Intensive Care

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RECORD 1
TITLE
  Social media for rapid knowledge dissemination: early experience from the COVID-19 pandemic
AUTHOR NAMES
  Chan A.K.M.;  Nickson C.P.;  Rudolph J.W.;  Lee A.;  Joynt G.M.
SOURCE
  Anaesthesia (2020). Date of Publication: 2020
FULL TEXT LINK
http://dx.doi.org/10.1111/anae.15057

RECORD 2
TITLE
  Identification of a potential mechanism of acute kidney injury during the COVID-19 outbreak: a study based on single-cell transcriptome analysis
AUTHOR NAMES
  Pan X.-W.;  Xu D.;  Zhang H.;  Zhou W.;  Wang L.-H.;  Cui X.-G.
SOURCE
  Intensive Care Medicine (2020). Date of Publication: 2020
FULL TEXT LINK
http://dx.doi.org/10.1007/s00134-020-06026-1

RECORD 3
TITLE
  Severe Outcomes Among Patients with Coronavirus Disease 2019 (COVID-19) – United States, February 12-March 16, 2020
SOURCE
  MMWR. Morbidity and mortality weekly report (2020) 69:12 (343-346). Date of Publication: 27 Mar 2020
ABSTRACT
  Globally, approximately 170,000 confirmed cases of coronavirus disease 2019 (COVID-19) caused by the 2019 novel coronavirus (SARS-CoV-2) have been reported, including an estimated 7,000 deaths in approximately 150 countries (1). On March 11, 2020, the World Health Organization declared the COVID-19 outbreak a pandemic (2). Data from China have indicated that older adults, particularly those with serious underlying health conditions, are at higher risk for severe COVID-19-associated illness and death than are younger persons (3). Although the majority of reported COVID-19 cases in China were mild (81%), approximately 80% of deaths occurred among adults aged ≥60 years; only one (0.1%) death occurred in a person aged ≤19 years (3). In this report, COVID-19 cases in the United States that occurred during February 12-March 16, 2020 and severity of disease (hospitalization, admission to intensive care unit [ICU], and death) were analyzed by age group. As of March 16, a total of 4,226 COVID-19 cases in the United States had been reported to CDC, with multiple cases reported among older adults living in long-term care facilities (4). Overall, 31% of cases, 45% of hospitalizations, 53% of ICU admissions, and 80% of deaths associated with COVID-19 were among adults aged ≥65 years with the highest percentage of severe outcomes among persons aged ≥85 years. In contrast, no ICU admissions or deaths were reported among persons aged ≤19 years. Similar to reports from other countries, this finding suggests that the risk for serious disease and death from COVID-19 is higher in older age groups.
FULL TEXT LINK
http://dx.doi.org/10.15585/mmwr.mm6912e2

RECORD 4
TITLE
  COVID-19 outbreak: An overview on dentistry
AUTHOR NAMES
  Spagnuolo G.;  De Vito D.;  Rengo S.;  Tatullo M.
SOURCE
  International Journal of Environmental Research and Public Health (2020) 17:6 Article Number: 2094. Date of Publication: 2 Mar 2020
FULL TEXT LINK
http://dx.doi.org/10.3390/ijerph17062094

RECORD 5
TITLE
  COVID-19, a pandemic or not?
AUTHOR NAMES
  The Lancet Infectious Diseases
SOURCE
  The Lancet Infectious Diseases (2020) 20:4 (383). Date of Publication: 1 Apr 2020
FULL TEXT LINK
http://dx.doi.org/10.1016/S1473-3099(20)30180-8

RECORD 6
TITLE
  Are patients with hypertension and diabetes mellitus at increased risk for COVID-19 infection?
AUTHOR NAMES
  Fang L.;  Karakiulakis G.;  Roth M.
SOURCE
  The Lancet Respiratory Medicine (2020) 8:4 (e21). Date of Publication: 1 Apr 2020
FULL TEXT LINK
http://dx.doi.org/10.1016/S2213-2600(20)30116-8

RECORD 7
TITLE
  COVID-19, ECMO, and lymphopenia: a word of caution
AUTHOR NAMES
  Henry B.M.
SOURCE
  The Lancet Respiratory Medicine (2020) 8:4 (e24). Date of Publication: 1 Apr 2020
FULL TEXT LINK
http://dx.doi.org/10.1016/S2213-2600(20)30119-3

RECORD 8
TITLE
  Staff safety during emergency airway management for COVID-19 in Hong Kong
AUTHOR NAMES
  Cheung J.C.-H.;  Ho L.T.;  Cheng J.V.;  Cham E.Y.K.;  Lam K.N.
SOURCE
  The Lancet Respiratory Medicine (2020) 8:4 (e19). Date of Publication: 1 Apr 2020
FULL TEXT LINK
http://dx.doi.org/10.1016/S2213-2600(20)30084-9

RECORD 9
TITLE
  Respiratory support for patients with COVID-19 infection
AUTHOR NAMES
  Ñamendys-Silva S.A.
SOURCE
  The Lancet Respiratory Medicine (2020) 8:4 (e18). Date of Publication: 1 Apr 2020
FULL TEXT LINK
http://dx.doi.org/10.1016/S2213-2600(20)30110-7

RECORD 10
TITLE
  Covid-19 mass testing facilities could end the epidemic rapidly
AUTHOR NAMES
  Peto J.
SOURCE
  The BMJ (2020) 368. Date of Publication: 22 Mar 2020
FULL TEXT LINK
http://dx.doi.org/10.1136/bmj.m1163

RECORD 11
TITLE
  Preparing for CovID-19: Early experience from an intensive care unit in Singapore
AUTHOR NAMES
  Liew M.F.;  Siow W.T.;  MacLaren G.;  See K.C.
SOURCE
  Critical Care (2020) 24:1 Article Number: 83. Date of Publication: 2020
FULL TEXT LINK
http://dx.doi.org/10.1186/s13054-020-2814-x

RECORD 12
TITLE
  COVID-19 infection epidemic: The medical management strategies in Heilongjiang Province, China
AUTHOR NAMES
  Wang H.;  Wang S.;  Yu K.
SOURCE
  Critical Care (2020) 24:1 Article Number: 107. Date of Publication: 2020
FULL TEXT LINK
http://dx.doi.org/10.1186/s13054-020-2832-8

RECORD 13
TITLE
  Reflections on Nursing Ingenuity During the COVID-19 Pandemic
AUTHOR NAMES
  Newby J.C.;  Mabry M.C.;  Carlisle B.A.;  Olson D.M.;  Lane B.E.
SOURCE
  The Journal of neuroscience nursing : journal of the American Association of Neuroscience Nurses (2020). Date of Publication: 27 Mar 2020
ABSTRACT
  INTRODUCTION: This reflections article provides insight toward nursing innovations to reduce the overuse of personal protective equipment while maintaining a safe environment for staff taking care of COVID-19 patients. The secondary aim of this paper to capitalize on recent advances in mass electronic communication through social media to encourage nurses across the globe to share their knowledge and expertise during this pandemic.The many innovations that have been implemented fall into 3 categories of: reducing unnecessary use of personal protective equipment (PPE), promoting staff safety and readiness, and reducing foot traffic. SUMMARY: These strategies are being shared to promote dissemination of innovative nursing interventions that will save lives during the COVID-19 pandemic.
FULL TEXT LINK
http://dx.doi.org/10.1097/JNN.0000000000000525

RECORD 14
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 15
TITLE
  The clinical characteristics of pneumonia patients coinfected with 2019 novel coronavirus and influenza virus in Wuhan, China
AUTHOR NAMES
  Ding Q.;  Lu P.;  Fan Y.;  Xia Y.;  Liu M.
SOURCE
  Journal of Medical Virology (2020). Date of Publication: 2020
ABSTRACT
  The outbreak of 2019 novel coronavirus (COVID-19) infection emerged in Wuhan, China, in December 2019. Since then the novel coronavirus pneumonia disease has been spreading quickly and many countries and territories have been affected, with major outbreaks in China, South Korea, Italy, and Iran. Influenza virus has been known as a common pathogen in winter and it can cause pneumonia. It was found clinically that very few patients were diagnosed with both COVID-19 and influenza virus. A total of 5 of the 115 patients confirmed with COVID-19 were also diagnosed with influenza virus infection, with three cases being influenza A and two cases being influenza B. In this study, we describe the clinical characteristics of those patients who got infected with COVID-19 as well as influenza virus. Common symptoms at onset of illness included fever (five [100%] patients), cough (five [100%] patients), shortness of breath (five [100%] patients), nasal tampon (three [60%] patients), pharyngalgia (three [60%] patients), myalgia (two [40%] patients), fatigue (two [40%] patients), headache (two [40%] patients), and expectoration (two [40%] patients). The laboratory results showed that compared to the normal values, the patients’ lymphocytes were reduced (four [80%] patients), and liver functions alanine aminotransferase and aspartate aminotransferase (two [40%] patients and two [40%] patients) and C-reactive protein (four [80%] patients) were increased when admitted to hospital. They stayed in the hospital for 14, 30, 17, 12, and 19 days (28.4 ± 7.02), respectively. The main complications for the patients were acute respiratory distress syndrome (one [20%] patients), acute liver injury (three [60%] patients), and diarrhea (two [40%] patients). All patients were given antiviral therapy (including oseltamivir), oxygen inhalation, and antibiotics. Three patients were treated with glucocorticoids including two treated with oral glucocorticoids. One of the five patients had transient hemostatic medication for hemoptysis. Fortunately, all patients did not need intensive care unit and were discharged from the hospital without death. In conclusion, those patients with both COVID-19 and influenza virus infection did not appear to show a more severe condition because based on the laboratory findings, imaging studies, and patient prognosis, they showed similar clinical characteristics as those patients with COVID-19 infection only. However, it is worth noting that the symptoms of nasal tampon and pharyngalgia may be more prone to appear for those coinfection patients.
FULL TEXT LINK
http://dx.doi.org/10.1002/jmv.25781

RECORD 16
TITLE
  COVID-19: global consequences for oncology
AUTHOR NAMES
  The Lancet Oncology
SOURCE
  The Lancet Oncology (2020) 21:4 (467). Date of Publication: 1 Apr 2020
FULL TEXT LINK
http://dx.doi.org/10.1016/S1470-2045(20)30175-3

RECORD 17
TITLE
  Video consultations for covid-19
AUTHOR NAMES
  Greenhalgh T.;  Wherton J.;  Shaw S.;  Morrison C.
SOURCE
  The BMJ (2020) 368 Article Number: m998. Date of Publication: 12 Mar 2020
FULL TEXT LINK
http://dx.doi.org/10.1136/bmj.m998

