Neurologic Characteristics in Coronavirus Disease 2019 (COVID-19): A Systematic Review and Meta-Analysis
Meta-analysis, review, Neurologic, symptoms, characteristics, COVID-19
Importance: Coronavirus disease 2019 (COVID-19) is a newly emerging infectious disease that has caused a global pandemic. The presenting symptoms are mainly respiratory symptom, yet studies have reported nervous system involvement in the disease. A systematic review and meta-analysis of these studies are required to understanding the neurologic characteristic of the disease and help physicians with early diagnosis and management.Objective: To conduct a systematic review and meta-analysis on the neurologic characteristics in patients with COVID-19.Evidence Review: Authors conducted a literature search through PubMed from January 1st, 2020 to April 8th, 2020. Furthermore, the authors added additional sources by reviewing related references. Studies presenting the neurologic features of COVID-19 patients in their data were included. Case reports and case series were also included in this review. The quality of the studies was assessed based on the Oxford Center for Evidence-Based Medicine guidelines. Selected studies were included in the meta-analysis of proportion and the heterogeneity test.Finding: From 280 identified studies, 33 were eligible, with 7,559 participants included. Most of the included studies were from China (29 [88%]). Muscle injury or myalgia was the most common (19.2%, 95%CI 15.4–23.2%) neurologic symptom of COVID-19, followed by headache (10.9%, 95%CI 8.62–13.51%); dizziness (8.7%, 95%CI 5.02–13.43%); nausea with or without vomiting (4.6%, 95%CI 3.17–6.27%); concurrent cerebrovascular disease (4.4%, 95%CI 1.92–7.91%); and impaired consciousness (3.8%, 95%CI 0.16–12.04%). Underlying cerebrovascular disease was found in 8.5% (95%CI 4.5–13.5%) of the studies.Conclusion: Neurologic findings vary from non-specific to specific symptoms in COVID-19 patients. Some severe symptoms or diseases can present in the later stage of the disease. Physicians should be aware of the presence of neurologic signs and symptoms as a chief complaint of COVID-19, in order to improve management and prevent a worsening outcome of the patients.
Rizaldy Taslim Pinzon, Vincent Ongko Wijaya, Ranbebasa Bijak Buana, Abraham Al Jody, Patrick Nalla Nunsio
Neurology. Diseases of the nervous system
Knowledge System Analysis on Emergency Management of Public Health Emergencies
emergency management, CiteSpace, knowledge system, Public health emergencies
The Coronavirus Disease 2019 (COVID-19) infectious pneumonia pandemic highlights the importance of emergency management of public health emergencies (EMPHE). This paper addresses the challenge of building a knowledge system for EMPHE research that may contribute to understand the spatial and temporal characteristics of knowledge distribution, research status, cutting-edge research and development trends, and helps to identify promising research topics and guide research and practice of EMPHE. Based on the Web of Science, this paper retrieves 1467 articles about EMPHE published from 2010 to date. Then, based on high-frequency keywords, we use CiteSpace to analyze their knowledge co-occurrence network, clustering network and knowledge evolution. Furthermore, we summarize the features and gaps in EMPHE research, providing references for future research directions. Based on the above analysis, this work constructs a knowledge system about EMPHE research, providing a comprehensive visual summary of the existing research in the field of EMPHE, with the aim to guide future research and practice.
