Pneumonia Of Unknown Etiology Research Articles

Epidemiological investigation of the first locally acquired case of COVID-19 identified by influenza surveillance-Taiwan, February 2020.

COVID-19 and influenza have similar clinical presentations that can range from mild to severe disease. The World Health Organization recommends that countries use existing influenza surveillance to monitor COVID-19 transmission in communities. We aim to describe the surveillance and investigation of COVID-19 at the early stage of the pandemic in Taiwan. In February 2020, the Taiwan Centers for Disease Control enhanced COVID-19 surveillance through its existing influenza surveillance. We retrospectively tested patients for SARS-CoV-2 who had symptoms of severe complicated influenza but were negative in influenza testing. We conducted an epidemiological investigation and contact tracing for the index patient and secondary cases to prevent virus transmission. We identified the first COVID-19 patient on February 15 through enhanced COVID-19 surveillance. He had no history of traveling abroad and an unclear history of contact with COVID-19 cases. He presented with influenza-like illness on January 27 and was hospitalized from February 3 to 15. We identified 39 close contacts of the index patient, including 11 family members and 28 healthcare workers. In total, four close family contacts of the index patient tested positive for SARS-CoV-2. An additional 84 close contacts of the four secondary cases were identified and traced; none was diagnosed with COVID-19. We recommend enhancing COVID-19 surveillance by testing patients with influenza-like illness. To prevent the spread of COVID-19, we recommend using appropriate personal protective equipment when in close contact with patients who present with influenza-like illness or when caring for patients with pneumonia of unknown etiology.

Aiming for the end of the COVID-19 pandemic: the what, how, who, where, and when.

Aiming for the end of the COVID-19 pandemic: the what, how, who, where, and when.

The prevalence and prognostic effect of hyponatremia in children with COVID-19 pneumonia: a retrospective study.

The aim of the study was to examine the effect of hyponatremia at admission as a negative prognostic factor in children hospitalized with COVID-19 pneumonia. The data of patients aged 1 month-18 years, who were followed with the diagnosis of pneumonia at Çanakkale Onsekiz Mart University Hospital, Department of Pediatrics, between January 2018 and May 2021 were examined, retrospectively. Patients (n=661) were divided into two main groups; COVID-19 pneumonia (n=158) and the other pneumonias [other viral pneumonia (n=161) and pneumonia of unknown etiology (n=342)]. Six hundred and twenty-three patients with a median (Q1-Q3) age of 4 (1.5-8) years, 59.4% of whom were male were included in the study. The overall prevalence of hyponatremia at admission was 11.2% and was lower in those with COVID-19 pneumonia than in those with other viral pneumonia (6.4% vs. 15.2%, p=0.013). When evaluated irrespective of their COVID-19 status, hyponatremic patients had a higher supplemental oxygen requirement (OR 2.5 [1.4-4.3], p < 0.001), higher need for intensive care unit (ICU) admission (OR 3.7 [1.3-10.2], p=0.009) and longer duration of hospitalization (p=0.016) than the normonatremic patients. In patients with COVID-19 pneumonia, being hyponatremic had no effect on supplemental oxygen requirements or the duration of hospitalization. When hyponatremic patients were evaluated, the supplemental oxygen requirements and duration of hospitalization of those with COVID-19 pneumonia were similar to the other pneumonias (p > 0.05 for all comparisons). However, normonatremic COVID-19 pneumonias had higher supplemental oxygen requirements than other viral pneumonias and pneumonia of unknown etiology (OR 4.7 [2.2-10.3], p < 0.001; OR 1.6 [1 -2.7], p=0.043, respectively). This study found that hyponatremia at admission is rarer in children with COVID-19 pneumonia than other viral pneumonias and has no effect on supplemental oxygen requirements or the duration of hospitalization.

