Articles: sars-cov-2.
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Comparative Study
COVID-19 and Inequity: a Comparative Spatial Analysis of New York City and Chicago Hot Spots.
There have been numerous reports that the impact of the ongoing COVID-19 epidemic has disproportionately impacted traditionally vulnerable communities associated with neighborhood attributes, such as the proportion of racial and ethnic minorities, migrants, and the lower income households. The goal of this ecological cross-sectional study is to examine the demographic and economic nature of spatial hot and cold spots of SARS-CoV-2 rates in New York City and Chicago as of April 13, 2020 using data from the New York City Department of Health and Mental Hygiene, Illinois Department of Public Health, and the American Community Survey. In both cities, cold spots (clusters of low SARS-CoV-2 rate ZIP code tabulation areas as identified by the Getis-Ord (GI*) statistic) demonstrated social determinants of health characteristics typically associated with better health outcomes and the ability to maintain physical distance ("social distancing"). ⋯ Findings suggest important differences between the cities' hot spots as well. NYC hot spots can be described as working-class and middle-income communities, perhaps indicative of greater concentrations of service workers and other occupations (including those classified as "essential services" during the pandemic) that may not require a college degree but pay wages above poverty levels. Chicago's hot spot neighborhoods, on the other hand, are among the city's most vulnerable, low-income neighborhoods with extremely high rates of poverty, unemployment, and non-Hispanic Black residents.
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Case Reports
Nasoseptal Flap Necrosis After Endoscopic Skull Base Surgery in the Setting of SARS-CoV-2/COVID-19.
A novel viral strain known as severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has created a worldwide pandemic known as coronavirus 2019 (COVID-19). Early reports from China have highlighted the risks associated with performing endoscopic endonasal skull base surgery in patients with SARS-CoV-2. We present a rare complication of nasoseptal flap (NSF) necrosis associated with COVID-19, further emphasizing the challenges of performing these procedures in this era. ⋯ To our knowledge, this is the first reported case of NSF necrosis in a patient with COVID-19. We postulate that the thrombotic complications of COVID-19 may have contributed to vascular pedicle thrombosis and NSF necrosis. Although the pathophysiology of SARS-CoV-2 and its effect on the nasal tissues is still being elucidated, this case highlights some challenges of performing endoscopic skull base surgery in the era of COVID-19.
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Since December 2019, the world has been facing the life-threatening disease, named Coronavirus disease-19 (COVID-19), recognized as a pandemic by the World Health Organization. The response of the Emergency Medicine network, integrating "out-of-hospital" and "hospital" activation, is crucial whenever the health system has to face a medical emergency, being caused by natural or human-derived disasters as well as by a rapidly spreading epidemic outbreak. We here report the Pavia Emergency Medicine network response to the COVID-19 outbreak. ⋯ The present study reports how the rapid and coordinated reorganization of both might help in facing such a disaster. AREU-112 and the Emergency Department should be ready to finely tune their usual cooperation to respond to a sudden and overwhelming increase in the healthcare needs brought about by a pandemia like the current one. This lesson should shape and reinforce the future.
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J Am Soc Echocardiogr · Aug 2020
ReviewCritical Care Transesophageal Echocardiography in Patients during the COVID-19 Pandemic.
The COVID-19 pandemic has placed an extraordinary strain on healthcare systems across North America. Defining the optimal approach for managing a critically ill COVID-19 patient is rapidly changing. Goal-directed transesophageal echocardiography (TEE) is frequently used by physicians caring for intubated critically ill patients as a reliable imaging modality that is well suited to answer questions at bedside. ⋯ In the right clinical scenario, TEE is a tool that can provide the information needed to deliver the best and safest possible care for the critically ill patients.