Outbreak Of Acute Respiratory Syndrome Research Articles

Evaluation of the Effectiveness of Remdesivir in the Treatment of COVID-19 Outpatients: A Retrospective Cohort Study

Background: The outbreak of acute respiratory syndrome with novel coronavirus 2019 (COVID-19) in December 2019 in Wuhan, China, caused a worldwide outbreak of the disease. To treat the disease, some drugs were identified and introduced that did not show a significant effect on the recovery of the disease. Due to the need to manage inpatient beds, this study was conducted to evaluate the effectiveness of Remdesivir in the treatment of outpatients with moderate to severe COVID-19. Methods: The present study was a retrospective cohort with a convenience sampling method. It was conducted by referring to the records of COVID-19 patients who were referred to the respiratory clinic of Shahid Beheshti Hospital as outpatients in the period from April to August 2021. Results: This study was conducted on 263 COVID-19 patients with a mean age of 51.16±14.39 years from 19 and 90 years old. Data were collected through a researcher-made checklist and analyzed using SPSS 20. Kolmogorov-Smirnov test, paired t-test, and Mc Nemar's test were used to evaluate the data. The significance level was considered at the level of 0.05. Conclusion: Findings revealed that no clear correlation was found between hospitalization and death rate compared to other patients. In our study, the risk factors for severe COVID-19 did not affect the rate of hospitalization or death of patients.

Evolution of Viral Pathogens Follows a Linear Order.

ABSTRACTAlthough lessons have been learned from previous severe acute respiratory syndrome (SARS) and Middle East respiratory syndrome (MERS) outbreaks, the rapid evolution of the viruses means that future outbreaks of a much larger scale are possible, as shown by the current coronavirus disease 2019 (COVID-19) outbreak. Therefore, it is necessary to better understand the evolution of coronaviruses as well as viruses in general. This study reports a comparative analysis of the amino acid usage within several key viral families and genera that are prone to triggering outbreaks, including coronavirus (severe acute respiratory syndrome coronavirus 2 [SARS-CoV-2], SARS-CoV, MERS-CoV, human coronavirus-HKU1 [HCoV-HKU1], HCoV-OC43, HCoV-NL63, and HCoV-229E), influenza A (H1N1 and H3N2), flavivirus (dengue virus serotypes 1 to 4 and Zika) and ebolavirus (Zaire, Sudan, and Bundibugyo ebolavirus). Our analysis reveals that the distribution of amino acid usage in the viral genome is constrained to follow a linear order, and the distribution remains closely related to the viral species within the family or genus. This constraint can be adapted to predict viral mutations and future variants of concern. By studying previous SARS and MERS outbreaks, we have adapted this naturally occurring pattern to determine that although pangolin plays a role in the outbreak of COVID-19, it may not be the sole agent as an intermediate animal. In addition to this study, our findings contribute to the understanding of viral mutations for subsequent development of vaccines and toward developing a model to determine the source of the outbreak.IMPORTANCE This study reports a comparative analysis of amino acid usage within several key viral genera that are prone to triggering outbreaks. Interestingly, there is evidence that the amino acid usage within the viral genomes is not random but in a linear order.