Ost-COVID-19 Syndrome - case report

Background: Coronaviruses are enveloped RNA viruses that are widely distributed among humans and other mammals and birds causing respiratory, enteric, liver, and neurological diseases. At the end of December 2019, a group of patients with pneumonia of unknown etiology were registered, where a new virus called SARS-CoV-2 was later presented, and the disease it causes, COVID-19. The main clinical manifestations of this virus are fever, dry cough, dyspnea and acute respiratory stress. Many subjects have mild symptoms, such as headache, non-productive cough, fatigue, myalgia, and anosmia. The recovery time from this disease and the reasons why the sequelae it leaves vary so much between patients is still unknown. Symptoms and clinical manifestations after SARS-CoV-2 / COVID-19 infection have appeared in many survivors and are similar to those of fatigue after Severe Acute Respiratory Syndrome. The most commonly reported symptoms are fatigue, anxiety, joint pain, ongoing headache, chest pain, dementia, depression, and dyspnea. The NICE guideline defines post-COVID-19 syndrome as the set of signs and symptoms that develop during or after an infection compatible with COVID-19 that continues for more than 12 weeks and is not explained by an alternative diagnosis. Post-COVID-19 syndrome has the characteristic that its symptoms cause a disability, which is why it generates a great impact on the individual, the care, and rehabilitation units. Purpose: The objective of this report is to present a clinical case of a patient with the post-COVID-19 syndrome and its management. Materials and methods: This is a 57-year-old female patient, with a previous history that in June 2021 began with a clinical picture consisting of asthenia, adynamia, anosmia, ageusia, headache, myoarthralgia, nausea, cough chest and lumbar pain, for which the PCR test for SARS-CoV-2 was performed, which was positive, his clinical picture worsened at home, for which he consulted an emergency service in the city of Palmira, Valle del Cauca (Colombia). Subsequently, they conclude through paraclinical SARS-CoV-2 infection plus bacterial pneumonia due to Klebsiella pneumoniae, for which she is transferred to the hospitalization room and treatment with antibiotics is started, however, At the beginning of July, the patient maintained hemodynamic and ventilatory stability, without cardiovascular support, but still with minimal ventilatory support, with oximetry goals, so it was decided to start the gradual withdrawal of sedatives in favor of spontaneous modes of mechanical ventilation. On July 6, the patient tolerates extubation with the transition to non-invasive mechanical ventilation and a decision was made to transfer to hospitalization. Then, on July 15, a patient was seen in acceptable general conditions, with support even by nasal cannula, on physical examination with attenuated vesicular murmur with declining rales, for which it was decided to discharge. Results: Currently, the patient manifests 15 symptoms 4 months after her discharge from the clinic. Conclusions: The post-COVID-19 patient must have an individual and comprehensive rehabilitation, which takes into account their needs, since this syndrome varies from person to person, it must be an early rehabilitation so as not to decrease the functionality of the patient, and does not deteriorate their physical or mental health. The great challenge identified in the midst of the pandemic is that work must be done to build an improved and strengthened health system, where true integration and coordination between levels of care, primary care, and hospital care is achieved.

Mental health during the COVID-19 epidemic: The role of social media

Currently, the COVID-19 pandemic is one of the major health issues in the world [1,2]. In December 2019, a population of patients with pneumonia of unknown etiology was found in Wuhan, China. Many of the first patients were associated with a local seafood shop and live wild animals [1]. Therefore, it was initially thought that the disease was transmitted from animal to human. But after closing the said shop, the number of infected cases increased and it seemed that the second method of transmission of this disease was human-to-human [3].

Surveillance system-based physician reporting of pneumonia of unknown etiology in China: A cross-sectional study

Objective: To describe the current reporting of pneumonia of unknown etiology (PUE) and factors that affect reporting by clinicians in China using the PUE surveillance system in order to provide a reference for improving PUE reporting rates in the future.Methods: Clinicians were recruited via the Sojump platform and requested to complete an anonymous self-administered questionnaire. Multivariate logistic regression analysis was used to assess factors influencing clinicians’ reporting activities.Results: This study showed a low PUE case reporting rate and a poor understanding of PUE reporting among the investigated clinicians. Of the 136 clinicians who had diagnosed PUE cases, multivariate logistic regression analysis results showed that clinicians who had attended in-hospital training were more likely to report PUE than those who had not (OR 4.48, 95% CI 1.49-13.46). Clinicians with an expert panel on PUE in their hospital were more likely to report PUE cases than those without (OR 5.46, 95% CI 1.85-16.11).Conclusions: There is a need to promote and reinforce PUE surveillance system training among medical staff. In addition, PUE testing technologies in hospital laboratories should be upgraded, especially in primary and unclassified hospitals, to increase surveillance efficiency and improve PUE reporting rates.

