What has been published about medical care?

Table of Contents

1 Resources to support skilled nursing facilities and long term care facilities.

1.0.0.1 Highlights

1.0.0.2 Articles

Date Authors Title LOE(?) & Sample Matches
2020 Schwartz et al Potential Maternal and Infant Outcomes from (Wuhan) Coronavirus 2019-nCoV Infecting Pregnant Women: Lessons from SARS, MERS, and Other Human Coronavirus Infections
Viruses
IV. Prevalence Study

A case-control study to determine the effects of SARS on pregnancy compared 10 pregnant and 40 non-pregnant women with the infection at the Princess Margaret Hospital in Hong Kong .
Regional health authorities in conjunction with hospital staff should consider designating specific facilities or health care units, including primary, secondary, or tertiary health care centers, to care for patients with SARS or similar illnesses."
2020 Huang et al Mental health survey of 230 medical staff in a tertiary infectious disease hospital for COVID-19
Zhonghua Lao Dong Wei Sheng Zhi Ye Bing Za Zhi
IV. Other Medical institutions should strengthen the training of psychological skills of medical staff.
2020-02-28 Heymann et al COVID-19: what is next for public health?
The Lancet
IV. Prevalence Study

8 Infected individuals produce a large quantity of virus in the upper respiratory tract during a prodrome period, are mobile, and carry on usual activities, contributing to the spread of infection.
People in long-term care facilities are also at risk of severe health consequences if they become infected.
2020-02-29 Lee et al Wuhan novel coronavirus (COVID-19): why global control is challenging?
Public Health
IV. Other 12 Disinvestment in health protection is risky as it is not easy to build up health protection infrastructure, skills, and workforce rapidly.
2020-03-05 Wilder-Smith et al Can we contain the COVID-19 outbreak with the same measures as for SARS?
The Lancet Infectious Diseases
IV. Prevalence Study

On Feb 18, 2020, the Chinese Center for Disease Control and Prevention published their data of the first 72 314 patients including 44 672 patients with confirmed COVID19.
23 In Hong Kong, 49% of the patients with SARS were in clinics, hospitals, and elderly or nursing homes.

22 Hospitalbased measures included isolation rooms with barrier nursing techniques, strict enforcement of personal protective equipment for staff, and restriction of visitors and movement of staff.
2020-03-05 Xiao et al The Effects of Social Support on Sleep Quality of Medical Staff Treating Patients with Coronavirus Disease 2019 (COVID-19) in January and February 2020 in China
Med Sci Monit
III-2. Cross Sectional Control Hospital managers should provide logistic support for medical staff, and support groups for medical staff should be established.
2020-03-08 Mullins et al CORONAVIRUS IN PREGNANCY AND DELIVERY: RAPID REVIEW AND EXPERT CONSENSUS
medrxiv
IV. Prevalence Study

A casecontrol study comparing 10 pregnant and 40 non-pregnant women affected by SARS in Hong Kong reported 60% ICU admission and 40% CFR in the pregnant group compared with 17.5% and 0% in the non-pregnant group .
Women will need to be cared for in units with appropriate neonatal intensive care facilities as COVID-19 is associated with pre-term delivery in 50% of reported cases.
2020-03-13 Dosa et al Long-Term Care Facilities and the Coronavirus Epidemic: Practical Guidelines for a Population at Highest Risk
Journal of the American Medical Directors Association
IV. Other Residents of long-term care facilities often have medical conditions associated with an increased risk of morbidity and mortality to COVID-19.

Several epidemiological variables make long-term care facilities a priority area for near term public health planning.

A key challenge to nursing home and assisted living (AL) facilities during any disaster scenario is the maintenance of adequate staffing levels.

This may be challenging in the nursing home environment, where supplies of these items may be limited and are prioritized for acute care hospitals.

12 Despite caring for frail older residents, AL settings are not staffed or equipped to provide the type of care that nursing homes can provide.
2020-03-13 Remuzzi et al COVID-19 and Italy: what next?
The Lancet
IV. Other Our analysis might help political leaders and health authorities to allocate enough resources, including personnel, beds, and intensive care facilities, to manage the situation in the next few days and weeks.

Given that the mortality of patients who are critically ill with SARS-CoV-2 pneumonia is high and that the survival time of non-survivors is 1-2 weeks, the number of people infected in Italy will probably impose a major strain on critical care facilities in our hospitals, some of which do not have adequate resources or staff to deal with this emergency.
2020-03-13 Li et al The demand for inpatient and ICU beds for COVID-19 in the US: lessons from Chinese cities
medrxiv
IV. Prevalence Study

During the peak of the epidemic from mid to late February, a maximum of 19,425 patients (24.5 per 10,000 adults) were hospitalized, 9,689 patients (12.2 per 10,000 adults) were considered to be in "serious" condition, and 2,087 patients (2.6 per 10,000 adults) needed critical care per day.
In several countries with high-performing healthcare systems where SARS-CoV-2 transmission has been established earlier, both supplies of personal protective equipment in hospitals and the availability of services has been problematic for COVID-19 care, and in all locations, ICU bed capacity is limited.

The media reported a significant shortage of hospital beds, intensive care unit (ICU) beds, and other healthcare resources.
2020-03-18 Legido-Quigley et al The resilience of the Spanish health system against the COVID-19 pandemic
The Lancet Public Health
IV. Other Second, long-term underinvestment in health services, as seen in many countries following the 2008 financial crisis, impairs their resilience by depleting their ability to respond to surges in need for health care with sufficient health professionals, intensive care unit beds, protective equipment, diagnostic test kits, and mechanical ventilators.
2020-03-19 Tolksdorf et al Influenza-associated pneumonia as reference to assess seriousness of coronavirus disease (COVID-19)
Euro Surveill
IV. Prevalence Study

described clinical courses and outcomes of 52 critically ill patients in a hospital in Wuhan .
Hospitals should prepare for high utilisation of ventilation and intensive care resources.

This can only be implemented if hospitals prepare for high utilisation of ventilation and intensive care resources.
2020-03-20 Jiang et al Development and validation of a rapid single-step reverse transcriptase loop-mediated isothermal amplification (RT-LAMP) system potentially to be used for reliable and high-throughput screening of COVID-19
medrxiv
IV. Other However, the requirement for advanced technology and 59 skilled personnel and long turn-around time (24 hours) are not feasible for local and referral 60 laboratories.
2020-03-20 Ramanathan et al 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
IV. Prevalence Study Workplace policies for management of staff wellbeing, including ensuring the presence of staff support services to provide basic amenities, such as meals and drinks, showering facilities, rest areas, and a laundry service for used scrubs or uniforms, could be introduced.

Operators should be familiar with the ECMO cannula sizes and dilators and be able to deal with cannulation complications while wearing PPE Developing organisations that support systems, equipment, facilities, and personnel is crucial to ensure optimal patient care, as well as family and staff safety during outbreaks of emerging infectious diseases.
2020-03-23 Milne et al The Effectiveness of Social Distancing in Mitigating COVID-19 Spread: a modelling analysis
medrxiv
IV. Other This approach aims to lessen the daily pressure on health care personnel and hospital facilities, such as intensive care beds, and to lower mortality rates.
2020-03-24 Portnoy et al Telemedicine in the Era of COVID-19
The Journal of Allergy and Clinical Immunology: In Practice
IV. Other 1 A significant portion of cases in China were due to hospital-related transmission, 2 and skilled nursing facilities in Washington state have followed suit.

In addition, because of the public health emergency, as of March 6, 2020, Medicare will pay to treat COVID-19 (and for other medically reasonable purposes) using TM services for patients if they have seen a provider in the same practice from offices, hospitals, and places of residence (such as homes, nursing homes, and assisted living facilities).
2020-03-25 Vahia et al COVID-19, Mental Health and Aging: A Need for New Knowledge to Bridge Science and Service
The American Journal of Geriatric Psychiatry
IV. Other We believe that a range of measures may have been implemented across various care settings worldwide, including inpatient and outpatient care and large tertiary care centers, community-based hospitals, primary care settings, nursing homes as well as residential environments such as assisted living facilities.
2020-03-26 Rios et al Guidelines for preventing respiratory illness in older adults aged 60 years and above living in long-term care: A rapid review of clinical practice guidelines
medrxiv
IV. Prevalence Study

If one or more respiratory samples from ILI cases in a suspected outbreak returns a positive laboratory result for influenza, then an influenza outbreak is confirmed.
Examples of long-term care include nursing homes, charitable homes, municipal homes, long-term care hospitals, long-term care facilities, skilled nursing facilities, convalescent homes, and assisted living facilities (https://www.canada.ca/en/health-canada/services/home-continuing-care/long-term-facilitiesbased-care.html).

According to the World Health Organization, "long-term care covers those activities undertaken by others to ensure that people with, or at risk of, a significant ongoing loss of intrinsic capacity can maintain a level of functional ability consistent with their basic rights, fundamental freedoms and human dignity" ( Examples of long-term care will include nursing homes, charitable homes, municipal homes, long-term care hospitals, long-term care facilities, skilled nursing facilities, convalescent homes, and assisted living facilities (https://www.canada.ca/en/health-canada/services/home-continuing-care/long-termfacilities-based-care.html).

CDC has resources for performing respiratory infection surveillance in long-term care facilities during an outbreak.

This refers to any public or private aged care, disability services or other congruent accommodation setting in Victoria where residents are provided with personal care or health care by facility staff.

When transmission in the community is identified, nursing homes and assisted living facilities may face staffing shortages.

For managing respiratory illness in long-term care facilities, the majority of the clinical practice guidelines recommended antivirals for prophylaxis of staff and/or residents.
2020-03-26 Rios et al Preventing respiratory illness in older adults aged 60 years and above living in long-term care: A rapid overview of reviews
medrxiv
I. Systematic Review

During full text review, articles were included if they contained the number of influenza cases occurring on a specific date or within a 3-day period, such as through an epidemic curve or a line list of symptom onset dates 37 studies N = NR Long term care facilitiesdefined as any residential environment that housed older adults or elderly individuals with the assistance of medical staff and included facilities referred to as 'assisted living' or 'nursing homes' but excluded community centers and daytime-only facilities serving older adults living in the outside community.
Examples of long-term care include nursing homes, charitable homes, municipal homes, long-term care hospitals, long-term care facilities, skilled nursing facilities, convalescent homes, and assisted living facilities (https://www.canada.ca/en/health-canada/services/home-continuing-care/long-term-facilitiesbased-care.html).

According to the World Health Organization, "long-term care covers those activities undertaken by others to ensure that people with, or at risk of, a significant ongoing loss of intrinsic capacity can maintain a level of functional ability consistent with their basic rights, fundamental freedoms and human dignity" ( Examples of long-term care will include nursing homes, charitable homes, municipal homes, long-term care hospitals, long-term care facilities, skilled nursing facilities, convalescent homes, and assisted living facilities (https://www.canada.ca/en/health-canada/services/home-continuing-care/long-termfacilities-based-care.html).

During full text review, articles were included if they contained the number of influenza cases occurring on a specific date or within a 3-day period, such as through an epidemic curve or a line list of symptom onset dates 37 studies N = NR Long term care facilitiesdefined as any residential environment that housed older adults or elderly individuals with the assistance of medical staff and included facilities referred to as 'assisted living' or 'nursing homes' but excluded community centers and daytime-only facilities serving older adults living in the outside community.

The rest of the strategies can be used in long-term care facilities, yet have limited evidence supporting their use.
2020-03-26 Zheng et al Recommendations and guidance for providing pharmaceutical care services during COVID-19 pandemic: A China perspective
Research in Social and Administrative Pharmacy
IV. Other The professional 67 skills of pharmacy staff and pharmacists work in these retail pharmacies varies significantly, and 68 are generally not considered as healthcare professionals .

Community pharmacists shall be prepared to provide skilled and effective PC services 309
2020-03-27 Hsiang et al The Effect of Large-Scale Anti-Contagion Policies on the Coronavirus (COVID-19) Pandemic
medrxiv
III-3. Time Series Analysis

We did not collect city level health outcomes recorded prior to January 24, 2020 in provinces that had fewer than ten confirmed cases at that date.
The " social_distance " category includes measures that prevent visits to elderly care facilities, close public facilities such as libraries, and require workers to work remotely.
2020-03-30 Wang et al Dementia care during COVID-19
The Lancet
IV. Other To lessen the chance of infection among older people in nursing homes, more local authorities are banning visitors to nursing homes and longterm care facilities.
2020-03-30 Kang et al Impact on Mental Health and Perceptions of Psychological Care among Medical and Nursing Staff in Wuhan during the 2019 Novel Coronavirus Disease Outbreak: a Cross-sectional Study
Brain, Behavior, and Immunity
III-2. Cross Sectional Control

In total, 994 participants, including 183 (18.4%) doctors and 811 (81.6%) nurses, completed the survey.
Psychological care needs of medical and nursing staff In terms of the content of interest, namely, psychological care, medical and nursing staff with subthreshold disturbances most wanted to obtain skills to help alleviate others' psychological distress, whereas other medical and nursing staff most wanted to obtain self-help skills.
2020-03-30 Truelove et al COVID-19: Projecting the impact in Rohingya refugee camps and beyond
medrxiv
IV. Other Currently, there is only one facility with few mechanical ventilators in the camps and one facility with less than 10 ICU beds and no ventilators.
2020-03-30 Deng et al A Genomic Survey of SARS-CoV-2 Reveals Multiple Introductions into Northern California without a Predominant Lineage
medrxiv
IV. Other The exponential growth in the number of cases has overburdened clinical care facilities and threatens to overwhelm the medical workforce.
2020-03-31 FINEGAN et al International Committee of the Red Cross (ICRC): General Guidance for the Management of the Dead Related to COVID-19
Forensic Science International: Synergy
IV. Other Existing facilities may be found within hospitals, public and private funeral homes and forensic services.
2020-03-31 Kluge et al Refugee and migrant health in the COVID-19 response
The Lancet
IV. Other The ability to access health-care services in humanitarian settings is usually compromised and exacerbated by shortages of medicines and lack of health-care facilities.
2020-04-01 Abhari et al COVID-19 Epidemic in Switzerland: Growth Prediction and Containment Strategy Using Artificial Intelligence and Big Data
medrxiv
IV. Other There seems to be some indication 13 that, when health care facilities are overwhelmed by demand and have limited resources, these facilities themselves can become a hot zone of significant additional infections to staff and visitors.
2020-04-01 Chen et al Novel Coronavirus International Public Health Emergency: Guidance on Radiation Oncology Facility Operation
Advances in Radiation Oncology
IV. Other At the above hospitals, these working groups have created protocols covering hospital and ambulatory care workflow, facility infection prevention and control, emergency operations, protective material management, and radiotherapy procedures and equipment maintenance.
2020-04-30 Carvalho et al The psychiatric impact of the novel coronavirus outbreak
Psychiatry Research
IV. Other Specialized psychiatric treatments and appropriate mental health services and facilities should be supplied to patients with comorbid mental disorders.
2020-04-30 Banerjee et al The COVID-19 outbreak: Crucial role the psychiatrists can play
Asian Journal of Psychiatry
IV. Prevalence Study People with mental illness are especially vulnerable to these effects, as are the health-care workers in hospitals and laboratories, the volunteers and social service personnel and those quarantined for prolonged duration.

