Guidelines

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International Guidelines on Radiation Therapy for Breast Cancer During the COVID-19 Pandemic
AUTHOR NAMES
Coles C.E.; Aristei C.; Bliss J.; Boersma L.; Brunt A.M.; Chatterjee S.; Hanna G.; Jagsi R.; Kaidar Person O.; Kirby A.; Mjaaland I.; Meattini I.; Luis A.M.; Marta G.N.; Offersen B.; Poortmans P.; Rivera S.
SOURCE
Clinical Oncology (2020) 32:5 (279-281). Date of Publication: 1 May 2020
FULL TEXT LINK
http://dx.doi.org/10.1016/j.clon.2020.03.006

RECORD 2
TITLE
Novel coronavirus treatment with ribavirin: Groundwork for evaluation concerning COVID-19
AUTHOR NAMES
Khalili J.S.; Zhu H.; Mak A.; Yan Y.; Zhu Y.
SOURCE
Journal of medical virology (2020). Date of Publication: 30 Mar 2020
ABSTRACT
Confronting the challenge of the outbreak of COVID-19 should sharpen our focus on global drug access as a key issue in anti-viral therapy testing. The testing and adoption of effective therapies for novel coronaviruses is hampered by the challenge of conducting controlled studies during a state of emergency. The access to direct anti-viral drugs such as ribavirin that have an existing inventory and reliable supply chain may be a priority consideration for therapies developed for the 2019-nCoV infection outbreaks and any strain variants that may emerge. Based on the direct anti-viral activity of ribavirin against 2019-nCoV in vitro and evidence for potency enhancement strategies developed during the prior SARS and MERS outbreaks, ribavirin may significantly impact our ability to end the lingering outbreaks in China and slow outbreaks in other countries. The apparent COVID-19 pandemic provides an opportunity to follow dosage guidelines for treatment with ribavirin, test new therapeutic concepts, and conduct controlled testing to apply the scientific rigor required to address the controversy around this mainstay of anti-viral therapy. This article is protected by copyright. All rights reserved.
FULL TEXT LINK
http://dx.doi.org/10.1002/jmv.25798

RECORD 3
TITLE
Preliminary Results of Initial Testing for Coronavirus (COVID-19) in the Emergency Department
AUTHOR NAMES
Tolia V.M.; Chan T.C.; Castillo E.M.
SOURCE
The western journal of emergency medicine (2020) 21:3. Date of Publication: 27 Mar 2020
ABSTRACT
INTRODUCTION: On March 10, 2020, the World Health Organization declared a global pandemic due to widespread infection of the novel coronavirus 2019 (COVID-19). We report the preliminary results of a targeted program of COVID-19 infection testing in the ED in the first 10 days of its initiation at our institution. METHODS: We conducted a review of prospectively collected data on all ED patients who had targeted testing for acute COVID-19 infection at two EDs during the initial 10 days of testing (March 10-19, 2020). During this initial period with limited resources, testing was targeted toward high-risk patients per Centers for Disease Control and Prevention guidelines. Data collected from patients who were tested included demographics, clinical characteristics, and test qualifying criteria. We present the data overall and by test results with descriptive statistics. RESULTS: During the 10-day study period, the combined census of the study EDs was 2157 patient encounters. A total of 283 tests were ordered in the ED. The majority of patients were 18-64 years of age, male, non-Hispanic white, had an Emergency Severity Index score of three, did not have a fever, and were discharged from the ED. A total of 29 (10.2%) tested positive. Symptoms-based criteria most associated with COVID-19 were the most common criteria identified for testing (90.6%). All other criteria were reported in 5.51-43.0% of persons being tested. Having contact with a person under investigation was significantly more common in those who tested positive compared to those who tested negative (63% vs 24.5%, respectively). The majority of patients in both results groups had at least two qualifying criteria for testing (75.2%). CONCLUSION: In this review of prospectively collected data on all ED patients who had targeted testing for acute COVID-19 infection at two EDs in the first 10 days of testing, we found that 10.2% of those tested were identified as positive. The continued monitoring of testing and results will help providers understand how COVID-19 is progressing in the community.
FULL TEXT LINK
http://dx.doi.org/10.5811/westjem.2020.3.47348

RECORD 4
TITLE
Consensus guidelines for managing the airway in patients with COVID-19
AUTHOR NAMES
Cook T.M.; El-Boghdadly K.; McGuire B.; McNarry A.F.; Patel A.; Higgs A.
SOURCE
Anaesthesia (2020). Date of Publication: 27 Mar 2020
ABSTRACT
Severe acute respiratory syndrome-corona virus-2 (SARS-CoV-2), which causes coronavirus disease 2019 (COVID-19), is highly contagious. Airway management of patients with COVID-19 is high risk to staff and patients. We aimed to develop principles for airway management of patients with COVID-19 to encourage safe, accurate and swift performance. This consensus statement has been brought together at short notice to advise on airway management for patients with COVID-19, drawing on published literature and immediately available information from clinicians and experts. Recommendations on the prevention of contamination of healthcare workers, the choice of staff involved in airway management, the training required and the selection of equipment are discussed. The fundamental principles of airway management in these settings are described for: emergency tracheal intubation; predicted or unexpected difficult tracheal intubation; cardiac arrest; anaesthetic care; and tracheal extubation. We provide figures to support clinicians in safe airway management of patients with COVID-19. The advice in this document is designed to be adapted in line with local workplace policies.
FULL TEXT LINK
http://dx.doi.org/10.1111/anae.15054

RECORD 5
TITLE
Covid-19: doctors are given new guidelines on when to admit patients to critical care
AUTHOR NAMES
Iacobucci G.
SOURCE
BMJ (Clinical research ed.) (2020) 368 (m1189). Date of Publication: 24 Mar 2020
FULL TEXT LINK
http://dx.doi.org/10.1136/bmj.m1189

RECORD 6
TITLE
Surviving Sepsis Campaign: guidelines on the management of critically ill adults with Coronavirus Disease 2019 (COVID-19)
AUTHOR NAMES
Alhazzani W.; Møller M.H.; Arabi Y.M.; Loeb M.; Gong M.N.; Fan E.; Oczkowski S.; Levy M.M.; Derde L.; Dzierba A.; Du B.; Aboodi M.; Wunsch H.; Cecconi M.; Koh Y.; Chertow D.S.; Maitland K.; Alshamsi F.; Belley-Cote E.; Greco M.; Laundy M.; Morgan J.S.; Kesecioglu J.; McGeer A.; Mermel L.; Mammen M.J.; Alexander P.E.; Arrington A.; Centofanti J.E.; Citerio G.; Baw B.; Memish Z.A.; Hammond N.; Hayden F.G.; Evans L.; Rhodes A.
SOURCE
Intensive care medicine (2020). Date of Publication: 28 Mar 2020
ABSTRACT
BACKGROUND: The novel severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is the cause of a rapidly spreading illness, Coronavirus Disease 2019 (COVID-19), affecting thousands of people around the world. Urgent guidance for clinicians caring for the sickest of these patients is needed. METHODS: We formed a panel of 36 experts from 12 countries. All panel members completed the World Health Organization conflict of interest disclosure form. The panel proposed 53 questions that are relevant to the management of COVID-19 in the ICU. We searched the literature for direct and indirect evidence on the management of COVID-19 in critically ill patients in the ICU. We identified relevant and recent systematic reviews on most questions relating to supportive care. We assessed the certainty in the evidence using the Grading of Recommendations, Assessment, Development and Evaluation (GRADE) approach, then generated recommendations based on the balance between benefit and harm, resource and cost implications, equity, and feasibility. Recommendations were either strong or weak, or in the form of best practice recommendations. RESULTS: The Surviving Sepsis Campaign COVID-19 panel issued 54 statements, of which 4 are best practice statements, 9 are strong recommendations, and 35 are weak recommendations. No recommendation was provided for 6 questions. The topics were: (1) infection control, (2) laboratory diagnosis and specimens, (3) hemodynamic support, (4) ventilatory support, and (5) COVID-19 therapy. CONCLUSION: The Surviving Sepsis Campaign COVID-19 panel issued several recommendations to help support healthcare workers caring for critically ill ICU patients with COVID-19. When available, we will provide new recommendations in further releases of these guidelines.
FULL TEXT LINK
http://dx.doi.org/10.1007/s00134-020-06022-5

