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Carmela Schwartz, , Carole Slama, Shmuel Benenson, Adiel Cohen, Ayelet Favor, Ilana Gross, Shahar Luski, Miriam Ottolenghi, Elchanan Parnasa, et al.
Open Forum Infectious Diseases; doi:10.1093/ofid/ofaa384

Abstract:
Background During the corona virus disease (COVID-19) epidemic, many healthcare workers (HCWs) were exposed to infected persons, leading to suspension from work. We describe a dynamic response to exposures of HCWs at the Hadassah Hospital, Jerusalem, to minimize the need for suspension from work. Methods We performed an epidemiological investigation following each exposure to a newly diagnosed COVID-19 patient or HCW; close contacts were suspended from work. During the course of the epidemic, we adjusted our isolation criteria according to the timing of exposure related to symptoms onset, use of personal protective equipment and duration of exposure. In parallel, we introduced universal masking and performed periodic SARS-CoV-2 screening for all hospital personnel. We analyzed the number of HCWs suspended weekly from work and those who subsequently acquired infection. Results In the 51 investigations conducted during March-May 2020, we interviewed 1095 HCWs and suspended 400 (37%) from work, most of them, 251 (63%), during the first two weeks of the outbreak. The median duration of exposure was 30 minutes (IQR, 15-120). Only 5/400 (1.3%) developed infection, all in the first two weeks of the epidemic. After introduction of universal masking and despite loosening the isolation criteria, none of the exposed HCWs developed COVID-19. Conclusions Relatively short exposures of HCWs, even if only either the worker or the patient wore a mask, probably poses a very low risk for infection. This allows us to perform strict follow-up of exposed HCWs in these exposures, combined with repeated testing, instead of suspension from work.
, , Hisatomo Ikehara, Ryoji Ichijima, Chika Kusano
Journal of Gastroenterology and Hepatology; doi:10.1111/jgh.15219

Abstract:
Background and Aim Minimizing endoscopist exposure to bodily fluids is important for reducing the risk of infection transmission. This study investigated the patient‐endoscopist vertical distance necessary to minimize an endoscopist's facial exposure to a patient's visible droplets during upper gastrointestinal endoscopy and the ability of a new device to prevent droplets from reaching the endoscopist's face. Methods A model was developed to simulate a patient experiencing a forceful cough during an upper gastrointestinal endoscopy with a model endoscopist. Fluorescent dye was expelled from the model patient's mouth towards the model endoscopist during simulated coughs; dye adhesion to the model endoscopist's face was evaluated using ultraviolet light. The simulation was repeated with the model patient positioned 70–100 cm above the floor, with and without a barrier to shield the patient's face. The accuracy of the cough simulation model and the relationship between patient‐endoscopist vertical distance and endoscopist's facial exposure were evaluated. Results The flow dynamics of the cough simulation model were similar to that of an actual human cough. There was a significant inverse correlation between the patient‐endoscopist vertical distance and the model endoscopist's facial exposure, with positive exposures decreasing from 87% at 70 cm to 0% at 100 cm (P < 0.001). The barrier device prevented facial exposure to droplets at all distances. Conclusions We found that positioning the patient at least 100 cm below the top of the endoscopist's head or using a barrier device minimized the endoscopist's facial exposure to visible droplets during upper gastrointestinal endoscopy.
, Andrea Vergara-Buenaventura
Journal of International Society of Preventive and Community Dentistry, Volume 10, pp 681-685; doi:10.4103/jispcd.jispcd_304_20

Abstract:
Objectives: Patients are mask-free during dental attention. In addition, dentists and dental staff after working for hours need to hydrate or eat. Removing the mask makes them vulnerable to the risk of contamination. For those cases, a prophylactic decontamination protocol could be useful as an adjunct to the most recommended biosecurity protocols. This article aims to provide a comprehensive review of the published evidence about the use of povidone–iodine (PVP-I) against SARS-CoV-2 and to propose a prophylactic protocol for dental attention using PVP-I during the COVID-19 pandemic. Materials and Methods: An electronic search in Medline via PubMed, Scopus, Cochrane Library and Scielo databases was performed up to July 24, 2020, to identify relevant literature focusing on Povidone Iodine, SARS-CoV-2, COVID-19, SARS-COV, MERS, antiviral mouthwashes, and oral cavity. Results: Clinical studies on the virucidal effectiveness of PVP-I against SARS‐CoV‐2 have not yet been reported. We identify a recent in vitro study showing PVP-I effectiveness at 0.5, 1, and 1.5% within 15s of contact. Moreover, another in vitro study has shown ≥99.99% virucidal activity as 1% mouthwash and 0.45% throat spray. The only study in SARS-CoV-2 confirmed patients reported a significant 3h drop in viral load after rinsing with 15 mL of 1% PVP-I for 1min. Conclusions: Although no clinical trials have reported the efficacy of PVP-I on SARS-CoV-2, recent studies in patients with positive PCR to SARS-CoV-2 found a significant 3-h drop in viral load. We believe that an oral prophylactic protocol with PVP-I for dental healthcare workers and patients as an adjunct to the current biosecurity protocol could minimize the transmission risk during COVID-19 pandemic.
PDA Journal of Pharmaceutical Science and Technology, Volume 74, pp 468-494; doi:10.5731/pdajpst.2020.012021

