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    COVID-19 Pandemic and the South African Podiatrist

    Authors: Bernhard Zipfel; Nadia Dembskey

    id:10.20944/preprints202009.0425.v1 Date: 2020-09-18 Source: Preprints.org

    The Coronavirus disease MESHD 2019 (COVID-19) pandemic is clearly taking a firmer grip on South Africa and more podiatrists will face the potential transmission TRANS of SARS-CoV-2. Government response was swift with the implementation of a travel TRANS ban, strict national lockdown as well as social distancing and hygiene protocols in line with international health regulations. Co-morbidities such as tuberculosis MESHD and HIV MESHD/ AIDS MESHD, endemic to South Africa, are considered a dangerous combination with COVID-19, making many South Africans vulnerable to contracting the COVID-19. Patients with diabetes MESHD as well as the aged TRANS are vulnerable, both in terms of potential combined complications and challenges in continuity in foot care. The demands of the pandemic may outstrip the ability of the health systems to cope. Should this time arrive, all healthcare practitioners, including podiatrists, would have to step in and take on a role beyond their scope of practice in order to ensure that the healthcare system does not get overwhelmed. It is important for podiatrists to keep abreast with the developments around the COVID-19, in order that they may institute appropriate clinical practice which will ensure maximum protection for themselves, staff and patients as well as providing quality foot health care.

    IFN signaling and neutrophil degranulation transcriptional signatures are induced during SARS-CoV-2 infection MESHD

    Authors: Bruce A. Rosa; Mushtaq Ahmed; Dhiraj K. Singh; Jose Alberto Choreno-Parra; Journey Cole; Luis Armando Jimenez-Alvarez; Tatiana Sofia Rodriguez-Reyna; Bindu Singh; Olga Golzalez; Ricardo Carrion; Larry S. Schlesinger; John Martin; Joaquin Zuniga; Makedonka Mitreva; Shabaana A Khader; Deepak Kaushal

    doi:10.1101/2020.08.06.239798 Date: 2020-08-06 Source: bioRxiv

    The novel virus SARS-CoV-2 has infected more than 14 million people worldwide resulting in the Coronavirus disease MESHD 2019 (COVID-19). Limited information on the underlying immune mechanisms that drive disease MESHD or protection during COVID-19 severely hamper development of therapeutics and vaccines. Thus, the establishment of relevant animal models that mimic the pathobiology of the disease is urgent. Rhesus macaques infected with SARS-CoV-2 exhibit disease pathobiology similar to human COVID-19, thus serving as a relevant animal model. In the current study, we have characterized the transcriptional signatures induced in the lungs of juvenile and old rhesus macaques following SARS-CoV-2 infection MESHD. We show that genes associated with Interferon (IFN) signaling, neutrophil degranulation and innate immune pathways are significantly induced in macaque infected lungs MESHD, while pathways associated with collagen formation are downregulated. In COVID-19, increasing age TRANS is a significant risk factor for poor prognosis and increased mortality. We demonstrate that Type I IFN and Notch signaling pathways are significantly upregulated in lungs of juvenile infected MESHD macaques when compared with old infected macaques. These results are corroborated with increased peripheral neutrophil counts and neutrophil lymphocyte ratio in older individuals with COVID-19 disease. In contrast, pathways involving VEGF are downregulated in lungs of old infected macaques. Using samples from humans with SARS-CoV-2 infection MESHD and COVID-19, we validate a subset of our findings. Finally, neutrophil degranulation, innate immune system and IFN gamma signaling pathways are upregulated in both tuberculosis MESHD and COVID-19, two pulmonary diseases MESHD where neutrophils are associated with increased severity. Together, our transcriptomic studies have delineated disease pathways to improve our understanding of the immunopathogenesis of COVID-19 to facilitate the design of new therapeutics for COVID-19.