RECORD 18
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 19
TITLE
  Clinical and coagulation characteristics of 7 patients with critical COVID-2019 pneumonia and acro-ischemia
AUTHOR NAMES
  Zhang Y.;  Cao W.;  Xiao M.;  Li Y.J.;  Yang Y.;  Zhao J.;  Zhou X.;  Jiang W.;  Zhao Y.Q.;  Zhang S.Y.;  Li T.S.
SOURCE
  Zhonghua xue ye xue za zhi = Zhonghua xueyexue zazhi (2020) 41 (E006). Date of Publication: 28 Mar 2020
ABSTRACT
  Objective: To investigate the clinical and coagulation characteristics of the critical Coronavirus disease 2019 (COVID-19) patients with acro-ischemia in the intensive care unit (ICU). Methods: The retrospective study included 7 critical COVID-19 patients with acro-ischemia in a single center in Wuhan, from Feb 4 to Feb 15, 2020. The clinical and laboratory data before and during the ICU stay were analyzed. Results: The median age of 7 patients was 59 years and 4 of them were men. 3 of them were associated with underlying comorbidities. Fever, cough, dyspnea and diarrhea were common clinical symptoms. All patients had acro-ischemia presentations including finger/toe cyanosis, skin bulla and dry gangrene. D-dimer, fibrinogen and fibrinogen degradation product (FDP) were significantly elevated in most patients. Prothrombin time (PT) were prolonged in 4 patients. D-dimer and FDP levels increased progressively when COVID-2019 exacerbated, and 4 patients were diagnosed with definite disseminated intravascular coagulation (DIC). 6 patients received low molecular weight heparin (LMWH) treatment, after which their D-dimer and FDP decreased, but there was no significant improvement in clinical symptoms. 5 patients died finally and the median time from acro-ischemia to death was 12 days. Conclusions: The existence of hypercoagulation status in critical COVID-2019 patients should be monitored closely, and anticoagulation therapy can be considered in selected patients. More clinical data is needed to investigate the role of anticoagulation in COVID-2019 treatment.
FULL TEXT LINK
http://dx.doi.org/10.3760/cma.j.issn.0253-2727.2020.0006

RECORD 20
TITLE
  The role of CT in case ascertainment and management of COVID-19 pneumonia in the UK: insights from high-incidence regions
AUTHOR NAMES
  Chua F.;  Armstrong-James D.;  Desai S.R.;  Barnett J.;  Kouranos V.;  Kon O.M.;  José R.;  Vancheeswaran R.;  Loebinger M.R.;  Wong J.;  Cutino-Moguel M.T.;  Morgan C.;  Ledot S.;  Lams B.;  Yip W.H.;  Li L.;  Lee Y.C.;  Draper A.;  Kho S.S.;  Renzoni E.;  Ward K.;  Periselneris J.;  Grubnic S.;  Lipman M.;  Wells A.U.;  Devaraj A.
SOURCE
  The Lancet. Respiratory medicine (2020). Date of Publication: 25 Mar 2020
FULL TEXT LINK
http://dx.doi.org/10.1016/S2213-2600(20)30132-6

RECORD 21
TITLE
  Italian Society of Interventional Cardiology (GISE) Position Paper for Cath lab-specific Preparedness Recommendations for Healthcare providers in case of suspected, probable or confirmed cases of COVID-19
AUTHOR NAMES
  Tarantini G.;  Fraccaro C.;  Chieffo A.;  Marchese A.;  Tarantino F.F.;  Rigattieri S.;  Limbruno U.;  Mauro C.;  La Manna A.;  Castiglioni B.;  Longoni M.;  Berti S.;  Greco F.;  Musumeci G.;  Esposito G.
SOURCE
  Catheterization and cardiovascular interventions : official journal of the Society for Cardiac Angiography & Interventions (2020). Date of Publication: 29 Mar 2020
ABSTRACT
  COVID-19 pandemic raised the issue to guarantee the proper level of care to patients with acute cardiovascular diseases and concomitant suspected or confirmed COVID-19 and, in the meantime safety and protection of healthcare providers. The aim of this position paper is to provide standards to healthcare facilities and healthcare providers on infection prevention and control measures during the management of suspected and confirmed cases of 2019-nCoV infection accessing in cath-lab. The document represents the view of the Italian Society of Interventional Cardiology (GISE), and it is based on recommendations from the main World and European Health Organizations (WHO, and ECDC) as well as from the Italian Society of Anesthesia, Analgesia, Resuscitation and Intensive Care (SIAARTI). This article is protected by copyright. All rights reserved.
FULL TEXT LINK
http://dx.doi.org/10.1002/ccd.28888

RECORD 22
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 23
TITLE
  Lower mortality of COVID-19 by early recognition and intervention: experience from Jiangsu Province
AUTHOR NAMES
  Sun Q.;  Qiu H.;  Huang M.;  Yang Y.
SOURCE
  Annals of Intensive Care (2020) 10:1 Article Number: 33. Date of Publication: 1 Dec 2020
FULL TEXT LINK
http://dx.doi.org/10.1186/s13613-020-00650-2

RECORD 24
TITLE
  Chronic kidney disease is associated with severe coronavirus disease 2019 (COVID-19) infection
AUTHOR NAMES
  Henry B.M.;  Lippi G.
SOURCE
  International Urology and Nephrology (2020). Date of Publication: 2020
FULL TEXT LINK
http://dx.doi.org/10.1007/s11255-020-02451-9

RECORD 25
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 26
TITLE
  The Italian coronavirus disease 2019 outbreak: recommendations from clinical practice
AUTHOR NAMES
  Sorbello M.;  El-Boghdadly K.;  Di Giacinto I.;  Cataldo R.;  Esposito C.;  Falcetta S.;  Merli G.;  Cortese G.;  Corso R.M.;  Bressan F.;  Pintaudi S.;  Greif R.;  Donati A.;  Petrini F.
SOURCE
  Anaesthesia (2020). Date of Publication: 2020
ABSTRACT
  Novel coronavirus 2019 is a single-stranded, ribonucleic acid virus that has led to an international pandemic of coronavirus disease 2019. Clinical data from the Chinese outbreak have been reported, but experiences and recommendations from clinical practice during the Italian outbreak have not. We report the impact of the coronavirus disease 2019 outbreak on regional and national healthcare infrastructure. We also report on recommendations based on clinical experiences of managing patients throughout Italy. In particular, we describe key elements of clinical management, including: safe oxygen therapy; airway management; personal protective equipment; and non-technical aspects of caring for patients diagnosed with coronavirus disease 2019. Only through planning, training and team working will clinicians and healthcare systems be best placed to deal with the many complex implications of this new pandemic.
FULL TEXT LINK
http://dx.doi.org/10.1111/anae.15049

RECORD 27
TITLE
  COVID-19: consider cytokine storm syndromes and immunosuppression
AUTHOR NAMES
  Mehta P.;  McAuley D.F.;  Brown M.;  Sanchez E.;  Tattersall R.S.;  Manson J.J.
SOURCE
  The Lancet (2020) 395:10229 (1033-1034). Date of Publication: 28 Mar 2020
FULL TEXT LINK
http://dx.doi.org/10.1016/S0140-6736(20)30628-0

RECORD 28
TITLE
  Active smoking is not associated with severity of coronavirus disease 2019 (COVID-19)
AUTHOR NAMES
  Lippi G.;  Henry B.M.
SOURCE
  European Journal of Internal Medicine (2020). Date of Publication: 2020
FULL TEXT LINK
http://dx.doi.org/10.1016/j.ejim.2020.03.014

RECORD 29
TITLE
  Safe patient transport for COVID-19
AUTHOR NAMES
  Liew M.F.;  Siow W.T.;  Yau Y.W.;  See K.C.
SOURCE
  Critical Care (2020) 24:1 Article Number: 94. Date of Publication: 18 Mar 2020
FULL TEXT LINK
http://dx.doi.org/10.1186/s13054-020-2828-4

RECORD 30
TITLE
  Coronavirus: Just imagine…
AUTHOR NAMES
  Vincent J.-L.;  Slutsky A.S.
SOURCE
  Critical Care (2020) 24:1 Article Number: 90. Date of Publication: 16 Mar 2020
FULL TEXT LINK
http://dx.doi.org/10.1186/s13054-020-2824-8

RECORD 31
TITLE
  COVID-19 – what should anaethesiologists and intensivists know about it?
AUTHOR NAMES
  Wujtewicz M.;  Dylczyk-Sommer A.;  Aszkiełowicz A.;  Zdanowski S.;  Piwowarczyk S.;  Owczuk R.
SOURCE
  Anaesthesiology intensive therapy (2020) 52:1 (34-41). Date of Publication: 2020
ABSTRACT
  Over the past three months, the world has faced an unprecedented health hazard. The World Health Organization has announced a pandemic infection with an unknown species of coronavirus called SARS-CoV-2. Spreading mainly through the droplet route, the virus causes mild symptoms in the majority of cases, the most common being: fever (80%), dry cough (56%), fatigue (22%) and muscle pain (7%); less common symptoms include a sore throat, a runny nose, diarrhea, hemoptysis and chills. A life-threatening complication of SARS-CoV-2 infection is an acute respiratory distress syndrome (ARDS), which occurs more often in older adults, those with immune disorders and co-morbidities. Severe forms of the infection, being an indication for treatment in the intensive care unit, comprise acute lung inflammation, ARDS, sepsis and septic shock. The article presents basic information about etiology, pathogenesis and diagnostics (with particular emphasis on the importance of tomocomputer imaging), clinical picture, treatment and prevention of the infection. It goes on to emphasize the specific risks of providing anesthesiology and intensive care services. Due to the fact that effective causal treatment is not yet available and the number of infections and deaths increases day by day, infection prevention and strict adherence to recommendations of infection control organizations remain the basis for fighting the virus.
FULL TEXT LINK
http://dx.doi.org/10.5114/ait.2020.93756

RECORD 32
TITLE
  SARS-CoV-2 viral load in upper respiratory specimens of infected patients
AUTHOR NAMES
  Zou L.;  Ruan F.;  Huang M.;  Liang L.;  Huang H.;  Hong Z.;  Yu J.;  Kang M.;  Song Y.;  Xia J.;  Guo Q.;  Song T.;  He J.;  Yen H.-L.;  Peiris M.;  Wu J.
SOURCE
  New England Journal of Medicine (2020) 382:12 (1177-1179). Date of Publication: 19 Mar 2020
FULL TEXT LINK
http://dx.doi.org/10.1056/NEJMc2001737

RECORD 33
TITLE
  CT imaging features of patients with different clinical types of coronavirus disease 2019 (COVID-19)
AUTHOR NAMES
  Zhong Q.;  Li Z.;  Shen X.;  Xu K.;  Shen Y.;  Fang Q.;  Chen F.;  Liang T.
SOURCE
  Zhejiang da xue xue bao. Yi xue ban = Journal of Zhejiang University. Medical sciences (2020) 49:1 (0). Date of Publication: 25 May 2020
ABSTRACT
  OBJECTIVE: To analyze the CT findings of patients with different clinical types of coronavirus disease 2019 (COVID-19). METHODS: A total of 67 patients diagnosed as COVID-19 by nucleic acid testing were included and divided into 4 groups according to the clinical staging based on Diagnosis and treatment of novel coronavirus pneumonia (Trial version 6). The CT imaging characteristics were analyzed among patients with different clinical types. RESULTS: Among 67 patients, 3 (4.5%) were mild cases, 35 (52.2%) were ordinary cases, 22 (32.8%) were severe cases, and 7 (10.4%) were critically ill. There were no abnormal CT findings in mild cases. In 35 ordinary cases, there were single lesions in 3 cases (8.6%) and multiple lesions in 33 cases (91.4%), while in severe case 1 case had single lesion (4.5%) and 21 had multiple lesions (95.5%). CT images of ordinary patients were mainly manifested as solid plaque shadow and halo sign (18/35, 51.4%); while fibrous strip shadow with ground glass shadow was more frequent in severe cases (7/22, 31.8%). Consolidation shadow as the main lesion was observed in 7 cases, and all of them were severe or critical ill patients. CONCLUSIONS: CT images in patients with different clinical types of COVID-19 have characteristic manifestations, and solid shadow may predict severe and critical illness.