The publisher has not yet granted permission to display this abstract.
, Valerie Shiwen Yang, Shuting Han, Qingyuan Zhuang, Gideon Ooi, Iris Huili Sin, Gail Wan Ying Chua, Si Ying Tan, Claramae Shulyn Chia, Veronique Kiak-Mien Tan, et al.
Published: 1 September 2020
Journal of Cancer Policy, Volume 25, pp 100241-100241; doi:10.1016/j.jcpo.2020.100241

The publisher has not yet granted permission to display this abstract.
, Simone Bianco, Ira B. Schwartz
Published: 6 January 2021
PLOS ONE, Volume 16; doi:10.1371/journal.pone.0244706

Abstract:
Without vaccines and treatments, societies must rely on non-pharmaceutical intervention strategies to control the spread of emerging diseases such as COVID-19. Though complete lockdown is epidemiologically effective, because it eliminates infectious contacts, it comes with significant costs. Several recent studies have suggested that a plausible compromise strategy for minimizing epidemic risk is periodic closure, in which populations oscillate between wide-spread social restrictions and relaxation. However, no underlying theory has been proposed to predict and explain optimal closure periods as a function of epidemiological and social parameters. In this work we develop such an analytical theory for SEIR-like model diseases, showing how characteristic closure periods emerge that minimize the total outbreak, and increase predictably with the reproductive number and incubation periods of a disease– as long as both are within predictable limits. Using our approach we demonstrate a sweet-spot effect in which optimal periodic closure is maximally effective for diseases with similar incubation and recovery periods. Our results compare well to numerical simulations, including in COVID-19 models where infectivity and recovery show significant variation.
Natalie Neu, Maricris Nee, Joseph Savitt, Laura Schneider Connelly, JieSue Choi, Linda Mosiello
Journal of the Pediatric Infectious Diseases Society, Volume 9, pp 626-629; doi:10.1093/jpids/piaa122

The publisher has not yet granted permission to display this abstract.
Junwei Ding, Chuck Wah Yu, Shi-Jie Cao
Published: 21 October 2020
Indoor and Built Environment; doi:10.1177/1420326x20951968

The publisher has not yet granted permission to display this abstract.
, , Emanuele Cerruto, Erdogan Nohuz
European Journal of Obstetrics & Gynecology and Reproductive Biology, Volume 255, pp 63-66; doi:10.1016/j.ejogrb.2020.10.011

Abstract:
Several societies have raised the risk of viral transmission of SARS-Cov-2 due to surgical smoke during laparoscopic procedures in infected patients. We propose to discuss this issue and to describe specific measures during laparoscopic procedures and a new homemade closed filtration system for smoke evacuation. Since the outbreak of COVID-19, performing a laparoscopy should meet multi-modal requirements. Surgical smoke evacuation device may be an effective tool in reducing exposure to surgical smoke and aerosols.
Saurabh RamBihariLal Shrivastava, Prateek Saurabh Shrivastava
Published: 1 January 2020
Medical Journal of Babylon, Volume 17; doi:10.4103/mjbl.mjbl_35_20

The publisher has not yet granted permission to display this abstract.
Ivan Pedrosa, Travis Browning, Jeannie K. Kwon, Michael Morriss, Lacy Matsler, Marco C. Pinho, Daniel Lamus, Anil Pillai, Sweta Patel Karow, Jon Garinn, et al.
Journal of Computer Assisted Tomography, Volume 44, pp 479-484; doi:10.1097/rct.0000000000001040

The publisher has not yet granted permission to display this abstract.
Saurabh RamBihariLal Shrivastava, Prateek Saurabh Shrivastava
Published: 1 January 2020
Matrix Science Medica, Volume 4; doi:10.4103/mtsm.mtsm_15_20

The publisher has not yet granted permission to display this abstract.
, Jonathan Rosen, Robert Harrison
Annals of Work Exposures and Health, Volume 65, pp 53-62; doi:10.1093/annweh/wxaa083

The publisher has not yet granted permission to display this abstract.
Sameh Hany Emile, Hytham K. S. Hamid
Minimally Invasive Therapy & Allied Technologies pp 1-7; doi:10.1080/13645706.2020.1838549

The publisher has not yet granted permission to display this abstract.
Published: 25 August 2020
by Wiley
Pediatric Pulmonology, Volume 55, pp 2877-2882; doi:10.1002/ppul.25041

Abstract:
Coronavirus (SARS‐CoV‐2) outbreak leading to the coronavirus disease (Covid‐19) has become a global pandemic. Patients with Cystic Fibrosis (CF) are considered of major risk, as respiratory tract infections are more severe than in the general population, with a higher risk of complications and a negative impact on lung function. The performance of physical exercise is considered as key for its well‐known general benefits and also as a complementary method to help airway clearance. Therefore, physical exercise is also considered as key in the therapeutic strategy during the quarantine period. However, the impossibility to perform exercise with appropriate prescription and monitoring is of considerable worry to health care professionals. Thus, alternative strategies, such as online measures to monitor this therapy and, consequently, to achieve a safe and effective dose is highly needed. Exercise regimens should include strength and endurance, as well as balance and flexibility exercises. Patients are highly encouraged to participate in exercise programs to maintain fitness and exercise should be continued during the quarantine period. This commentary provides a summary of the main effects and benefits of physical exercise, as well as the main recommendations for its adequate execution, including exercise modality, frequency, intensity and volume. This article is protected by copyright. All rights reserved.
Yan Li, Junhua Wu, Sihua Wang, Xiang Li, Junjie Zhou, Bo Huang, Danju Luo, Qin Cao, Yajun Chen, Shuo Chen, et al.
Published: 14 September 2020
by Wiley
Histopathology, Volume 78, pp 542-555; doi:10.1111/his.14249