2 Mobilization of surge medical staff to address shortages in overwhelmed communities

2.0.0.1 Highlights

2.0.0.2 Articles

Date Authors Title LOE(?) & Sample Matches
2020 Zhang et al Recommended psychological crisis intervention response to the 2019 novel coronavirus pneumonia outbreak in China: a model of West China Hospital
Precision Clinical Medicine
IV. Other Psychological rescue teams conduct crisis interventions for confirmed patients and front-line staff.
2020 Liu et al Critical care response to a hospital outbreak of the 2019-nCoV infection in Shenzhen, China
Critical Care
IV. Other These challenges have caused severe shortage of healthcare workers, medical materials, and beds with isolation.
2020-01-26 Liu et al Time-varying transmission dynamics of Novel Coronavirus Pneumonia in China
biorxiv
III-3. Time Series Analysis

We estimated the doubling time, basic reproduction number (R0) and time-varying reproduction number (Rt) of NCP and SARS.Measurements and main resultsAs of February 7, 2020, 34,598 NCP cases were identified in China, and daily confirmed cases decreased after February 4.
Reasons for such delays include the time to complete diagnosis test, logistics, and overwhelmed surveillance systems.
2020-02-11 Khan et al Novel coronavirus: how things are in Wuhan
Clinical Microbiology and Infection
IV. Other To cope with further shortages, the designated hospitals have transferred medical and clinical testing staff to frontline departments from other departments such as oncology, orthopaedics and medicines.
2020-02-19 Chen et al Mental health care for medical staff in China during the COVID-19 outbreak
The Lancet Psychiatry
IV. Other in addition to disease knowledge and protective measures, pre-job training was arranged to address identification of and responses to psychological problems in patients with COVID-19, and hospital security staff were available to be sent to help deal with uncooperative patients.
2020-02-20 Qiu et al Intensive care during the coronavirus epidemic
Intensive Care Medicine
IV. Other This surge of critically ill patients in designated hospitals as well as fever clinics represents urgent demands for intensive care with regards to space, supplies, and staff (Table 1) .
2020-02-20 Ling et al COVID-19: A critical care perspective informed by lessons learnt from other viral epidemics
Anaesthesia Critical Care & Pain Medicine
IV. Other Expansion of critical care beds to cope with increased numbers of patients by opening more ICU beds, and converting wards and other monitored areas for ICU provision is often recommended in outbreak disaster plans.
2020-02-21 Feng et al Chinese medical personnel against the 2019-nCoV
Journal of Infection
IV. Other Although the epidemic in Wuhan is serious, a large number of medical staff rushed to Wuhan to supplement the shortage of manpower in Wuhan hospitals.
2020-03-01 Yan et al A machine learning-based model for survival prediction in patients with severe COVID-19 infection
medrxiv
IV. Other Both the reach and severity of cases is putting great pressure on the medical services, and readily lead to a shortage of intensive care resources.
2020-03-02 Cao et al Hospital Emergency Management Plan During the COVID-19 Epidemic
Academic Emergency Medicine
IV. Other Enormous demand for handling the COVID-19 outbreak challenged both the healthcare personnel and medical supply system.
2020-03-05 Wilder-Smith et al Can we contain the COVID-19 outbreak with the same measures as for SARS?
The Lancet Infectious Diseases
IV. Prevalence Study

On Feb 18, 2020, the Chinese Center for Disease Control and Prevention published their data of the first 72 314 patients including 44 672 patients with confirmed COVID19.
Hospitals were initially overwhelmed by the number of patients, and many patients were not hospitalised because of a shortage of hospital beds, thereby contributing to seeding in the community.
2020-03-07 Baker et al Preparing for a Surge of Coronavirus Cases
The Joint Commission Journal on Quality and Patient Safety
IV. Other However, surge hospitals could have a role in pandemics if all hospitals in a community are overwhelmed despite activating their internal surge plans.

3 Surge hospitals, so-called because they are designed to treat a surge in the number of patients needing care, contain triage, treatment, and sometimes even surgical capabilities.

2 If there are severe outbreaks, some communities may even want to consider creating surge hospitals.
2020-03-12 qiu et al Revealing the influence of national public health policies for the outbreak of the SARS-CoV-2 epidemic in Wuhan, China through status dynamic modeling
medrxiv
IV. Other Despite the advantage of epidemic control, the lockdown of Wuhan has significantly increased the pressure of local medical resources, including the rapidly growing demands for hospitalization, lack of medical staff such as doctors and nurses, and shortage of medical supplies.
2020-03-13 Bhagavathula et al Novel Coronavirus (COVID-19) Knowledge and Perceptions: A Survey of Healthcare Workers
medrxiv
III-2. Cross Sectional Control

A total of 529 HCWs participated, 453 of whom completed the study questionnaire (85.6% response rate), including 234 (51.6%) men and 219 (48.3%) women; most of the participants were below 44 years of age (82.4%).
This is unfortunate because the surge of COVID-19 is globally devastating, and a large number of resources are provided by healthcare authorities to educate HCWs and improve their knowledge about COVID-19.
2020-03-13 Li et al The demand for inpatient and ICU beds for COVID-19 in the US: lessons from Chinese cities
medrxiv
IV. Prevalence Study

During the peak of the epidemic from mid to late February, a maximum of 19,425 patients (24.5 per 10,000 adults) were hospitalized, 9,689 patients (12.2 per 10,000 adults) were considered to be in "serious" condition, and 2,087 patients (2.6 per 10,000 adults) needed critical care per day.
During the early phase of the response in Wuhan, the number of patients overwhelmed local fever clinics and hospitals designated to receive COVID-19 patients.
2020-03-13 Remuzzi et al COVID-19 and Italy: what next?
The Lancet
IV. Other Given that the mortality of patients who are critically ill with SARS-CoV-2 pneumonia is high and that the survival time of non-survivors is 1-2 weeks, the number of people infected in Italy will probably impose a major strain on critical care facilities in our hospitals, some of which do not have adequate resources or staff to deal with this emergency.
2020-03-15 Xiang et al Tribute to health workers in China: A group of respectable population during the outbreak of the COVID-19
Int J Biol Sci
IV. Other Given the surge of increasing number of confirmed cases on a daily basis in China, health workers have to take care of the increasing number of patients flocking in hospitals.
2020-03-16 Ye et al Environmental contamination of the SARS-CoV-2 in healthcare premises: An urgent call for protection for healthcare workers
medrxiv
IV. Other 5, 6 The large patient surge overwhelmed hospitals, despite continuous efforts to expand hospital capacity.
2020-03-18 Kandel et al Health security capacities in the context of COVID-19 outbreak: an analysis of International Health Regulations annual report data from 182 countries
The Lancet
IV. Prevalence Study During emergencies, different skillsets, surge capacity, and timely mobilisation of health-care workers are needed to prevent, detect, and control events.
2020-03-18 Legido-Quigley et al The resilience of the Spanish health system against the COVID-19 pandemic
The Lancet Public Health
IV. Other Second, long-term underinvestment in health services, as seen in many countries following the 2008 financial crisis, impairs their resilience by depleting their ability to respond to surges in need for health care with sufficient health professionals, intensive care unit beds, protective equipment, diagnostic test kits, and mechanical ventilators.
2020-03-19 Kinross et al Rapidly increasing cumulative incidence of coronavirus disease (COVID-19) in the European Union/European Economic Area and the United Kingdom, 1 January to 15 March 2020
Euro Surveill
III-3. Time Series Analysis

As at 15 March 2020, COVID-19 cases had been detected in all 30 EU/EEA countries and the United Kingdom (UK) , whereby between 31 December 2019 and that date included, 39,768 cases and 1,727 deaths had been reported, with 17,750 cases and 1,441 deaths from Italy alone .
Based on the experience from Italy, countries, hospitals and intensive care units should increase their preparedness for a surge of patients with COVID-19 who will require healthcare, and in particular intensive care.
2020-03-20 Ramanathan et al 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
IV. Prevalence Study During the 2009 influenza A(H1N1) pandemic, inadequate surge capacity highlighted the need for intensive-care reserves and improved health-care resource planning at all levels.
2020-03-20 Matthay et al Treatment for severe acute respiratory distress syndrome from COVID-19
The Lancet Respiratory Medicine
III-2. Cross Sectional Control They also address some of the anticipated challenges with local and regional surges in COVID-19 ARDS cases; although there has been an increase in hospitals with the capacity to provide ECMO, the potential demand might exceed the available resources.
2020-03-23 Pu et al Screening and managing of suspected or confirmed novel coronavirus (COVID-19) patients: experiences from a tertiary hospital outside Hubei province
medrxiv
III-3. Time Series Analysis

The male patient has been discharged after repeated negative SARS-CoV-2 testing, whilst the two female patients have not yet met discharge criteria and remained hospitalized at the end of the study follow-up period (28 February 2020).
In the situation of an unanticipated surge of patients combined with a relative shortage of medical resources (beds, staff and PPE), the establishment of screening and diagnostic protocol for suspected patients can focus medical resources on patients who need them and may help reduce missed cases.
2020-03-23 Mareiniss et al The impending storm: COVID-19, pandemics and our overwhelmed emergency departments
The American Journal of Emergency Medicine
IV. Other 1 As many of us know, emergency departments (EDs) are being overwhelmed by untenable patient volumes and care requirements.

Currently, one of the federal government's strategies to deal with a J o u r n a l P r e -p r o o f potentially overwhelming catastrophic disaster that outstrips resources is to engage in -crisis standards of care.‖ 8, 9 That is, if overwhelmed, the federal government has advised states to create guidelines for hospitals to allocate scarce resources to save the greatest number of lives.
2020-03-24 Wang et al Tracking and forecasting milepost moments of the epidemic in the early-outbreak: framework and applications to the COVID-19
medrxiv
IV. Computer Model The pressure on medical resources will soon be overwhelmed.
2020-03-24 Lippi et al Chronic obstructive pulmonary disease is associated with severe coronavirus disease 2019 (COVID-19)
Respiratory Medicine
I. Systematic Review

Overall, 87 articles were initially identified based on our electronic and reference search, which after screening by tile, abstract, and full text, 80 were excluded as not related to COVID-19 (n ¼ 27), were review articles (n ¼ 7), did not provide relevant data (n ¼ 28), were editorials (n ¼ 10), did not provide data on severity or comorbidities (n ¼ 5), compared patients by mortality not severity (n ¼ 2) or compared mild cases to critical cases (n ¼ 1).
In outbreak regions, the surge in critically ill patients has placed significant strain on intensive care units (ICUs), with volume demands that overwhelm current capacity .
2020-03-26 Rios et al Guidelines for preventing respiratory illness in older adults aged 60 years and above living in long-term care: A rapid review of clinical practice guidelines
medrxiv
IV. Prevalence Study

If one or more respiratory samples from ILI cases in a suspected outbreak returns a positive laboratory result for influenza, then an influenza outbreak is confirmed.
Facilities should develop (or review existing) plans to mitigate staffing shortages.

When transmission in the community is identified, nursing homes and assisted living facilities may face staffing shortages.
2020-03-26 Viswanath et al Working through the COVID-19 outbreak: Rapid review and recommendations for MSK and allied heath personnel
Journal of Clinical Orthopaedics and Trauma
IV. Other MSK teams deal with a huge proportion of patients in the primary and secondary care.
2020-03-26 Zheng et al Recommendations and guidance for providing pharmaceutical care services during COVID-19 pandemic: A China perspective
Research in Social and Administrative Pharmacy
IV. Other During the pandemic, the public mostly rely on community pharmacies to get adequate supply of supply the demand", as suggested in FIP's "Information and interim guidelines for pharmacists 130 and the pharmacy workforce" for COVID-19 outbreak .
2020-03-27 Wynants et al Systematic review and critical appraisal of prediction models for diagnosis and prognosis of COVID-19 infection
medrxiv
I. Systematic Review

Based on nine of the 15 studies that reported study dates, data were collected between 8 th December 2019 and 3 rd March 2020.
2 3 Outbreaks lead to important increases in the demand for hospital beds and shortage of medical equipment, while medical staff themselves may also get infected.
2020-03-27 Gage et al Reacquainting Cardiology with Mechanical Ventilation in Response to the COVID-19 Pandemic
JACC: Case Reports
IV. Prevalence Study Reports from countries struck by the coronavirus disease 2019 (COVID-19) pandemic have consistently highlighted physician shortages and the utilization of physicians not specifically trained in critical care to care for COVID-19 patients.
2020-03-30 Ross et al Maximizing the Calm Before the Storm: Tiered Surgical Response Plan for Novel Coronavirus (COVID-19)
Journal of the American College of Surgeons
III-2. Cross Sectional Control

Utilizing these methods, in the first week of implementation, out of 21 scheduled ACS clinic patients, we have already identified 19 patients able to be managed by virtual or telephone visits (91% reduction in clinic visit exposure).
Many hospitals, healthcare networks, and specifically Departments of Surgery are asking the same questions of how to cope and plan for surge capacity, personnel attrition, novel infrastructure utilization, and resource exhaustion.
2020-03-31 Kluge et al Refugee and migrant health in the COVID-19 response
The Lancet
IV. Other The ability to access health-care services in humanitarian settings is usually compromised and exacerbated by shortages of medicines and lack of health-care facilities.
2020-03-31 Codispoti et al Running a virtual allergy division and training program in the time of COVID-19 pandemic
Journal of Allergy and Clinical Immunology
IV. Other 121 122 123 Faculty volunteered to screen concerned patients for COVID-19 Nurses volunteers in various COVID-19 testing areas All providers were added to hospital surge lists for COVID-19
2020-03-31 Papachristofilou et al Contingency plans in a radiation oncology department amid the 2019-nCoV outbreak in Switzerland
Advances in Radiation Oncology
IV. Other In times of crisis, one may be faced with additional (and unknown) tasks to carry out, since staff shortages and patient overload will have hospital-wide consequences.
2020-03-31 Stahel et al How to risk-stratify elective surgery during the COVID-19 pandemic?
Patient Saf Surg
IV. Other Acute challenges include the exponential increase in emergency department (ED) visits and inpatient admission volumes, in conjunction with the impending risk of health care workforce shortage due to viral exposure, respiratory illness, and logistical issues due to the widespread closure of school systems .
2020-03-31 Cadogan et al On the frontline against COVID-19: Community pharmacists’ contribution during a public health crisis
Research in Social and Administrative Pharmacy
IV. Prevalence Study Community pharmacists are well placed to handle out of hours emergency supply requests and can help to divert patients from emergency care services.
2020-03-31 Grech et al Unknown unknowns – COVID-19 and potential global mortality
Early Human Development
IV. Prevalence Study Intensive care units have been overwhelmed, with the bottleneck being availability of ventilators to tide critically ill patients over their intensive care stay.
2020-03-31 Keller et al COVID-19 and immigration detention in the USA: time to act
The Lancet Public Health
IV. Other As SARS-CoV-2 spreads, local health-care systems will be overwhelmed.
2020-03-31 Olivia Li et al Preparedness among Ophthalmologists: During and Beyond the COVID-19 Pandemic
Ophthalmology
IV. Other In particular, front-line health care workers -emergency medicine physicians, intensivists, anesthesiologists, nurses, and many others -have continued to care for massive surges of COVID-19 patients in the setting of health systems illprepared for the level of disease severity with dangerous, worldwide shortages of personal protective equipment (PPE) and protocols that might attenuate health worker risk overwhelmed.
2020-04-01 Sultan et al AGA Institute Rapid Recommendations for Gastrointestinal Procedures During the COVID-19 Pandemic
Gastroenterology
I. Systematic Review

58, 59 First, the systematic reviews by Offeddu et al included a meta-analysis of 3 observational studies that showed a benefit in using N95 respirators over standard masks in protecting health care workers from SARS (OR = 0.86; 95% CI: 0.
In the setting of a pandemic, the limited availability of resources (such as critical shortages of PPE) combined with the risk of potential exposure and spread of infection to patients and the availability of appropriate health care workers, often become the main drivers for provision of health care services.
2020-04-01 Castro et al Demand for hospitalization services for COVID-19 patients in Brazil
medrxiv
IV. Other As the number of cases grows in the country, there is a concern that the health system may become overwhelmed, resulting in shortages of hospital beds, intensive care unit beds, and mechanical ventilators.
2020-04-01 Abhari et al COVID-19 Epidemic in Switzerland: Growth Prediction and Containment Strategy Using Artificial Intelligence and Big Data
medrxiv
IV. Other The primary goal of public authorities is to manage the outbreak so as to avoid overwhelming the health care system, in addition to buy time in order to bring online more capacity and resources that can handle the current and potential future peaks in the demand for emergency services.
2020-04-15 Musazzi et al New regulatory strategies to manage medicines shortages in Europe
International Journal of Pharmaceutics
IV. Prevalence Study In the absence of a harmonized triage procedure, there is the risk of increasing the workload for MAHs and Regulatory Authorities to manage shortages with a low impact on public health, even though they are already mitigated and managed effectively at dispensing level.
2020-05-31 Lima et al The emotional impact of Coronavirus 2019-nCoV (new Coronavirus disease)
Psychiatry Research
IV. Other Residents have been comparing the situation to "the end of the world," hospitals are "overwhelmed" and there are concerns about food shortages.

