Delaware\u2019s My Healthy Community Data Platform:

Is Africa prepared for tackling the COVID-19 (SARS-CoV-2) epidemic. Lessons from past outbreaks, ongoing pan-African public health efforts, and implications for the future

Prolonged SARS-CoV-2 shedding and mild course of COVID-19 in a patient after recent heart transplantation.

Sharpening the global focus on ethnicity and race in the time of COVID-19

Perioperative Cardiac Research Considerations During the Coronavirus Disease 2019 (COVID-19) Pandemic

PurposeThe coronavirus disease 2019 (COVID-19) pandemic has spread to all countries in the world, and different countries have been impacted differently. The study aims to understand what factors contribute to different COVID-19 impacts at the country level. MethodsMultivariate statistical analyses were used to evaluate COVID-19 deaths and cases relative to nine other demographic and socioeconomic factors in all countries and regions of the world using data as of August 1, 2020. The factors analyzed in the study include a country’s total COVID-19 deaths and cases per million population, per capita gross domestic product (GDP), population density, virus tests per million population, median age, government response stringency index, hospital beds availability per thousand population, extreme poverty rate, Bacille Calmette–Guérin (BCG) vaccination rate, and diphtheria–tetanus–pertussis (DTP3) immunization rate. ResultsThe study reveals that COVID-19 deaths per million population in a country most significantly correlates, inversely, with the country’s BCG vaccination rate (r = − 0.50, p = 5.3e-5), and also significantly correlates a country’s per capita GDP (r = 0.39, p = 7.4e-3) and median age (r = 0.30, p = 0.042), while COVID-19 cases per million population significantly correlate with per capita GDP and tests per thousand population. To control for possible confounding effects of age, the correlation was assessed in countries propensity score matched for age. The inverse correlation between BCG vaccination rates and COVID-19 case (r = − 0.30, p = 0.02) and death (r = − 0.42, p = 0.0007) remained significant among the top 61 countries with the highest median age.ConclusionThis study contributes to a growing body of evidence supporting the notion that BCG vaccination may be protective against COVID-19 mortality.Supplementary InformationThe online version contains supplementary material available at 10.1007/s15010-020-01566-6.

Using preprints in evidence synthesis: Commentary on experience during the COVID-19 pandemic

The coronavirus disease 2019 (COVID-19) pandemic has disproportionately affected socially disadvantaged populations. Whether disparities in COVID-19 incidence related to race/ethnicity and socioeconomic factors exist in the hemodialysis population is unknown. Our study involved patients receiving in-center hemodialysis in New York City. We used a validated index of neighborhood social vulnerability, the Social Vulnerability Index (SVI), which comprises 15 census tract-level indicators organized into four themes: socioeconomic status, household composition and disability, minority status and language, and housing type and transportation. We examined the association of race/ethnicity and the SVI with symptomatic COVID-19 between March 1, 2020 and August 3, 2020. COVID-19 cases were ascertained using PCR testing. We performed multivariable logistic regression to adjust for demographics, individual-level social factors, dialysis-related medical history, and dialysis facility factors. Of the 1378 patients on hemodialysis in the study, 247 (17.9%) developed symptomatic COVID-19. In adjusted analyses, non-Hispanic Black and Hispanic patients had significantly increased odds of COVID-19 compared with non-Hispanic White patients. Census tract-level overall SVI, modeled continuously or in quintiles, was not associated with COVID-19 in unadjusted or adjusted analyses. Among non-Hispanic White patients, the socioeconomic status SVI theme, the minority status and language SVI theme, and housing crowding were significantly associated with COVID-19 in unadjusted analyses. Among patients on hemodialysis in New York City, there were substantial racial/ethnic disparities in COVID-19 incidence not explained by neighborhood-level social vulnerability. Neighborhood-level socioeconomic status, minority status and language, and housing crowding were positively associated with acquiring COVID-19 among non-Hispanic Whites. Our findings suggest that socially vulnerable patients on dialysis face disparate COVID-19-related exposures, requiring targeted risk-mitigation strategies.

COVID-19 and Gastrointestinal Tract Symptoms: Recognition, Containment, and Learning From the Past

