2021-03-15

School of Medicine, University of California, San Diego, La Jolla, California, USA.; School of Medicine, University of California, San Diego, La Jolla, California, USA.; Simulation Training Center, University of California, San Diego, La Jolla, California, USA.; Department of NanoEngineering, University of California, San Diego, La Jolla, California, USA.; Department of NanoEngineering, University of California, San Diego, La Jolla, California, USA.; Viterbi Family Department of Ophthalmology, Shiley Eye Institute, University of California, San Diego, La Jolla, California, USA. Electronic address: dlchao@ucsd.edu.

PURPOSE: The global COVID-19 pandemic has resulted in a renewed focus on the importance of personal protective equipment (PPE) and other interventions to decrease spread of infectious diseases. Although several ophthalmology organizations have released guidance on appropriate PPE for surgical procedures and ophthalmology clinics, there is limited experimental evidence that demonstrates the efficacy of various interventions that have been suggested. In this study, we evaluated high-risk aspects of the slit-lamp exam and the effect of various PPE interventions, specifically the use of a surgical mask and a slit-lamp shield. DESIGN: Experimental simulation study. METHODS: This was a single-center study in a patient simulation population. This study examined the presence of particles in the air near or on a slit-lamp, a simulated slit-lamp examiner, or a simulated patient using a fluorescent surrogate of respiratory droplets. RESULTS: Simulated coughing without a mask or slit-lamp shield

2021-09-21

Division of Cardiology, Virginia Commonwealth University, Richmond, VA, United States of America. Electronic address: Antonio.abbate@vcuhealth.org.; Allergy, Immunology and Rheumatology, Virginia Commonwealth University, Richmond, VA, United States of America.; Allergy, Immunology and Rheumatology, Virginia Commonwealth University, Richmond, VA, United States of America.; Anesthesiology, Virginia Commonwealth University, Richmond, VA, United States of America.; Anesthesiology, Virginia Commonwealth University, Richmond, VA, United States of America.; Cardiothoracic Surgery, Virginia Commonwealth University, Richmond, VA, United States of America.; Infectious Disease - Virginia Commonwealth University, Richmond, VA, United States of America.; Division of Cardiology, Virginia Commonwealth University, Richmond, VA, United States of America.; Allergy, Immunology and Rheumatology, Virginia Commonwealth University, Richmond, VA, United States of America.; Allergy, Immunology and Rheumatology, Virginia Commonwealth University, Richmond, VA, United States of America. Electronic address: Stamatina.danielides@vcuhealth.org.

Immune-mediated myocardial injury following Severe Acute Respiratory Syndrome Coronavirys-2 (SARS-CoV2) infection has been described in adults and children. Cases of myocarditis following immunization for SARS-CoV2 have recently been documented, mostly associated with mild severity and spontaneous recovery. We herein report two cases of fulminant myocarditis following BNT162b2 mRNA Covid-19 vaccination associated with systemic hyperinflammatory syndrome and refractory shock requiring support with veno-arterial extracorporeal membrane oxygenation.CI - Copyright © 2021 Elsevier B.V. All rights reserved.

2021-03-17

Zeeman Institute (SBIDER), University of Warwick, Mathematical Sciences Building, Gibbet Hill Road, Coventry, CV4 7AL, UK.; Department of Epidemiology and Public Health, Swiss Tropical and Public Health Institute, Socinstrasse 57, Postfach, CH-4002 Basel, Switzerland.; Zeeman Institute (SBIDER), University of Warwick, Mathematical Sciences Building, Gibbet Hill Road, Coventry, CV4 7AL, UK.; Department of Statistics, University of Warwick, Mathematical Sciences Building, Gibbet Hill Road, Coventry, CV4 7AL, UK.; Programme National de lutte contre la THA (PNLTHA), Kinshasa 2, Democratic Republic of the Congo.; Department of Statistics, University of Warwick, Mathematical Sciences Building, Gibbet Hill Road, Coventry, CV4 7AL, UK.; Zeeman Institute (SBIDER), University of Warwick, Mathematical Sciences Building, Gibbet Hill Road, Coventry, CV4 7AL, UK.; Department of Epidemiology and Public Health, Swiss Tropical and Public Health Institute, Socinstrasse 57, Postfach, CH-4002 Basel, Switzerland.; Zeeman Institute (SBIDER), University of Warwick, Mathematical Sciences Building, Gibbet Hill Road, Coventry, CV4 7AL, UK.