3 Age-adjusted mortality data for Acute Respiratory Distress Syndrome (ARDS) with/without other organ failure – particularly for viral etiologies

3.0.0.1 Highlights

3.0.0.2 Articles

Date Authors Title LOE(?) & Sample Matches
2020 Hui et al The continuing 2019-nCoV epidemic threat of novel coronaviruses to global health — The latest 2019 novel coronavirus outbreak in Wuhan, China - International Journal of Infectious Diseases
International Journal of Infectious Diseases
IV. Other The diagnoses included severe pneumonia, acute respiratory distress syndrome, septic shock and multi-organ failure.
2020 Li et al Extracorporeal membrane oxygenation support in 2019 novel coronavirus disease: indications, timing, and implementation
Chin Med J (Engl)
IV. Other However, in some patients, the phenotype may rapidly progress to acute respiratory distress syndrome (ARDS) and multi-organ failure.
2020 Schwartz et al Potential Maternal and Infant Outcomes from (Wuhan) Coronavirus 2019-nCoV Infecting Pregnant Women: Lessons from SARS, MERS, and Other Human Coronavirus Infections
Viruses
IV. Prevalence Study

A case-control study to determine the effects of SARS on pregnancy compared 10 pregnant and 40 non-pregnant women with the infection at the Princess Margaret Hospital in Hong Kong .
The clinical presentation of MERS varies from asymptomatic to severe pneumonia with acute respiratory distress syndrome (ARDS), septic shock, and multiple organ failure, often resulting in death.
2020 XU et al Clinical analysis of 23 cases of 2019 novel coronavirus infection in Xinyang City, Henan Province
Chinese Critical Care Medicine
IV. Other Complications included acute respiratory distress syndrome [4 (17%)].
2020 Amodio et al Outbreak of Novel Coronavirus (SARS-Cov-2): First Evidences From International Scientific Literature and Pending Questions
Healthcare (Basel)
IV. Prevalence Study Most common complications are: 1) acute respiratory distress syndrome; 2) septic shock; 3) acute kidney injury; 4) myocardial injury; 5) secondary bacterial and fungal infections; 6) multiorgan failure .
2020 Minjin Wang et al A precision medicine approach to managing Wuhan Coronavirus pneumonia
Precision Clinical Medicine
IV. Prevalence Study

As of January 29, 2020, the virus had been diagnosed in more than 7,000 patients in China and 77 outside this country.
Severely ill patients may have acute respiratory distress syndrome (ARDS), acute cardiac injury, secondary infection, septic shock, and acute kidney injury.
2020-02-07 Wang et al ACE2 expression by colonic epithelial cells is associated with viral infection, immunity and energy metabolism
medrxiv
IV. Other Patients infected by 2019-nCoV can develop acute respiratory distress syndrome (ARDS) and sepsis.
2020-02-09 Guan et al Clinical characteristics of 2019 novel coronavirus infection in China
medrxiv
III-2. Retrospective Cohort

The core data sets (including clinical outcomes and symptoms) of 3 patients were lacking due to the incompleteness of original reports, hence this report delineates 1,099 patients with 2019-nCoV ARD from 552 hospitals in 31 provinces/province-level municipalities (Fig.
The definition of exposure to wildlife, acute respiratory distress syndrome (ARDS), pneumonia, acute kidney failure, acute heart failure and rhabdomyolysis are provided in the Supplementary Appendix.
2020-02-09 Liu et al Clinical and biochemical indexes from 2019-nCoV infected patients linked to viral loads and lung injury
Sci China Life Sci
IV. Other Pneumonia was the most common applications, followed by acute respiratory distress syndrome (ARDS) (including two cases with severe ARDS).
2020-02-12 Liu et al Neutrophil-to-Lymphocyte Ratio Predicts Severe Illness Patients with 2019 Novel Coronavirus in the Early Stage
medrxiv
III-3. Time Series Analysis

This study was a prospective single-center study, which included 61 patients with 2019-nCoV infection treated at Beijing Ditan Hospital from January 13, 2020 to January 31, 2020.
Severe ill patients progressed rapidly to acute respiratory failure, acute respiratory distress syndrome, metabolic acidosis, coagulopathy, and septic shock.
2020-02-18 Liu et al Longitudinal characteristics of lymphocyte responses and cytokine profiles in the peripheral blood of SARS-CoV-2 infected patients
medrxiv
III-3. Time Series Analysis

Findings: Of the 40 COVID-19 patients enrolled, 13 severe cases showed significant and sustained decreases in lymphocyte counts but increases in neutrophil counts than 27 mild cases.
In contrast, some patients develop severe pneumonia, acute respiratory distress syndrome (ARDS) or multiple organ failure, with death rates ranging from between 4.3% to 15% according to different study reports .
2020-02-21 Chen et al Epidemiological and clinical characteristics of 99 cases of 2019 novel coronavirus pneumonia in Wuhan, China: a descriptive study
The Lancet
IV. Other In the early stages of this pneumonia, severe acute respiratory infection symptoms occurred, with some patients rapidly dev eloping acute respiratory distress syndrome (ARDS), acute respiratory failure, and other serious complications.
2020-02-24 El Zowalaty et al From SARS to COVID-19: A previously unknown SARS- related coronavirus (SARS-CoV-2) of pandemic potential infecting humans – Call for a One Health approach
One Health
IV. Prevalence Study

However, it was recently reported that the Chinese Centers for Disease Control and Prevention isolated SARS-CoV-2 from 33 samples out of 585 environmental samples collected from Huanan Seafood Market .
The mortality of the emerging coronavirus of 2019 seems mainly to be caused by acute respiratory distress syndrome (ARDS) which may be associated with comorbidities and followed by multiple organ failure leading to death .
2020-02-25 Jin et al Gender differences in patients with COVID-19: Focus on severity and mortality
medrxiv
III-3. Time Series Analysis

In the public data set, the first 37 cases died of COVID-19 in Wuhan city and the 1019 survived patients with COVID-19 from six cities with a high prevalence of the disease were obtained from the Chinese Public Health Science Data Center.
Severe patients progressed rapidly to critical conditions including acute respiratory distress syndrome (ARDS), acute respiratory failure, coagulopathy, septic shock, and metabolic acidosis.
2020-02-26 Yang et al Clinical characteristics and imaging manifestations of the 2019 novel coronavirus disease (COVID-19):A multi-center study in Wenzhou city, Zhejiang, China
Journal of Infection
III-2. Retrospective Cohort

The symptoms of these 12 patients included fever (8 patients), cough (3 patients), expectoration (1 patient), headache (1 patient), sore throat (2 patients), snotty (1 patient), diarrhea (1 patient).
No complications such as acute respiratory distress syndrome, acute respiratory system injury, acute kidney injury or septic shock occurred in our cohort.
2020-02-27 Zhang et al Clinical characteristics of 82 death cases with COVID-19
medrxiv
III-2. Cross Sectional Control

Methods Clinical data on 82 death cases laboratory-confirmed as SARS-CoV-2 infection were obtained from a Wuhan local hospital′s electronic medical records according to previously designed standardized data collection forms.
8, 9 Organ dysfunction including acute respiratory distress syndrome (ARDS), shock, acute cardiac injury, and acute renal injury, can happen in severe cases with COVID-19.
2020-02-28 Chen et al Clinical Study of Mesenchymal Stem Cell Treatment for Acute Respiratory Distress Syndrome Induced by Epidemic Influenza A (H7N9) Infection: A Hint for COVID-19 Treatment
Engineering
IV. Prevalence Study

Based on the principles of voluntariness and informed consent, 44 patients with H7N9-induced ARDS were included as a control group, while 17 patients with H7N9-induced ARDS acted as an experimental group with allogeneic menstrual-blood-derived MSCs.
Acute respiratory distress syndrome (ARDS), lung failure, and fulminant pneumonia are major lung diseases in H7N9 patients.
2020-02-29 Huang et al Clinical characteristics of 36 non-survivors with COVID-19 in Wuhan, China
medrxiv
IV. Other All the patients had acute respiratory distress syndrome (ARDS).
2020-03-03 Chen et al Detectable serum SARS-CoV-2 viral load (RNAaemia) is closely associated with drastically elevated interleukin 6 (IL-6) level in critically ill COVID-19 patients
medrxiv
IV. Other In contrast, some patients may develop severe pneumonia, acute respiratory distress syndrome (ARDS) or multiple organ failure .
2020-03-06 Shi et al Clinical characteristics of 101 non-surviving hospitalized patients with COVID-19: A single center, retrospective study
medrxiv
III-2. Cross Sectional Control

Methods: 101 non-surviving patients with confirmed COVID-19 were included in this retrospective study.
In the early stages of this COVID-19, respiratory infection symptoms occurred, with some patients rapidly developed acute respiratory distress syndrome (ARDS), acute respiratory failure and even death.
2020-03-06 Xu et al Clinical findings in critical ill patients infected with SARS-Cov-2 in Guangdong Province, China: a multi-center, retrospective, observational study
medrxiv
IV. Prevalence Study

Demographic, Epidemiologic, and Baseline Characteristics of the Patients A total of 45 critically ill patients were identified with SARS-CoV-2 infections, the first case included was confirmed on January 14, 2020, and the last one was confirmed on February 20, 2020.
Incidence of SARS-CoV-2 related comorbidities were identified, including acute respiratory distress syndrome (ARDS), sepsis shock, cardiac injury, acute kidney injury (AKI), liver dysfunction and gastrointestinal haemorrhage.
2020-03-09 Shetty et al Mesenchymal Stem Cell Infusion Shows Promise for Combating Coronavirus (COVID-19)- Induced Pneumonia
Aging Dis
IV. Prevalence Study

A new study published by the journal "Aging & Disease" by a team led by Dr. Zhao reports that intravenous administration of clinical-grade human mesenchymal stem cells (MSCs) into seven patients with Coronavirus Disease 2019 (COVID-19) resulted in improved functional outcomes and facilitated recovery .
Such expression pattern explains why infected ICU patients are afflicted with not only acute respiratory distress syndrome but also other complications such as myocardial injury, arrhythmia, acute kidney injury, shock, and death from multiple organ dysfunction syndromes .
2020-03-09 Leng et al Transplantation of ACE2(-) Mesenchymal Stem Cells Improves the Outcome of Patients with COVID-19 Pneumonia
Aging Dis
IV. Other This explains why not only all infected ICU patients are suffering from acute respiratory distress syndrome, but also complications such as acute myocardial injury, arrhythmia, acute kidney injury, shock, and death from multiple organ dysfunction syndrome (Fig.
2020-03-10 Tang et al A retrospective study of the clinical characteristics of COVID-19 infection in 26 children
medrxiv
IV. Other No severe complications such as acute respiratory distress syndrome (ARDS) and acute lung injury (ALI) occurred in the cases.
2020-03-10 Xu et al Clinical Characteristics of Two Human to Human Transmitted Coronaviruses: Corona Virus Disease 2019 versus Middle East Respiratory Syndrome Coronavirus.
medrxiv
I. Systematic Review

Among thirty-two included studies, four studies obtained 6 points of NOS , and remaining twenty-eight studies obtained 7 points of NOS or more [8-25, 27, 29-31, 33-34, 36-39] .
For COVID-19 population, the main complications included shock, arrhythmia, acute respiratory distress syndrome (ARDS), acute cardiac injury, acute kidney injury and acute .
2020-03-10 Zeng et al Mortality of COVID-19 is Associated with Cellular Immune Function Compared to Immune Function in Chinese Han Population
medrxiv
IV. Prevalence Study

14 All patients with SARS-CoV-2 pneumonia enrolled in this study were diagnosed according to World Health Organization interim guidance.
(shock, acute respiratory distress syndrome [ARDS], acute cardiac injury, and acute kidney injury, etc.)
2020-03-12 Chen et al Retrospective Analysis of Clinical Features in 101 Death Cases with COVID-19
medrxiv
IV. Other Conclusions Critical COVID-19 can cause fatal respiratory distress syndrome and multiple organ failure with high mortality rate.
2020-03-13 Wu et al Risk Factors Associated With Acute Respiratory Distress Syndrome and Death in Patients With Coronavirus Disease 2019 Pneumonia in Wuhan, China
JAMA Internal Medicine
III-2. Retrospective Cohort

Design, Setting, and Participants Retrospective cohort study of 201 patients with confirmed COVID-19 pneumonia admitted to Wuhan Jinyintan Hospital in China between December 25, 2019, and January 26, 2020.
Risk Factors Associated With Acute Respiratory Distress Syndrome and Death in Patients With Coronavirus Disease 2019 Pneumonia in Wuhan, China
2020-03-13 Singhal et al A Review of Coronavirus Disease-2019 (COVID-19)
Indian J Pediatr
IV. Prevalence Study

The median age was 8 y 11 mo and in 28 children the infection was linked to a family member and 26 children had history of travel/residence to Hubei province in China.
The disease is mild in most people; in some (usually the elderly and those with comorbidities), it may progress to pneumonia, acute respiratory distress syndrome (ARDS) and multi organ dysfunction.
2020-03-15 Yi et al COVID-19: what has been learned and to be learned about the novel coronavirus disease
Int J Biol Sci
IV. Prevalence Study

