Pub Date : 2020-01-01DOI: 10.18297/jri/vol4/iss1/50
Paul S. Schulz, Ashley M. Wilde, S. Hester, Jim Frazier, Julio A. Ramirez
Health care professionals (HCP) are at increased risk of COVID-19 infection due to the unpredictable clinical presentation of COVID-19 disease, limited SARS-CoV-2 testing, personal protective equipment (PPE) shortages, and the inherent inability to distance from patients. Infected HCP may infect others, including coworkers, leading to a simultaneous increase in the number of infections and decrease in the availability of HCP in a community.[1] Due to PPE shortages, many healthcare systems have faced difficult decisions regarding utilization of PPE to protect HCP, patients, and the communities they serve. We describe Norton Healthcare’s success utilizing surveillance COVID-19 testing of HCP to inform the decision to increase the use of PPE during a PPE shortage in the form of universal masking. Many healthcare systems could benefit from surveillance COVID-19 testing of HCP and universal masking of HCP.
{"title":"COVID-19 Surveillance Testing of Healthcare Personnel Drives Universal Masking Practice","authors":"Paul S. Schulz, Ashley M. Wilde, S. Hester, Jim Frazier, Julio A. Ramirez","doi":"10.18297/jri/vol4/iss1/50","DOIUrl":"https://doi.org/10.18297/jri/vol4/iss1/50","url":null,"abstract":"Health care professionals (HCP) are at increased risk of COVID-19 infection due to the unpredictable clinical presentation of COVID-19 disease, limited SARS-CoV-2 testing, personal protective equipment (PPE) shortages, and the inherent inability to distance from patients. Infected HCP may infect others, including coworkers, leading to a simultaneous increase in the number of infections and decrease in the availability of HCP in a community.[1] Due to PPE shortages, many healthcare systems have faced difficult decisions regarding utilization of PPE to protect HCP, patients, and the communities they serve. We describe Norton Healthcare’s success utilizing surveillance COVID-19 testing of HCP to inform the decision to increase the use of PPE during a PPE shortage in the form of universal masking. Many healthcare systems could benefit from surveillance COVID-19 testing of HCP and universal masking of HCP.","PeriodicalId":91979,"journal":{"name":"The University of Louisville journal of respiratory infections","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2020-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"82912492","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2020-01-01DOI: 10.18297/jri/vol4/iss2/4
S. Furmanek, Connor Glick, T. Chandler, M. Tella, William A. Mattingly, J. Ramirez, T. Wiemken
Background: One weakness that applies to all population-based studies performed in the Unit- ed States (US) is that investigators perform population-based extrapolations without providing objective statistical evidence to show how well a particular city is a suitable surrogate for the US. The objective of this study was to propose and utilize a novel computational metric to compare individual US cities with the US average. Methods: This was a secondary data analysis of publicly available databases containing US sociodemographic, economic, and health-related data. In total, 58 demographic, housing, economic, health behavior, and health status variables for each US city with a residential population of at least 500,000 were obtained. All variables were recorded as proportions. Euclidean, Manhattan, and the average absolute difference metrics were used to compare the 58 variables to the average in the US. Results: Oklahoma City, Oklahoma had the lowest distance from the United States, with Eu- clidean and Manhattan distances in proportion of 0.261 and 1.519, respectively. Louisville, Kentucky had the second lowest distance for both Euclidean distance and Manhattan distance, with distances of 0.286 and 1.545, respectively. The average absolute differences in proportion for Oklahoma City and Louisville to the US average were 0.026 and 0.027, respectively. Conclusion: To our knowledge, this represents the first study evaluating a method for comput- ing statistical comparisons of United States city sociodemographic, economic, and health-relat-ed data with the United States average. Our study shows that among cities with at least 500,000 residents, Oklahoma City is the closest to the United States, followed closely by Louisville. On average, these cities deviate from the US average on any variable studied by less than 3 percent.