Abstract:
Aims Coronavirus Disease 2019 (COVID‐19) caused by Severe Acute Respiratory Syndrome Coronavirus ‐2 (SARS‐CoV‐2) infection has been deemed as a global pandemic by World Health Organization. While diffuse alveolar damage (DAD) is recognized to be the primary manifestation COVID‐19 pneumonia, there has been little emphasis on the progression to the fibrosing phase of DAD. This topic is of great interest due to growing concerns regarding the potential long‐term complications in prolonged survivors. Methods Here we report a detailed histopathologic study of thirty autopsy cases with COVID‐19 virus infection, based on minimally invasive autopsies performed between February to March, 2020. Results The mean age was 69 years, with twenty (67%) males and 10 (33%) females and frequent (70.0%) underlying comorbidities. The duration of illness ranged from 16 to 82 (median=42) days. Histologically, the most common manifestation was diffuse alveolar damage (DAD) in 28 (93.3%) cases which showed predominantly acute (32%), organizing (25%), and/or fibrosing (43%) patterns. Patients with fibrosing DAD were one decade younger (p=0.034) and they had a longer duration of illness (p=0.033), hospitalization (p=0.037) and mechanical ventilation (p=0.014) compared to those with acute DAD. Patients with organizing DAD had a longer duration of illness (p=0.032) and hospitalization (p=0.023) compared to those with acute DAD. Conclusions COVID‐19 pneumonia patients who develop DAD can progress to the fibrosing pattern. While we observed fibrosing DAD in fatal cases, whether surviving patients are at risk for developing pulmonary fibrosis and the frequency of this complication will require further clinical and radiologic follow‐up studies.
Bhanu P. Lakhani, Apoorva Sharma, Varun Sanwalka, Pulkit Lakhani
European Journal of Medical and Health Sciences, Volume 2; doi:10.24018/ejmed.2020.2.3.294

Abstract:
— Introduction: The challenging times of COVID 19 pandemic pose a greater risk to dental professionals and patients. Since the worldwide outbreak, dental offices have been advised to disrupt regular functioning. Aim and Objective: This article aims to discuss measures of infection prevention and control, special procedural recommendations to minimize disease transmission while reducing aerosol generation, surface disinfection and careful waste management to assist dental offices to limit the risk of COVID 19. Conclusion: Adhering to the principles of infection control and non-aerosol generating practices in dental office could help control disease transmission, keeping the dental professionals and the patients safe.
, , Aseel Hamandosh, Eliandro Barbosa De Aguiar, Antonio Carlos Guerra Filho,
Brazilian Archives of Biology and Technology, Volume 63; doi:10.1590/1678-4324-2020200335

Abstract:
The spread of Coronavirus is causing in the society all around the world a considerable degree of fear, worry and concern and particularly among healthcare workers that are at increased risk for infection. This paper gathers the strategy/guidelines to reduce the contamination in Intensive care unit (ICU) and in allthe hospital environment. The ASHRAE and REHVA guidelines applied the UV-C Lamps, Pressure control filtration, Restroom actions and Humidity control to reduce the coronavirus disease (Covid-19) in ICU. The role of infection control in the design of hospitals is increasing every day. This paper highlights the role of heating, ventilating and air-conditioning minimizing the risk of infection from airborne transmission within the built environment through the application of best practices.
Ahmed Abulwefa
Khalij-Libya Journal of Dental and Medical Research pp 4-7; doi:10.47705/kjdmr.204102

Abstract:
The recent spread of COVID-19 infection and its associated disease has gripped the entire international community and caused widespread public health concerns. Despite global efforts to contain the disease spread, the outbreak is still on a rise because of the community spread pattern of this infection. Responsible behavior of dentists, aimed at stopping the spread of the virus from dental offices showed that only emergency procedures were to be performed, in cases of toothache, trauma and odontogenic infections that might put organs or systems at risk. At the same time, with the cessation of all types of treatments, there was an immediate cessation of teaching processes in all university settings for dental medicine, since the data from World Health Organization strongly suggested death rates among doctors and students in close contact with infected persons. Guidelines for minimizing risk of COVID-19 transmission in dental clinics have been fabricated together with responsible behavior in dental medicine; will result with a staged inclusion of teachers, students, researchers and clinicians in everyday work. While we are expecting an efficient vaccine, the only way to counter the virus are epidemiological measures and responsible behavior of every individual, in order to stop the spread of COVID-19 virus.
Jasper Seth Yao, Joseph Alexander Paguio, Edward Christopher Dee, Hanna Clementine Tan, Achintya Moulick, Carmelo Milazzo, Jerry Jurado, Nicolás Della Penna,
Published: 1 January 2021
Chest, Volume 159, pp 108-111; doi:10.1016/j.chest.2020.06.082

