Covid-19 Secondary Studies

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New-onset type 1 diabetes in children and adolescents as postacute sequelae of SARS-CoV-2 infection: A systematic review and meta-analysis of cohort studies
Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection in children and adolescents may increase risk for a variety of post-acute sequelae including new-onset type 1 […]
The effect of telerehabilitation on balance in stroke patients: is it more effective than the traditional rehabilitation model? A meta-analysis of randomized controlled trials published during the COVID-19 pandemic
CONCLUSION: Studies on changes in medical conditions during the COVID-19 pandemic also demonstrated that, for stroke patients, telerehabilitation achieves similar effects as the conventional rehabilitation […]
A systematic review of gut microbiota profile in COVID-19 and among those who have recovered from COVID-19 patients
CONCLUSION: Gut dysbiosis was evident in COVID-19, and available data suggested that dysbiosis persisted even in recovered COVID-19 patients, with decreased Firmicutes and SCFA-producing bacteria.
Harnessing Machine Learning in Early COVID-19 Detection and Prognosis: A Comprehensive Systematic Review
During the early phase of the COVID-19 pandemic, reverse transcriptase-polymerase chain reaction (RT-PCR) testing faced limitations, prompting the exploration of machine learning (ML) alternatives for […]

List of Studies

RECORD 1
TITLE
Novel coronavirus infection (Covid-19) in humans: A scoping review and meta-analysis
AUTHOR NAMES
Do Nascimento I.J.B.; Cacic N.; Abdulazeem H.M.; von Groote T.C.; Jayarajah U.; Weerasekara I.; Esfahani M.A.; Civile V.T.; Marusic A.; Jeroncic A.; Junior N.C.; Pericic T.P.; Zakarija-Grkovic I.; Guimarães S.M.M.; Bragazzi N.L.; Bjorklund M.; Sofi-Mahmudi A.; Altujjar M.; Tian M.; Arcani D.M.C.; O’mathúna D.P.; Marcolino M.S.
SOURCE
Journal of Clinical Medicine (2020) 9:4 Article Number: 941. Date of Publication: 1 Apr 2020
ABSTRACT
A growing body of literature on the 2019 novel coronavirus (SARS-CoV-2) is becoming available, but a synthesis of available data has not been conducted. We performed a scoping review of currently available clinical, epidemiological, laboratory, and chest imaging data related to the SARS-CoV-2 infection. We searched MEDLINE, Cochrane CENTRAL, EMBASE, Scopus and LILACS from 01 January 2019 to 24 February 2020. Study selection, data extraction and risk of bias assessment were performed by two independent reviewers. Qualitative synthesis and meta-analysis were conducted using the clinical and laboratory data, and random-effects models were applied to estimate pooled results. A total of 61 studies were included (59,254 patients). The most common disease-related symptoms were fever (82%, 95% confidence interval (CI) 56%–99%; n = 4410), cough (61%, 95% CI 39%–81%; n = 3985), muscle aches and/or fatigue (36%, 95% CI 18%–55%; n = 3778), dyspnea (26%, 95% CI 12%–41%; n = 3700), headache in 12% (95% CI 4%–23%, n = 3598 patients), sore throat in 10% (95% CI 5%–17%, n = 1387) and gastrointestinal symptoms in 9% (95% CI 3%–17%, n = 1744). Laboratory findings were described in a lower number of patients and revealed lymphopenia (0.93 × 10⁹ /L, 95% CI 0.83–1.03 × 10⁹ /L, n = 464) and abnormal C-reactive protein (33.72 mg/dL, 95% CI 21.54–45.91 mg/dL; n = 1637). Radiological findings varied, but mostly described ground-glass opacities and consolidation. Data on treatment options were limited. All-cause mortality was 0.3% (95% CI 0.0%–1.0%; n = 53,631). Epidemiological studies showed that mortality was higher in males and elderly patients. The majority of reported clinical symptoms and laboratory findings related to SARS-CoV-2 infection are non-specific. Clinical suspicion, accompanied by a relevant epidemiological history, should be followed by early imaging and virological assay.
FULL TEXT LINK
http://dx.doi.org/10.3390/jcm9040941

RECORD 2
TITLE
A systematic review of covid-19 epidemiology based on current evidence
AUTHOR NAMES
Park M.; Cook A.R.; Lim J.T.; Sun Y.; Dickens B.L.
SOURCE
Journal of Clinical Medicine (2020) 9:4 Article Number: 967. Date of Publication: 1 Apr 2020
ABSTRACT
As the novel coronavirus (SARS-CoV-2) continues to spread rapidly across the globe, we aimed to identify and summarize the existing evidence on epidemiological characteristics of SARS-CoV-2 and the effectiveness of control measures to inform policymakers and leaders in formulating management guidelines, and to provide directions for future research. We conducted a systematic review of the published literature and preprints on the coronavirus disease (COVID-19) outbreak following predefined eligibility criteria. Of 317 research articles generated from our initial search on PubMed and preprint archives on 21 February 2020, 41 met our inclusion criteria and were included in the review. Current evidence suggests that it takes about 3-7 days for the epidemic to double in size. Of 21 estimates for the basic reproduction number ranging from 1.9 to 6.5, 13 were between 2.0 and 3.0. The incubation period was estimated to be 4-6 days, whereas the serial interval was estimated to be 4-8 days. Though the true case fatality risk is yet unknown, current model-based estimates ranged from 0.3% to 1.4% for outside China. There is an urgent need for rigorous research focusing on the mitigation efforts to minimize the impact on society.
FULL TEXT LINK
http://dx.doi.org/10.3390/jcm9040967

RECORD 3
TITLE
Chloroquine and hydroxychloroquine in the treatment of COVID-19 with or without diabetes: A systematic search and a narrative review with a special reference to India and other developing countries
AUTHOR NAMES
Singh A.K.; Singh A.; Shaikh A.; Singh R.; Misra A.
SOURCE
Diabetes and Metabolic Syndrome: Clinical Research and Reviews (2020) 14:3 (241-246). Date of Publication: 1 May 2020
ABSTRACT
Background and aims: No drugs are currently approved for Coronavirus Disease-2019 (COVID-19), although some have been tried. In view of recent studies and discussion on chloroquine and hydroxychloroquine (HCQ), we aimed to review existing literature and relevant websites regarding these drugs and COVID-19, adverse effects related to drugs, and related guidelines. Aims and methods: We systematically searched the PubMed database up till March 21, 2020 and retrieved all the articles published on chloroquine and HCQ and COVID-19. Results: Two small human studies have been conducted with both these drugs in COVID-19, and have shown significant improvement in some parameters in patients with COVID-19. Conclusion: Considering minimal risk upon use, a long experience of use in other diseases, cost-effectiveness and easy availability across India, we propose that both these drugs are worthy of fast track clinical trial for treatment, and may be carefully considered for clinical use as experimental drugs. Since HCQ has been approved for treatment of diabetes in India, it should be further researched in diabetes and COVID-19, a subgroup where significant mortality has been shown.
FULL TEXT LINK
http://dx.doi.org/10.1016/j.dsx.2020.03.011

RECORD 4
TITLE
Contentious issues and evolving concepts in the clinical presentation and management of patients with COVID-19 infectionwith reference to use of therapeutic and other drugs used in Co-morbid diseases (Hypertension, diabetes etc)
AUTHOR NAMES
Gupta R.; Misra A.
SOURCE
Diabetes and Metabolic Syndrome: Clinical Research and Reviews (2020) 14:3 (251-254). Date of Publication: 1 May 2020
ABSTRACT
Background and aims: Multiple issues in management of COVID have emerged, but confusion persists regarding rational interpretation. Aim of this brief review is to review these issues based on current literature. Methods: This is a narrative review with Pubmed and Google Scholar search till 23 March 2020. Search terms were, COVID-19, treatment of coronavirus, COVID 19 and following terms; chloroquine, hydroxychloroquine, ibuprofen, ACE-inhibitors or angiotensin receptor blockers, cardiovascular disease, diarrhoea, liver, testis and gastrointestinal disease. Results: We discuss evidence regarding role of chloroquine and hydroxychloroquine in treatment and prophylaxis, use of inhibitors of the renin angiotensin system, safety of ibuprofen, unusual clinical features like gastrointestinal symptoms and interpretation of tests for cardiac enzymes and biomarkers. Conclusions: While our conclusions on management of COVID-19 patients with co-morbidities are based on current evidence, however, data is limited and there is immediate need for fast track research.
FULL TEXT LINK
http://dx.doi.org/10.1016/j.dsx.2020.03.012

RECORD 5
TITLE
The possible of immunotherapy for COVID-19: A systematic review
AUTHOR NAMES
AminJafari A.; Ghasemi S.
SOURCE
International Immunopharmacology (2020) 83 Article Number: 106455. Date of Publication: 1 Jun 2020
ABSTRACT
The novel coronavirus (2019-nCoV) is an emerging pathogen that was first described in late December 2019 and causes a severe respiratory infection in humans. Since the outbreak of COVID-19, international attention has raised to develop treatment and control options such as types of immunotherapies. The immunotherapy is an effective method for fighting against similar viral infections such as SARS-CoV, and MERS-CoV. These methods include several types of vaccines, monoclonal antibody candidates, and etc. This systematic review article was designed to evaluate the existing evidence and experience related to immunotherapy for 2019-nCoV. Web of Science (ISI), PubMed, and Scopus databases were used to search for suitable keywords such as 2019-nCoV, novel coronavirus, Immunotherapy, interleukin, vaccine and the related words for relevant publications up to 24.3.2020. The present systematic review was performed based on PRISMA protocol. Data extraction and quality valuation of articles were performed by two reviewers. 51 articles were the results of the search and based on the inclusions and exclusions criteria, 7 articles were included in the final review. As a conclusion of these studies demonstrated that although no serious research has been done on this subject at the time of writing this article, similar studies on the related viruses showed notable results. So immunotherapy for this virus can also be a suitable option.
FULL TEXT LINK
http://dx.doi.org/10.1016/j.intimp.2020.106455

