COVID-19: guida rapida per medici.

Una guida rapida per il medico semplice ed esaustiva su COVID-19 è stata pubblicata dall’American Medical Association.

Scarica e leggi il documento in full text:
A Physiacian’s Guide to COVID-19

Read the full CDC guidance for health care facilities.
Get the full health care facility guidance from WHO.

Terapia Coronavirus: le sperimentazioni in Italia.

L’Agenzia Italiana per il Farmaco (AIFA) ha dato il via libera alla sperimentazione di diverse tipologie di farmaci. Di seguito una sintesi dei protocolli di studio attualmente in corso.

Favipiravir (Avigan)
La Commissione Tecnico Scientifica dell’Aifa ha dato il via libera alla valutazione di un programma di sperimentazione clinica per valutare efficacia e sicurezza del medicinale favipiravir nella malattia COVID-19.

Tocilizumab
Su questo medicinale, già utilizzato nel trattamento di altre patologie come l’artrite reumatoide, è in corso uno studio multicentrico di fase 2 sulla sua efficacia e sicurezza nel trattamento di pazienti con polmonite da COVID-19 . Lo studio, che dovrebbe terminare entro la metà del mese di maggio 2020, nasce dai risultati di un’esperienza resa nota da ricercatori cinesi (Xiaoling Xu, Mingfeng Han, Tiantian Li et al.)
Tocilizumab è un anticorpo monoclonale diretto contro il recettore dell’IL-6, uno dei mediatori dell’infiammazione che consegue alla risposta immunitaria contro il virus che si realizza a livello degli alveoli polmonari.

Remdesivir
L’Italia partecipa a due studi di fase 3 promossi da Gilead Sciences per valutare l’efficacia e la sicurezza della molecola sperimentale Remdesivir negli adulti ricoverati con diagnosi di COVID-19.

Gli studi saranno inizialmente condotti presso l’Ospedale Sacco di Milano, il Policlinico di Pavia, l’Azienda Ospedaliera di Padova, l’Azienda Ospedaliera Universitaria di Parma e l’Istituto Nazionale di Malattie Infettive Lazzaro Spallanzani

Associazione di farmaci Lopinavir-Ritonavir
Un primo studio su malati Covid-19 è stato effettuato a Wuhan (Cina) per testare l’efficacia della combinazione dei farmaci Lopinavir-Ritonavir. I protocolli attualmente in uso presso i principali centri clinici, nonché le più recenti Linee guida SIMIT Lombardia, prevedono l’utilizzo di questi medicinali in fasi più precoci e in pazienti meno compromessi di quelli su cui è stata effettuata la sperimentazione in Cina.

Fonti: AIFA -Salute H24

WHO: linee guida sulla prevenzione della tubercolosi.

Sono state pubblicate a cura dell’Organizzazione Mondiale della Sanità le linee guida sulla prevenzione della tubercolosi.

“COVID-19 sta evidenziando quanto possano essere vulnerabili le persone con malattie polmonari e sistemi immunitari indeboliti“, ha affermato il dott. Tedros Adhanom Ghebreyesus, direttore generale dell’OMS. “Il mondo si è impegnato a porre fine alla TB entro il 2030; migliorare la prevenzione è la chiave per far sì che ciò accada. Milioni di persone devono essere in grado di prendere un trattamento preventivo per la tubercolosi per fermare l’insorgenza della malattia, evitare la sofferenza e salvare vite”.

Scarica e leggi i documenti in full text:

WHO Consolidated guidelines on tuberculosis
New WHO recommendations to prevent tuberculosis aim to save millions of lives – World Health Organization

LitCovid: portale di letteratura scientifica aggiornata.

LitCovid è un hub di letteratura curato per tracciare informazioni scientifiche aggiornate sulla pandemia Coronavirus-2019. È la risorsa più completa sull’argomento, fornendo un accesso a 1558 (e più) articoli rilevanti provenienti da PubMed. Gli articoli vengono aggiornati quotidianamente e sono ulteriormente classificati in base a diversi argomenti di ricerca e posizioni geografiche per un migliore accesso.

LitCovid è una risorsa creata dal National Center for Biotechnology Information della National Library of Medicine

Leggi il full text dell’articolo di presentazione:
Keep up with the latest coronavirus research
Qingyu Chen, Alexis Allot & Zhiyong Lu
Nature 579, 193 (2020) doi: 10.1038/d41586-020-00694-1

Accedi a LitCovid: https://www.ncbi.nlm.nih.gov/research/coronavirus/

Fonte: National Center for Biotechnology Information, U.S. National Library of Medicine

Un supercomputer contro il coronavirus.

Tramite i supercomputer il Cineca di Bologna, sta simulando il comportamento delle proteine che consentono al virus di replicarsi in modo da poter testare virtualmente le molecole farmaceutiche più efficaci a inibire il virus, e poter poi passare alla fase di validazione in laboratorio. La ricerca tramite i supercalcolatori può collaborare con la ricerca tradizionale accorciando i tempi per lo sviluppo di farmaci.

La commissione Europea ha finanziato con 3 milioni di euro Exscalate4CoV, il progetto guidato da Dompè che si pone l’obiettivo di individuare i farmaci più sicuri e promettenti per il trattamento immediato della popolazione già infetta a cui seguirà l’individuazione di molecole capaci di inibire la patogenesi del coronavirus per contrastare i contagi futuri.

In questa prima fase tramite i supercomputer stiamo simulando il comportamento delle proteine che consentono al virus di replicarsi in modo da poter testare virtualmente le molecole farmaceutiche più efficaci a inibire il virus, e poter poi passare alla fase di validazione in laboratorio accelerando la produzione di farmaci efficaci per ridurne la replicabilità.

“Una volta che è stato sequenziato il virus, grazie alla piattaforma di supercalcolo Exscalate, riusciamo a mettere in relazione le proteine che permettono lo sviluppo del Covid-19 con una ‘biblioteca’ di 500 miliardi di molecole farmacologiche“, chiarisce il prof. David Vannozzi. Normalmente, sottolinea il direttore del Cineca, “per analizzare ogni molecola servono quattro mesi“.

