bluuebunny/crossref_metadata_2025_split huggingface dataset:
Famotidine Use is Associated with Improved Clinical Outcomes in Hospitalized COVID-19 Patients: A Propensity Score Matched Retrospective Cohort Study
Authors: Freedberg Daniel E. , Conigliaro Joseph , Sobieszczyk Magdalena E. , Markowitz David D. , Gupta Aakriti , O’Donnell Max R. , Li Jianhua , Tuveson David A. , Jin Zhezhen , Turner William C. , Landry Donald W. , Wang Timothy C. , Tracey Kevin J. , Callahan Michael V. , Abrams Julian A. 
Published: May 2020

ABSTRACTBackground and AimsThe COVID-19 pandemic has caused widespread mortality and mortality. Famotidine is commonly used for gastric acid suppression but has recently gained attention as an antiviral that may inhibit SARS-CoV-2 replication. This study tested whether famotidine use is associated with improved clinical outcomes in patients with COVID-19 initially hospitalized to a non-intensive care setting.MethodsThis was a retrospective cohort study conducted among consecutive hospitalized patients with COVID-19 infection from February 25 to April 13, 2020 at a single medical center. The primary exposure was famotidine, received within 24 hours of hospital admission. The primary outcome was intubation or death. Propensity score matching was used to balance the baseline characteristics of patients who did and did not use famotidine.Results1,620 hospitalized patients with COVID-19 were identified including 84 (5.1%) who received famotidine within 24 hours of hospital admission. 340 (21%) patients met the study composite outcome of death or intubation. Use of famotidine was associated with reduced risk for death or intubation (adjusted hazard ratio (aHR) 0.42, 95% CI 0.21-0.85) and also with reduced risk for death alone (aHR 0.30, 95% CI 0.11-0.80). After balancing baseline patient characteristics using propensity score matching, these relationships were unchanged (HR for famotidine and death or intubation: 0.43, 95% CI 0.21-0.88). Proton pump inhibitors, which also suppress gastric acid, were not associated with reduced risk for death or intubation.ConclusionFamotidine use is associated with reduced risk of intubation or death in hospitalized COVID-19 patients. Randomized controlled trials are warranted to determine whether famotidine therapy improves outcomes in hospitalized COVID-19 patients.
Hydroxychloroquine and azithromycin plus zinc vs hydroxychloroquine and azithromycin alone: outcomes in hospitalized COVID-19 patients
Authors: Carlucci Philip M. , Ahuja Tania , Petrilli Christopher , Rajagopalan Harish , Jones Simon , Rahimian Joseph 
Published: May 2020

AbstractBackgroundCOVID-19 has rapidly emerged as a pandemic infection that has caused significant mortality and economic losses. Potential therapies and means of prophylaxis against COVID-19 are urgently needed to combat this novel infection. As a result of in vitro evidence suggesting zinc sulfate may be efficacious against COVID-19, our hospitals began using zinc sulfate as add-on therapy to hydroxychloroquine and azithromycin. We performed a retrospective observational study to compare hospital outcomes among patients who received hydroxychloroquine and azithromycin plus zinc versus hydroxychloroquine and azithromycin alone.MethodsData was collected from electronic medical records for all patients being treated with admission dates ranging from March 2, 2020 through April 5, 2020. Initial clinical characteristics on presentation, medications given during the hospitalization, and hospital outcomes were recorded. Patients in the study were excluded if they were treated with other investigational medications.ResultsThe addition of zinc sulfate did not impact the length of hospitalization, duration of ventilation, or ICU duration. In univariate analyses, zinc sulfate increased the frequency of patients being discharged home, and decreased the need for ventilation, admission to the ICU, and mortality or transfer to hospice for patients who were never admitted to the ICU. After adjusting for the time at which zinc sulfate was added to our protocol, an increased frequency of being discharged home (OR 1.53, 95% CI 1.12-2.09) reduction in mortality or transfer to hospice remained significant (OR 0.449, 95% CI 0.271-0.744).ConclusionThis study provides the first in vivo evidence that zinc sulfate in combination with hydroxychloroquine may play a role in therapeutic management for COVID-19.40-word summary: Zinc sulfate added to hydroxychloroquine and azithromycin may improve outcomes among hospitalized patients.
Social distancing and movement constraint as the most likely factors for COVID-19 outbreak control in Brazil
Authors: Baumgartner Matheus Tenório , Lansac-Tôha Fernando Miranda , Coelho Marco Túlio Pacheco , Dobrovolski Ricardo , Diniz-Filho José Alexandre Felizola 
Published: May 2020