Abstract:
Zinc is an investigational agent against coronavirus disease 2019 (COVID-19) and has known preventative and therapeutic roles in other infections.1US National Library of MedicineClinicalTrials.gov.https://clinicaltrials.gov/Date accessed: April 30, 2020Google Scholar, 2Skalny A. Rink L. Ajsuvakova O. et al.Zinc and respiratory tract infections: perspectives for COVID-19 (review).Int J Mol Med. 2020; 46: 17-26PubMed Google Scholar, 3Jayawardena R. Sooriyaarachchi P. Chourdakis M. Jeewandara C. Ranasinghe P. Enhancing immunity in viral infections, with special emphasis on COVID-19: a review.Diabetes Metab Syndr Clin Res Rev. 2020; 14: 367-382Crossref PubMed Scopus (39) Google Scholar Zinc deficiency is associated with lower survival among older patients with pneumonia and predisposes to other viral infections.3Jayawardena R. Sooriyaarachchi P. Chourdakis M. Jeewandara C. Ranasinghe P. Enhancing immunity in viral infections, with special emphasis on COVID-19: a review.Diabetes Metab Syndr Clin Res Rev. 2020; 14: 367-382Crossref PubMed Scopus (39) Google Scholar Established risk factors for critical COVID-19, including older age, diabetes mellitus, and cardiovascular disease, are also associated with zinc deficiency.2Skalny A. Rink L. Ajsuvakova O. et al.Zinc and respiratory tract infections: perspectives for COVID-19 (review).Int J Mol Med. 2020; 46: 17-26PubMed Google Scholar
, , , Peter Kan, , Adnan H Siddiqui, , Kenneth V Snyder, Howard Riina, Omar Tanweer, et al.
Published: 20 May 2020
by BMJ
Journal of NeuroInterventional Surgery, Volume 12, pp 643-647; doi:10.1136/neurintsurg-2020-016161

Abstract:
BackgroundInfection from the SARS-CoV-2 virus has led to the COVID-19 pandemic. Given the large number of patients affected, healthcare personnel and facility resources are stretched to the limit; however, the need for urgent and emergent neurosurgical care continues. This article describes best practices when performing neurosurgical procedures on patients with COVID-19 based on multi-institutional experiences.MethodsWe assembled neurosurgical practitioners from 13 different health systems from across the USA, including those in hot spots, to describe their practices in managing neurosurgical emergencies within the COVID-19 environment.ResultsPatients presenting with neurosurgical emergencies should be considered as persons under investigation (PUI) and thus maximal personal protective equipment (PPE) should be donned during interaction and transfer. Intubations and extubations should be done with only anesthesia staff donning maximal PPE in a negative pressure environment. Operating room (OR) staff should enter the room once the air has been cleared of particulate matter. Certain OR suites should be designated as covid ORs, thus allowing for all neurosurgical cases on covid/PUI patients to be performed in these rooms, which will require a terminal clean post procedure. Each COVID OR suite should be attached to an anteroom which is a negative pressure room with a HEPA filter, thus allowing for donning and doffing of PPE without risking contamination of clean areas.ConclusionBased on a multi-institutional collaborative effort, we describe best practices when providing neurosurgical treatment for patients with COVID-19 in order to optimize clinical care and minimize the exposure of patients and staff.
, Alan S. Kliger
Nature Reviews Nephrology, Volume 16, pp 311-313; doi:10.1038/s41581-020-0280-y

Abstract:
Patients on haemodialysis or peritoneal dialysis are likely to be at increased risk of novel coronavirus disease (COVID-19). Preventive strategies must be implemented to minimize the risk of disease transmission in dialysis facilities, including education of staff and patients, screening for COVID-19 and separation of infected or symptomatic and non-infected patients.
Saurabh Shrivastava, Prateek Shrivastava
Medicine Science | International Medical Journal, Volume 9; doi:10.5455/medscience.2020.05.077

A Ahmad, M U Rehman,
Published: 1 April 2020
The publisher has not yet granted permission to display this abstract.
Yan Leng, Ming Chen, Mengyuan Dai, Yang Wu, Shao‐Qing Lei, Kuo Yan, , ,
Published: 7 October 2020
by Wiley
Journal of Medical Virology; doi:10.1002/jmv.26584

Abstract:
The recent coronavirus disease (COVID‐19) is caused by severe acute respiratory syndrome coronavirus 2 (SARS‐CoV‐2) and has been spreading rapidly throughout the continents. The insights in how this viral disease affects general population is thus urgently needed. Diabetes mellitus is one of the leading threats for morbidity and mortality globally. Infection of coronavirus in diabetic patients may trigger acute hyperglycemia due to increased secretion of hyperglycemic hormones, extensive application of glucocorticoids to patients with severe symptoms and the potential pathogenicity of coronavirus in pancreas expressing angiotensin‐converting enzyme 2 (ACE2) This article is protected by copyright. All rights reserved.
SaurabhR Shrivastava, PrateekS Shrivastava
Published: 1 January 2020
Journal of Acute Disease, Volume 9; doi:10.4103/2221-6189.278654