RECORD 6
TITLE
COVID-19: From bench to bed side
AUTHOR NAMES
Singh A.; Shaikh A.; Singh R.; Singh A.K.
SOURCE
Diabetes and Metabolic Syndrome: Clinical Research and Reviews (2020) 14:4 (277-281). Date of Publication: 1 Jul 2020
ABSTRACT
Background and aims: The last two decades have experienced the outbreaks of three different coronaviruses in the different parts of the world namely; Severe acute respiratory syndrome cornonavirus-1 (SARS-CoV-1), Middle East respiratory syndrome (MERS-CoV) and Severe acute respiratory syndrome cornonavirus-2 (SARS-CoV-2). We aimed to delineate the differences in viral dynamics and clinical features between them and tried to focus on every basic details of SARS-COV-2 (COVID-19) that every health care provider must know. Methods: We systematically searched the PubMed database up till April 2, 2020 and retrieved all the articles published on SARS-CoV-2, SARS-CoV-1, MERS-CoV that dealt with viral dynamics. Results: Ample data is available to suggest the differences in etiology, transmission cycle, diagnosis, genetics, hosts, reproductive rates, clinical features, laboratory diagnosis and radiological features between SARS-CoV-1, MERS-CoV and SARS-CoV-2. Conclusion: Although SARS-CoV-2 (COVID-19) is more infectious than SARS-CoV-1 and MERS-CoV, most infections are generally mild and self-limiting. However, case-fatality rates are very high in patients with COVID-19 with comorbidities, compared to SARS-CoV-1 and MERS-CoV.
FULL TEXT LINK
http://dx.doi.org/10.1016/j.dsx.2020.04.011

RECORD 7
TITLE
Comorbidities in COVID-19: Outcomes in hypertensive cohort and controversies with renin angiotensin system blockers
AUTHOR NAMES
Singh A.K.; Gupta R.; Misra A.
SOURCE
Diabetes and Metabolic Syndrome: Clinical Research and Reviews (2020) 14:4 (283-287). Date of Publication: 1 Jul 2020
ABSTRACT
Background and aims: COVID-19 is already a pandemic. Emerging data suggest an increased association and a heightened mortality in patients of COVID-19 with comorbidities. We aimed to evaluate the outcome in hypertensive patients with COVID-19 and its relation to the use of renin-angiotensin system blockers (RASB). Methods: We have systematically searched the medical database up to March 27, 2020 and retrieved all the published articles in English language related to our topic using MeSH key words. Results: From the pooled data of all ten available Chinese studies (n = 2209) that have reported the characteristics of comorbidities in patients with COVID-19, hypertension was present in nearly 21%, followed by diabetes in nearly 11%, and established cardiovascular disease (CVD) in approximately 7% of patients. Although the emerging data hints to an increase in mortality in COVID-19 patients with known hypertension, diabetes and CVD, it should be noted that it was not adjusted for multiple confounding factors. Harm or benefit in COVID-19 patients receiving RASB has not been typically assessed in these studies yet, although mechanistically and plausibly both, benefit and harm is possible with these agents, given that COVID-19 expresses to tissues through the receptor of angiotensin converting enzyme-2. Conclusion: Special attention is definitely required in patients with COVID-19 with associated comorbidities including hypertension, diabetes and established CVD. Although the role of RASB has a mechanistic equipoise, patients with COVID-19 should not stop these drugs at this point of time, as recommended by various world organizations and without the advice of health care provider.
FULL TEXT LINK
http://dx.doi.org/10.1016/j.dsx.2020.03.016

RECORD 8
TITLE
COVID-19 and diabetes: Knowledge in progress
AUTHOR NAMES
Hussain A.; Bhowmik B.; do Vale Moreira N.C.
SOURCE
Diabetes Research and Clinical Practice (2020) 162 Article Number: 108142. Date of Publication: 1 Apr 2020
ABSTRACT
Aims: We aimed to briefly review the general characteristics of the novel coronavirus (SARS-CoV-2) and provide a better understanding of the coronavirus disease (COVID-19) in people with diabetes, and its management. Methods: We searched for articles in PubMed and Google Scholar databases till 02 April 2020, with the following keywords: “SARS-CoV-2”, “COVID-19”, “infection”, “pathogenesis”, “incubation period”, “transmission”, “clinical features”, “diagnosis”, “treatment”, “diabetes”, with interposition of the Boolean operator “AND”. Results: The clinical spectrum of COVID-19 is heterogeneous, ranging from mild flu-like symptoms to acute respiratory distress syndrome, multiple organ failure and death. Older age, diabetes and other comorbidities are reported as significant predictors of morbidity and mortality. Chronic inflammation, increased coagulation activity, immune response impairment, and potential direct pancreatic damage by SARS-CoV-2 might be among the underlying mechanisms of the association between diabetes and COVID-19. No conclusive evidence exists to support the discontinuation of angiotensin-converting enzyme inhibitors (ACEI), angiotensin receptor blockers or thiazolidinediones because of COVID-19 in people with diabetes. Caution should be taken to potential hypoglycemic events with the use of chloroquine in these subjects. Patient tailored therapeutic strategies, rigorous glucose monitoring and careful consideration of drug interactions might reduce adverse outcomes. Conclusions: Suggestions are made on the possible pathophysiological mechanisms of the relationship between diabetes and COVID-19, and its management. No definite conclusions can be made based on current limited evidence. Further research regarding this relationship and its clinical management is warranted.
FULL TEXT LINK
http://dx.doi.org/10.1016/j.diabres.2020.108142

RECORD 9
TITLE
COVID-19 and smoking: A systematic review of the evidence
AUTHOR NAMES
Vardavas C.I.; Nikitara K.
SOURCE
Tobacco Induced Diseases (2020) 18:March Article Number: 20. Date of Publication: 2020
FULL TEXT LINK
http://dx.doi.org/10.18332/tid/119324

RECORD 10
TITLE
COVID-19 and mental health: A review of the existing literature
AUTHOR NAMES
Rajkumar R.P.
SOURCE
Asian Journal of Psychiatry (2020) 52 Article Number: 102066. Date of Publication: 1 Aug 2020
ABSTRACT
The COVID-19 pandemic is a major health crisis affecting several nations, with over 720,000 cases and 33,000 confirmed deaths reported to date. Such widespread outbreaks are associated with adverse mental health consequences. Keeping this in mind, existing literature on the COVID-19 outbreak pertinent to mental health was retrieved via a literature search of the PubMed database. Published articles were classified according to their overall themes and summarized. Preliminary evidence suggests that symptoms of anxiety and depression (16–28%) and self-reported stress (8%) are common psychological reactions to the COVID-19 pandemic, and may be associated with disturbed sleep. A number of individual and structural variables moderate this risk. In planning services for such populations, both the needs of the concerned people and the necessary preventive guidelines must be taken into account. The available literature has emerged from only a few of the affected countries, and may not reflect the experience of persons living in other parts of the world. In conclusion, subsyndromal mental health problems are a common response to the COVID-19 pandemic. There is a need for more representative research from other affected countries, particularly in vulnerable populations.
FULL TEXT LINK
http://dx.doi.org/10.1016/j.ajp.2020.102066

RECORD 11
TITLE
Impact of meteorological factors on the COVID-19 transmission: A multi-city study in China
AUTHOR NAMES
Liu J.; Zhou J.; Yao J.; Zhang X.; Li L.; Xu X.; He X.; Wang B.; Fu S.; Niu T.; Yan J.; Shi Y.; Ren X.; Niu J.; Zhu W.; Li S.; Luo B.; Zhang K.
SOURCE
Science of the Total Environment (2020) 726 Article Number: 138513. Date of Publication: 15 Jul 2020
ABSTRACT
The purpose of the present study is to explore the associations between novel coronavirus disease 2019 (COVID-19) case counts and meteorological factors in 30 provincial capital cities of China. We compiled a daily dataset including confirmed case counts, ambient temperature (AT), diurnal temperature range (DTR), absolute humidity (AH) and migration scale index (MSI) for each city during the period of January 20th to March 2nd, 2020. First, we explored the associations between COVID-19 confirmed case counts, meteorological factors, and MSI using non-linear regression. Then, we conducted a two-stage analysis for 17 cities with more than 50 confirmed cases. In the first stage, generalized linear models with negative binomial distribution were fitted to estimate city-specific effects of meteorological factors on confirmed case counts. In the second stage, the meta-analysis was conducted to estimate the pooled effects. Our results showed that among 13 cities that have less than 50 confirmed cases, 9 cities locate in the Northern China with average AT below 0 °C, 12 cities had average AH below 4 g/m³, and one city (Haikou) had the highest AH (14.05 g/m³). Those 17 cities with 50 and more cases accounted for 90.6% of all cases in our study. Each 1 °C increase in AT and DTR was related to the decline of daily confirmed case counts, and the corresponding pooled RRs were 0.80 (95% CI: 0.75, 0.85) and 0.90 (95% CI: 0.86, 0.95), respectively. For AH, the association with COVID-19 case counts were statistically significant in lag 07 and lag 014. In addition, we found the all these associations increased with accumulated time duration up to 14 days. In conclusions, meteorological factors play an independent role in the COVID-19 transmission after controlling population migration. Local weather condition with low temperature, mild diurnal temperature range and low humidity likely favor the transmission.
FULL TEXT LINK
http://dx.doi.org/10.1016/j.scitotenv.2020.138513