Correlation of hematological findings with severity of COVID-19

SARS-COV-2 emerged as pneumonia of unknown etiology and transforming into global pandemic leading mass casualties globally. It leads to serious complications with a wide range of symptoms and laboratory and radiological abnormalities. Methodology: This retrospective study included 191 admitted patients was conducted between 15 April 2020 and 31 August 2020 at university of Lahore teaching hospital, Lahore, Pakistan. Baseline demographics, clinical, laboratory and radiological characteristics were compared amongst disease severity categories with One way ANOVA and comparison amongst recovered and non-recovered was carried out by independent t test, Fisher’s exact and chi-square test respectively. All data were analysed in SPSS 25 and p-value &lt;0.05 was considered significant. Results: Out of 191 patients enrolled in this study, majority were male and above 50 year age. Fever (68%) was the most common symptom though dyspnea was statistically significant (p-value&lt;0.05) and diabetes (41.4%) being the most common comorbidity. A statistical significant downtrend in eosinophil counts were observed in critical and severe disease from non-severe disease and similar trend was observed in non-recovered (died) patients than recovered. A significant rise in neutrophil to lymphocyte ratio, crp, ferritin and d-dimer were observed amongst critical and severe disease and non-recovered patients (p-value&lt;0.05). Patients with eosinopenia had low survival proportion at day 5 and 10 than those with relatively normal eosinophil counts. Conclusion: Patients with advanced age, multiple comorbidities, elevated hematological, deranged coagulation markers presented with more severe disease and had poor outcome. In particular, eosinopenia can play key role in early diagnosis, disease severity recognition and disease surveillance as it is an independent risk factor for prognosis.

Retrospective Analysis of Hematological Parameters in Covid Positive Pregnancy

The newly identified SARS-CoV-2 virus and its ongoing implicated COVID-19 pandemic started off as pneumonia of unknown aetiology in Wuhan, China, in December 2019. Certain laboratory values that may be considered deranged in non pregnant states are normal physiological changes in pregnancy. An understanding of the normal haematological and immunologic parameters in pregnancy is necessary for the interpretation of COVID-19 severity. Considering the COVID-19 infection is still new, little is known about the clinical course of the disease in pregnancy. This is a retrospective observational study undertaken in the Department of Obstetrics and Gynaecology, Saveetha Medical College Hospital, Chennai, India, from April to November 2020. Out of the 50 women in the study, 19 women were anaemic with haemoglobin &lt;11, accounting for 38% of the study population. A neutrophil to lymphocyte ratio greater than 4.5 was observed in 44% of the population. Thrombocytopenia was present in 12% of the population. D-dimer greater than 1000 was found in 12% of the study population. All of our patients were asymptomatic, had good maternal and fetal outcomes even though derangement of inflammatory markers were noted. The immunological changes of pregnancy make pregnant women more susceptible to pathogens. Though our patients had instances suggestive of critical prognosis like an increased neutrophil-lymphocyte-ratio and affirmative acute phase reactants and inflammatory markers, they were asymptomatic (category BNH) and stable in room air. However, further analysis of laboratory parameters and their correlation to clinical scenarios in the second wave of COVID19 infection is warranted.

A Comprehensive Review on Covid-19

: During the past two decades, multiple viral epidemics have emerged, including the epidemics of H1N1 influenza in 2009 and the acute respiratory syndrome coronavirus (SARS-CoV) in 2002 - 2003. Moreover, the middle east respiratory syndrome coronavirus (MERS-CoV) was initially recognized in Saudi Arabia in 2012. Recently, cases of another lower respiratory tract infection (LRTI) were discovered in Wuhan, Hubei province, China, on December 31st 2019, and reported to the WHO country office in the country. Studies in the field have referred to the identification of first symptomatic people in early December 2019. Since experts in the field could not determine the causative agent of the disease, they mistakenly categorized the first reported cases as pneumonia of unknown etiology (PUE). Therefore, the Chinese Center for Disease Control and Prevention (China CDC), as well as local CDCs, arranged a full outbreak investigation plan, ascribing the etiology to a newly discovered virus of the coronavirus (CoV) family (i.e., the causative agent of COVID-19).