AbstractAs thousands of new cases of COVID-19 have been confirmed, there is an increasing demand to understand the factors underlying the spread of this disease. Using country-level data, we modeled the early growth in the number of cases for over 480 cities in all Brazilian states. As the main findings, we found that the percentage of people respecting social distancing protocols was the main explanatory factor for the observed growth rate of COVID-19. Those cities that presented the highest spread of the new coronavirus were also those that had lower averages of social distancing. We also underline that total population of cities and connectivity, represented by the city-level importance to the air transportation of people across the country, plays important roles in the dissemination of SARS-CoV-2. Climate and socioeconomic predictors had little contribution to the big-picture scenario. Our results show that different States had high variability in their growth rates, mostly due to quite different public health strategies to retain the outbreak of COVID-19. In spite of all limitations of such a large-scale approach, our results underline that climatic conditions are likely weak limiting factors for the spread of the new coronavirus, and the circulation of people in the city- and country-level are the most responsible factors for the early outbreak of COVID-19 in Brazil. Moreover, we reinforce that social distancing protocols are fundamental to avoid critical scenarios and the collapse of healthcare systems. We also predict that economic-induced decisions for relaxing social distancing might have catastrophic consequences, especially in large cities.
Environmental sampling for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) during a coronavirus disease (COVID-19) outbreak aboard a commercial cruise ship
Authors: Suzuki Motoi , Kamiya Hajime , Okamoto Kiyoko , Yamagishi Takuya , Kakimoto Kensaku , Takeda Makoto , Matsuyama Syutoku , Shirato Kazuya , Nao Naganori , Hasegawa Hideki , Kageyama Tsutomu , Takayama Ikuyo , Saito Shinji , Wakita Takaji , Ohnishi Makoto , Wada Koji , Fujita Retsu , Gu Yoshiaki , Matsunaga Nobuaki , Sakaguchi Mikiyo , Taichi Tajima R.N. , Ohmagari Norio , Takaya Saho , Saito Hiroki , Okinaka Keiji , Griffith Mathew , Parry Amy Elizabeth , Plucinski Mateusz M , Barnetson Brenda , Leonard James 
Published: May 2020

SummaryBackgroundA COVID-19 outbreak occurred in a cruise ship with 3711 passengers and crew in 2020. This study is to test the hypothesis that environmental surfaces played important roles in transmission for SARS-CoV-2 during this outbreak.MethodsWe sampled environmental surfaces including air from common areas in the cruise ship and cabins in which confirmed COVID-19 cases and non-cases had stayed after they left the cabins. We tested the samples for SARS-CoV-2 by rt-PCR and conducted viral isolation.FindingsOf 601 samples tested, SARS-CoV-2 RNA was detected from 58 samples (10%) from case-cabins from which they left 1-17 days before sampling, but not from non-case-cabins. Except for one sample from an air hood in a corridor, SARS-CoV-2 RNA was not detected from samples in common areas. SARS-CoV-2 RNA was not detected from all 14 air samples. RNA was most often detected on the floor around toilet in the bathroom (39%, 13/33, cycle quantification (Cq): 26.21-37.62) and bed pillow (34%, 11/32, Cq: 34.61-38.99). There was no difference in the detection proportion between cabins for symptomatic (15%, 28/189, Cq: 29.79-38.86) and asymptomatic cases (21%, 28/131, Cq: 26.21-38.99). No SARS-CoV-2 virus was isolated from any of the samples.InterpretationThe environment around the COVID-19 cases was extensively contaminated from SARS-CoV-2 during COVID-19 outbreak in the cruise ship. Transmission risk of SARS-CoV-2 from symptomatic and asymptomatic patients seems to be similar and the environmental surface could involve viral transmission through direct contact.
The Infection Rate of the Coronavirus Disease 2019 (COVID-19) in Wuhan, China
Authors: Qu Hui-Qi , Cheng Zhangkai J. , Duan Zhifeng , Tian Lifeng , Hakonarson Hakon 
Published: May 2020