RECORD 12
TITLE
The GReek study in the Effects of Colchicine in COvid-19 complications prevention (GRECCO-19 study): rationale and study design
AUTHOR NAMES
Deftereos S.G.; Siasos G.; Giannopoulos G.; Vrachatis D.A.; Angelidis C.; Giotaki S.G.; Gargalianos P.; Giamarellou H.; Gogos C.; Daikos G.; Lazanas M.; Lagiou P.; Saroglou G.; Sipsas N.; Tsiodras S.; Chatzigeorgiou D.; Moussas N.; Kotanidou A.; Koulouris N.; Oikonomou E.; Kaoukis A.; Kossyvakis C.; Raisakis K.; Fountoulaki K.; Comis M.; Tsiachris D.; Sarri E.; Theodorakis A.; Martinez-Dolz L.; Jorge S.-S.; Reimers B.; Stefanini G.G.; Cleman M.; Filippou D.; Olympios C.D.; Pyrgakis V.N.; Goudevenos J.; Hahalis G.; Kolettis T.M.; Iliodromitis E.; Tousoulis D.; Stefanadis C.
SOURCE
Hellenic journal of cardiology : HJC = Hellenike kardiologike epitheorese (2020). Date of Publication: 3 Apr 2020
ABSTRACT
BACKGROUND: Colchicine has been utilized safely in a variety of cardiovascular clinical conditions. Among its potential mechanisms of action is the non-selective inhibition of NLRP3 inflammasome which is thought to be a major pathophysiologic component in the clinical course of patients with COVID-19. METHODS: GRECCO-19 will be prospective, cluster randomized, open-labeled, controlled study. Patients with laboratory confirmed SARS-CoV-2 infection (under RT PCR) and clinical picture that involves temperature >37.5 oC and at least two out of the: i. sustained coughing, ii. sustained throat pain, iii. Anosmia and/or ageusia, iv. fatigue/tiredness, v. PaO2<95 mmHg will be included. CONCLUSIONS: GRECCO-19 trial aims to identify whether colchicine may positively intervene in the clinical course of COVID-19. (The study has been submitted to clinicaltrials.gov on March 26, 2020).
FULL TEXT LINK
http://dx.doi.org/10.1016/j.hjc.2020.03.002

RECORD 13
TITLE
Prediction models for diagnosis and prognosis of covid-19 infection: systematic review and critical appraisal
AUTHOR NAMES
Wynants L.; Van Calster B.; Bonten M.M.J.; Collins G.S.; Debray T.P.A.; De Vos M.; Haller M.C.; Heinze G.; Moons K.G.M.; Riley R.D.; Schuit E.; Smits L.J.M.; Snell K.I.E.; Steyerberg E.W.; Wallisch C.; van Smeden M.
SOURCE
BMJ (Clinical research ed.) (2020) 369 (m1328). Date of Publication: 7 Apr 2020
ABSTRACT
OBJECTIVE: To review and critically appraise published and preprint reports of prediction models for diagnosing coronavirus disease 2019 (covid-19) in patients with suspected infection, for prognosis of patients with covid-19, and for detecting people in the general population at risk of being admitted to hospital for covid-19 pneumonia. DESIGN: Rapid systematic review and critical appraisal. DATA SOURCES: PubMed and Embase through Ovid, Arxiv, medRxiv, and bioRxiv up to 24 March 2020. STUDY SELECTION: Studies that developed or validated a multivariable covid-19 related prediction model. DATA EXTRACTION: At least two authors independently extracted data using the CHARMS (critical appraisal and data extraction for systematic reviews of prediction modelling studies) checklist; risk of bias was assessed using PROBAST (prediction model risk of bias assessment tool). RESULTS: 2696 titles were screened, and 27 studies describing 31 prediction models were included. Three models were identified for predicting hospital admission from pneumonia and other events (as proxy outcomes for covid-19 pneumonia) in the general population; 18 diagnostic models for detecting covid-19 infection (13 were machine learning based on computed tomography scans); and 10 prognostic models for predicting mortality risk, progression to severe disease, or length of hospital stay. Only one study used patient data from outside of China. The most reported predictors of presence of covid-19 in patients with suspected disease included age, body temperature, and signs and symptoms. The most reported predictors of severe prognosis in patients with covid-19 included age, sex, features derived from computed tomography scans, C reactive protein, lactic dehydrogenase, and lymphocyte count. C index estimates ranged from 0.73 to 0.81 in prediction models for the general population (reported for all three models), from 0.81 to more than 0.99 in diagnostic models (reported for 13 of the 18 models), and from 0.85 to 0.98 in prognostic models (reported for six of the 10 models). All studies were rated at high risk of bias, mostly because of non-representative selection of control patients, exclusion of patients who had not experienced the event of interest by the end of the study, and high risk of model overfitting. Reporting quality varied substantially between studies. Most reports did not include a description of the study population or intended use of the models, and calibration of predictions was rarely assessed. CONCLUSION: Prediction models for covid-19 are quickly entering the academic literature to support medical decision making at a time when they are urgently needed. This review indicates that proposed models are poorly reported, at high risk of bias, and their reported performance is probably optimistic. Immediate sharing of well documented individual participant data from covid-19 studies is needed for collaborative efforts to develop more rigorous prediction models and validate existing ones. The predictors identified in included studies could be considered as candidate predictors for new models. Methodological guidance should be followed because unreliable predictions could cause more harm than benefit in guiding clinical decisions. Finally, studies should adhere to the TRIPOD (transparent reporting of a multivariable prediction model for individual prognosis or diagnosis) reporting guideline. SYSTEMATIC REVIEW REGISTRATION: Protocol https://osf.io/ehc47/, registration https://osf.io/wy245.
FULL TEXT LINK
http://dx.doi.org/10.1136/bmj.m1328

RECORD 14
TITLE
Quarantine alone or in combination with other public health measures to control COVID-19: a rapid review
AUTHOR NAMES
Nussbaumer-Streit B.; Mayr V.; Dobrescu A.I.; Chapman A.; Persad E.; Klerings I.; Wagner G.; Siebert U.; Christof C.; Zachariah C.; Gartlehner G.
SOURCE
The Cochrane database of systematic reviews (2020) 4 (CD013574). Date of Publication: 8 Apr 2020
ABSTRACT
BACKGROUND: Coronavirus disease 2019 (COVID-19) is a rapidly emerging disease that has been classified a pandemic by the World Health Organization (WHO). To support WHO with their recommendations on quarantine, we conducted a rapid review on the effectiveness of quarantine during severe coronavirus outbreaks. OBJECTIVES: We conducted a rapid review to assess the effects of quarantine (alone or in combination with other measures) of individuals who had contact with confirmed cases of COVID-19, who travelled from countries with a declared outbreak, or who live in regions with high transmission of the disease. SEARCH METHODS: An information specialist searched PubMed, Ovid MEDLINE, WHO Global Index Medicus, Embase, and CINAHL on 12 February 2020 and updated the search on 12 March 2020. WHO provided records from daily searches in Chinese databases up to 16 March 2020. SELECTION CRITERIA: Cohort studies, case-control-studies, case series, time series, interrupted time series, and mathematical modelling studies that assessed the effect of any type of quarantine to control COVID-19. We also included studies on SARS (severe acute respiratory syndrome) and MERS (Middle East respiratory syndrome) as indirect evidence for the current coronavirus outbreak. DATA COLLECTION AND ANALYSIS: Two review authors independently screened 30% of records; a single review author screened the remaining 70%. Two review authors screened all potentially relevant full-text publications independently. One review author extracted data and assessed evidence quality with GRADE and a second review author checked the assessment. We rated the certainty of evidence for the four primary outcomes: incidence, onward transmission, mortality, and resource use. MAIN RESULTS: We included 29 studies; 10 modelling studies on COVID-19, four observational studies and 15 modelling studies on SARS and MERS. Because of the diverse methods of measurement and analysis across the outcomes of interest, we could not conduct a meta-analysis and conducted a narrative synthesis. Due to the type of evidence found for this review, GRADE rates the certainty of the evidence as low to very low. Modeling studies consistently reported a benefit of the simulated quarantine measures, for example, quarantine of people exposed to confirmed or suspected cases averted 44% to 81% incident cases and 31% to 63% of deaths compared to no measures based on different scenarios (incident cases: 4 modelling studies on COVID-19, SARS; mortality: 2 modelling studies on COVID-19, SARS, low-certainty evidence). Very low-certainty evidence suggests that the earlier quarantine measures are implemented, the greater the cost savings (2 modelling studies on SARS). Very low-certainty evidence indicated that the effect of quarantine of travellers from a country with a declared outbreak on reducing incidence and deaths was small (2 modelling studies on SARS). When the models combined quarantine with other prevention and control measures, including school closures, travel restrictions and social distancing, the models demonstrated a larger effect on the reduction of new cases, transmissions and deaths than individual measures alone (incident cases: 4 modelling studies on COVID-19; onward transmission: 2 modelling studies on COVID-19; mortality: 2 modelling studies on COVID-19; low-certainty evidence). Studies on SARS and MERS were consistent with findings from the studies on COVID-19. AUTHORS’ CONCLUSIONS: Current evidence for COVID-19 is limited to modelling studies that make parameter assumptions based on the current, fragmented knowledge. Findings consistently indicate that quarantine is important in reducing incidence and mortality during the COVID-19 pandemic. Early implementation of quarantine and combining quarantine with other public health measures is important to ensure effectiveness. In order to maintain the best possible balance of measures, decision makers must constantly monitor the outbreak situation and the impact of the measures implemented. Testing in representative samples in different settings could help assess the true prevalence of infection, and would reduce uncertainty of modelling assumptions. This review was commissioned by WHO and supported by Danube-University-Krems.
FULL TEXT LINK
http://dx.doi.org/10.1002/14651858.CD013574