ABO blood grouping and COVID-19: a hospital-based study in Eastern India

BackgroundBlood group has been stated to be one of the risk factors associated with viral diseases like dengue, hepatitis virus, Norwalk virus and even the coronavirus associated with 2003 severe acute respiratory syndrome (SARS) outbreak. In addition, anti-A antibodies in experimental models have been shown to inhibit the interaction between coronavirus and angiotensin converting enzyme (ACE) receptor of the host target cell, the major receptor involved in viral pathogenesis. Thus, several workers propose an association between ABO blood type and coronavirus disease- 2019 (COVID-19) disease in many previous studies. The present study was undertaken in the Eastern part of India in line with these authors to study the association of ABO blood group of patients with COVID susceptibility and severity.MethodsThis is a retrospective study over a period of 6 months from June 2020 to November 2020 where patients who underwent quantitative real-time polymerase chain reaction (qRT-PCR) test for SARS-COV2 and having a recorded patient blood group type were considered. The qRT-PCR positive admitted cases were considered as cases, and qRT-PCR negative cases were considered as controls. Data were entered in Microsoft Excel format and analyzed by statistical method to obtain association.ResultsConsecutively obtained 5000 qRT-PCR positive patients (cases) and 11,700 (controls) were included in the present study. The mean age of cases was higher (54.24 vs. 34. 67) than the controls. Among the cases, the highest number (2379; 47.6%) of samples belonged to A blood group followed by B (1278; 25.6%) while among the control group O blood group had the highest prevalence (4215; 36%). Blood group A had a higher odd of testing positive (Odds ratio-2.552; CI 2.381–2.734; p < 0.0001) than all other blood groups. A blood group is also associated with higher risk of ICU admission (Odds ratio- 1.699; 95% CI 1.515–1.905) and 65.3% of this group is also associated with high viral load which gives an indication of higher disease severity.ConclusionBlood group A is associated with an increased susceptibility to COVID 19 infection than other blood groups. Cases of this blood group are also associated with more critical care needs and a higher viral load on testing.

Влияние новой коронавирусной инфекции на мочеполовую систему. Иммунонутриенты как метод патогенетического воздействия при COVID-19

On December 12, 2019, the novel coronavirus was identified in Wuhan, China, which caused the outbreak of severe acute respiratory syndrome (COVID-19) in human population, spreading rapidly all over the world; on March 11, 2020 the World Health Organization declared the current situation a pandemic. COVID-19 is considered a systemic disease. Kidney may be one of the targets, since the virus enters the cells via angiotensin-converting enzyme receptor, which is present in kidney. The evidence of the kidney cells’ viral invasion is provided by the large number of renal dysfunction cases in patients with COVID-19. Etiotropic therapy for COVID-19 has not been developed; antibiotics are not useful for this infection. It is advisable to improve the immunity of the microorganism, primarily by vaccination, but also by normalization of the intestinal microbiota and the micronutrients’ balance recovery. Vitamins C and E, trace elements selenium and zinc significantly increase the body's resistance to viral infection. The rapid increase in the number of resistant pathogens is expected due to increased antibiotic use for treatment of COVID-19. The overall impact of the pandemic could be assessed later. Currently, the strictest approach is required to prescribing antibacterial drugs to patients with infectious and inflammatory diseases of the urogenital system. If etiotropic antibiotic therapy is unavoidable, it should be supported by pathogenetic therapy. The immune-stimulatory nutraceuticals should be prescribed.

Pathogenesis of extrapulmonary organ damage in SARS-CоV-2 coronavirus infection (analytical review)

Over the past two decades, coronavirus infection has caused two major pandemics: SARS in 2002 and acute respiratory syndrome (MERS) in the Middle East in 2012. In December 2019, the novel coronavirus (CV) SARS-CoV-2 caused an outbreak of pneumonia in Wuhan, China. Experts from the World Health Organization (WHO) have confirmed the risk of this disease for the public health of the entire planet. SARS-CoV-2 was isolated from epithelial cells of the human respiratory tract. It was found that the genotype KB SARS-CoV-2 is closer to bat-SL-CoVZC45 and bat-SL-CoVZXC21, and the spike glycoprotein (SB) of the virus, which determines the ability to bind to the cellular receptor, is similar to the SARS-CoV coronavirus, which is responsible for the outbreak of severe acute respiratory syndrome (SARS / SARS) in 2002]. Angiotensin-converting enzyme 2 (ACE2) is an endogenous spike protein (spike glycoprotein with the S-domain) SARS-CoV-2, which, as part of the ACE2 + SARS-CoV-2 complex, binds to the ACE2 receptor located on the target cell membrane. The article discusses the mechanisms of infection with SARS-CoV-2, cell-cell interactions, and transmission routes. The issues of the epidemiology of COVID-19 and the prospects for the involvement of organs and systems other than the respiratory one in maintaining the viral load are covered in detail. The problems of the immune defense of the human body during infection with SARS-CoV-2 have been identified. Clinical parallels with progenitor viruses, namely SARS-CoV-1 and MERS-CoV, have been drawn. Highlighted risk factors for SARSCoV-2 infection, which make it possible to predict the nature of the course and probable outcomes of COVID-19.