Understanding the Dynamics of COVID-19 Outbreak: Structure, Diagnosis, Prevention and Treatment

Currently, mankind is fighting against an invisible enemy. The novel Coronavirus disease (COVID-19) has been spreading at a rapid rate across the world, which made the World Health Organization (WHO) to declare it as pandemic disease. COVID-19 is an acute respiratory tract infection that was first reported in December 2019, initially presented as pneumonia of unknown etiology in a group of patients in Wuhan, a city in the Hubei Province of China. Sometimes, animals infected with coronavirus infect humans and spread further via human-to-human transmission similar to the case of Middle East respiratory syndrome coronavirus (MERS-CoV), severe acute respiratory syndrome-related coronavirus (SARS-CoV), and severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), previously referred to as 2019-nCoV (COVID-19). SARS-- CoV-2 is an extremely pathogenic virus and is crushing the well-equipped health systems of developed countries. According to the WHO situation report updated on October 25, 2020 over 42 million cases and 1.1 million deaths have been reported globally. Since the figure of cases continues to increase, these viruses create a threat to global public health. This review summarizes an overview of the study of the novel coronavirus, including origin, epidemiology, etiology, targets for viral entry, and describes the clinical manifestation, diagnosis, and therapeutics used in clinical settings. Furthermore, our review focuses on the most up-to-date clinical information for the effective management, prevention, and counseling to control COVID-19 worldwide.

MODES OF SARS-COV-2 TRANSMISSION

Background: On 12th December 2019, pneumonia of unknown etiology was reported in number of human cases from Wuhan, central China. On 11th February 2020, the WHO named the disease COVID-19, short for “COronaVIrus Disease 2019”. This COVID-19 out-break has grown substantially to that of pandemic nature currently. Close personal contact and respiratory droplets from sneezes and coughs of patient can disseminate SARS-CoV-2. The WHO continues to stress the usefulness of environmental cleaning and disinfection, frequent hand hygiene, respiratory etiquette. The WHO also suggests avoidance of close, unprotected contact and maintenance of physical distance with people having fever or respiratory symptoms. Purpose: To develop strategies for lowering transmission of COVID-19, development of ways for distinguishing the various modes of transmission such as urine and fecal samples is need of the hour. Review: In a clinical scenario where possibility of vertical transmission of Covid-19 is increasingly being reported and transplacental transmission of the SARS-COV-2 cannot be ruled out, medical fraternity requires more evidence on vertical transmission for better mother and newborn care. Conclusion: In order to study the vertical dissemination of SARS-CoV-2, the heath authorities should include additional examinations of maternal and newborn samples in standard treatment guideline for pregnant women.

COVID-19, a threat to human and animals and its probable treatment options to mitigate this pandemic

In late December 2019, Wuhan city of Hubei province, China faced a newly emerged highly contagious viral zoonosis mainly characterized by respiratory illness, associated with pneumonia of unknown etiology which claimed many lives. The virus was then provisionally designated as 2019-nCoV by WHO and officially named as Severe Acute Respiratory Syndrome Coronavirus-2 (SARS-CoV-2) by International Committee on Taxonomy of Viruses (ICTV). On 11 Feb 2020, WHO officially announced the name of disease as Coronavirus disease 2019 (COVID-19) and declared the global pandemic on March 11, 2020. Initially, the disease was highly restricted to China but later it scared the world because hugenumber of new cases was reported from the entire world in a short period of 5 months. The dynamic spread of this contagious virus occurred due to exposure of individuals from infected aerosols, community contact and travelling of affected individual worldwide. Bats were thought to be the initial source of this pandemic but the intermediate host of this zoonosis is yet to be established. Many studies reported fever, dry cough, dyspnea, generalized weakness, anosmia, ageusia, muscle ache, rhinorrhea, headache, nausea, conjunctivitis, vomiting and diarrhoea along with many non-specific symptoms as clinical signs of the disease. Many treatment regimen including various antivirals, antibiotics, neutralizing antibodies, repurposed drugs and traditional medicines were being explored but the authorized effective treatment regimen is still awaited. This review is aimed to summarize the current scenario and status of probable treatment options available for ongoing illness caused by the novel coronavirus.