Rui Yang, Yanhong Tang, Xin Miao, Guoming Du, Ziwei Duan, Mengjin Du
Environmental sciences, Renewable energy sources, Environmental effects of industries and plants
Forecast Possible Risk for COVID-19 Epidemic Dissemination Under Current Control Strategies in Japan
Basic reproduction number, COVID-19, SEIHR epidemic model
COVID-19 has globally spread to over 4 million people and the epidemic situation in Japan is very serious. The purpose of this research was to assess the risk of COVID-19 epidemic dissemination in Japan by estimating the current state of epidemic dissemination and providing some epidemic prevention and control recommendations. Firstly, the period from 6 January to 31 March 2020 was divided into four stages and the relevant parameters were estimated according to the imported cases in Japan. The basic reproduction number of the current stage is 1.954 (95% confidence interval (CI) 1.851–2.025), which means COVID-19 will spread quickly, and the self-healing rate of Japanese is about 0.495 (95% CI 0.437–0.506), with small variations in the four stages. Secondly, the results were applied to the actual reported cases from 1 to 5 April 2020, verifying the reliability of the estimated data using the accumulated reported cases located within the 95% confidence interval and the relative error of forecast data of five days being less than 2 . 5 % . Thirdly, considering the medical resources in Japan, the times the epidemic beds and ventilators become fully occupied are predicted as 5 and 15 May 2020, respectively. Keeping with the current situation, the final death toll in Japan may reach into the millions. Finally, based on experience with COVID-19 prevention and control in China, robust measures such as nationwide shutdown, store closures, citizens isolating themselves at home, and increasing PCR testing would quickly and effectively prevent COVID-19 spread.
International Journal of Environmental Research and Public Health
Sociodemographic Predictors of Health Risk Perception, Attitude and Behavior Practices Associated with Health-Emergency Disaster Risk Management for Biological Hazards: The Case of COVID-19 Pandemic in Hong Kong, SAR China
urban, health risks, Pandemic, biological hazard, Health emergency and disaster risk management, COVID-19
In addition to top-down Health-Emergency and Disaster Risk Management (Health-EDRM) efforts, bottom-up individual and household measures are crucial for prevention and emergency response of the COVID-19 pandemic, a Public Health Emergency of International Concern (PHEIC). There is limited scientific evidence of the knowledge, perception, attitude and behavior patterns of the urban population. A computerized randomized digital dialing, cross-sectional, population landline-based telephone survey was conducted from 22 March to 1 April 2020 in Hong Kong Special Administrative Region, China. Data were collected for socio-demographic characteristics, knowledge, attitude and risk perception, and various self-reported Health-EDRM behavior patterns associated with COVID-19. The final study sample was 765. Although the respondents thought that individuals (68.6%) had similar responsibilities as government (67.5%) in infection control, less than 50% had sufficient health risk management knowledge to safeguard health and well-being. Among the examined Health-EDRM measures, significant differences were found between attitude and practice in regards to washing hands with soap, ordering takeaways, wearing masks, avoidance of visiting public places or using public transport, and travel avoidance to COVID-19-confirmed regions. Logistic regression indicated that the elderly were less likely to worry about infection with COVID-19. Compared to personal and household hygiene practices, lower compliance was found for public social distancing.
Zhe Huang, Samuel Yeung Shan Wong, Emily Ying Yang Chan, Kevin Kei Ching Hung, Eliza Lai Yi Wong, Eugene Siu Kai Lo
Symptomatic Protective Action of Glycyrrhizin (Licorice) in COVID-19 Infection?
inflammation, coronavirus, mineralocorticoid receptor, Toll-like receptor 4 (TLR4), Glycyrrhizin, COVID-19
The role of the ACE2 enzyme in the COVID-19 infection is 2-fold, with opposing implications for the disease development. 1. The membrane bound angiotensin converting enzyme 2 (ACE2) serves as the entry point of COVID-19 2. Conversely, it supports an anti-inflammatory pathway. This led to the controversy of the impact of medications, which influence its expression. ACE2 is part of the wider renin-angiotensin-aldosterone system (RAAS) and is upregulated via compounds, which inhibits the classical ACE, thereby plasma aldosterone and aldosterone receptor (MR) activation. MR activation may therefore protect organs from binding the COVID-19 by reducing ACE2 expression. Glycyrrhizin (GL) is a frequent component in traditional Chinese medicines, which have been used to control COVID-19 infections. Its systemically active metabolite glycyrrhetinic acid (GA) inhibits 11beta hydroxysteroid dehydrogenase(11betaHSD2) and activates MR in organs, which express this enzyme, including the lungs. Does this affect the protective effect of ACE2? Importantly, GL has anti-inflammatory properties by itself via toll like receptor 4 (TLR4) antagonism and therefore compensates for the reduced protection of the downregulated ACE2. Finally, a direct effect of GL or GA to reduce virus transmission exists, which may involve reduced expression of type 2 transmembrane serine protease (TMPRSS2), which is required for virus uptake. Glycyrrhizin may reduce the severity of an infection with COVID-19 at the two stages of the COVID-19 induced disease process, 1. To block the number of entry points and 2. provide an ACE2 independent anti-inflammatory mechanism.