Respiratory Care in Corona

BACKGROUND&#x0D; The expanse of the coronavirus disease 2019 or COVID-19 is huge. The impact is multispectral and affected almost all aspects of human life.&#x0D; SUMMARY&#x0D; Respiratory impact of the COVID-19 is the most felt and widely reported impact. As the novel coronavirus maintained its history of affecting lungs as seen previously in severe acute respiratory syndrome (SARS) outbreak. Ventilators and oxygen support system are required mostly in comorbid patients particularly amongpatientsbearing illnesses like asthma, bronchial impairment and so on.&#x0D; CONCLUSION&#x0D; More study needs to be done in order to assess the impact on the respiratory functioning of the body. Respiratory care must be including proper instruments so that more efficient result can be obtained. Research is needed to promote the invention of specific therapy for targeted action for respiratory functioning improvement.

Review of research on tourism-related diseases

ABSTRACT This study analyzes the contents of 115 articles related to the risk of tourism diseases to investigate research development trends from the period after the outbreak of severe acute respiratory syndrome to early 2020. The main findings show that researchers lack attention to the risk posed by tourism-related diseases, and research on these diseases is often synchronized with the occurrence of major international diseases and the development trends in tourism. Additionally, diseases are related to tourism, and they can interact with each other; research on disease risk management lacks a theoretical basis and the research themes are uneven.

MACROSCOPIC AND MICROSCOPIC INJURIES OF PATIENTS AFFECT-ED BY COVID-19

After the first report of an outbreak of acute respiratory syndrome in China in December 2019, a new coronavirus, severe acute respiratory syndrome - coronavirus 2 (SARS-CoV-2) was identified. Despite to the high number of cases and deaths, limited information is available regarding the pathogenesis and injuries caused by the new coronavirus. This study aims to carry out a literature review concerning the macroscopic and microscopic aspects of the disease, since the progression of the disease is closely related to the viral action and the cellular and tissue response in the lesions caused by it. In conclusion COVID-19 is a disease that can affect all types of body tissues. The lesions affect mainly the pulmonary parenchyma and are usually macroscopically observed as consolidation areas, and histologically as plasmacytic lymphoid interstitial pneumonia and with neutrophil infiltration, already observed lesions outside the lung are mainly due to the inflammatory action of lymphocytes and histiocytes, and to the intense production of cytokines with systemic action

The Spatial Allocation of Hospitals With Negative Pressure Isolation Rooms in Korea: Are We Prepared for New Outbreaks?

Background: Allocation of adequate healthcare facilities is one of the most important factors that public health policymakers consider when preparing for infectious disease outbreaks. Negative pressure isolation rooms (NPIRs) are one of the critical resources for control of infectious respiratory diseases, such as the novel coronavirus disease 2019 (COVID-19) outbreak. However, there is insufficient attention to efficient allocation of NPIR-equipped hospitals. Methods: We aim to explore any insufficiency and spatial disparity of NPIRs in South Korea in response to infectious disease outbreaks based on a simple analytic approach. We examined the history of installing NPIRs in South Korea between the severe acute respiratory syndrome (SARS) outbreak in 2003 and the Middle East respiratory syndrome coronavirus (MERS-Cov) in 2015 to evaluate the allocation process and spatial distribution of NPIRs across the country. Then, for two types of infectious diseases (a highly contagious disease like COVID-19 vs. a hospital-based transmission like MERS-Cov), we estimated the level of disparity between NPIR capacity and demand at the sub-regional level in South Korea by applying the two-step floating catchment area (2SFCA) method. Results: Geospatial information system (GIS) mapping reveals a substantial shortage and misallocation of NPIRs, indicating that the Korean government should consider a simple but evidence-based spatial method to identify the areas that need NPIRs most and allocate funds wisely. The 2SFCA method suggests that, despite the recent addition of NPIRs across the country, there should still be more NPIRs regardless of the spread pattern of the disease. It also illustrates high levels of regional disparity in allocation of those facilities in preparation for an infectious disease, due to the lack of evidence-based approach. Conclusion: These findings highlight the importance of evidence-based decision-making processes in allocating public health facilities, as misallocation of facilities could impede the responsiveness of the public health system during an epidemic. This study provides some evidence to be used to allocate the resources for NPIRs, the urgency of which is heightened in the face of rapidly evolving threats from the novel COVID-19 outbreak.