RECORD 15
TITLE
Does comorbidity increase the risk of patients with COVID-19: evidence from meta-analysis
AUTHOR NAMES
Wang B.; Li R.; Lu Z.; Huang Y.
SOURCE
Aging (2020) 12. Date of Publication: 8 Apr 2020
ABSTRACT
Currently, the number of patients with coronavirus disease 2019 (COVID-19) has increased rapidly, but relationship between comorbidity and patients with COVID-19 still not clear. The aim was to explore whether the presence of common comorbidities increases COVID-19 patients’ risk. A literature search was performed using the electronic platforms (PubMed, Cochrane Library, Embase, and other databases) to obtain relevant research studies published up to March 1, 2020. Relevant data of research endpoints in each study were extracted and merged. All data analysis was performed using Stata12.0 software. A total of 1558 patients with COVID-19 in 6 studies were enrolled in our meta-analysis eventually. Hypertension (OR: 2.29, P<0.001), diabetes (OR: 2.47, P<0.001), chronic obstructive pulmonary disease (COPD) (OR: 5.97, P<0.001), cardiovascular disease (OR: 2.93, P<0.001), and cerebrovascular disease (OR:3.89, P=0.002)were independent risk factors associated with COVID-19 patients. The meta-analysis revealed no correlation between increased risk of COVID-19 and liver disease, malignancy, or renal disease. Hypertension, diabetes, COPD, cardiovascular disease, and cerebrovascular disease are major risk factors for patients with COVID-19. Knowledge of these risk factors can be a resource for clinicians in the early appropriate medical management of patients with COVID-19.
FULL TEXT LINK
http://dx.doi.org/10.18632/aging.103000

RECORD 16
TITLE
Response to: Sore throat in COVID-19: comment on “Clinical characteristics of hospitalized patients with SARS-CoV-2 infection: A single arm meta-analysis”
AUTHOR NAMES
Sun P.; Ren J.; Li K.; Qie S.; Liu Z.; Xi J.
SOURCE
Journal of Medical Virology (2020). Date of Publication: 2020
FULL TEXT LINK
http://dx.doi.org/10.1002/jmv.25818

RECORD 17
TITLE
Sore throat in COVID-19: Comment on “Clinical characteristics of hospitalized patients with SARS-CoV-2 infection: A single arm meta-analysis”
AUTHOR NAMES
Lovato A.; Rossettini G.; de Filippis C.
SOURCE
Journal of Medical Virology (2020). Date of Publication: 2020
FULL TEXT LINK
http://dx.doi.org/10.1002/jmv.25815

RECORD 18
TITLE
Diabetes in COVID-19: Prevalence, pathophysiology, prognosis and practical considerations
AUTHOR NAMES
Singh A.K.; Gupta R.; Ghosh A.; Misra A.
SOURCE
Diabetes and Metabolic Syndrome: Clinical Research and Reviews (2020) 14:4 (303-310). Date of Publication: 1 Jul 2020
ABSTRACT
Background and aims: High prevalence of diabetes makes it an important comorbidity in patients with COVID-19. We sought to review and analyze the data regarding the association between diabetes and COVID-19, pathophysiology of the disease in diabetes and management of patients with diabetes who develop COVID-19 infection. Methods: PubMed database and Google Scholar were searched using the key terms ‘COVID-19’, ‘SARS-CoV-2’, ‘diabetes’, ‘antidiabetic therapy’ up to April 2, 2020. Full texts of the retrieved articles were accessed. Results: There is evidence of increased incidence and severity of COVID-19 in patients with diabetes. COVID-19 could have effect on the pathophysiology of diabetes. Blood glucose control is important not only for patients who are infected with COVID-19, but also for those without the disease. Innovations like telemedicine are useful to treat patients with diabetes in today’s times.
FULL TEXT LINK
http://dx.doi.org/10.1016/j.dsx.2020.04.004

RECORD 19
TITLE
Central nervous system manifestations of COVID-19: A systematic review
AUTHOR NAMES
Asadi-Pooya A.A.; Simani L.
SOURCE
Journal of the Neurological Sciences (2020) 413 Article Number: 116832. Date of Publication: 15 Jun 2020
ABSTRACT
Objective: In this systematic review, we will discuss the evidence on the occurrence of central nervous system (CNS) involvement and neurological manifestations in patients with COVID-19. Methods: MEDLINE (accessed from PubMed) and Scopus from December 01, 2019 to March 26, 2020 were systematically searched for related published articles. In both electronic databases, the following search strategy was implemented and these key words (in the title/abstract) were used: “COVID 19” OR “coronavirus” AND “brain” OR “CNS” OR “neurologic”. Results: Through the search strategy, we could identify two articles about neurological involvement by COVID-19. One of these publications was a narrative review and the other one was a viewpoint. However, the authors scanned the reference lists of the included studies and could identify multiple references. One study, specifically investigated the neurological manifestations of COVID-19 and could document CNS manifestations in 25% of the patients. Most of the studies investigated the manifestations of COVID-19 in general. Conclusion: While neurological manifestations of COVID-19 have not been studied appropriately, it is highly likely that some of these patients, particularly those who suffer from a severe illness, have CNS involvement and neurological manifestations. Precise and targeted documentation of neurological symptoms, detailed clinical, neurological, and electrophysiological investigations of the patients, attempts to isolate SARS-CoV-2 from cerebrospinal fluid, and autopsies of the COVID-19 victims may clarify the role played by this virus in causing neurological manifestations.
FULL TEXT LINK
http://dx.doi.org/10.1016/j.jns.2020.116832

RECORD 20
TITLE
An evidence-based framework for priority clinical research questions for COVID-19
AUTHOR NAMES
Harris C.; Carson G.; Baillie J.K.; Horby P.; Nair H.
SOURCE
Journal of global health (2020) 10:1 (011001). Date of Publication: 1 Jun 2020
ABSTRACT
Background: On 31 December, 2019, the World Health Organization China Country Office was informed of cases of pneumonia of unknown aetiology. Since then, there have been over 75 000 cases globally of the 2019 novel coronavirus (COVID-19), 2000 deaths, and over 14 000 cases recovered. Outbreaks of novel agents represent opportunities for clinical research to inform real-time public health action. In 2018, we conducted a systematic review to identify priority research questions for Severe Acute Respiratory Syndrome-related coronavirus (SARS-CoV) and Middle East Respiratory Syndrome-related coronavirus (MERS-CoV). Here, we review information available on COVID-19 and provide an evidenced-based framework for priority clinical research in the current outbreak. Methods: Three bibliographic databases were searched to identify clinical studies published on SARS-CoV and MERS-CoV in the outbreak setting. Studies were grouped thematically according to clinical research questions addressed. In February 2020, available information on COVID19 was reviewed and compared to the results of the SARS-CoV and MERS-CoV systematic review. Results: From the research objectives for SARS-CoV and MERS-CoV, ten themes in the literature were identified: Clinical characterisation, prognosis, diagnosis, clinical management, viral pathogenesis, epidemiological characterisation, infection prevention and control/transmission, susceptibility, psychosocial, and aetiology. For COVID19, some information on clinical presentation, diagnostic testing, and aetiology is available but many clinical research gaps have yet to be filled. Conclusions: Based on a systematic review of other severe coronaviruses, we summarise the state of clinical research for COVID-19, highlight the research gaps, and provide recommendations for the implementation of standardised protocols. Data based on internationally standardised protocols will inform clinical practice real-time.
FULL TEXT LINK
http://dx.doi.org/10.7189/jogh.10-011001

RECORD 21
TITLE
Evidence synthesis relevant to COVID-19: a protocol for multiple systematic reviews and overviews of systematic reviews
AUTHOR NAMES
Rada G.; Verdugo-Paiva F.; Ávila C.; Morel-Marambio M.; Bravo-Jeria R.; Pesce F.; Madrid E.; Izcovich A.
SOURCE
Medwave (2020) 20:3 (e7868). Date of Publication: 1 Apr 2020
FULL TEXT LINK
http://dx.doi.org/10.5867/medwave.2020.03.7867

RECORD 22
TITLE
Response to the covid-19 epidemic: The chinese experience and implications for other countries
AUTHOR NAMES
Liu W.; Yue X.-G.; Tchounwou P.B.
SOURCE
International Journal of Environmental Research and Public Health (2020) 17:7 Article Number: 2304. Date of Publication: 1 Apr 2020
ABSTRACT
The ongoing outbreak of the novel coronavirus disease (COVID-19) that occurred in China is rapidly spreading globally. China’s bond and strict containment measures have been proved (in practice) to significantly reduce the spread of the epidemic. This was obtained through the use of emergency control measures in the epidemic areas and the integration of resources from multiple systems, including business, community, technology, education, and transportation, across the country. In order to better understand how China has managed to reduce the public health and economic impacts of the COVID-19 epidemic, this editorial systematically reviews the specific measures for infection prevention and control of the disease. The best practices for COVID-19 eradication in China provide evidence-based strategies that could be replicated in other countries.
FULL TEXT LINK
http://dx.doi.org/10.3390/IJERPH17072304