RECORD 7
TITLE
Practical considerations in the anaesthetic management of patients during a COVID-19 epidemic
AUTHOR NAMES
Ong S.; Tan T.K.
SOURCE
Anaesthesia (2020). Date of Publication: 27 Mar 2020
ABSTRACT
We read with interest the excellent Association guidelines [1] for the anaesthetic management of patients during a COVID-19 outbreak. We concur with these guidelines, which are not dissimilar to our hospital’s protocols since Singapore reported its first case of COVID-19 on 23 January 2020. To date, there have been 226 confirmed cases in Singapore with no deaths reported [2]. We are preparing for many more when community transmission becomes widespread and every patient presenting for surgery becomes a potential asymptomatic infected case. We would like to highlight additional anaesthetic considerations in this COVID-19 pandemic. Our discussion is limited to patients not known to be COVID infected.
FULL TEXT LINK
http://dx.doi.org/10.1111/anae.15053

RECORD 8
TITLE
Guidelines for surgical management of gynaecological cancer during pandemic COVID-19 period – FRANCOGYN group for the CNGOF
AUTHOR NAMES
Vincent L.; Cherif A.; Henri A.; Marcos B.; Sofiane B.; Pierre-Adrien B.; Nicolas B.; Alexandre B.; Geoffroy C.; Xavier C.; Pauline C.; Pierre C.; Charles C.; Yohann D.; Ludivine D.; Tristan G.; Olivier G.; Cyrille H.; Martin K.; Frederic K.; Lise L.; Matthieu M.; Camille M.; Lobna O.; Emilie R.; Cyril T.
SOURCE
Gynecologie, obstetrique, fertilite & senologie (2020). Date of Publication: 25 Mar 2020
FULL TEXT LINK
http://dx.doi.org/10.1016/j.gofs.2020.03.017

RECORD 9
TITLE
Use of in situ simulation to evaluate the operational readiness of a high-consequence infectious disease intensive care unit
AUTHOR NAMES
Fregene T.E.; Nadarajah P.; Buckley J.F.; Bigham S.; Nangalia V.
SOURCE
Anaesthesia (2020). Date of Publication: 2020
ABSTRACT
On 30 January 2020, the World Health Organization (WHO) declared that the outbreak of a coronavirus disease-2019 (COVID-19) was a public health emergency of international concern. The WHO guidance states that patients with (COVID-19) should be managed by staff wearing appropriate personal protective equipment; however, working whilst wearing personal protective equipment is unfamiliar to many healthcare professionals. We ran high-fidelity, in-situ simulation of high-risk procedures on patients with COVID-19 in a negative-pressure side room on our intensive care unit (ICU). Our aim was to identify potential problems, test the robustness of our systems and inform modification of our standard operating procedures for any patients with COVID-19 admitted to our ICU. The simulations revealed several important latent risks and allowed us to put corrective measures in place before the admission of patients with COVID-19. We recommend that staff working in clinical areas expected to receive patients with COVID-19 conduct in-situ simulation in order to detect their own unique risks and aid in the creation of local guidelines of management of patients with COVID-19.
FULL TEXT LINK
http://dx.doi.org/10.1111/anae.15048

RECORD 10
TITLE
Anesthetic Management of Patients Undergoing Aortic Dissection Repair With Suspected Severe Acute Respiratory Syndrome Coronavirus-2 Infection
AUTHOR NAMES
He H.; Zhao S.; Han L.; Wang Q.; Xia H.; Huang X.; Yao S.; Huang J.; Chen X.
SOURCE
Journal of Cardiothoracic and Vascular Anesthesia (2020). Date of Publication: 2020
ABSTRACT
Severe acute respiratory syndrome coronavirus-2 is still active in Wuhan, China, and is spreading to the rest of the world. Recently, perioperative anesthetic management in patients with suspected or confirmed coronavirus-2 has been reported. However, little has been reported on the anesthetic management of patients undergoing aortic dissection repair in patients with suspected severe acute respiratory syndrome coronavirus-2 infection. During the outbreak in Wuhan, the authors’ team completed 4 cases of aortic dissection repair successfully in patients with suspected severe acute respiratory syndrome coronavirus-2 infection. The purpose of the present report is to summarize current knowledge and experiences on anesthetic management in this patient population and to provide clinical practice guidelines on anesthetic management and infection prevention and control in these critically ill patients.
FULL TEXT LINK
http://dx.doi.org/10.1053/j.jvca.2020.03.021

RECORD 11
TITLE
Safety Recommendations for Evaluation and Surgery of the Head and Neck during the COVID-19 Pandemic
AUTHOR NAMES
Givi B.; Schiff B.A.; Chinn S.B.; Clayburgh D.; Iyer N.G.; Jalisi S.; Moore M.G.; Nathan C.-A.; Orloff L.A.; O’Neill J.P.; Parker N.; Zender C.; Morris L.G.T.; Davies L.
SOURCE
JAMA Otolaryngology – Head and Neck Surgery (2020). Date of Publication: 2020
ABSTRACT
Importance: The rapidly expanding novel coronavirus disease 2019 (COVID-19) pandemic, caused by severe acute respiratory syndrome coronavirus 2, has challenged the medical community to an unprecedented degree. Physicians and health care workers are at added risk of exposure and infection during the course of patient care. Because of the rapid spread of this disease through respiratory droplets, health care workers who come in close contact with the upper aerodigestive tract during diagnostic and therapeutic procedures, such as otolaryngologists-head and neck surgeons, are particularly at risk. A set of safety recommendations was created based on a review of the literature and communications with physicians with firsthand knowledge of safety procedures during the COVID-19 pandemic. Observations: A high number of health care workers were infected during the first phase of the pandemic in the city of Wuhan, China. Subsequently, by adopting strict safety precautions, other regions were able to achieve high levels of safety for health care workers without jeopardizing the care of patients. The most common procedures related to the examination and treatment of upper aerodigestive tract diseases were reviewed. Each category was reviewed based on the potential risk imposed to health care workers. Specific recommendations were made based on the literature, when available, or consensus best practices. Specific safety recommendations were made for performing tracheostomy in patients with COVID-19. Conclusions and Relevance: Preserving a highly skilled health care workforce is a top priority for any community and health care system. Based on the experience of health care systems in Asia and Europe, by following strict safety guidelines, the risk of exposure and infection of health care workers could be greatly reduced while providing high levels of care. The provided recommendations, which may evolve over time, could be used as broad guidance for all health care workers who are involved in the care of patients with COVID-19..
FULL TEXT LINK
http://dx.doi.org/10.1001/jamaoto.2020.0780

RECORD 12
TITLE
Association of Coronavirus Disease 2019 (COVID-19) with Myocardial Injury and Mortality
AUTHOR NAMES
Bonow R.O.; Fonarow G.C.; O’Gara P.T.; Yancy C.W.
SOURCE
JAMA Cardiology (2020). Date of Publication: 2020
FULL TEXT LINK
http://dx.doi.org/10.1001/jamacardio.2020.1105