A Positive-Pressure Environment Disposable Shield (PEDS) for COVID-19 Health Care Worker Protection.

The COVID-19 pandemic has strained health care system resources and reduced the availability of life-sustaining and medical-grade personal protective equipment (PPE) though the combination of increased demand and disrupted manufacturing supply chains. As a result of these shortages, many health care providers have temporarily used largely untested, improvised PPE (iPPE). Lack of quality control for makeshift PPE and frequent repurposing of used items to conserve supplies increase both the risk of provider infection and nosocomial spread to uninfected patients. One strategy to reduce risk of infection and preserve existing equipment is the implementation of secondary barrier devices placed directly over patients or providers. The authors describe an inexpensive, disposable, positive-pressure head isolation unit that can be rapidly constructed from materials readily available in nearly all health care settings for under five US dollars. The unit was successfully deployed in Taiwan during the 2003 Severe Acute Respiratory Syndrome (SARS) outbreak, and again during the COVID-19 pandemic. The iPPE worn directly by the health care workers (HCWs) can be donned prior to patient contact in the presence of an air source. This strategy may be more protective than a covering placed over the patient in an aerosol-generating environment, which requires the HCW to be in close contact with the patient prior to securing the protective device.

Severe Acute Respiratory Syndrome (SARS): A Systematic Review

Severe Acute Respiratory Syndrome (SARS) outbreak between 2002 to 2003 has accounted for the world panic. SARS was caused by a novel coronavirus (SARS-CoV) and had continued to expand int the 21 st century (Tsang et al., 2003). Initially, the disease was observed to be incepted in a small district named as Shunde, which was present in the city named the Foshan City of Guangdong Province. From this area, it rapidly disseminated to Hong Kong and following it to the rest of North America, Asia, as well as Europe in the few months. The disease affected about 8437 patients, accounting for a mortality rate of 9.6 percent. World Health Organization (WHO), in May of the year 2005, forwarded a declaration that SARS disease has been eliminated, which ranked it as the second disease in humans to be labeled such following the first disease, i.e., smallpox. The civet cats isolated coronaviruses in China has substantial sequence homology with SARS-CoV, which indicates a zoonotic origin.Thereby this research paper reviews the general causes of SARS, its clinical manifestation, along with its treatment and prevention. Keywords: SARS; Systematic; Review DOI: 10.7176/JMPB/64-01 Publication date: February 29 th 2020

A Narrative Literature Review of Global Pandemic Novel Coronavirus Disease 2019 (COVID-19): Epidemiology, Virology, Potential Drug Treatments Available

Coronaviruses (CoVs) are the largest group of viruses belonging to the Nidovirales order, which includes Coronaviridae, Arteriviridae, Mesoniviridae and Roniviridae families. Coronavirus virion are circular with a diameter of nearly 125 nm. Its most conspicuous characteristic of coronaviruses is the club-shaped spiked projections originating from the surface of the virion. Such spikes are a definite characteristic of the virion and give them a solar corona appearance leading the term coronaviruses [1]. Coronaviridae covers a broad range of host & carriers, infecting many mammalian & avian species/subspecies, this may affect the upper respiratory, gastrointestinal, hepatic and central nervous system via a number of diseases [2]. SARS-CoV, group 2b-β coronavirus, was detected as the potential cause of the 2002-2003 outbreak of Severe Acute Respiratory Syndrome (SARS) in the Guangdong Province of China. In a cluster of highly pathogenic respiratory tract infections in Saudi Arabia and other Countries in the middle east throughout 2012, Middle East Respiratory Syndrome-CoV (MERS-CoV), was found to be the potential cause is an example of another novel human CoV [3]. On 31 December 2019, the Wuhan Health Commission in the Republic of China's Hubei Province notified the National Health Commission, China CDC and the WHO of a series of 27 cases of unexplained etiological pneumonia. Leaks have been predominantly tracked to the Huanan Seafood Wholesale Market in Wuhan, that trades fish and a myriad of livestock species comprising chickens, bats, marmots and snakes [4]. By January 7th, 2020 Chinese Center for Disease Control and Prevention officials had isolated severe acute respiratory syndrome coronavirus 2 (SARSCoV- 2). On 11 February, WHO officially named the disease as the coronavirus disease 2019 (COVID-19) [5]. The World Health Organization (WHO) also announced a global emergency on January 31st due to increasing concern about its rapid expansion and the disease became listed as a pandemic by March 11th.