“Dopo appena un mese di lavoro, sottolinea Vannozzi, è stata analizzata “circa la metà” del maxi-archivio di 500 miliardi di molecole a disposizione dello studio e “abbiamo individuato le prime 40 che hanno un effetto sulle proteine alla base dello sviluppo del virus”.

Video intervista: https://youtu.be/o6ssLZ4Ch_Y

Fonte: Cineca Bologna

Coronavirus (COVID-19): ultimi articoli, news – 24 marzo.

Segnaliamo articoli, linee guida e news provenienti dalle maggiori riviste scientifiche relativamente al Coronavirus (COVID-19) – aggiornamento del 24/03/2020.

World Health Organization COVID-19 Situation Report:

• WHO: Latest COVID-19 Situation Report – 23 March 2020
• WHO Director-General’s opening remarks at the media briefing on COVID-19 – 23 March 2020

Linee guida:

• Ventilator Supply Mitigation Strategies: Letter to Health Care Providers – U.S. Food & Drug Administration
• Medical Glove Conservation Strategies: Letter to Health Care Providers – U.S. Food & Drug Administration
• FDA advises patients on use of non-steroidal anti-inflammatory drugs (NSAIDs) for COVID-19 – U.S. Food & Drug Administration
• Guidance on shielding and protecting people defined on medical grounds as extremely vulnerable from COVID-19 – Public Health England
• Troponin and BNP Use in COVID-19 – Cardiology Magazine, American College of Cardiology AND Commentary: COVID-19: ACC Advises Caution on Use of Troponin, Natriuretic Peptide Tests – Medscape (free registration required)
• Infection Prevention and Control guidance for Long-Term Care Facilities in the context of COVID-19 – World Health Organization (PDF)

Ultimi articoli:

• Preprint: Incidence, clinical characteristics and prognostic factor of patients with COVID-19: a systematic review and meta-analysis – medRxiv (PDF) AND Commentary: Study Calculates Just How Much Age, Medical Conditions Raise Odds Of Severe COVID-19 – NPR (free)
• WHO launches global megatrial of the four most promising coronavirus treatments – Science
• The Toughest Triage — Allocating Ventilators in a Pandemic – New England Journal of Medicine
• Fair Allocation of Scarce Medical Resources in the Time of Covid-19 – New England Journal of Medicine AND Commentary: Life, or death? Experts guide pandemic medical equipment decisions – CIDRAP
• COVID-19 in Europe: the Italian lesson – The Lancet
• Planning and provision of ECMO services for severe ARDS during the COVID-19 pandemic and other outbreaks of emerging infectious diseases – The Lancet Respiratory Medicine
• Rational use of face masks in the COVID-19 pandemic – The Lancet Respiratory Medicine
• What Should Gastroenterologists and Patients Know About COVID-19? – Clinical Gastroenterology and Hepatology
• Factors Associated With Mental Health Outcomes Among Health Care Workers Exposed to Coronavirus Disease 2019 – JAMA Network Open AND Commentary: Survey Finds COVID-19 Takes Heavy Psychological Toll on Health Care Workers – Psychiatric News Alert
• Supporting Clinicians During the COVID-19 Pandemic – Annals of Internal Medicine
• Covert coronavirus infections could be seeding new outbreaks – Nature
• Misguided drug advice for COVID-19 – Science
• New blood tests for antibodies could show true scale of coronavirus pandemic – Science

 

ASCO: linee guida sul trattamento del cancro al colon-retto.

Sono state pubblicate a cura di ASCO delle linee guida sul trattamento di pazienti con carcinoma del colon-retto in stadio avanzato.

I destinatari di queste linee guida sono: esperti in oncologia medica, oncologia radiologica, chirurgia, oncologia chirurgica, gastroenterologia.

Scarica e leggi il full text dell’articolo:
Treatment of Patients With Late-Stage Colorectal Cancer: ASCO Resource-Stratified Guideline
E. Gabriela Chiorean, Govind Nandakumar, Temidayo Fadelu, Sarah Temin, Ashley Efrain Alarcon-Rozas, Suyapa Bejarano, Adina-Emilia Croitoru, Surbhi Grover, Pritesh V. Lohar, Andrew Odhiambo, Se Hoon Park, Erika Ruiz Garcia, Catherine Teh, Azmina Rose, Bassem Zaki, and Mary D. Chamberlin
JCO Global Oncology 2020 :6, 414-438

Commento della prof.ssa Mary D. Chamberlin

NICE: linee guida su COVID-19.

NICE pubblica le prime linee guida rapide COVID-19. Le nuove linee guida riguardano:

• La gestione dei pazienti in terapia intensiva,
• La gestione dei pazienti sottoposti a dialisi renale,
• La gestione dei pazienti sottoposti a trattamenti antitumorali sistemici.

Scarica e leggi documenti in full text:

• terapia intensiva;
• dialisi renale;
• trattamenti antitumorali sistemici.

COVID-19: aggiornamento per nefrologi.

Pubblichiamo un aggiornamento di linee guida  per nefrologi su COVID-19.

Linee guida:

• COVID-19 rapid guideline: dialysis service delivery – National Institute for Health and Care Excellence (03/2020)
• Guidance for Infection Control and Prevention of Coronavirus Disease 2019 (COVID-19) in dialysis facilities – Centers for Medicare & Medicaid Services (03/2020)
• Interim Additional Guidance for Infection Prevention and Control Recommendations for Patients with Suspected or Confirmed COVID-19 in Outpatient Hemodialysis Facilities – Centers for Disease Control and Prevention (03/2020)
• HFSA/ACC/AHA Statement Addresses Concerns Re: Using RAAS Antagonists in COVID-19 – American College of Cardiology AND Commentaries: Patients with COVID-19 should keep taking key CVD medications – Cardiovascular Business AND Patients taking ACE-i and ARBs who contract COVID-19 should continue treatment, unless otherwise advised by their physician – American Heart Association (03/2020)
• The Renal Association, UK position statement on COVID-19 and ACE Inhibitor/Angiotensin Receptor Blocker use (03/2020)
• Position Statement of the ESC Council on Hypertension on ACE-Inhibitors and Angiotensin Receptor Blockers – European Society of Cardiology (03/2020)

COVID-19: aggiornamento per oncologi ed ematologi.

