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ALLMedicine™ Detailed topics Center - Guidelines

Reopening schools after the COVID-19 lockdown

With nationwide school closures currently operating in 191 countries, the United Nations Educational, Scientific and Cultural Organization (UNESCO) has estimated that 1.6 billion (90.2%) students are currently out of primary, secondary and tertiary education (henceforth schools) as a result of the global COVID-19 lockdown [1]. These restrictions have been introduced to help maintain physical di...

New Method to Reduce COVID-19 Transmission - The Need for Medical Air Disinfection is Now

The coronavirus disease 2019 (COVID-19) is caused by severe acute respiratory syndrome coronavirus 2 (SARSCoV-2) [1]. It has led to a pandemic worldwide due to its extremely infectious nature. At present, the route of transmission of SARS-CoV-2 is still controversial, but the major route of the COVID-19 to rapidly spread through indoor environments, is caused by the airborne route of the ...

What aerosol physics tells us about airborne pathogen transmission

While a global pandemic by SARS-CoV in 2002–2003 was averted by fast identification, effective surveillance, and quarantine, such measures cannot be easily transferred to new situations, as the case of SARS-CoV-2 demonstrates. Knowledge of the fundamental biological and physical parameters affecting transmission pathways of respiratory pathogens is thus critical for the design of effective non-...

Airborne SARS-CoV-2: Weighing the Evidence for Its Role in Community Transmission

We read with great interest Bae’s recent publication on the incubation period of severe acute respiratory coronavirus 2 (SARS-CoV-2) and its infectivity [1]. However, we would like to launch a further discussion on the infectivity of SARS-CoV-2 and the controversy regarding concerns about airborne SARSCoV-2 transmission.

Coronaviruses and Immunosuppressed Patients: The Facts During the Third Epidemic

Following the outbreak in China, the Lombardy region of Italy has become one of the areas of highest incidence of severe acute respiratory syndrome coronavirus 2 (SARS‐CoV‐2). As the outbreak grew to a pandemic, many centers worldwide raised the concern that immunocompromised patients may be at high risk of developing a severe respiratory disease called coronavirus disease 2019 (COVID‐19). Unli...

Characterization of acute acral skin lesions in nonhospitalized patients: A case series of 132 patients during the COVID-19 outbreak

The coronavirus disease 2019 (COVID-19) has been associated with several skin manifestations, including widespread urticaria, erythematous rash, and varicella-like exanthem.1,2 Ischemic and ecchymotic acral lesions have also been described in patients with severe forms of COVID-19 as a manifestation of clotting disorders.3 Coincident with the COVID-19 pandemic, similar acral lesions hav...

Pooling of samples for testing for SARS-CoV-2 in asymptomatic people

The ongoing coronavirus disease 2019 (COVID-19) pandemic is a substantial challenge for health-care systems and their infrastructure. RT-PCR-based diagnostic confirmation of infected individuals is crucial to contain viral spread because infection can be asymptomatic despite high viral loads. Sufficient molecular diagnostic capacity is important for public health interventions such as case dete...

Clustered cases of acral perniosis: Clinical features, histopathology, and relationship to COVID‐19

A recent marked increase in pediatric and adult patients presenting with purpuric acral lesions concerning for ischemia, thrombosis and necrosis has been observed in COVID‐19 prevalent regions worldwide. The clinical and histopathological features and relationship to COVID‐19 have not been well described. The objective of this case series is to describe the clinical features and determine the h...

Immune mechanisms of pulmonary intravascular coagulopathy in COVID-19 pneumonia

The lung pathology seen in patients with coronavirus disease 2019 (COVID-19) shows marked microvascular thrombosis and haemorrhage linked to extensive alveolar and interstitial inflammation that shares features with macrophage activation syndrome (MAS). We have termed the lung-restricted vascular immunopathology associated with COVID-19 as diffuse pulmonary intravascular coagulopathy, which in ...

Clinical features and multidisciplinary treatment outcome of COVID-19 pneumonia: A report of three cases

The novel coronavirus disease 2019 (COVID-19) caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has caused a pandemic threatening global public health. In the current paper, we describe our successful treatment of three COVID-19 pneumonia patients cases including severe cases and cases with mortality risk factors. One 32-year-old male COVID-19 patient was diagnosed with sev...