RECORD 23
TITLE
Current drugs with potential for treatment of covid-19: A literature review
AUTHOR NAMES
Rabby M.I.I.
SOURCE
Journal of Pharmacy and Pharmaceutical Sciences (2020) 23:1 (58-64). Date of Publication: 4 Apr 2020
ABSTRACT
Purpose: SARS-CoV-2 first emerged in China in December 2019 and rapidly spread worldwide. No vaccine or approved drug is available to eradicate the virus, however, some drugs that are indicated for other afflictions seems to be potentially beneficial to treat the infection albeit without unequivocal evidence. The aim of this article is to review the published background on the effectiveness of these drugs against COVID-19 Methods: A thorough literature search was conducted on recently published studies which have published between January 1 to March 25, 2020. PubMed, Google Scholar and Science Direct databases were searched Results: A total 22 articles were found eligible. 8 discuss about treatment outcomes from their applied drugs during treatment of COVID-19 patients, 4 report laboratory tests, one report animal trial and other 9 articles discuss recommendations and suggestions based on the treatment process and clinical outcomes of other diseases such as malaria, ebola, severe acute respiratory syndrome (SARS) and Middle East respiratory syndrome (MERS). The data and/or recommendations are categorized in 4 classes: (a) anti-viral and anti-inflammatory drugs, (b) anti-malaria drugs, (c) traditional Chinese drugs and (d) other treatments/drugs. Conclusion: All examined treatments, although potentiality effective against COVID-19, need either appropriate drug development or clinical trial to be suitable for clinical use.
FULL TEXT LINK
http://dx.doi.org/10.18433/jpps31002

RECORD 24
TITLE
Neutrophil-to-lymphocyte ratio and lymphocyte-to-C-reactive protein ratio in patients with severe coronavirus disease 2019 (COVID-19): A meta-analysis
AUTHOR NAMES
Lagunas-Rangel F.A.
SOURCE
Journal of Medical Virology (2020). Date of Publication: 2020
FULL TEXT LINK
http://dx.doi.org/10.1002/jmv.25819

RECORD 25
TITLE
Poor survival with extracorporeal membrane oxygenation in acute respiratory distress syndrome (ARDS) due to coronavirus disease 2019 (COVID-19): Pooled analysis of early reports
AUTHOR NAMES
Henry B.M.; Lippi G.
SOURCE
Journal of Critical Care (2020) 58 (27-28). Date of Publication: 1 Aug 2020
FULL TEXT LINK
http://dx.doi.org/10.1016/j.jcrc.2020.03.011

RECORD 26
TITLE
Narrative synthesis of psychological and coping responses towards emerging infectious disease outbreaks in the general population: practical considerations for the COVID-19 pandemic
AUTHOR NAMES
Chew Q.H.; Wei K.C.; Vasoo S.; Chua H.C.; Sim K.
SOURCE
Singapore medical journal (2020). Date of Publication: 3 Apr 2020
ABSTRACT
INTRODUCTION: Emerging infectious disease outbreaks, such as the present coronavirus disease 2019 (COVID-19) pandemic, often have a psychological impact on the well-being of the general population, including survivors and caregivers. Our study aimed to synthesise extant literature regarding the combined psychological responses and coping methods used by the general population in past outbreaks. METHODS: We conducted a narrative synthesis of the published literature over the last two decades with a quality appraisal of included articles that reported both psychological responses and coping strategies within infectious disease outbreaks. RESULTS: A total of 144 papers were identified from the search, 24 of which were included in the review. Overall, 18 studies examined the psychosocial responses of the general population towards the severe acute respiratory syndrome epidemic, four studies focused on the Ebola epidemic and two studies covered the H1N1 outbreak. Common themes in psychological responses included anxiety/fears, depression, anger, guilt, grief and loss, post-traumatic stress, and stigmatisation, but also a greater sense of empowerment and compassion towards others. Coping strategies adopted included problem-focused coping (seeking alternatives, self- and other-preservation), seeking social support, avoidance, and positive appraisal of the situation. CONCLUSION: Amid the range of psychosocial responses seen in past infectious disease outbreaks, practical considerations for the current COVID-19 pandemic need to focus on the individual in the context of the larger social environment, with an emphasis on raising awareness of the range of possible psychosocial responses, access to psychological help, self- care, empowering self-support groups and sustained engagement with updated, reliable information about the outbreak.
FULL TEXT LINK
http://dx.doi.org/10.11622/smedj.2020046

RECORD 27
TITLE
Imaging and Clinical Features of Patients With 2019 Novel Coronavirus SARS-CoV-2: A systematic review and meta-analysis
AUTHOR NAMES
Cao Y.; Liu X.; Xiong L.; Cai K.
SOURCE
Journal of medical virology (2020). Date of Publication: 3 Apr 2020
ABSTRACT
BACKGROUND: Currently, the epidemic of Coronavirus Disease 2019 (COVID-19) has begun to spread worldwide. We aim to explore reliable evidences for the diagnosis and treatment of the COVID-19 by analyzing all the published studies by Chinese scholars on the clinical and imaging features in novel coronavirus pneumonia (NCP) caused by SARS-CoV-2. METHODS: We searched five medical databases including two Chinese and three English databases for all published articles on COVID-19 since the outbreak. A random-effects model was designed, and the imaging and clinical data from all studies were collected for meta-analysis. RESULTS: Overall, 31 articles and 46959 patients were included, including 10 English articles, 21 Chinese articles. The results of meta-analysis showed that the most common clinical manifestations were fever (87.3%, 0.838-0.909), cough (58.1%, 0.502-0.660), dyspnea (38.3%, 0.246-0.520), muscle soreness or fatigue (35.5%, 0.253-0.456), chest distress (31.2%, -0.024-0.648). The main imaging finding were bilateral pneumonia (75.7%, 0.639-0.871), and ground glass opacification (69.9%, 0.602-0.796). Among the patients, the incidence of required intensive care unit (ICU) was (29.3%, 0.190-0.395), the incidence of acute respiratory distress syndrome (ARDS) was (28.8%, 0.147-0.429), the multiple organ dysfunction syndrome (MODS) was (8.5%, -0.008-0.179), and and the case fatality rate of patients with COVID-19 was (6.8%, 0.044-0.093). CONCLUSION: COVID-19 is a new clinical infectious disease, which mainly causes bilateral pneumonia, and lung function will deteriorate rapidly. Nearly a third of patients need to be admitted to the ICU, and patients are likely to cause respiratory failure or even death. This article is protected by copyright. All rights reserved.
FULL TEXT LINK
http://dx.doi.org/10.1002/jmv.25822

RECORD 28
TITLE
Cardiovascular disease and COVID-19
AUTHOR NAMES
Bansal M.
SOURCE
Diabetes and Metabolic Syndrome: Clinical Research and Reviews (2020) 14:3 (247-250). Date of Publication: 1 May 2020
ABSTRACT
Background and aims: Many patients with coronavirus disease 2019 (COVID-19) have underlying cardiovascular (CV) disease or develop acute cardiac injury during the course of the illness. Adequate understanding of the interplay between COVID-19 and CV disease is required for optimum management of these patients. Methods: A literature search was done using PubMed and Google search engines to prepare a narrative review on this topic. Results: Respiratory illness is the dominant clinical manifestation of COVID-19; CV involvement occurs much less commonly. Acute cardiac injury, defined as significant elevation of cardiac troponins, is the most commonly reported cardiac abnormality in COVID-19. It occurs in approximately 8–12% of all patients. Direct myocardial injury due to viral involvement of cardiomyocytes and the effect of systemic inflammation appear to be the most common mechanisms responsible for cardiac injury. The information about other CV manifestations in COVID-19 is very limited at present. Nonetheless, it has been consistently shown that the presence of pre-existing CV disease and/or development of acute cardiac injury are associated with significantly worse outcome in these patients. Conclusions: Most of the current reports on COVID-19 have only briefly described CV manifestations in these patients. Given the enormous burden posed by this illness and the significant adverse prognostic impact of cardiac involvement, further research is required to understand the incidence, mechanisms, clinical presentation and outcomes of various CV manifestations in COVID-19 patients.
FULL TEXT LINK
http://dx.doi.org/10.1016/j.dsx.2020.03.013

RECORD 29
TITLE
Perinatal-Neonatal Management of COVID-19 Infection – Guidelines of the Federation of Obstetric and Gynecological Societies of India (FOGSI), National Neonatology Forum of India (NNF), and Indian Academy of Pediatrics (IAP)
AUTHOR NAMES
Chawla D.; Chirla D.; Dalwai S.; Deorari A.K.; Ganatra A.; Gandhi A.; Kabra N.S.; Kumar P.; Mittal P.; Parekh B.J.; Sankar M.J.; Singhal T.; Sivanandan S.; Tank P.
SOURCE
Indian pediatrics (2020). Date of Publication: 1 Apr 2020
ABSTRACT
JUSTIFICATION: During the current rapidly evolving pandemic of COVID-19 infection, pregnant women with suspected or confirmed COVID-19 and their newborn infants form a special vulnerable group that needs immediate attention. Unlike other elective medical and surgical problems for which care can be deferred during the pandemic, pregnancies and childbirths will continue. Perinatal period poses unique challenges and care of the mother-baby dyads requires special resources for prevention of transmission, diagnosis of infection and providing clinical care during labor, resuscitation and postnatal period. PROCESS: The GRADE approach recommended by the World Health Organization was used to develop the guideline. A Guideline Development Group (GDG) comprising of obstetricians, neonatologists and pediatricians was constituted. The GDG drafted a list of questions which are likely to be faced by clinicians involved in obstetric and neonatal care. An e-survey was carried out amongst a wider group of clinicians to invite more questions and prioritize. Literature search was carried out in PubMed and websites of relevant international and national professional organizations. Existing guidelines, systematic reviews, clinical trials, narrative reviews and other descriptive reports were reviewed. For the practice questions, the evidence was extracted into evidence profiles. The context, resources required, values and preferences were considered for developing the recommendations. OBJECTIVES: To provide recommendations for prevention of transmission, diagnosis of infection and providing clinical care during labor, resuscitation and postnatal period. RECOMMENDATIONS: A set of twenty recommendations are provided under the following broad headings: 1) pregnant women with travel history, clinical suspicion or confirmed COVID-19 infection; 2) neonatal care; 3) prevention and infection control; 4) diagnosis; 5) general questions.