Pubblichiamo un aggiornamento per medici oncologi ed ematologi su COVID-19 relativamente a linee guida ed ultimi articoli pubblicati su riviste mediche internazionali.

Linee guida:

• COVID-19 rapid guideline: delivery of systemic anticancer treatments – National Institute for Health and Care Excellence (03/2020)

Ultimi articoli:

• Managing Cancer Care During the COVID-19 Pandemic: Agility and Collaboration Toward a Common Goal – Journal of the National Comprehensive Cancer Network (03/2020)
• How do we plan hematopoietic cell transplant and cellular therapy with the looming COVID‐19 threat? – British Journal of Haematology (03/2020)
• Cancer patients in SARS-CoV-2 infection: a nationwide analysis in China – The Lancet Oncology AND Commentaries: Risk of COVID-19 for patients with cancer – The Lancet Oncology AND Risk of COVID-19 for cancer patients – The Lancet Oncology (03/2020)
• Prominent changes in blood coagulation of patients with SARS-CoV-2 infection – Clinical Chemistry and Laboratory Medicine (03/2020)
• Clinical strategies for treating pediatric cancer during the outbreak of 2019 novel coronavirus infection – Pediatric Blood & Cancer (03/2020)
• Risk of COVID-19 for patients with cancer – The Lancet Oncology (03/2020)

COVID-19: aggiornamento per ostetrici e ginecologi.

Pubblichiamo un aggiornamento per ostetrici e ginecologi  su COVID-19 relativamente a linee guida ed ultimi articoli pubblicati su riviste mediche internazionali.

Linee guida: 

• Coronavirus (COVID-19) infection and pregnancy – Royal College of Obstetricians & Gynaecologists AND News Release: National guidance on managing coronavirus infection in pregnancy published (03/2020)
• ABM Statement on Coronavirus 2019 (COVID-19) – Academy of Breastfeeding Medicine (03/2020)
• ISUOG Interim Guidance on 2019 novel coronavirus infection during pregnancy and puerperium: information for healthcare professionals (03/2020)

Ultimi articoli:

• Coronavirus in pregnancy and delivery: rapid review – Ultrasound in Obstetrics & Gynecology (03/2020)
• Infants Born to Mothers With a New Coronavirus (COVID-19) – Frontiers in Pediatrics AND Commentary: Chinese case study suggests COVID-19 is not transmitted from pregnant mothers to newborns – Frontiers (03/2020)

COVID-19: aggiornamento per gastroenterologi.

Pubblichiamo un aggiornamento per gastroenterologi su COVID-19 relativamente a linee guida ed ultimi articoli pubblicati su riviste mediche internazionali specialistiche.

Linee guida:

• Coronavirus (COVID-19) outbreak: what the department of endoscopy should know – Gastrointestinal Endoscopy AND Commentary: Endoscopy During the COVID-19 Pandemic – NEJM Journal Watch (03/2020)

Ultimi articoli

• Clinical characteristics of COVID-19 patients with digestive symptoms in Hubei, China: a descriptive, cross-sectional, multicenter study – American Journal of Gastroenterology AND Commentaries: Study from The American Journal of Gastroenterology Reveals Diarrhea is a Prominent Symptom of COVID-19 – American College of Gastroenterology AND Diarrhea a key symptom in 1 of 4 COVID-19 patients, study finds – UPI (03/2020)
• Liver injury during highly pathogenic human coronavirus infections – Liver International (03/2020)
• Implications of COVID-19 for patients with pre-existing digestive diseases – The Lancet Gastroenterology & Hepatology (03/2020)
• COVID-19: Gastrointestinal manifestations and potential fecal-oral transmission – Gastroenterology (03/2020)
• Evidence for gastrointestinal infection of SARS-CoV-2 – Gastroenterology AND Commentary: Gastrointestinal manifestations and fecal-oral transmission of novel coronavirus – New Medical (03/2020)

COVID-19: aggiornamento per cardiologi.

Pubblichiamo un aggiornamento per cardiologi su COVID-19 relativamente a linee guida ed ultimi articoli pubblicati su riviste mediche internazionali specialistiche.

Linee guida:

• Cardiovascular Considerations for Patients, Health Care Workers, and Health Systems During the Coronavirus Disease 2019 (COVID-19) Pandemic – Journal of the American College of Cardiology AND Commentary: CVD in the Setting of COVID-19: Considerations to Prepare Patients, Providers, Health Systems – American College of Cardiology (03/2020)
• HFSA/ACC/AHA Statement Addresses Concerns Re: Using RAAS Antagonists in COVID-19 – American College of Cardiology AND Commentaries: Patients with COVID-19 should keep taking key CVD medications – Cardiovascular Business AND Patients taking ACE-i and ARBs who contract COVID-19 should continue treatment, unless otherwise advised by their physician – American Heart Association (03/2020)
• The Renal Association, UK position statement on COVID-19 and ACE Inhibitor/Angiotensin Receptor Blocker use (03/2020)
• Position Statement of the ESC Council on Hypertension on ACE-Inhibitors and Angiotensin Receptor Blockers – European Society of Cardiology (03/2020)

Ultimi articoli:

• COVID-19 and the cardiovascular system – Nature Reviews Cardiology (03/2020)
• Cardiologists and Coronavirus: Looking after ourselves and each other so we can continue to look after patients – Heart (03/2020)
• Coronaviruses and the cardiovascular system: acute and long-term implications – European Heart Journal (03/2020)
• SARS-CoV-2: a potential novel etiology of fulminant myocarditis – Herz (03/2020)
• Impact of Coronavirus Disease 2019 (COVID-19) Outbreak on ST-Segment–Elevation Myocardial Infarction Care in Hong Kong, China – Circulation: Cardiovascular Quality and Outcomes (03/2020)
• Coronavirus fulminant myocarditis saved with glucocorticoid and human immunoglobulin – European Heart Journal (03/2020)
• How to balance acute myocardial infarction and COVID-19: the protocols from Sichuan Provincial People’s Hospital – Intensive Care Medicine (03/2020)
• Are patients with hypertension and diabetes mellitus at increased risk for COVID-19 infection? – The Lancet Respiratory Medicine (03/2020)
• Prevalence and impact of cardiovascular metabolic diseases on COVID-19 in China – Clinical Research in Cardiology (03/2020)

 

COVID-19: aggiornamento per medici di terapia intensiva e di emergenza.