COVID-19 : history, pathogenesis and host immune response

By the end of 2019, pneumonia of unknown etiology occurred in Wuhan, China. Local hospitals started receiving patients presenting symptoms like dry cough, fatigue, and breathing difficulties, most of these patients were linked to the Huanan seafood market, Wuhan, China. The pandemic was afterward confirmed to be associated with a novel coronavirus. The virus spread quickly from Wuhan to other provinces of China, then from china to the rest of the world causing thereby one of the most brutal pandemics in the world’s history. SARS-CoV2 has a long incubation period ranging from 3 to 7 days and can go up to 14 days in some cases which makes the infection difficult to be detected early and subsequently the disease spread harder to be controlled. SARS-CoV-2 is a single-stranded RNA virus with 4 main structural proteins, the spike (S) glycoprotein, the small envelope (E) the glycoprotein, the membrane (M) glycoprotein as well as the nucleocapsid (N) protein. Current knowledge about the virus shows that it uses its spike protein to invade host cells, mainly the alveolar epithelial cells. The the lung is the most targeted organ among many other organs like the heart, small intestine, and kidneys that are vulnerable to SARS-CoV-2 infection. The COVID-19 is known to be mild in most cases, but in some cases, it can be severe or even fatal. In the severe cases, acute respiratory distress syndrome was reported, and the the capability of SARS-CoV-2 to infect many organs can lead to multiorgan failure and death. SARS-CoV-2 invasion induces several immune responses that could be efficient for infection clearance in mild cases, while in severe cases, the immune response dysfunctions can even contribute to the disease aggravation. Neither the the pathogenic mechanism by which SARS-CoV-2 infects host cells, nor the host immune response to its infection have been fully understood, hence further studies are needed to give further evidence about these two phenomena. Keywords: COVID-19, SARS-CoV-2, Coronavirus, Structural proteins, Immune response.

Does Wearing a Face Mask During the COVID-19 Pandemic Increase the Incidence of Dermatological Conditions in Health Care Workers? Narrative Literature Review.

BackgroundCOVID-19 is a health emergency. SARS-CoV-2 was discovered in Wuhan (Hubei Province, China) and has rapidly spread worldwide, leaving no country untouched. COVID-19 is a respiratory infection characterized by a pneumonia of unknown etiology. It is transmitted through respiratory droplets; for example: through breathing, talking, and coughing. Transmission of the virus is high. Health care workers play important roles in helping those affected by COVID-19; this could not be done without the use of personal protective equipment (PPE). PPE involves the use of goggles, masks, gloves, and gowns and is known to reduce COVID-19 transmission; however, multiple reports of skin disease and damage associated with occupational mask-wearing have emerged.ObjectiveThe objective of this study is to review the literature for newly emerging dermatological conditions as a result of occupational mask-wearing during the COVID-19 pandemic.MethodsA narrative review of new reports of dermatological conditions associated with occupational mask-wearing was carried out in May 2020 by referencing keywords including: “covid mask dermatology,” “covid dermatological damage,” “covid mask skin,” “covid N95 mask damage,” and “covid mask skin damage” from PubMed, supplemented by searches on both Google Scholar and ResearchGate. A total of 287 articles were found, of which 40 were successfully included in this study, and an additional 7 were selected from the reference lists of these 40 articles. The findings were tabulated and analyzed under the following headings: dermatological diagnosis, causes, and management.ResultsQualitative analysis of the reviewed data was carried out. A number of dermatological conditions were found to increasingly occur owing to prolonged and frequent use of face masks. Pressure-related injuries were often the most serious complaint; recommendations to reduce this type of injury include the use of hydrocolloid dressings, plastic handles, education, and regular moisturization. Innovation in PPE as well as services, such as virtual clinics, need to be advanced to protect the welfare of health care staff.ConclusionsIn these unprecedented times, PPE has been an effective barrier to the transmission of COVID-19 among health care workers. This has allowed health care workers to provide care to patients, with minimal risk. However, our findings suggest that despite the obvious benefits of using face masks to protect the respiratory system, there are also considerable health consequences to the skin. Future research studies are required to focus on improving face masks to ensure both the protection of the respiratory system as well as skin care, which, according to our study, has been overlooked.