RECORD 13
TITLE
Potential Effects of Coronaviruses on the Cardiovascular System: A Review
AUTHOR NAMES
Madjid M.; Safavi-Naeini P.; Solomon S.D.; Vardeny O.
SOURCE
JAMA Cardiology (2020). Date of Publication: 2020
ABSTRACT
Importance: Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), which causes coronavirus disease 2019 (COVID-19) has reached a pandemic level. Coronaviruses are known to affect the cardiovascular system. We review the basics of coronaviruses, with a focus on COVID-19, along with their effects on the cardiovascular system. Observations: Coronavirus disease 2019 can cause a viral pneumonia with additional extrapulmonary manifestations and complications. A large proportion of patients have underlying cardiovascular disease and/or cardiac risk factors. Factors associated with mortality include male sex, advanced age, and presence of comorbidities including hypertension, diabetes mellitus, cardiovascular diseases, and cerebrovascular diseases. Acute cardiac injury determined by elevated high-sensitivity troponin levels is commonly observed in severe cases and is strongly associated with mortality. Acute respiratory distress syndrome is also strongly associated with mortality. Conclusions and Relevance: Coronavirus disease 2019 is associated with a high inflammatory burden that can induce vascular inflammation, myocarditis, and cardiac arrhythmias. Extensive efforts are underway to find specific vaccines and antivirals against SARS-CoV-2. Meanwhile, cardiovascular risk factors and conditions should be judiciously controlled per evidence-based guidelines..
FULL TEXT LINK
http://dx.doi.org/10.1001/jamacardio.2020.1286

RECORD 14
TITLE
Coronavirus Disease 2019 (COVID-19) and Pregnancy: Responding to a Rapidly Evolving Situation
AUTHOR NAMES
Rasmussen S.A.; Jamieson D.J.
SOURCE
Obstetrics and gynecology (2020). Date of Publication: 19 Mar 2020
ABSTRACT
As the world confronts coronavirus disease 2019 (COVID-19), an illness caused by yet another emerging pathogen (severe acute respiratory syndrome coronavirus 2 [SARS-CoV-2]), obstetric care providers are asking what this means for pregnant women. The global spread has been swift, and many key questions remain. The case-fatality rate for persons cared for in the United States and whether asymptomatic persons transmit the virus are examples of questions that need to be answered to inform public health control measures. There are also unanswered questions specific to pregnant women, such as whether pregnant women are more severely affected and whether intrauterine transmission occurs. Although guidelines for pregnant women from the American College of Obstetricians and Gynecologists and the Centers for Disease Control and Prevention have been rapidly developed based on the best available evidence, additional information is critically needed to inform key decisions, such as whether pregnant health care workers should receive special consideration, whether to temporarily separate infected mothers and their newborns, and whether it is safe for infected women to breastfeed. Some current recommendations are well supported, based largely on what we know from seasonal influenza: patients should avoid contact with ill persons, avoid touching their face, cover coughs and sneezes, wash hands frequently, disinfect contaminated surfaces, and stay home when sick. Prenatal clinics should ensure all pregnant women and their visitors are screened for fever and respiratory symptoms, and symptomatic women should be isolated from well women and required to wear a mask. As the situation with COVID-19 rapidly unfolds, it is critical that obstetricians keep up to date.
FULL TEXT LINK
http://dx.doi.org/10.1097/AOG.0000000000003873

RECORD 15
TITLE
Expanded Umbilical Cord Mesenchymal Stem Cells (UC-MSCs) as a Therapeutic Strategy in Managing Critically Ill COVID-19 Patients: The Case for Compassionate Use
AUTHOR NAMES
Atluri S.; Manchikanti L.; Hirsch J.A.
SOURCE
Pain physician (2020) 23:2 (E71-E83). Date of Publication: 1 Mar 2020
ABSTRACT
COVID-19 has affected the United States leading to a national emergency with health care and economic impact, propelling the country into a recession with disrupted lifestyles not seen in recent history. COVID-19 is a serious illness leading to multiple deaths in various countries including the United States. Several million Americans satisfy the Center for Disease Control and Prevention (CDC) criteria for being high risk. Unfortunately, the available supply of medical beds and equipment for mechanical ventilation are much less than is projected to be needed. The World Health Organization (WHO) and multiple agencies led by the CDC in the United States have attempted to organize intensive outbreak investigation programs utilizing appropriate preventive measures, evaluation, and treatment. The clinical spectrum of COVID-19 varies from asymptomatic forms to conditions encompassing multiorgan and systemic manifestations in terms of septic shock, and multiple organ dysfunction (MOD) syndromes. The presently approved treatments are supportive but not curative for the disease. There are multiple treatments being studied. These include vaccines, medications Remdesivir and hydroxychloroquine and potentially combination therapy. Finally, expanded umbilical cord mesenchymal stem cells or (UC-MSCs) may have a role and are being studied. The cure of COVID-19 is essentially dependent on the patients’ own immune system. When the immune system is over activated in an attempt to kill the virus, this can lead to the production of a large number of inflammatory factors, resulting in severe cytokine storm. The cytokine storm may induce organ damage followed by the edema, dysfunction of air exchange, acute respiratory distress syndrome (ARDS), acute cardiac injury, and secondary infection, which may lead to death. Thus, at this point, the avoidance of the cytokine storm may be the key for the treatment of HCOV-19 infected patients.In China, where there was limited availability of effective modalities to manage COVID-19 several patients were treated with expanded UC-MSCs. Additionally, the Italian College of Anesthesia, Analgesia, Resuscitation and Intensive Care have reported guidelines to treat coronavirus patients with stem cells in the hope of decreasing the number of patients going to the ICU, and, also relatively quickly getting them out of ICU. In this manuscript, we describe the urgent need for various solutions, pathogenesis of coronavirus and the clinical evidence for treatment of COVID-19 with stem cells. The limited but emerging evidence regarding UC MSC in managing COVID-19 suggests that it might be considered for compassionate use in critically ill patients to reduce morbidity and mortality in the United States. The administration and Coronavirus Task Force might wish to approach the potential of expanded UC-MSCs as an evolutionary therapeutic strategy in managing COVID-19 illness with a 3-pronged approach: If proven safe and effective on a specific and limited basis…1. Minimize regulatory burden by all agencies so that critically ill COVID-19 patients will have access regardless of their financial circumstance.2. Institute appropriate safeguards to avoid negative consequences from unscrupulous actors.3. With proper informed consent from patients or proxy when necessary, and subject to accumulation of data in that cohort, allow the procedure to be initiated in critically ill patients who are not responding to conventional therapies.KEY WORDS: Coronavirus, COVID-19, cytokine storm, multiorgan failure, expanded umbilical cord mesenchymal stem cells.