On February 11, 2020, a multi-center study on 8,866 patients including 4,021 confirmed COVID-19 patients presented a more updated illustration of the epidemic as follows ( UlBi-HX_rHPXa1qHA2bhdA).
Patients often develop an atypical pneumonia, acute lung injury, and acute respiratory distress syndrome (ARDS) .
2020-03-15 Li et al Progression of Mental Health Services during the COVID-19 Outbreak in China
Int J Biol Sci
IV. Other Infected patients may develop severe and even fatal respiratory diseases (e.g., acute respiratory distress syndrome (ARDS) and acute respiratory failure) ending up in intensive care .
2020-03-16 Mehta et al COVID-19: consider cytokine storm syndromes and immunosuppression
The Lancet
IV. Other Current management of COVID-19 is supportive, and respiratory failure from acute respiratory distress syndrome (ARDS) is the leading cause of mortality.
2020-03-19 Arshad Ali et al The outbreak of Coronavirus Disease 2019 (COVID-19)—An emerging global health threat
Journal of Infection and Public Health
III-3. Time Series Analysis

In 2002, a pandemic of SARS occurred endangering the lives of 8098 individuals with a mortality of 774 patients .
The complications of the illness included acute respiratory distress syndrome (ARDS), RNAaemia, acute cardiac injury, and secondary infection.
2020-03-25 Ren et al EPIDEMIOLOGICAL AND CLINICAL CHARACTERISTICS OF HEART TRANSPLANT RECIPIENTS DURING THE 2019 CORONAVIRUS OUTBREAK IN WUHAN, CHINA: A DESCRIPTIVE SURVEY REPORT
The Journal of Heart and Lung Transplantation
IV. Prevalence Study

There are 63 men and 24 women, average age is 51±12 years, 80 (92.0%) of them lived together with relatives, the number of relatives ranged from 1 to 8.
Some severe cases develop into acute respiratory distress syndrome (ARDS), which can be fatal.
2020-03-26 Cheng et al Can early and high intravenous dose of vitamin C prevent and treat coronavirus disease 2019 (COVID-19)?
Medicine in Drug Discovery
IV. Other Acute respiratory distress syndrome (ARDS) is a key factor of fatality.
2020-03-26 He et al Moving-average based index to timely evaluate the current epidemic situation after COVID-19 outbreak
medrxiv
IV. Other Some patients would experience severe complications, including acute respiratory distress syndrome (ARDS), arrhythmia and shock ).
2020-03-27 Wen et al Immune Cell Profiling of COVID-19 Patients in the Recovery Stage by Single-Cell Sequencing
medrxiv
III-3. Time Series Analysis

We analyzed 128,096 scRNA-seq profiles that passed quality control, including 36,442 myeloid cells, 64,247 NKT cells, and 10,177 B cells from five HCs, five ERS, and five LRS patients.
Some patients develop severe pneumonia, acute respiratory distress syndrome (ARDS), or multiple organ failure .
2020-03-27 Zhang et al Anaesthetic managment and clinical outcomes of parturients with COVID-19: a multicentre, retrospective, propensity score matched cohort study
medrxiv
III-2. Matched Case Control

A total of 1,588 patients undergoing cesarean delivery were retrospectively included in the study.
The clinical manifestations of SARS-Cov-2 infection range from asymptomatic (no symptoms) mild to severe organ dysfunction such as acute respiratory distress syndrome (ARDS) that can lead to death .
2020-03-27 Lou et al Serology characteristics of SARS-CoV-2 infection since the exposure and post symptoms onset
medrxiv
IV. Other Severe cases could rapidly progress to acute respiratory distress syndrome (ARDS) and septic shock.
2020-03-27 Gage et al Reacquainting Cardiology with Mechanical Ventilation in Response to the COVID-19 Pandemic
JACC: Case Reports
IV. Prevalence Study Acute respiratory distress syndrome, or ARDS, is a life-threatening form of lung injury.
2020-03-28 Petrosillo et al COVID-19, SARS and MERS: are they closely related?
Clinical Microbiology and Infection
IV. Other This novel Coronavirus Disease (COVID-19) is associated with a respiratory illness that may cause severe pneumonia and acute respiratory distress syndrome (ARDS).
2020-03-29 Li et al Coronavirus disease 2019 (COVID-19): current status and future perspective
International Journal of Antimicrobial Agents
III-2. Retrospective Cohort

Analysis of the first 99 confirmed cases of SARS-CoV2 infection revealed that cytokine storm syndromes occurred in patients with severe COVID-19 and 17 (17%) had ARDS and, among them, 11 (11%) patients deteriorated within a short period of time and died of multiple organ failure .
Cytokine storm syndromes, also known as hypercytokinemia, are a group of disorders characterized by the uncontrolled production of pro-inflammatory cytokines and are important causes of acute respiratory distress syndrome (ARDS) and multiple organ failure .
2020-03-29 Li et al Anesthesia Management and Perioperative Infection Control in Patients with the Novel Coronavirus
Journal of Cardiothoracic and Vascular Anesthesia
IV. Other Patients who develop acute respiratory distress syndrome, septic shock, refractory metabolic acidosis, coagulation dysfunction, and multiple organ failure, suffer a high mortality rate.
2020-03-30 Wang et al Genetic Profiles in Pharmacogenes Indicate Personalized Drug Therapy for COVID-19
medrxiv
IV. Prevalence Study

As many as 16 clinical trials related to chloroquine, and two clinical trials for mild and common patients and severe patients will be completed on April 30, 2020 (ChiCTR2000029898, ChiCTR2000029899), each clinical trial includes a total of 100 participants.
However, severe cases progress rapidly to acute respiratory distress syndrome (ARDS), shock, multiple organ failure and even death.
2020-03-30 Gómez et al Recomendaciones de consenso respecto al soporte respiratorio no invasivo en el paciente adulto con insuficiencia respiratoria aguda secundaria a infección por SARS-CoV-2*
Archivos de Bronconeumología
IV. Other In severe cases, COVID-19 can be complicated by the acute respiratory distress syndrome (ARDS), sepsis and septic shock, and multiorgan failure.
2020-03-30 Gómez et al Recomendaciones de consenso respecto al soporte respiratorio no invasivo en el paciente adulto con insuficiencia respiratoria aguda secundaria a infección por SARS-CoV-2
Medicina Intensiva
IV. Other In severe cases, COVID-19 can be complicated by the acute respiratory distress syndrome (ARDS), sepsis and septic shock, and multiorgan failure.
2020-03-31 Ding et al Experience on radiological examinations and infection prevention for COVID-19 in radiology department
Radiology of Infectious Diseases
IV. Prevalence Study Severe acute respiratory infection symptoms occurred in most patients, with some patients rapidly developing acute respiratory distress syndrome and acute respiratory failure .
2020-04-01 Henry et al Poor survival with extracorporeal membrane oxygenation in acute respiratory distress syndrome (ARDS) due to coronavirus disease 2019 (COVID-19): Pooled analysis of early reports
Journal of Critical Care
IV. Prevalence Study

Thus, a total of 4 studies were finally included in our pooled analysis, comprising 562 COVID-19 patients, 234 (41.6%)of which developed ARDS.
The novel coronavirus disease 2019 (COVID-19) can induce acute respiratory distress syndrome (ARDS), which can progress to refractory pulmonary failure.
2020-07-31 Lippi et al Thrombocytopenia is associated with severe coronavirus disease 2019 (COVID-19) infections: A meta-analysis
Clinica Chimica Acta
I. Systematic Review

The clinical severity was defined as the composite of ICU admission, use of mechanical ventilation or death in two studies , ICU admission in two studies , progression towards ARDS in one study , death in three studies , and need of mechanical ventilation in the remaining study .
Severe COVID-19 can lead to critical illness, with acute respiratory distress (ARDS) and multi-organ failure (MOF) as its primary complications, eventually followed by intravascular coagulopathy .
2020-12-31 Song et al Prospect and application of Internet of Things technology for prevention of SARIs
Clinical eHealth
IV. Prevalence Study Causes of death are related to sepsis, hypoxic respiratory failure, acute respiratory distress syndrome (ARDS), multiple organ failure, and complications and pregnancy.

4 Extracorporeal membrane oxygenation (ECMO) outcomes data of COVID-19 patients

4.0.0.1 Highlights

4.0.0.2 Articles

Date Authors Title LOE(?) & Sample Matches
2020 Lai et al Asymptomatic carrier state, acute respiratory disease, and pneumonia due to severe acute respiratory syndrome coronavirus 2 (SARSCoV-2): Facts and myths
Journal of Microbiology, Immunology and Infection
IV. Prevalence Study

Regarding children with COVID-19, nine (0.9%) patients aged 0-14 years were found in only one study, 11 while 14 (0.35%) patients were aged ≤ 10 years in another study.
Moreover, patients with pneumonia were more likely to require oxygenation therapy, mechanical ventilator, renal replacement, and extracorporeal membrane oxygenation, and received more antibiotics and antiviral therapy than patients with ARD.
2020 Li et al Extracorporeal membrane oxygenation support in 2019 novel coronavirus disease: indications, timing, and implementation
Chin Med J (Engl)
IV. Other Among the 41 patients, 13 patients received medical care in the intensive care unit (ICU), 4 patients were provided invasive mechanical ventilations, whereas for 2 others, extracorporeal membrane oxygenation (ECMO) treatment was applied.
2020 Battegay et al 2019-novel Coronavirus (2019-nCoV): estimating the case fatality rate - a word of caution
Swiss Med Wkly
IV. Other Hence, the large-scale capacities for medical care in the Hubei province, and specifically large-scale intensive care and extracorporeal membrane oxygenation (ECMO) may lag behind the epidemic.
2020 Liu et al Critical care response to a hospital outbreak of the 2019-nCoV infection in Shenzhen, China
Critical Care
IV. Other Critical management 2019-nCoV management was largely supportive, including intubation, early prone positioning, neuromuscular blockade, and extracorporeal membrane oxygenation (ECMO) according to the recommendations updated by CNHC.
2020 MacIntyre et al Wuhan novel coronavirus 2019nCoV
Global Biosecurity
IV. Other Intensive care, ventilation and ECMO may be used for severe pneumonia and respiratory failure.
2020 Liu et al Analysis of factors associated with disease outcomes in hospitalized patients with 2019 novel coronavirus disease
Chin Med J (Engl)
IV. Prevalence Study

In the present study, 78 patients with COVID-19 associated pneumonia included 39 males and 39 females.
Extracorporeal membrane oxygenation; qd: every day; iv: intravenously.
2020-02-09 Guan et al Clinical characteristics of 2019 novel coronavirus infection in China
medrxiv
III-2. Retrospective Cohort

The core data sets (including clinical outcomes and symptoms) of 3 patients were lacking due to the incompleteness of original reports, hence this report delineates 1,099 patients with 2019-nCoV ARD from 552 hospitals in 31 provinces/province-level municipalities (Fig.
Moreover, extracorporeal membrane oxygenation was adopted in 5 severe cases but none in non-severe cases (P<0.001).
2020-02-10 Arabi et al Critical care management of adults with community-acquired severe respiratory viral infection
Intensive Care Med
II. Randomized Controlled Trial

The importance of timing of oseltamivir treatment has been demonstrated in an observational study of 1950 patients admitted to ICUs with influenza A(H1N1) pdm09, which showed a trend toward improved survival for those treated earliest .
Additionally, a study demonstrated accumulation of oseltamivir in patients on both extracorporeal membrane oxygenation and continuous venovenous hemodiafiltration leading to 4-to 5-fold increase in plasma levels .
2020-02-13 Anastassopoulou et al Data-Based Analysis, Modelling and Forecasting of the COVID-19 outbreak
medrxiv
IV. Computer Model Supportive care with extracorporeal 358 membrane oxygenation (ECMO) in intensive care units (ICUs) is critical for severe 359 respiratory disease.
2020-02-19 Zhang et al A Novel Coronavirus (COVID-19) Outbreak A Call for Action
Chest
IV. Prevalence Study

12 In the last 2 weeks of January 2020, thirteen children were diagnosed, fortunately with a mild clinical presentation.
Due to the severe lung injury caused by SARS-CoV and MERS-CoV, patients who were infected and required invasive mechanical ventilation and extracorporeal membrane oxygenation had a very high mortality.
2020-02-20 Deng et al Characteristics of and Public Health Responses to the Coronavirus Disease 2019 Outbreak in China
J Clin Med
IV. Prevalence Study If necessary, ventilation in the prone position, recruitment maneuver, or extracorporeal membrane oxygenation (ECMO) can be used.
2020-02-21 Huang et al Clinical features of patients infected with 2019 novel coronavirus in Wuhan, China
The Lancet
III-2. Cross Sectional Control

14 Of 59 suspected cases, 41 patients were confirmed to be infected with 2019-nCoV.
Invasive mechanical ventilation was required in four (10%) patients, with two of them (5%) had refractory hypoxaemia and received extracorporeal membrane oxygenation as salvage therapy.
2020-02-21 Chen et al Epidemiological and clinical characteristics of 99 cases of 2019 novel coronavirus pneumonia in Wuhan, China: a descriptive study
The Lancet
IV. Other Moreover, nine (9%) patients received continuous blood purifi cation due to renal failure and three (3%) patients were treated with extracorporeal membrane oxygenation (ECMO; table 2).
2020-02-25 yaqian et al Clinical and pathological characteristics of 2019 novel coronavirus disease (COVID-19): a systematic review
medrxiv
I. Systematic Review

Results: 34 COVID-19-related articles were eligible for this systematic review;Four of the articles were related to pathology.
Another 1.4% and 2.5% of people use of extracorporeal membrane oxygenation and continuous renal-replacement therapy.
2020-02-27 Chen et al Convalescent plasma as a potential therapy for COVID-19
The Lancet Infectious Diseases
IV. Other Apart from supportive care, such as oxygen supply in mild cases and extracorporeal membrane oxygenation for the critically ill patients, specific drugs for this disease are still being researched.
2020-02-28 Chen et al Clinical Study of Mesenchymal Stem Cell Treatment for Acute Respiratory Distress Syndrome Induced by Epidemic Influenza A (H7N9) Infection: A Hint for COVID-19 Treatment
Engineering
IV. Prevalence Study

Based on the principles of voluntariness and informed consent, 44 patients with H7N9-induced ARDS were included as a control group, while 17 patients with H7N9-induced ARDS acted as an experimental group with allogeneic menstrual-blood-derived MSCs.
Moreover, other extensive therapeutic interventions (such as extracorporeal membrane oxygenation (ECMO) and continuous renal replacement therapy (CRRT)) have been applied to patients with severe H7N9 infectious patients [20−22] .
2020-02-28 Fisher et al Q&A: The novel coronavirus outbreak causing COVID-19
BMC Med
IV. Other Extra Corporeal Membrane Oxygenation (ECMO) is potentially of benefit and we will know more particularly when cities with higher technology health systems become affected and ECMO is truly tested in the most severely ill. ECMO is currently being used in China, however, its effectiveness is yet to be determined.
2020-03-03 Yang et al The deadly coronaviruses: The 2003 SARS pandemic and the 2020 novel coronavirus epidemic in China
Journal of Autoimmunity
IV. Prevalence Study

In Wang's study , of the 36 patients in the ICU, four patients received high-flow oxygen therapy, 15 patients received non-invasive ventilation, and 17 patients received invasive ventilation (four patients switched to ECMO).
In Huang's study , four (10%) patients needed invasive mechanical ventilation, and two received extracorporeal membrane oxygenation (ECMO).
2020-03-04 Memish et al Middle East respiratory syndrome
The Lancet
II. Randomized Controlled Trial

A retrospective study of 136 patients with MERS found that macrolide therapy resulted in no reduction in mortality or faster MERS-CoV RNA clearance compared with those who were not treated with macrolides.
Another study is comparing patients who received extracorporeal membrane oxygenation (ECMO) support with those who did not receive ECMO support (NCT02627378).