Coronavirus Disease (Covid-19): What Are We Learning in a Country With High Mortality Rate?
coronavirus, HLA, ARDS (Acute respiratory distress syndrome), SARS-CoV-2, COVID-19
Giovanni Baglio, Antonio Giordano, Luciano Mutti, PATRIZIA MAIORANO, Francesca Pentimalli, Pierpaolo Correale, Rita Emilena Saladino
Global Health Diplomacy Amid the COVID-19 Pandemic: A Strategic Opportunity for Improving Health, Peace, and Well-Being in the CARICOM Region—A Systematic Review
Globalization, Public Health, epidemics, Caricom, Health Security, global health diplomacy (GHD)
Increased globalization has ushered in changes in diplomatic purposes and practices. As such, global health diplomacy (GHD) has become a growing field connecting the urgencies of global health and foreign affairs. More academics and policy-makers are thinking about how to structure and utilize diplomacy in pursuit of global health goals. This article aims to explore how the health, peace, and well-being of people in the region can be achieved through global health diplomacy. A systematic review of the literature was conducted on various terms such as “Global Health Diplomacy OR Foreign Policy”; “Disasters”, “Infectious disease epidemics” OR “Non-Communicable diseases” AND “Caribbean” by searching PubMed, Scopus, Embase, Web of Science databases, and Google Scholar search engines. A total of 33 articles that met the inclusion criteria were analyzed, and the critical role of GHD was highlighted. There is an increasing need to understand the complex global health challenges, coupled with the need to design appropriate solutions. Many regional initiatives addressing infectious and chronic diseases have been successful in multiple ways by strengthening unity and also by showing directions for other nations at a global level, e.g., the Port of Spain Summit declaration. GHD has a great scope to enhance preparedness, mitigation, peace, and development in the region. Amid the COVID-19 pandemic, the region needs to strengthen its efforts on equity issues, health promotion, and sustainable development to promote peace and well-being.
Obstetric Management of COVID-19 in Pregnant Women
Perinatal outcome, vertical transmission, severe acute respiratory syndrome, Middle East respiratory syndrome, Antiviral drug, COVID-19
The 2019 novel coronavirus disease (COVID-19), which is caused by the novel beta coronavirus, SARS-CoV-2, is currently prevalent all over the world, causing thousands of deaths with relatively high virulence. Like two other notable beta coronaviruses, severe acute respiratory syndrome coronavirus-1 (SARS-CoV-1) and Middle East respiratory syndrome coronavirus (MERS-CoV), SARS-CoV-2 can lead to severe contagious respiratory disease. Due to impaired cellular immunity and physiological changes, pregnant women are susceptible to respiratory disease and are more likely to develop severe pneumonia. Given the prevalence of COVID-19, it is speculated that some pregnant women have already been infected. However, limited data are available for the clinical course and management of COVID-19 in pregnancy. Therefore, we conducted this review to identify strategies for the obstetric management of COVID-19. We compared the clinical course and outcomes of COVID-19, SARS, and MERS in pregnancy and discussed several drugs for the treatment of COVID-19 in pregnancy.