RECORD 16
TITLE
Preliminary Recommendations for Surgical Practice of Neurosurgery Department in the Central Epidemic Area of 2019 Coronavirus Infection
AUTHOR NAMES
Tan Y.-T.; Wang J.-W.; Zhao K.; Han L.; Zhang H.-Q.; Niu H.-Q.; Shu K.; Lei T.
SOURCE
Current medical science (2020). Date of Publication: 26 Mar 2020
ABSTRACT
Since December 2019, an outbreak of coronavirus disease 2019 (COVID-19) has posed significant threats to the public health and life in China. Unlike the other 6 identified coronaviruses, the SARS-Cov-2 has a high infectious rate, a long incubation period and a variety of manifestations. In the absence of effective treatments for the virus, it becomes extremely urgent to develop scientific and standardized proposals for prevention and control of virus transmission. Hereby we focused on the surgical practice in Neurosurgery Department, Tongji Hospital, Wuhan, and drafted several recommendations based on the latest relevant guidelines and our experience. These recommendations have helped us until now to achieve ‘zero infection’ of doctors and nurses in our department, we would like to share them with other medical staff of neurosurgery to fight 2019-nCoV infection.
FULL TEXT LINK
http://dx.doi.org/10.1007/s11596-020-2173-5

RECORD 17
TITLE
Oral Health Management of Children during the Epidemic Period of Coronavirus Disease 2019
AUTHOR NAMES
Wang Y.; Zhou C.-C.; Shu R.; Zou J.
SOURCE
Sichuan da xue xue bao. Yi xue ban = Journal of Sichuan University. Medical science edition (2020) 51:2 (151-154). Date of Publication: 1 Mar 2020
ABSTRACT
Coronavirus disease 2019 (COVID-19) is becoming a major public health event affecting China and even the whole world. During the epidemic period of corona virus disease, appropriate oral health management and disease prevention of children is very important for children’s oral and general health. In order to prevent the occurrence of cross-infection and epidemic spreading of COVID-19 during dental practice, the recommendations to parents include: not only training children to maintain hand hygiene at home, exercise appropriately, strengthen physical resistance, but also helping children develop good oral and diet habit such as effective brushing and flossing to avoid oral diseases and emergency. If non-emergency oral situation occur, parents could assist their child to take home based care such as rinsing to relieve the symptoms. When oral emergencies such as acute pulpitis, periapical periodontitis, dental trauma, oral and maxillofacial infections happen, parents and children should visit dental clinic in time with correct personal protection. During the epidemic period, children’s oral emergencies should be treated in accordance with current guidelines and control of COVID-19.
FULL TEXT LINK
http://dx.doi.org/10.12182/20200360101

RECORD 18
TITLE
COVID-19 and the otolaryngologist – preliminary evidence-based review
AUTHOR NAMES
Vukkadala N.; Qian Z.J.; Holsinger F.C.; Patel Z.M.; Rosenthal E.
SOURCE
The Laryngoscope (2020). Date of Publication: 26 Mar 2020
ABSTRACT
The SARS-CoV-2 virus which causes coronavirus disease 2019 (COVID-19) has rapidly swept across the world since its identification in December 2019. Otolaryngologists are at unique risk due to the close contact with mucus membranes of the upper respiratory tract and have been among the most affected healthcare workers in Wuhan, China. We present information on COVID-19 management relevant to otolaryngologists on the frontlines of this pandemic and provide preliminary guidance based on practices implemented in China and other countries and practical strategies deployed at Stanford University. This article is protected by copyright. All rights reserved.
FULL TEXT LINK
http://dx.doi.org/10.1002/lary.28672

RECORD 19
TITLE
Clinical and immunologic features in severe and moderate Coronavirus Disease 2019
AUTHOR NAMES
Chen G.; Wu D.; Guo W.; Cao Y.; Huang D.; Wang H.; Wang T.; Zhang X.; Chen H.; Yu H.; Zhang X.; Zhang M.; Wu S.; Song J.; Chen T.; Han M.; Li S.; Luo X.; Zhao J.; Ning Q.
SOURCE
The Journal of clinical investigation (2020). Date of Publication: 27 Mar 2020
ABSTRACT
BACKGROUND: Since December 2019, an outbreak of Coronavirus Disease 2019 (COVID-19) caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) emerged in Wuhan, and is now becoming a global threat. We aimed to delineate and compare the immunologic features of severe and moderate COVID-19. METHODS: In this retrospective study, the clinical and immunologic characteristics of 21 patients (17 male and 4 female) with COVID-19 were analyzed. These patients were classified as severe (11 cases) and moderate (10 cases) according to the Guidelines released by the National Health Commission of China. RESULTS: The median age of severe and moderate cases was 61.0 and 52.0 years, respectively. Common clinical manifestations included fever, cough and fatigue. Compared to moderate cases, severe cases more frequently had dyspnea, lymphopenia, and hypoalbuminemia, with higher levels of alanine aminotransferase, lactate dehydrogenase, C-reactive protein, ferritin and D-dimer as well as markedly higher levels of IL-2R, IL-6, IL-10, and TNF-α. Absolute number of T lymphocytes, CD4+T and CD8+T cells decreased in nearly all the patients, and were markedly lower in severe cases (294.0, 177.5 and 89.0 × 106/L) than moderate cases (640.5, 381.5 and 254.0 × 106/L). The expressions of IFN-γ by CD4+T cells tended to be lower in severe cases (14.1%) than moderate cases (22.8%). CONCLUSION: The SARS-CoV-2 infection may affect primarily T lymphocytes particularly CD4+T and CD8+ T cells, resulting in decrease in numbers as well as IFN-γ production. These potential immunological markers may be of importance due to their correlation with disease severity in COVID-19.
FULL TEXT LINK
http://dx.doi.org/10.1172/JCI137244

RECORD 20
TITLE
Translating COVID-19 Pandemic Surge Theory to Practice in the Emergency Department: How to Expand Structure
AUTHOR NAMES
Paganini M.; Conti A.; Weinstein E.; Della Corte F.; Ragazzoni L.
SOURCE
Disaster medicine and public health preparedness (2020) (1-30). Date of Publication: 27 Mar 2020
ABSTRACT
Multiple professional societies, nongovernment and government agencies have studied the science of sudden onset disaster mass casualty incidents to create and promote surge response guidelines. The COVID-19 pandemic has presented the health care system with challenges that have limited science to guide the staff, stuff and structure surge response.This study reviewed the available surge science literature specifically to guide an Emergency Department’s surge structural response using a translational science approach to answer the question: How does the concept of sudden onset mass casualty incident (MCI) surge capability apply to the process to expand COVID-19 Pandemic surge structure response?The available surge structural science literature was reviewed to determine the application to a pandemic response. The on-line ahead of print and print COVID-19 scientific publications, as well as grey, literature were studied to learn the best available COVID-19 surge structural response science. A checklist was created to guide the Emergency Department team’s COVID-19 surge structural response.
FULL TEXT LINK
http://dx.doi.org/10.1017/dmp.2020.57

RECORD 21
TITLE
Toward Universal Deployable Guidelines for the Care of Patients with COVID-19
AUTHOR NAMES
Lamontagne F.; Angus D.C.
SOURCE
JAMA – Journal of the American Medical Association (2020) (E1-E2). Date of Publication: 2020
FULL TEXT LINK
http://dx.doi.org/10.1001/jama.2020.5110

RECORD 22
TITLE
The Trial of Chloroquine in the Treatment of Corona Virus Disease 2019 (COVID-19) and Its Research Progress in Forensic Toxicology
AUTHOR NAMES
Duan Y.J.; Liu Q.; Zhao S.Q.; Huang F.; Ren L.; Liu L.; Zhou Y.W.
SOURCE
Fa yi xue za zhi (2020) 36:2. Date of Publication: 25 Mar 2020
ABSTRACT
Abstract: Chloroquine is a long-established prescription drug that is often used clinically to treat malaria and connective tissue diseases. Since December 2019, COVID-19 (corona virus disease 2019) outbreaks caused by SARS-CoV-2 (severe acute respiratory syndrome coronavirus 2) has occurred in China and many countries around the world. Due to the lack of drugs against COVID-19, the disease spreads rapidly and the mortality rate is relatively high. Therefore, specific drugs against SARS-CoV-2 need to be quickly screened. The antimalarial drug Chloroquine phosphate which has already been approved is confirmed to have an anti-SARS-CoV-2 effect and has been included in diagnostic and therapeutic guidelines. However, awareness of the risk of chloroquine phosphate causing acute poisoning or even death should be strengthened. The dosage used according to current clinical recommended dosage and course of treatment are larger than that of previous treatment of malaria. Many provinces have required close clinical monitoring of adverse reactions. This paper reviews the pharmacological effects, poisoning and toxicological mechanisms, in vivo metabolism and distribution, and forensic issues of chloroquine drugs, in order to provide help to forensic practice and clinical work.
FULL TEXT LINK
http://dx.doi.org/10.12116/j.issn.1004-5619.2020.02.001