Many control programmes against neglected tropical diseases have been interrupted due to the coronavirus disease 2019 (COVID-19) pandemic, including those that rely on active case finding. In this study we focus on gambiense human African trypanosomiasis (gHAT), where active screening was suspended in the Democratic Republic of Congo (DRC) due to the pandemic. We use two independent mathematical models to predict the impact of COVID-19 interruptions on transmission and reporting and achievement of the 2030 elimination of transmission (EOT) goal for gHAT in two moderate-risk regions of the DRC. We consider different interruption scenarios, including reduced passive surveillance in fixed health facilities, and whether this suspension lasts until the end of 2020 or 2021. Our models predict an increase in the number of new infections in the interruption period only if both active screening and passive surveillance were suspended, and with a slowed reduction-but no increase-if passive

2021-03-14

Department of Neurology, Henry Ford Hospital, Detroit, Michigan, USA; Wayne State University, School of Medicine, Detroit, Michigan, USA. Electronic address: AMEMON2@hfhs.org.; Department of Neurology, Henry Ford Hospital, Detroit, Michigan, USA.; Department of Radiology, Henry Ford Hospital, Detroit, Michigan, USA; Wayne State University, School of Medicine, Detroit, Michigan, USA.; Department of Neurology, Henry Ford Hospital, Detroit, Michigan, USA; Wayne State University, School of Medicine, Detroit, Michigan, USA.; Department of Neurology, Henry Ford Hospital, Detroit, Michigan, USA.; Department of Neurology, Henry Ford Hospital, Detroit, Michigan, USA.; Department of Neurology, Henry Ford Hospital, Detroit, Michigan, USA.; Department of Radiology, Henry Ford Hospital, Detroit, Michigan, USA; Wayne State University, School of Medicine, Detroit, Michigan, USA.

Department of Drug Discovery and Development, Auburn University Harrison School of Pharmacy, Auburn, AL 36849, USA.; Department of Drug Discovery and Development, Auburn University Harrison School of Pharmacy, Auburn, AL 36849, USA.; Department of Drug Discovery and Development, Auburn University Harrison School of Pharmacy, Auburn, AL 36849, USA.; Department of Drug Discovery and Development, Auburn University Harrison School of Pharmacy, Auburn, AL 36849, USA.; Department of Internal Medicine, Ramaiah Medical College and Hospital, Bengaluru 560054, Karnataka, India.; Department of Neuroscience, Middlebury College, Middlebury, VT 05753, USA.; Department of Drug Discovery and Development, Auburn University Harrison School of Pharmacy, Auburn, AL 36849, USA.; Department of Drug Discovery and Development, Auburn University Harrison School of Pharmacy, Auburn, AL 36849, USA.; Department of Drug Discovery and Development, Auburn University Harrison School of Pharmacy, Auburn, AL 36849, USA.; Department of Drug Discovery and Development, Auburn University Harrison School of Pharmacy, Auburn, AL 36849, USA.

The widespread increase in multiple severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) variants is causing a significant health concern in the United States and worldwide. These variants exhibit increased transmissibility, cause more severe disease, exhibit evasive immune properties, impair neutralization by antibodies from vaccinated individuals or convalescence sera, and reinfection. The Centers for Disease Control and Prevention (CDC) has classified SARS-CoV-2 variants into variants of interest, variants of concern, and variants of high consequence. Currently, four variants of concern (B.1.1.7, B.1.351, P.1, and B.1.617.2) and several variants of interests (B.1.526, B.1.525, and P.2) are characterized and are essential for close monitoring. In this review, we discuss the different SARS-CoV-2 variants, emphasizing variants of concern circulating the world and highlight the various mutations and how these mutations affect the characteristics of the virus. In addition, we