Abstract:
The Coronavirus Disease-2019 (COVID-19) outbreak has become a global health emergency owing to its magnitude, attributed deaths, and its propensity to spread across the world. In-fact, owing to its quick spread across international boundaries and the resulting caseload, the disease has been declared as a Public Health Emergency of International Concern on 30 January 2020. It is worth noting that out of the 395 cases detected in other nations, 165 (41.8%) have a positive history of travel to China. As of now, the World Health Organization has not recommended for any restrictions on the travel or trade aspects, but has clearly specified that implementation of International Health Regulations should be strictly done at the airports and seaports. In conclusion, the COVID- 19 outbreak has created an alarm across the globe as the causative virus is novel in nature. However, strengthening of standard infection control practices and adoption of preventive measures for travelers can significantly minimize the threat of further transmission of the disease.
Maria Urban
Published: 16 July 2020
Abstract:
Use Taxis to minimize your chances of catching Covid-19So, Covid19 is here and as per the experts it’s not going anywhere for next 6 months or so. As the pandemic is picking strengths, experts are advising people to avoid mass gatherings and this has also triggered a significant change in our daily lifestyle.The things which were previously common are now prohibited, for instance, experts advise people to maintain social distancing even while travelling. The idea of social distances may be alien to some communities but it’s the only way we can survive this pandemic.And this has also spurred the debate that whether primary means of travelling like buses, trains, airplanes and taxis should be left intact - of course not, this would lead us to a disaster. Certain governments have taken measures to maintain social distancing during aerial flights and journeys by train, but the other left means buses and taxis are still intact..Undoubtedly, Taxi is the safest mode of travelling we currently have during this pandemic - that too with only 2 people behind and 2 in the front. If people adopt taxis as the primary means of travelling instead of buses and trains - for domestic travelling - the rate of infection can be significantly reduced.In contrast, when you travel on bus or other tightly packed transports, the risk of catching a virus gets higher. Not only can you catch the virus but you can spread the virus to hundreds of people if you unknowingly had the virus before.People coming from foreign countries, should choose taxis over other means of transportation. So, in case, if they had the virus before, at least it won’t be spread to other people. Also, social distancing measures can be best practiced inside a taxi rather than other means of transport.So, the conclusion is, taxis are the best possible transport available for airport transfer. However, finding a reliable taxi service in London is not easy, especially when you are choosing online. Slightest negligence causes you a significant amount of money.Introducing Luton Taxi Service, which is one of the best available services in the area. They ensure you every comfort. You can book online and in advance, you are pre-informed about the approximate fare of your ride. Moreover, they provide taxis in Luton 24/7, whether it's midnight or early dawn, you can call a cab or minicab at your doorstep on just one click.Likewise, if you are planning your transfer to the airport, with the help of their app you can book any cab according to your budget and confirm your timely transfer to the airport.Among Taxi companies of Luton, they are a credible name with experience of catering 1000s of airport transfers before. Not only airport transfers, but your station transfers and internal travelling can be made risk-free, budget-friendly, timely and according to the SOP’s if you choose the best Luton Taxi service.
Kartik Prabhakaran, Ryan Malcom, James Choi, Alexandra Chudner, Augustine Moscatello, Peter Panzica, Rifat Latifi, Peter Rhee
Journal of Trauma and Acute Care Surgery, Volume 89, pp 265-271; doi:10.1097/ta.0000000000002780

The publisher has not yet granted permission to display this abstract.
Sami A. Chadi, Keegan Guidolin, Antonio Caycedo-Marulanda, Abdu Sharkawy, Antonino Spinelli, Fayez A. Quereshy, Allan Okrainec
Annals of Surgery, Volume 272; doi:10.1097/sla.0000000000004010

The publisher has not yet granted permission to display this abstract.
Michael Eder, Robert Strassl, Johannes Kläger, Christof Aigner, Florian Thalhammer,
Wiener klinische Wochenschrift pp 1-2; doi:10.1007/s00508-020-01776-w