Summary BoxWhat is already known about this subject?The Wuhan city in China had a much higher mortality rate (Feb 10th statistics: 748 death/18,454 diagnosis =4.05%; Apr 24th statistics: 3,869 death/50,333 diagnosis=7.69%) than the rest of China.What are the new findings?Based on our analysis, the number of infected people in Wuhan is estimated to be 143,000 (88,000 to 242,000) in late January and early February, significantly higher than the published number of diagnosed cases.What are the recommendations for policy and practice?Increased awareness of the original infection rates in Wuhan, China is critically important for proper public health measures at all levels, as well as to eliminate panic caused by overestimated mortality rate that may bias health policy actions by the authorities
Estimative of real number of infections by COVID-19 on Brazil and possible scenarios
Authors: Cintra H. P. C , Fontinele F. N. 
Published: May 2020

AbstractThis paper attempts to provide methods to estimate the real scenario of the novel coronavirus pandemic crisis on Brazil and the states of Sao Paulo, Pernambuco, Espirito Santo, Amazonas and Distrito Federal. By the use of a SEIRD mathematical model with age division, we predict the infection and death curve, stating the peak date for Brazil and these states. We also carry out a prediction for the ICU demand on these states for a visualization of the size of a possible collapse on the local health system. By the end, we establish some future scenarios including the stopping of social isolation and the introduction of vaccines and efficient medicine against the virus.
Etiologic Subtypes of Ischemic Stroke in SARS-COV-2 Virus patients in a cohort of New York City hospitals
Authors: Berekashvili Ketevan , Dmytriw Adam A , Vulkanov Volodomyr , Agarwal Shashank , Khaneja Amit , Turkel-Parella David , Liff Jeremy , Farkas Jeffrey , Nandakumar Thambinajar , Zhou Ting , Frontera Jennnifer , Kahn David E , Kim Sun , Humbert Kelly A , Sanger Matthew D , Yaghi Shadi , Lord Aaron , Arcot Karthikeyan , Tiwari Ambooj 
Published: May 2020

AbstractObjectiveTo describe the ischemic stroke subtypes related to COVID-19 in a cohort of NYC hospitals and explore their etiopathogenesis.BackgroundExtra-pulmonary involvement of COVID-19 has been reported in the hepatic, renal and hematological systems. Most neurological manifestations are non-focal, but few have reported the characteristics of ischemic strokes or investigated its pathophysiology.MethodsData were collected prospectively from March 15 to April 15, 2020 from four centers in New York City to review possible ischemic stroke types seen in COVID-19 positive patients. Patient presentation, demographics, other related vascular risk factors, associated laboratory and coagulation markers, as well as imaging and outcomes for consecutive stroke patients positive for SARS-COV2 infection over the period studied were collected.ResultsIn our study, the age range of patients was 25-75 with no significant male preponderance. The median age of LVO patients was 48. Stroke was the presenting and hospitalizing event in 70%. One fifth of patients did not have common risk factors for ischemic stroke and none had atrial fibrillation, coronary or cerebrovascular disease, or were smokers. Half had a poor outcome with 40% ending in mortality (60% in LVO group) and one in a critical condition due ARDS. All had high neutrophil/lymphocyte ratio except one who demonstrated some neurological recovery. D-dimer levels showed mild to severe elevation when collected. None of the LVO cases had known cardiac risk factors but two out of five were found to have cardiac abnormalities during their hospitalization. All LVOs had hypercoagulable lab markers especially elevated D-dimer and/or fibrinogen. The LVO patients were younger and sicker with a median age of 46 and mean NIHSS of 24 as opposed to non-LVOs with a median age of 62 and mean NIHSS of 6 respectively.ConclusionCOVID-19 related ischemic events can be small vessel, branch emboli or large vessel occlusions. The latter is often associated with either a hypercoagulable state or cardio-embolism. Patient outcomes were worse when multi-organ or pulmonary system failure prevailed.
Occurrence and Timing of Subsequent SARS-CoV-2 RT-PCR Positivity Among Initially Negative Patients
Authors: Long Dustin R. , Gombar Saurabh , Hogan Catherine A. , Greninger Alexander L. , Shah Vikas O’Reilly , Bryson-Cahn Chloe , Stevens Bryan , Rustagi Arjun , Jerome Keith R. , Kong Christina S. , Zehnder James , Shah Nigam H. , Weiss Noel S. , Pinsky Benjamin A. , Sunshine Jacob 
Published: May 2020