{"title":"The City of Louisville Encapsulates the United States Demographics","authors":"S. Furmanek, Connor Glick, T. Chandler, M. Tella, William A. Mattingly, J. Ramirez, T. Wiemken","doi":"10.18297/jri/vol4/iss2/4","DOIUrl":"https://doi.org/10.18297/jri/vol4/iss2/4","url":null,"abstract":"Background: One weakness that applies to all population-based studies performed in the Unit- ed States (US) is that investigators perform population-based extrapolations without providing objective statistical evidence to show how well a particular city is a suitable surrogate for the US. The objective of this study was to propose and utilize a novel computational metric to compare individual US cities with the US average. Methods: This was a secondary data analysis of publicly available databases containing US sociodemographic, economic, and health-related data. In total, 58 demographic, housing, economic, health behavior, and health status variables for each US city with a residential population of at least 500,000 were obtained. All variables were recorded as proportions. Euclidean, Manhattan, and the average absolute difference metrics were used to compare the 58 variables to the average in the US. Results: Oklahoma City, Oklahoma had the lowest distance from the United States, with Eu- clidean and Manhattan distances in proportion of 0.261 and 1.519, respectively. Louisville, Kentucky had the second lowest distance for both Euclidean distance and Manhattan distance, with distances of 0.286 and 1.545, respectively. The average absolute differences in proportion for Oklahoma City and Louisville to the US average were 0.026 and 0.027, respectively. Conclusion: To our knowledge, this represents the first study evaluating a method for comput- ing statistical comparisons of United States city sociodemographic, economic, and health-relat-ed data with the United States average. Our study shows that among cities with at least 500,000 residents, Oklahoma City is the closest to the United States, followed closely by Louisville. On average, these cities deviate from the US average on any variable studied by less than 3 percent.","PeriodicalId":91979,"journal":{"name":"The University of Louisville journal of respiratory infections","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2020-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"84190268","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2020-01-01DOI: 10.18297/jri/vol4/iss1/15
Sarah E Moore PharmD, Bcps-Aq Id Ashley M Wilde PharmD, Bcidp Matthew Song PharmD, Brian C Bohn PharmD, Bcps Clayton J Patross PharmD, Bryan Denham, Paul S. Schulz, Julio A. Ramirez
Patients with COVID-19 may have co-infections with other mi- croorganisms. Here we report a case of a patient with an Es-cheria coli bacteremia secondary to a urinary tract infection, who experienced fevers while on active antimicrobial therapy. The patient was eventually tested for COVID-19 and found to be positive. This case emphasizes the need to suspect COVID-19 even in patients with documented bacterial infec- tion.
{"title":"A Patient with Escherichia coli Bacteremia and COVID-19 Co-Infection: A Case Report for the Louisville COVID-19 Epidemiology Study","authors":"Sarah E Moore PharmD, Bcps-Aq Id Ashley M Wilde PharmD, Bcidp Matthew Song PharmD, Brian C Bohn PharmD, Bcps Clayton J Patross PharmD, Bryan Denham, Paul S. Schulz, Julio A. Ramirez","doi":"10.18297/jri/vol4/iss1/15","DOIUrl":"https://doi.org/10.18297/jri/vol4/iss1/15","url":null,"abstract":"Patients with COVID-19 may have co-infections with other mi- croorganisms. Here we report a case of a patient with an Es-cheria coli bacteremia secondary to a urinary tract infection, who experienced fevers while on active antimicrobial therapy. The patient was eventually tested for COVID-19 and found to be positive. This case emphasizes the need to suspect COVID-19 even in patients with documented bacterial infec- tion.","PeriodicalId":91979,"journal":{"name":"The University of Louisville journal of respiratory infections","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2020-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"72459706","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2020-01-01DOI: 10.18297/jri/vol4/iss1/11
G. R. Fernandez-Botran
Since December 2019, the SARS-CoV-2 (COVID-19) pan- demic has extended its reach over most of the world, infecting over four million people and causing well over 300,000 deaths so far.[1] A significant percentage of infected patients de-velop severe symptoms and life-threatening conditions. While COVID-19 infection can affect all ages, available evidence points to older age and pre-existing comor- bidities, such as hypertension, diabetes, and coronary heart disease, as important risk factors related to increased mortality rates.[2- 4] Moreover, recent reports from China and the U.S. have suggested that susceptibility, and perhaps even mortality, to COVID-19 infection might be influenced by the ABO blood type. The purpose of the present minireview is to analyze the evidence published in the COVID-19 literature and to put it in the context of the existing knowledge about the association of blood group types and disease.