RECORD 23
TITLE
Recommendations for general surgery clinical practice in 2019 coronavirus disease situation
AUTHOR NAMES
Tao K.X.; Zhang B.X.; Zhang P.; Zhu P.; Wang G.B.; Chen X.P.
SOURCE
Zhonghua wai ke za zhi Chinese journal of surgery 58:3 (170-177). Date of Publication: 1 Mar 2020
ABSTRACT
The 2019 coronavirus disease(COVID-19) is a highly infectious disease, has a long incubation period and a variety of clinical manifestations, which has a significant impact on public health and life. Afterwards, scientific and standardized work processing during the epidemic is of great significance for prevention and control. In order to implement the central government’s decision-making deployment and defeat the COVID-19 as soon as possible, we had focused on the key points in the clinical work of general surgery according to latest relevant guidelines, literature and experience in epidemic prevention. Finally, we drafted the prevention and control strategies and recommendations to make a reference for medical staff of general surgery to fight against COVID-19.
FULL TEXT LINK
http://dx.doi.org/10.3760/cma.j.issn.0529-5815.2020.03.003

RECORD 24
TITLE
Treatment strategies for colorectal cancer patients in tumor hospitals under the background of corona virus disease 2019
AUTHOR NAMES
Hu X.H.; Niu W.B.; Zhang J.F.; Li B.K.; Yu B.; Zhang Z.Y.; Zhou C.X.; Zhang X.N.; Gao Y.; Wang G.Y.
SOURCE
Zhonghua wei chang wai ke za zhi = Chinese journal of gastrointestinal surgery (2020) 23:3 (201-208). Date of Publication: 25 Mar 2020
ABSTRACT
In December 2019, a new outbreak of corona virus disease 2019 began to occur. Its pathogen is 2019-nCoV, which has the characteristics of strong infectivity and general susceptibility. The current situation of prevention and control of new coronavirus pneumonia is severe. In this context, as front-line medical workers bearing important responsibilities and pressure, while through strict management strategy, we can minimize the risk of infection exposure. By summarizing the research progress and guidelines in recent years in the fields of colorectal cancer disease screening, treatment strategies (including early colorectal cancer, locally advanced colorectal cancer, obstructive colorectal cancer, metastatic colorectal cancer and the treatment of patients after neoadjuvant therapy), the choice of medication and time limit for adjuvant therapy, the protective measures for patients undergoing emergency surgery, the re-examination of postoperative patients and the protection of medical staff, etc., authors improve treatment strategies in order to provide more choices for patients to obtain the best treatment under the severe epidemic situation of new coronavirus pneumonia. Meanwhile we hope that it can also provide more timely treatment modeling schemes for colleagues.
FULL TEXT LINK
http://dx.doi.org/10.3760/cma.j.cn.441530-20200217-00058

RECORD 25
TITLE
COVID-19: An Update on the Epidemiological, Clinical, Preventive and Therapeutic Evidence and Guidelines of Integrative Chinese-Western Medicine for the Management of 2019 Novel Coronavirus Disease
AUTHOR NAMES
Chan K.W.; Wong V.T.; Tang S.C.W.
SOURCE
American Journal of Chinese Medicine (2020). Date of Publication: 2020
ABSTRACT
As of 22 February 2020, more than 77662 cases of confirmed COVID-19 have been documented globally with over 2360 deaths. Common presentations of confirmed cases include fever, fatigue, dry cough, upper airway congestion, sputum production, shortness of breath, myalgia/arthralgia with lymphopenia, prolonged prothrombin time, elevated C-reactive protein, and elevated lactate dehydrogenase. The reported severe/critical case ratio is approximately 7-10% and median time to intensive care admission is 9.5-10.5 days with mortality of around 1-2% varied geographically. Similar to outbreaks of other newly identified virus, there is no proven regimen from conventional medicine and most reports managed the patients with lopinavir/ritonavir, ribavirin, beta-interferon, glucocorticoid and supportive treatment with remdesivir undergoing clinical trial. In China, Chinese medicine is proposed as a treatment option by national and provincial guidelines with substantial utilization. We reviewed the latest national and provincial clinical guidelines, retrospective cohort studies, and case series regarding the treatment of COVID-19 by add-on Chinese medicine. We have also reviewed the clinical evidence generated from SARS and H1N1 management with hypothesized mechanisms and latest in silico findings to identify candidate Chinese medicines for the consideration of possible trials and management. Given the paucity of strongly evidence-based regimens, the available data suggest that Chinese medicine could be considered as an adjunctive therapeutic option in the management of COVID-19.
FULL TEXT LINK
http://dx.doi.org/10.1142/S0192415X20500378

RECORD 26
TITLE
Planning and provision of ECMO services for severe ARDS during the COVID-19 pandemic and other outbreaks of emerging infectious diseases
AUTHOR NAMES
Ramanathan K.; Antognini D.; Combes A.; Paden M.; Zakhary B.; Ogino M.; MacLaren G.; Brodie D.; Shekar K.
SOURCE
The Lancet. Respiratory medicine (2020). Date of Publication: 20 Mar 2020
ABSTRACT
WHO interim guidelines recommend offering extracorporeal membrane oxygenation (ECMO) to eligible patients with acute respiratory distress syndrome (ARDS) related to coronavirus disease 2019 (COVID-19). The number of patients with COVID-19 infection who might develop severe ARDS that is refractory to maximal medical management and require this level of support is currently unknown. Available evidence from similar patient populations suggests that carefully selected patients with severe ARDS who do not benefit from conventional treatment might be successfully supported with venovenous ECMO. The need for ECMO is relatively low and its use is mostly restricted to specialised centres globally. Providing complex therapies such as ECMO during outbreaks of emerging infectious diseases has unique challenges. Careful planning, judicious resource allocation, and training of personnel to provide complex therapeutic interventions while adhering to strict infection control measures are all crucial components of an ECMO action plan. ECMO can be initiated in specialist centres, or patients can receive ECMO during transportation from a centre that is not specialised for this procedure to an expert ECMO centre. Ensuring that systems enable safe and coordinated movement of critically ill patients, staff, and equipment is important to improve ECMO access. ECMO preparedness for the COVID-19 pandemic is important in view of the high transmission rate of the virus and respiratory-related mortality.
FULL TEXT LINK
http://dx.doi.org/10.1016/S2213-2600(20)30121-1