Abstract:
SummaryIn this case report we present a rare case of a patient with multiple risk factors for severe coronavirus disease (COVID 19) in whom intensive glucocorticoid treatment due to incipient nephrotic syndrome coincided with SARS-CoV‑2 infection. Despite this high baseline risk profile and the use of glucocorticoids the patient developed only mild disease including IgG SARS-CoV‑2 seroconversion.
Published: 1 September 2020
Abstract:
Background The coronavirus disease 2019 (COVID-19) pandemic raised concern for exposure to healthcare providers through aerosol generating procedures, such as bronchoalveolar lavage (BAL). Current society guidelines recommended limiting use of BAL to reduce operators’ risk for infection, yet data on the infection rate for providers after BAL is sparse. Since March 2020, our institution used a modified protocol to perform over 450 BALs on intubated COVID-19 patients. We therefore sought to describe the subsequent infectious risks to providers associated with BAL. Methods Fifty-two pulmonary and critical care providers (faculty and fellows) at our tertiary-care, urban medical center were surveyed. Survey participants were asked to provide the number of BALs on COVID-19 patients they performed, the number of weeks they cared for intensive care unit (ICU) patients with COVID-19, and the results of any SARS-CoV-2 testing that they received. Participants were asked to assess the difficulty of BAL on intubated COVID-19 patients as compared to routine ICU BAL using a numeric perceived difficulty score ranging from 1 (easier) to 10 (harder). Results We received forty-seven responses from fifty-two surveyed (90% response rate), with 2 declining to participate. Many respondents (19/45, 42%) spent >5 weeks on an ICU service with COVID-19 patients. The number of BALs performed by providers ranged from 0 to >60. Sixteen of the 35 providers (46%) who performed BALs underwent at least one nasopharyngeal (NP) swab to test for SARS-CoV-2, but none were positive. Twenty-seven of the 35 providers (77%) who performed BALs underwent SARS- CoV-2 serology testing, and only one (3.7%) was positive. Respondents indicated occasionally not being able to follow aerosol-minimizing steps but overall felt BALs in COVID-19 patients was only slightly more difficult than routine bronchoscopy. Discussion At a high-volume center having performed >450 BALs on intubated COVID-19 patients with aerosol-limiting precautions, our survey of bronchoscopists found no positive NP SARS-CoV-2 tests and only one positive antibody test result. While the optimal role for COVID-19 BAL remains to be determined, these data suggest that BAL can be safely performed in intubated COVID-19 patients if experienced providers take precautions to limit aerosol generation and wear personal protective equipment.
Chris D Meletis, Kimberly Wilkes
Published: 1 August 2020
The publisher has not yet granted permission to display this abstract.
Naoya Iwasaki, , Toru Egawa, Kazunori Yamashita, Tetsuya Hara
Published: 1 January 2020
by Wiley
Acute Medicine & Surgery, Volume 7; doi:10.1002/ams2.529

Abstract:
The rapid, global spread of coronavirus disease (COVID‐19) has overwhelmed hospital functions in many countries. To ameliorate this crisis, it is important to protect health care providers (HCPs) from COVID‐19. Many intensive care associations advocate guidelines for airway management, since COVID‐19 is considered to spread via droplets from the patient. Additionally, coughing during tracheal intubation and extubation contaminates the area surrounding the patient and increases the risk of infection to HCPs.
Jason Hindes, Simone Bianco, Ira B. Schwartz
Published: 31 July 2020
by ArXiv
Abstract:
Without vaccines and treatments, societies must rely on non-pharmaceutical intervention strategies to control the spread of emerging diseases such as COVID-19. Though complete lockdown is epidemiologically effective, because it eliminates infectious contacts, it comes with significant costs. Several recent studies have suggested that a plausible compromise strategy for minimizing epidemic risk is periodic closure, in which populations oscillate between wide-spread social restrictions and relaxation. However, no underlying theory has been proposed to predict and explain optimal closure periods as a function of epidemiological and social parameters. In this work we develop such an analytical theory for SEIR-like model diseases, showing how characteristic closure periods emerge that minimize the total outbreak, and increase predictably with the reproductive number and incubation periods of a disease, as long as both are within predictable limits. Using our approach we demonstrate a sweet-spot effect in which optimal periodic closure is maximally effective for diseases with similar incubation and recovery periods. Our results compare well to numerical simulations, including in COVID-19 models where infectivity and recovery show significant variability.
, Benjamin L. Judson, Kevin G. Billingsley, Domenico Galetta, Paul Fontanez, Craig Odermatt, Kristy Lindner, Marci R. Mitchell, Cara M. Henderson, Tracy Carafeno, et al.
Published: 1 August 2020
The Annals of Thoracic Surgery, Volume 110, pp 718-724; doi:10.1016/j.athoracsur.2020.05.003

The publisher has not yet granted permission to display this abstract.
, Jonathan-Hien Vu, Thomas F. Rehring, Peter F. Layman, Stephen P. Johnson
Journal of Vascular and Interventional Radiology, Volume 31, pp 2150-2153; doi:10.1016/j.jvir.2020.08.009

Abstract:
Patients with coronavirus disease 2019 (COVID-19) present with a wide spectrum of symptoms, but mounting experience is noted with an apparent prothrombotic state. In addition to microvascular thromboses, there are reports of macrovascular thrombotic events in critically ill patients infected with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (1Zhang Y. Xiao M. Zhang S. et al.Coagulopathy and antiphospholipid antibodies in patients with covid-19.N Engl J Med. 2020; 382: e38https://doi.org/10.1056/NEJMc2007575Crossref PubMed Scopus (571) Google Scholar,2Bellosta R. Luzzani L. Natalini G. et al.Acute limb ischemia in patients with COVID-19 pneumonia.J Vasc Surg. 2020; https://doi.org/10.1016/j.jvs.2020.04.483Abstract Full Text Full Text PDF PubMed Scopus (44) Google Scholar). However, acute limb ischemia was also seen in a patient only minimally symptomatic with SARS-CoV-2 infection and no other risk factors for embolus or thrombosis. The present case report was approved by the institutional review board.
Renata Aparecida De Almeida Monteiro, , Luiz Fernando Ferraz Da Silva, Thais Mauad, Jair Theodoro-Filho, Ilka Regina Souza De Oliveira, Paulo Hilario Do Nascimento Saldiva, Marisa Dolhnikoff
Published: 9 April 2020
Abstract:
Post mortem tissue sampling is of paramount importance to conduct in-situ and molecular studies of COVID-19. Ultrasound-based minimally invasive autopsies (MIA/US) is an inexpensive procedure to obtain tissue samples of several organs and, at the same time, reduce the risks of the autopsy procedure in situations of high contagiousness. The images obtained by ultrasound are good enough to localize and orient the sampling, and to select the most affected areas within each organ. The amount of tissue sampled is adequate for histological and molecular studies and microorganism identification, and delivers information within a rapid time window. The combination of the aforementioned aspects may extend the possibility of conducting autopsies in different parts of the world, perhaps helping to understand local characteristics of COVID-19 infections, within an extended range of genetic, social and economic diversity.
Charalampos Seretis, Lucy Archer, Lida Lalou, Shuker Yahia, Christian Katz, Iram Parwaiz, Altaf Haji, Lourdusamy Selvam
Published: 1 August 2020
The publisher has not yet granted permission to display this abstract.
D. Lu, H. Wang, R. Yu, , Y. Zhao
Published: 1 April 2020
Journal of Hospital Infection, Volume 104, pp 454-455; doi:10.1016/j.jhin.2020.02.018