Pubblichiamo un aggiornamento per medici di terapia intensiva e di emergenza su COVID-19 relativamente a linee guida ed ultimi articoli pubblicati su riviste mediche internazionali specialistiche.

Linee guida:

• Surviving Sepsis Campaign: Guidelines on the Management of Critically Ill Adults with Coronavirus Disease 2019 (COVID-19) – Intensive Care Medicine AND Infographics: The Surviving Sepsis Campaign Rapid Guidelines on the Management of Critically Ill Adults with COVID-19 (03/2020)
• COVID-19 rapid guideline: critical care – National Institute for Health and Care Excellence (NICE) (03/2020)
• Guidance: COVID-19 Airway Management Principles – Intensive Care Society; The Faculty of Intensive Care Management; Association of Anaesthetists; and Royal College of Anaesthetists (03/2020)
• Consensus statement: Safe Airway Society principles of airway management and tracheal intubation specific to the COVID-19 adult patient group – Medical Journal of Australia AND Summary: COVID-19 Airway Management Principles (03/2020)
• Clinical management of severe acute respiratory infection when novel coronavirus (nCoV) infection is suspected – World Health Organization (03/2020)
• Strategies for Optimizing the Supply of Facemasks – Centers for Disease Control and Prevention (03/2020)
• Surgical Mask and Gown Conservation Strategies – Letter to Healthcare Providers – U.S. Food & Drug Administration (03/2020)
• Novel coronavirus (SARS-CoV-2) – Discharge criteria for confirmed COVID-19 cases – European Centre for Disease Prevention and Control (03/2020)
• COVID-19 Prioritization of Diagnostic Testing – Infectious Diseases Society of America AND Summary: IDSA Statement On COVID-19 Testing Recommendations – Infectious Diseases Society of America (03/2020)
• Interim Infection Prevention and Control Recommendations for Patients with Suspected or Confirmed Coronavirus Disease 2019 (COVID-19) in Healthcare Settings – Centers for Disease Control and Prevention (03/2020)
• Coronavirus disease 2019 (covid-19): a guide for UK GPs – The BMJ (03/2020)
• Chinese Clinical Guidance for COVID-19 Pneumonia Diagnosis and Treatment (7th edition) AND Commentary: Chinese Clinical Guidance For COVID-19 Pneumonia Diagnosis and Treatment – American College of Cardiology (03/2020)

Ultimi articoli:

• Novel Coronavirus COVID-19: An Overview for Emergency Clinicians – EXTRA Supplement – Emergency Medicine Practice (03/2020)
• COVID 19 – BMJ Best Practice (03/2020)
• Critical Care Utilization for the COVID-19 Outbreak in Lombardy, Italy: Early Experience and Forecast During an Emergency Response – JAMA (03/2020)
• Protecting Health Care Workers during the COVID-19 Coronavirus Outbreak –Lessons from Taiwan’s SARS response – Clinical Infectious Diseases (03/2020)
• COVID-19 and the Risk to Health Care Workers: A Case Report – Annals of Internal Medicine (03/2020)
• Can Lung US Help Critical Care Clinicians in the Early Diagnosis of Novel Coronavirus (COVID-19) Pneumonia? – Radiology (03/2020)
• Treatment of COVID-19: old tricks for new challenges – Critical Care (03/2020)
• Safe patient transport for COVID-19 – Critical Care (03/2020)
• Preparing for COVID-19: early experience from an intensive care unit in Singapore – Critical Care (03/2020)
• How to balance acute myocardial infarction and COVID-19: the protocols from Sichuan Provincial People’s Hospital – Intensive Care Medicine (03/2020)
• People at Risk for Serious Illness from COVID-19 – Centers for Disease Control and Prevention AND Commentaries: COVID-19 continues spread in U.S., CDC issues recommendations for high-risk patients – ACP Internist AND Are You At Higher Risk For Serious COVID-19 Illness? Here Is What To Do – Forbes (03/2020)
• Clinical course and risk factors for mortality of adult inpatients with COVID-19 in Wuhan, China: a retrospective cohort study – The Lancet  AND Commentaries: First study identifies risk factors associated with death in adults hospitalised with new coronavirus disease in Wuhan – The Lancet (free) AND Older age, history of sepsis, heart trouble elevate COVID-19 death risk – UPI (03/2020)
• Comorbidities and multi-organ injuries in the treatment of COVID-19 – The Lancet (03/2020)
• Respiratory support for patients with COVID-19 infection – The Lancet Respiratory Medicine (03/2020)
• Clinical Characteristics of Coronavirus Disease 2019 in China – New England Journal of Medicine (03/2020)

COVID-19: aggiornamento per pediatri.

Pubblichiamo un aggiornamento per pediatri su COVID-19 relativamente a review ed ultimi articoli pubblicati su riviste mediche internazionali.