RECORD 27
TITLE
Early estimation of the case fatality rate of COVID-19 in mainland China: A data-driven analysis
AUTHOR NAMES
Yang S.; Cao P.; Du P.; Wu Z.; Zhuang Z.; Yang L.; Yu X.; Zhou Q.; Feng X.; Wang X.; Li W.; Liu E.; Chen J.; Chen Y.; He D.
SOURCE
Annals of Translational Medicine (2020) 8:4. Date of Publication: 1 Feb 2020
ABSTRACT
Background: An ongoing outbreak of pneumonia caused by a novel coronavirus [severe acute respiratory syndrome coronavirus (SARS-CoV)-2], named COVID-19, hit a major city of China, Wuhan in December 2019 and subsequently spread to other provinces/regions of China and overseas. Several studies have been done to estimate the basic reproduction number in the early phase of this outbreak, yet there are no reliable estimates of case fatality rate (CFR) for COVID-19 to date. Methods: In this study, we used a purely data-driven statistical method to estimate the CFR in the early phase of the COVID-19 outbreak. Daily numbers of laboratory-confirmed COVID-19 cases and deaths were collected from January 10 to February 3, 2020 and divided into three clusters: Wuhan city, other cities of Hubei province, and other provinces of mainland China. Simple linear regression model was applied to estimate the CFR from each cluster. Results: We estimated that CFR during the first weeks of the epidemic ranges from 0.15% (95% CI: 0.120.18%) in mainland China excluding Hubei through 1.41% (95% CI: 1.381.45%) in Hubei province excluding the city of Wuhan to 5.25% (95% CI: 4.985.51%) in Wuhan. Conclusions: Our early estimates suggest that the CFR of COVID-19 is lower than the previous coronavirus epidemics caused by SARS-CoV and Middle East respiratory syndrome coronavirus (MERS-CoV).
FULL TEXT LINK
http://dx.doi.org/10.21037/atm.2020.02.66

RECORD 28
TITLE
Autopsy in suspected COVID-19 cases
AUTHOR NAMES
Hanley B.; Lucas S.B.; Youd E.; Swift B.; Osborn M.
SOURCE
Journal of clinical pathology (2020). Date of Publication: 20 Mar 2020
ABSTRACT
The severe acute respiratory syndrome (SARS)-coronavirus-2 (CoV-2) outbreak in Wuhan, China, has now spread to many countries across the world including the UK with over 3000 deaths as of early March 2020. This will inevitably lead to an increase in the number of suspected coronavirus disease 2019 (COVID-19)-related deaths at autopsy. The Royal College of Pathologists has responded to this concern with the release of guidelines on autopsy practice relating to COVID-19. The following article is a summary and interpretation of these guidelines. It includes a description of hazard group 3 organisms to which SARS-CoV-2 has been assigned, a brief description of what is currently known about the pathological and autopsy findings in COVID-19, a summary of the recommendations for conducting autopsies in suspected COVID-19 cases and the techniques for making the diagnosis at autopsy. It concludes by considering the clinicopathological correlation and notification of such cases.
FULL TEXT LINK
http://dx.doi.org/10.1136/jclinpath-2020-206522

RECORD 29
TITLE
Understanding COVID-19 new diagnostic guidelines – a message of reassurance from an internal medicine doctor in Shanghai
AUTHOR NAMES
Bischof E.; Chen G.; Ferretti M.T.
SOURCE
Swiss medical weekly (2020) 150 (w20216). Date of Publication: 24 Feb 2020
FULL TEXT LINK
http://dx.doi.org/10.4414/smw.2020.20216

RECORD 30
TITLE
COVID-19 Infection: Implications for Perioperative and Critical Care Physicians
AUTHOR NAMES
Greenland J.R.; Michelow M.D.; Wang L.; London M.J.
SOURCE
Anesthesiology (2020). Date of Publication: 19 Mar 2020
ABSTRACT
Healthcare systems worldwide are responding to Coronavirus Disease 2019 (COVID-19), an emerging infectious syndrome caused by the Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) virus. Patients with COVID-19 can progress from asymptomatic or mild illness to hypoxemic respiratory failure or multisystem organ failure, necessitating intubation and intensive care management. Healthcare providers, and particularly anesthesiologists, are at the frontline of this epidemic, and they need to be aware of the best available evidence to guide therapeutic management of patients with COVID-19 and to keep themselves safe while doing so. Here, the authors review COVID-19 pathogenesis, presentation, diagnosis, and potential therapeutics, with a focus on management of COVID-19-associated respiratory failure. The authors draw on literature from other viral epidemics, treatment of acute respiratory distress syndrome, and recent publications on COVID-19, as well as guidelines from major health organizations. This review provides a comprehensive summary of the evidence currently available to guide management of critically ill patients with COVID-19.
FULL TEXT LINK
http://dx.doi.org/10.1097/ALN.0000000000003303

RECORD 31
TITLE
Expert consensus for managing pregnant women and neonates born to mothers with suspected or confirmed novel coronavirus (COVID-19) infection
AUTHOR NAMES
Chen D.; Yang H.; Cao Y.; Cheng W.; Duan T.; Fan C.; Fan S.; Feng L.; Gao Y.; He F.; He J.; Hu Y.; Jiang Y.; Li Y.; Li J.; Li X.; Li X.; Lin K.; Liu C.; Liu J.; Liu X.; Pan X.; Pang Q.; Pu M.; Qi H.; Shi C.; Sun Y.; Sun J.; Wang X.; Wang Y.; Wang Z.; Wang Z.; Wang C.; Wu S.; Xin H.; Yan J.; Zhao Y.; Zheng J.; Zhou Y.; Zou L.; Zeng Y.; Zhang Y.; Guan X.; Eppes C.S.; Fox K.; Belfort M.A.
SOURCE
International journal of gynaecology and obstetrics: the official organ of the International Federation of Gynaecology and Obstetrics (2020). Date of Publication: 20 Mar 2020
ABSTRACT
OBJECTIVE: To provide clinical management guidelines for novel coronavirus (COVID-19) in pregnancy. METHODS: On February 5, 2020, a multidisciplinary teleconference comprising Chinese physicians and researchers was held and medical management strategies of COVID-19 infection in pregnancy were discussed. RESULTS: Ten key recommendations were provided for the management of COVID-19 infections in pregnancy. CONCLUSION: Currently, there is no clear evidence regarding optimal delivery timing, the safety of vaginal delivery, or whether cesarean delivery prevents vertical transmission at the time of delivery; therefore, route of delivery and delivery timing should be individualized based on obstetrical indications and maternal-fetal status.
FULL TEXT LINK
http://dx.doi.org/10.1002/ijgo.13146

RECORD 32
TITLE
Guide to the Forensic Pathology Practice on Death Cases Related to Corona Virus Disease 2019 (COVID-19) (Trial Draft)
AUTHOR NAMES
Mao D.M.; Zhou N.; Zheng D.; Le J.C.; Zhao Q.H.; Luo B.; Guan D.W.; Zhou Y.W.; Hu B.J.; Cheng J.D.
SOURCE
Fa yi xue za zhi (2020) 36:1 (6-5). Date of Publication: 25 Feb 2020
ABSTRACT
Abstract: Autopsy is of great significance to the elucidation of the pathological changes, pathogenesis and cause of death of corona virus disease 2019 (COVID-19) and can provide theoretical basis for more scientific and accurate prevention and control of the outbreak. Based on related laws and regulations, such as Law of the People’s Republic of China on Prevention and Control of Infectious Diseases, the clinical manifestations and epidemiological characteristics of COVID-19, and the related guidelines on the prevention and control of the outbreak, combined with the practical work of forensic pathology examination, the Guide to the Forensic Pathology Practice on Death Cases Related to Corona Virus Disease 2019 (COVID-19) (Trial Draft) has been developed. This guide includes information on the background investigation of the cases, autopsy room requirements, personal prevention and protections, external examinations, autopsy, auxiliary examinations, and so on. This guide can be used as a reference by forensic and pathological examination institutions, as well as examination staff.
FULL TEXT LINK
http://dx.doi.org/10.12116/j.issn.1004-5619.2020.01.003

