Articles: pandemics.
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The Coronavirus Disease 2019 (COVID-19) pandemic has caused an unprecedented disruption in medical education and healthcare systems worldwide. The disease can cause life-threatening conditions and it presents challenges for medical education, as instructors must deliver lectures safely, while ensuring the integrity and continuity of the medical education process. It is therefore important to assess the usability of online learning methods, and to determine their feasibility and adequacy for medical students. ⋯ As we face the prospect of a second wave of virus transmission, we must take certain measures and make changes to minimize the effects of the COVID-19 outbreak on medical education and on the progression of training. The time for change is now, and there should be support and enthusiasm for providing valid solutions to reduce this disruption, such as online training and virtual clinical experience. These measures could then be followed by hands-on experience that is provided in a safe environment.
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The emergence of coronavirus disease 19 pandemic and novel research on the high transmissibility of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has raised controversies over the use of face masks to prevent community transmission. Specific regulations need to be fulfilled to use a face mask as part of the personal protective equipment and high quality of evidence supporting its use to prevent respiratory viral infections, including SARS-CoV-2, is lacking. However, its widespread use is becoming a standard practice in some countries and discrepancies between health authorities on their policy have led to controversy. The aim of this review is to provide an outlook on recent research in this matter and areas of opportunity.
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Meta Analysis
Risk factors for the exacerbation of patients with 2019 Novel Coronavirus: A meta-analysis.
Many studies have reported the risk factors for exacerbations in patients with 2019 novel coronavirus (2019-nCoV). This study aims to perform the meta-analysis of risk factors for the exacerbation of the novel coronavirus-infected pneumonia (NCIP). PubMed, Embase and Google scholar have been searched. ⋯ After comparing the patients between intensive care (ICU) group and non-ICU group, several important factors were found to significantly increase the risk of exacerbations in patients with NCIP, and they included hypertension (RR=2.34; 95% CI=1.21 to 4.51; P=0.01), cardiovascular diseases (RR=2.28; 95% CI=1.13 to 4.58; P=0.02), COPD (RR=7.65; 95% CI=1.24 to 47.13; P=0.03), dyspnea (RR=2.89; 95% CI=2.05 to 4.08; P<0.00001), myalgia or fatigue (RR=1.24; 95% CI=1.01 to 1.52; P=0.04), but several factors such as gender, Huanan Seafood Wholesale Market exposure, diabetes, chronic liver disease, malignancy, fever, cough, expectoration, headache and diarrhoea appeared to have no obvious effect on the exacerbation of pneumonia. In addition, as the exacerbation of pneumonia, some complications had the high probability to occur according to the meta-analysis of acute respiratory distress syndrome (ARDS) (RR=13.95; 95% CI=6.20 to 31.41; P<0.00001), shock (RR=24.29; 95% CI=4.66 to 126.69; P=0.0002), acute cardiac injury (RR=10.32; 95% CI=3.05 to 34.96; P=0.0002) and acute kidney injury (RR=5.90; 95% CI=1.32 to 26.35; P=0.02) between two groups. Several risk factors were confirmed to significantly improve the risk of exacerbation in patients with NCIP, which was very important for the exacerbation prediction and treatment of these patients.
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Front Public Health · Jan 2020
ReviewThe Successes and Failures of the Initial COVID-19 Pandemic Response in Romania.
In the context of the COVID-19 pandemic, countries around the world varied in the strength and timeliness of their responses. In Romania, specific challenges were faced with regards to managing the spread and limiting the impact of the disease, ranging from healthcare infrastructure to demographic and sociocultural aspects. As the country has a sizeable diaspora, major difficulties were faced when large numbers of individuals from highly affected areas returned to Romania. ⋯ Furthermore, early control was facilitated by the exploitation of communication channels that penetrated all layers of society, from ordinary citizens to governmental authorities and high-ranking religious figures. The management of the COVID-19 crisis in Romania illustrates the importance of a fast initial response which takes into account the role played by sociocultural aspects in the context of an epidemic. As the challenges faced by Romania are not unique, these results could inform future public health strategies worldwide.
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Over one million cases of the SARS-CoV-2 virus have been confirmed worldwide, with the death toll exceeding 50,000 people. An important issue to be addressed concerns the exposure of health professionals to this new virus. ⋯ However, there is no specific guidance on how to proceed in cases of need for chest tubes in patients with positive COVID-19 active air leak. The objective of this work is to assist surgeons of the most diverse specialties during the chest drainage of a patient with COVID-19 and to avoid a risk of contamination to the professional and the environment.