Review:

• Coronavirus Infections in Children Including COVID-19: An Overview of the Epidemiology, Clinical Features, Diagnosis, Treatment and Prevention Options in Children – The Pediatric Infectious Diseases Journal (03/2020)
• A Review of Coronavirus Disease-2019 (COVID-19) – Indian Journal of Pediatrics (03/2020)

Ultimi articoli:

• SARS-CoV-2 Infection in Children – New England Journal of Medicine (03/2020)
• Epidemiological Characteristics of 2143 Pediatric Patients With 2019 Coronavirus Disease in China – Pediatrics (03/2020)
• Detection of Covid-19 in Children in Early January 2020 in Wuhan, China – New England Journal of Medicine (03/2020)
• Characteristics of pediatric SARS-CoV-2 infection and potential evidence for persistent fecal viral shedding – Nature Medicine (03/2020)
• Infants Born to Mothers With a New Coronavirus (COVID-19) – Frontiers in Pediatrics AND Commentary: Chinese case study suggests COVID-19 is not transmitted from pregnant mothers to newborns – Frontiers (03/2020)
• Clinical and CT features in pediatric patients with COVID‐19 infection: Different points from adults – Pediatric Pulmonology (03/2020)
• Chest computed tomography in children with COVID-19 respiratory infection – Pediatric Radiology (free)
• Clinical strategies for treating pediatric cancer during the outbreak of 2019 novel coronavirus infection – Pediatric Blood & Cancer (03/2020)

 

 

COVID-19: aggiornamento per radiologi.

Pubblichiamo un aggiornamento per radiologi su COVID-19 relativamente a linee guida e ultimi articoli pubblicati su riviste specialistiche.

Linee guida:

• Radiology Department Preparedness for COVID-19: Radiology Scientific Expert Panel – Radiology AND Commentary: Experts stress radiology preparedness for COVID-19 – Radiology Society of North America (03/2020)

Ultimi articoli:

• Coronavirus Disease 2019 (COVID-19): A Systematic Review of Imaging Findings in 919 Patients – American Journal of Roentgenology (03/2020)
• Clinical Features and Chest CT Manifestations of Coronavirus Disease 2019 (COVID-19) in a Single-Center Study in Shanghai, China – American Journal of Roentgenology (03/2020)
• Chest computed tomography images of early coronavirus disease (COVID-19) – Canadian Journal of Anesthesia (03/2020)
• Can Lung US Help Critical Care Clinicians in the Early Diagnosis of Novel Coronavirus (COVID-19) Pneumonia? – Radiology (03/2020)
• An Illustrated Guide to the Chest CT in COVID-19 – PulmCCM (03/2020)
• Clinical and CT features in pediatric patients with COVID‐19 infection: Different points from adults – Pediatric Pulmonology (03/2020)
• Chest computed tomography in children with COVID-19 respiratory infection – Pediatric Radiology (03/2020)
• Can Lung US Help Critical Care Clinicians in the Early Diagnosis of Novel Coronavirus (COVID-19) Pneumonia? – Radiology (03/2020)

COVID-19: aggiornamento per anestesisti.

Pubblichiamo un aggiornamento per anestesisti su COVID-19 relativamente a linee guida e ultimi articoli pubblicati su riviste specialistiche.

Linee guida:

• Perioperative Management of Patients Infected with the Novel Coronavirus: Recommendation from the joint task force of the Chinese Society of Anesthesiology and Chinese Association of Anesthesiologists (03/2020)
• Guidance: COVID-19 Airway Management Principles – Intensive Care Society; The Faculty of Intensive Care Management; Association of Anaesthetists; and Royal College of Anaesthetists AND Summary: COVID-19 Airway Management Principles (03/2020)
• Consensus statement: Safe Airway Society principles of airway management and tracheal intubation specific to the COVID-19 adult patient group – Medical Journal of Australia AND Summary: COVID-19 Airway Management Principles (03/2020)
• What we do when a COVID-19 patient needs an operation: operating room preparation and guidance – Canadian Journal of Anesthesia (03/2020)

Ultimi articoli:

• Novel Coronavirus 2019 and Anesthesiolog – Anesthesiology (03/2020)
• Preventing Infection of Patients and Healthcare Workers Should Be the New Normal in the Era of Novel Coronavirus Epidemics – Anesthesiology (03/2020)
• Intubation and Ventilation Amid COVID-19 Outbreak – Anesthesiology (03/2020)
• Response of Chinese anesthesiologists to the COVID-19 outbreak (03/2020)
• Establishing and Managing a Temporary Coronavirus Disease 2019 Specialty Hospital in Wuhan, China – Anesthesiology (03/2020)
• COVID-19: Perioperative Implications – Anesthesiology (03/2020)
• Precautions for Intubating Patients with COVID-19 Infections – Anesthesiology (03/2020)
• Outbreak of a new coronavirus: what anaesthetists should know – British Journal of Anaesthesia (03/2020)
• Recommendations for Anesthesia in Patients Suspected of Coronavirus 2019-nCoV Infection – Korean Journal of Anesthesiology (03/2020)
• Anesthetic Management of Patients With Suspected or Confirmed 2019 Novel Coronavirus Infection During Emergency Procedures – Journal of Cardiothoracic and Vascular Anesthesia (03/2020)
• Safety and efficacy of different anesthetic regimens for parturients with COVID-19 undergoing Cesarean delivery: a case series of 17 patients – Canadian Journal of Anesthesia (03/2020)
• Review paper: COVID-19 – what should anaethesiologists and intensivists know about it? – Anaesthesiology Intensive Therapy (03/2020)

Coronavirus FDA: ok test rapido sui tamponi rinofaringei.

Il test Diasorin per la diagnosi di Covid-19 ha ricevuto l’autorizzazione dalla statunitense Food and Drug Administration (Fda) per l’uso di emergenza. Il kit – spiega l’azienda – è in grado di fornire “una risposta rapida e semplice per la rilevazione della sindrome respiratoria acuta causata dal coronavirus 2, direttamente dai tamponi rinofaringei“.

Il test è composto da una miscela di reagenti pronta per l’uso, non necessita della procedura tradizionale di estrazione degli acidi nucleici e consente dunque un rilevamento rapido: ci vuole poco più di un’ora rispetto alle 7 richieste attualmente dalle tecnologie tradizionali di estrazione e amplificazione, agevolando decisioni sull’isolamento dei pazienti infetti. Il test, evidenzia l’azienda, è stato disegnato con un’altissima specificità per il genoma del nuovo coronavirus e, grazie alla rilevazione di diverse regioni del Rna virale, riduce la suscettibilità a possibili mutazioni future, garantendo la certezza del risultato.

Comunicato stampa:
DiaSorin COVID-19 test has received FDA Emergency Use Authorization

Coronavirus (COVID-19): studi preliminari con idrossiclorochina.

