Severe Acute Respiratory Syndrome Outbreak Research Articles

Biopsychosocial and Spiritual Implications of Patients With COVID-19 Dying in Isolation

Critically ill patients with the Coronavirus disease 2019 (COVID-19) are dying in isolation without the comfort of their family or other social support in unprecedented numbers. Recently, healthcare teams at COVID-19 epicenters have been inundated with critically ill patients. Patients isolated for COVID-19 have had no contact with their family or loved ones and may have likely experienced death without closure. This situation highlights concerns about patients’ psychological and spiritual well-being with COVID-19 and their families, as they permanently part ways. While palliative care has advanced to adequately address these patients’ needs, the COVID-19 pandemic presents several barriers that force healthcare teams to deprioritize these essential aspects of patient care. The severe acute respiratory syndrome (SARS) outbreak in 2003 gave us a glimpse of these challenges as these patients were also isolated in hospitals. Here, we discuss the importance of the biopsychosocial spiritual model in end-of-life care and its implications on patients dying with COVID-19. Furthermore, we outline an integrative approach to address the unique and holistic needs of critically ill patients dying with COVID-19. These include intentional and increased coordination with trained palliative care staff, early and frequent goals of care including discussion of end-of-life plans, broader use of technology to improve connectedness, and shared decision making with patients’ families.

Correlación entre diagnósticos, resultados e intervenciones de enfermería en el cuidado al paciente hospitalizado por COVID-19

La pandemia de COVID-19 confirmada por la Organización Mundial de la Salud (OMS) en el año 2020 es conocida como una enfermedad respiratoria infecciosa causada por un nuevo virus perteneciente a la familia coronaviridae, posee un genoma de ácido ribonucleico (ARN) de gran tamaño y simetría helicoidal, su característica definitoria son las espículas que posee en su envoltura vírica que le dan la forma de corona; así mismo, le permiten junto con las proteínas que se encuentran en la envoltura poder anclarse a los receptores de la célula.

Surgical Oncology Practice in the Wake of COVID-19 Crisis.

The coronavirus disease 2019 (COVID-19) caused by the severe acute respiratory syndrome (SARS-CoV-2) outbreak has placed unprecedented challenges globally dismantling healthcare systems and forcing rapid transformations of healthcare services. In patients with cancer, these changes are having profound effects on vital aspects of their care. It has been advised that hospitals discontinue elective surgery and work on triage of nonemergent surgical procedures during the pandemic. The purpose of this article is to highlight the recommendations and adapted workflow from the private and public tertiary level hospitals in India advising on the best practices and views on better patient management, redesigning of SOPs for OR, surgeon, and staff safety and resumption of cancer care especially from surgical perspective. Different concerns are addressed that are necessary to optimize the quality of care provided to COVID-19 patients and to reduce the risk of viral transmission to other patients or healthcare workers.

The strategy to develop newly joined radiographers in a COVID-19 world: a curated orientation programme

The strategy to develop newly joined radiographers in a COVID-19 world: a curated orientation programme

Comparison of spatiotemporal characteristics of the COVID-19 and SARS outbreaks in mainland China

BackgroundBoth coronavirus disease 2019 (COVID-19) and severe acute respiratory syndrome (SARS) are caused by coronaviruses and have infected people in China and worldwide. We aimed to investigate whether COVID-19 and SARS exhibited similar spatial and temporal features at provincial level in mainland China.MethodsThe number of people infected by COVID-19 and SARS were extracted from daily briefings on newly confirmed cases during the epidemics, as of Mar. 4, 2020 and Aug. 3, 2003, respectively. We depicted spatiotemporal patterns of the COVID-19 and SARS epidemics using spatial statistics such as Moran’s I and the local indicators of spatial association (LISA).ResultsCompared to SARS, COVID-19 had a higher overall incidence. We identified 3 clusters (predominantly located in south-central China; the highest RR = 135.08, 95% CI: 128.36–142.08) for COVID-19 and 4 clusters (mainly in Northern China; the highest RR = 423.51, 95% CI: 240.96–722.32) for SARS. Fewer secondary clusters were identified after the “Wuhan lockdown”. The LISA cluster map detected a significantly high-low (Hubei) and low-high spatial clustering (Anhui, Hunan, and Jiangxi, in Central China) for COVID-19. Two significant high-high (Beijing and Tianjin) and low-high (Hebei) clusters were detected for SARS.ConclusionsCOVID-19 and SARS outbreaks exhibited distinct spatiotemporal clustering patterns at the provincial levels in mainland China, which may be attributable to changes in social and demographic factors, local government containment strategies or differences in transmission mechanisms.