Plasma exchange and COVID 19

Introduction: Contact tracing is an essential public health response to infectious disease outbreaks, principally in the early stages of an outbreak when specific treatments are limited. Importation of novel coronavirus (SARS CoV-2) from Hubei province China and elsewhere into the world highlights the need to recognize the power of contact tracing as a preventive measure. This study was performed to estimate the SARS CoV-2 transmission among the contacts of confirmed cases of coronavirus disease-19 (COVID-19). Methods: The present study included data from contact tracing performed on confirmed COVID-19 cases admitted in the tertiary care hospital of western Maharashtra. Contacts were categorized into high-risk and low-risk contacts. Contacts were quarantined in home or institute, and reverse transcription–polymerase chain reaction (RT-PCR) was done as per the COVID-19 testing strategy. Contacts were admitted once they were RT-PCR-confirmed COVID-19 positive. Results: Out of 471 COVID-19 cases, 104 (22.08%) were females and 367 (77.92%) were males. A total of 2617 contacts were traced with the mean (standard deviation) of 5.56 (8.52). Of these 2617 contacts, 289 (11.04%) contacts became RT-PCR-confirmed positive COVID-19 cases. Out of 471 COVID-19 cases, 271 (46.7) were the contacts of RT-PCR-confirmed COVID-19 cases, and from them, 92 (42.4%) were asymptomatic at the time of admission. Conclusion: The contact tracing strategy in India helped to identify a sufficient proportion of infected individuals, and due to that, subsequent spread of the disease could be prevented. However, the complete achievement will depend on the rapid detection of cases and isolation of contacts. With the increasingly large number of cases globally once in between the null period, this strategy can be effectively utilized to contain the spread of disease.

Post-mortem molecular investigations of SARS-CoV-2 in an unexpected death of a recent kidney transplant recipient.

he wider health impacts of the coronavirus disease 2019 (COVID-19) pandemic are of increasing concern, with an increase in rates of non-COVID-19 excess mortality observed. In England and the United States, the early pandemic was accompanied by a decline in patient visits to Emergency Departments (EDs), including those for cardiac diseases. 1, The decline may have been influenced by patient's reluctance to visit hospital due to the public health messages to protect National Health Service capacity, concerns about the risk of coronavirus infection, or difficulties in accessing medical care. The impact of delayed or nonpresentation to EDs with suspected cardiac disease on cardiac mortality is unknown. In this study, we used instrumental variable analysis to estimate the effects of reduced ED visits on cardiac mortality in England.

Implications of the COVID-19 Pandemic for Pediatric Primary Care Practice in Europe

Coronavirus Disease 2019: Coronaviruses and Kidney Injury.

Coronavirus disease 2019 (COVID-19) is a major threat to nursing homes. During the COVID-19 pandemic wave that hit France in March and April 2020, staff members of some French nursing homes decided to confine themselves with their residents on a voluntary basis to reduce the risk of entry of the severe acute respiratory syndrome coronavirus 2 into the facility. To investigate COVID-19-related outcomes in French nursing homes that implemented voluntary staff confinement with residents. This retrospective cohort study was conducted in French nursing homes from March 1 to May 11, 2020. Participants included residents and staff members of the nursing homes where staff participated in voluntary self-confinement as well as those of the facilities for elderly people where staff did not practice self-confinement. Rates of COVID-19 cases and mortality in the cohort of nursing homes with self confinement were compared with those derived from a population-based survey of nursing homes conducted by French health authorities. Nursing homes with staff who self-confined were identified from the media and included if the confinement period of staff with residents was longer than 7 days. Mortality related to COVID-19 among residents and COVID-19 cases among residents and staff members. COVID-19 was diagnosed by primary care or hospital physicians on the basis of fever and respiratory signs (eg, cough, dyspnea) or a clinical illness compatible with COVID-19; COVID-19 diagnoses were considered confirmed if real-time reverse transcriptase-polymerase chain reaction testing for severe acute respiratory syndrome coronavirus 2 on nasopharyngeal swab was positive and considered possible if the test had not been performed or results were negative. Cases of COVID-19 were recorded by a telephone interview with the directors of nursing homes with staff who self-confined and by a nationwide declaration survey to health authorities for all facilities. This study included 17 nursing homes in which 794 staff members confined themselves to the facility with their 1250 residents. The national survey included 9513 facilities with 385 290 staff members and 695 060 residents. Only 1 nursing home with staff who self-confined (5.8%) had cases of COVID-19 among residents, compared with 4599 facilities in the national survey (48.3%) (P < .001). Five residents (0.4%) in the nursing homes with staff who self-confined had confirmed COVID-19, compared with 30 569 residents (4.4%) with confirmed COVID-19 in the national survey (P < .001); no residents of facilities with self-confinement had possible COVID-19, compared with 31 799 residents (4.6%) with possible COVID-19 in the national survey (P < .001). Five residents (0.4%) in the nursing homes with staff who self-confined died of COVID-19, compared with 12 516 (1.8%) in the national survey (odds ratio, 0.22; 95% CI, 0.09-0.53; P < .001). Twelve staff members (1.6%) from the facilties with self-confinement had confirmed or possible COVID-19, compared with 29 463 staff members (7.6%) in the national survey (P < .001). In this cohort study of French nursing homes during the COVID-19 pandemic, mortality rates related to COVID-19 were lower among nursing homes that implemented staff confinement with residents compared with those in a national survey. These findings suggest that self-confinement of staff members with residents may help protect nursing home residents from mortality related to COVID-19 and residents and staff from COVID-19 infection.