Di seguito segnaliamo i risultati, pubblicati sulla rivista “International Journal of Antimicrobial Agents” di uno studio clinico non randomizzato in aperto su idrossiclorochina e azitromicina come trattamento di COVID-19.

Lo studio in aperto con solo 42 pazienti senza endpoint rilevanti per il paziente. I 6 pazienti che hanno ricevuto idrossiclorochina + azitromicina hanno ottenuto un’eliminazione del virus più efficiente rispetto ai pazienti di controllo. L’idrossiclorochina, un derivato meno tossico della clorochina, è efficace nell’inibire l’infezione da SARS-CoV-2 anche in vitro.

La Food and Drugs Administration approva l’utilizzo della clorichina nel trattamento dei pazienti affetti da covid-19. L’uso sperimentale inizierà da subito. Il farmaco è usato nelle terapie contro la malaria e l’artrite reumatoide.

Scarica e leggi i documenti in full text:

Hydroxychloroquine and azithromycin as a treatment of COVID-19: results of an open label non-randomized clinical trial – International Journal of Antimicrobial Agents (free PDF)

New in Vitro Study: Hydroxychloroquine, a less toxic derivative of chloroquine, is effective in inhibiting SARS-CoV-2 infection in vitro – Cell Discovery (free)

Related Articles:

• In Vitro Antiviral Activity and Projection of Optimized Dosing Design of Hydroxychloroquine for the Treatment of Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) – Clinical Infectious Diseases (free PDF)
• New insights on the antiviral effects of chloroquine against coronavirus: what to expect for COVID-19? – International Journal of Antimicrobial Agents (free)
• A systematic review on the efficacy and safety of chloroquine for the treatment of COVID-19 – Journal of Critical Care (free)
• Of chloroquine and COVID-19 – Antiviral Research (free)

L’epidemia di coronavirus COVID-19 ha un’origine naturale.

Un’analisi dei dati della sequenza del genoma pubblico da SARS-CoV-2 e virus correlati non ha trovato prove del fatto che il virus sia stato prodotto in laboratorio o altrimenti progettato.

La nascita del coronavirus SARS-CoV-2 che è emerso nella città di Wuhan, in Cina,e che ha causato un’epidemia su larga scala COVID-19 diffondendosi in moltissimi altri paesi è il prodotto dell’evoluzione naturale, secondo i risultati pubblicati sulla rivista “Nature Medicine“.

“Confrontando i dati disponibili sulla sequenza del genoma per ceppi di coronavirus noti, possiamo stabilire con certezza che la SARS-CoV-2 ha avuto origine attraverso processi naturali“, ha affermato Kristian Andersen, PhD, professore associato di immunologia e microbiologia presso Scripps Research.

Ricordiamo che i coronavirus sono una grande famiglia di virus che possono causare malattie che variano ampiamente in gravità. La prima malattia nota nota causata da un coronavirus è emersa con l’epidemia di sindrome respiratoria acuta grave (SARS) del 2003 in Cina. Un secondo focolaio di malattia grave è iniziato nel 2012 in Arabia Saudita con la sindrome respiratoria del Medio Oriente (MERS).

Gli scienziati hanno analizzato il modello genetico per le proteine ​​dei picchi, le armature all’esterno del virus che utilizza per afferrare e penetrare le pareti esterne delle cellule umane e animali. Più specificamente, si sono concentrati su due importanti caratteristiche della proteina spike: il dominio legante il recettore (RBD), una specie di uncino che si aggrappa alle cellule ospiti e il sito di scissione, un apriscatole molecolare che consente al virus di aprirsi e inserisci le celle host.

Gli scienziati hanno scoperto che la porzione di RBD delle proteine ​​del picco SARS-CoV-2 si era evoluta per colpire efficacemente una caratteristica molecolare all’esterno delle cellule umane chiamata ACE2, un recettore coinvolto nella regolazione della pressione sanguigna. La proteina del picco SARS-CoV-2 era così efficace nel legare le cellule umane, infatti, che gli scienziati hanno concluso che era il risultato della selezione naturale e non il prodotto dell’ingegneria genetica.

Scarica e leggi l’articolo in full text:
The proximal origin of SARS-CoV-2.
Kristian G. Andersen, Andrew Rambaut, W. Ian Lipkin, Edward C. Holmes, Robert F. Garry.
Nature Medicine, 2020; DOI: 10.1038/s41591-020-0820-9

Fonte: Scripps Research

Coronavirus (COVID-19): ultimi articoli, news – 19 marzo.

Segnaliamo articoli, linee guida e news provenienti dalle maggiori riviste scientifiche relativamente al Coronavirus (COVID-19) – aggiornamento del 19/03/2020.

 

World Health Organization COVID-19 Situation Report:

• WHO: Latest COVID-19 Situation Report – 18 March 2020 (free PDF)
• WHO Director-General’s opening remarks at the media briefing on COVID-19 – 18 March 2020 (free)
• WHO Homepage on the Coronavirus disease (COVID-19) outbreak (free resources)

Clinical Trials:

• Coronavirus (COVID-19) Update: FDA Issues Guidance for Conducting Clinical Trials – U.S Food & Drug Administration (free)
• FDA Issues Guidelines on Conducting Trials During COVID-19 Pandemic – ContagionLive (free)
• Coronavirus will have a ‘big impact’ on one-third of U.S. clinical trial sites, survey finds – STAT (free)
• FDA urges virtual patient visits as coronavirus disrupts clinical trials – Reuters (free)

Guidelines:

• New CDC Guideline: Disinfecting your home if someone is sick – Centers for Disease Control and Prevention (free)
• Video Consultations: A Guide for Practice – British Journal of General Practice (free)
• NHS Specialty
• Chinese Clinical Guidance For COVID-19 Pneumonia Diagnosis and Treatment – American College of Cardiology (free)

Ultimi articoli:

• A Trial of Lopinavir–Ritonavir in Adults Hospitalized with Severe Covid-19 – New England Journal of Medicine (free) AND Editorial: Covid-19 — The Search for Effective Therapy (free) AND Commentary: A Promising Treatment for Coronavirus Fails – The New York Times (10 articles per month are free)
• SARS-CoV-2 Infection in Children – New England Journal of Medicine (free)
• Editorial: Coronavirus: three things all governments and their science advisers must do now – Nature (Free)
• Cardiologists and Coronavirus: Looking after ourselves and each other so we can continue to look after patients – Heart (free)
• Coronaviruses and the cardiovascular system: acute and long-term implications – European Heart Journal (free)
• A serological assay to detect SARS-CoV-2 seroconversion in humans – medRxiv (free PDF)

News:

• The Treatment of Patients With Cancer and Containment of COVID-19: Experiences From Italy – ASCO Daily News (free)
• Patients with breathing, lung problems at highest risk with COVID-19: study – Reuters (free)
• Scientists say mass tests in Italian town have halted Covid-19 there – The Guardian (free).

