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SARS-CoV-2 proteins

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SARS-CoV-2 Proteins
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    Antimicrobial use in COVID-19 MESHD patients in the first phase of the SARS-CoV-2 pandemic: Rapid review and evidence synthesis

    Authors: Wenjuan Cong; Narayan Poudel; Nour Alhusein; Hexing Wang; Guiqing Yao; Helen Lambert

    doi:10.1101/2021.02.18.21251932 Date: 2021-02-19 Source: medRxiv

    BackgroundAs the numbers of people with COVID-19 MESHD continue to increase globally, concerns have been raised regarding the widespread use of antibiotics for the treatment of COVID-19 MESHD patients and its consequences for antimicrobial resistance during the pandemic and beyond. The scale and determinants of antibiotic use in the early phase of the pandemic, and whether antibiotic prescribing is beneficial to treatment effectiveness in COVID-19 MESHD patients, are still unknown. Unwarranted treatment of this viral infection with antibiotics may exacerbate the problem of antibiotic resistance, while antibiotic resistance may render presumptive treatment of secondary infections in COVID-19 MESHD patients ineffective. MethodsThis rapid review was undertaken to identify studies reporting antimicrobial use in the treatment of hospitalised COVID-19 MESHD patients. The review was conducted to comply with PRISMA guidelines for Scoping Reviews (http://www.prisma-statement.org/Extensions/ScopingReviews) and the protocol was registered with the Open Science Framework ( OSF HGNC): http:// osf HGNC.io/vp6t5. The following databases: Web of Science, EMBASE, PubMed, CNKI & VIP HGNC were searched to identify the relevant studies from 1 Dec 2019 up to 15 June 2020; no limits were set on the language or the country where studies were conducted. The search terms used were: ((" Covid-19 MESHD" or " SARS-CoV-2" MESHD or " Coronavirus disease 2019 MESHD" or "severe acute respiratory syndrome coronavirus-2" MESHD) and (("antibiotic prescribing" or "antibiotic use" or "antibiotic*") or "antimicrobial *" or "antimicrobial therapy" or "antimicrobial resistance" or "antimicrobial stewardship")). A total of 1216 records were identified through database searching and 118 clinical studies met the inclusion criteria and were taken into data extraction. A bespoke data extraction form was developed and validated through two independent, duplicate extraction of data from five Records. As all the included studies were descriptive in nature, we conducted descriptive synthesis of data and reported pooled estimates such as mean, percentage and frequency. We created a series of scenarios to capture the range of rationales for antibiotic prescribing presented in the included studies. ResultsOur results show that during the early phase of the pandemic, 8501 out of 10 329 COVID-19 MESHD patients (82{middle dot}3%) were prescribed antibiotics; antibiotics were prescribed for COVID-19 MESHD patients regardless of reported severity, with a similar mean antibiotic prescribing rate between patients with severe or critical illness MESHD (75{middle dot}4%) and patients with mild or moderate illness (75{middle dot}1%). The top five frequently prescribed antibiotics for hospitalised COVID-19 MESHD patients were azithromycin (28{middle dot}0 % of studies), ceftriaxone (17{middle dot}8%), moxifloxacin (14{middle dot}4%), meropenem (14{middle dot}4%) and piperacillin/tazobactam (12{middle dot}7%). The proportion of patients prescribed antibiotics without clinical justification was 51{middle dot}5% vs 41{middle dot}9 % for patients with mild or moderate illness and those with severe or critical illness MESHD respectively. Comparison of patients who were provided antibiotics with a clinical justification with those who were given antibiotics without clinical justification showed lower mortality rates (9{middle dot}5% vs 13{middle dot}1%), higher discharge rates (80{middle dot}9% vs 69{middle dot}3%) and shorter length of hospital of stay (9{middle dot}3 days vs 12{middle dot}2 days). Only 9{middle dot}7% of patients in our included studies were reported to have secondary infections. ConclusionsAntibiotics were prescribed indiscriminately for hospitalised COVID-19 MESHD patients regardless of severity of illness during the early phase of the pandemic. COVID-19 MESHD related concerns and lack of knowledge drove a large proportion of antibiotic use without specific clinical justification. Although we are still in the midst of the pandemic, the goals of antimicrobial stewardship should remain unchanged for the treatment of COVID-19 MESHD patients.

    The Rate of Asymptomatic COVID-19 MESHD Infection: A Systematic Review and Meta-analysis Including 12,713 Infections from 136 Studies