{"title":"ABO Blood Group Type and Susceptibility to COVID-19 Infection","authors":"G. R. Fernandez-Botran","doi":"10.18297/jri/vol4/iss1/11","DOIUrl":"https://doi.org/10.18297/jri/vol4/iss1/11","url":null,"abstract":"Since December 2019, the SARS-CoV-2 (COVID-19) pan- demic has extended its reach over most of the world, infecting over four million people and causing well over 300,000 deaths so far.[1] A significant percentage of infected patients de-velop severe symptoms and life-threatening conditions. While COVID-19 infection can affect all ages, available evidence points to older age and pre-existing comor- bidities, such as hypertension, diabetes, and coronary heart disease, as important risk factors related to increased mortality rates.[2- 4] Moreover, recent reports from China and the U.S. have suggested that susceptibility, and perhaps even mortality, to COVID-19 infection might be influenced by the ABO blood type. The purpose of the present minireview is to analyze the evidence published in the COVID-19 literature and to put it in the context of the existing knowledge about the association of blood group types and disease.","PeriodicalId":91979,"journal":{"name":"The University of Louisville journal of respiratory infections","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2020-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"85368780","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2020-01-01DOI: 10.18297/RGH/VOL4/ISS1/1
F. Arnold, Mark V. Burns, K. Mahmood, Darmaan Aden, S. Furmanek, M. Tella, Connor Glick, Anupama Raghuram, Leslie A Beavin, R. Cavallazzi, Dawn Balcom, L. Wolf, K. Palmer, R. Carrico, J. Ramirez
ULJRI | https://doi.org/10.18297/jri/vol4/iss1/1 1 Abstract Introduction: There are four endemic serotypes of human coronavirus (HCoV) that may cause community-acquired pneumonia (CAP) in humans. The clinical syndrome of CAP due to HCoVs is not well characterized. The objectives of this study were to evaluate incidence, epidemiology, and outcomes of CAP in adults due to HCoV and to compare them to CAP due to influenza.
{"title":"Endemic Human Coronaviruses in Hospitalized Adults with Community-Acquired Pneumonia: Results from the Louisville Pneumonia Study","authors":"F. Arnold, Mark V. Burns, K. Mahmood, Darmaan Aden, S. Furmanek, M. Tella, Connor Glick, Anupama Raghuram, Leslie A Beavin, R. Cavallazzi, Dawn Balcom, L. Wolf, K. Palmer, R. Carrico, J. Ramirez","doi":"10.18297/RGH/VOL4/ISS1/1","DOIUrl":"https://doi.org/10.18297/RGH/VOL4/ISS1/1","url":null,"abstract":"ULJRI | https://doi.org/10.18297/jri/vol4/iss1/1 1 Abstract Introduction: There are four endemic serotypes of human coronavirus (HCoV) that may cause community-acquired pneumonia (CAP) in humans. The clinical syndrome of CAP due to HCoVs is not well characterized. The objectives of this study were to evaluate incidence, epidemiology, and outcomes of CAP in adults due to HCoV and to compare them to CAP due to influenza.","PeriodicalId":91979,"journal":{"name":"The University of Louisville journal of respiratory infections","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2020-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"91302331","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2020-01-01DOI: 10.18297/jri/vol4/iss2/1
T. Wiemken, D. Hoft, Jeffrey F. Scherrer
Background: Depression is associated with risk for chronic disease, though its relationship with infectious diseases is less understood. Depression may modify the clinical outcomes of patients with infectious diseases such as influenza via its association with inflammation. The objective of this study was to evaluate the relationships between depression and clinical outcomes in non-elderly adults with influenza infection. Methods: This was a secondary analysis of the Nationwide Inpatient Sample database, years 2012-2016. Hospitalized adults aged 18-65 admitted during each influenza season were included. Depression status was documented via ICD-10 codes. The association between depression and clinical outcomes (e.g. disease