Nuovo coronavirus stabile per ore sulle superfici.

Un nuovo studio del National Institutes of Health, CDC, UCLA e Princeton University ha trovato che la sindrome respiratoria acuta grave coronavirus 2 (SARS-CoV-2) è stabile negli aerosol per un massimo di 3 ore, fino a 4 ore su rame, fino a 24 ore su cartone e fino a 2 o 3 giorni su ha e acciaio inossidabile.

This scanning electron microscope image shows SARS-CoV-2 (yellow)—also known as 2019-nCoV, the virus that causes COVID-19—isolated from a patient in the U.S., emerging from the surface of cells (blue/pink) cultured in the lab.NIAID-RML

Il virus che causa la malattia di coronavirus 2019 (COVID-19) è stabile per diverse ore o giorni negli aerosol e sulle superfici.
I risultati forniscono informazioni chiave sulla stabilità della SARS-CoV-2, che causa la malattia COVID-19, e suggeriscono che le persone possono acquisire il virus attraverso l’aria e dopo aver toccato oggetti contaminati. Le informazioni sullo studio sono state ampiamente condivise.

Leggi il full text dell’articolo:
Aerosol and surface stability of HCoV-19 (SARS-CoV-2) compared to SARS-CoV-1.
N van Doremalen, et al.
The New England Journal of Medicine. DOI: 10.1056/NEJMc2004973 (2020).

New coronavirus stable for hours on surfacesSARS-CoV-2 stability similar to original SARS virus.

Fonte: http://www.nih.gov

Coronavirus (COVID-19): ultimi articoli, news – 17 marzo.

Proseguiamo con la segnalazione di articoli, linee guida e news provenienti dalle maggiori riviste scientifiche relativamente al Coronavirus (COVID-19) – aggiornamento del 17/03/2020.

Guidelines & Reports:

• Report 9: Impact of non-pharmaceutical interventions (NPIs) to reduce COVID19 mortality and healthcare demand – Imperial College London (free PDF) AND Summary: Report 9 (free)
• Guidance on social distancing for everyone in the UK and protecting older people and vulnerable adults – Public Health England (free)
• COVID-19: guidance for households with possible coronavirus infection – Public Health England (free)
• Surgical Mask and Gown Conservation Strategies – Letter to Healthcare Providers – U.S. Food & Drug Administration (free)
• COVID-19: Recommendations for Management of Elective Surgical Procedures – American College of Surgeons (free) AND Commentary: U.S. hospitals, patients cancel elective surgery as coronavirus spreads – Reuters (free)
• Consensus statement: Safe Airway Society principles of airway management and tracheal intubation specific to the COVID-19 adult patient group – Medical Journal of Australia (free)

Clinical Trial of Investigational Vaccine Begins:

• NIH clinical trial of investigational vaccine for COVID-19 begins – NIH News Releases (free)
• Related: When will a coronavirus vaccine be ready? – The Guardian (free) AND First in Human: COVID-19 Vaccines & Tales of Phase 1 Clinical Trials Past – Absolutely Maybe Blog (free) AND A coronavirus vaccine will take at least 18 months—if it works at all – MIT Technology Review (free)

Ultimi articoli:

• Substantial undocumented infection facilitates the rapid dissemination of novel coronavirus (SARS-CoV2) – Science (free) AND Commentaries: 80% of COVID-19 spreads from people who don’t know they are sick – UPI (free) AND Coronavirus Is Hiding in Plain Sight – The New York Times (10 articles per month are free)
• Epidemiological Characteristics of 2143 Pediatric Patients With 2019 Coronavirus Disease in China – Pediatrics (free PDF) AND Commentary: Children with COVID-19 Impacted Less Severely Than Adults: Study – American Academy of Pediatrics (free)

Coronavirus (COVID-19): ultimi articoli, News – 16 marzo.

Pubblichiamo di seguito gli ultimi articoli, le linee guida e le news provenienti dalle maggiori riviste scientifiche relativamente al Coronavirus (COVID-19) – aggiornamento del 16/03/2020.

World Health Organization COVID-19 Situation Report:

• WHO: Latest COVID-19 Situation Report – 15 March 2020 (free PDF)
• WHO Director-General’s opening remarks at the media briefing on COVID-19 – 13 March 2020 (free)

Linee guida:

• COVID 19 – BMJ Best Practice (free)
• Interim Guidance: Clinical management of severe acute respiratory infection when novel coronavirus (nCoV) infection is suspected – World Health Organization (free PDF)
• Mental Health and Psychosocial Considerations During COVID-19 Outbreak – World Health Organization (free PDF)
• Guidance: COVID-19 Airway Management Principles AND Summary: COVID-19 Airway Management Principles (free PDF) – From the Intensive Care Society; The Faculty of Intensive Care Management; Association of Anaesthetists; and Royal College of Anaesthetists.
• Considerations relating to social distancing measures in response to the COVID-19 epidemic – European Centre for Disease Prevention and Control (free)
• Get Your Mass Gatherings or Large Community Events Ready – Centers for Disease Control and Prevention (free) AND Commentary: The CDC recommends organizers cancel or postpone events with 50 people or more for 8 weeks – CNN (free)
• ABM Statement on Coronavirus 2019 (COVID-19) – Academy of Breastfeeding Medicine (free)
• Alert: Important coronavirus updates for ophthalmologists – American Academy of Ophthalmology (free)