RECORD 30
TITLE
Hypertension and its severity or mortality in Coronavirus Disease 2019 (COVID-19): a pooled analysis
AUTHOR NAMES
Lippi G.; Wong J.; Henry B.M.
SOURCE
Polish archives of internal medicine (2020). Date of Publication: 31 Mar 2020
ABSTRACT
INTRODUCTION: As the coronavirus disease 2019 (COVID-19) outbreak, identification of clinical predictors of severe or fatal disease are necessary to enable risk stratification and optimize allocation of limited resources. Hypertension has been widely reported to be associated with increase disease severity, however, other studies have reported different findings. OBJECTIVES: To evaluate the association of hypertension and severe and fatal COVID-19. PATIENTS AND METHODS: Scopus, Medline, and Web of Science was performed to identify studies reporting the rate of hypertension in COVID-19 patients with severe or non-severe disease or among survivors and non-survivors. The obtained data was pooled into a meta-analysis to calculate odds ratio (OR) with 95% confidence intervals (95%CI). RESULTS: Hypertension was associated with a nearly 2.5-fold significantly increased risk of severe COVID-19 disease (OR: 2.49 [95%CI: 1.98-3.12] I2=24%), as well as with a similarly significant higher risk of mortality (OR: 2.42 [95%CI: 1.51-3.90] I2=0%). In meta-regression, a significant correlation was observed with an increase in mean age of patients with severe COVID-19 associated with increased log odds of hypertension and severity (p=0.03). CONCLUSIONS: The results of this pooled analysis of the current scientific literature would suggest that hypertension may be associated with an up to 2.5-fold higher risk of severe and fatal COVID-19, especially among older individuals.
FULL TEXT LINK
http://dx.doi.org/10.20452/pamw.15272

RECORD 31
TITLE
2019 novel coronavirus patients’ clinical characteristics, discharge rate, and fatality rate of meta-analysis
AUTHOR NAMES
Li L.-Q.; Huang T.; Wang Y.-Q.; Wang Z.-P.; Liang Y.; Huang T.-B.; Zhang H.-Y.; Sun W.; Wang Y.
SOURCE
Journal of Medical Virology (2020). Date of Publication: 2020
ABSTRACT
The aim of this study was to analyze the clinical data, discharge rate, and fatality rate of COVID-19 patients for clinical help. The clinical data of COVID-19 patients from December 2019 to February 2020 were retrieved from four databases. We statistically analyzed the clinical symptoms and laboratory results of COVID-19 patients and explained the discharge rate and fatality rate with a single-arm meta-analysis. The available data of 1994 patients in 10 literatures were included in our study. The main clinical symptoms of COVID-19 patients were fever (88.5%), cough (68.6%), myalgia or fatigue (35.8%), expectoration (28.2%), and dyspnea (21.9%). Minor symptoms include headache or dizziness (12.1%), diarrhea (4.8%), nausea and vomiting (3.9%). The results of the laboratory showed that the lymphocytopenia (64.5%), increase of C-reactive protein (44.3%), increase of lactic dehydrogenase (28.3%), and leukocytopenia (29.4%) were more common. The results of single-arm meta-analysis showed that the male took a larger percentage in the gender distribution of COVID-19 patients 60% (95% CI [0.54, 0.65]), the discharge rate of COVID-19 patients was 42% (95% CI [0.29, 0.55]), and the fatality rate was 7% (95% CI [0.04,0.10]).
FULL TEXT LINK
http://dx.doi.org/10.1002/jmv.25757

RECORD 32
TITLE
2019 novel coronavirus (2019-nCoV) outbreak: A new challenge
AUTHOR NAMES
Lupia T.; Scabini S.; Mornese Pinna S.; Di Perri G.; De Rosa F.G.; Corcione S.
SOURCE
Journal of Global Antimicrobial Resistance (2020) 21 (22-27). Date of Publication: 1 Jun 2020
ABSTRACT
Objectives: Following the public-health emergency of international concern (PHEIC) declared by the World Health Organization (WHO) on 30 January 2020 and the recent outbreak caused by 2019 novel coronavirus (2019-nCoV) [officially renamed severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2)] in China and 29 other countries, we aimed to summarise the clinical aspects of the novelBetacoronavirus disease (COVID-19) and its possible clinical presentations together with suggested therapeutic algorithms for patients who may require antimicrobial treatment. Methods: The currently available literature was reviewed for microbiologically confirmed infections by 2019-nCoV or COVID-19 at the time of writing (13 February 2020). A literature search was performed using the PubMed database and Cochrane Library. Search terms included ‘novel coronavirus’ or ‘2019-nCoV’ or ‘COVID-19’. Results: Published cases occurred mostly in males (age range, 8–92 years). Cardiovascular, digestive and endocrine system diseases were commonly reported, except previous chronic pulmonary diseases [e.g. chronic obstructive pulmonary disease (COPD), asthma, bronchiectasis] that were surprisingly underreported. Fever was present in all of the case series available, flanked by cough, dyspnoea, myalgia and fatigue. Multiple bilateral lobular and subsegmental areas of consolidation or bilateral ground-glass opacities were the main reported radiological features of 2019-nCoV infection, at least in the early phases of the disease. Conclusion: The new 2019-nCoV epidemic is mainly associated with respiratory disease and few extrapulmonary signs. However, there is a low rate of associated pre-existing respiratory co-morbidities.
FULL TEXT LINK
http://dx.doi.org/10.1016/j.jgar.2020.02.021

RECORD 33
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 34
TITLE
Medical Masks vs N95 Respirators for Preventing COVID-19 in Health Care Workers A Systematic Review and Meta-Analysis of Randomized Trials
AUTHOR NAMES
Bartoszko J.J.; Farooqi M.A.M.; Alhazzani W.; Loeb M.
SOURCE
Influenza and other respiratory viruses (2020). Date of Publication: 4 Apr 2020
ABSTRACT
BACKGROUND: Respiratory protective devices are critical in protecting against infection in health care workers at high risk of novel 2019 coronavirus disease (COVID-19); however, recommendations are conflicting and epidemiological data on their relative effectiveness against COVID-19 are limited. PURPOSE: To compare medical masks to N95 respirators in preventing laboratory confirmed viral infection and respiratory illness including coronavirus specifically in health care workers. DATA SOURCES: MEDLINE, Embase and CENTRAL from January 1st 2014 to March 9th 2020. Update of published search conducted from January 1st 1990 to December 9th 2014. STUDY SELECTION: Randomized controlled trials (RCTs) comparing the protective effect of medical masks to N95 respirators in health care workers. DATA EXTRACTION: Reviewer pair independently screened, extracted data, and assessed risk of bias and the certainty of the evidence. DATA SYNTHESIS: Four RCTs were meta-analysed adjusting for clustering. Compared to N95 respirators; the use of medical masks did not increase laboratory confirmed viral (including coronaviruses) respiratory infection (OR 1.06; 95% CI 0.90-1.25; I2 =0%; low certainty in the evidence) or clinical respiratory illness (OR 1.49; 95%CI 0.98-2.28; I2 =78%; very low certainty in the evidence). Only one trial evaluated coronaviruses separately and found no difference between the two groups (p=0.49). LIMITATIONS: Indirectness and imprecision of available evidence. CONCLUSIONS: Low certainty evidence suggests that medical masks and N95 respirators offer similar protection against viral respiratory infection including coronavirus in health care workers during non-aerosol generating care. Preservation of N95 respirators for high-risk, aerosol generating procedures in this pandemic should be considered when in short supply.
FULL TEXT LINK
http://dx.doi.org/10.1111/irv.12745

RECORD 35
TITLE
Chest CT manifestations of new coronavirus disease 2019 (COVID-19): a pictorial review
AUTHOR NAMES
Ye Z.; Zhang Y.; Wang Y.; Huang Z.; Song B.
SOURCE
European Radiology (2020). Date of Publication: 2020
ABSTRACT
Coronavirus disease 2019 (COVID-19) outbreak, first reported in Wuhan, China, has rapidly swept around the world just within a month, causing global public health emergency. In diagnosis, chest computed tomography (CT) manifestations can supplement parts of limitations of real-time reverse transcription polymerase chain reaction (RT-PCR) assay. Based on a comprehensive literature review and the experience in the frontline, we aim to review the typical and relatively atypical CT manifestations with representative COVID-19 cases at our hospital, and hope to strengthen the recognition of these features with radiologists and help them make a quick and accurate diagnosis. Key Points • Ground glass opacities, consolidation, reticular pattern, and crazy paving pattern are typical CT manifestations of COVID-19. • Emerging atypical CT manifestations, including airway changes, pleural changes, fibrosis, nodules, etc., were demonstrated in COVID-19 patients. • CT manifestations may associate with the progression and prognosis of COVID-19.
FULL TEXT LINK
http://dx.doi.org/10.1007/s00330-020-06801-0