Sumei Wei, Yue Pan, Dan Luo, Xiao Yang, Xiaoyan Liao, Youwen Mei, Yonghong Lin
Ophthalmology practice during the COVID-19 pandemic
ObjectiveTo present an established practice protocol for safe and effective hospital-setting ophthalmic practice during the coronavirus disease 2019 (COVID-19) pandemic.Methods and AnalysisLiterature was reviewed to identify articles relevant to COVID-19 pandemic and ophthalmology. The following keywords were used: COVID-19, SARS-CoV-2 and telemedicine, combined with eye, ophthalmology, conjunctivitis and tears. Data were extracted from the identified manuscripts and discussed among subspecialists to obtain consensus evidence-based practice.ResultsA protocol for ophthalmic practice in the era of COVID-19 pandemic was established. The protocol covered patient screening, clinic flow, required personal protective equipment and modifications of ophthalmic equipment for improved safety.ConclusionImportant literature emerged with respect to the practice of ophthalmology in the era of COVID-19. An evidence-based ophthalmic practice protocol was established and should be modified in the future to accommodate new insights on the COVID-19 pandemic.
Itay Chowers, Jaime Levy, David Landau, Abraham SOLOMON, Shahar Frenkel, Hadas Ben-Eli, Radgonde Amer, Liran Tiosano, Shay Ofir, Khaled Safadi, Joshua M. Kruger, Hamzah Aweidah, Hadas Mechoulam, Irene Anteby, Itay Lavy, Tarek Jaouni, Gabriel Greifner, Tamar Levi Vineberg
Population vulnerability to COVID-19 in Europe: a burden of disease analysis
coronavirus, burden of disease, daly, SUMMARY MEASURES OF POPULATION HEALTH, YLD, COVID-19
Abstract Background Evidence has emerged showing that elderly people and those with pre-existing chronic health conditions may be at higher risk of developing severe health consequences from COVID-19. In Europe, this is of particular relevance with ageing populations living with non-communicable diseases, multi-morbidity and frailty. Published estimates of Years Lived with Disability (YLD) from the Global Burden of Disease (GBD) study help to characterise the extent of these effects. Our aim was to identify the countries across Europe that have populations at highest risk from COVID-19 by using estimates of population age structure and YLD for health conditions linked to severe illness from COVID-19. Methods Population and YLD estimates from GBD 2017 were extracted for 45 countries in Europe. YLD was restricted to a list of specific health conditions associated with being at risk of developing severe consequences from COVID-19 based on guidance from the United Kingdom Government. This guidance also identified individuals aged 70 years and above as being at higher risk of developing severe health consequences. Study outcomes were defined as: (i) proportion of population aged 70 years and above; and (ii) rate of YLD for COVID-19 vulnerable health conditions across all ages. Bivariate groupings were established for each outcome and combined to establish overall population-level vulnerability. Results Countries with the highest proportions of elderly residents were Italy, Greece, Germany, Portugal and Finland. When assessments of population-level YLD rates for COVID-19 vulnerable health conditions were made, the highest rates were observed for Bulgaria, Czechia, Croatia, Hungary and Bosnia and Herzegovina. A bivariate analysis indicated that the countries at high-risk across both measures of vulnerability were: Bulgaria; Portugal; Latvia; Lithuania; Greece; Germany; Estonia; and Sweden. Conclusion Routine estimates of population structures and non-fatal burden of disease measures can be usefully combined to create composite indicators of vulnerability for rapid assessments, in this case to severe health consequences from COVID-19. Countries with available results for sub-national regions within their country, or national burden of disease studies that also use sub-national levels for burden quantifications, should consider using non-fatal burden of disease estimates to estimate geographical vulnerability to COVID-19.
José L. Peñalvo, Ian Grant, Dietrich Plass, Elena von der Lippe, Jane Idavain, Sarah Cuschieri, Marek Majdan, Grant M A Wyper, Sara M Pires, Juanita A Haagsma, Eilidh Fletcher, Ricardo Assunção, Elena Pallari, Diane L. Stockton, Brecht Devleeschauwer, Henk B. M. Hilderink, Tina Lesnik, Milena S. Milicevic, João V. Santos, Sofie Theresa Thomsen