Compassionate remdesivir treatment of severe Covid-19 pneumonia in intensive care unit (ICU) and Non-ICU patients: Clinical outcome and differences in post-treatment hospitalisation status

SARS-CoV-2 is causing an increasing number of deaths worldwide because no effective treatment is currently available. Remdesivir has shown in vitro activity against coronaviruses and is a possible antiviral treatment for SARS-CoV-2 infection.

COVID-19 in Immunocompromised Hosts: What We Know So Far
Clinical Infectious Diseases; Monica Fung MD, MPH et. al.

Jun 26th, 2020 - The coronavirus disease 2019 (COVID-19) pandemic caused by SARS coronavirus 2 (SARS-CoV-2) has caused significant morbidity and mortality for patients and stressed healthcare systems worldwide. The clinical features and outcomes of COVID-19 among immunosuppressed patients, who are at presumed risk for more severe disease but who may also have decreased detrimental inflammatory responses, are no...

A case of COVID-19 pneumonia with cerebral hemorrhage

We agree with Dr. Klok that thromboprophylactic dose low molecular weight heparin should be recommended for all the critically ill patients with 2019 novel coronavirus disease (COVID-19) pneumonia [1]. The very high cumulative incidence of thrombotic complications raises the question if therapeutic anticoagulation should be considered for severe COVID-19 pneumonia patients. As previously report...

Expression of the COVID‐19 receptor ACE2 in the human conjunctiva

SARS‐CoV‐2 is assumed to use angiotensin‐converting enzyme 2 (ACE2 ) and other auxiliary proteins for cell entry. Recent studies have described conjunctival congestion in 0.8% of patients with laboratory‐confirmed severe acute respiratory syndrome coronavirus‐2 (SARS‐CoV‐2), and there has been speculation that SARS‐CoV‐2 can be transmitted through the conjunctiva. However, it is currently uncle...

Ocular conjunctival inoculation of SARS-CoV-2 can cause mild COVID-19 in Rhesus macaques

The outbreak of Corona Virus Disease 2019 caused by the severe acute respiratory syndrome coronavirus (SARS-CoV-2) is highly transmitted. The potential extra-respiratory transmission routes remain uncertain. Five rhesus macaques were inoculated with 1×106 TCID50 of SARS-CoV-2 via conjunctival (CJ), intratracheal (IT), and intragastric (IG) routes, respectively. Remarkably, the CJ inoculated-mac...

Is novel coronavirus disease (COVID‐19) transmitted through conjunctiva?

We read with interest the article of Dr Xia et al 1 on the detection of RNA of severe acute respiratory syndrome coronavirus 2 (SARS‐CoV‐2) in tears and conjunctival secretions of patients with novel coronavirus disease (COVID‐19). Xia et al tested a total of 60 tears and conjunctival secretions samples from 30 patients, with two samples from each patient collected at an interval of 2 to 3 days...

Two immunocompromised patients with diffuse alveolar hemorrhage as a complication of severe COVID-19

Diffuse alveolar hemorrhage (DAH) is a severe and potentially life-threatening disease manifestation. Besides autoimmune diseases such as anti-neutrophil cytoplasmatic antibody (ANCA) associated vasculitis and anti-glomerular basement membrane (anti-GBM) syndrome pulmonary viral infections are also known to be culprits of DAH. The coronavirus disease 2019 (COVID-19) pandemic confronts healthcar...

COVID-19 receptor ACE2 is expressed in human conjunctival tissue, expecially in diseased conjunctival

COVID-19 virus has currently caused major outbreaks worldwide. ACE2 is a major cellular-entry receptor for the COVID-19 virus. Although ACE2 is known to be expressed in many organs, whether it is expressed by the conjunctival tissue is largely unknown. Human conjunctival tissues from 68 subjects were obtained, which included 10 subjects with conjunctival nevi, 20 subjects with conjunctiviti...

SARS-CoV-2 infection in conjunctival tissue

In a recent study published in The Lancet Respiratory Medicine in May, 2020, Kenrie Hui and colleagues1 described the tropism, replication competence, and innate immune responses of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in the human respiratory tract and conjunctiva. The authors concluded that SARS-CoV-2 replication in the conjunctiva was greater than SARS-CoV replication...

Hemorrhagic Stroke in Setting of Severe COVID-19 Infection Requiring Extracorporeal Membrane Oxygenation (ECMO)

To highlight the increased risk of hemorrhagic stroke secondary to postulated COVID-19 mediated vasculopathy with concomitant ECMO related bleeding complications.