RECORD 36
TITLE
Blended learning via distance in pre-registration nursing education: A scoping review
AUTHOR NAMES
Jowsey T.; Foster G.; Cooper-Ioelu P.; Jacobs S.
SOURCE
Nurse education in practice (2020) 44 (102775). Date of Publication: 25 Mar 2020
ABSTRACT
Prior to the Covid-19 global pandemic, we reviewed literature and identified comprehensive evidence of the efficacy of blended learning for pre-registration nursing students who learn across distances and/or via satellite campuses. Following a methodological framework, a scoping literature review was undertaken. We searched six databases (EBSCOHOST (CINHAL plus; Education research Complete; Australia/New Zealand Reference Centre); Google Scholar; EMBASE (Ovid) [ERIC (Ovid); Medline (Ovid)]; PubMed: ProQuest Education Journals & ProQuest Nursing & Allied Health Source) for the period 2005-December 2015. Critical appraisal for critiquing qualitative and quantitative studies was undertaken, as was a thematic analysis. Twenty-eight articles were included for review, which reported nursing research (n = 23) and student experiences of blended learning in higher education (n = 5). Four key themes were identified in the literature: active learning, technological barriers, support, and communication. The results suggest that when delivered purposefully, blended learning can positively influence and impact on the achievements of students, especially when utilised to manage and support distance education. Further research is needed about satellite campuses with student nurses, to assist with the development of future educational practice.
FULL TEXT LINK
http://dx.doi.org/10.1016/j.nepr.2020.102775

RECORD 37
TITLE
Cardiac troponin I in patients with coronavirus disease 2019 (COVID-19): Evidence from a meta-analysis
AUTHOR NAMES
Lippi G.; Lavie C.J.; Sanchis-Gomar F.
SOURCE
Progress in Cardiovascular Diseases (2020). Date of Publication: 2020
FULL TEXT LINK
http://dx.doi.org/10.1016/j.pcad.2020.03.001

RECORD 38
TITLE
CT morphology of COVID-19: Case report and review of literature
AUTHOR NAMES
Hamer O.W.; Salzberger B.; Gebauer J.; Stroszczynski C.; Pfeifer M.
SOURCE
RoFo : Fortschritte auf dem Gebiete der Rontgenstrahlen und der Nuklearmedizin (2020). Date of Publication: 26 Mar 2020
FULL TEXT LINK
http://dx.doi.org/10.1055/a-1142-4094

RECORD 39
TITLE
COVID-19 and the otolaryngologist – preliminary evidence-based review
AUTHOR NAMES
Vukkadala N.; Qian Z.J.; Holsinger F.C.; Patel Z.M.; Rosenthal E.
SOURCE
The Laryngoscope (2020). Date of Publication: 26 Mar 2020
ABSTRACT
The SARS-CoV-2 virus which causes coronavirus disease 2019 (COVID-19) has rapidly swept across the world since its identification in December 2019. Otolaryngologists are at unique risk due to the close contact with mucus membranes of the upper respiratory tract and have been among the most affected healthcare workers in Wuhan, China. We present information on COVID-19 management relevant to otolaryngologists on the frontlines of this pandemic and provide preliminary guidance based on practices implemented in China and other countries and practical strategies deployed at Stanford University. This article is protected by copyright. All rights reserved.
FULL TEXT LINK
http://dx.doi.org/10.1002/lary.28672

RECORD 40
TITLE
Potential interventions for novel coronavirus in China: A systematic review
AUTHOR NAMES
Zhang L.; Liu Y.
SOURCE
Journal of Medical Virology (2020) 92:5 (479-490). Date of Publication: 1 May 2020
ABSTRACT
An outbreak of a novel coronavirus (COVID-19 or 2019-CoV) infection has posed significant threats to international health and the economy. In the absence of treatment for this virus, there is an urgent need to find alternative methods to control the spread of disease. Here, we have conducted an online search for all treatment options related to coronavirus infections as well as some RNA-virus infection and we have found that general treatments, coronavirus-specific treatments, and antiviral treatments should be useful in fighting COVID-19. We suggest that the nutritional status of each infected patient should be evaluated before the administration of general treatments and the current children’s RNA-virus vaccines including influenza vaccine should be immunized for uninfected people and health care workers. In addition, convalescent plasma should be given to COVID-19 patients if it is available. In conclusion, we suggest that all the potential interventions be implemented to control the emerging COVID-19 if the infection is uncontrollable.
FULL TEXT LINK
http://dx.doi.org/10.1002/jmv.25707

RECORD 41
TITLE
Epidemiology, causes, clinical manifestation and diagnosis, prevention and control of coronavirus disease (COVID-19) during the early outbreak period: A scoping review
AUTHOR NAMES
Adhikari S.P.; Meng S.; Wu Y.-J.; Mao Y.-P.; Ye R.-X.; Wang Q.-Z.; Sun C.; Sylvia S.; Rozelle S.; Raat H.; Zhou H.
SOURCE
Infectious Diseases of Poverty (2020) 9:1 Article Number: 29. Date of Publication: 17 Mar 2020
ABSTRACT
Background: The coronavirus disease (COVID-19) has been identified as the cause of an outbreak of respiratory illness in Wuhan, Hubei Province, China beginning in December 2019. As of 31 January 2020, this epidemic had spread to 19 countries with 11 791 confirmed cases, including 213 deaths. The World Health Organization has declared it a Public Health Emergency of International Concern. Methods: A scoping review was conducted following the methodological framework suggested by Arksey and O’Malley. In this scoping review, 65 research articles published before 31 January 2020 were analyzed and discussed to better understand the epidemiology, causes, clinical diagnosis, prevention and control of this virus. The research domains, dates of publication, journal language, authors’ affiliations, and methodological characteristics were included in the analysis. All the findings and statements in this review regarding the outbreak are based on published information as listed in the references. Results: Most of the publications were written using the English language (89.2%). The largest proportion of published articles were related to causes (38.5%) and a majority (67.7%) were published by Chinese scholars. Research articles initially focused on causes, but over time there was an increase of the articles related to prevention and control. Studies thus far have shown that the virus’ origination is in connection to a seafood market in Wuhan, but specific animal associations have not been confirmed. Reported symptoms include fever, cough, fatigue, pneumonia, headache, diarrhea, hemoptysis, and dyspnea. Preventive measures such as masks, hand hygiene practices, avoidance of public contact, case detection, contact tracing, and quarantines have been discussed as ways to reduce transmission. To date, no specific antiviral treatment has proven effective; hence, infected people primarily rely on symptomatic treatment and supportive care. Conclusions: There has been a rapid surge in research in response to the outbreak of COVID-19. During this early period, published research primarily explored the epidemiology, causes, clinical manifestation and diagnosis, as well as prevention and control of the novel coronavirus. Although these studies are relevant to control the current public emergency, more high-quality research is needed to provide valid and reliable ways to manage this kind of public health emergency in both the short- and long-term.
FULL TEXT LINK
http://dx.doi.org/10.1186/s40249-020-00646-x

RECORD 42
TITLE
Systematic review of COVID-19 in children show milder cases and a better prognosis than adults
AUTHOR NAMES
Ludvigsson J.F.
SOURCE
Acta paediatrica (Oslo, Norway : 1992) (2020). Date of Publication: 23 Mar 2020
ABSTRACT
AIM: The coronavirus disease 2019 (COVID-19) pandemic has affected hundreds of thousands of people. Data on symptoms and prognoses in children are rare. METHODS: A systematic literature review was carried out to identify papers on COVID-19, which is caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), using the Medline and EMBASE databases between 1 January and 18 March 2020. RESULTS: The search identified 45 relevant scientific papers and letters. The review showed that children have so far accounted for 1-5% of diagnosed COVID-19 cases, they often have milder disease than adults and deaths have been extremely rare. Diagnostic findings have been similar to adults, with fever and respiratory symptoms being prevalent, but fewer children seem to have developed severe pneumonia. Elevated inflammatory markers were less common in children and lymphocytopenia seemed rare. Newborn infants have developed symptomatic COVID-19, but evidence of vertical intrauterine transmission was scarce. Suggested treatment included providing oxygen, inhalations, nutritional support and maintaining fluids and electrolyte balances. CONCLUSIONS: COVID-19 has occurred in children, but they seemed to have a milder disease course and better prognoses than adults. Deaths were extremely rare.
FULL TEXT LINK
http://dx.doi.org/10.1111/apa.15270

RECORD 43
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 44
TITLE
Prevalence of comorbidities in the novel Wuhan coronavirus (COVID-19) infection: a systematic review and meta-analysis
AUTHOR NAMES
Yang J.; Zheng Y.; Gou X.; Pu K.; Chen Z.; Guo Q.; Ji R.; Wang H.; Wang Y.; Zhou Y.
SOURCE
International journal of infectious diseases : IJID : official publication of the International Society for Infectious Diseases (2020). Date of Publication: 12 Mar 2020
ABSTRACT
BACKGROUND: An outbreak of Novel Coronavirus (COVID -19) in Wuhan, China, the epidemic is more widespread than initially estimated, with cases now confirmed in multiple countries. AIMS: The aim of the meta-analysis was to assess the prevalence of comorbidities in the COVID-19 infection patients and the risk of underlying diseases in severe patients compared to non-severe patients. METHODS: A literature search was conducted using the databases PubMed, EMBASE, and Web of sciences until February 25, 2020. Risk ratio (OR) and 95% confidence intervals (CIs) were pooled using random-effects models. RESULTS: Eight studies were included in the meta- analysis, including 46248 infected patients. The result showed the most prevalent clinical symptom was fever ( 91 ± 3, 95% CI 86-97% ), followed by cough (67 ± 7, 95% CI 59-76%), fatigue ( 51 ± 0, 95% CI 34-68% ) and dyspnea ( 30 ± 4, 95% CI 21-40%). The most prevalent comorbidity were hypertension (17 ± 7, 95% CI 14-22%) and diabetes ( 8 ± 6, 95% CI 6-11% ), followed by cardiovascular diseases ( 5 ± 4, 95% CI 4-7% ) and respiratory system disease( 2 ± 0, 95% CI 1-3% ). Compared with the Non-severe patient, the pooled odds ratio of hypertension, respiratory system disease, cardiovascular disease in severe patients were (OR 2.36, 95% CI: 1.46-3.83), (OR 2.46, 95% CI: 1.76-3.44) and (OR 3.42, 95% CI: 1.88-6.22)respectively. CONCLUSION: We assessed the prevalence of comorbidities in the COVID-19 infection patients and found underlying disease, including hypertension, respiratory system disease and cardiovascular, may be a risk factor for severe patients compared with Non-severe patients.
FULL TEXT LINK
http://dx.doi.org/10.1016/j.ijid.2020.03.017