    Implications of COVID-19 in high burden HIV/TB countries: A systematic review of evidence

    Authors: Jacques L Tamuzi; Ayele T Birhanu; Constance S Shumba; Olatunji Adetokunboh; Jeannine Uwimana-Nico; Zelalem T Haile; Joseph Inugu; Peter Suwirakwenda Nyasulu

    doi:10.21203/rs.3.rs-35019/v1 Date: 2020-06-12 Source: ResearchSquare

    Background The triple burden of COVID-19, tuberculosis MESHD and human immunodeficiency HP immunodeficiency MESHD virus is one of the major global health challenges of the 21st century and in the future. In high burden HIV/TB countries, the spread of COVID-19 among people living with HIV MESHD is a well-founded concern. A thorough understanding of HIV/TB and COVID-19 pandemics is important as the three diseases interact. This may clarify HIV MESHD/TB/COVID-19 as a newly related field and play an important role in the present and future management of the co-infections MESHD. However, several gaps are remaining in the knowledge of the burden of COVID-19 on patients with TB MESHD and HIV MESHD, the diagnosis, and management of these patients. The study was conducted to review different studies on SARS-CoV, MERS-CoV MESHD or COVID-19 associated with HIV/TB co-infection MESHD or only TB and to understand the interactions between HIV, TB and COVID-19 and its implications on the burden of the COVID-19 among HIV/TB co-infected MESHD or TB patients, screening algorithm and clinical management.Methods We conducted electronic search of potential eligible studies published in English in the Cochrane Controlled Register of Trials, PubMed, Medrxiv, Google scholar and Clinical Trials Registry databases. We included case studies, case series and observational studies published between January, 2002 and March, 2020 in which SARS-CoV MESHD, MERS-CoV and COVID-19 co-infected to HIV/TB MESHD or TB were managed in adult TRANS patients. We screened titles, abstracts and full articles for eligibility. As we anticipated heterogeneity in the literature, results were reported narratively.Results After removing 69 duplicates, 24 out of 246 articles were assessed for eligibility, of which 9 studies were included for qualitative analysis. Among them, we included two case reports, four case series, one case-control and two retrospective observational studies. The studies have shown that TB may occur during or after SARS-CoV. In terms of severity, the proportion of severe/critical SARS, MERS MESHD and COVID cases with TB co-infection MESHD was higher than in patients with mild/moderate stages (P = 0.0008).Conclusion SARS/MERS-CoV/COVID-19 associated to HIV/TB MESHD or TB subjects had a higher risk of developing severe/critical than mild/moderate SARS/MERS-CoV/COVID-19. Diagnostic algorithms and clinical management were suggested for efficiently improving COVID-19/ HIV/TB co-infections MESHD outcomes.

    Exercising caution in correlating COVID-19 incidence and mortality rates with BCG vaccination policies due to variable rates of SARS CoV-2 testing

    Authors: Janine Hensel; Daniel J McGrail; Kathleen M McAndrews; Dara Dowlatshahi; Valerie S LeBleu; Raghu Kalluri

    doi:10.1101/2020.04.08.20056051 Date: 2020-04-11 Source: medRxiv

    TThe Bacillus Calmette-Guerin (BCG) vaccine provides protection against tuberculosis MESHD ( TB MESHD), and is proposed to provide protection to non- TB MESHD infectious diseases MESHD. The COVID-19 outbreak results from infection MESHD with the novel coronavirus SARS-CoV-2 MESHD (CoV-2) and was declared a pandemic on March 11th, 2020. We queried whether the BCG vaccine offers protection against CoV-2 infection MESHD. We observed that countries with a current universal BCG vaccination policy have a significantly lower COVID-19 incidence than countries which never had a universal BCG policy or had one in the past. However, population density, median age TRANS, TB MESHD incidence, urban population, and, most significantly, CoV-2 testing rate, were also connected with BCG policy and could potentially confound the analysis. By limiting the analysis to countries with high CoV-2 testing rates, defined as greater than 2,500 tests per million inhabitants, these parameters were no longer statistically associated with BCG policy. When analyzing only countries with high testing rates, there was no longer a significant association between the number of COVID-19 cases per million inhabitants and the BCG vaccination policy. Although preliminary, our analyses indicate that the BCG vaccination may not offer protection against CoV-2 infection MESHD. While reporting biases may confound our observations, our findings support exercising caution in determining potential correlation between BCG vaccination and COVID-19 incidence, in part due significantly lower rates of CoV-2 testing per million inhabitants in countries with current universal BCG vaccination policy.