10, 70 Respiratory failure and acute kidney injury (with haematuria and proteinuria) are common among patients admitted for hospital care because of the severity of their disease and who require mechanical ventilation, extracorporeal membrane oxygenation, and dialyses.
2020-03-06 Xu et al Clinical findings in critical ill patients infected with SARS-Cov-2 in Guangdong Province, China: a multi-center, retrospective, observational study
medrxiv
IV. Prevalence Study

Demographic, Epidemiologic, and Baseline Characteristics of the Patients A total of 45 critically ill patients were identified with SARS-CoV-2 infections, the first case included was confirmed on January 14, 2020, and the last one was confirmed on February 20, 2020.
In addition, extracorporeal membrane oxygenation (ECMO) and continuous renal replacement therapy (CRRT) was applied in 9 (20.0%) and 4 (8.9%) patients, respectively.

A total of 20 (44.4%) patients required intubation and 9 (20%) required extracorporeal membrane oxygenation.

Moreover, aggressive treatments and intensive care were applied for the severe patients, including convalescent plasma, invasive mechanical ventilation, CRRT, ECMO.
2020-03-06 Yu et al Immunodepletion with Hypoxemia: A Potential High Risk Subtype of Coronavirus Disease 2019
medrxiv
III-3. Time Series Analysis

Methods This is a retrospective study from 3 patients with 2019-nCoV infection admitted to Renmin Hospital of Wuhan University, a COVID-2019 designated hospital in Wuhan, from January 31 to February 6, 2020.
For these critical patients, extracorporeal membrane oxygenation (ECMO) therapy also should be supported early to ameliorate the symptom of refractory hypoxia.
2020-03-06 Zhang et al Clinical features and outcomes of 221 patients with COVID-19 in Wuhan, China
medrxiv
III-2. Cross Sectional Control

The study population included a total of 221 admitted patients with confirmed COVID-19 infection in Zhongnan Hospital of Wuhan University, between January 2, 2019 and and 62 (28.1%), respectively.
oseltamivir, arbidol hydrochloride, α-interferon atomization inhalation, and lopinavir/ritonavir), Extracorporeal membrane oxygenation (ECMO) support was used for the patients with refractory hypoxemia that is difficult to be corrected by prone and protective lung ventilation strategy.
2020-03-08 Xu et al Acute Myocardial Injury of Patients with Coronavirus Disease 2019
medrxiv
IV. Prevalence Study

Methods: We analyzed data from 53 consecutive laboratory-confirmed and hospitalized COVID-19 patients (28 men, 25 women; age, 19-81 years).
as antiviral or antibiotic therapy, respiratory support, continuous renal replacement therapy, and extracorporeal membrane oxygenation [ECMO]) were collected from the patients' medical records.

The copyright holder for this preprint (which was not peer-reviewed) is the ECMO, extracorporeal membrane oxygenation; ARDS, Acute respiratory distress syndrome; AKI, acute kidney injury; ICU, intensive care unit; other abbreviations the same as those in the footnote of Table 1 .
2020-03-10 Xu et al Clinical Characteristics of SARS-CoV-2 Pneumonia Compared to Controls in Chinese Han Population
medrxiv
IV. Prevalence Study

Results The study population included 69 hospitalized patients with confirmed SARS-CoV-2 pneumonia without comorbidities and 14,117 normal controls.
No patients were treated with extracorporeal membrane oxygenation (ECMO).
2020-03-13 Singhal et al A Review of Coronavirus Disease-2019 (COVID-19)
Indian J Pediatr
IV. Prevalence Study

The median age was 8 y 11 mo and in 28 children the infection was linked to a family member and 26 children had history of travel/residence to Hubei province in China.
In the case series of 99 hospitalized patients with COVID-19 infection from Wuhan, oxygen was given to 76%, noninvasive ventilation in 13%, mechanical ventilation in 4%, extracorporeal membrane oxygenation (ECMO) in 3%, continuous renal replacement therapy (CRRT) in 9%, antibiotics in 71%, antifungals in 15%, glucocorticoids in 19% and intravenous immunoglobulin therapy in 27% .
2020-03-14 Li et al Diagnosis and clinical management of severe acute respiratory syndrome Coronavirus 2 (SARS-CoV-2) infection: an operational recommendation of Peking Union Medical College Hospital (V2.0): Working Group of 2019 Novel Coronavirus, Peking Union Medical College Hospital
Emerg Microbes Infect
IV. Prevalence Study For those patients with most severe ARDS, extracorporeal membrane oxygenation or prone position is recommended.
2020-03-15 Yi et al COVID-19: what has been learned and to be learned about the novel coronavirus disease
Int J Biol Sci
IV. Prevalence Study

On February 11, 2020, a multi-center study on 8,866 patients including 4,021 confirmed COVID-19 patients presented a more updated illustration of the epidemic as follows ( UlBi-HX_rHPXa1qHA2bhdA).
Patients with severe respiratory symptoms have to be supported by extracorporeal membrane oxygenation (ECMO), a modified cardiopulmonary bypass technique used for the treatment of life-threatening cardiac or respiratory failure.
2020-03-15 Lo et al Evaluation of SARS-CoV-2 RNA shedding in clinical specimens and clinical characteristics of 10 patients with COVID-19 in Macau
Int J Biol Sci
IV. Other Less than half of patients (40%) required low-flow oxygen therapy, and none of the patients needed invasive ventilation or extracorporeal membrane oxygenation.
2020-03-15 Zheng et al SARS-CoV-2: an Emerging Coronavirus that Causes a Global Threat
Int J Biol Sci
IV. Other Currently, supportive care is provided to the patients, including oxygen therapy, antibiotic treatment, and antifungal treatment, extra-corporeal membrane oxygenation (ECMO) etc.
2020-03-16 liu et al Clinical features and outcomes of 2019 novel coronavirus-infected patients with cardiac injury
medrxiv
IV. Other Compared with patients without cardiac injury, patients with cardiac injury were more likely to develop acute respiratory distress syndrome (73.3%), and receive mechanical ventilation (53.4%), continuous renal replacement therapy (33.3%), extracorporeal membrane oxygenation (26.7%) and vasopressor therapy (26.7%) and be admitted to the intensive care unit (73.3%).
2020-03-17 Giani et al Exuberant Plasmocytosis in Bronchoalveolar Lavage Specimen of the First Patient Requiring Extracorporeal Membrane Oxygenation for SARS-CoV-2 in Europe
Journal of Thoracic Oncology
IV. Other Our Extracorporeal Membrane Oxygenation team was called to retrieve the patient.
2020-03-18 Liew et al Safe patient transport for COVID-19
Crit Care
IV. Other Inter-hospital transfer may be required for extracorporeal membrane oxygenation (ECMO) if patients with COVID-19 develop severe acute respiratory distress syndrome within hospitals with only basic ventilation facilities.
2020-03-20 Ramanathan et al 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
IV. Prevalence Study 20, 21 WHO interim guidelines recommend offering extracorporeal membrane oxygenation (ECMO) to eligible patients with acute respiratory distress syndrome (ARDS) related to coronavirus disease 2019 (COVID-19).

Summary WHO interim guidelines recommend offering extracorporeal membrane oxygenation (ECMO) to eligible patients with acute respiratory distress syndrome (ARDS) related to coronavirus disease 2019 (COVID-19).
2020-03-20 Zhang et al Epidemiological, clinical characteristics of cases of SARS-CoV-2 infection with abnormal imaging findings
International Journal of Infectious Diseases
IV. Prevalence Study

It is mentioned in a recent study includes 21 symptomatic patients at the time of initial presentation that CT findings are variable, ranging from normal to multiple lobes involvement and J o u r n a l P r e -p r o o f patients show different radiologic progression (Chung et al., 2020) .
no patients were administrated with continuous blood purification and extracorporeal membrane oxygenation (EMCO).
2020-03-23 Luo et al Characteristics of patients with COVID-19 during epidemic ongoing outbreak in Wuhan, China
medrxiv
IV. Other High-flow nasal cannula oxygen therapy (HFNC) and mechanical ventilation are recommended for patients with ARDS.
2020-03-25 Li et al Clinical observation and management of COVID-19 patients
Emerg Microbes Infect
IV. Other All critically ill patients received invasive mechanical ventilation, and six patients received extracorporeal membrane oxygenation (ECMO).
2020-03-27 Zheng et al Risk-adapted Treatment Strategy For COVID-19 Patients
International Journal of Infectious Diseases
IV. Other Treatment-failure patients should be prepared early for intubation and invasive mechanical ventilation, and even considered with extracorporeal membrane oxygenation (ECMO) .
2020-03-29 He et al Characteristic ECG Manifestations in Patients with COVID-19
Canadian Journal of Cardiology
IV. Prevalence Study Finally, trachea intubation and vein-to-vein extracorporeal membrane oxygenation (VV-ECMO) were employed in order to maintain optimal PaO2.
2020-03-29 Tan et al Response and Operating Room Preparation for the COVID-19 Outbreak: A Perspective from the National Heart Centre Singapore
Journal of Cardiothoracic and Vascular Anesthesia
IV. Other Besides providing services in NHCS, perfusionists also support the Extracorporeal Membrane Oxygenation (ECMO) services in both SGH and the National Centre for Infectious Diseases (NCID).
2020-03-30 He et al Chinese Society of Anesthesiology Expert Consensus on Anesthetic Management of Cardiac Surgical Patients with Suspected or Confirmed Coronavirus Disease 2019
Journal of Cardiothoracic and Vascular Anesthesia
IV. Other In patients with severe cardiac and pulmonary dysfunctions, intra-aortic balloon pump (IABP) or extracorporeal membrane oxygenation (ECMO) might be considered .
2020-03-30 Fan et al Medical treatment of 55 patients with COVID-19 from seven cities in northeast China who fully recovered: a single-center, retrospective, observational study
medrxiv
IV. Other and extracorporeal membrane oxygenation were provided to patients in the present study, their use was not investigated.
2020-04-01 Henry et al Poor survival with extracorporeal membrane oxygenation in acute respiratory distress syndrome (ARDS) due to coronavirus disease 2019 (COVID-19): Pooled analysis of early reports
Journal of Critical Care
IV. Prevalence Study

Thus, a total of 4 studies were finally included in our pooled analysis, comprising 562 COVID-19 patients, 234 (41.6%)of which developed ARDS.
In such cases, extracorporeal membrane oxygenation (ECMO) may be considered as a rescue therapy.

The mortality rate was 94.1% in the ECMO patients and 70.9% in conventional therapy patients.
2020-04-30 Wang et al A contingency plan for the management of the 2019 novel coronavirus outbreak in neonatal intensive care units
The Lancet Child & Adolescent Health
IV. Prevalence Study

About 100 children were affected, with the youngest being 30 h after birth.
In critically ill neonates, continuous renal replacement and extracorporeal membrane oxygenation could be implemented if necessary.
2020-12-31 Bai et al Chinese experts’ consensus on the Internet of Things-aided diagnosis and treatment of coronavirus disease 2019 (COVID-19)
Clinical eHealth
IV. Prevalence Study In patients with poor prone ventilation, extracorporeal membrane oxygenation should be considered as soon as possible.

5 Outcomes data for COVID-19 after mechanical ventilation adjusted for age.

5.0.0.1 Highlights

5.0.0.2 Articles

Date Authors Title LOE(?) & Sample Matches
2020-02-06 Villamil-Gómez et al Fatal human coronavirus 229E (HCoV-229E) and RSV–Related pneumonia in an AIDS patient from Colombia
Travel Medicine and Infectious Disease
IV. Other The patient's condition deteriorated rapidly, requiring endotracheal intubation and mechanical ventilation.
2020-02-09 Guan et al Clinical characteristics of 2019 novel coronavirus infection in China
medrxiv
III-2. Retrospective Cohort

The core data sets (including clinical outcomes and symptoms) of 3 patients were lacking due to the incompleteness of original reports, hence this report delineates 1,099 patients with 2019-nCoV ARD from 552 hospitals in 31 provinces/province-level municipalities (Fig.
The primary composite endpoint was the admission to intensive care unit (ICU), or mechanical ventilation, or death.
2020-02-20 Ling et al COVID-19: A critical care perspective informed by lessons learnt from other viral epidemics
Anaesthesia Critical Care & Pain Medicine
IV. Other Infection control Outbreak SARS-CoV-2 strategies during mechanical ventilation and prevention of hospital acquired infections is likely to contribute to improved outcomes in critically ill patients.
2020-02-20 Deng et al Characteristics of and Public Health Responses to the Coronavirus Disease 2019 Outbreak in China
J Clin Med
IV. Prevalence Study The "lung-protective ventilation strategy" with low tidal volume should be adopted in invasive mechanical ventilation to reduce ventilator-associated lung injury.
2020-02-21 Chen et al Epidemiological and clinical characteristics of 99 cases of 2019 novel coronavirus pneumonia in Wuhan, China: a descriptive study
The Lancet
IV. Other 13 patients used noninvasive ventilator mechanical ventilation for 4-22 days (median 9 days [IQR 7-19]).
2020-02-24 Yang et al Clinical course and outcomes of critically ill patients with SARS-CoV-2 pneumonia in Wuhan, China: a single-centered, retrospective, observational study
The Lancet Respiratory Medicine
III-2. Retrospective Cohort

Findings Of 710 patients with SARS-CoV-2 pneumonia, 52 critically ill adult patients were included.
37 (71%) patients required mechanical ventilation.
2020-02-27 Gong et al Correlation Analysis Between Disease Severity and Inflammation-related Parameters in Patients with COVID-19 Pneumonia
medrxiv
IV. Other Respiratory failure occurs and mechanical ventilation required; 2.
2020-02-28 Chen et al Clinical Study of Mesenchymal Stem Cell Treatment for Acute Respiratory Distress Syndrome Induced by Epidemic Influenza A (H7N9) Infection: A Hint for COVID-19 Treatment
Engineering
IV. Prevalence Study