RECORD 45
TITLE
Coronavirus Disease 2019 (COVID-19): A Systematic Review of Imaging Findings in 919 Patients
AUTHOR NAMES
Salehi S.; Abedi A.; Balakrishnan S.; Gholamrezanezhad A.
SOURCE
AJR. American journal of roentgenology (2020) (1-7). Date of Publication: 14 Mar 2020
ABSTRACT
OBJECTIVE. Available information on CT features of the 2019 novel coronavirus disease (COVID-19) is scattered in different publications, and a cohesive literature review has yet to be compiled. MATERIALS AND METHODS. This article includes a systematic literature search of PubMed, Embase (Elsevier), Google Scholar, and the World Health Organization database. RESULTS. Known features of COVID-19 on initial CT include bilateral multilobar ground-glass opacification (GGO) with a peripheral or posterior distribution, mainly in the lower lobes and less frequently within the right middle lobe. Atypical initial imaging presentation of consolidative opacities superimposed on GGO may be found in a smaller number of cases, mainly in the elderly population. Septal thickening, bronchiectasis, pleural thickening, and subpleural involvement are some of the less common findings, mainly in the later stages of the disease. Pleural effusion, pericardial effusion, lymphadenopathy, cavitation, CT halo sign, and pneumothorax are uncommon but may be seen with disease progression. Follow-up CT in the intermediate stage of disease shows an increase in the number and size of GGOs and progressive transformation of GGO into multifocal consolidative opacities, septal thickening, and development of a crazy paving pattern, with the greatest severity of CT findings visible around day 10 after the symptom onset. Acute respiratory distress syndrome is the most common indication for transferring patients with COVID-19 to the ICU and the major cause of death in this patient population. Imaging patterns corresponding to clinical improvement usually occur after week 2 of the disease and include gradual resolution of consolidative opacities and decrease in the number of lesions and involved lobes. CONCLUSION. This systematic review of current literature on COVID-19 provides insight into the initial and follow-up CT characteristics of the disease.
FULL TEXT LINK
http://dx.doi.org/10.2214/AJR.20.23034

RECORD 46
TITLE
Prevalence and impact of cardiovascular metabolic diseases on COVID-19 in China
AUTHOR NAMES
Li B.; Yang J.; Zhao F.; Zhi L.; Wang X.; Liu L.; Bi Z.; Zhao Y.
SOURCE
Clinical Research in Cardiology (2020). Date of Publication: 2020
ABSTRACT
Background: Studies have reminded that cardiovascular metabolic comorbidities made patients more susceptible to suffer 2019 novel corona virus (2019-nCoV) disease (COVID-19), and exacerbated the infection. The aim of this analysis is to determine the association of cardiovascular metabolic diseases with the development of COVID-19. Methods: A meta-analysis of eligible studies that summarized the prevalence of cardiovascular metabolic diseases in COVID-19 and compared the incidences of the comorbidities in ICU/severe and non-ICU/severe patients was performed. Embase and PubMed were searched for relevant studies. Results: A total of six studies with 1527 patients were included in this analysis. The proportions of hypertension, cardia-cerebrovascular disease and diabetes in patients with COVID-19 were 17.1%, 16.4% and 9.7%, respectively. The incidences of hypertension, cardia-cerebrovascular diseases and diabetes were about twofolds, threefolds and twofolds, respectively, higher in ICU/severe cases than in their non-ICU/severe counterparts. At least 8.0% patients with COVID-19 suffered the acute cardiac injury. The incidence of acute cardiac injury was about 13 folds higher in ICU/severe patients compared with the non-ICU/severe patients. Conclusion: Patients with previous cardiovascular metabolic diseases may face a greater risk of developing into the severe condition and the comorbidities can also greatly affect the prognosis of the COVID-19. On the other hand, COVID-19 can, in turn, aggravate the damage to the heart.
FULL TEXT LINK
http://dx.doi.org/10.1007/s00392-020-01626-9

RECORD 47
TITLE
The Incubation Period of Coronavirus Disease 2019 (COVID-19) From Publicly Reported Confirmed Cases: Estimation and Application
AUTHOR NAMES
Lauer S.A.; Grantz K.H.; Bi Q.; Jones F.K.; Zheng Q.; Meredith H.R.; Azman A.S.; Reich N.G.; Lessler J.
SOURCE
Annals of internal medicine (2020). Date of Publication: 10 Mar 2020
ABSTRACT
Background: A novel human coronavirus, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), was identified in China in December 2019. There is limited support for many of its key epidemiologic features, including the incubation period for clinical disease (coronavirus disease 2019 [COVID-19]), which has important implications for surveillance and control activities. Objective: To estimate the length of the incubation period of COVID-19 and describe its public health implications. Design: Pooled analysis of confirmed COVID-19 cases reported between 4 January 2020 and 24 February 2020. Setting: News reports and press releases from 50 provinces, regions, and countries outside Wuhan, Hubei province, China. Participants: Persons with confirmed SARS-CoV-2 infection outside Hubei province, China. Measurements: Patient demographic characteristics and dates and times of possible exposure, symptom onset, fever onset, and hospitalization. Results: There were 181 confirmed cases with identifiable exposure and symptom onset windows to estimate the incubation period of COVID-19. The median incubation period was estimated to be 5.1 days (95% CI, 4.5 to 5.8 days), and 97.5% of those who develop symptoms will do so within 11.5 days (CI, 8.2 to 15.6 days) of infection. These estimates imply that, under conservative assumptions, 101 out of every 10 000 cases (99th percentile, 482) will develop symptoms after 14 days of active monitoring or quarantine. Limitation: Publicly reported cases may overrepresent severe cases, the incubation period for which may differ from that of mild cases. Conclusion: This work provides additional evidence for a median incubation period for COVID-19 of approximately 5 days, similar to SARS. Our results support current proposals for the length of quarantine or active monitoring of persons potentially exposed to SARS-CoV-2, although longer monitoring periods might be justified in extreme cases. Primary Funding Source: U.S. Centers for Disease Control and Prevention, National Institute of Allergy and Infectious Diseases, National Institute of General Medical Sciences, and Alexander von Humboldt Foundation.
FULL TEXT LINK
http://dx.doi.org/10.7326/M20-0504

RECORD 48
TITLE
The differential diagnosis of pulmonary infiltrates in cancer patients during the outbreak of the 2019 novel coronavirus disease
AUTHOR NAMES
Zhu W.J.; Wang J.; He X.H.; Qin Y.; Yang S.; Hu X.S.; Wang H.Y.; Huang J.; Zhou A.P.; Ma F.; Shi Y.K.; Zhou S.Y.
SOURCE
Zhonghua zhong liu za zhi [Chinese journal of oncology] (2020) 42 (E008). Date of Publication: 5 Mar 2020
ABSTRACT
Objective: To investigate the principles of differential diagnosis of pulmonary infiltrates in cancer patients during the outbreak of novel coronavirus (2019-nCoV) by analyzing one case of lymphoma who presented pulmonary ground-glass opacities (GGO) after courses of chemotherapy. Methods: Baseline demographics and clinicopathological data of eligible patients were retrieved from medical records. Information of clinical manifestations, history of epidemiology, lab tests and chest CT scan images of visiting patients from February 13 to February 28 were collected. Literatures about pulmonary infiltrates in cancer patients were searched from databases including PUBMED, EMBASE and CNKI. Results: Among the 139 cancer patients underwent chest CT scans before chemotherapy, pulmonary infiltrates were identified in eight patients (5.8%), five of whom were characterized as GGOs in lungs. 2019-nCoV nuclear acid testing was performed in three patients and the results were negative. One case was a 66-year-old man diagnosed as non-Hodgkin lymphoma and underwent CHOP chemotherapy regimen. His chest CT scan image displayed multiple GGOs in lungs and the complete blood count showed decreased lymphocytes. This patient denied any contact with confirmed/suspected cases of 2019-nCoV infection and without fever and other respiratory symptoms. Considering the negative result of nuclear acid testing, this patient was presumptively diagnosed as viral pneumonia and an experiential anti-infection treatment had been prescribed for him. Conclusions: The 2019 novel coronavirus disease (COVID-19) complicates the clinical scenario of pulmonary infiltrates in cancer patients. The epidemic history, clinical manifestation, CT scan image and lab test should be combined consideration. The 2019-nCoV nuclear acid testing might be applicated in more selected patients. Active anti-infection treatment and surveillance of patient condition should be initiated if infectious disease is considered.
FULL TEXT LINK
http://dx.doi.org/10.3760/cma.j.cn112152-20200303-00166

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