Online learning during COVID-19 emergency– a descriptive study of university students experience in Mozambique

Initially described as pneumonia of unknown etiology, COVID-19 emerged in China in late 2019 and quickly spread around the world. Its impact has resulted in the closure of schools in several countries, including Mozambique, and at that time, the teaching and learning process shifted to digital platforms. In this context, this research was developed with the aim of describing students’ experience with the teaching and learning process using digital platforms during the state of emergency. We surveyed 6,542 students from 43 public and private higher education institutions, of whom 3,226 (52%) were male and the average age was 24 years. The survey was answered using the Google Forms platform between 4th and 12th of May 2020. Descriptive statistics were used for data analysis, and the results are presented in simple tables. 98.5% of the students were at the undergraduate level, about 1% pursued a Master’s degree and only 0.3% were attending a doctoral course. The most used platforms were WhatsApp, email and Google Classroom, and about 64% reported an unsatisfactory level of competence and just over three quarters had some kind of difficulty. The most used device to access the platforms was the cellphone (59.4%), however only 45.5% had the device available full time. Only 27% of the students were able to follow all classes, and difficulty of comprehending some topics and the poor quality of the internet were the main barriers. Furthermore, only 34% of them stated that they continued to have all classes initially planned and about 78% rated the performance of their teachers as poor or reasonable. About 65% believed that the quality of the teaching and learning process had decreased, and 80% had an unsatisfactory experience in their adaptation to the process and almost the same proportion (79%) would not continue with this teaching modality. During the suspension of classes, students used a variety of digital platforms and faced constraints regarding access to the internet, as well as difficulties in adapting to the process.

New Drug/Vaccine RNA-Peptide Named Melody Against SARS-CoV-2: Adapting Antiviral Pathways in Cell Culture WM-266 as Temporal Memory of “In Vitro Cell”

The new coronavirus formed a clade within the subgenus Orthocoronavirinae, sarbecovirus subfamily. The first time these cases were published, and they were classified as “pneumonia of unknown etiology.” The Chinese Center for Disease Control and Prevention (CDC) and local CDCs organized an intensive outbreak investigation program. The etiology of this illness is now attributed to a novel virus belonging to the coronavirus (CoV) family, COVID-19. This disease has inflicted catastrophic damages in public health, economic and social stability-putting life globally on hold in 2020 and presumably a year more. The authorized vaccine against severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) more often are Pfizer-BioNTech, Moderna, Johnson &amp; Johnson and AstraZeneca in order to face the global pandemic COVID-19. Our aim was focused on toxicological evaluation of a new drug/vaccine model against SARS-CoV-2 with therapeutic and prophylactic actions, also useful in postCOVID-19 infection rehabilitation. Our candidate of drug/vaccine RNA-peptide named Melody was tested in cell culture WM-266 as temporal memory of “In vitro cell”. We carry out our studies of this RNA target Human Malignant Melanoma cell lines, (WM-266) monitoring dead cell number. The lethal concentration (LC) at 50% and 100% (CL50 and CL100) were calculated and reported the toxicological and efficacity findings in each study.

Coronavirus pandemic in Vietnam: an effective response model

ABSTRACT In late December 2019, the World Health Organisation declared that pneumonia of unknown aetiology broke out in China and then expanded to become a pandemic. Vietnam was predicted to be one of the hardest-hit countries of this pandemic. However, this country has written its own exceptional story with a low and contained infection rate and few deaths on its territory. This study seeks to highlight the global significance of the Vietnamese response model in the fight against COVID-19. The study suggests that the Vietnamese Government’s procedures, from central officials to grassroots cadre, have significance on three levels with comparative importance. First, attention is given to the use of tracking mechanisms enabled by medical surveillance and record systems. Then, the role of social media in educational epidemiology. Finally, we highlight the adjustment of Vietnamese social practices, behaviours, and cultural habituation, which were crucial in fighting the pandemic. These results of this study suggest an effective, low-cost model in combating pandemic which could be applied by other countries, despite a surprising, but sadly recurrent, the reluctance of international media to represent Vietnam fairly and impartially. The paper draws attention to the importance of Vietnam’s experience in tracking systems, health, and education, aiming to illustrate effective measures that have global significance and suggest opportunities for international implementation.