Abstract:
Coronavirus disease 2019 (COVID-19) is caused by a novel coronavirus (2019-nCoV). The most common symptoms are fever and dry cough; a minority of patients report other symptoms such as headache, sore throat, and sneeze [1Chen N. Zhou M. Dong X. Qu J. Gong F. Han Y. et al.Epidemiological and clinical characteristics of 99 cases of 2019 novel coronavirus pneumonia in Wuhan, China: a descriptive study.Lancet. 2020; 395: 507-513https://doi.org/10.1016/S0140-6736(20)30211-7Abstract Full Text Full Text PDF PubMed Scopus (3990) Google Scholar,2Huang C. Wang Y. Li X. Ren L. Zhao J. Hu Y. et al.Clinical features of patients infected with 2019 novel coronavirus in Wuhan.China. Lancet. 2020; 395: 497-506https://doi.org/10.1016/S0140-6736(20)30183-5Abstract Full Text Full Text PDF PubMed Scopus (7859) Google Scholar]. COVID-19 has rapidly spread from Wuhan, throughout China and into other countries. The virus-specific nucleic acid sequences have been detected in lung fluid, throat, oropharyngeal and nasopharyngeal swab samples [3Lu H. Stratton C.W. Tang Y.W. Outbreak of pneumonia of unknown etiology in Wuhan, China: the mystery and the miracle.J Med Virol. 2020; 92: 401-402https://doi.org/10.1002/jmv.25678Crossref PubMed Scopus (518) Google Scholar]. Due to lack of sufficient awareness of the COVID-19 in the early stages of the epidemic, some healthcare workers (HCWs) have been infected [4Li Q. Guan X. Wu P. Wang X. Zhou L. Tong Y. et al.Early transmission dynamics in Wuhan, China, of novel coronavirus-infected pneumonia.N Engl J Med. 2020; ([Epub ahead of print])https://doi.org/10.1056/NEJMoa2001316Crossref Scopus (2941) Google Scholar,5Wang D. Hu B. Hu C. Zhu F. Liu X. Zhang J. et al.Clinical characteristics of 138 hospitalized patients with 2019 novel coronavirus-infected pneumonia in Wuhan, China.JAMA. 2020; ([Epub ahead of print])https://doi.org/10.1001/jama.2020.1585Crossref Scopus (4609) Google Scholar]. Patients with symptoms of COVID-19 may present to ear, nose, and throat (ENT) departments. Moreover diagnostic and therapeutic procedures in ENT departments involve direct contact with patients' upper respiratory tract mucosa, and/or induce patients to cough or sneeze. Thus there is an especially high risk to HCWs and other patients in ENT departments.
Published: 7 July 2020
Abstract:
BackgroundUniversity campuses present an ideal environment for viral spread and are therefore at extreme risk of serving as a hotbed for a COVID-19 outbreak. While active surveillance throughout the semester such as widespread testing, contact tracing, and case isolation, may assist in detecting and preventing early outbreaks, these strategies will not be sufficient should a larger outbreak occur. It is therefore necessary to limit the initial number of active cases at the start of the semester. We examine the impact of pre-semester NAT testing on disease spread in a university setting.MethodsWe implement simple dynamic transmission models of SARS-CoV-2 infection to explore the effects of pre-semester testing strategies on the number of active infections and occupied isolation beds throughout the semester. We assume an infectious period of 3 days and vary R0 to represent the effectiveness of disease mitigation strategies throughout the semester. We assume the prevalence of active cases at the beginning of the semester is 5%. The sensitivity of the NAT test is set at 90%.ResultsIf no pre-semester screening is mandated, the peak number of active infections occurs in under 10 days and the size of the peak is substantial, ranging from 5,000 active infections when effective mitigation strategies (R0 = 1.25) are implemented to over 15,000 active infections for less effective strategies (R0 = 3). When one NAT test is mandated within one week of campus arrival, effective (R0 = 1.25) and less effective (R0 = 3) mitigation strategies delay the onset of the peak to 40 days and 17 days, respectively, and result in peak size ranging from 1,000 to over 15,000 active infections. When two NAT tests are mandated, effective (R0 = 1.25) and less effective (R0 = 3) mitigation strategies delay the onset of the peak through the end of fall semester and 20 days, respectively, and result in peak size ranging from less than 1,000 to over 15,000 active infections. If maximum occupancy of isolation beds is set to 2% of the student population, then isolation beds would only be available for a range of 1 in 2 confirmed cases (R0 = 1.25) to 1 in 40 confirmed cases (R0 = 3) before maximum occupancy is reached.ConclusionEven with highly effective mitigation strategies throughout the semester, inadequate pre-semester testing will lead to early and large surges of the disease and result in universities quickly reaching their isolation bed capacity. We therefore recommend NAT testing within one week of campus return. While this strategy is sufficient for delaying the timing of the outbreak, pre-semester testing would need to be implemented in conjunction with effective mitigation strategies to reduce the outbreak size.
, Wael Alqarawi, Ciorsti J. MacIntyre, Rafik Tadros, Christian Steinberg, Jason D. Roberts, Zachary Laksman, Jeff S. Healey, Andrew D. Krahn
Published: 1 June 2020
Canadian Journal of Cardiology, Volume 36, pp 948-951; doi:10.1016/j.cjca.2020.04.003