severity, length of hospital stay, and inpatient all-cause mortality) were evaluated using multivariable regression modeling. Results: A total of 44,292 patients were included, 12% with depression. After adjustment for confounding, non-elderly influenza patients with depression had a 3.8% decreased risk of a severe disease (95% CI: 1.9% - 5.7%; P<0.001), no difference in length of stay (Hazard Ratio: 0.99, 95% Confidence Interval 0.96 – 1.02), and lower all-cause in-hospital mortality versus those without depression (Odds Ratio=0.76; 95% CI 0.59 - 0.97; P=0.028). Conclusions: This study suggests that in non-elderly hospitalized patients with influenza, depression is associated with a decreased severity of illness and acute mortality. Chronic inflammation in those with depression may enhance the ability of the immune response to limit influenza infection or reduce pathologic acute inflammation associated with influenza disease.
{"title":"Depression is associated with decreased severity and lower mortality in non-elderly hospitalized adults with influenza in the United States","authors":"T. Wiemken, D. Hoft, Jeffrey F. Scherrer","doi":"10.18297/jri/vol4/iss2/1","DOIUrl":"https://doi.org/10.18297/jri/vol4/iss2/1","url":null,"abstract":"Background: Depression is associated with risk for chronic disease, though its relationship with infectious diseases is less understood. Depression may modify the clinical outcomes of patients with infectious diseases such as influenza via its association with inflammation. The objective of this study was to evaluate the relationships between depression and clinical outcomes in non-elderly adults with influenza infection. Methods: This was a secondary analysis of the Nationwide Inpatient Sample database, years 2012-2016. Hospitalized adults aged 18-65 admitted during each influenza season were included. Depression status was documented via ICD-10 codes. The association between depression and clinical outcomes (e.g. disease severity, length of hospital stay, and inpatient all-cause mortality) were evaluated using multivariable regression modeling. Results: A total of 44,292 patients were included, 12% with depression. After adjustment for confounding, non-elderly influenza patients with depression had a 3.8% decreased risk of a severe disease (95% CI: 1.9% - 5.7%; P<0.001), no difference in length of stay (Hazard Ratio: 0.99, 95% Confidence Interval 0.96 – 1.02), and lower all-cause in-hospital mortality versus those without depression (Odds Ratio=0.76; 95% CI 0.59 - 0.97; P=0.028). Conclusions: This study suggests that in non-elderly hospitalized patients with influenza, depression is associated with a decreased severity of illness and acute mortality. Chronic inflammation in those with depression may enhance the ability of the immune response to limit influenza infection or reduce pathologic acute inflammation associated with influenza disease.","PeriodicalId":91979,"journal":{"name":"The University of Louisville journal of respiratory infections","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2020-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"72864522","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2020-01-01DOI: 10.18297/jri/vol4/iss1/60
S. Durugu, H. Tanzeem, Divya Menghani, Z. Imran, P. Krishnan
Introduction: The period from exposure to a potential pathogen to the manifestation of symptoms, i.e. the incubation period, is time the virus spends replicating in the host. An estimation of this period and subsequent quarantine of the host can limit potential spread, particularly in asymptomatic carriers. Effective contact tracing, length of self-quarantine, repeat testing, and understanding of disease transmission are all contingent on a true estimation of this incubation period. Methods: Articles in English published since December 1st, 2019, on Google scholar, PubMed, and Research Gate, along with bulletins from the World Health Organization and the Centers for Disease Control and Prevention, were identified using the