Articles: coronavirus.
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Concerns have been raised about the potential for renin-angiotensin system (RAS) inhibitors to upregulate expression of angiotensin-converting enzyme 2 (ACE2) and thus increase susceptibility to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) entry. Currently, there is no evidence that even if RAS inhibitors increase expression and activity of ACE2, that they would increase the risk of SARS-CoV-2 infection by facilitating greater viral entry or worsen outcomes in patients with COVID-19. At this time, there is no clinical evidence to suggest that treatment with RAS inhibitors should be discontinued in stable patients with COVID-19. In hospitalized patients with severe COVID-19, decisions about these medications should be based on clinical condition, including hemodynamic status and renal function.
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Int J Environ Res Public Health · May 2020
Artificial Intelligence-Empowered Mobilization of Assessments in COVID-19-like Pandemics: A Case Study for Early Flattening of the Curve.
The global outbreak of the Coronavirus Disease 2019 (COVID-19) pandemic has uncovered the fragility of healthcare and public health preparedness and planning against epidemics/pandemics. In addition to the medical practice for treatment and immunization, it is vital to have a thorough understanding of community spread phenomena as related research reports 17.9-30.8% confirmed cases to remain asymptomatic. ⋯ To this end, a self-organizing feature map (SOFM) is trained by using data acquired from past mobile crowdsensing (MCS) campaigns to model mobility patterns of individuals in multiple districts of a city so to maximize the assessed population with minimum agents in the shortest possible time. Through simulation results for a real street map on a mobile crowdsensing simulator and considering the worst case analysis, it is shown that on the 15th day following the first confirmed case in the city under the risk of community spread, AI-enabled mobilization of assessment centers can reduce the unassessed population size down to one fourth of the unassessed population under the case when assessment agents are randomly deployed over the entire city.
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The novel coronavirus has challenged medical systems worldwide to provide optimal medical care in the setting of limited resources. Although we are uncovering many facets of its disease spectrum, with rapidly emerging data, there is still limited knowledge of the sequelae of this infection, making treatment guidelines incomplete and resulting in serious unpredictable outcomes in patients at seemingly low risk, especially ones afflicted by neurological consequences. We present a case of a cortical stroke in a 31-year-old coronavirus disease-19 (COVID-19) positive female with otherwise no stroke risk factors. We noted a correlation between cytokine release, encephalopathy, and the onset of stroke symptoms. Patients with marked pro-thrombotic and inflammatory markers may benefit from closer neurological monitoring and thromboprophylaxis at therapeutic doses. The establishment of acute care pathways to manage critically ill patients with neurological consequences may reverse the suboptimal outcome trends seen during the pandemic.
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The expression "flatten the curve" has gained significant attention in the midst of the COVID-19 pandemic. The idea is to decrease and/or delay the peak of an epidemic wave so as not to strain or exceed the capacity of healthcare systems. ⋯ This paper provides perspectives on the impact of containment, suppression, and mitigation measures on interdependent workforce sectors. Reflections on the trade-offs between flattening the curve versus personal liberty and socioeconomic disparities are also presented in this paper.
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JMIR Public Health Surveill · May 2020
Prediction of the COVID-19 Pandemic for the Top 15 Affected Countries: Advanced Autoregressive Integrated Moving Average (ARIMA) Model.
The coronavirus disease (COVID-19) pandemic has affected more than 200 countries and has infected more than 2,800,000 people as of April 24, 2020. It was first identified in Wuhan City in China in December 2019. ⋯ The observed predicted values showed that the confirmed cases, deaths, and recoveries will double in all the observed countries except China, Switzerland, and Germany. It was also observed that the death and recovery rates were rose faster when compared to confirmed cases over the next 2 months. The associated mortality rate will be much higher in the United States, Spain, and Italy followed by France, Germany, and the United Kingdom. The forecast analysis of the COVID-19 dynamics showed a different angle for the whole world, and it looks scarier than imagined, but recovery numbers start looking promising by July 7, 2020.