International journal of infectious diseases : IJID : official publication of the International Society for Infectious Diseases
-
Int. J. Infect. Dis. · Aug 2020
Linking key intervention timing to rapid decline of the COVID-19 effective reproductive number to quantify lessons from mainland China.
Effective reproductive numbers (Rt) were calculated from data on the COVID-19 outbreak in China and linked to dates in 2020 when different interventions were enacted. From a maximum of 3.98 before the lockdown in Wuhan City, the values of Rt declined to below 1 by the second week of February, after the construction of hospitals dedicated to COVID-19 patients. The Rt continued to decline following additional measures in line with the policy of "early detection, early report, early quarantine, and early treatment." The results provide quantitative evaluations of how intervention measures and their timings succeeded, from which lessons can be learned by other countries dealing with future outbreaks.
-
The outbreak of coronavirus disease 2019 (COVID-19) in China has been basically controlled. However, the global epidemic of COVID-19 is worsening. We established a method to estimate the instant case fatality rate (CFR) and cure rate of COVID-19 in China. ⋯ The instant CFR of COVID-19 in China overall was much higher than that in China except Hubei Province. The CFR of COVID-19 in China was underestimated.
-
Int. J. Infect. Dis. · Aug 2020
The effectiveness and nephrotoxicity of loading dose colistin combined with or without meropenem for the treatment of carbapenem-resistant A. baumannii.
Acinetobacter baumannii has emerged as an important nosocomial pathogen worldwide. In Thailand, the incidence and mortality rate of carbapenem-resistant A. baumannii (CRAB) is continuously increasing. This organism is a common pathogen that can cause HAP and VAP. CRAB tends to be susceptible to only colistin, so colistin would be the last line of treatment for CRAB. The recent data from in-vitro studies found that colistin and meropenem combination therapy could exert synergistic effects. However, some in-vivo studies have shown no significant difference in antibacterial effect between colistin monotherapy and colistin plus meropenem. Moreover, the clinical data are recently limited and not clear. Thus, the objective of this study was to compare clinical outcome, microbiological response, mortality rate and nephrotoxicity between loading dose (LD) colistin monotherapy and LD colistin-meropenem for treatment of infection caused by CRAB in Maharaj Nakorn Chiang Mai Hospital. ⋯ There were no significant differences in effectiveness and nephrotoxicity of LD colistin monotherapy versus LD colistin plus meropenem for treatment of CRAB infection, so colistin combination therapy was not necessary for the management of infection caused by CRAB.
-
Int. J. Infect. Dis. · Aug 2020
Multicenter Study Observational StudyTreatment with hydroxychloroquine, azithromycin, and combination in patients hospitalized with COVID-19.
The United States is in an acceleration phase of the COVID-19 pandemic. Currently there is no known effective therapy or vaccine for treatment of SARS-CoV-2, highlighting urgency around identifying effective therapies. ⋯ In this multi-hospital assessment, when controlling for COVID-19 risk factors, treatment with hydroxychloroquine alone and in combination with azithromycin was associated with reduction in COVID-19 associated mortality. Prospective trials are needed to examine this impact.
-
Int. J. Infect. Dis. · Aug 2020
ReviewIron: Innocent bystander or vicious culprit in COVID-19 pathogenesis?
The coronavirus 2 (SARS-CoV-2) pandemic is viciously spreading through the continents with rapidly increasing mortality rates. Current management of COVID-19 is based on the premise that respiratory failure is the leading cause of mortality. However, mounting evidence links accelerated pathogenesis in gravely ill COVID-19 patients to a hyper-inflammatory state involving a cytokine storm. ⋯ Another key component of the heightened inflammatory state is hyper-ferritinemia which reportedly identifies patients with increased mortality risk. In spite of its strong association with mortality, it is not yet clear if hyper-ferritinemia in COVID-19 patients is merely a systemic marker of disease progression, or a key modulator in disease pathogenesis. Here we address implications of a possible role for hyper-ferritinemia, and altered iron homeostasis in COVID-19 pathogenesis, and potential therapeutic targets in this regard.