Population dispersal and optimal control of an SEIR epidemic model

This paper formulates and analyses a susceptible-exposed-infected-recovered (SEIR) type epidemic model with the effect of transport-related infection between two cities in the presence of treatment control. The dispersal of populations from one city to another city has an important impact on the dynamics of disease evolution. The basic reproduction number is calculated for all the different cases of the proposed model system. It is found out that the disease-free equilibrium is disease-free if the basic reproduction is less than unity, otherwise the disease may remain in the system. In addition, the optimal control problem is constructed and solved analytically and numerically by considering the treatment control as a control variable. Further, we present a numerical simulation to confirm the analytical results. Finally, we show a comparison of the result of our predicted model with the real data of severe acute respiratory syndrome (SARS) outbreak in 2003 in Hong Kong.

An Intensive Care Unit Outbreak of Acute Respiratory Distress Syndrome due to Human Metapneumo Virus Infection

Human metapneumo virus is an emerging cause of upper and lower respiratory tract illness with increasing reports of a varied spectrum of disease over all age groups. We report an outbreak of 6 cases of human metapneumo virus infection in the intensive care unit of a metropolitan tertiary care center over 6 weeks, leading to severe acute respiratory distress syndrome. We report the subsequent favorable outcomes due to the institution of extracorporeal membrane oxygenation.

An overview of the National Microbiology Laboratory emergency management program.

The National Microbiology Laboratory (NML) emergency management program was developed after the 2003 Severe Acute Respiratory Syndrome (SARS) outbreak to provide a framework for the responses to public health events. The program comprises three components (Site response, Continuity and Site support) that have adopted the Incident Command System (ICS) as their management structure and follows the four phases of emergency management. All program components have extensive competency-based training for staff and exercise plans. The emergency management program ensures quality and continuous improvement through its certification in International Organization for Standardization (ISO) 9001 and structured review processes. This means that the Operations Centre can be activated and working at optimum capacity with highly trained and experienced staff within an hour of receiving notice to begin a response. The NML can also send mobile laboratories to aid Canadian or international efforts to address outbreaks or bioterrorism events.

Emerging Infectious Diseases Require Biosafety Awareness and Procedures

In 2015, there was a Middle East respiratory syndrome (MERS) outbreak in Korea. Interestingly, most of the cases were nosocomial infection and significant numbers of healthcare workers (HCWs) were infected. There were various causes, but this study focused on HCWs and their ability to self-protect from infectious materials. HCWs did not receive sufficient instruction or training on biosafety, including how to use personal protection equipment and risk assessment at the beginning of the outbreak. Previous experience from an outbreak of severe acute respiratory syndrome or Ebola showed that HCWs must self-protect from infection sources, but HCW infection occurred again with this MERS outbreak. Therefore, the concept of biosafety self-protection must be emphasized so that HCWs can protect themselves from diseases and avoid spreading them.

Measuring and containing longitudinal flow: Important for airborne pollutants control in an aircraft cabin

Transmission of airborne contaminants in aircraft cabins is a concern, especially after the outbreak of Severe Acute Respiratory Syndrome in 2003 and H1N1, a pandemic in 2009. In an aircraft cabin, the longitudinal flow can intensify the spread of airborne contaminants, and current design is to minimize it. This study developed a practical method to measure the longitudinal flow rate in a functional aircraft cabin by the tracer gas method and validated it with the flow rate measured by using ultrasonic anemometers. Measurements found that the longitudinal flow was significant. This investigation identified the mechanism causing the longitudinal flow and proposed to adjust the inlet flow rate along the aircraft cabin according to its outlet pressure to control the longitudinal flow. In addition, this study has analyzed the characteristic of the longitudinal flow with and without heated manikins.