2021-08-12

Department of Infectious Diseases, Northwick Park Hospital, London North West University Healthcare NHS Trust, Harrow, UK.; Department of Acute Medicine, Northwick Park Hospital, London North West University Healthcare NHS Trust, Harrow, UK.; School of Medicine, Imperial College London, London, UK.; School of Medicine, Imperial College London, London, UK.; School of Medicine, Imperial College London, London, UK.; School of Medicine, Imperial College London, London, UK.; School of Medicine, Imperial College London, London, UK.; Department of Infectious Diseases, Northwick Park Hospital, London North West University Healthcare NHS Trust, Harrow, UK.; Transformation Programme Director, London North West University Healthcare NHS Trust, London, UK.; Emergency Department, Northwick Park Hospital, London North West University Healthcare NHS Trust, Harrow, UK.; Department of Pathology, Northwick Park Hospital, London North West University Healthcare NHS Trust, Harrow, UK.; Department of Acute Medicine, Northwick Park Hospital, London North West University Healthcare NHS Trust, Harrow, UK.; Department of Microbiology, Northwick Park Hospital, London North West University Healthcare NHS Trust, Harrow, UK.; Department of Medicine, Imperial College London, London, UK.; Department of Microbiology, Northwick Park Hospital, London North West University Healthcare NHS Trust, Harrow, UK.; Institute for Global Health, University College London, London, UK a.gupta-wright@ucl.ac.uk.; Clinical Research Department, London School of Hygiene & Tropical Medicine, London, UK.; Department of Infectious Diseases, Northwick Park Hospital, London North West University Healthcare NHS Trust, Harrow, UK.

OBJECTIVE: To evaluate a triage algorithm used to identify and isolate patients with suspected COVID-19 among medical patients needing admission to hospital using simple clinical criteria and the FebriDx assay. DESIGN: Retrospective observational cohort. SETTING: Large acute National Health Service hospital in London, UK. PARTICIPANTS: All medical admissions from the emergency department between 10 August 2020 and 4 November 2020 with a valid SARS-CoV-2 RT-PCR result. INTERVENTIONS: Medical admissions were triaged as likely, possible or unlikely COVID-19 based on clinical criteria. Patients triaged as possible COVID-19 underwent FebriDx lateral flow assay on capillary blood, and those positive for myxovirus resistance protein A (a host response protein) were managed as likely COVID-19. PRIMARY OUTCOME MEASURES: Diagnostic accuracy (sensitivity, specificity and predictive values) of the algorithm and the FebriDx assay using SARS-CoV-2 RT-PCR from nasopharyngeal swabs as the reference

2021-03-09

Department of Internal Medicine, Yuma Regional Medicine, Yuma, AZ, USA.; Department of Internal Medicine, Medical University of South Carolina, Charleston, SC, USA.; Department of Internal Medicine, Abrazo Central Campus, Phoenix, AZ, USA.; American University of Antigua, Jabberwock Road, Osbourn, Antigua & Barbuda, USA.; Department of Neurosciences and Internal Medicine, University of California School of Medicine, San Diego, CA, USA.; Department of Internal Medicine, Larkin Community Hospital, FL, USA.; Department of Internal Medicine and Cardiology, University of Illinois, Chicago, IL, USA.; Department of Internal Medicine, Loyola University, Chicago, IL, USA.; Department of Internal Medicine, Swedish Covenant Hospital, Chicago, IL, USA.; Department of Internal Medicine, Jackson Park Hospital, Chicago, IL, USA.; Department of Internal Medicine, Hackensack Ocean Medical Center, Brick Township, NJ, USA.; Clinical Research Program, Icahn School of Medicine at Mount Sinai, New York City, NY, USA.; Department of Internal Medicine, Medical University of South Carolina, Charleston, SC, USA.; Department of Internal Medicine, Geisinger Commonwealth School of Medicine, Scranton, PA, USA.; Department of Public Health, Icahn School of Medicine at Mount Sinai, New York City, NY, USA.; Department of Public Health, Icahn School of Medicine at Mount Sinai, New York City, NY, USA. Electronic address: pmalik.ma@gmail.com.

INTRODUCTION AND OBJECTIVES: The coronavirus disease 2019 (COVID-19) pandemic has been a challenge globally. In severe acute respiratory syndrome (SARS) epidemic 60% of patients had hepatic injury, due to phylogenetic similarities of the viruses it is assumed that COVID-19 is associated with acute liver injury. In this meta-analysis, we aim to study the occurrence and association of liver injury, comorbid liver disease and elevated liver enzymes in COVID-19 confirmed hospitalizations with outcomes. MATERIALS AND METHODS: Data from observational studies describing comorbid chronic liver disease, acute liver injury, elevated aspartate aminotransferase (AST), alanine aminotransferase (ALT) levels and outcomes of COVID-19 hospitalized patients from December 1, 2019, to June 30, 2020 was extracted following PRISMA guidelines. Adverse outcomes were defined as admission to intensive care unit (ICU), oxygen saturation <90%, invasive mechanical ventilation (IMV), severe disease and in-hospital