    Authors: Abhijeet Singh; Ayush Gupta; Kamanashish Das

    doi:10.21203/rs.3.rs-22464/v3 Date: 2020-04-11 Source: ResearchSquare

    Background: The ongoing pandemic of novel coronavirus disease MESHD 2019 (COVID-19) has received worldwide attention by becoming a major global health threat. We encountered one case with COVID-19 and tuberculosis MESHD ( TB MESHD) coinfection which has not been frequently reported. Case presentation: A 76 year old female TRANS presented with acute respiratory symptoms MESHD superimposed on chronic symptoms, suggestive to have pneumonia HP pneumonia MESHD. Oropharyngeal throat swab sample for COVID-19 was positive as detected by real-time reverse-transcriptase–polymerase-chain-reaction (RT-PCR) assay. GeneXpert Ultra detected Mycobacterium tuberculosis MESHD complex with Rifampicin resistance indeterminate. Patient was treated with appropriate management. Conclusion: Clinicians should suspect coinfection with TB MESHD during ongoing pandemic of COVID-19 as therapeutic strategies need to be determined timely to improve outcome and prevent transmission TRANS in community. 

    Authors: Abhijeet Singh; Ayush Gupta; Kamanashish Das

    doi:10.21203/rs.3.rs-22464/v4 Date: 2020-04-11 Source: ResearchSquare

    Background: The ongoing pandemic of novel coronavirus disease MESHD 2019 (COVID-19) has received worldwide attention by becoming a major global health threat. We encountered one case with COVID-19 and tuberculosis MESHD ( TB MESHD) coinfection which has not been frequently reported. Case presentation: A 76 year old female TRANS presented with acute respiratory symptoms MESHD superimposed on chronic symptoms, suggestive to have pneumonia HP pneumonia MESHD. Oropharyngeal throat swab sample for COVID-19 was positive as detected by real-time reverse-transcriptase–polymerase-chain-reaction (RT-PCR) assay. GeneXpert Ultra detected Mycobacterium tuberculosis MESHD complex with Rifampicin resistance indeterminate. Patient was treated with appropriate management. Conclusion: Clinicians should suspect coinfection with TB MESHD during ongoing pandemic of COVID-19 as therapeutic strategies need to be determined timely to improve outcome and prevent transmission TRANS in community. 

    The unexplained increasing of Erythrocyte Sedimentation Rate in a case recovered from COVID-19 

    Authors: Shenglan Pu; Xiangyan Zhang; Daishun Liu; Baning Ye; Jianquan Li

    doi:10.21203/rs.3.rs-21001/v1 Date: 2020-04-02 Source: ResearchSquare

    Background A novel c oronavirus virus pneumonia MESHD pneumonia HP (named COVID-19) broke out in Wuhan, China on December 2019, and spread around of the word [1, 2]. As of March 4th, 2020, 93090 confirmed cases TRANS and 2984 deaths have been reported in more than 80 countries and territories. It has triggered global public health security [2, 3]. However, the features and prognosis of COVID-19 are incompletely understood [2].Case presentation We here report that the erythrocyte sedimentation rate (ESR) increased in a confirmed COVID patient, the high level of ESR sustained for long time even patient recovered from COVID-19, while all results related to t umor, MESHD t uberculosis, MESHD r heumatic diseases, MESHD anemia HP nemia, MESHD et al. cannot explain the abnormal ESR presented in this case.Conclusion Although the increased ESR cannot be explained by all existing evidences, which possibly links the abnormal pathologic change in some COVID-19 patients and negative prognosis, and provides the clue to dissect the mechanism of illness progressing in COVID-19 and its prognosis.