The burden of COVID-19 on pharmacists

The unprecedented changes brought about by the global coronavirus disease 2019 (COVID-19) pandemic have had important impacts on society. The pandemic has provided an opportunity to highlight the crucial role pharmacists play in the provision of health care. The critical and unique role of pharmacists in pandemics and other disasters has been highlighted in the past (severe acute respiratory syndrome and Ebola outbreaks) and more recently with reports of the contributions of pharmacists during the global COVID-19 pandemic. Many reports have documented that health care professionals are experiencing significant psychological morbidity as a result of providing essential care and services during the global COVID-19 pandemic. In these reports, pharmacists are not well represented, and, therefore, it is essential to understand the impact of COVID-19 on pharmacists across multiple practice settings. This is particularly true as the experiences of pharmacists working through previous pandemics and disasters, and the associated psychological burden, are likely to offer insights and be useful in supporting the psychological well-being of pharmacists during the global COVID-19 pandemic. Research into the effect of the global COVID-19 pandemic on pharmacists should improve the understanding of the impact and the psychological morbidity associated with their role as frontline health care professionals.

Coronavirus and Homo Sapiens

AbstractThe Spanish influenza pandemic of 1918 globally claimed death between 50 and 100 million lives. In India, it was referred to as “The Bombay Fever,” and accounted for a fifth of the global death toll at that time. The current outbreak of the novel coronavirus disease 2019 (COVID-19), a new human-infecting beta coronavirus, has demonstrated that the size of an organism does not reflect on its ability to affect almost an entire human population. COVID-19, first detected in December 2019 in Wuhan, China, that spread rapidly worldwide. In humans, this disease ranged from flu-like symptoms to severe acute hypoxic respiratory failure. By appearance, this virus closely related to two bat-derived severe acute respiratory syndrome (SARS) coronaviruses. Although bats were likely the original host, animals sold at the Huanan seafood market in Wuhan might have been the intermediate host that enabled the emergence of the virus in humans. Under the electron microscope, the severe acute respiratory syndrome-coronavirus-2 (SARS-CoV-2) virus grips its receptor tighter than the virus behind the SARS outbreak in 2003 to 2004. The viral particle docks onto the angiotensin-converting enzyme 2 (ACE2) receptor and initiates viral entry. This review discusses the various aspects of the SARS-CoV-2 virus, its structure, pathophysiology, mechanism of interaction with human cells, virulence factors, and drug involved in the treatment of the disease.

The sequel to COVID-19: the antithesis to life

The sequel to COVID-19: the antithesis to life

Outbreak of COVID-19 and SARS in mainland China: a comparative study based on national surveillance data

ObjectiveTo compare the epidemiological characteristics and transmission dynamics in relation to interventions against the COVID-19 and severe acute respiratory syndrome (SARS) outbreak in mainland China.DesignComparative study based on a unique...

S1436 Outcome of the Use of Corticosteroids for Treatment of Autoimmune Pancreatitis (AIP) in a COVID-19 Patient

INTRODUCTION: Autoimmune Pancreatitis (AIP) is a steroid-responsive disease of the pancreas. Due to poor outcomes in severe acute respiratory syndrome (SARS-CoV) and Middle East respiratory syndrome (MERS-CoV) outbreaks, the World Health Organization (WHO) advises against the use of corticosteroids in the treatment of 2019 Coronavirus Disease (COVID-19) except if steroid therapy is required for coexisting illness. We present a case of uncontrolled AIP which was treated with high dose steroids while the patient was hospitalized with COVID-19. CASE DESCRIPTION/METHODS: A 53-year-old male was hospitalized with COVID-19 and uncontrolled AIP. The patient had elevated IgG4 levels and negative work up for other etiology of pancreatitis in the past and was already taking prednisone 40 mg daily due to a recent AIP exacerbation. On physical exam, temperature of 101 F, heart rate 101 beats/minute, respiratory rate 20 breaths/minute while blood pressure was normal. Tenderness in the epigastric region was noted. Labs showed Hct 35.8%, WBC 12.32 thousand/uL, BUN 9 mg/dL, lipase 530 u/L and normal LFTs. CT abdomen showed severe necrotizing pancreatitis with infected necrosis (multiloculated collections of gas and fluid) (Image 1). Chest imaging showed bibasilar infiltrates consistent with COVID-19 pneumonia (Image 2). Patient was continued on steroids, started on meropenem, and supportive treatment for COVID-19. Due to persistent abdominal pain and inability to tolerate oral intake, the patient underwent CT-guided percutaneous drainage of the necrotic collection. Azathioprine (AZA) was added to treatment regimen due to uncontrolled AIP despite steroid therapy. Patient recovered clinically without need for oxygen supplementation or further complication from COVID-19. He was discharged from the hospital with a short antibiotic course, a prescription to continue AZA and prednisone 40 mg with plan to taper dose by 5 mg per week. He returned home to continue quarantine which he completed without problems. DISCUSSION: Despite having multiple risk factors associated with poor outcomes in COVID-19 (age greater than 45 years, male gender, comorbidity due to uncontrolled AIP and immunosupression with steroid treatment), our patient experienced complete resolution of the illness with supportive measures. Our case supports current recommendations advocating steroid therapy for co-existing diseases in patients with COVID-19.Figure 1.: Image 1. CT scan abdomen shows multiloculated ill-defined of herterogeneous consistency as well as presence of gas pockets in the pancreatic and peri-pancreatic tissues, consistent with infected pancreatic necrotic collection in (A) and (B).Figure 2.: Image 2: Bibasilar lower lung infiltrates seen on CT scan chest (A) and Chest X-ray PA view (B), consistent with COVID-19 pneumonia.