2021-12-12

National Influenza Center of Cambodia, Virology Unit, Institut Pasteur du Cambodgegrid.418537.c, Phnom Penh, Cambodia.; School of Public Health, LKS Faculty of Medicine, The University of Hong Kong, Hong Kong, China.; HKU-Pasteur Research Pole, School of Public Health, LKS Faculty of Medicine, The University of Hong Kong, Hong Kong, China.; School of Public Health, LKS Faculty of Medicine, The University of Hong Kong, Hong Kong, China.; HKU-Pasteur Research Pole, School of Public Health, LKS Faculty of Medicine, The University of Hong Kong, Hong Kong, China.; World Health Organization Collaborating Center, Victorian Infectious Diseases Reference Laboratory, Peter Doherty Institute for Infection and Immunity, Melbourne, Australia.; World Health Organization Country Office, Phnom Penh, Cambodia.; World Health Organization Country Office, Phnom Penh, Cambodia.; World Health Organization Collaborating Center, Victorian Infectious Diseases Reference Laboratory, Peter Doherty Institute for Infection and Immunity, Melbourne, Australia.; World Health Organization Collaborating Center, Victorian Infectious Diseases Reference Laboratory, Peter Doherty Institute for Infection and Immunity, Melbourne, Australia.; World Health Organization Collaborating Center, Victorian Infectious Diseases Reference Laboratory, Peter Doherty Institute for Infection and Immunity, Melbourne, Australia.; U.S. Centers for Disease Control and Preventiongrid.416738.f, Phnom Penh, Cambodia.; National Institute of Public Health, Ministry of Health, Phnom Penh, Cambodia.; Centers for Disease Control and Preventiongrid.416738.f, Ministry of Health, Phnom Penh, Cambodia.; World Health Organization Country Office, Phnom Penh, Cambodia.; U.S. Centers for Disease Control and Preventiongrid.416738.f, Phnom Penh, Cambodia.; National Institute of Public Health, Ministry of Health, Phnom Penh, Cambodia.; World Health Organization Country Office, Phnom Penh, Cambodia.; National Influenza Center of Cambodia, Virology Unit, Institut Pasteur du Cambodgegrid.418537.c, Phnom Penh, Cambodia.; Centers for Disease Control and Preventiongrid.416738.f, Ministry of Health, Phnom Penh, Cambodia.; World Health Organization Collaborating Center, Victorian Infectious Diseases Reference Laboratory, Peter Doherty Institute for Infection and Immunity, Melbourne, Australia.; National Influenza Center of Cambodia, Virology Unit, Institut Pasteur du Cambodgegrid.418537.c, Phnom Penh, Cambodia.

Introduction of non-pharmaceutical interventions to control COVID-19 in early 2020 coincided with a global decrease in active influenza circulation. However, between July and November 2020, an influenza A(H3N2) epidemic occurred in Cambodia and in other neighboring countries in the Greater Mekong Subregion in Southeast Asia. We characterized the genetic and antigenic evolution of A(H3N2) in Cambodia and found that the 2020 epidemic comprised genetically and antigenically similar viruses of Clade3C2a1b/131K/94N, but they were distinct from the WHO recommended influenza A(H3N2) vaccine virus components for 2020-2021 Northern Hemisphere season. Phylogenetic analysis revealed multiple virus migration events between Cambodia and bordering countries, with Laos PDR and Vietnam also reporting similar A(H3N2) epidemics immediately following the Cambodia outbreak: however, there was limited circulation of these viruses elsewhere globally. In February 2021, a virus from the Cambodian outbreak

2021-04-26

Department of Radiology, Columbia University Irving Medical Center, 622 W 168th Street, New York, NY 10032. Electronic address: kmc9020@nyp.org.; Department of Radiology, Columbia University Irving Medical Center, 622 W 168th Street, New York, NY 10032.; Department of Radiology, Columbia University Irving Medical Center, 622 W 168th Street, New York, NY 10032.; Department of Radiology, Columbia University Irving Medical Center, 622 W 168th Street, New York, NY 10032.; Department of Radiology, Columbia University Irving Medical Center, 622 W 168th Street, New York, NY 10032.; Department of Radiology, Columbia University Irving Medical Center, 622 W 168th Street, New York, NY 10032.; Department of Radiology, Columbia University Irving Medical Center, 622 W 168th Street, New York, NY 10032.; Department of Radiology, Columbia University Irving Medical Center, 622 W 168th Street, New York, NY 10032.; Department of Radiology, Columbia University Irving Medical Center, 622 W 168th Street, New York, NY 10032.; Department of Radiology, Columbia University Irving Medical Center, 622 W 168th Street, New York, NY 10032.; Department of Radiology, Columbia University Irving Medical Center, 622 W 168th Street, New York, NY 10032.; Department of Radiology, Columbia University Irving Medical Center, 622 W 168th Street, New York, NY 10032.; Department of Radiology, Columbia University Irving Medical Center, 622 W 168th Street, New York, NY 10032.; Department of Radiology, Columbia University Irving Medical Center, 622 W 168th Street, New York, NY 10032.; Department of Radiology, Columbia University Irving Medical Center, 622 W 168th Street, New York, NY 10032.; Department of Radiology, Columbia University Irving Medical Center, 622 W 168th Street, New York, NY 10032.; Department of Radiology, Columbia University Irving Medical Center, 622 W 168th Street, New York, NY 10032.