Ultimi articoli:

• Critical Care Utilization for the COVID-19 Outbreak in Lombardy, Italy: Early Experience and Forecast During an Emergency Response – JAMA (free)
• Characteristics of pediatric SARS-CoV-2 infection and potential evidence for persistent fecal viral shedding – Nature Medicine (free) AND Commentary: How Does The Coronavirus Affect Kids? What We Know So Far About COVID-19 In Children – Forbes (free) AND Coronavirus study finds children with COVID-19 show milder symptom pattern – Reuters (free)
• Coronavirus Infections in Children Including COVID-19: An Overview of the Epidemiology, Clinical Features, Diagnosis, Treatment and Prevention Options in Children – The Pediatric Infectious Diseases Journal (free PDF) AND Commentary: COVID-19 appears less severe in children – Wolters Kluwer Health (free)
• A Review of Coronavirus Disease-2019 (COVID-19) – Indian Journal of Pediatrics (free)
• Editorial: COVID-19: delay, mitigate, and communicate – The Lancet (free PDF)
• Editorial: Bearing the brunt of covid-19: older people in low and middle income countries – The BMJ (free) AND Commentary: Call for older people in poor countries to be considered in global responses to COVID-19 – University of East Anglia (free)
• In the fight against the new coronavirus outbreak, we must also struggle with human bias – Nature (free)
• From Containment to Mitigation of COVID-19 in the US – JAMA (free)
• The convalescent sera option for containing COVID-19 – The Journal of Clinical Investigation (free)
• Preparing for a COVID-19 pandemic: a review of operating room outbreak response measures in a large tertiary hospital in Singapore – Canadian Journal of Anaesthesia (free)
• Research and Development on Therapeutic Agents and Vaccines for COVID-19 and Related Human Coronavirus Diseases – American Chemical Society (free) AND Commentaries: Potential therapeutic agents, vaccines for COVID-19 – American Chemical Society (free) AND COVID-19: Research and Development on Therapeutic Agents and Vaccines – MedicalResearch.com (free)
• In Vitro Antiviral Activity and Projection of Optimized Dosing Design of Hydroxychloroquine for the Treatment of Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) – Clinical Infectious Diseases (free)
• Protecting Health Care Workers during the COVID-19 Coronavirus Outbreak –Lessons from Taiwan’s SARS response – Clinical Infectious Diseases (free)
• A Novel Approach for a Novel Pathogen: using a home assessment team to evaluate patients for 2019 novel coronavirus (SARS-CoV-2) – Clinical Infectious Diseases (free)
• A case report of neonatal COVID-19 infection in China – Clinical Infectious Diseases (free PDF)
• A comparative study on the clinical features of COVID-19 pneumonia to other pneumonias – Clinical Infectious Diseases (free PDF)
• Dysregulation of immune response in patients with COVID-19 in Wuhan, China – Clinical Infectious Diseases (free PDF)
• COVID-19 – the role of mass gatherings – Travel Medicine and Infectious Disease (free)
• Risk Factors Associated With Acute Respiratory Distress Syndrome and Death in Patients With Coronavirus Disease 2019 Pneumonia in Wuhan, China – JAMA Internal Medicine (free)
• A systematic review on the efficacy and safety of chloroquine for the treatment of COVID-19 – Journal of Critical Care (free).

News:

• A visual history of pandemics – World Economic Forum (free)
• How many tests for COVID-19 are being performed around the world? – Our World in Data (free)
• A COVID-19 coronavirus update from concerned physicians – KevinMD (free)
• US takes more big pandemic response steps; Europe COVID-19 cases soar – CIDRAP (free)
• WHO: Europe now world’s COVID-19 epicenter – CIDRAP (free)
• World closes borders, restricts travel to contain coronavirus spread – Reuters (free)
• As The Pandemic Spreads, Will There Be Enough Ventilators? – NPR (free)
• The New Coronavirus Can Live On Surfaces For 2-3 Days — Here’s How To Clean Them – NPR (free)
• The COVID-19 Coronavirus Is Now A Pandemic – Can We Ethically Deal With Lockdowns? – Forbes (free)
• What Is Social Distancing? Here Are 10 Ways To Keep The Coronavirus Away – Forbes (free)
• Coronavirus Drug Update: The Latest Info On Pharmaceutical Treatments And Vaccines – Forbes (free)
• Behavioural scientists form new front in battle against coronavirus – The Guardian (free)
• Coronavirus and social distancing: is it risky to go to the pub or gym? – The Guardian (free)
• The coronavirus pandemic: visualising the global crisis – The Guardian (free)

 

Le cure palliative in pazienti con tumore incurabile.

Sono state pubblicate sulla rivista “Deutsches Ärzteblatt international“, a cura del German Oncology Guideline Program (Leitlinienprogramm Onkologie) le linee guida sulle cure palliative nei pazienti con tumore incurabile.

Lo scopo della medicina palliativa è ottimizzare la qualità della vita dei pazienti con malattie incurabili e progressive. L’assistenza erogata nella pratica clinica effettiva non è uniforme e spesso tiene conto insufficientemente delle prove scientifiche attualmente disponibili.

Le opzioni non farmacologiche per il trattamento dell’affaticamento comprendono l’esercizio aerobico e metodi psicoeducativi, in particolare la terapia comportamentale cognitiva. I disturbi del sonno possono essere trattati con una migliore igiene del sonno e tecniche di rilassamento, nonché con farmaci. Per la nausea e il vomito, la prima linea di trattamento consiste in farmaci antidopaminergici, come l’aloperidolo.

Il presente documento aggiorna il precedente pubblicato nel 2015.

Scarica e leggi il documento in full text:
The Palliative Care of Patients With Incurable Cancer
Simon, S T; Pralong, A; Radbruch, L; Bausewein, C; Voltz, R.
Dtsch Arztebl Int 2020; 117: 108-15. DOI: 10.3238/arztebl.2020.0108