RECORD 33
TITLE
CT manifestations of coronavirus disease-2019: A retrospective analysis of 73 cases by disease severity
AUTHOR NAMES
Liu K.-C.; Xu P.; Lv W.-F.; Qiu X.-H.; Yao J.-L.; Gu J.-F.; Wei W.
SOURCE
European Journal of Radiology (2020) 126 Article Number: 108941. Date of Publication: 1 May 2020
ABSTRACT
Purpose: To report CT features of coronavirus disease-2019 (COVID-19) in patients with various disease severity. Methods: The CT manifestations and clinical data of 73 patients with COVID-19 were retrospectively collected in 6 hospitals from Jan 21 to Feb 3, 2020. We analyzed the initial and follow-up CT features of patients with disease severity, according to the Guidelines for the Diagnosis and Treatment of New Coronavirus Pneumonia. Results: Six patients (8%) were diagnosed as mild type pneumonia; these patients had no obvious abnormal CT findings or manifested mild changes of lung infection. All 43 patients (59 %) with common type presented unique or multiple ground-glass opacities (GGO) in the periphery of the lungs, with or without interlobular septal thickening. In the 21 patients (29 %) with severe type, extensive GGO and pulmonary consolidation were found in 16 cases (16/21, 76 %) and 5 cases (24 %), respectively. An extensive “white lung”, with atelectasis and pleural effusion were found in critical type patients (3, 4%). On the resolutive phase of the disease, CT abnormalities showed complete resolution, or demonstrated residual linear opacities. Conclusions: Different CT features are seen according to disease severity, which can help COVID-19 stratification.
FULL TEXT LINK
http://dx.doi.org/10.1016/j.ejrad.2020.108941

RECORD 34
TITLE
Breakthrough: Chloroquine phosphate has shown apparent efficacy in treatment of COVID-19 associated pneumonia in clinical studies
AUTHOR NAMES
Gao J.; Tian Z.; Yang X.
SOURCE
Bioscience trends (2020) 14:1 (72-73). Date of Publication: 16 Mar 2020
ABSTRACT
The coronavirus disease 2019 (COVID-19) virus is spreading rapidly, and scientists are endeavoring to discover drugs for its efficacious treatment in China. Chloroquine phosphate, an old drug for treatment of malaria, is shown to have apparent efficacy and acceptable safety against COVID-19 associated pneumonia in multicenter clinical trials conducted in China. The drug is recommended to be included in the next version of the Guidelines for the Prevention, Diagnosis, and Treatment of Pneumonia Caused by COVID-19 issued by the National Health Commission of the People’s Republic of China for treatment of COVID-19 infection in larger populations in the future.
FULL TEXT LINK
http://dx.doi.org/10.5582/bst.2020.01047

RECORD 35
TITLE
Management strategies for patients with gynecological malignancies during the outbreak of COVID19
AUTHOR NAMES
Zhang J.; Peng P.; Li X.; Zha Y.F.; Zhang G.N.; Zhang Y.; Xiang Y.
SOURCE
Zhonghua fu chan ke za zhi (2020) 55 (E011). Date of Publication: 16 Mar 2020
ABSTRACT
Objective: To explore the management strategies for patients with gynecological malignant tumors during the outbreak and transmission of COVID19. Methods: We retrospectively analyzed the clinical characteristics, treatment, and disease outcomes of three patients with gynecological malignancies associated with COVID19 in Renmin Hospital of Wuhan University in January 2020, and proposed management strategies for patients with gynecological tumors under risk of COVID19. Results: Three patients were treated COVID19 based on the national diagnosis and treatment protocol as well as research progress. Meanwhile, these patients were appropriately adjusted the treatment plan in accordance with the clinical guidelines for gynecological tumors. Pneumonia was cured in 2 patients, and one patient died of COVID-19. Conclusions: Patients with gynecological malignant tumors are high-risk groups prone to COVID-19 infection, and gynecological oncologists need to carry out education, prevention, control and treatment according to specific conditions. While actively preventing and controlling COVID-19, the diagnosis and treatment of gynecological malignant tumors should be carried out in an orderly and safe manner.
FULL TEXT LINK
http://dx.doi.org/10.3760/cma.j.cn112141-20200302-00168

RECORD 36
TITLE
COVID-2019 and Pregnancy: A plea for transparent reporting of all cases
AUTHOR NAMES
Sahu K.K.; Lal A.; Mishra A.K.
SOURCE
Acta obstetricia et gynecologica Scandinavica (2020). Date of Publication: 19 Mar 2020
ABSTRACT
We read with great interest a recent editorial by Liang et al. on the management of COVID-19 in pregnancy. Their recommendations are clinically oriented and are likely to be useful to obstetricians and other healthcare professionals caring for such patients. However, we feel that development of evidence-based guidelines has been hindered by selective reporting of cases. We hereby would like to discuss a few additional points with regards to the challenges encountered while managing pregnant patients with COVID-19.
FULL TEXT LINK
http://dx.doi.org/10.1111/aogs.13850

RECORD 37
TITLE
Coronavirus infection and pregnancy (Covid-19)
AUTHOR NAMES
Calda P.; Břešťák M.; Fischerová D.; Zikán M.; Smetanová D.; Machala L.
SOURCE
Aktualni Gynekologie a Porodnictvi (2020) 12 (17-19). Date of Publication: 2020
ABSTRACT
Guidelines. The Czech Society for Ultrasound in Obstetrics and Gynecology of the Czech Medical Association of J. E. Purkyně issues this opinion in connection with statements of the World Health Organization (WHO) and other international authorities regarding the concerns about COVID-19 infection in pregnancy. The impact of this year‘s coronavirus COVID-19 infection on pregnant women seems to be less severe than in previous years of H1N1 influenza type A, SARS-CoV or MERS-CoV. From the information published so far it was not possible to prove the transmission of infection from mother to fetus. It also seems that there is no risk of vertical transmission during breastfeeding. This opinion does not replace the recommendations and opinions issued by governmental bodies such as the Ministry of Health and others, and concerns solely consultation of pregnant women.

RECORD 38
TITLE
Preparing for a COVID-19 pandemic: a review of operating room outbreak response measures in a large tertiary hospital in Singapore
AUTHOR NAMES
Wong J.; Goh Q.Y.; Tan Z.; Lie S.A.; Tay Y.C.; Ng S.Y.; Soh C.R.
SOURCE
Canadian Journal of Anesthesia (2020). Date of Publication: 2020
ABSTRACT
The coronavirus disease 2019 (COVID-19) outbreak has been designated a public health emergency of international concern. To prepare for a pandemic, hospitals need a strategy to manage their space, staff, and supplies so that optimum care is provided to patients. In addition, infection prevention measures need to be implemented to reduce in-hospital transmission. In the operating room, these preparations involve multiple stakeholders and can present a significant challenge. Here, we describe the outbreak response measures of the anesthetic department staffing the largest (1,700-bed) academic tertiary level acute care hospital in Singapore (Singapore General Hospital) and a smaller regional hospital (Sengkang General Hospital). These include engineering controls such as identification and preparation of an isolation operating room, administrative measures such as modification of workflow and processes, introduction of personal protective equipment for staff, and formulation of clinical guidelines for anesthetic management. Simulation was valuable in evaluating the feasibility of new operating room set-ups or workflow. We also discuss how the hierarchy of controls can be used as a framework to plan the necessary measures during each phase of a pandemic, and review the evidence for the measures taken. These containment measures 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.
FULL TEXT LINK
http://dx.doi.org/10.1007/s12630-020-01620-9