AbstractBackgroundSARS-CoV-2 reverse transcriptase polymerase chain reaction (RT-PCR) testing remains the cornerstone of laboratory-based identification of patients with COVID-19. As the availability and speed of SARS-CoV-2 testing platforms improve, results are increasingly relied upon to inform critical decisions related to therapy, use of personal protective equipment, and workforce readiness. However, early reports of RT-PCR test performance have left clinicians and the public with concerns regarding the reliability of this predominant testing modality and the interpretation of negative results. In this work, two independent research teams report the frequency of discordant SARS-CoV-2 test results among initially negative, repeatedly tested patients in regions of the United States with early community transmission and access to testing.MethodsAll patients at the University of Washington (UW) and Stanford Health Care undergoing initial testing by nasopharyngeal (NP) swab between March 2nd and April 7th, 2020 were included. SARS-CoV-2 RT-PCR was performed targeting the N, RdRp, S, and E genes and ORF1ab, using a combination of Emergency Use Authorization laboratory-developed tests and commercial assays. Results through April 14th were extracted to allow for a complete 7-day observation period and an additional day for reporting.ResultsA total of 23,126 SARS-CoV-2 RT-PCR tests (10,583 UW, 12,543 Stanford) were performed in 20,912 eligible patients (8,977 UW, 11,935 Stanford) undergoing initial testing by NP swab; 626 initially test-negative patients were re-tested within 7 days. Among this group, repeat testing within 7 days yielded a positive result in 3.5% (4.3% UW, 2.8% Stanford) of cases, suggesting an initial false negative RT-PCR result; the majority (96.5%) of patients with an initial negative result who warranted reevaluation for any reason remained negative on all subsequent tests performed within this window.ConclusionsTwo independent research teams report the similar finding that, among initially negative patients subjected to repeat SARS-CoV-2 RT-PCR testing, the occurrence of a newly positive result within 7 days is uncommon. These observations suggest that false negative results at the time of initial presentation do occur, but potentially at a lower frequency than is currently believed. Although it is not possible to infer the clinical sensitivity of NP SARS-CoV-2 RT-PCR testing using these data, they may be used in combination with other reports to guide the use and interpretation of this common testing modality.
Reduced mortality and shortened ICU stay in SARS-COV-2 patients: a low PEEP strategy
Authors: Ceruti Samuele , Roncador Marco , Gié Olivier , Bona Giovanni , Iattoni Martina , Biggiogero Maira , Maida Pier Andrea ,   COVID-19 Clinical Management Team, Garzoni Christian , Mauri Romano ,   COVID-19 Clinical Management Team, Biondi Carola , Canovi Sara , Cavagna Mattia , Di Mari Bruno , Horvath Zsofia , Leo Rosambra , Lo Presti Giorgia , Luvini Giorgia , Meloni Dario , Orlando Francesca , Ravasi Sara , Sonzini Roberta , Tinessa Giuseppe 
Published: May 2020

ABSTRACTBackgroundIntensive Care Unit (ICU) management of COVID-19 patients with severe hypoxemia is associated with high mortality. We implemented a ‘care map’, as a standardized multidisciplinary approach to improve patients monitoring using: uniform patient selection for ICU admission, a low-PEEP strategy and a pharmacologic strategic thromboembolism management.MethodsA standardized protocol for managing COVID-19 patients and ICU admissions was implemented through accurate Early Warning Score (EWS) monitoring and thromboembolism prophylaxis at hospital admission. Dyspnea, mental confusion or SpO2 less than 85% were criteria for ICU admission. Ventilation approach employed low PEEP values (about 10 cmH2O in presence of lung compliance > 40 mL/cmH2O) and FiO2 as needed. In presence of lower lung compliance (< 40 mL/cmH2O) PEEP value was increased to about 14 cmH2O.FindingsFrom March 16th to April 12nd 2020, 41 COVID-19 patients were admitted to our ICU from a total of 310 patients. 83% (34) of them needed mechanical ventilation. The ventilation approach chosen employed low PEEP value based on BMI (PEEP 11± 3.8 (10-12) cmH2O if BMI < 30 Kg/m2; PEEP 15± 3.26 (12-18) cmH2O if BMI >30 Kg/m2). To date, ten patients (24%) died, four (9.7%) received mechanical ventilation, two were transferred to another hospital and 25 (60.9%) were discharged from ICU after a median of nine days.InterpretationA multimodal approach for COVID-19 patients is mandatory. The knowledge of this multi-organ disease is growing rapidly, requiring improvements in the standard of care. Our approach implements an accurate pre-ICU monitoring and strict selection for ICU admission, and allows to reduce mechanical ventilation, ICU stay and mortality.FundingNo funding has been required.
Temperature and relative humidity are not major contributing factor on the occurrence of COVID-19 pandemic: An observational study in 57 countries (2020-05-08)
Authors: Sobur Md. Abdus , Islam Md. Saiful , Haque Md. Emdadul , Rahman AMM Taufiquer , Islam Md. Taohidul , Toniolo Antonio , Rahman Md. Tanvir 
Published: May 2020