"The Duty to Prevent" during an epidemic situation like 2015 Korean MERS outbreak.

Epidemiology, a core discipline in public health, identifies factors related to disease prevention and health promotion and applies these findings to local communities [1]. In particular, in cases of pandemic outbreak in local communities, epidemiology plays a central role in managing infected individuals and preventing disease propagation [2]. On May 20, 2015, after the confirmatory diagnosis of Middle East Respiratory Syndrome (MERS) [3], preventive medicine residents convened for an epidemic survey in early June 2015 to respond to worries about the risk of in-hospital infections spreading to local communities. On June 26, an anonymous interview with a preventive medicine resident was published in the media [4]. The media article was published in the same setting as the issue of ethical responsibility imposed on the medical corps as the “duty to care” in the 2003 Severe Acute Respiratory Syndrome (SARS) outbreak case [5]. In this context, there is a need for preventive medicine specialists, including epidemiologists, to clarify ethical concepts at the level of “duty to prevent” during pandemics. The obligations of epidemiologists in local communities include communication with local residents, explanation of outcomes, and performing appropriate disease prevention measures by disseminating results of epidemic surveys of pandemic-related measures to the local community wherever applicable [2]. This is similar to the duty of a clinician to treat infected individuals. Regarding the imposition of the “duty to treat” during a pandemic, Malm et al. [6] presented five underlying ethical principles: consent, implied consent, special training, reciprocity, and oaths and codes. This duty can be interpreted as the responsibility of preventive medicine specialists, as doctors accredited by the country, to play the professional role expected of them by local communities in critical situations [2]. And epidemic surveillance is the first task of preventive medicine specialists in their role of disease management [7]. Ethical obligations based on ethical principles should be differentiated from ethical virtues [2,8]. While obligations specify roles and responsibilities, virtues are the character traits underlying personal attitude and behavior in fulfilling a just cause [2, 8]. The major character traits required of epidemiologists are benevolence, honesty, prudence, excellence, and integrity [2]. Especially, solidarity and loyalty are additional character traits that are utmost important, as they ensure the trust of the local community [8]. However, these character traits cannot be acquired by education, and should be cultivated by individuals [9]. In this regard, specialist training programs should be help residents more efficiently carry out their “duty to prevent”. Additionally, the proper methods for wearing and removing protective coveralls should be taught without fail during training so that specialists can protect themselves from infection. Along with these efforts, the most desirable attitude for bridging the ethical gap during a pandemic is the voluntary participation of the specialists [10].

A Portable Infection Screening System Designed for Onboard Entry Screening Based on Multi-Parameter Vital Signs

After outbreak of severe acute respiratory syndrome (SARS) in 2003, many international airport quarantines adopted fever-based screening to identify infected individuals using infrared thermography to control global pandemic. Unfortunately, the sensitivity of fever-based screening system did not exceed 70.4% at Narita International Airport. In order to achieve accurate onboard entry screening for highly contagious infectious diseases, the authors developed a portable system designed for onboard entry screening with linear discriminant analysis. Within several tens of seconds, the system automatically discriminates infected individuals from normal subjects using measured heart rate, respiratory rate, as well as facial surface temperature determined by thermography. The size of system is small enough to be placed on airplane tray tables. The authors tested on 68 subjects including 12 influenza patients to evaluate the system. The result showed sensitivity of 91.7% and specificity of 92.9%. The system seems to be promising for onboard infection screening to safeguard public health.

Chance missed, but still there! Memoirs at the 10(th) anniversary of 2003 SARS outbreak.

It has been ten years since the outbreak of severe acute respiratory syndrome (SARS) was recognized in Guangdong Province, China, in November 2002. As the new infectious disease first emerging at the beginning of the twenty-first century like AIDS in 1980s, SARS posed a serious threat to global health security, human livelihood, functioning of health systems and stability and growth of economies.