Based on the principles of voluntariness and informed consent, 44 patients with H7N9-induced ARDS were included as a control group, while 17 patients with H7N9-induced ARDS acted as an experimental group with allogeneic menstrual-blood-derived MSCs.
Factors which are possible to correlate to clinical features and therapeutic outcomes in H7N9 patients with ARDS were analyzed: 1) baseline characteristics including age, underlying conditions, and symptoms; 2) data from the laboratory examination and imaging scan; 3) Combined treatments by basic therapy, antiviral therapy, antibiotic therapy, vasoactive drugs, glucocorticoid therapy, mechanical ventilation, ECMO, ALSS, and CRRT.
2020-02-29 Huang et al Clinical characteristics of 36 non-survivors with COVID-19 in Wuhan, China
medrxiv
IV. Other All these patients had ARDS and 28 (77.78%) patients needed mechanical ventilation.
2020-03-01 Zhou et al Effectiveness of glucocorticoid therapy in patients with severe novel coronavirus pneumonia: protocol of a randomized controlled trial
Chinese Medical Journal
IV. Other Secondary endpoints include the timing of clinical improvement after intervention, duration of mechanical ventilation, duration of hospitalization, overall incidence of adverse events, as well as rate of adverse events at each visit, and mortality at 2 and 4 weeks.
2020-03-02 Xie et al Critical care crisis and some recommendations during the COVID-19 epidemic in China
Intensive Care Medicine
IV. Other Many severe hypoxemic patients only receive high-flow nasal oxygen (HFNO) or noninvasive mechanical ventilation rather than invasive mechanical ventilation because of intubation delay or lack of mechanical ventilators (especially at early phase).
2020-03-03 Rello et al Coronavirus Disease 2019 (COVID-19): A critical care perspective beyond China
Anaesthesia Critical Care & Pain Medicine
III-3. Time Series Analysis

Among 37 ventilated patients in the Wuhan cohort , only 4 (10.8%) were alive and free of mechanical ventilation 28-days after ICU admission.
Among 37 ventilated patients in the Wuhan cohort , only 4 (10.8%) were alive and free of mechanical ventilation 28-days after ICU admission.
2020-03-03 Qi et al Epidemiological and clinical features of 2019-nCoV acute respiratory disease cases in Chongqing municipality, China: a retrospective, descriptive, multiple-center study
medrxiv
IV. Prevalence Study

Methods:In this retrospective, descriptive, multiple-center study, total of 267 patients with COVID-19 confirmed by real-time RT-PCR in Chongqing from Jan 19 to Feb 16, 2020 were recruited.
Invasive mechanical ventilation in prone position, non-invasive mechanical ventilation, high-flow nasal cannula oxygen therapy was adopted only in severe patients with respiratory failure (5[10.0%], 35[70.0%], 12[24.0%]).
2020-03-05 Wilder-Smith et al Can we contain the COVID-19 outbreak with the same measures as for SARS?
The Lancet Infectious Diseases
IV. Prevalence Study

On Feb 18, 2020, the Chinese Center for Disease Control and Prevention published their data of the first 72 314 patients including 44 672 patients with confirmed COVID19.
5 Risk factors for severe disease outcomes are old age and comorbidities.
2020-03-06 Xu et al Clinical findings in critical ill patients infected with SARS-Cov-2 in Guangdong Province, China: a multi-center, retrospective, observational study
medrxiv
IV. Prevalence Study

Demographic, Epidemiologic, and Baseline Characteristics of the Patients A total of 45 critically ill patients were identified with SARS-CoV-2 infections, the first case included was confirmed on January 14, 2020, and the last one was confirmed on February 20, 2020.
There were 13 (28.9%) patients treated with high-flow nasal cannula, 6 (13.3%) with non-invasive mechanical ventilation, 20 (44.4%) with invasive mechanical ventilation.
2020-03-10 Xu et al Clinical Characteristics of SARS-CoV-2 Pneumonia Compared to Controls in Chinese Han Population
medrxiv
IV. Prevalence Study

Results The study population included 69 hospitalized patients with confirmed SARS-CoV-2 pneumonia without comorbidities and 14,117 normal controls.
Three patients used non-invasive ventilator mechanical ventilation.
2020-03-11 Zhou et al Clinical course and risk factors for mortality of adult inpatients with COVID-19 in Wuhan, China: a retrospective cohort study
The Lancet
III-2. Retrospective Cohort

Before Jan 11, 2020, SARS-CoV-2 RNA detection results were not available in the electronic medical records, from which data for this study were obtained retrospectively; therefore, this study includes 29 of the 41 patients originally reported on.
The median time from dyspnoea to intubation was 10·0 days (IQR 5·0-12·5) for patients who received invasive mechanical ventilation and the time from invasive mechanical ventilation to occurrence of ventilatorassociated pneumonia was 8·0 days (2·0-9·0; figure 1 ).
2020-03-12 Chen et al Retrospective Analysis of Clinical Features in 101 Death Cases with COVID-19
medrxiv
IV. Other The median time from ARDS to invasive mechanical ventilation was 3.00 days(IQR0.00-6.00), of which 21 patients were intubated 2 days before deaths.

84(83.17%) patients were treated with non-invasive ventilator or high-flow oxygen therapy, and 77(76.24%), invasive mechanical ventilation.

7 patients were treated with ECMO and 8 patients were treated with CRRT.The median time from ARDS to invasive mechanical ventilation was 3.00 days(IQR 0.00-6.00).

The duration of invasive mechanical ventilation was 5 days (IQR2.00-8.00).
2020-03-13 Singhal et al A Review of Coronavirus Disease-2019 (COVID-19)
Indian J Pediatr
IV. Prevalence Study

The median age was 8 y 11 mo and in 28 children the infection was linked to a family member and 26 children had history of travel/residence to Hubei province in China.
The duration of non-invasive ventilation was 4-22 d [median 9 d] and mechanical ventilation for 3-20 d [median 17 d].
2020-03-15 Ye et al Zoonotic origins of human coronaviruses
Int J Biol Sci
IV. Prevalence Study Approximately 20-30% of patients subsequently require intensive care and mechanical ventilation.
2020-03-16 Jain et al Systematic review and meta-analysis of predictive symptoms and comorbidities for severe COVID-19 infection
medrxiv
I. Systematic Review

Results Of the 2259 studies identified, 42 were selected after title and abstract analysis, and 7 studies (including 1813 COVID−19 patients) were chosen for inclusion.
15.20035360 (including ICU, mechanical ventilation or death, where data was grouped together) vs. non-ICU admission.
2020-03-18 Diagnosis and treatment plan of Corona Virus Disease 2019 (tentative sixth edition)
Global Health Journal
IV. Other Respiratory failure occurs and mechanical ventilation is required; 5.4.2.
2020-03-18 Dhama et al COVID-19, an emerging coronavirus infection: advances and prospects in designing and developing vaccines, immunotherapeutics, and therapeutics
Hum Vaccin Immunother
IV. Other 14, 73 The main treatments such as mechanical ventilation, ICU admission, and symptomatic and supportive care are recommended for severe cases.
2020-03-19 Arshad Ali et al The outbreak of Coronavirus Disease 2019 (COVID-19)—An emerging global health threat
Journal of Infection and Public Health
III-3. Time Series Analysis

In 2002, a pandemic of SARS occurred endangering the lives of 8098 individuals with a mortality of 774 patients .
Mechanical ventilation was given to 50%-89% of patients, associated with a mortality rate of 36% .

Mechanical ventilation support was given to 20%-30% of the infected patients and the fatality rate was 10%.
2020-03-19 Tolksdorf et al Influenza-associated pneumonia as reference to assess seriousness of coronavirus disease (COVID-19)
Euro Surveill
IV. Prevalence Study

described clinical courses and outcomes of 52 critically ill patients in a hospital in Wuhan .
The high ventilation rates and the long duration of ventilation (data from one case series) can be attributed to a high rate of acute respiratory distress syndrome (ARDS) among COVID-19 patients.
2020-03-20 Yang et al Effect of continuous renal replacement therapy on all-cause mortality in COVID-19 patients undergoing invasive mechanical ventilation: a retrospective cohort study
medrxiv
III-2. Retrospective Cohort

In a study of 52 critically ill patients in Wuhan, 32 (61.5%) patients died at 28 days and the mortality rate was 81.1% (30/37) in patients requiring mechanical ventilation.
Consistently, the association between CRRT treatment and a reduced risk of mortality remained significant after adjusting for selected confounding factors, such as age, sex, the baseline laboratory findings, or the average values of all tests between the start of invasive mechanical ventilation and the endpoint.

Findings: Of 36 hospitalized COVID-19 patients with invasive mechanical ventilation, the mean age was 69.4 (SD 1.8) years and 30 (83.3%) were men.

The Cox regression model was conducted to adjust for potential confounders, including age, sex, the baseline values, and the average values of all tests between the start of invasive mechanical ventilation and the endpoint.

Interpretation: CRRT may be beneficial for the treatment of COVID 19 patients with invasive mechanical ventilation.

35, 36 In our study, CRRT was associated with prolonged survival in COVID-19 patients with invasive mechanical ventilation.

Common comorbidity factors in COVID-19 patients with invasive mechanical ventilation were hypertension (n=14, 38.9%) and cardiac disease (n=12, 33.3%).
2020-03-20 Zhang et al Epidemiological, clinical characteristics of cases of SARS-CoV-2 infection with abnormal imaging findings
International Journal of Infectious Diseases
IV. Prevalence Study

It is mentioned in a recent study includes 21 symptomatic patients at the time of initial presentation that CT findings are variable, ranging from normal to multiple lobes involvement and J o u r n a l P r e -p r o o f patients show different radiologic progression (Chung et al., 2020) .
9 of 573 patients received mechanical ventilation.
2020-03-20 Chen et al Favipiravir versus Arbidol for COVID-19: A Randomized Clinical Trial
medrxiv
IV. Prevalence Study

For 42 patients with hypertension and/or diabetes in the favipiravir group, 28 had a fever and 25 had a cough; of 35 patients with hypertension and/or diabetes in the All rights reserved.
Duration of fever, cough relief time and auxiliary oxygen therapy or noninvasive mechanical ventilation rate were the secondary outcomes.
2020-03-25 Blazquez-Prieto et al Cellular senescence limits acute lung injury induced by mechanical ventilation
biorxiv
IV. Other There were no differences in age between the three groups of patients (62±6, 61±11 and 54±10 years for patients without ARDS or mechanical ventilation, with ARDS but without .

Meta-scores were finally compared among controls and animals with lung injury and/or mechanical ventilation.
2020-03-26 Zhang et al Analysis of clinical characteristics and laboratory findings of 95 cases of 2019 novel coronavirus pneumonia in Wuhan, China: a retrospective analysis
Respir Res
IV. Other The composite endpoint was the admission to intensive care unit (ICU), or mechanical ventilation, or death.
2020-03-26 Zhang et al Clinical characteristics of COVID-19-infected cancer patients: A retrospective case study in three hospitals within Wuhan, China
Annals of Oncology
III-2. Retrospective Cohort

Results 28 COVID-19-infected cancer patients were included; 17 (60.7%) patients were male.
Univariate and multivariate analyses were performed to assess the risk factors associated with severe events defined as a condition requiring admission to an intensive care unit, the use of mechanical ventilation, or death.
2020-03-26 Zhang et al A Multicentre Study of 2019 Novel Coronavirus Disease Outcomes of Cancer Patients in Wuhan, China
medrxiv
III-2. Retrospective Cohort

Among those 23 patients, 9 cases were receiving chemotherapy-based comprehensive therapies, 7 cases were during perioperative period, 3 cases were receiving supportive treatment, 2 cases were receiving radiotherapy combined with targeted therapy or with endocrinotherapy, and the rest 2 patients were receiving endocrinotherapy or immunotherapy.
About 40% of the patients received mechanical ventilation.
2020-03-27 Rivera et al The Impact of COVID-19 on Radiation Oncology Clinics and Cancer Patients in the U.S.
Advances in Radiation Oncology
IV. Other Data from a report of the clinical characteristics of patients with COVID-19 showed that 6.1% of patients required intensive care, mechanical ventilation or died.
2020-03-27 Nie et al Clinical features and the maternal and neonatal outcomes of pregnant women with coronavirus disease 2019
medrxiv
IV. Prevalence Study

Three women were in the second trimester (17 weeks, 20 weeks, and 26 weeks), and the other 30 women were in the third trimester at the time of presentation.
The primary composite endpoints were admission to an ICU, the use of mechanical ventilation, or death.

The primary composite endpoints were admission to an intensive care unit (ICU), the use of mechanical ventilation, or death.
2020-03-27 Zheng et al Risk-adapted Treatment Strategy For COVID-19 Patients
International Journal of Infectious Diseases
IV. Other Treatment-failure patients should be prepared early for intubation and invasive mechanical ventilation, and even considered with extracorporeal membrane oxygenation (ECMO) .
2020-03-29 Zhang et al The cytokine release syndrome (CRS) of severe COVID-19 and Interleukin-6 receptor (IL-6R) antagonist Tocilizumab may be the key to reduce the mortality
International Journal of Antimicrobial Agents
II. Randomized Controlled Trial

With regard to the safety of tocilizumab in the treatment of patients with severe COVID-19, a preprinted study was included in a study of 21 patients.
Critical criteria meet one of the following: respiratory failure requiring mechanical ventilation; shock; and admission to ICU with other organ failure.
2020-03-30 Ding et al A Multi-hospital Study in Wuhan, China:Protective Effects of Non-menopause and Female Hormones on SARS-CoV-2 infection
medrxiv
III-3. Time Series Analysis

To determine the correlation between menstruation and disease progression, 435 patients who offered their complete menstruation history were included.
Sex differences in severity and composite endpoints (admission to intensive care unit (ICU), use of mechanical ventilation, or death) of COVID-19 patients were compared.
2020-04-01 Ma et al Potential effect of blood purification therapy in reducing cytokine storm as a late complication of severe COVID-19
Clinical Immunology
IV. Other During the ongoing outbreak of COVID-19, 5-6% of the patients need ICU admission or even mechanical ventilation due to severe respiratory failure, with the mortality increasing from 1.4% to over 60% .
2020-07-31 Lippi et al Thrombocytopenia is associated with severe coronavirus disease 2019 (COVID-19) infections: A meta-analysis
Clinica Chimica Acta
I. Systematic Review

The clinical severity was defined as the composite of ICU admission, use of mechanical ventilation or death in two studies , ICU admission in two studies , progression towards ARDS in one study , death in three studies , and need of mechanical ventilation in the remaining study .
The clinical severity was defined as the composite of ICU admission, use of mechanical ventilation or death in two studies , ICU admission in two studies , progression towards ARDS in one study , death in three studies , and need of mechanical ventilation in the remaining study .

6 Knowledge of the frequency, manifestations, and course of extrapulmonary manifestations of COVID-19, including, but not limited to, possible cardiomyopathy and cardiac arrest.

