COVID-19

Objectives To determine the prevalence and factors associated with depression, anxiety and stress among healthcare workers (HCWs) during COVID-19 pandemic. Design Cross-sectional online survey. Setting HCWs from four major hospitals within the Regional Health Authorities of Trinidad and Tobago. Participants 395 HCWs aged ≥18 years. Main outcome measures Depression, anxiety and stress scores. Results Among the 395 HCWs, 42.28%, 56.2% and 17.97% were found to have depression, anxiety and stress, respectively. In the final stepwise regression model, contact with patients with confirmed COVID-19, p<0.001 (95% CI 3.072 to 6.781) was reported as significant predictors of depression. Further, gender, p<0.001 (95% CI 2.152 to 5.427) and marital status, p<0.001 (95% CI 1.322 to 4.270) of the HCWs were considered to be correlated with anxiety. HCWs who had contact with patients with suspected COVID-19 had lower depression, p<0.001 (95% CI –5.233 to –1.692) and stress, p<0.001 (95% CI –5.364 to –1.591). Conclusions This study has depicted the prevalence and evidence of depression, anxiety and stress among HCWs during the COVID-19 pandemic. The findings of the study will serve as supportive evidence for the timely implementation of further planning of preventative mental health services by the Ministry of Health, for frontline workers within the public and private health sectors.

Introduction The current coronavirus (SARS-CoV-2) pandemic has placed unprecedented restrictions on people’s lives and routines. To counteract the exponential spread of this virus, a lockdown was implemented in Germany in March 2020. Infected persons and their contacts were also quarantined. Compliance with quarantine measures is essential for containing the spread of the virus and avoiding incalculable consequences in terms of morbidity and mortality. On the other hand, prolonged homestays, particularly quarantining, may lead to fear, panic, anxiety and depression. Hence, determining the psychological response in people during quarantine and their coping strategies is relevant for the counselling and support of affected persons by healthcare workers. Methods and analysis The CoCo-Fakt-Survey (Cologne-Corona-Beratung und Unterstützung Für Index- und KontAKt-Personen während der Quarantäne-ZeiT; Cologne-Corona counselling and support for index and contacts during the quarantine period—author’s translation) will examine a cohort of persons in Cologne quarantined since the beginning of the SARS-CoV-2 outbreak during March 2020. The questionnaire will include demographic data, transmission route, health status, knowledge of and adherence to quarantine measurements, psychological impact on individuals and their family members including children, mental health status, and lifestyle (physical activity/sedentary behaviour, relaxation techniques, nutrition, smoking). All Cologne residents who needed to be quarantined due to a coronavirus infection and the individuals with whom they had contact will be surveyed. Ethics and dissemination No risks have been identified and no complications are expected. Ethics approval was obtained from the Rheinisch-Westfälische Technische Hochschule (RWTH) Aachen Human Ethics Research Committee (351/20), and the research will be conducted in accordance with the approved protocol. The results will be disseminated through peer-reviewed journals and social medicine conferences.

Objective To investigate the association between participation in government subsidies for domestic travel (subsidise up to 50% of all travel expenses) introduced nationally in Japan on 22 July 2020 and the incidence of symptoms indicative of COVID-19 infections. Design Cross-sectional analysis of nationally representative survey data. Setting Internet survey conducted between 25 August and 30 September 2020 in Japan. Sampling weights were used to calculate national estimates. Participants 25 482 survey respondents (50.3% (12 809) women; mean (SD) age, 48.8 (17.4) years). Main outcome measures Incidence rate of five symptoms indicative of the COVID-19 infection (high fever, sore throat, cough, headache, and smell and taste disorder) within the past month of the survey, after adjustment for characteristics of individuals and prefecture fixed effects (effectively comparing individuals living in the same prefecture). Results At the time of the survey, 3289 (12.9%) participated in the subsidy programme. After adjusting for potential confounders, we found that participants in the subsidy programme exhibited higher incidence of high fever (adjusted rate, 4.7% for participants vs 3.7% for non-participants; adjusted OR (aOR) 1.83; 95% CI 1.34 to 2.48; p<0.001), sore throat (19.8% vs 11.3%; aOR 2.09; 95% CI 1.37 to 3.19; p=0.002), cough (19.0% vs 11.3%; aOR 1.96; 95% CI 1.26 to 3.01; p=0.008), headache (29.2% vs 25.5%; aOR 1.24; 95% CI 1.08 to 1.44; p=0.006) and smell and taste disorder (2.6% vs 1.8%; aOR 1.98; 95% CI 1.15 to 3.40; p=0.01) compared with non-participants. These findings remained qualitatively unaffected by additional adjustment for the use of 17 preventative measures (eg, social distancing, wearing masks and handwashing) and fear against the COVID-19 infection. Conclusions The participation of the government subsidy programme for domestic travel was associated with a higher probability of exhibiting symptoms indicative of the COVID-19 infection.

D. Chu et al.

M. Zhang et al.

After a cyberattack late last year against the European Medicines Agency (EMA), anonymous emails dispatched a trove of classified documents to academics and journalists.

