From the Italian Society of Digestive Endoscopy During COVID-19 Spread.

The present survey from the Italian Society of Digestive Endoscopy (SIED-Società Italiana di Endoscopia Digestiva) was aimed at reporting infection control practice and outcomes at Digestive Endoscopy Units in a high-incidence area. Lombardy was the Italian region with the highest coronavirus disease-2019 (COVID-19) prevalence, at the end of March 2020 accounting for 20% of all worldwide deaths. Joint Gastro-Intestinal societies released recommendations for Endoscopy Units to reduce the risk of the contagion. However, there are few data from high-prevalence areas on adherence to these recommendations and on their efficacy. A survey was designed by the Lombardy section of SIED to analyze (a) changes in activity and organization, (b) adherence to recommendations, (c) rate of health care professionals' (HCP) infection during the COVID-19 outbreak. In total, 35/61 invited centers (57.4%) participated; most modified activities were according to recommendations and had filtering face piece 2/filtering face piece 3 and water-repellent gowns available, but few had negative-pressure rooms or provided telephonic follow-up; 15% of HCPs called in sick and 6% had confirmed COVID-19. There was a trend (P=0.07) toward different confirmed COVID-19 rates among endoscopists (7.9%), nurses (6.6%), intermediate-care technicians (3.4%), and administrative personnel (2.2%). There was no correlation between the rate of sick HCPs and COVID-19 incidence in the provinces and personal protective equipment availability and use, whereas an inverse correlation with hospital volume was found. Adherence to recommendations was rather good, though a minority were able to follow all recommendations. Confirmed COVID-19 seemed higher among endoscopists and nurses, suggesting that activities in the endoscopy rooms are at considerable viral spread risk.