keywords, “SARS-CoV-2,” “COVID-19,” “median incubation period,” “mean incubation period,” “symptom on-set,” “quarantine,” and “exposure interval” and reviewed independently by two authors to establish consensus. Travel to Wuhan, or in absence of travel, the earliest possible exposure, were used to calculate mean or median incubation period. Correspondingly, we reviewed the advised lengths of quarantine period. Results: Five studies with a combined sample size of 505 patients were reviewed for mean/median incubation period. Four studies recommended periods for self-quarantine, ranging from 2 to 14 days. Linton et al. reported the shortest estimate of median incubation period at 4.3 days (95% confidence interval [CI] 4.5–5.6), whereas the longest was by Backer et al. at 6.4 days (95% CI 4.5–5.8). Similarly, the shortest estimation of mean incubation period was by Liu et al. ( n =16) at 4.8 days (95% CI 2.2–7.4) days while the longest at 5.5 days (95% CI 4.5–5.8) was by Lauer et al. ( n =181). Although the range for quarantine in these four studies was 12.5–14 days, all four recommended 14 days as the optimum for self-quarantine. Conclusion: An estimate of incubation period is instrumental in outlining an effective quarantine measure. Calculation of the incubation period using mathematical models has established an accurate measure, albeit with uncertainty increasing towards the tail of each distribution. Based on a thorough review of these studies, a quarantine period of 14 days can be recommended, allowing 97.5% of the infected people to show symptoms. These symptomatic patients would be further evaluated based on their respective state health guidelines so that they may be effectively isolated and treated.
导读:从接触潜在病原体到出现症状的这段时间，即潜伏期，是病毒在宿主体内复制的时间。对这段时间的估计和随后对宿主的隔离可以限制潜在的传播，特别是在无症状携带者中。有效的接触者追踪、自我隔离时间、重复检测以及对疾病传播的了解都取决于对潜伏期的真实估计。方法:以“SARS-CoV-2”、“COVID-19”、“中位潜伏期”、“平均潜伏期”、“症状发作”、“隔离”和“暴露间隔”为关键词，对2019年12月1日以来在谷歌scholar、PubMed和Research Gate上发表的英文文章以及世界卫生组织和美国疾病预防控制中心的公告进行识别，并由两位作者独立审查，以建立共识。使用到武汉旅行或未旅行，尽早接触的方法计算平均或中位数潜伏期。相应地，我们审查了建议的隔离期长度。结果:对505例患者的5项研究的平均/中位潜伏期进行了回顾。四项研究建议进行自我隔离，时间从2天到14天不等。Linton等人估计的中位潜伏期最短，为4.3天(95%可信区间[CI] 4.5-5.6)，而Backer等人估计的最长潜伏期为6.4天(95%可信区间[CI] 4.5-5.8)。同样，Liu等人(n =16)估计的平均潜伏期最短，为4.8天(95% CI 2.2-7.4)天，而Lauer等人(n =181)估计的最长，为5.5天(95% CI 4.5-5.8)。虽然这四项研究的隔离时间范围为12.5-14天，但四项研究都推荐14天为最佳自我隔离时间。结论:潜伏期的估计有助于制定有效的检疫措施。使用数学模型计算潜伏期已经建立了一个精确的测量，尽管不确定性在每个分布的尾部增加。根据对这些研究的全面审查，可以建议隔离14天，使97.5%的感染者出现症状。这些有症状的患者将根据各自的州健康指南进行进一步评估，以便有效地隔离和治疗。
{"title":"A Review Of Quarantine Period In Relation To Incubation Period Of SARS-CoV-2","authors":"S. Durugu, H. Tanzeem, Divya Menghani, Z. Imran, P. Krishnan","doi":"10.18297/jri/vol4/iss1/60","DOIUrl":"https://doi.org/10.18297/jri/vol4/iss1/60","url":null,"abstract":"Introduction: The period from exposure to a potential pathogen to the manifestation of symptoms, i.e. the incubation period, is time the virus spends replicating in the host. An estimation of this period and subsequent quarantine of the host can limit potential spread, particularly in asymptomatic carriers. Effective contact tracing, length of self-quarantine, repeat testing, and understanding of disease transmission are all contingent on a true estimation of this incubation period. Methods: Articles in English published since December 1st, 2019, on Google scholar, PubMed, and Research Gate, along with bulletins from the World Health Organization and the Centers for Disease Control and Prevention, were identified using the keywords, “SARS-CoV-2,” “COVID-19,” “median incubation period,” “mean incubation period,” “symptom on-set,” “quarantine,” and “exposure interval” and reviewed independently by two authors to establish consensus. Travel to Wuhan, or in absence of travel, the earliest possible exposure, were used to calculate mean or median incubation period. Correspondingly, we reviewed the advised lengths of quarantine period. Results: Five studies with a combined sample size of 505 patients were reviewed for mean/median incubation period. Four studies recommended periods for