Current Understanding of Novel Coronavirus: Molecular Pathogenesis, Diagnosis, and Treatment Approaches

An outbreak of “Pneumonia of Unknown Etiology” occurred in Wuhan, China, in late December 2019. Later, the agent factor was identified and coined as severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), and the disease was named coronavirus disease 2019 (COVID-19). In a shorter period, this newly emergent infection brought the world to a standstill. On 11 March 2020, the WHO declared COVID-19 as a pandemic. Researchers across the globe have joined their hands to investigate SARS-CoV-2 in terms of pathogenicity, transmissibility, and deduce therapeutics to subjugate this infection. The researchers and scholars practicing different arts of medicine are on an extensive quest to come up with safer ways to curb the pathological implications of this viral infection. A huge number of clinical trials are underway from the branch of allopathy and naturopathy. Besides, a paradigm shift on cellular therapy and nano-medicine protocols has to be optimized for better clinical and functional outcomes of COVID-19-affected individuals. This article unveils a comprehensive review of the pathogenesis mode of spread, and various treatment modalities to combat COVID-19 disease.

Early Detection of COVID-19 in Portugal: Use of Clinical Records

Syndromic surveillance allows early detection of changes in the population's morbidity pattern. The aim of this study is to evaluate the usefulness of indicators related to access to healthcare services, in COVID-19 surveillance. A time series analysis was performed using the weekly incidence rate of COVID-19 in Mainland Portugal, between weeks 14/2020 (March 30 to April 5) and 25/2020 (June 15 to 21), and six indicators: 1) COVID-19 consultations in primary healthcare; 2) number of COVID-19 emergency department visits; 3) number of emergency department visits due to viral pneumonia; 4) number of hospitalizations due to viral pneumonia; 5) proportion of emergency department visits due to viral pneumonia; and 6) proportion of hospitalizations for viral pneumonia. Pearson correlation and cross-correlations were computed. A strong correlation was found between the weekly incidence rate of COVID-19 and all indicators. [(1) 0.76; (2) 0.82; (3) 0.77; (4) 0.84; (5) 0.86; e (6) 0.90]. Emergency department visits and hospitalizations for viral pneumonia detect variations in the frequency of the disease with a one week lag compared to the incidence rate of COVID-19, in one week. COVID-19 consultations in primary healthcare and emergency department visits trail behind the incidence rate of COVID-19, in one week. The proportion of viral pneumonias in emergency department visits, or hospitalizations, is temporally aligned with the weekly incidence rate of COVID-19. The delay found in the COVID-19 primary healthcare consultations and emergency department visits, may be related to changes in access to healthcare services and clinical coding. Emergency department visits and hospitalizations for viral pneumonia may be useful in the early detection of COVID-19. Viral pneumonia may have been coded as being of unknown origin. Future monitoring of these indicators is necessary to ascertain whether the incidence of COVID-19 is significantly influenced by changes in testing strategies. The indicators described in this study will be an asset for the optimization of testing strategies, allocation of healthcare resources to the communities that are most vulnerable to severe morbidity and assessing vaccination impact. As such, surveillance systems based on clinical data will be a valuable complementary tool to SINAVE. The indicators under analysis could be used regularly, with special attention to viral pneumonias, to detect outbreaks of COVID-19. Information on pneumonia of unknown etiology may be considered in the surveillance of COVID-19.

Investigation and Management of COVID-19

In December 2019, an outbreak of viral pneumonia of unknown etiology arose in Wuhan, Hubei Province, China. Eventually isolated and named Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2), this virus has caused a global pandemic of the pneumonia-like Coronavirus Disease (COVID-19). With global infection rates and deaths mounting, the medical community has been forced to recognize, test, and treat these patients within a rapidly evolving situation and a shortage of resources. In this article, we summarize the most recent data pertaining to the clinical presentation, diagnostic tests, imaging, and management strategies for COVID-19. This article concludes with a discussion of ongoing efforts to develop critically needed therapeutics and vaccines, which may subsequently shape our responses to future pandemics.