RECORD 34
TITLE
  Management of IBD during the COVID-19 outbreak: resetting clinical priorities
AUTHOR NAMES
  Danese S.;  Cecconi M.;  Spinelli A.
SOURCE
  Nature reviews. Gastroenterology & hepatology (2020). Date of Publication: 25 Mar 2020
FULL TEXT LINK
http://dx.doi.org/10.1038/s41575-020-0294-8

RECORD 35
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 36
TITLE
  Comorbidity and its impact on 1590 patients with Covid-19 in China: A Nationwide Analysis
AUTHOR NAMES
  Guan W.-J.;  Liang W.-H.;  Zhao Y.;  Liang H.-R.;  Chen Z.-S.;  Li Y.-M.;  Liu X.-Q.;  Chen R.-C.;  Tang C.-L.;  Wang T.;  Ou C.-Q.;  Li L.;  Chen P.-Y.;  Sang L.;  Wang W.;  Li J.-F.;  Li C.-C.;  Ou L.-M.;  Cheng B.;  Xiong S.;  Ni Z.-Y.;  Xiang J.;  Hu Y.;  Liu L.;  Shan H.;  Lei C.-L.;  Peng Y.-X.;  Wei L.;  Liu Y.;  Hu Y.-H.;  Peng P.;  Wang J.-M.;  Liu J.-Y.;  Chen Z.;  Li G.;  Zheng Z.-J.;  Qiu S.-Q.;  Luo J.;  Ye C.-J.;  Zhu S.-Y.;  Cheng L.-L.;  Ye F.;  Li S.-Y.;  Zheng J.-P.;  Zhang N.-F.;  Zhong N.-S.;  He J.-X.
SOURCE
  The European respiratory journal (2020). Date of Publication: 26 Mar 2020
ABSTRACT
  BACKGROUND: The coronavirus disease 2019 (Covid-19) outbreak is evolving rapidly worldwide. OBJECTIVE: To evaluate the risk of serious adverse outcomes in patients with coronavirus disease 2019 (Covid-19) by stratifying the comorbidity status. METHODS: We analysed the data from 1590 laboratory-confirmed hospitalised patients 575 hospitals in 31 province/autonomous regions/provincial municipalities across mainland China between December 11th, 2019 and January 31st, 2020. We analyse the composite endpoints, which consisted of admission to intensive care unit, or invasive ventilation, or death. The risk of reaching to the composite endpoints was compared according to the presence and number of comorbidities. RESULTS: The mean age was 48.9 years. 686 patients (42.7%) were females. Severe cases accounted for 16.0% of the study population. 131 (8.2%) patients reached to the composite endpoints. 399 (25.1%) reported having at least one comorbidity. The most prevalent comorbidity was hypertension (16.9%), followed by diabetes (8.2%). 130 (8.2%) patients reported having two or more comorbidities. After adjusting for age and smoking status, COPD [hazards ratio (HR) 2.681, 95% confidence interval (95%CI) 1.424-5.048], diabetes (HR 1.59, 95%CI 1.03-2.45), hypertension (HR 1.58, 95%CI 1.07-2.32) and malignancy (HR 3.50, 95%CI 1.60-7.64) were risk factors of reaching to the composite endpoints. The HR was 1.79 (95%CI 1.16-2.77) among patients with at least one comorbidity and 2.59 (95%CI 1.61-4.17) among patients with two or more comorbidities. CONCLUSION: Among laboratory-confirmed cases of Covid-19, patients with any comorbidity yielded poorer clinical outcomes than those without. A greater number of comorbidities also correlated with poorer clinical outcomes.
FULL TEXT LINK
http://dx.doi.org/10.1183/13993003.00547-2020

RECORD 37
TITLE
  Stability Issues of RT-PCR Testing of SARS-CoV-2 for Hospitalized Patients Clinically Diagnosed with COVID-19
AUTHOR NAMES
  Li Y.;  Yao L.;  Li J.;  Chen L.;  Song Y.;  Cai Z.;  Yang C.
SOURCE
  Journal of medical virology (2020). Date of Publication: 26 Mar 2020
ABSTRACT
  In this study, we collected a total of 610 hospitalized patients from Wuhan between Feb 2, 2020, and Feb 17, 2020. We reported a potentially high false negtive rate of RT-PCR testing for SARS-CoV-2 in the 610 hospitalized patients clinically diagnosed with COVID-19 during the 2019 outbreak. We also found that the RT-PCR results from several tests at different points were variable from the same patients during the course of diagnosis and treatment of these patients. Our results indicate that in addition to the emphasis on RT-PCR testing, clinical indicators such as CT images should also be used not only for diagnosis and treatment but also for isolation, recovery/discharge and transferring for hospitalized patients clinically diagnosed with COVID-19 during the current epidemic. These results suggested the urgent needs for standard of procedures(SOP) of sampling from different anatomic sites, sample transportation, optimization of RT-PCR, serology diagnosis/screening for SARS-CoV-2 infection, and distinct diagnosis from other respiratory diseases such as fluenza infections as well. This article is protected by copyright. All rights reserved.
FULL TEXT LINK
http://dx.doi.org/10.1002/jmv.25786

RECORD 38
TITLE
  The first infant case of COVID-19 acquired from a secondary transmission in Vietnam
AUTHOR NAMES
  Le H.T.;  Nguyen L.V.;  Tran D.M.;  Do H.T.;  Tran H.T.;  Le Y.T.;  Phan P.H.
SOURCE
  The Lancet. Child & adolescent health (2020). Date of Publication: 23 Mar 2020
FULL TEXT LINK
http://dx.doi.org/10.1016/S2352-4642(20)30091-2

RECORD 39
TITLE
  COVID-19: Melatonin as a potential adjuvant treatment
AUTHOR NAMES
  Zhang R.;  Wang X.;  Ni L.;  Di X.;  Ma B.;  Niu S.;  Liu C.;  Reiter R.J.
SOURCE
  Life sciences (2020) (117583). Date of Publication: 23 Mar 2020
ABSTRACT
  This article summarizes the likely benefits of melatonin in the attenuation of COVID-19 based on its putative pathogenesis. The recent outbreak of COVID-19 has become a pandemic with tens of thousands of infected patients. Based on clinical features, pathology, the pathogenesis of acute respiratory disorder induced by either highly homogenous coronaviruses or other pathogens, the evidence suggests that excessive inflammation, oxidation, and an exaggerated immune response very likely contribute to COVID-19 pathology. This leads to a cytokine storm and subsequent progression to acute lung injury (ALI)/acute respiratory distress syndrome (ARDS) and often death. Melatonin, a well-known anti-inflammatory and anti-oxidative molecule, is protective against ALI/ARDS caused by viral and other pathogens. Melatonin is effective in critical care patients by reducing vessel permeability, anxiety, sedation use, and improving sleeping quality, which might also be beneficial for better clinical outcomes for COVID-19 patients. Notably, melatonin has a high safety profile. There is significant data showing that melatonin limits virus-related diseases and would also likely be beneficial in COVID-19 patients. Additional experiments and clinical studies are required to confirm this speculation.
FULL TEXT LINK
http://dx.doi.org/10.1016/j.lfs.2020.117583

RECORD 40
TITLE
  Thrombocytopenia is associated with severe coronavirus disease 2019 (COVID-19) infections: A meta-analysis
AUTHOR NAMES
  Lippi G.;  Plebani M.;  Henry B.M.
SOURCE
  Clinica Chimica Acta (2020) 506 (145-148). Date of Publication: 1 Jul 2020
ABSTRACT
  Background: Coronavirus disease 2019 (COVID-19) is a novel infectious disease with lack of established laboratory markers available to evaluate illness severity. In this study, we investigate whether platelet count could differentiate between COVID-19 patients with or without severe disease. Additionally, we evaluate if thrombocytopenia is associated with severe COVID-19. Methods: An electronic search in Medline, Scopus and Web of Science was performed to identify studies reporting data on platelet count in COVID-19 patients. A meta-analysis was performed, with calculation of weighted mean difference (WMD) of platelet number in COVID-19 patients with or without severe disease and odds ratio (OR) of thrombocytopenia for severe form of COVID-19. Results: Nine studies with 1779 COVID-19 patients, 399 (22.4%) with severe disease, were included in the meta-analysis. The pooled analysis revealed that platelet count was significantly lower in patients with more severe COVID-19 (WMD −31 × 109/L; 95% CI, from −35 to −29 × 109/L). A subgroup analysis comparing patients by survival, found an even lower platelet count was observed with mortality (WMD, −48 × 109/L; 95% CI, −57 to −39 × 109/L. In the four studies (n = 1427) which reported data on rate of thrombocytopenia, a low platelet count was associated with over fivefold enhanced risk of severe COVID-19 (OR, 5.1; 95% CI, 1.8–14.6). Conclusions: Low platelet count is associated with increased risk of severe disease and mortality in patients with COVID-19, and thus should serve as clinical indicator of worsening illness during hospitalization.
FULL TEXT LINK
http://dx.doi.org/10.1016/j.cca.2020.03.022

RECORD 41
TITLE
  The use of anti-inflammatory drugs in the treatment of people with severe coronavirus disease 2019 (COVID-19): The experience of clinical immunologists from China
AUTHOR NAMES
  Zhang W.;  Zhao Y.;  Zhang F.;  Wang Q.;  Li T.;  Liu Z.;  Wang J.;  Qin Y.;  Zhang X.;  Yan X.;  Zeng X.;  Zhang S.
SOURCE
  Clinical Immunology (2020) 214 Article Number: 108393. Date of Publication: 1 May 2020
ABSTRACT
  The pandemic outbreak of coronavirus disease 2019 (COVID-19) is rapidly spreading all over the world. Reports from China showed that about 20% of patients developed severe disease, resulting in a fatality of 4%. In the past two months, we clinical immunologists participated in multi-rounds of MDT (multidiscipline team) discussion on the anti-inflammation management of critical COVID-19 patients, with our colleagues dispatched from Chinese leading PUMC Hospital to Wuhan to admit and treat the most severe patients. Here, from the perspective of clinical immunologists, we will discuss the clinical and immunological characteristics of severe patients, and summarize the current evidence and share our experience in anti-inflammation treatment, including glucocorticoids, IL-6 antagonist, JAK inhibitors and choloroquine/hydrocholoroquine, of patients with severe COVID-19 that may have an impaired immune system.
FULL TEXT LINK
http://dx.doi.org/10.1016/j.clim.2020.108393

RECORD 42
TITLE
  A Framework for Rationing Ventilators and Critical Care Beds during the COVID-19 Pandemic
AUTHOR NAMES
  White D.B.;  Lo B.
SOURCE
  JAMA – Journal of the American Medical Association (2020). Date of Publication: 2020
FULL TEXT LINK
http://dx.doi.org/10.1001/jama.2020.5046

