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Management of Coronavirus Disease 2019 (COVID-19) Pandemic: From Diagnosis to Treatment Strategies.

ABSTRACT: Following the emergence of severe acute respiratory syndrome (SARS) in 2002 and the Middle East respiratory syndrome (MERS) in 2012, the world is now combating a third large-scale outbreak caused by a coronavirus, the coronavirus disease 2019 (COVID-19). After the rapid spread of SARS-coronavirus (CoV)-2 (the virus causing COVID-19) from its origin in China, the World Health Organization (WHO) declared a Public Health Emergency of International Concern (PHEIC) on January 30, 2020. From the beginning of the COVID-19 pandemic, a significant number of studies have been conducted to better understand the biology and pathogenesis of the novel coronavirus, and to aid in developing effective treatment regimens, therapeutics, and vaccines. This review focuses on the recent advancements in the rapidly evolving areas of clinical care and management of COVID-19. The emerging strategies for the diagnosis and treatment of this disease are explored, and the development of effective vaccines is reviewed.

SUBMITTER: Hadisi Z

PROVIDER: S-EPMC7883285 | biostudies-literature | 2020 Dec

REPOSITORIES: biostudies-literature

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Management of Coronavirus Disease 2019 (COVID-19) Pandemic: From Diagnosis to Treatment Strategies.

Hadisi Zhina Z Walsh Tavia T Dabiri Seyed Mohammad Hossein SMH Seyfoori Amir A Hamdi David D Mirani Bahram B Pagan Erik E Jardim Armando A Akbari Mohsen M

Advanced therapeutics 20201216 3

Following the emergence of severe acute respiratory syndrome (SARS) in 2002 and the Middle East respiratory syndrome (MERS) in 2012, the world is now combating a third large-scale outbreak caused by a coronavirus, the coronavirus disease 2019 (COVID-19). After the rapid spread of SARS-coronavirus (CoV)-2 (the virus causing COVID-19) from its origin in China, the World Health Organization (WHO) declared a Public Health Emergency of International Concern (PHEIC) on January 30, 2020. From the begin ...[more]

PMID: 33614905

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Project description:The current coronavirus disease 2019 (COVID-19) pneumonia pandemic, caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is spreading globally at an accelerated rate, with a basic reproduction number (R0) of 2-2.5, indicating that 2-3 persons will be infected from an index patient. A serious public health emergency, it is particularly deadly in vulnerable populations and communities in which healthcare providers are insufficiently prepared to manage the infection. As of March 16, 2020, there are more than 180,000 confirmed cases of COVID-19 worldwide, with more than 7000 related deaths. The SARS-CoV-2 virus has been isolated from asymptomatic individuals, and affected patients continue to be infectious 2 weeks after cessation of symptoms. The substantial morbidity and socioeconomic impact have necessitated drastic measures across all continents, including nationwide lockdowns and border closures. Pregnant women and their fetuses represent a high-risk population during infectious disease outbreaks. To date, the outcomes of 55 pregnant women infected with COVID-19 and 46 neonates have been reported in the literature, with no definite evidence of vertical transmission. Physiological and mechanical changes in pregnancy increase susceptibility to infections in general, particularly when the cardiorespiratory system is affected, and encourage rapid progression to respiratory failure in the gravida. Furthermore, the pregnancy bias toward T-helper 2 (Th2) system dominance, which protects the fetus, leaves the mother vulnerable to viral infections, which are more effectively contained by the Th1 system. These unique challenges mandate an integrated approach to pregnancies affected by SARS-CoV-2. Here we present a review of COVID-19 in pregnancy, bringing together the various factors integral to the understanding of pathophysiology and susceptibility, diagnostic challenges with real-time reverse transcription polymerase chain reaction (RT-PCR) assays, therapeutic controversies, intrauterine transmission, and maternal-fetal complications. We discuss the latest options in antiviral therapy and vaccine development, including the novel use of chloroquine in the management of COVID-19. Fetal surveillance, in view of the predisposition to growth restriction and special considerations during labor and delivery, is addressed. In addition, we focus on keeping frontline obstetric care providers safe while continuing to provide essential services. Our clinical service model is built around the principles of workplace segregation, responsible social distancing, containment of cross-infection to healthcare providers, judicious use of personal protective equipment, and telemedicine. Our aim is to share a framework that can be adopted by tertiary maternity units managing pregnant women in the flux of a pandemic while maintaining the safety of the patient and healthcare provider at its core.

Project description:BackgroundWhile the 2019 novel coronavirus disease (COVID-19) outbreak has been largely kept under control in China, it remains a global pandemic, and the source, transmission route, and treatments of SARS-COV-2 are still being investigated. Here, we summarized the clinical features, diagnosis, treatment, and prognosis of COVID-19 patients based on our clinical practice.MethodsThe clinical and imaging findings, treatments, and follow-up data of 471 patients with COVID-19 who were discharged from the Wuhan Jinyintan Hospital prior to February 6, 2020, were retrospectively analyzed.ResultsAmong these patients, there were 2 mild cases, 282 moderate cases, 181 severe cases, and 6 critical cases. There were 250 males and 221 females aged 17 to 90 years. The median age was 54 years in the severe/critical group, which was significantly older than in the mild/moderate group (P<0.05). 44.59% of them had one or more underlying diseases. The most common symptoms were fever, cough, expectoration, and dyspnea. The median body temperature in the severe/critical group was 39°C, which was significantly higher than in the mild/moderate group (P<0.05). The incidences of lymphopenia and CD4+ T lymphocytopenia were 53.5% and 41.86%, respectively. Ground-glass opacity and small patchy shadows were the most common findings on chest computed tomography (CT). Compared with the mild/moderate group, the severe/critical group showed higher proportions of severe lymphocytopenia and CD4+ T lymphocytopenia, along with more ground-glass shadows and large-scale consolidation. After anti-infection, oxygen therapy, and symptomatic support, lymphocytes and CD4+ T lymphocytes were markedly increased, all patients were discharged. The median time of nucleic acid conversion and hospital stay were 9 and 12 days, respectively, which were significantly longer in the severe/critical group than in the mild/moderate group. Of the 390 cases followed, only 19 were hospitalized again due to other diseases. All patients recovered well from COVID-19, with negative nucleic acid test results.ConclusionsLymphocytopenia and CD4+ T lymphocytopenia were found to be associated with COVID-19 and thus may be important indicators in evaluating the severity and prognosis. Multidisciplinary management including antiviral treatment, immune regulation, and symptomatic support is effective, and yields a low recurrence rate.

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Management of Coronavirus Disease 2019 (COVID-19) Pandemic: From Diagnosis to Treatment Strategies.

Publications

Management of Coronavirus Disease 2019 (COVID-19) Pandemic: From Diagnosis to Treatment Strategies.

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