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  • ST-Segment Elevation in Patients with Covid-19 — A Case Series

    19 Apr, 2020

    Myocardial injury with ST-segment elevation has been observed in patients with coronavirus disease 2019 (Covid-19). Here, we describe our experience in the initial month of the Covid-19 outbreak in New York City.

    Patients with confirmed Covid-19 who had ST-segment elevation on electrocardiography were included in the study from six New York hospitals. Patients with Covid-19 who had nonobstructive disease on coronary angiography or had normal wall motion on echocardiogra...
  • Hydroxychloroquine in the management of critically ill patients with COVID-19: the need for an evidence base

    19 Apr, 2020
    With the rapid spread of the novel severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), critical care physicians are seeing increasing numbers of patients with acute respiratory failure secondary to coronavirus disease 2019 (COVID-19) and reporting mortality rates of 40–65% for those requiring mechanical ventilation1 —strikingly higher than the mortality rates reported for the more typical acute respiratory distress syndrome associated with other diseases. The focus of ther...
  • Temporal dynamics in viral shedding and transmissibility of COVID-19

    19 Apr, 2020
    AbstractWe report temporal patterns of viral shedding in 94 patients with laboratory-confirmed COVID-19 and modeled COVID-19 infectiousness profiles from a separate sample of 77 infector–infectee transmission pairs. We observed the highest viral load in throat swabs at the time of symptom onset, and inferred that infectiousness peaked on or before symptom onset. We estimated that 44% (95% confidence interval, 25–69%) of secondary cases were infected during the index cases’ presymptomatic stag...
  • Rates of Co-infection Between SARS-CoV-2 and Other Respiratory Pathogens

    18 Apr, 2020
    Last April 15th, the Journal of the American Medical Association (JAMA) published a research letter relating the Covid-19 infections with other respiratory diseases. 
    As of April 3, 2020, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) had caused 972 303 cases of coronavirus disease 2019 (COVID-19) and 50 322 deaths worldwide. Early reports from China suggested that co-infection with other respiratory pathogens was rare. If this were the case, patients positive ...
  • Remdesivir is a direct-acting antiviral that inhibits RNA-dependent RNA polymerase from severe acute respiratory syndrome coronavirus 2 with high potency

    18 Apr, 2020
    Effective treatments for coronavirus disease 2019 (COVID-19) are urgently needed to control this current pandemic, caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Replication of SARS-CoV-2 depends on the viral RNA-dependent RNA polymerase (RdRp), which is the likely target of the investigational nucleotide analogue remdesivir (RDV). RDV shows broad-spectrum antiviral activity against RNA viruses, and previous studies with RdRps from Ebola virus (EBOV) and Middle East r...
  • Antibiotic treatment for COVID-19 complications could fuel resistant bacteria

    18 Apr, 2020

    Science’s COVID-19 reporting is supported by the Pulitzer Center.

    In her regular job, Priya Nori runs Montefiore Medical Center’s antibiotic stewardship program, and spends most of her time ensuring that the Bronx-based hospital doesn’t overuse the drugs and allow bacteria resistant to them to thrive. But like many physicians, Nori is now spending all of her time helping treat COVID-19 patients at her New York City hospital, which like other medical centers in the pand...
  • How does coronavirus kill? Clinicians trace a ferocious rampage through the body, from brain to toes

    18 Apr, 2020
    How does coronavirus kill? Clinicians trace a ferocious rampage through the body, from brain to toes

    On rounds in a 20-bed intensive care unit (ICU) one recent day, physician Joshua Denson assessed two patients with seizures, many with respiratory failure and others whose kidneys were on a dangerous downhill slide. Days earlier, his rounds had been interrupted as his team tried, and failed, to resuscitate a young woman whose heart had stopped. All shared one thing, says Denson,...
  • Personal Protective Equipment and COVID-19 – A Review for Surgeons

    17 Apr, 2020
    The concept of personal protective equipment (PPE) for the surgeon has been in place for greater than 100 years. The aim has been to protect both the surgeon and the patient. However, as zoonotic respiratory pathogens emerge, surgeons and their teams will need to adapt quickly to what will adequately protect them and their patients. There has been a generalized call for more personal protective equipment (PPE), however, there is a wide array of PPE available. High quality ...
  • Surgical consent during the COVID-19 pandemic

    17 Apr, 2020

    “We know there are things we know we know. We also know there are known unknowns; that is to say that we know there are some things we do not know. But there are also unknown unknowns—the ones we don’t know we don’t know.”
    – Donald Rumsfeld, February 12, 2002

    The history of informed consent is one of continuous evolution in search of a best practice, from the mid-20th century, physician...
  • Neurologic Features in Severe SARS-CoV-2 Infection

    17 Apr, 2020

    We report the neurologic features in an observational series of 58 of 64 consecutive patients admitted to the hospital because of acute respiratory distress syndrome (ARDS) due to Covid-19. The patients received similar evaluations by intensivists in two intensive care units (ICUs) in Strasbourg, France, between March 3 and April 3, 2020.

    Six patients were excluded because of paralytic neuromuscular blockade when neurologic...
  • Clinical Features of COVID-19-Related Liver Damage

    17 Apr, 2020
    IntroductionIn December 2019, a novel coronavirus was identified as the pathogen to cause pneumonia in Wuhan, China , which was temporarily named as 2019-nCoV by WHO. On 11 February 2020, based on the phylogeny, taxonomy and established practice, 2019-nCoV was officially named as SARS-CoV-2, and the disease caused by SARS-CoV-2 was named as COVID-19. SARS-CoV-2 can be transmitted from person to person through respiratory droplets and close contact , posing a huge public health challenge...
  • Global guidance for surgical care during the COVID‐19 pandemic

    16 Apr, 2020
    NIHR Global Health Research Unit on Global Surgery created CovidSurg, an international collaborating group of surgeons and anesthetists with representation from 20 different countries: Canada, China, Germany, Hong Kong, Italy, Korea, Singapore, Spain, United Kingdom, United States, Benin, Democratic Republic of Congo, Ghana, India, Mexico, Nigeria, Rwanda, Sierra Leone, South Africa and Zimbabwe. This platform of studies aims to explore the impact of Covid-19 in surgical patients and ser...