RECORD 43
TITLE
  Why is COVID-19 so mild in children?
AUTHOR NAMES
  Brodin P.
SOURCE
  Acta paediatrica (Oslo, Norway : 1992) (2020). Date of Publication: 25 Mar 2020
ABSTRACT
  There is an urgent need to understand why the course of the coronavirus that started in late 2019 (COVID-19) is affecting different groups of individuals with varying severity during the ongoing global pandemic. Greater knowledge of the disease, which is caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV2), will help us to prioritise our limited health resources. Because the virus is new, and no vaccine is yet available, everyone is naïve and susceptible to being infected with SARS-CoV2. The virus will continue to spread until an effective vaccine exists or sufficient members of our global population have been infected to establish herd immunity. At the moment, the best way to minimize loss of life and severe cases requiring intensive care is to try and shelter vulnerable groups of individuals and slow down the spread of the virus.
FULL TEXT LINK
http://dx.doi.org/10.1111/apa.15271

RECORD 44
TITLE
  „Coronavirus disease 2019“ (COVID-19): update für Anästhesisten und Intensivmediziner März 2020
AUTHOR NAMES
  Thomas-Rüddel D.;  Winning J.;  Dickmann P.;  Ouart D.;  Kortgen A.;  Janssens U.;  Bauer M.
SOURCE
  Der Anaesthesist (2020). Date of Publication: 24 Mar 2020
FULL TEXT LINK
http://dx.doi.org/10.1007/s00101-020-00760-3

RECORD 45
TITLE
  Rapid Progression to Acute Respiratory Distress Syndrome: Review of Current Understanding of Critical Illness from COVID-19 Infection
AUTHOR NAMES
  Goh K.J.;  Choong M.C.;  Cheong E.H.;  Kalimuddin S.;  Duu Wen S.;  Phua G.C.;  Chan K.S.;  Haja Mohideen S.
SOURCE
  Annals of the Academy of Medicine, Singapore (2020) 49:1 (1-9). Date of Publication: 1 Jan 2020
ABSTRACT
  The coronavirus disease 2019 (COVID-19) outbreak that started in Wuhan, Hubei province, China in December 2019 has now extended across the globe with >100,000 cases and 3,000 deaths reported in 93 countries as of 7 March 2020. We report a case of COVID-19 infection in a 64-year-old man who developed rapidly worsening respiratory failure and acute respiratory distress syndrome (ARDS) that required intubation. As the clinical spectrum of COVID-19 ranges widely from mild illness to ARDS with a high risk of mortality, there is a need for more research to identify early markers of disease severity. Current evidence suggests that patients with advanced age, pre-existing comorbidities or dyspnoea should be closely monitored, especially at 1-2 weeks after symptom onset. It remains to be seen if laboratory findings such as lymphopenia or elevated lactate dehydrogenase may serve as early surrogates for critical illness or markers of disease recovery. Management of ARDS in COVID-19 remains supportive while we await results of drug trials. More studies are needed to understand the incidence and outcomes of ARDS and critical illness from COVID-19, which will be important for critical care management and resource planning.

RECORD 46
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 47
TITLE
  COVID-19 in gastroenterology: A clinical perspective
AUTHOR NAMES
  Ong J.;  Young B.E.;  Ong S.
SOURCE
  Gut (2020). Date of Publication: 2020
FULL TEXT LINK
http://dx.doi.org/10.1136/gutjnl-2020-321051

RECORD 48
TITLE
  COVID-19 and the liver: little cause for concern
AUTHOR NAMES
  Bangash M.N.;  Patel J.;  Parekh D.
SOURCE
  The lancet. Gastroenterology & hepatology (2020). Date of Publication: 20 Mar 2020
FULL TEXT LINK
http://dx.doi.org/10.1016/S2468-1253(20)30084-4

RECORD 49
TITLE
  Rapid response to COVID-19 outbreak in Northern Italy: how to convert a classic infectious disease ward into a COVID-19 response centre
AUTHOR NAMES
  Asperges E.;  Novati S.;  Muzzi A.;  Biscarini S.;  Sciarra M.;  Lupi M.;  Sambo M.;  Gallazzi I.;  Peverini M.;  Lago P.;  Mojoli F.;  Perlini S.;  Bruno R.
SOURCE
  The Journal of hospital infection (2020). Date of Publication: 20 Mar 2020
FULL TEXT LINK
http://dx.doi.org/10.1016/j.jhin.2020.03.020

RECORD 50
TITLE
  COVID-19 pandemic: triage for intensive-care treatment under resource scarcity
AUTHOR NAMES
  Swiss Academy Of Medical Sciences
SOURCE
  Swiss medical weekly (2020) 150 (w20229). Date of Publication: 23 Mar 2020
FULL TEXT LINK
http://dx.doi.org/10.4414/smw.2020.20229

RECORD 51
TITLE
  Recommendations for the admission of patients with COVID-19 to intensive care and intermediate care units (ICUs and IMCUs)
AUTHOR NAMES
  Swiss Society Of Intensive Care Medicine
SOURCE
  Swiss medical weekly (2020) 150 (w20227). Date of Publication: 23 Mar 2020
FULL TEXT LINK
http://dx.doi.org/10.4414/smw.2020.20227

RECORD 52
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 53
TITLE
  Guidance for building a dedicated health facility to contain the spread of the 2019 novel coronavirus outbreak
AUTHOR NAMES
  Agarwal A.;  Nagi N.;  Chatterjee P.;  Sarkar S.;  Mourya D.;  Sahay R.R.;  Bhatia R.
SOURCE
  The Indian journal of medical research (2020). Date of Publication: 16 Mar 2020
ABSTRACT
  Preparedness for the ongoing coronavirus disease 2019 (COVID-19) and its spread in India calls for setting up of adequately equipped and dedicated health facilities to manage sick patients while protecting healthcare workers and the environment. In the wake of other emerging dangerous pathogens in recent times, such as Ebola, Nipah and Zika, it is important that such facilities are kept ready during the inter-epidemic period for training of health professionals and for managing cases of multi-drug resistant and difficult-to-treat pathogens. While endemic potential of such critically ill patients is not yet known, the health system should have surge capacity for such critical care units and preferably each tertiary government hospital should have at least one such facility. This article describes elements of design of such unit (e.g., space, infection control, waste disposal, safety of healthcare workers, partners to be involved in design and plan) which can be adapted to the context of either a new construction or makeshift construction on top of an existing structure. In view of a potential epidemic of COVID-19, specific requirements to handle it are also given.
FULL TEXT LINK
http://dx.doi.org/10.4103/ijmr.IJMR_518_20

RECORD 54
TITLE
  Correction to: COVID-19: a novel coronavirus and a novel challenge for critical care (Intensive Care Medicine, (2020), 10.1007/s00134-020-05955-1)
AUTHOR NAMES
  Arabi Y.M.;  Murthy S.;  Webb S.
SOURCE
  Intensive Care Medicine (2020). Date of Publication: 2020
ABSTRACT
  the original version of this article unfortunately contained a mistake. there was an error in table one: in the last row, second column the part “still being defined to” should be crossed out. the correct table 1 can be found below. we apologize for the mistake.
FULL TEXT LINK
http://dx.doi.org/10.1007/s00134-020-06009-2

RECORD 55
TITLE
  Influenza-associated pneumonia as reference to assess seriousness of coronavirus disease (COVID-19)
AUTHOR NAMES
  Tolksdorf K.;  Buda S.;  Schuler E.;  Wieler L.H.;  Haas W.
SOURCE
  Euro surveillance : bulletin Europeen sur les maladies transmissibles = European communicable disease bulletin (2020) 25:11. Date of Publication: 1 Mar 2020
ABSTRACT
  Information on severity of coronavirus disease (COVID-19) (transmissibility, disease seriousness, impact) is crucial for preparation of healthcare sectors. We present a simple approach to assess disease seriousness, creating a reference cohort of pneumonia patients from sentinel hospitals. First comparisons exposed a higher rate of COVID-19 patients requiring ventilation. There were more case fatalities among COVID-19 patients without comorbidities than in the reference cohort. Hospitals should prepare for high utilisation of ventilation and intensive care resources.
FULL TEXT LINK
http://dx.doi.org/10.2807/1560-7917.ES.2020.25.11.2000258

RECORD 56
TITLE
  Coronavirus disease 2019 (COVID-19): update for anesthesiologists and intensivists March 2020
AUTHOR NAMES
  Thomas-Rüddel D.;  Winning J.;  Dickmann P.;  Ouart D.;  Kortgen A.;  Janssens U.;  Bauer M.
SOURCE
  Der Anaesthesist (2020). Date of Publication: 18 Mar 2020
FULL TEXT LINK
http://dx.doi.org/10.1007/s00101-020-00758-x

RECORD 57
TITLE
  Evaluation of the Effectiveness of Surveillance and Containment Measures for the First 100 Patients with COVID-19 in Singapore – January 2-February 29, 2020
AUTHOR NAMES
  Ng Y.;  Li Z.;  Chua Y.X.;  Chaw W.L.;  Zhao Z.;  Er B.;  Pung R.;  Chiew C.J.;  Lye D.C.;  Heng D.;  Lee V.J.
SOURCE
  MMWR. Morbidity and mortality weekly report (2020) 69:11 (307-311). Date of Publication: 20 Mar 2020
ABSTRACT
  Coronavirus disease 2019 (COVID-19) was first reported in Wuhan, China, in December 2019, and has since spread globally, resulting in >95,000 confirmed COVID-19 cases worldwide by March 5, 2020 (1). Singapore adopted a multipronged surveillance strategy that included applying the case definition at medical consults, tracing contacts of patients with laboratory-confirmed COVID-19, enhancing surveillance among different patient groups (all patients with pneumonia, hospitalized patients in intensive care units [ICUs] with possible infectious diseases, primary care patients with influenza-like illness, and deaths from possible infectious etiologies), and allowing clinician discretion (i.e., option to order a test based on clinical suspicion, even if the case definition was not met) to identify COVID-19 patients. Containment measures, including patient isolation and quarantine, active monitoring of contacts, border controls, and community education and precautions, were performed to minimize disease spread. As of March 5, 2020, a total of 117 COVID-19 cases had been identified in Singapore. This report analyzes the first 100 COVID-19 patients in Singapore to determine the effectiveness of the surveillance and containment measures. COVID-19 patients were classified by the primary means by which they were detected. Application of the case definition and contact tracing identified 73 patients, 16 were detected by enhanced surveillance, and 11 were identified by laboratory testing based on providers’ clinical discretion. Effectiveness of these measures was assessed by calculating the 7-day moving average of the interval from symptom onset to isolation in hospital or quarantine, which indicated significant decreasing trends for both local and imported COVID-19 cases. Rapid identification and isolation of cases, quarantine of close contacts, and active monitoring of other contacts have been effective in suppressing expansion of the outbreak and have implications for other countries experiencing outbreaks.
FULL TEXT LINK
http://dx.doi.org/10.15585/mmwr.mm6911e1