COVID-19 Pregnant Patient Management with a Case of COVID-19 Patient with An Uncomplicated Delivery.

Pregnancy has always been a concern in epidemics all over the world. While coronavirus (COVID-19) disease ravages the world, it is a big curiosity how pregnant women will be affected by this disease. There are a few published case series and commentary of COVID-19 occurring during pregnancy. In this study, we discussed how to manage this disease in pregnant women. A 38-week pregnant, 37-year-old woman whose father passed away from COVID-19 admitted to the hospital with dyspnea, nonproductive cough, and fever. She had positive radiological features for COVID-19, and her rapid antibody test was positive. Lopinavir-ritonavir combination and azithromycin treatments were given, and the patient's symptoms regressed with treatment. The patient was taken to cesarean by providing isolation conditions, and she had a healthy baby with an uncomplicated delivery. There are no certain data about whether COVID-19 infection is worse in pregnant patients or not. On the basis of the limited data in the literature, we cannot see intrauterine transmission from infected mother to baby. However, we know that there would be serious pulmonary complications for the infected mother. Fortunately, the severe acute respiratory syndrome coronavirus 2 infection did not progress more severely in pregnant women than in the normal population compared with the previous severe acute respiratory syndrome outbreak.

Tackling COVID19 by Exploiting Pre-existing Cross-Reacting Spike-Specific Immunity

Tackling COVID19 by Exploiting Pre-existing Cross-Reacting Spike-Specific Immunity

Preventing the Interaction between Coronaviruses Spike Protein and Angiotensin I Converting Enzyme 2: An In Silico Mechanistic Case Study on Emodin as a Potential Model Compound

Emodin, a widespread natural anthraquinone, has many biological activities including health-protective and adverse effects. Amongst beneficial effects, potential antiviral activity against coronavirus responsible for the severe acute respiratory syndrome outbreak in 2002–2003 has been described associated with the inhibition of the host cells target receptors recognition by the viral Spike protein. However, the inhibition mechanisms have not been fully characterized, hindering the rational use of emodin as a model compound to develop more effective analogues. This work investigates emodin interaction with the Spike protein to provide a mechanistic explanation of such inhibition. A 3D molecular modeling approach consisting of docking simulations, pharmacophoric analysis and molecular dynamics was used. The plausible mechanism is described as an interaction of emodin at the protein–protein interface which destabilizes the viral protein-target receptor complex. This analysis has been extended to the Spike protein of the coronavirus responsible for the current pandemic hypothesizing emodin’s functional conservation. This solid knowledge-based foothold provides a possible mechanistic rationale of the antiviral activity of emodin as a future basis for the potential development of efficient antiviral cognate compounds. Data gaps and future work on emodin-related adverse effects in parallel to its antiviral pharmacology are explored.

Covid-19: The Wuhan Pandemic

Coronavirus belongs to a large family of viruses that usually cause respiratory illness in human beings that can be mild and severe depending upon the strain. In 2002, the outbreak of SARS (severe acute respiratory syndrome) reported more than 8000 infected cases with 774 mortalities. In 2012, the outbreak of MERS (middle east respiratory syndrome) infected around 2494 people and 858 deaths were reported according to the WHO. In January 2020, a new strain of coronavirus named 2019-nCoV has been identified in China. The number of confirmed cases has been increasing reaching 5,593,631 cases worldwide with 353,334 deaths up till 28th May 2020 according to WHO situation report-129. Concerned authorities are working on minimizing its spread. Prevention guidelines have been released by WHO, hoping to control the transmission and save the world from the effects of this novel virus.

Is There a Link Between the Pathogenic Human Coronavirus Envelope Protein and Immunopathology? A Review of the Literature.