Abstract:
The emergence of COVID-19 has prompted rapid investigation of potential therapeutic options. Some early candidates have included chloroquine, hydroxychloroquine, azithromycin, lopinavir/ritonavir, remdesivir, ribavirin, and others. Some of these are known to pose a risk of ventricular arrhythmia. With an uncertain degree of potential for benefit, an assessment of risk of therapy should be undertaken. During the pandemic, avoidance of nonessential testing, including electrocardiography (ECG), reduces exposure of health care workers and other patients to infectious risk and is therefore recommended when possible.1Canadian Cardiovascular SocietyGuidance from the CCS COVID-19 Rapid Response Team: Reducing in-hospital spread and the optimal use of resources for the care of hospitalized cardiovascular patients during the COVID-19 pandemic.https://www.ccs.ca/images/Images_2020/NEW_CCS_RRT_Inhoptial_infection_reduction_30Mar.pdfDate: March 30, 2020Google Scholar An expert writing group of members of the Canadian Heart Rhythm Society was selected to derive a set of consensus-based recommendations to guide clinicians. This report was approved by the board of the Canadian Heart Rhythm Society; a fully referenced version is available as Supplementary Material.
Katharina Boehm, Anita Thomas, Axel Bex, Peter C. Black, Michael Coburn, Axel Haferkamp, Freddie Hamdy, Ronald P. Kaufman, Laurence Klotz, Seth P. Lerner, et al.
Published: 1 November 2020
Urology, Volume 145, pp 73-78; doi:10.1016/j.urology.2020.07.043

The publisher has not yet granted permission to display this abstract.
, Giuseppe Lippi
Seminars in Thrombosis and Hemostasis, Volume 46, pp 379-382; doi:10.1055/s-0040-1709498

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, Eleonora Beccaloni, Lucia Bonadonna, Carla Cini, Elisabetta Confalonieri, Giuseppina La Rosa, Maria Rosaria Milana, Emanuela Testai, Federica Scaini
Published: 15 November 2020
Science of The Total Environment, Volume 743, pp 140803-140803; doi:10.1016/j.scitotenv.2020.140803

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Ming Pan, Khalid Hirmiz, Junaid Yousuf, Kitty Huang, Colvin Springer, Ken Schneider, Laura D’Alimonte
Poster Presentations - Proffered Abstracts, Volume 26; doi:10.1158/1557-3265.covid-19-po-026

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, Franklin Camargo-Junior, Thiago Chalhub, Josué Morisson De Moraes Filho, Ruan Santos, Fabio Feitosa, Raul Freire, Paula Benayon, Matheus Hausen, Flavio Bachini, et al.
Revista Brasileira de Medicina do Esporte, Volume 26, pp 371-377; doi:10.1590/1517-869220202605237107

Abstract:
In March 2020, the World Health Organization (WHO) declared the disease caused by the SARS-CoV2 virus, known as COVID-19, to be a pandemic. The sporting world, too, is suffering from the global effects of this disease, with the postponement or cancellation of competitions, including the 2020 Tokyo Olympic Games. As a proposal for containing the disease, social isolation was declared. Despite the importance of this measure, it was harmful for Olympic athletes, as they had to stay away from their training site and trainers, as well as their interdisciplinary teams. It is therefore important to study this harm caused, in order to minimize it. In general, it is believed that regular physical activity is associated with improved immune system functioning. The lack of training can therefore have significant consequences for the performance and health of the Olympic athlete. From the athlete's point of view, the impaired immune system, due to the reduced frequency of physical exercise, leaves them more vulnerable to contracting or developing infections or other diseases. The risk of harm due to the decreased performance of preventive works is also evident in this population. The reductions in training load and intensity can cause changes in the athlete's body composition and affect various aspects of cardiorespiratory fitness, as well as reducing strength levels and muscle potency. In relation to the athlete's mental health, two aspects are particularly challenging: isolation and uncertainty. Based on the possible harm caused by social isolation, the need is seen for a specific and joint work, in an attempt to minimize it. This work addresses the following topics: (I) context: transmission, symptoms, diagnosis, treatment, discharge criteria, isolation and post-pandemic consequences; (II) harm and proposals: nutritional, physiological, biomechanical and psychological. Level of evidence II; Review Article.
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