BACKGROUND: COVID-19 commonly presents with upper respiratory symptoms; however, studies have shown that SARS-CoV-2 infection affects multiple organ systems. Here, we review the pathophysiology and imaging characteristics of SARS-CoV-2 infection in organ systems throughout the body and explore commonalities. OBJECTIVE: Familiarity with the underlying pathophysiology and imaging characteristics is essential for the radiologist to recognize these findings in patients with COVID-19 infection. Though pulmonary findings are the most prevalent presentation, COVID-19 may have multiple manifestations and recognition of the extrapulmonary manifestations is especially important because of the potential serious and long-term effects of COVID-19 on multiple organ systems.CI - Copyright © 2021. Published by Elsevier Inc.

2021-09-28

Zydus Hospital, Ahmedabad, Gujarat, India.; Department of ENT, GCS Medical College, Ahmedabad, India.; Zydus Hospital, Ahmedabad, Gujarat, India.; Department of Neurology, Ramkrishna Care Hospitals, Raipur, India.; Department of Neurology, Max Hospital, New Delhi, India.; Zydus Hospital, Ahmedabad, Gujarat, India.; Zydus Hospital, Ahmedabad, Gujarat, India.; Zydus Hospital, Ahmedabad, Gujarat, India.; Zydus Hospital, Ahmedabad, Gujarat, India.; Zydus Hospital, Ahmedabad, Gujarat, India.; Zydus Hospital, Ahmedabad, Gujarat, India.; Zydus Hospital, Ahmedabad, Gujarat, India.; Zydus Hospital, Ahmedabad, Gujarat, India.; Zydus Hospital, Ahmedabad, Gujarat, India.; Zydus Hospital, Ahmedabad, Gujarat, India.; Department of Neurology, Ramkrishna Care Hospitals, Raipur, India.; Zydus Hospital, Ahmedabad, Gujarat, India.; Department of Neurology, Ramkrishna Care Hospitals, Raipur, India.; Department of Neurology, Ramkrishna Care Hospitals, Raipur, India.; Department of Neurology, Ramkrishna Care Hospitals, Raipur, India.; Department of Neurology, Ramkrishna Care Hospitals, Raipur, India.; BJ Medical College and Civil Hospital, Ahmedabad, India.; Division of Neurology, Department of Medicine, National University Hospital and Yong Loo Lin School of Medicine, National University of Singapore, Singapore.; Zydus Hospital, Ahmedabad, Gujarat, India.; Division of Neurology, Department of Medicine, National University Hospital and Yong Loo Lin School of Medicine, National University of Singapore, Singapore.; Division of Neurology, Department of Medicine, National University Hospital and Yong Loo Lin School of Medicine, National University of Singapore, Singapore.

IMPORTANCE: Coronavirus disease (COVID-19) causes an immunosuppressed state and increases risk of secondary infections like mucormycosis. We evaluated clinical features, predisposing factors, diagnosis and outcomes for mucormycosis among patients with COVID-19 infection. METHODS: This prospective, observational, multi-centre study included 47 consecutive patients with mucormycosis, diagnosed during their course of COVID-19 illness, between January 3 and March 27, 2021. Data regarding demography, underlying medical conditions, COVID-19 illness and treatment were collected. Clinical presentations of mucormycosis, imaging and biochemical characteristics and outcome were recorded. RESULTS: Of the 2567 COVID-19 patients admitted to 3 tertiary centres, 47 (1.8%) were diagnosed with mucormycosis. Mean age was 55 ± 12.8years, and majority suffered from diabetes mellitus (n = 36, 76.6%). Most were not COVID-19 vaccinated (n = 31, 66.0%) and majority (n = 43, 91.5%) had developed