Less than half of US workers in non–health care fields had COVID-19 prevention measures in place at work as of June 2020, based on an online survey of 4000 US, nonremote workers.

This Arts and Medicine feature presents global postage and commemorative stamps issued by countries and nongovernmental organizations in 2020 featuring coronavirus pandemic-related themes.

This Viewpoint summarizes the current best evidence about COVID-19 vaccines, immunity, and whether SARS-CoV-2 will become an endemic or seasonal virus.

This randomized trial compares the effects of ivermectin vs placebo on time to symptom resolution within 21 days among patients with mild COVID-19.

This JAMA Insights Clinical Update from the CDC’s COVID-19 Response Team discusses the importance of observational data for identifying behaviors associated with SARS-CoV-2 transmission, and presents data suggesting that indoor eating or drinking poses the highest risk, presumably because of prolonged exposure to unmasked, non–physically distanced companions.

This cohort study characterizes the accuracy of the Sequential Organ Failure Assessment (SOFA) score to discriminate death from survival in patients with COVID-19 pneumonia receiving oxygen therapy for 4 hours or longer before undergoing endotracheal intubation.

In the fight against COVID-19, the general population in many countries has not been empowered to pursue diagnostic testing, but rather has been a subject to often frustrating and inadequate testing capacity. Diagnostics have been a cornerstone of the COVID-19 response globally, because strategies to contain and respond to the pandemic rely primarily on case counts. Although RT-PCR remains the gold standard for detecting SARS-CoV-2, high testing demand has overwhelmed molecular laboratory capacities.

The novel coronavirus disease 2019 (COVID-19) pandemic, caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), has exerted enormous relentless pressures on the global healthcare systems. As of February 4, 2021, over 102 million people were infected with SARS-CoV-2, and more than 2.2 million died since the start of the pandemic (WHO, 2020). The true number of cases may even exceed the number of diagnosed cases by more than 10-fold (Havers et al., 2020; Stringhini et al., 2020).

For more than one year the health systems all over the world are combating the global Corona virus disease 2019 (COVID-19) pandemic, cased by a novel Corona virus (N-COV) which was first described in Wuhan city, China, presenting as an atypical infection of the lower respiratory tract.

As of this writing, the novel coronavirus (COVID-19) outbreak is considered to be almost over in China after an intensive spread lasting over two months. The complete data of the COVID-19 epidemic in China enables us to make a complete and accurate estimation of the epidemiological parameters in the country. Early confirmed cases were mainly linked to a seafood wholesale market in Wuhan, Hubei province, China, starting from late November, 2019 (Li et al., 2020; Zhu et al., 2020). The epidemic transmission in the early phase was associated with the movement of populations from the seafood market and away from Wuhan.

The Coronavirus disease 2019 (COVID-19) pandemic continues with 122.5 million cases and over 2.7 million deaths reported by the World Health Organization on the 23rd of March 2021(WHO, 2021). The virus has more impact onimmunocompromised patients such as cancer patients (Belsky, 2021, Jindal, 2020), stem cell transplant patients (Belsky, 2021, Sahu, 2020), HIV patients (Patel, 2021), solid organ transplant recipients (Belsky, 2021) including heart transplant patients (Marcondes-Braga, 2021). We present a case of COVID-19-related post-myocarditis state on MRI late after initial infection in a HT recipient.

by Kalpana Sriraman, Ambreen Shaikh, Swapneil Parikh, Shreevatsa Udupa, Nirjhar Chatterjee, Jayanthi Shastri, Nerges Mistry Infectious respiratory particles expelled by SARS-CoV-2 positive patients are attributed to be the key driver of COVID-19 transmission. Understanding how and by whom the virus is transmitted can help implement better disease control strategies. Here we have described the use of a noninvasive mask sampling method to detect and quantify SARS-CoV-2 RNA in respiratory particles expelled by COVID-19 patients and discussed its relationship to transmission risk. Respiratory particles of 31 symptomatic SARS-CoV-2 positive patients and 31 asymptomatic healthy volunteers were captured on N-95 masks layered with a gelatin membrane in a 30-minute process that involved talking/reading, coughing, and tidal breathing. SARS-CoV-2 viral RNA was detected and quantified using rRT-PCR in the mask and in concomitantly collected nasopharyngeal swab (NPS) samples. The data were analyzed with respect to patient demographics and clinical presentation. Thirteen of 31(41.9%) patients showed SARS-COV-2 positivity in both the mask and NPS samples, while 16 patients were mask negative but NPS positive. Two patients were both mask and NPS negative. All healthy volunteers except one were mask and NPS negative. The mask positive patients had significantly lower NPS Ct value (26) compared to mask negative patients (30.5) and were more likely to be rapid antigen test positive. The mask positive patients could be further grouped into low emitters (expelling 1000 viral copies). The study presents evidence for variation in emission of SARS-CoV-2 virus particles by COVID-19 patients reflecting differences in infectivity and transmission risk among individuals. The results conform to reported secondary infection rates and transmission and also suggest that mask sampling could be explored as an effective tool to assess individual transmission risks, at different time points and during different activities.