self-quarantine, ranging from 2 to 14 days. Linton et al. reported the shortest estimate of median incubation period at 4.3 days (95% confidence interval [CI] 4.5–5.6), whereas the longest was by Backer et al. at 6.4 days (95% CI 4.5–5.8). Similarly, the shortest estimation of mean incubation period was by Liu et al. ( n =16) at 4.8 days (95% CI 2.2–7.4) days while the longest at 5.5 days (95% CI 4.5–5.8) was by Lauer et al. ( n =181). Although the range for quarantine in these four studies was 12.5–14 days, all four recommended 14 days as the optimum for self-quarantine. Conclusion: An estimate of incubation period is instrumental in outlining an effective quarantine measure. Calculation of the incubation period using mathematical models has established an accurate measure, albeit with uncertainty increasing towards the tail of each distribution. Based on a thorough review of these studies, a quarantine period of 14 days can be recommended, allowing 97.5% of the infected people to show symptoms. These symptomatic patients would be further evaluated based on their respective state health guidelines so that they may be effectively isolated and treated.","PeriodicalId":91979,"journal":{"name":"The University of Louisville journal of respiratory infections","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2020-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"88055329","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2020-01-01DOI: 10.18297/jri/vol4/iss1/54
J. Bordón, Dong-Hoon Chung, Priya Krishnan, R. Carrico, Julio A. Ramirez
Some patients recover from COVID-19, but their reverse transcription-polymerase chain reaction (RT-PCR) for SARS-CoV-2 remains persistently positive. In the evaluation of these patients, it is important to define the cycle threshold (Ct) value of the RT-PCR test. This article will present a case study, address relevant findings and interpretation of the RT-PCR test, and explain the use of Ct values in defining when a healthcare worker may return to work. Our current approach is to allow health care workers with persistently positive RT-PCR to return to work if the Ct value is greater than 35.
{"title":"The Importance of Cycle Threshold Values in the Evaluation of Patients with Persistent Positive PCR for SARS-CoV-2: Case Study and Brief Review","authors":"J. Bordón, Dong-Hoon Chung, Priya Krishnan, R. Carrico, Julio A. Ramirez","doi":"10.18297/jri/vol4/iss1/54","DOIUrl":"https://doi.org/10.18297/jri/vol4/iss1/54","url":null,"abstract":"Some patients recover from COVID-19, but their reverse transcription-polymerase chain reaction (RT-PCR) for SARS-CoV-2 remains persistently positive. In the evaluation of these patients, it is important to define the cycle threshold (Ct) value of the RT-PCR test. This article will present a case study, address relevant findings and interpretation of the RT-PCR test, and explain the use of Ct values in defining when a healthcare worker may return to work. Our current approach is to allow health care workers with persistently positive RT-PCR to return to work if the Ct value is greater than 35.","PeriodicalId":91979,"journal":{"name":"The University of Louisville journal of respiratory infections","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2020-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"89072830","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2020-01-01DOI: 10.18297/jri/vol4/iss1/43
Bcidp Matthew Song PharmD, Ashley M. Wilde, Sarah E Moore PharmD, Brian C Bohn PharmD, Clayton J Patross, Bryan Denham, Paul S. Schulz, Julio A. Ramirez
We report a case of false-negative SARS-CoV-2 reverse transcriptase-polymerase chain reaction (RT-PCR) on a nasopharyngeal swab. Treating clinicians and infection preven- tionists should maintain a high suspicion for COVID-19 in the appropriate clinical setting despite negative test results. Utilization of chest computed tomography (CT) should be strongly considered in the diagnostic work-up for suspected COVID-19, particularly in areas with limited RT-PCR availabil- ity.