RECORD 58
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 59
TITLE
  Clinical features of severe pediatric patients with coronavirus disease 2019 in Wuhan: a single center’s observational study
AUTHOR NAMES
  Sun D.;  Li H.;  Lu X.-X.;  Xiao H.;  Ren J.;  Zhang F.-R.;  Liu Z.-S.
SOURCE
  World journal of pediatrics : WJP (2020). Date of Publication: 19 Mar 2020
ABSTRACT
  BACKGROUND: An outbreak of coronavirus disease 2019 (COVID-19) caused by SARS-CoV-2 was first detected in Wuhan, Hubei, China. People of all ages are susceptible to SARS-CoV-2 infection. No information on severe pediatric patients with COVID-19 has been reported. We aimed to describe the clinical features of severe pediatric patients with COVID-19. METHODS: We included eight severe or critically ill patients with COVID-19 who were treated at the Intensive Care Unit (ICU), Wuhan Children’s Hospital from January 24 to February 24. We collected information including demographic data, symptoms, imaging data, laboratory findings, treatments and clinical outcomes of the patients with severe COVID-19. RESULTS: The onset age of the eight patients ranged from 2 months to 15 years; six were boys. The most common symptoms were polypnea (8/8), followed by fever (6/8) and cough (6/8). Chest imaging showed multiple patch-like shadows in seven patients and ground-glass opacity in six. Laboratory findings revealed normal or increased whole blood counts (7/8), increased C-reactive protein, procalcitonin and lactate dehydrogenase (6/8), and abnormal liver function (4/8). Other findings included decreased CD16 + CD56 (4/8) and Th/Ts*(1/8), increased CD3 (2/8), CD4 (4/8) and CD8 (1/8), IL-6 (2/8), IL-10 (5/8) and IFN-γ (2/8). Treatment modalities were focused on symptomatic and respiratory support. Two critically ill patients underwent invasive mechanical ventilation. Up to February 24, 2020, three patients remained under treatment in ICU, the other five recovered and were discharged home. CONCLUSIONS: In this series of severe pediatric patients in Wuhan, polypnea was the most common symptom, followed by fever and cough. Common imaging changes included multiple patch-like shadows and ground-glass opacity; and a cytokine storm was found in these patients, which appeared more serious in critically ill patients.
FULL TEXT LINK
http://dx.doi.org/10.1007/s12519-020-00354-4

RECORD 60
TITLE
  Clinical, laboratory and imaging features of COVID-19: A systematic review and meta-analysis
AUTHOR NAMES
  Rodriguez-Morales A.J.;  Cardona-Ospina J.A.;  Gutiérrez-Ocampo E.;  Villamizar-Peña R.;  Holguin-Rivera Y.;  Escalera-Antezana J.P.;  Alvarado-Arnez L.E.;  Bonilla-Aldana D.K.;  Franco-Paredes C.;  Henao-Martinez A.F.;  Paniz-Mondolfi A.;  Lagos-Grisales G.J.;  Ramírez-Vallejo E.;  Suárez J.A.;  Zambrano L.I.;  Villamil-Gómez W.E.;  Balbin-Ramon G.J.;  Rabaan A.A.;  Harapan H.;  Dhama K.;  Nishiura H.;  Kataoka H.;  Ahmad T.;  Sah R.
SOURCE
  Travel Medicine and Infectious Disease (2020) Article Number: 101623. Date of Publication: 2020
ABSTRACT
  Introduction: An epidemic of Coronavirus Disease 2019 (COVID-19) began in December 2019 in China leading to a Public Health Emergency of International Concern (PHEIC). Clinical, laboratory, and imaging features have been partially characterized in some observational studies. No systematic reviews on COVID-19 have been published to date. Methods: We performed a systematic literature review with meta-analysis, using three databases to assess clinical, laboratory, imaging features, and outcomes of COVID-19 confirmed cases. Observational studies and also case reports, were included, and analyzed separately. We performed a random-effects model meta-analysis to calculate pooled prevalences and 95% confidence intervals (95%CI). Results: 660 articles were retrieved for the time frame (1/1/2020-2/23/2020). After screening, 27 articles were selected for full-text assessment, 19 being finally included for qualitative and quantitative analyses. Additionally, 39 case report articles were included and analyzed separately. For 656 patients, fever (88.7%, 95%CI 84.5–92.9%), cough (57.6%, 95%CI 40.8–74.4%) and dyspnea (45.6%, 95%CI 10.9–80.4%) were the most prevalent manifestations. Among the patients, 20.3% (95%CI 10.0–30.6%) required intensive care unit (ICU), 32.8% presented with acute respiratory distress syndrome (ARDS) (95%CI 13.7–51.8), 6.2% (95%CI 3.1–9.3) with shock. Some 13.9% (95%CI 6.2–21.5%) of hospitalized patients had fatal outcomes (case fatality rate, CFR). Conclusion: COVID-19 brings a huge burden to healthcare facilities, especially in patients with comorbidities. ICU was required for approximately 20% of polymorbid, COVID-19 infected patients and hospitalization was associated with a CFR of >13%. As this virus spreads globally, countries need to urgently prepare human resources, infrastructure and facilities to treat severe COVID-19.
FULL TEXT LINK
http://dx.doi.org/10.1016/j.tmaid.2020.101623

RECORD 61
TITLE
  2019 novel coronavirus infection in a three-month-old baby
AUTHOR NAMES
  Zhang Y.H.;  Lin D.J.;  Xiao M.F.;  Wang J.C.;  Wei Y.;  Lei Z.X.;  Zeng Z.Q.;  Li L.;  Li H.A.;  Xiang W.
SOURCE
  Zhonghua er ke za zhi = Chinese journal of pediatrics (2020) 58:3 (182-184). Date of Publication: 2 Mar 2020
FULL TEXT LINK
http://dx.doi.org/10.3760/cma.j.issn.0578-1310.2020.03.004

RECORD 62
TITLE
  Laboratory abnormalities in children with novel coronavirus disease 2019
AUTHOR NAMES
  Henry B.M.;  Lippi G.;  Plebani M.
SOURCE
  Clinical chemistry and laboratory medicine (2020). Date of Publication: 16 Mar 2020
FULL TEXT LINK
http://dx.doi.org/10.1515/cclm-2020-0272

RECORD 63
TITLE
  Rapidly increasing cumulative incidence of coronavirus disease (COVID-19) in the European Union/European Economic Area and the United Kingdom, 1 January to 15 March 2020
AUTHOR NAMES
  Kinross P.;  Suetens C.;  Gomes Dias J.;  Alexakis L.;  Wijermans A.;  Colzani E.;  Monnet D.L.;  European Centre For Disease Prevention And Control Ecdc Public Health Emergency Team
SOURCE
  Euro surveillance : bulletin Europeen sur les maladies transmissibles = European communicable disease bulletin (2020) 25:11. Date of Publication: 1 Mar 2020
ABSTRACT
  The cumulative incidence of coronavirus disease (COVID-19) cases is showing similar trends in European Union/European Economic Area countries and the United Kingdom confirming that, while at a different stage depending on the country, the COVID-19 pandemic is progressing rapidly in all countries. Based on the experience from Italy, countries, hospitals and intensive care units should increase their preparedness for a surge of patients with COVID-19 who will require healthcare, and in particular intensive care.
FULL TEXT LINK
http://dx.doi.org/10.2807/1560-7917.ES.2020.25.11.2000285

RECORD 64
TITLE
  SARS-CoV-2, the Virus that Causes COVID-19: Cytometry and the New Challenge for Global Health
AUTHOR NAMES
  Cossarizza A.;  De Biasi S.;  Guaraldi G.;  Girardis M.;  Mussini C.
SOURCE
  Cytometry. Part A : the journal of the International Society for Analytical Cytology (2020). Date of Publication: 18 Mar 2020
FULL TEXT LINK
http://dx.doi.org/10.1002/cyto.a.24002

RECORD 65
TITLE
  Recommendations on the clinical management of the COVID-19 infection by the «new coronavirus» SARS-CoV2. Spanish Paediatric Association working group
AUTHOR NAMES
  Calvo C.;  García López-Hortelano M.;  de Carlos Vicente J.C.;  Vázquez Martínez J.L.;  Ramos J.T.;  Baquero-Artigao F.;  Navarro M.L.;  Rodrigo C.;  Neth O.;  Fumadó V.;  Menendez Suso J.J.;  Slocker Barrio M.;  Bustinza Arriortua A.;  Jordán García I.;  Pilar Orive J.
SOURCE
  Anales de Pediatria (2020). Date of Publication: 2020
ABSTRACT
  On 31 December 2019, the Wuhan Municipal Committee of Health and Healthcare (Hubei Province, China) reported that there were 27 cases of pneumonia of unknown origin with symptoms starting on the 8 December. There were 7 serious cases with common exposure in market with shellfish, fish, and live animals, in the city of Wuhan. On 7 January 2020, the Chinese authorities identified that the agent causing the outbreak was a new type of virus of the Coronaviridae family, temporarily called «new coronavirus», 2019-nCoV. On January 30th, 2020, the World Health Organisation (WHO) declared the outbreak an International Emergency. On 11 February 2020 the WHO assigned it the name of SARS-CoV2 and COVID-19 (SARS-CoV2 and COVID-19). The Ministry of Health summoned the Specialties Societies to prepare a clinical protocol for the management of COVID-19. The Spanish Paediatric Association appointed a Working Group of the Societies of Paediatric Infectious Diseases and Paediatric Intensive Care to prepare the present recommendations with the evidence available at the time of preparing them.
FULL TEXT LINK
http://dx.doi.org/10.1016/j.anpedi.2020.02.001

RECORD 66
TITLE
  Similarity in Case Fatality Rates (CFR) of COVID-19/SARS-COV-2 in Italy and China
AUTHOR NAMES
  Porcheddu R.;  Serra C.;  Kelvin D.;  Kelvin N.;  Rubino S.
SOURCE
  Journal of Infection in Developing Countries (2020) 14:2 (125-128). Date of Publication: 2020
ABSTRACT
  As of 28 February 2020, Italy had 888 cases of SARS-CoV-2 infections, with most cases in Northern Italy in the Lombardia and Veneto regions. Travel-related cases were the main source of COVID-19 cases during the early stages of the current epidemic in Italy. The month of February, however, has been dominated by two large clusters of outbreaks in Northern Italy, south of Milan, with mainly local transmission the source of infections. Contact tracing has failed to identify patient zero in one of the outbreaks. As of 28 February 2020, twenty-one cases of COVID-19 have died. Comparison between case fatality rates in China and Italy are identical at 2.3. Additionally, deaths are similar in both countries with fatalities in mostly the elderly with known comorbidities. It will be important to develop point-of-care devices to aid clinicians in stratifying elderly patients as early as possible to determine the potential level of care they will require to improve their chances of survival from COVID-19 disease.
FULL TEXT LINK
http://dx.doi.org/10.3855/jidc.12600

RECORD 67
TITLE
  First case of severe childhood novel coronavirus pneumonia in China
AUTHOR NAMES
  Chen F.;  Liu Z.S.;  Zhang F.R.;  Xiong R.H.;  Chen Y.;  Cheng X.F.;  Wang W.Y.;  Ren J.
SOURCE
  Zhonghua er ke za zhi = Chinese journal of pediatrics (2020) 58:3 (179-182). Date of Publication: 2 Mar 2020
FULL TEXT LINK
http://dx.doi.org/10.3760/cma.j.issn.0578-1310.2020.03.003