H. L. Verhasselt et al.

S. K. Greene et al.

The COVID-19 pandemic has created a public health crisis. Because SARS-CoV-2 can spread from individuals with presymptomatic, symptomatic, and asymptomatic infections, the reopening of societies and the control of virus spread will be facilitated by robust population screening, for which virus testing will often be central. After infection, individuals undergo a period of incubation during which viral titers are too low to detect, followed by exponential viral growth, leading to peak viral load and infectiousness and ending with declining titers and clearance. Given the pattern of viral load kinetics, we model the effectiveness of repeated population screening considering test sensitivities, frequency, and sample-to-answer reporting time. These results demonstrate that effective screening depends largely on frequency of testing and speed of reporting and is only marginally improved by high test sensitivity. We therefore conclude that screening should prioritize accessibility, frequency, and sample-to-answer time; analytical limits of detection should be secondary.

Viral epidemics or pandemics of acute respiratory infections (ARIs) pose a global threat. Examples are influenza (H1N1) caused by the H1N1pdm09 virus in 2009, severe acute respiratory syndrome (SARS) in 2003, and coronavirus disease 2019 (COVID-19) caused by SARS-CoV-2 in 2019. Antiviral drugs and vaccines may be insufficient to prevent their spread. This is an update of a Cochrane Review published in 2007, 2009, 2010, and 2011. The evidence summarised in this review does not include results from studies from the current COVID-19 pandemic.

Population-level knowledge on individuals at high risk of severe and fatal coronavirus disease 2019 (COVID-19) is urgently needed to inform targeted protection strategies in the general population.

What is the role of drug interventions in the treatment and prevention of covid-19?

Remdesivir demonstrated clinical benefit in a placebo-controlled trial in patients with severe coronavirus disease 2019 (COVID-19), but its effect in patients with moderate disease is unknown.

Coronavirus disease 2019 (Covid-19) is associated with diffuse lung damage. Glucocorticoids may modulate inflammation-mediated lung injury and thereby reduce progression to respiratory failure and death.

Remdesivir is an RNA polymerase inhibitor with potent antiviral activity in vitro and efficacy in animal models of coronavirus disease 2019 (Covid-19).

Although several therapeutic agents have been evaluated for the treatment of coronavirus disease 2019 (Covid-19), no antiviral agents have yet been shown to be efficacious.

The clinical presentation of European patients with mild-to-moderate COVID-19 infection is still unknown.

There is no specific antiviral therapy recommended for coronavirus disease 2019 (COVID-19). In vitro studies indicate that the antiviral effect of chloroquine diphosphate (CQ) requires a high concentration of the drug.

Since the outbreak of coronavirus disease (COVID-19) in Wuhan in December 2019, by March 10, 2020, a total of 80,932 confirmed cases have been reported in China. Two consecutively negative RT-PCR test results in respiratory tract specimens is required for the evaluation of discharge from hospital, and oropharyngeal swabs were the most common sample. However, false negative results occurred in the late stage of hospitalization, and avoiding false negative result is critical essential.

Coronavirus disease 2019 (COVID-19) or severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), a novel coronavirus strain disease, has recently emerged in China and rapidly spread worldwide. This novel strain is highly transmittable and severe disease has been reported in up to 16% of hospitalized cases. More than 600,000 cases have been confirmed and the number of deaths is constantly increasing. COVID-19 hospitalized patients, especially those suffering from severe respiratory or systemic manifestations, fall under the spectrum of the acutely ill medical population, which is at increased venous thromboembolism risk. Thrombotic complications seem to emerge as an important issue in patients infected with COVID-19. Preliminary reports on COVID-19 patients' clinical and laboratory findings include thrombocytopenia, elevated D-dimer, prolonged prothrombin time, and disseminated intravascular coagulation. As the pandemic is spreading and the whole picture is yet unknown, we highlight the importance of coagulation disorders in COVID-19 infected patients and review relevant data of previous coronavirus epidemics caused by the severe acute respiratory syndrome coronavirus 1 (SARS-CoV-1) and the Middle East Respiratory Syndrome coronavirus (MERS-CoV).

The pandemic of coronavirus disease 2019 (COVID-19) caused by the novel severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) presents an unprecedented challenge to identify effective drugs for prevention and treatment. Given the rapid pace of scientific discovery and clinical data generated by the large number of people rapidly infected by SARS-CoV-2, clinicians need accurate evidence regarding effective medical treatments for this infection.

The novel severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is the cause of a rapidly spreading illness, Coronavirus Disease 2019 (COVID-19), affecting thousands of people around the world. Urgent guidance for clinicians caring for the sickest of these patients is needed.

No therapeutics have yet been proven effective for the treatment of severe illness caused by SARS-CoV-2.

The 2019 novel coronavirus (2019-nCoV) causing an outbreak of pneumonia in Wuhan, Hubei province of China was isolated in January 2020. This study aims to investigate its epidemiologic history, and analyze the clinical characteristics, treatment regimens, and prognosis of patients infected with 2019-nCoV during this outbreak.