6.0.0.1 Highlights

6.0.0.2 Articles

Date Authors Title LOE(?) & Sample Matches
2020 Zhang et al Clinical features of 2019 novel coronavirus pneumonia in the early stage from a fever clinic in Beijing
Zhonghua Jie He He Hu Xi Za Zhi
IV. Other The clinical manifestations are fever and cough.
2020 Khot et al The 2019 Novel Coronavirus Outbreak - A Global Threat
The Journal of the Association of Physicians of India
IV. Other There is a spectrum of clinical features from mild to severe life threatening disease with major complications like severe pneumonia, ARDS, acute cardiac injury and septic shock.
2020 MA et al High resolution CT features of novel coronavirus pneumonia in children
Chinese Journal of Radiology
IV. Other The HRCT manifestations were as follows.
2020-01-28 Chan et al Genomic characterization of the 2019 novel human-pathogenic coronavirus isolated from a patient with atypical pneumonia after visiting Wuhan
Emerg Microbes Infect
IV. Other In contrast, SARS-CoV (lineage B βCoV) and MERS-CoV (lineage C βCoV) may cause severe lower respiratory tract infection with acute respiratory distress syndrome and extrapulmonary manifestations, such as diarrhea, lymphopenia, deranged liver and renal function tests, and multiorgan dysfunction syndrome, among both immunocompetent and immunocompromised hosts with mortality rates of ∼10% and ∼35%, respectively .
2020-02-19 Kooraki et al Coronavirus (COVID-19) Outbreak: What the Department of Radiology Should Know
Journal of the American College of Radiology
IV. Other Radiologists should be aware of the imaging manifestations of the novel COVID-19 infection.
2020-02-25 Xu et al Clinical and computed tomographic imaging features of novel coronavirus pneumonia caused by SARS-CoV-2
Journal of Infection
IV. Other The imaging manifestations of this group are sometimes inconsistent with the clinical manifestations.
2020-02-28 Chen et al Clinical Study of Mesenchymal Stem Cell Treatment for Acute Respiratory Distress Syndrome Induced by Epidemic Influenza A (H7N9) Infection: A Hint for COVID-19 Treatment
Engineering
IV. Prevalence Study

Based on the principles of voluntariness and informed consent, 44 patients with H7N9-induced ARDS were included as a control group, while 17 patients with H7N9-induced ARDS acted as an experimental group with allogeneic menstrual-blood-derived MSCs.
In the 1-year follow-up, fibrosis and pulmonary/ pulmonary parenchymal dysfunction are very common clinical phenomena in H1N1-associated severe ARDS infection.

ARDS, lung failure, and fulminant pneumonia are major lung diseases in H7N9 patients, and H7N9 virus causes extrapulmonary diseases including rhabdomyolysis and encephalopathy through cytokine storms in vivo .
2020-02-28 Shah et al Guide to Understanding the 2019 Novel Coronavirus
Mayo Clinic Proceedings
IV. Other Other manifestations might include renal failure, anorexia, nausea, vomiting, diarrhea, abdominal pain, and disseminated intravascular coagulation.
2020-02-29 Liu et al Therapeutic effects of dipyridamole on COVID-19 patients with coagulation dysfunction
medrxiv
IV. Other The human coronavirus HCoV-19 infection can cause acute respiratory distress syndrome (ARDS), hypercoagulability, hypertension, extrapulmonary multiorgan dysfunction.
2020-03-03 Liu et al Association of Cardiovascular Manifestations with In-hospital Outcomes in Patients with COVID-19: A Hospital Staff Data
medrxiv
III-2. Cross Sectional Control

Liu et al analyzed 137 cases with COVID-19 and found that patients who complains palpitation as initial symptom accounted for 7.3% .
Cardiovascular manifestations (CVMs) could be the initial presentation or appear throughout the whole course of COVID-19.
2020-03-06 Zhang et al Clinical features and outcomes of 221 patients with COVID-19 in Wuhan, China
medrxiv
III-2. Cross Sectional Control

The study population included a total of 221 admitted patients with confirmed COVID-19 infection in Zhongnan Hospital of Wuhan University, between January 2, 2019 and and 62 (28.1%), respectively.
Common complications among the total 221 subjects included ARDS, arrhythmia, acute cardiac injury, acute kidney injury (AKI) and shock.
2020-03-07 Lupia et al 2019-novel coronavirus outbreak: A new challenge
Journal of Global Antimicrobial Resistance
III-3. Time Series Analysis

in up to 12% occurred an increase in troponin I count, and five patients have complained an acute cardiac injury: this finding requires further study to assess the heart tropism of 2019-nCoV and cardiovascular risk of infected patients during acute illness.
Conclusions The new 2019-nCoV epidemics is mainly associated with respiratory disease and few extrapulmonary signs.
2020-03-08 Xu et al Acute Myocardial Injury of Patients with Coronavirus Disease 2019
medrxiv
IV. Prevalence Study

Methods: We analyzed data from 53 consecutive laboratory-confirmed and hospitalized COVID-19 patients (28 men, 25 women; age, 19-81 years).
Second, our data showed the clinical characteristics of AMI induced by COVID-19, including the clinical presentations, electrophysiological abnormality, myocardial enzyme and myocardial injury marker levels, and cardiac dysfunction and enlargement.

Conclusions: Cardiac complications are common in COVID-19 patients.

Data on epidemiological and demographic characteristics, clinical signs and symptoms, underlying comorbidities, complications, and treatment management (such All rights reserved.
2020-03-09 Shetty et al Mesenchymal Stem Cell Infusion Shows Promise for Combating Coronavirus (COVID-19)- Induced Pneumonia
Aging Dis
IV. Prevalence Study

A new study published by the journal "Aging & Disease" by a team led by Dr. Zhao reports that intravenous administration of clinical-grade human mesenchymal stem cells (MSCs) into seven patients with Coronavirus Disease 2019 (COVID-19) resulted in improved functional outcomes and facilitated recovery .
Such expression pattern explains why infected ICU patients are afflicted with not only acute respiratory distress syndrome but also other complications such as myocardial injury, arrhythmia, acute kidney injury, shock, and death from multiple organ dysfunction syndromes .
2020-03-10 Tang et al A retrospective study of the clinical characteristics of COVID-19 infection in 26 children
medrxiv
IV. Other In our study, the clinical types were mild and common, and the probability of severe complications such as myocarditis and ARDS was low, which provided important information for understanding the clinical characteristics of children with COVID-19.
2020-03-11 Zhou et al Clinical course and risk factors for mortality of adult inpatients with COVID-19 in Wuhan, China: a retrospective cohort study
The Lancet
III-2. Retrospective Cohort

Before Jan 11, 2020, SARS-CoV-2 RNA detection results were not available in the electronic medical records, from which data for this study were obtained retrospectively; therefore, this study includes 29 of the 41 patients originally reported on.
Cardiac arrest occurs in about 3% of inpatients with pneumonia.
2020-03-12 Wu et al The SARS-CoV-2 outbreak: what we know
International Journal of Infectious Diseases
IV. Other A wide range of clinical manifestations are seen in patients with SARS-CoV-2 from mild, moderate, to severe and rapidly progressive and fulminant disease.
2020-03-13 Lei et al Protocol of a randomized controlled trial testing inhaled Nitric Oxide in mechanically ventilated patients with severe acute respiratory syndrome in COVID-19 (SARS-CoV-2).
medrxiv
II. Randomized Controlled Trial Findings in cardiac and hepatic tissues may suggest the contribution of a viral infection as well .
2020-03-13 Baig et al Evidence of the COVID-19 Virus Targeting the CNS: Tissue Distribution, Host–Virus Interaction, and Proposed Neurotropic Mechanisms
ACS Chem Neurosci
IV. Other Recently, a study posted in medRxiv 4 has reported neurological manifestations in COVID-19 in the current outbreak that involved 214 patients, of which 78 (36.4%) patients had neurologic manifestations, which affirms our rationale of the neurotropic potential in the COVID-19 virus.
2020-03-14 Salehi et al Coronavirus Disease 2019 (COVID-19): A Systematic Review of Imaging Findings in 919 Patients
American Journal of Roentgenology
I. Systematic Review Pleural effusion, pericardial effusion, lymphadenopathy, cavitation, CT halo sign, and pneumothorax are uncommon but may be seen with disease progression.
2020-03-16 Seah et al Can the Coronavirus Disease 2019 (COVID-19) Affect the Eyes? A Review of Coronaviruses and Ocular Implications in Humans and Animals
Ocul Immunol Inflamm
IV. Prevalence Study

In 2004, tear samples collected from 36 suspected SARS-CoV patients were sent for RT-PCR for the SARS-CoV.
38 The ocular manifestation of FIP is likely due to underlying vasculitis, resulting in inflammation of varying ocular segments.
2020-03-18 Diagnosis and treatment plan of Corona Virus Disease 2019 (tentative sixth edition)
Global Health Journal
IV. Other The clinical symptoms are mild and no pneumonia manifestation can be found in imaging.
2020-03-19 Wang et al A review of the 2019 Novel Coronavirus (COVID-19) based on current evidence
International Journal of Antimicrobial Agents
II. Randomized Controlled Trial

In a study of 214 COVID-19 patients, 78 (36.4%) patients had neurological manifestations .
In a study of 214 COVID-19 patients, 78 (36.4%) patients had neurological manifestations .
2020-03-19 Driggin et al 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
IV. Prevalence Study

A meta-analysis of six studies inclusive of 1,527 patients with COVID-19 examined the prevalence of CVD and reported the prevalence of hypertension, cardiac and cerebrovascular disease, and diabetes to be 17.1%, 16.4%, and 9.7%, respectively .
Whether heart failure is most commonly due to exacerbation of pre-existing left ventricular dysfunction versus new cardiomyopathy (either due to myocarditis or stress cardiomyopathy) remains unclear .

Second, infection has been associated with multiple direct and indirect cardiovascular complications including acute myocardial injury, myocarditis, arrhythmias and venous thromboembolism.
2020-03-19 Zhao et al The characteristics and clinical value of chest CT images of novel coronavirus pneumonia
Clinical Radiology
IV. Other The CT manifestations of the recovery period are related to the extent of the lesions.

The main CT manifestations of NCP in this group were pulmonary interstitial changes, whereas the CT manifestations of SARS were mostly interstitial changes with parenchymal lesions, 19 which may be related to the more aggressive virulence of the SARS virus.
2020-03-19 Lei et al Comprehensive analysis for diagnosis of novel coronavirus disease (COVID-19) infection
Journal of Infection
IV. Prevalence Study

Of 14 patients, white-cell count was tended to be normal in 12 patients (85.71%), lymphocyte (8/14, 57.14%) and monocyte (9/14, 64.29%) percentage had a tendency to decrease.
5, 7 Of these clinical characteristics, fever and cough were the most frequency percentage of initial symptoms, and the other manifestations should be taken consideration.
2020-03-23 Fu et al Association between Clinical, Laboratory and CT Characteristics and RT-PCR Results in the Follow-up of COVID-19 patients
medrxiv
IV. Other The data we recorded included demographic and epidemic information, symptoms and signs, treatment strategies, complications, underlying comorbidities, and subtypes of 2019 novel coronavirus pneumonia (NCP).
2020-03-23 Zhang et al COVID-19: Melatonin as a potential adjuvant treatment
Life Sciences
II. Randomized Controlled Trial

A recent meta-analysis of a total of 22 randomized controlled trials suggested that a supplementary use of melatonin is associated with a significant reduction of TNF-α and IL-6 level .
Based on clinical reports of COVID-19, patients with severe ALI/ARDS may also have an increased risk of sepsis and cardiac arrest .
2020-03-25 Bansal et al Cardiovascular disease and COVID-19
Diabetes & Metabolic Syndrome: Clinical Research & Reviews
IV. Prevalence Study

A study describing clinical profile and outcomes in 138 Chinese patients with COVID-19 reported 16.7% incidence of arrhythmia .
Given the enormous burden posed by this illness and the significant adverse prognostic impact of cardiac involvement, further research is required to understand the incidence, mechanisms, clinical presentation and outcomes of various CV manifestations in COVID-19 patients.

Although respiratory illness is the dominant clinical manifestation of COVID-19, the shear burden of the illness implies that a large number of patients with COVID-19 present with preexisting CVD or develop new-onset cardiac dysfunction during the course of the illness.

Background and aims Many patients with coronavirus disease 2019 (COVID-19) have underlying cardiovascular (CV) disease or develop acute cardiac injury during the course of the illness.

The impact of pre-existing CVD and new onset cardiac complications on clinical outcomes in these patients is also discussed.
2020-03-26 Pambuccian et al The COVID-19 pandemic: Implications for the cytology laboratory
Journal of the American Society of Cytopathology
IV. Other Involvement of endothelial cells may be implicated in the pathogenesis of the severe complications of the disease, including diffuse alveolar damage (DAD) and disseminated intravascular coagulation.
2020-03-27 Sharifi-Razavi et al COVID 19 and Intra cerebral hemorrhage: Causative or Coincidental
New Microbes and New Infections
IV. Other Abstract: Pneumonia appears to be the most manifestation of COVID 19, but some extrapulmonary involvement such as gastrointestinal, cardiac and renal has been reported.

Text: Pneumonia appears to be the most manifestation of new COVID 19, but some extrapulmonary involvement such as gastrointestinal, cardiac and renal has been reported .
2020-03-27 Zhang et al Anaesthetic managment and clinical outcomes of parturients with COVID-19: a multicentre, retrospective, propensity score matched cohort study
medrxiv
III-2. Matched Case Control

A total of 1,588 patients undergoing cesarean delivery were retrospectively included in the study.
The clinical manifestations of SARS-Cov-2 infection range from asymptomatic (no symptoms) mild to severe organ dysfunction such as acute respiratory distress syndrome (ARDS) that can lead to death .
2020-03-27 Quintão et al The Anesthesiologist and COVID-19
Brazilian Journal of Anesthesiology (English Edition)
IV. Other 12 There is a spectrum of clinical manifestations related to COVID-19, from asymptomatic infection to severe respiratory failure.
2020-03-30 He et al Chinese Society of Anesthesiology Expert Consensus on Anesthetic Management of Cardiac Surgical Patients with Suspected or Confirmed Coronavirus Disease 2019
Journal of Cardiothoracic and Vascular Anesthesia
IV. Other Right heart dysfunction might develop from increased pulmonary vascular resistance due to pulmonary edema, left heart dysfunction and stress cardiomyopathy in COVID-2019.
2020-03-30 Wang et al Coronavirus Disease 2019 in elderly patients: characteristics and prognostic factors based on 4-week follow-up
Journal of Infection
IV. Prevalence Study

Of the included 339 patients, lymphocytopenia were found in 211 cases (63.2%).
Common complications during hospitalization were bacterial infection, liver enzyme abnormalities, ARDS and acute cardiac injury.