RECORD 39
TITLE
Anesthetic Management of Patients With Suspected or Confirmed 2019 Novel Coronavirus Infection During Emergency Procedures
AUTHOR NAMES
Zhao S.; Ling K.; Yan H.; Zhong L.; Peng X.; Yao S.; Huang J.; Chen X.
SOURCE
Journal of Cardiothoracic and Vascular Anesthesia (2020). Date of Publication: 2020
ABSTRACT
Objectives: The aim of the present study was to prevent cross-infection in the operating room during emergency procedures for patients with confirmed or suspected 2019 novel coronavirus (2019-nCoV) by following anesthesia management protocols, and to document clinical- and anesthesia-related characteristics of these patients. Design: This was a retrospective, multicenter clinical study. Setting: This study used a multicenter dataset from 4 hospitals in Wuhan, China. Participants: Patients and health care providers with confirmed or suspected 2019-nCoV from January 23 to 31, 2020, at the Wuhan Union Hospital, the Wuhan Children’s Hospital, The Central Hospital of Wuhan, and the Wuhan Fourth Hospital in Wuhan, China. Interventions: Anesthetic management and infection control guidelines for emergency procedures for patients with suspected 2019-nCoV were drafted and applied in 4 hospitals in Wuhan. Measurements and Main Results: Cross-infection in the operating rooms of the 4 hospitals was effectively reduced by implementing the new measures and procedures. The majority of patients with laboratory-confirmed 2019-nCoV infection or suspected infection were female (23 [62%] of 37), and the mean age was 41.0 years old (standard deviation 19.6; range 4-78). 10 (27%) patients had chronic medical illnesses, including 4 (11%) with diabetes, 8 (22%) with hypertension, and 8 (22%) with digestive system disease. Twenty-five (68%) patients presented with lymphopenia, and 23 (62%) patients exhibited multiple mottling and ground-glass opacity on computed tomography scanning. Conclusions: The present study indicates that COVID 19–specific guidelines for emergency procedures for patients with confirmed or suspected 2019-nCoV may effectively prevent cross-infection in the operating room. Most patients with confirmed or suspected COVID 19 presented with fever and dry cough and demonstrated bilateral multiple mottling and ground-glass opacity on chest computed tomography scans.
FULL TEXT LINK
http://dx.doi.org/10.1053/j.jvca.2020.02.039

RECORD 40
TITLE
Which sampling method for the upper respiratory tract specimen should be taken to diagnose patient with COVID-19?
AUTHOR NAMES
Ye B.; Fan C.; Pan Y.; Ding R.; Hu H.X.; Xiang M.L.
SOURCE
Zhonghua er bi yan hou tou jing wai ke za zhi = Chinese journal of otorhinolaryngology head and neck surgery (2020) 55 (E003). Date of Publication: 13 Mar 2020
ABSTRACT
Coronavirus disease 2019 (COVID-19) is raging in China, especially in Hubei Province, which has resulted great dangers in people’s life and national economy. According to the guidelines drafted by China’s Center for Disease prevention and Control (CDC), the positive nucleic acid test is need to the diagnosis of patient with COVID-19. Upper respiratory tract specimens are the main sources for nucleic acid detection. However, based on international guidelines of COVID-19 , no recommended level of upper respiratory tract sampling method is proposed. Therefore, which kind of sampling methods should be chosen to help the COVID-19 diagnosis and which way is the most secure for doctors and nurses is our concern. In this review, we analyzed a total of 10 literatures on the sampling methods of upper respiratory tract related to infectious diseases such as severe acute respiratory syndrome coronavirus (SARS), middle east respiratory syndrome coronavirus (MERS), and influenza A (H1N1), which were spread worldwide in past years. Literatures were collected from the three dimensions of sampling method, sampling time, and sampling safety. It was found that among all the upper respiratory sampling methods, nasopharyngeal aspirate (NPA) had a higher positive rate within 2 weeks of symptom onset, while combined nasal and oropharyngeal swabs (NS + OPS) was the least harmful to medical staff during sampling. We wish this review is helpful for the prevention of COVID-19.
FULL TEXT LINK
http://dx.doi.org/10.3760/cma.j.cn115330-20200223-00116

RECORD 41
TITLE
Coronavirus Disease 2019 (COVID-19): Emerging and Future Challenges for Dental and Oral Medicine
AUTHOR NAMES
Meng L.; Hua F.; Bian Z.
SOURCE
Journal of dental research (2020) (22034520914246). Date of Publication: 12 Mar 2020
ABSTRACT
The epidemic of coronavirus disease 2019 (COVID-19), originating in Wuhan, China, has become a major public health challenge for not only China but also countries around the world. The World Health Organization announced that the outbreaks of the novel coronavirus have constituted a public health emergency of international concern. As of February 26, 2020, COVID-19 has been recognized in 34 countries, with a total of 80,239 laboratory-confirmed cases and 2,700 deaths. Infection control measures are necessary to prevent the virus from further spreading and to help control the epidemic situation. Due to the characteristics of dental settings, the risk of cross infection can be high between patients and dental practitioners. For dental practices and hospitals in areas that are (potentially) affected with COVID-19, strict and effective infection control protocols are urgently needed. This article, based on our experience and relevant guidelines and research, introduces essential knowledge about COVID-19 and nosocomial infection in dental settings and provides recommended management protocols for dental practitioners and students in (potentially) affected areas.
FULL TEXT LINK
http://dx.doi.org/10.1177/0022034520914246

RECORD 42
TITLE
The treatment proposal for the patients with breast diseases in the central epidemic area of 2019 coronavirus disease
AUTHOR NAMES
Zhao L.; Zhang L.; Liu J.W.; Yang Z.F.; Shen W.Z.; Li X.R.
SOURCE
Zhonghua wai ke za zhi Chinese journal of surgery 58 (E005). Date of Publication: 25 Feb 2020
ABSTRACT
Currently, the epidemic of 2019 coronavirus disease (COVID-19) is still ongoing. The characteristics including high contagiousness, herd susceptibility and clinical phenotype diversity, made a serious influence on people’s daily life and rountine therapy for other diseases. Breast dieases are clinical common diseases. In the central epidemic area of COVID-19, Hubei province, especially Wuhan, the clinical specialists of breast diseases should consider all of the following factors comprehensively: the prevention of COVID-19, the diagnosis and treatment of breast diseases and the accessibility of medical resources. Besides, we should select the appropriate therapy and optimize treatment process so as to prevent the propagation and cross infection of COVID-19 as well as manage the breast diseases without delay. Therefore, we carried out some management proposals of the patients with breast diseases in the central epidemic area during the epidemic of COVID-19 on the basis of conventional treatment guidelines and clinical experiences. The suggestions and corrections from colleagues will be welcomed.
FULL TEXT LINK
http://dx.doi.org/10.3760/cma.j.cn112139-20200221-00116

RECORD 43
TITLE
Cluster investigation Technical Guidelines for the 2019 Novel Coronavirus Pneumonia (COVID-19), China (1st Trial Version)
SOURCE
Zhonghua liu xing bing xue za zhi = Zhonghua liuxingbingxue zazhi (2020) 41:3 (293-295). Date of Publication: 16 Feb 2020
FULL TEXT LINK
http://dx.doi.org/10.3760/cma.j.issn.0254-6450.2020.03.001

RECORD 44
TITLE
Cluster investigation Technical Guidelines for the 2019 Novel Coronavirus Pneumonia (COVID-19), China (1st Trial Version)
SOURCE
Zhonghua liu xing bing xue za zhi = Zhonghua liuxingbingxue zazhi (2020) 41:3 (293-295). Date of Publication: 19 Feb 2020
FULL TEXT LINK
http://dx.doi.org/10.3760/cma.j.issn.0254-6450.2020.0006