RECORD 68
TITLE
  Clinical progression of patients with COVID-19 in Shanghai, China
AUTHOR NAMES
  Chen J.;  Qi T.;  Liu L.;  Ling Y.;  Qian Z.;  Li T.;  Li F.;  Xu Q.;  Zhang Y.;  Xu S.;  Song Z.;  Zeng Y.;  Shen Y.;  Shi Y.;  Zhu T.;  Lu H.
SOURCE
  The Journal of infection (2020). Date of Publication: 11 Mar 2020
ABSTRACT
  BACKGROUND: Studies on the 2019 novel coronavirus disease (COVID-19) have generally been limited to the description of the epidemiology and initial clinical characteristics. We investigated the temporal progression in patients with COVID-19. METHODS: In this retrospective, single-center study, we included confirmed cases of COVID-19 from Jan 20 to Feb 6, 2020 in Shanghai. Final date of follow-up was February 25, 2020. RESULTS: Of the 249 patients enrolled, the median age was 51 years old, and 126 (50.6%) were male. The duration from onset of symptoms to hospitalization was 4(2-7) days in symptomatic patients. Fever was occurred in 235(94.3%) patients. A total of 215 (86.3%) patients had been discharged after 16(12-20) days hospitalization. The estimated median duration of fever in all the patients with fever was 10 days (95 confidential intervals [CIs]: 8-11 days) after onset of symptoms. Patients who were transferred to intensive care units (ICU) had significantly longer duration of fever as compared to those not in ICU (31 days v.s. 9 days after onset of symptoms, respectively, P<0.0001). Radiological aggravation of initial image was observed in 163 (65.7%) patients on day 7 after onset of symptoms. 154(94.5%) of these patients showed radiological improvement on day 14. The median duration to negative reverse-transcriptase PCR tests of upper respiratory tract samples was 11 days (95 CIs: 10-12 days). Viral clearance was more likely to be delayed in patients in ICU than those not in ICU (P<0.0001). In multivariate logistical analysis, age (Odds ratio [OR]=1.06) and CD4 T cell count (OR=0.55 per 100 cells/ul increase) were independently associated with ICU admission. CONCLUSIONS: The majority of COVID-19 cases are mild. The clinical progression pattern suggests that early control of viral replication and application of host-directed therapy in later stage is essential to improve the prognosis of CVOID-19.
FULL TEXT LINK
http://dx.doi.org/10.1016/j.jinf.2020.03.004

RECORD 69
TITLE
  Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and coronavirus disease-2019 (COVID-19): The epidemic and the challenges
AUTHOR NAMES
  Lai C.-C.;  Shih T.-P.;  Ko W.-C.;  Tang H.-J.;  Hsueh P.-R.
SOURCE
  International Journal of Antimicrobial Agents (2020) 55:3 Article Number: 105924. Date of Publication: 1 Mar 2020
ABSTRACT
  The emergence of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2; previously provisionally named 2019 novel coronavirus or 2019-nCoV) disease (COVID-19) in China at the end of 2019 has caused a large global outbreak and is a major public health issue. As of 11 February 2020, data from the World Health Organization (WHO) have shown that more than 43 000 confirmed cases have been identified in 28 countries/regions, with >99% of cases being detected in China. On 30 January 2020, the WHO declared COVID-19 as the sixth public health emergency of international concern. SARS-CoV-2 is closely related to two bat-derived severe acute respiratory syndrome-like coronaviruses, bat-SL-CoVZC45 and bat-SL-CoVZXC21. It is spread by human-to-human transmission via droplets or direct contact, and infection has been estimated to have mean incubation period of 6.4 days and a basic reproduction number of 2.24–3.58. Among patients with pneumonia caused by SARS-CoV-2 (novel coronavirus pneumonia or Wuhan pneumonia), fever was the most common symptom, followed by cough. Bilateral lung involvement with ground-glass opacity was the most common finding from computed tomography images of the chest. The one case of SARS-CoV-2 pneumonia in the USA is responding well to remdesivir, which is now undergoing a clinical trial in China. Currently, controlling infection to prevent the spread of SARS-CoV-2 is the primary intervention being used. However, public health authorities should keep monitoring the situation closely, as the more we can learn about this novel virus and its associated outbreak, the better we can respond.
FULL TEXT LINK
http://dx.doi.org/10.1016/j.ijantimicag.2020.105924

RECORD 70
TITLE
  2019-novel Coronavirus severe adult respiratory distress syndrome in two cases in Italy: An uncommon radiological presentation
AUTHOR NAMES
  Albarello F.;  Pianura E.;  Di Stefano F.;  Cristofaro M.;  Petrone A.;  Marchioni L.;  Palazzolo C.;  Schininà V.;  Nicastri E.;  Petrosillo N.;  Campioni P.;  Eskild P.;  Zumla A.;  Ippolito G.;  Abbonizio M.A.;  Agrati C.;  Amadei G.;  Amendola A.;  Antonini M.;  Barbaro R.;  Bartolini B.;  Benigni M.;  Bevilacqua N.;  Bordi L.;  Bordoni V.;  Branca M.;  Capobianchi M.R.;  Caporale C.;  Caravella I.;  Carletti F.;  Castilletti C.;  Chiappini R.;  Ciaralli C.;  Colavita F.;  Corpolongo A.;  Curiale S.;  D’Abramo A.;  Dantimi C.;  Angelis A.D.;  Angelis G.D.;  Lorenzo R.D.;  Stefano F.D.;  Ferraro F.;  Fiorentini L.;  Frustaci A.;  Gallì P.;  Garotto G.;  Giancola M.L.;  Giansante F.;  Giombini E.;  Greci M.C.;  Lalle E.;  Lanini S.;  Lapa D.;  Lepore L.;  Lucia A.;  Lufrani F.;  Macchione M.;  Marani A.;  Mariano A.;  Marini M.C.;  Maritti M.;  Matusali G.;  Meschi S.;  Montaldo F.M.C.;  Murachelli S.;  Noto R.;  Pallini E.;  Passeri V.;  Pelliccioni F.;  Petrecchia A.;  Pisciotta M.;  Pittalis S.;  Proietti C.;  Puro V.;  Rinonapoli G.;  Rueca M.;  Sacchi A.;  Sanasi F.;  Santagata C.;  Scarcia S.;  Scognamiglio P.;  Scorzolini L.;  Stazi G.;  Vaia F.;  Vairo F.;  Valli M.B.
SOURCE
  International Journal of Infectious Diseases (2020) 93 (192-197). Date of Publication: 1 Apr 2020
ABSTRACT
  Introduction: Several recent case reports have described common early chest imaging findings of lung pathology caused by 2019 novel Coronavirus (SARS-COV2) which appear to be similar to those seen previously in SARS-CoV and MERS-CoV infected patients. Objective: We present some remarkable imaging findings of the first two patients identified in Italy with COVID-19 infection travelling from Wuhan, China. The follow-up with chest X-Rays and CT scans was also included, showing a progressive adult respiratory distress syndrome (ARDS). Results: Moderate to severe progression of the lung infiltrates, with increasing percentage of high-density infiltrates sustained by a bilateral and multi-segmental extension of lung opacities, were seen. During the follow-up, apart from pleural effusions, a tubular and enlarged appearance of pulmonary vessels with a sudden caliber reduction was seen, mainly found in the dichotomic tracts, where the center of a new insurgent pulmonary lesion was seen. It could be an early alert radiological sign to predict initial lung deterioration. Another uncommon element was the presence of mediastinal lymphadenopathy with short-axis oval nodes. Conclusions: Although only two patients have been studied, these findings are consistent with the radiological pattern described in literature. Finally, the pulmonary vessels enlargement in areas where new lung infiltrates develop in the follow-up CT scan, could describe an early predictor radiological sign of lung impairment.
FULL TEXT LINK
http://dx.doi.org/10.1016/j.ijid.2020.02.043

RECORD 71
TITLE
  Systematic comparison of two animal-to-human transmitted human coronaviruses: SARS-CoV-2 and SARS-CoV
AUTHOR NAMES
  Xu J.;  Zhao S.;  Teng T.;  Abdalla A.E.;  Zhu W.;  Xie L.;  Wang Y.;  Guo X.
SOURCE
  Viruses (2020) 12:2 Article Number: 244. Date of Publication: 2020
ABSTRACT
  After the outbreak of the severe acute respiratory syndrome (SARS) in the world in 2003, human coronaviruses (HCoVs) have been reported as pathogens that cause severe symptoms in respiratory tract infections. Recently, a new emerged HCoV isolated from the respiratory epithelium of unexplained pneumonia patients in theWuhan seafood market caused a major disease outbreak and has been named the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). This virus causes acute lung symptoms, leading to a condition that has been named as “coronavirus disease 2019” (COVID-19). The emergence of SARS-CoV-2 and of SARS-CoV caused widespread fear and concern and has threatened global health security. There are some similarities and differences in the epidemiology and clinical features between these two viruses and diseases that are caused by these viruses. The goal of this work is to systematically review and compare between SARS-CoV and SARS-CoV-2 in the context of their virus incubation, originations, diagnosis and treatment methods, genomic and proteomic sequences, and pathogenic mechanisms.
FULL TEXT LINK
http://dx.doi.org/10.3390/v12020244

RECORD 72
TITLE
  Are high-performing health systems resilient against the COVID-19 epidemic?
AUTHOR NAMES
  Legido-Quigley H.;  Asgari N.;  Teo Y.Y.;  Leung G.M.;  Oshitani H.;  Fukuda K.;  Cook A.R.;  Hsu L.Y.;  Shibuya K.;  Heymann D.
SOURCE
  The Lancet (2020) 395:10227 (848-850). Date of Publication: 14 Mar 2020
FULL TEXT LINK
http://dx.doi.org/10.1016/S0140-6736(20)30551-1

RECORD 73
TITLE
  COVID-19 and Italy: what next?
AUTHOR NAMES
  Remuzzi A.;  Remuzzi G.
SOURCE
  The Lancet (2020). Date of Publication: 2020
ABSTRACT
  The spread of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has already taken on pandemic proportions, affecting over 100 countries in a matter of weeks. A global response to prepare health systems worldwide is imperative. Although containment measures in China have reduced new cases by more than 90%, this reduction is not the case elsewhere, and Italy has been particularly affected. There is now grave concern regarding the Italian national health system’s capacity to effectively respond to the needs of patients who are infected and require intensive care for SARS-CoV-2 pneumonia. The percentage of patients in intensive care reported daily in Italy between March 1 and March 11, 2020, has consistently been between 9% and 11% of patients who are actively infected. The number of patients infected since Feb 21 in Italy closely follows an exponential trend. If this trend continues for 1 more week, there will be 30 000 infected patients. Intensive care units will then be at maximum capacity; up to 4000 hospital beds will be needed by mid-April, 2020. Our analysis might help political leaders and health authorities to allocate enough resources, including personnel, beds, and intensive care facilities, to manage the situation in the next few days and weeks. If the Italian outbreak follows a similar trend as in Hubei province, China, the number of newly infected patients could start to decrease within 3–4 days, departing from the exponential trend. However, this cannot currently be predicted because of differences between social distancing measures and the capacity to quickly build dedicated facilities in China.
FULL TEXT LINK
http://dx.doi.org/10.1016/S0140-6736(20)30627-9

RECORD 74
TITLE
  COVID-19: delay, mitigate, and communicate
AUTHOR NAMES
  The Lancet Respiratory Medicine
SOURCE
  The Lancet Respiratory Medicine (2020) 8:4 (321). Date of Publication: 1 Apr 2020
FULL TEXT LINK
http://dx.doi.org/10.1016/S2213-2600(20)30128-4