AbstractThe world searching for hope has already experienced a huge loss of lives due to COVID-19 caused by SARS-CoV-2 started in Wuhan, China. There are speculations that climatic conditions can slowdown the transmission of COVID-19. Findings from the early outbreak indicated the possible association of air temperature and relative humidity in COVID-19 occurrence in China. Current study focused on whether climatic conditions (temperature and relative humidity) are having any influence in the occurrence of COVID-19 when the outbreak has been classified as pandemic. To determine the effect of daily average temperature and average relative humidity on log-transformed total daily cases of COVID-19, polynomial regression as a quadratic term and linear regression were done. Linear regression analysis was also carried out to explore the same effect on selected countries. Present study observed no correlation between the climatic conditions (the daily average temperature and relative humidity) and the number of cases of COVID-19. Similar result was found in relation between daily average temperature and average number of cases per day in country-wise analysis. However, about 93.5% cases of COVID-19 occurred between 1°C to 16°C and the average number of cases per day was lower in high temperature country than low temperature country with exceptions. The minimum effect of summer temperature may not be effective to control the pandemic rather need to apply the control measures of COVID-19.
A seven-day cycle in COVID-19 infection, hospitalization, and mortality rates: Do weekend social interactions kill susceptible people?
Authors: Ricon-Becker Itay , Tarrasch Ricardo , Blinder Pablo , Ben-Eliyahu Shamgar 
Published: May 2020

AbstractSeven-day cycles in numbers of COVID-19 new-cases and deaths are markedly evident in most public databases (e.g. Worldometer, ECDC), but it is unclear whether they reflect systematic artifacts of delays in information reporting/gathering, or have a more profound basis. To address this question we located 11 databases of US states that provide date- authenticated information (actual date of symptom onset and/or specimen collection, or actual hospitalization or death date) that reported more than 1,000 deaths each. Numbers of new cases showed a weekly cyclic pattern in 10 out of 11 states, commonly peaking on weekdays, 2-6 days after the weekend, corresponding with a reported median 5-day lag between infection and the manifestation of clinical symptoms. We postulate that this pattern emerges from interactions with different and/or extended social-circles during weekends, including increased inter-generational meetings, which in turn facilitate transfer of COVID-19 from younger people to older vulnerable individuals. Furthermore, we found weekly periodicity in hospitalizations in 2 out of 2 authenticated databases providing this information. Actual death date, which is more difficult to attribute to individual choice, and is expected to occur approximately 2-3 weeks following hospitalization, showed significant 7-day periodicity in 1 out of 11 states, and a trend in 2 additional states. If weekly peaks in new cases can be truncated by physical/social distancing, especially during weekends, the mortality of COVID-19 may be reduced, or at least hospitalization and mortality curves may be flattened.Significance StatementWe believe our findings are significant, as it appears that it is difficult for people to grasp an ambiguous “price” for visiting their friends and family, when they cannot be certain that they are not carrying and spreading the virus. Our findings could be used as an effective “tool” to demonstrate such a cost, clearly presented in terms of number of excessive infections. During these days of uncertainly, we believe it is fundamental to provide scientific facts that could illuminate this connection and make it tangible for the general. The amplitude of the cycles we describe here is such that many thousands of infections could be averted by carefully scrutinizing local policies, medical practice, and social norms.