Since the severe acute respiratory syndrome (SARS) outbreak in 2003, human coronaviruses (hCoVs) have been identified as causative agents of severe acute respiratory tract infections. Two more hCoV outbreaks have since occurred, the most recent being SARS-CoV-2, the causative agent of coronavirus disease 2019 (COVID-19). The clinical presentation of SARS and MERS is remarkably similar to COVID-19, with hyperinflammation causing a severe form of the disease in some patients. Previous studies show that the expression of the SARS-CoV E protein is associated with the hyperinflammatory response that could culminate in acute respiratory distress syndrome (ARDS), a potentially fatal complication. This immune-mediated damage is largely caused by a cytokine storm, which is induced by significantly elevated levels of inflammatory cytokines interleukin (IL)-1β and IL-6, which are partly mediated by the expression of the SARS-CoV E protein. The interaction between the SARS-CoV E protein and the host protein, syntenin, as well as the viroporin function of SARS-CoV E, are linked to this cytokine dysregulation. This review aims to compare the clinical presentation of virulent hCoVs with a specific focus on the cause of the immunopathology. The review also proposes that inhibition of IL-1β and IL-6 in severe cases can improve patient outcome.

Current COVID-19 guidelines for respiratory protection of health care workers are inadequate.

Current COVID-19 guidelines for respiratory protection of health care workers are inadequate.

Lessons from Severe Acute Respiratory Syndrome Coronavirus 2003 Pandemic as Evidence to Advocate for Stroke Public Education During the Current Coronavirus Disease 2019 Pandemic

The coronavirus disease 2019 (COVID-19) outbreak is affecting hospital admissions of stroke patients. This, in turn, will reduce the use of proven stroke treatments, which will result in poorer stroke outcomes. We examined local stroke admissions before, during, and after the 2003 outbreak of the severe acute respiratory syndrome (SARS) (these periods being defined in both the Singapore and worldwide contexts), to extrapolate stroke admission patterns in Singapore during the current COVID-19 crisis. National inpatient admission data from the Ministry of Health (MOH), Singapore, and death data from the Registry of Births and Deaths (RBD), Singapore, were analysed. Trends of local stroke admissions and stroke-related mortality pre-SARS, during SARS, and post-SARS periods, both in the Singapore and worldwide contexts, were analysed using time series plot in monthly time units. Differences between periods were presented as percentage change between: (1) SARS and pre-SARS periods, and (2) post-SARS and SARS periods and compared using two-sample t-tests. There was a 19% decline in stroke admissions into all local hospitals during the Singapore SARS period (P = 0.002) and a 13% reduction during the worldwide SARS period (P = 0.006). Stroke admissions increased by 18% after the Singapore SARS period was over (P = 0.003) and rose by a further 8% when the worldwide SARS period ended (P = 0.046). Stroke-related mortality remained stable throughout. During the SARS pandemic, there was a reduction in the number of stroke admissions, and this was apparent during both the local SARS and worldwide SARS outbreak periods. We should take appropriate steps through public education to minimise the expected reduced stroke admissions during the COVID-19 pandemic, inferred from the findings during the SARS pandemic.

COVID-19 and Gastrointestinal Tract Symptoms: Recognition, Containment, and Learning From the Past

COVID-19 and Gastrointestinal Tract Symptoms: Recognition, Containment, and Learning From the Past

Is Exposure to Epidemic Associated With Older Adults' Health Behavior? Evidence From China's 2002-2004 SARS Outbreak.

ObjectivesTo determine whether exposure to an epidemic is associated with better health behaviors.MethodsUsing nationally representative survey data collected in 2011 and 2014, we identified middle-aged and older Chinese adults whose communities experienced an outbreak of the 2002–2004 severe acute respiratory syndrome (SARS). We estimated logistic models of health behaviors in the years after the SARS epidemic.ResultsCompared to those who lived in communities not hit by the epidemic, respondents who lived in communities with a SARS outbreak in 2002–2004 were more likely to get a physical examination in 2010–2011 and have their blood pressure checked and participate in regular physical exercise in the years following the SARS epidemic. These associations varied by gender and rural–urban residence.DiscussionExposure to the SARS epidemic could be positively associated with health behavior among middle-aged and older Chinese adults.

Neuroimaging in Zoonotic Outbreaks Affecting the Central Nervous System: Are We Fighting the Last War?

When preparing for the coronavirus disease 2019 pandemic and its effects on the CNS, radiologists should be familiar with neuroimaging appearances in past zoonotic infectious disease outbreaks. Organisms that have crossed the species barrier from animals to humans include viruses such as Hendra, Nipah, Severe Acute Respiratory Syndrome, and influenza, as well as bacteria and others. Brain CT and MR imaging findings have included cortical abnormalities, microinfarction in the white matter, large-vessel occlusion, and features of meningitis. In particular, the high sensitivity of diffusion-weighted MR imaging in detecting intracranial abnormalities has been helpful in outbreaks. Although the coronaviruses causing the previous Severe Acute Respiratory Syndrome outbreak and the current coronavirus disease 19 pandemic are related, it is important to be aware of their similarities as well as potential differences. This review describes the neuroimaging appearances of selected zoonotic outbreaks so that neuroradiologists can better understand the current pandemic and potential future outbreaks.