RECORD 75
TITLE
  Clinical Characteristics of Coronavirus Disease 2019 in China
AUTHOR NAMES
  Guan W.-J.;  Ni Z.-Y.;  Hu Y.;  Liang W.-H.;  Ou C.-Q.;  He J.-X.;  Liu L.;  Shan H.;  Lei C.-L.;  Hui D.S.C.;  Du B.;  Li L.-J.;  Zeng G.;  Yuen K.-Y.;  Chen R.-C.;  Tang C.-L.;  Wang T.;  Chen P.-Y.;  Xiang J.;  Li S.-Y.;  Wang J.-L.;  Liang Z.-J.;  Peng Y.-X.;  Wei L.;  Liu Y.;  Hu Y.-H.;  Peng P.;  Wang J.-M.;  Liu J.-Y.;  Chen Z.;  Li G.;  Zheng Z.-J.;  Qiu S.-Q.;  Luo J.;  Ye C.-J.;  Zhu S.-Y.;  Zhong N.-S.
SOURCE
  The New England journal of medicine (2020). Date of Publication: 28 Feb 2020
ABSTRACT
  BACKGROUND: Since December 2019, when coronavirus disease 2019 (Covid-19) emerged in Wuhan city and rapidly spread throughout China, data have been needed on the clinical characteristics of the affected patients. METHODS: We extracted data regarding 1099 patients with laboratory-confirmed Covid-19 from 552 hospitals in 30 provinces, autonomous regions, and municipalities in China through January 29, 2020. The primary composite end point was admission to an intensive care unit (ICU), the use of mechanical ventilation, or death. RESULTS: The median age of the patients was 47 years; 41.9% of the patients were female. The primary composite end point occurred in 67 patients (6.1%), including 5.0% who were admitted to the ICU, 2.3% who underwent invasive mechanical ventilation, and 1.4% who died. Only 1.9% of the patients had a history of direct contact with wildlife. Among nonresidents of Wuhan, 72.3% had contact with residents of Wuhan, including 31.3% who had visited the city. The most common symptoms were fever (43.8% on admission and 88.7% during hospitalization) and cough (67.8%). Diarrhea was uncommon (3.8%). The median incubation period was 4 days (interquartile range, 2 to 7). On admission, ground-glass opacity was the most common radiologic finding on chest computed tomography (CT) (56.4%). No radiographic or CT abnormality was found in 157 of 877 patients (17.9%) with nonsevere disease and in 5 of 173 patients (2.9%) with severe disease. Lymphocytopenia was present in 83.2% of the patients on admission. CONCLUSIONS: During the first 2 months of the current outbreak, Covid-19 spread rapidly throughout China and caused varying degrees of illness. Patients often presented without fever, and many did not have abnormal radiologic findings. (Funded by the National Health Commission of China and others.).
FULL TEXT LINK
http://dx.doi.org/10.1056/NEJMoa2002032

RECORD 76
TITLE
  Critical Care Utilization for the COVID-19 Outbreak in Lombardy, Italy: Early Experience and Forecast during an Emergency Response
AUTHOR NAMES
  Grasselli G.;  Pesenti A.;  Cecconi M.
SOURCE
  JAMA – Journal of the American Medical Association (2020). Date of Publication: 2020
FULL TEXT LINK
http://dx.doi.org/10.1001/jama.2020.4031

RECORD 77
TITLE
  Epidemiological characteristics of confirmed COVID-19 cases in Tianjin
AUTHOR NAMES
  Dong X.C.;  Li J.M.;  Bai J.Y.;  Liu Z.Q.;  Zhou P.H.;  Gao L.;  Li X.Y.;  Zhang Y.
SOURCE
  Zhonghua liu xing bing xue za zhi = Zhonghua liuxingbingxue zazhi (2020) 41:5 (638-642). Date of Publication: 13 Mar 2020
ABSTRACT
  Objective: To investigate the clinical and epidemiological characteristics of 135 confirmed cases of COVID-19 in Tianjin. Methods: The clinical and epidemiological data of 135 cases of COVID-19 in Tianjin were collected, and the data were analyzed with descriptive method. The factors influencing the severity of the illness were analyzed. Results: Among the 135 COVID-19 cases, 72 were males and 63 were females, the age of the cases was (48.62±16.83) years, and the case fatality rate was 2.22%. Local transmission caused 74.81% of the cases. A total of 33 clusters occurred, involving 85.92% of all COVID-19 cases. The median of the incubation period of COVID-19 was 6.50 days, the average generation interval was 5 days, and the household secondary transmission rate was 20.46%. Fever was the main symptom (78.63%), followed by cough (56.48%). Multivariate regression analysis indicated that age (OR=1.038, 95%CI: 1.010-1.167) and the number of chronic underlying diseases (OR=1.709, 95%CI: 1.052-2.777) were the risk factors of severe illness. Conclusions: Fever was the main symptom at the early phase of COVID-19 in Tianjin, and the local cluster cases accounted for high proportion in confirmed COVID-19 cases reported in Tianjin. Severe illness was prone to occur in people with old age and multi underlying diseases. Strict isolation of close contacts and intensive care of high-risk groups are the main measures to reduce the morbidity and case fatality of COVID-19.
FULL TEXT LINK
http://dx.doi.org/10.3760/cma.j.cn112338-20200221-00146

RECORD 78
TITLE
  Can Lung US Help Critical Care Clinicians in the Early Diagnosis of Novel Coronavirus (COVID-19) Pneumonia?
AUTHOR NAMES
  Poggiali E.;  Dacrema A.;  Bastoni D.;  Tinelli V.;  Demichele E.;  Mateo Ramos P.;  Marcianò T.;  Silva M.;  Vercelli A.;  Magnacavallo A.
SOURCE
  Radiology (2020) (200847). Date of Publication: 13 Mar 2020
FULL TEXT LINK
http://dx.doi.org/10.1148/radiol.2020200847

RECORD 79
TITLE
  Procalcitonin in patients with severe coronavirus disease 2019 (COVID-19): A meta-analysis
AUTHOR NAMES
  Lippi G.;  Plebani M.
SOURCE
  Clinica Chimica Acta (2020) 505 (190-191). Date of Publication: 1 Jun 2020
FULL TEXT LINK
http://dx.doi.org/10.1016/j.cca.2020.03.004

RECORD 80
TITLE
  Imaging changes of severe COVID-19 pneumonia in advanced stage
AUTHOR NAMES
  Zhang W.
SOURCE
  Intensive Care Medicine (2020). Date of Publication: 2020
FULL TEXT LINK
http://dx.doi.org/10.1007/s00134-020-05990-y

RECORD 81
TITLE
  Critical care crisis and some recommendations during the COVID-19 epidemic in China
AUTHOR NAMES
  Xie J.;  Tong Z.;  Guan X.;  Du B.;  Qiu H.;  Slutsky A.S.
SOURCE
  Intensive Care Medicine (2020). Date of Publication: 2020
FULL TEXT LINK
http://dx.doi.org/10.1007/s00134-020-05979-7

RECORD 82
TITLE
  Imaging changes in severe COVID-19 pneumonia
AUTHOR NAMES
  Zhang W.
SOURCE
  Intensive Care Medicine (2020). Date of Publication: 2020
FULL TEXT LINK
http://dx.doi.org/10.1007/s00134-020-05976-w

RECORD 83
TITLE
  COVID-19: a novel coronavirus and a novel challenge for critical care
AUTHOR NAMES
  Arabi Y.M.;  Murthy S.;  Webb S.
SOURCE
  Intensive Care Medicine (2020). Date of Publication: 2020
FULL TEXT LINK
http://dx.doi.org/10.1007/s00134-020-05955-1

RECORD 84
TITLE
  Clinical predictors of mortality due to COVID-19 based on an analysis of data of 150 patients from Wuhan, China
AUTHOR NAMES
  Ruan Q.;  Yang K.;  Wang W.;  Jiang L.;  Song J.
SOURCE
  Intensive Care Medicine (2020). Date of Publication: 2020
FULL TEXT LINK
http://dx.doi.org/10.1007/s00134-020-05991-x

RECORD 85
TITLE
  A systematic review on the efficacy and safety of chloroquine for the treatment of COVID-19
AUTHOR NAMES
  Cortegiani A.;  Ingoglia G.;  Ippolito M.;  Giarratano A.;  Einav S.
SOURCE
  Journal of Critical Care (2020). Date of Publication: 2020
ABSTRACT
  Purpose: COVID-19 (coronavirus disease 2019) is a public health emergency of international concern. As of this time, there is no known effective pharmaceutical treatment, although it is much needed for patient contracting the severe form of the disease. The aim of this systematic review was to summarize the evidence regarding chloroquine for the treatment of COVID-19. Methods: PubMed, EMBASE, and three trial Registries were searched for studies on the use of chloroquine in patients with COVID-19. Results: We included six articles (one narrative letter, one in-vitro study, one editorial, expert consensus paper, two national guideline documents) and 23 ongoing clinical trials in China. Chloroquine seems to be effective in limiting the replication of SARS-CoV-2 (virus causing COVID-19) in vitro. Conclusions: There is rationale, pre-clinical evidence of effectiveness and evidence of safety from long-time clinical use for other indications to justify clinical research on chloroquine in patients with COVID-19. However, clinical use should either adhere to the Monitored Emergency Use of Unregistered Interventions (MEURI) framework or be ethically approved as a trial as stated by the World Health Organization. Safety data and data from high-quality clinical trials are urgently needed.
FULL TEXT LINK
http://dx.doi.org/10.1016/j.jcrc.2020.03.005

RECORD 86
TITLE
  Analysis of myocardial injury in patients with COVID-19 and association between concomitant cardiovascular diseases and severity of COVID-19
AUTHOR NAMES
  Chen C.;  Yan J.T.;  Zhou N.;  Zhao J.P.;  Wang D.W.
SOURCE
  Zhonghua xin xue guan bing za zhi (2020) 48 (E008). Date of Publication: 6 Mar 2020
ABSTRACT
  Objective: To evaluate the cardiovascular damage of patients with COVID-19, and determine the correlation of serum N-terminal pro B-type natriuretic peptide (NT-proBNP) and cardiac troponin-I (cTnI) with the severity of COVID-19, and the impact of concomitant cardiovascular disease on severity of COVID-19 was also evaluated. Methods: A cross-sectional study was designed on 150 consecutive patients with COVID-19 in the fever clinic of Tongji Hospital in Wuhan from January to February in 2020, including 126 mild cases and 24 cases in critical care. Both univariate and multivariate logistic regression were used to analyze the correlation of past medical history including hypertension, diabetes and coronary heart disease (CHD) , as well as the levels of serum NT-proBNP and cTnI to the disease severity of COVID-19 patients. Results: Age, hypersensitive C-reactive protein(hs-CRP) and serum creatinine levels of the patients were higher in critical care cases than in mild cases(all P<0.05). Prevalence of male, elevated NT-proBNP and cTnI, hypertension and coronary heart disease were significantly higher in critical cases care patients than in the mild cases(all P<0.05). Univariate logistic regression analysis showed that age, male, elevated NT-proBNP, elevated cTnI, elevated hs-CRP, elevated serum creatinine, hypertension, and CHD were significantly correlated with critical disease status(all P<0.05). Multivariate logistic regression analysis showed that elevated cTnI(OR=26.909, 95%CI 4.086-177.226, P=0.001) and CHD (OR=16.609, 95%CI 2.288-120.577, P=0.005) were the independent risk factors of critical disease status. Conclusions: COVID-19 can significantly affect the heart function and lead to myocardial injury. The past medical history of CHD and increased level of cTnI are two independent determinants of clinical disease status in patients with COVID-19.
FULL TEXT LINK
http://dx.doi.org/10.3760/cma.j.cn112148-20200225-00123