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Pub Date : 2020-01-01DOI: 10.18297/jri/vol4/iss1/3
Julio Ramirez
ULJRI | https://doi.org/10.18297/jri/vol4/iss1/3 1 Abstract An important feature of COVID-19, the disease produced by the new coronavirus SARS-CoV-2, is the high number of health care workers (HCWs) that acquire the disease. In an initial report of 138 patients hospitalized with COVID-19 pneumonia in China, 40 patients (29%) were HCWs. One reason why HCWs are at higher risk of acquiring COVID-19 is because some patients with COVID-19 are admitted to the hospital without the classical presentation, and are therefore not tested for the disease early during hospitalization. Presently in the US, it is recommended to test for COVID-19 when physicians suspect the disease. This subjective approach may allow hospital transmission of COVID-19 from patients without the classical clinical presentation. The primary objective of this study is to establish a surveillance system for early identification of patients hospitalized with COVID-19 to allow for early implementation of infection control interventions in an attempt to prevent transmission of COVID-19 to HCWs and other hospitalized patients. We are proposing to test all patients who present to the emergency departments and/ or are hospitalized with signs and symptoms of respiratory infection or gastrointestinal infection for SARS-CoV-2, regardless of clinical suspicion of COVID-19. Biological samples obtained from all patients having symptoms of respiratory or gastrointestinal infection will be tested using real-time polymerase chain reaction (RT-PCR) for detection of SARS-CoV-2. Using a robotic instrument, the CMP laboratory will be able to test more than 500 samples a day. Data will be reported in real-time to participating hospitals for rapid implementation of infection control measures.
{"title":"Louisville Coronavirus Surveillance Program","authors":"Julio Ramirez","doi":"10.18297/jri/vol4/iss1/3","DOIUrl":"https://doi.org/10.18297/jri/vol4/iss1/3","url":null,"abstract":"ULJRI | https://doi.org/10.18297/jri/vol4/iss1/3 1 Abstract An important feature of COVID-19, the disease produced by the new coronavirus SARS-CoV-2, is the high number of health care workers (HCWs) that acquire the disease. In an initial report of 138 patients hospitalized with COVID-19 pneumonia in China, 40 patients (29%) were HCWs. One reason why HCWs are at higher risk of acquiring COVID-19 is because some patients with COVID-19 are admitted to the hospital without the classical presentation, and are therefore not tested for the disease early during hospitalization. Presently in the US, it is recommended to test for COVID-19 when physicians suspect the disease. This subjective approach may allow hospital transmission of COVID-19 from patients without the classical clinical presentation. The primary objective of this study is to establish a surveillance system for early identification of patients hospitalized with COVID-19 to allow for early implementation of infection control interventions in an attempt to prevent transmission of COVID-19 to HCWs and other hospitalized patients. We are proposing to test all patients who present to the emergency departments and/ or are hospitalized with signs and symptoms of respiratory infection or gastrointestinal infection for SARS-CoV-2, regardless of clinical suspicion of COVID-19. Biological samples obtained from all patients having symptoms of respiratory or gastrointestinal infection will be tested using real-time polymerase chain reaction (RT-PCR) for detection of SARS-CoV-2. Using a robotic instrument, the CMP laboratory will be able to test more than 500 samples a day. Data will be reported in real-time to participating hospitals for rapid implementation of infection control measures.","PeriodicalId":91979,"journal":{"name":"The University of Louisville journal of respiratory infections","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2020-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"83913445","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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