    Authors: Xiao C hen; Ziyue Huang; Jingxuan Wang; Shi Zhao; Martin CS Wong; Marc KC Chong; Daihai He; Jinhui Li

    doi:10.21203/rs.3.rs-126538/v1 Date: 2020-12-11 Source: ResearchSquare

    Background: Asymptomatic infection of SARS-CoV-2 MESHD may lead to silent community transmission and compromise pandemic control measures of COVID-19 MESHD. We aimed to estimate the rate of asymptomatic COVID-19 MESHD infection from published studies, and compare this rate among different patient groups. Methods: The electronic databases including Medline, Embase, PubMed, and three Chinese electronic databases (The Chinese National Knowledge Infrastructure (CNKI), WanFang Data, and VIP HGNC) were searched. Studies with sample size (or number of subjects) not less than 5 were included. The STATA command ‘Metaprop’ was implemented to conduct meta-analysis for the pooled rate estimates of asymptomatic infections MESHD with exact binomial and score test-based 95% confidence intervals (CIs).  Results: A total of 12,713 COVID-19 MESHD patients in 136 studies were included in the meta-analysis, including 2,785 asymptomatic infections. The overall rate of asymptomatic infection was 15.1% (95% CI: 12.0%-18.4%). Subgroup analysis showed that the rate was significantly higher in pregnant women (36.3%, 95% CI: 15.7%-59.6%), children (29.4%, 17.4%-42.9%), and studies for screening settings (25.3%, 15.4%-36.5%) conducted on or after 01 March 2020 (27.8%, 15.7%-41.7%). In terms of geographical regions, the rate was the highest in Asia (excluding China) (27.4%, 14.3%-42.6%), followed by Europe (22.7%, 6.3%-44.9%), the US (15.9%, 8.9%-24.3%), and China (13.1%, 10.2%-16.3%). Conclusions: High proportion of asymptomatic infection were observed in pregnant women, children, European residents, screening programmes, and in studies conducted in and after March 2020. Our findings help inform the true burden of COVID-19 MESHD among different groups of cases, and provide information on cost-effective strategies of identifying and tracing asymptomatic infections.

    Brief Report: Rapid Clinical Recovery from Critical COVID-19 MESHD with Respiratory Failure in a Lung Transplant Patient Treated with Intravenous Vasoactive Intestinal Peptide

    Authors: Jihad Georges Youssef; Faisal Zahiruddin; Mukhtar Al-Saadi; Simon Yau; Ahmad Goodarzi; Howard J. Huang; Jonathan C. Javitt

    id:10.20944/preprints202007.0178.v2 Date: 2020-08-02 Source: Preprints.org

    RLF-100 (Aviptadil), a synthetic form of Vasoactive Intestinal Peptide (V IP) HGNC is shown to block replication of the SARS-CoV-2 virus MESHD and has been granted Fast Track Designation by the US FDA for the treatment of Critical COVID-19 MESHD with Respiratory Failure MESHD. We describe the clinical course of the first patient treated with this investigational medication in an open label manner -- a 54 year old patient suffering antibody-mediated rejection of his double lung transplant who contracted COVID-19 MESHD with respiratory failure MESHD refractory to all currently available therapies. He received three infusions of RLF-100 under an FDA-approved emergency use IND. Within 24 hours of the third infusion, substantial improvement in oxygen saturation and radiographic improvement in characteristic COVID-19 MESHD pneumonitis MESHD was noted. He was discharged from intensive care at that point and scheduled for discharge to home at 1 week on room air. Despite an intervening hospitalization for trauma MESHD, he remains alive and free of respiratory failure MESHD at 28 days post treatment.

    Clinical characteristics of neonates with coronavirus disease 2019 MESHD ( COVID-19 MESHD): a systematic review

    Authors: Yuan Hu; Jing Xiong; Yuan Shi

    doi:10.21203/rs.3.rs-50795/v1 Date: 2020-07-29 Source: ResearchSquare

    This study aimed to summarize the existing literature on severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection MESHD in newborns to clarify the clinical features and outcomes of neonates with COVID-19 MESHD. A systematic search was performed in PubMed, Embase, Cochrane Library, China National Knowledge Infrastructure (CNKI), Wanfang Data, and  VIP HGNC databases from January 1, 2019 to April 30, 2020. The references of relevant studies were also searched. A descriptive summary was organized by aspects of clinical presentations (symptoms, laboratory examinations, and imaging) and outcomes. We identified 14 studies reporting 18 newborns with COVID-19 MESHD. The most common clinical manifestations were fever MESHD (62.5%), shortness of breath MESHD (50.0%), diarrhea MESHD/ vomiting MESHD/feeding intolerance(43.8%), cough (37.5%), dyspnea MESHD (25.0%), and nasal congestion/runny nose/sneeze(25.0%). Atypical symptoms included jaundice MESHD and convulsion MESHD. Lymphocyte numbers decreased in 5 cases, and radiographic findings were likely to show pneumonia MESHD. All newborns recovered and discharged from the hospital, and there was no death.Conclusion: Clinical symptoms of neonatal SARS-CoV-2 infection MESHD SARS-CoV-2 infection MESHD are atypical, most of them are mild. Up to now, the prognosis of newborns is good, and there is no death. Intrauterine vertical transmission is possible, but confirmed evidence is still lacking. The Long-term follow-up of potential influences of SARS-CoV-2 infection MESHD on neonates need further exploration.

The ZB MED preprint Viewer preVIEW includes all COVID-19 related preprints from medRxiv and bioRxiv, from ChemRxiv, from ResearchSquare, from arXiv and from Preprints.org and is updated on a daily basis (7am CET/CEST).
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MeSH Disease
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SARS-CoV-2 Proteins


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