    Truncated Inception Net: COVID-19 Outbreak Screening using Chest X-rays

    Authors: Dipayan Das; KC Santosh; Umapada Pal

    doi:10.21203/rs.3.rs-20795/v1 Date: 2020-04-01 Source: ResearchSquare

    Since December 2019, the Coronavirus Disease MESHD (COVID-19) pandemic has caused world-wide turmoil in less than a couple of months, and the infection MESHD, caused by SARS-CoV-2, is spreading at an unprecedented rate. AI-driven tools are used to identify Coronavirus outbreaks as well as forecast their nature of spread, where imaging techniques are widely used, such as CT scans and chest X-rays (CXRs). In this paper, motivated by the fact that X-ray imaging systems are more prevalent and cheaper than CT scan systems, a deep learning-based Convolutional Neural Network (CNN) model, which we call Truncated Inception Net, is proposed to screen COVID-19 positive CXRs from other non-COVID and/or healthy cases. To validate our proposal, six different types of datasets were employed by taking the following CXRs: COVID-19 positive, Pneumonia HP positive, Tuberculosis positive MESHD, and healthy cases into account. The proposed model achieved an accuracy of 99.96% (AUC of 1.0) in classifying COVID- 19 positive cases from combined Pneumonia HP and healthy cases. Similarly, it achieved an accuracy of 99.92% (AUC of 0.99) in classifying COVID-19 positive cases from combined Pneumonia HP, Tuberculosis MESHD and healthy CXRs. To the best of our knowledge, as of now, the achieved results outperform the existing AI-driven tools for screening COVID-19 using CXRs.

    A Tool to Early Predict Severe 2019-Novel Coronavirus Pneumonia HP (COVID-19) : A Multicenter Study using the Risk Nomogram in Wuhan and Guangdong, China

    Authors: Jiao Gong; Jingyi Ou; Xueping Qiu; Yusheng Jie; Yaqiong Chen; Lianxiong Yuan; Jing Cao; Mingkai Tan; Wenxiong Xu; Fang Zheng; Yaling Shi; Bo Hu

    doi:10.1101/2020.03.17.20037515 Date: 2020-03-20 Source: medRxiv

    Background Severe cases of coronavirus disease MESHD 2019 (COVID-19) rapidly develop acute respiratory distress HP respiratory distress MESHD leading to respiratory failure HP respiratory failure MESHD, with high short-term mortality rates. At present, there is no reliable risk stratification tool for non-severe COVID-19 patients at admission. We aimed to construct an effective model for early identifying cases at high risk of progression to severe COVID-19. Methods SARS-CoV-2 infected MESHD patients from one center in Wuhan city and two centers in Guangzhou city, China were included retrospectively. All patients with non-severe COVID-19 during hospitalization were followed for more than 15 days after admission. Patients who deteriorated to severe or critical COVID-19 and patients who kept non-severe state were assigned to the severe and non-severe group, respectively. We compared the demographic, clinical, and laboratory data between severe and non-severe group. Based on baseline data, least absolute shrinkage and selection operator (LASSO) algorithm and logistic regression model were used to construct a nomogram for risk prediction in the train cohort. The predictive accuracy and discriminative ability of nomogram were evaluated by area under the curve (AUC) and calibration curve. Decision curve analysis (DCA) and clinical impact curve analysis (CICA) were conducted to evaluate the clinical applicability of our nomogram. Findings The train cohort consisted of 189 patients, while the two independent validation cohorts consisted of 165 and 18 patients. Among all cases, 72 (19.35%) patients developed severe COVID-19 and 107 (28.76%) patients had one of the following basic disease, including hypertension HP hypertension MESHD, diabetes MESHD, coronary heart disease MESHD, chronic respiratory disease MESHD, tuberculosis disease MESHD. We found one demographic and six serological indicators ( age TRANS, serum SERO lactate dehydrogenase, C-reactive protein, the coefficient of variation of red blood SERO cell distribution width (RDW), blood SERO urea nitrogen, albumin, direct bilirubin) are associated with severe COVID-19. Based on these features, we generated the nomogram, which has remarkably high diagnostic accuracy in distinguishing individuals who exacerbated to severe COVID-19 from non-severe COVID-19 (AUC 0.912 [95% CI 0.846-0.978]) in the train cohort with a sensitivity SERO of 85.71 % and specificity of 87.58% ; 0.853 [0.790-0.916] in validation cohort with a sensitivity SERO of 77.5 % and specificity of 78.4%. The calibration curve for probability of severe COVID-19 showed optimal agreement between prediction by nomogram and actual observation. DCA and CICA further indicated that our nomogram conferred significantly high clinical net benefit. Interpretation Our nomogram could help clinicians to early identify patients who will exacerbate to severe COVID-19. And this risk stratification tool will enable better centralized management and early treatment of severe patients, and optimal use of medical resources via patient prioritization and thus significantly reduce mortality rates. The RDW plays an important role in predicting severe COVID-19, implying that the role of RBC in severe disease is underestimated.

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MeSH Disease
Human Phenotype
Transmission
Seroprevalence


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