RECORD 87
TITLE
  SARS-CoV-2 and COVID-19: facing the pandemic together as citizens and cardiovascular practitioners
AUTHOR NAMES
  Biondi-Zoccai G.;  Landoni G.;  Carnevale R.;  Cavarretta E.;  Sciarretta S.;  Frati G.
SOURCE
  Minerva cardioangiologica (2020). Date of Publication: 9 Mar 2020
FULL TEXT LINK
http://dx.doi.org/10.23736/S0026-4725.20.05250-0

RECORD 88
TITLE
  The neuroinvasive potential of SARS-CoV2 may be at least partially responsible for the respiratory failure of COVID-19 patients
AUTHOR NAMES
  Li Y.-C.;  Bai W.-Z.;  Hashikawa T.
SOURCE
  Journal of Medical Virology (2020). Date of Publication: 2020
ABSTRACT
  Following the severe acute respiratory syndrome coronavirus (SARS-CoV) and Middle East respiratory syndrome coronavirus (MERS-CoV), another highly pathogenic coronavirus named SARS-CoV-2 (previously known as 2019-nCoV) emerged in December 2019 in Wuhan, China, and rapidly spreads around the world. This virus shares highly homological sequence with SARS-CoV, and causes acute, highly lethal pneumonia coronavirus disease 2019 (COVID-19) with clinical symptoms similar to those reported for SARS-CoV and MERS-CoV. The most characteristic symptom of patients with COVID-19 is respiratory distress, and most of the patients admitted to the intensive care could not breathe spontaneously. Additionally, some patients with COVID-19 also showed neurologic signs, such as headache, nausea, and vomiting. Increasing evidence shows that coronaviruses are not always confined to the respiratory tract and that they may also invade the central nervous system inducing neurological diseases. The infection of SARS-CoV has been reported in the brains from both patients and experimental animals, where the brainstem was heavily infected. Furthermore, some coronaviruses have been demonstrated able to spread via a synapse-connected route to the medullary cardiorespiratory center from the mechanoreceptors and chemoreceptors in the lung and lower respiratory airways. In light of the high similarity between SARS-CoV and SARS-CoV2, it is quite likely that the potential invasion of SARS-CoV2 is partially responsible for the acute respiratory failure of patients with COVID-19. Awareness of this will have important guiding significance for the prevention and treatment of the SARS-CoV-2-induced respiratory failure.
FULL TEXT LINK
http://dx.doi.org/10.1002/jmv.25728

RECORD 89
TITLE
  How to balance acute myocardial infarction and COVID-19: the protocols from Sichuan Provincial People’s Hospital
AUTHOR NAMES
  Zeng J.;  Huang J.;  Pan L.
SOURCE
  Intensive Care Medicine (2020). Date of Publication: 2020
FULL TEXT LINK
http://dx.doi.org/10.1007/s00134-020-05993-9

RECORD 90
TITLE
  Preparing for the Most Critically Ill Patients with COVID-19: The Potential Role of Extracorporeal Membrane Oxygenation
AUTHOR NAMES
  Maclaren G.;  Fisher D.;  Brodie D.
SOURCE
  JAMA – Journal of the American Medical Association (2020). Date of Publication: 2020
FULL TEXT LINK
http://dx.doi.org/10.1001/jama.2020.2342

RECORD 91
TITLE
  Coronavirus Disease 2019 (COVID-19): A critical care perspective beyond China
AUTHOR NAMES
  Rello J.;  Tejada S.;  Userovici C.;  Arvaniti K.;  Pugin J.;  Waterer G.
SOURCE
  Anaesthesia Critical Care and Pain Medicine (2020). Date of Publication: 2020
FULL TEXT LINK
http://dx.doi.org/10.1016/j.accpm.2020.03.001

RECORD 92
TITLE
  Imaging changes in severe COVID-19 pneumonia
AUTHOR NAMES
  Zhang W.
SOURCE
  Intensive care medicine (2020) 46:4 (583-585). Date of Publication: 1 Apr 2020
FULL TEXT LINK
http://dx.doi.org/10.1007/s00134-020-05976-w

RECORD 93
TITLE
  COVID-19: A critical care perspective informed by lessons learnt from other viral epidemics
AUTHOR NAMES
  Ling L.;  Joynt G.M.;  Lipman J.;  Constantin J.-M.;  Joannes-Boyau O.
SOURCE
  Anaesthesia Critical Care and Pain Medicine (2020). Date of Publication: 2020
FULL TEXT LINK
http://dx.doi.org/10.1016/j.accpm.2020.02.002

RECORD 94
TITLE
  Analysis of factors associated with disease outcomes in hospitalized patients with 2019 novel coronavirus disease
AUTHOR NAMES
  Liu W.;  Tao Z.-W.;  Lei W.;  Ming-Li Y.;  Kui L.;  Ling Z.;  Shuang W.;  Yan D.;  Jing L.;  Liu H.-G.;  Ming Y.;  Yi H.
SOURCE
  Chinese medical journal (2020). Date of Publication: 28 Feb 2020
ABSTRACT
  BACKGROUND: Since early December 2019, the 2019 novel coronavirus disease (COVID-19) has caused pneumonia epidemic in Wuhan, Hubei province of China. This study aims to investigate the factors affecting the progression of pneumonia in COVID-19 patients. Associated results will be used to evaluate the prognosis and to find the optimal treatment regimens for COVID-19 pneumonia. METHODS: Patients tested positive for the COVID-19 based on nucleic acid detection were included in this study. Patients were admitted to 3 tertiary hospitals in Wuhan between December 30, 2019, and January 15, 2020. Individual data, laboratory indices, imaging characteristics, and clinical data were collected, and statistical analysis was performed. Based on clinical typing results, the patients were divided into a progression group or an improvement/stabilization group. Continuous variables were analyzed using independent samples t-test or Mann-Whitney U test. Categorical variables were analyzed using Chi-squared test or Fisher exact test. Logistic regression analysis was performed to explore the risk factors for disease progression. RESULTS: Seventy-eight patients with COVID-19-induced pneumonia met the inclusion criteria and were included in this study. Efficacy evaluation at 2 weeks after hospitalization indicated that 11 patients (14.1%) had deteriorated, and 67 patients (85.9%) had improved/stabilized. The patients in the progression group were significantly older than those in the disease improvement/stabilization group (66 [51, 70] vs. 37 [32, 41] years, U = 4.932, P = 0.001). The progression group had a significantly higher proportion of patients with a history of smoking than the improvement/stabilization group (27.3% vs. 3.0%, χ = 9.291, P = 0.018). For all the 78 patients, fever was the most common initial symptom, and the maximum body temperature at admission was significantly higher in the progression group than in the improvement/stabilization group (38.2 [37.8, 38.6] vs. 37.5 [37.0, 38.4]°C, U = 2.057, P = 0.027). Moreover, the proportion of patients with respiratory failure (54.5% vs. 20.9%, χ = 5.611, P = 0.028) and respiratory rate (34 [18, 48] vs. 24 [16, 60] breaths/min, U = 4.030, P = 0.004) were significantly higher in the progression group than in the improvement/stabilization group. C-reactive protein was significantly elevated in the progression group compared to the improvement/stabilization group (38.9 [14.3, 64.8] vs. 10.6 [1.9, 33.1] mg/L, U = 1.315, P = 0.024). Albumin was significantly lower in the progression group than in the improvement/stabilization group (36.62 ± 6.60 vs. 41.27 ± 4.55 g/L, U = 2.843, P = 0.006). Patients in the progression group were more likely to receive high-level respiratory support than in the improvement/stabilization group (χ = 16.01, P = 0.001). Multivariate logistic analysis indicated that age (odds ratio [OR], 8.546; 95% confidence interval [CI]: 1.628-44.864; P = 0.011), history of smoking (OR, 14.285; 95% CI: 1.577-25.000; P = 0.018), maximum body temperature at admission (OR, 8.999; 95% CI: 1.036-78.147, P = 0.046), respiratory failure (OR, 8.772, 95% CI: 1.942-40.000; P = 0.016), albumin (OR, 7.353, 95% CI: 1.098-50.000; P = 0.003), and C-reactive protein (OR, 10.530; 95% CI: 1.224-34.701, P = 0.028) were risk factors for disease progression. CONCLUSIONS: Several factors that led to the progression of COVID-19 pneumonia were identified, including age, history of smoking, maximum body temperature on admission, respiratory failure, albumin, C-reactive protein. These results can be used to further enhance the ability of management of COVID-19 pneumonia.
FULL TEXT LINK
http://dx.doi.org/10.1097/CM9.0000000000000775

RECORD 95
TITLE
  Practical recommendations for critical care and anesthesiology teams caring for novel coronavirus (2019-nCoV) patients
AUTHOR NAMES
  Wax R.S.;  Christian M.D.
SOURCE
  Canadian Journal of Anesthesia (2020). Date of Publication: 2020
ABSTRACT
  A global health emergency has been declared by the World Health Organization as the 2019-nCoV outbreak spreads across the world, with confirmed patients in Canada. Patients infected with 2019-nCoV are at risk for developing respiratory failure and requiring admission to critical care units. While providing optimal treatment for these patients, careful execution of infection control measures is necessary to prevent nosocomial transmission to other patients and to healthcare workers providing care. Although the exact mechanisms of transmission are currently unclear, human-to-human transmission can occur, and the risk of airborne spread during aerosol-generating medical procedures remains a concern in specific circumstances. This paper summarizes important considerations regarding patient screening, environmental controls, personal protective equipment, resuscitation measures (including intubation), and critical care unit operations planning as we prepare for the possibility of new imported cases or local outbreaks of 2019-nCoV. Although understanding of the 2019-nCoV virus is evolving, lessons learned from prior infectious disease challenges such as Severe Acute Respiratory Syndrome will hopefully improve our state of readiness regardless of the number of cases we eventually manage in Canada.
FULL TEXT LINK
http://dx.doi.org/10.1007/s12630-020-01591-x

RECORD 96
TITLE
  Pathological findings of COVID-19 associated with acute respiratory distress syndrome
AUTHOR NAMES
  Xu Z.;  Shi L.;  Wang Y.;  Zhang J.;  Huang L.;  Zhang C.;  Liu S.;  Zhao P.;  Liu H.;  Zhu L.;  Tai Y.;  Bai C.;  Gao T.;  Song J.;  Xia P.;  Dong J.;  Zhao J.;  Wang F.-S.
SOURCE
  The Lancet Respiratory Medicine (2020) 8:4 (420-422). Date of Publication: 1 Apr 2020
FULL TEXT LINK
http://dx.doi.org/10.1016/S2213-2600(20)30076-X