Complications including acute cardiac injury, arrhythmia, acute kidney injury (AKI), ARDS, cardiac insufficiency and bacterial infection were all predictors of death.
2020-03-30 Gao et al Evaluation the auxiliary diagnosis value of antibodies assays for detection of novel coronavirus (SARS-Cov-2) causing an outbreak of pneumonia (COVID-19)
medrxiv
IV. Other Patients' clinical manifestations mainly included fever, cough, dyspnea, myalgia, fatigue, and radiographic evidence of pneumonia.
2020-03-31 Wu et al SARS-CoV-2, COVID-19 and inherited arrhythmia syndromes
Heart Rhythm
IV. Prevalence Study

In the afore-mentioned study 93 of 138 hospitalized COVID-19 patients, arrhythmia (not further specified) was reported in 17% 6 of total patients and in 16 of 36 patients admitted to the ICU.
While myocardial damage evidenced by high cardiac markers such as hs-TnI has 91 been recognized 9 and fulminant myocarditis has been reported, 8 whether cardiovascular 92 complications include malignant arrhythmias is not yet known.
2020-03-31 Tuech et al Strategy for the practice of digestive and oncological surgery during the Covid-19 epidemic
Journal of Visceral Surgery
IV. Prevalence Study

This prospective trial included 1421 patients, and mortality at 3 months was 6.3%.
Overall and severe complication rates were respectively 75% and 30% with, in order of frequency, specific complications (pancreatic fistula, haemorrhage) and infectious complications .
2020-04-01 Sultan et al AGA Institute Rapid Recommendations for Gastrointestinal Procedures During the COVID-19 Pandemic
Gastroenterology
I. Systematic Review

58, 59 First, the systematic reviews by Offeddu et al included a meta-analysis of 3 observational studies that showed a benefit in using N95 respirators over standard masks in protecting health care workers from SARS (OR = 0.86; 95% CI: 0.
Extrapulmonary symptoms may occur early in the disease course.
2020-05-31 Yang et al New thinking in the treatment of 2019 novel coronavirus pneumonia
Complementary Therapies in Clinical Practice
IV. Prevalence Study Critically ill patients can be used reasonable combination with clinical manifestations and CT manifestations.

7 Application of regulatory standards (e.g., EUA, CLIA) and ability to adapt care to crisis standards of care level.

7.0.0.1 Highlights

7.0.0.2 Articles

Date Authors Title LOE(?) & Sample Matches
2020 Cohen et al In bid to rapidly expand coronavirus testing, U.S. agency abruptly changes rules | Science | AAAS
Science Magazine
IV. Other The new recommendations focus on “high-complexity testing laboratories” that are certified under federal rules known as Clinical Laboratory Improvement Amendments.
2020 Cascella et al Features, Evaluation and Treatment Coronavirus (COVID-19)
StatPearls
IV. Other In a meeting on January 30, 2020, per the International Health Regulations (IHR, 2005), the outbreak was declared by the WHO a Public Health Emergency of International Concern (PHEIC) as it had spread to 18 countries with four countries reporting human-to-human transmission.
2020-01-31 Koenig et al 2019-nCoV: The Identify-Isolate-Inform (3I) Tool Applied to a Novel Emerging Coronavirus
West J Emerg Med
IV. Prevalence Study

One preliminary, small-scale study of 41 patients in Wuhan China, reported 6 deaths (15% mortality) with a median age of 49.0 years.
Patients who do not meet medical criteria for admission can be isolated at home during the evaluation phase.
2020-02-06 Jin et al A rapid advice guideline for the diagnosis and treatment of 2019 novel coronavirus (2019-nCoV) infected pneumonia (standard version)
Mil Med Res
II. Randomized Controlled Trial This guideline was prepared in accordance with the methodology and general rules of WHO Guideline Development and the WHO Rapid Advice Guidelines .
2020-02-13 Gostin et al US Emergency Legal Responses to Novel Coronavirus: Balancing Public Health and Civil Liberties
JAMA
IV. Other The emergency declaration of the HHS authorizes additional resources, enhanced federal powers, interjurisdictional coordination, and waivers of specific regulations.
2020-02-23 Feng et al Early Prediction of Disease Progression in 2019 Novel Coronavirus Pneumonia Patients Outside Wuhan with CT and Clinical Characteristics
medrxiv
III-2. Retrospective Cohort

Results: A total of 141 patients with moderate NCP were included, of which 15 (10.6%) patients developed severe NCP during hospitalization and assigned to the progressive group.
Our study was conducted in compliance with the Health Insurance Portability and Accountability Act (HIPAA).
2020-02-24 El Zowalaty et al From SARS to COVID-19: A previously unknown SARS- related coronavirus (SARS-CoV-2) of pandemic potential infecting humans – Call for a One Health approach
One Health
IV. Prevalence Study

However, it was recently reported that the Chinese Centers for Disease Control and Prevention isolated SARS-CoV-2 from 33 samples out of 585 environmental samples collected from Huanan Seafood Market .
On January 30, 2020, the International Health Regulations Emergency Committee of the World Health Organization declared COVID-19 outbreak a public health emergency of international concern (PHEIC) .
2020-02-27 Fan et al Clinical Features of COVID-19 Related Liver Damage
medrxiv
IV. Other The clinical criteria of diagnosis and discharge refer to the standards for "Diagnosis and Treatment Scheme of New Coronavirus Infected Pneumonia" (trial version 6).
2020-02-27 Peng et al Outbreak of a new coronavirus: what anaesthetists should know
British Journal of Anaesthesia
IV. Prevalence Study

The median age of infected individuals is between 49 and 56 yr. 1 13 Children are rarely diagnosed with 2019-nCoV, a phenomenon that has not yet been explained.
8 The update International Health Regulations was signed 2 yr after the SARS outbreak by 194 member states, with legal binding on the protection of all people of the world from international spread of disease.
2020-02-29 Lee et al Wuhan novel coronavirus (COVID-19): why global control is challenging?
Public Health
IV. Other On 30 January 2020, the Emergency Committee of the WHO, under the 2005 International Health Regulations, declared COVID-19 acute respiratory disease a public health emergency of international concern.
2020-02-29 Rodríguez-Morales et al Going global – Travel and the 2019 novel coronavirus
Travel Medicine and Infectious Disease
IV. Other In fact, the PHEIC designation was created following an update to the International Health Regulations after that outbreak.
2020-02-29 Biscayart et al The next big threat to global health? 2019 novel coronavirus (2019-nCoV): What advice can we give to travellers? – Interim recommendations January 2020, from the Latin-American society for Travel Medicine (SLAMVI)
Travel Medicine and Infectious Disease
IV. Other The WHO Emergency Committee met on January 23rd and although the situation at that time is not considered to be a Public Health Emergency of International Concern (PHEIC), WHO monitors the situation closely and can, under the global legal framework, the revised International Health Regulations (IHR), recommend travel and trade restrictions when these are deemed necessary.
2020-03-11 Chopra et al How Should U.S. Hospitals Prepare for Coronavirus Disease 2019 (COVID-19)?
Ann Intern Med
IV. Other Hospitals should anticipate that normal staffing ratios and some standards of care are unlikely to be maintained; plans for contingency and crisis standards that lay out a legal and ethical framework for care decisions, including who will make decisions, how, and under what circumstances, must be readied.
2020-03-11 Hollander et al Virtually Perfect? Telemedicine for Covid-19
New England Journal of Medicine
IV. Other Telemedicine for Covid-19 Telemedicine’s payment and regulatory structures, licensing, credentialing, and implementation take time to work through, but health systems that have a...
2020-03-15 Li et al Progression of Mental Health Services during the COVID-19 Outbreak in China
Int J Biol Sci
IV. Other This expert consensus addressed that mental health institutions should strictly implement the 'Technical Guidelines for the Prevention and Control of Novel Coronavirus Infection in Medical Institutions (1st edition)' , the 'Diagnosis and Treatment Protocol for Novel Coronavirus Pneumonia (revised pilot version 5)' , and related infectious disease protection requirements.
2020-03-17 Adhikari et al Epidemiology, causes, clinical manifestation and diagnosis, prevention and control of coronavirus disease (COVID-19) during the early outbreak period: a scoping review
Infect Dis Poverty
III-2. Cross Sectional Control

In China, 11 791 cases were confirmed and 17 988 cases were suspected in 34 provinces as of 24:00, 31 January 2020 (Fig.
According to this guideline, individuals with respiratory symptoms are advised to use medical masks both in health care and home care settings properly following the infection prevention guidelines.
2020-03-18 Kandel et al Health security capacities in the context of COVID-19 outbreak: an analysis of International Health Regulations annual report data from 182 countries
The Lancet
IV. Prevalence Study 19 IHR=International Health Regulations.

Few studies have highlighted the strength and gaps of national capacities in relation to operational readiness against health emergencies and the state of national International Health Regulations (IHR, 2005) implementation.

The operational readiness index can be used to support WHO, governments, and other international agencies to prioritise their support and implementation of operational readiness capacities for the COVID-19 outbreak.
2020-03-18 Jin et al Core Outcome Set for Clinical Trials on Coronavirus Disease 2019 (COS-COVID)
Engineering
IV. Prevalence Study

The consensus meeting was held on 24 February 2020, and involved 20 participants.
Thus far, a series of guidelines and handbooks have been published, including the COMET Handbook (version 1.0) , the COS-STAndards for Development (COS-STAD) , the COS-STAndards for Reporting (COS-STAR) , and the COS-STAndardised Protocol Items (COS-STAP) .
2020-03-19 Filippi et al COVID-19 OUTBREAK IN NORTHERN ITALY: FIRST PRACTICAL INDICATIONS FOR RADIOTHERAPY DEPARTMENTS
International Journal of Radiation OncologyBiologyPhysics
IV. Other The indications were integrated with the WHO recommendations and with the local health authorities' guidelines.
2020-03-19 Arshad Ali et al The outbreak of Coronavirus Disease 2019 (COVID-19)—An emerging global health threat
Journal of Infection and Public Health
III-3. Time Series Analysis

In 2002, a pandemic of SARS occurred endangering the lives of 8098 individuals with a mortality of 774 patients .
Under the International Health Regulations 2005, an emergency committee on 2019-nCoV has put Public Health Emergency of International Concern (PHEIC) into effect .
2020-03-20 Gilbert et al Preparedness and vulnerability of African countries against importations of COVID-19: a modelling study
The Lancet
IV. Prevalence Study Each country's functional capacity to manage health security issues is based on WHO International Health Regulations (IHR) Monitoring and Evaluation Framework (MEF), 10 and on an indicator of vulnerability to emerging epidemics.
2020-03-21 Poole et al Responding to the COVID-19 pandemic in complex humanitarian crises
Int J Equity Health
IV. Other Without the adaptation of existing standards, mitigation plans will fall short of health and human rights obligations in outbreak response.
2020-03-23 Ikizler et al COVID-19 and Dialysis Units: What Do We Know Now and What Should We Do?
American Journal of Kidney Diseases
IV. Other Regulatory agencies should allow temporary changes in telehealth regulations and patient-care regulations such as allowing patients to swiftly move between health systems.
2020-03-23 Tao et al High incidence of asymptomatic SARS-CoV-2 infection, Chongqing, China
medrxiv
IV. Other COVID-19 is diagnosed according to the WHO Interim Guidelines 6 .
2020-03-24 Chen et al First Clinical Study Using HCV Protease Inhibitor Danoprevir to Treat Naive and Experienced COVID-19 Patients
medrxiv
IV. Other The treatment duration of both lopinavir/ritonavir and interferon nebulization exceeded the recommendation by China National Standards .

All patients were moderate COVID-19 patients per China National Standards .
2020-03-24 Simcock et al COVID-19: Global Radiation Oncology’s Targeted Response for Pandemic Preparedness
Clinical and Translational Radiation Oncology
IV. Prevalence Study

During the weekend over 121 individuals from 17 countries and 6 continents contributed to the online discussion.
Governments and International health organisations have regularly updated their guidance on self-isolation, social distancing and quarantine rules and these will continue to evolve during the pandemic.
2020-03-26 Rios et al Guidelines for preventing respiratory illness in older adults aged 60 years and above living in long-term care: A rapid review of clinical practice guidelines
medrxiv
IV. Prevalence Study

If one or more respiratory samples from ILI cases in a suspected outbreak returns a positive laboratory result for influenza, then an influenza outbreak is confirmed.
Storage and handling of all waste must meet the Environment Protection Authority (EPA) Victoria legislative requirements.
2020-03-26 Rios et al Preventing respiratory illness in older adults aged 60 years and above living in long-term care: A rapid overview of reviews
medrxiv
I. Systematic Review

During full text review, articles were included if they contained the number of influenza cases occurring on a specific date or within a 3-day period, such as through an epidemic curve or a line list of symptom onset dates 37 studies N = NR Long term care facilitiesdefined as any residential environment that housed older adults or elderly individuals with the assistance of medical staff and included facilities referred to as 'assisted living' or 'nursing homes' but excluded community centers and daytime-only facilities serving older adults living in the outside community.
1101 /2020 guidelines, we will abstract the recommendations and level of evidence for reach recommendation.
2020-03-27 Dinh et al Radiation Therapy in King County, Washington During The COVID-19 Pandemic: Balancing Patient Care, Transmission Mitigation and Resident Training
Advances in Radiation Oncology
IV. Other At an institutional level, providers are being quickly 54 certified for telemedicine, with proposals to temporarily relaxed billing standards.
2020-03-27 Lee et al Telehealth: Helping Your Patients and Practice Survive and Thrive During the COVID-19 Crisis with Rapid Quality Implementation
Journal of the American Academy of Dermatology
IV. Other To preserve both patient and society's trust, medical communities must hold our standards for professionalism and quality care high.
2020-03-27 Garrett et al COVID-19: the medium is the message
The Lancet
IV. Other When WHO named the disease COVID-19, the choice was based on scientific standards.
2020-03-27 White et al Historical linkages: epidemic threat, economic risk, and xenophobia
The Lancet
IV. Prevalence Study The International Sanitary Conventions were reformed and ultimately renamed under WHO to the International Health Regulations in 1969, which were revised to their current form in 2005.

In 1948, the UN and World Health Assembly transferred responsibility for the International Sanitary Conventions to WHO in its charter.
2020-03-27 Zhou et al A New Predictor of Disease Severity in Patients with COVID-19 in Wuhan, China
medrxiv
III-2. Cross Sectional Control

Between January 1 and February 28, 2020, a total of 393 patients with COVID-19 were enrolled, but only 377 eligible participants were finally included in our analysis.
The AUC was 0.879 (95% CI: 0.838-0.921), with a specificity of 73.7% and a sensitivity of 88.6% in the training sets ( Figure 6 ), and the cutoff value was 7.9622.
2020-03-27 Han et al Lactate dehydrogenase, a Risk Factor of Severe COVID-19 Patients
medrxiv
III-2. Cross Sectional Control

A total of 47 diagnosed cases were enrolled in this study, with 24 severe cases and 23 non-severe cases ( Table 1)
To assess the diagnostic value of these selected parameters, LDH (0.9727) had maximum sensitivity (100.00%) and specificity (86.67%), with the cutoff value of 283.
2020-03-27 Lescure et al Clinical and virological data of the first cases of COVID-19 in Europe: a case series
The Lancet Infectious Diseases
III-3. Time Series Analysis

11 The five patients in this case series, at different stages of infection, include two patients with a mild disease at admission and a secondary worsening that resulted in their admission to an intensive care unit (ICU), one initially severely ill patient directly admitted to an ICU for an acute respiratory failure, and two patients with a mild disease diagnosed very early after infection.
Clinical samples for SARS-CoV-2 diagnostic testing were obtained according to WHO guidelines.
2020-03-29 Tan et al Response and Operating Room Preparation for the COVID-19 Outbreak: A Perspective from the National Heart Centre Singapore
Journal of Cardiothoracic and Vascular Anesthesia
IV. Other Since the SARS outbreak, hospitals in Singapore have beefed up their infection control standards as well as management capabilities.
2020-03-30 Yang et al In-flight Transmission Cluster of COVID-19: A Retrospective Case Series
medrxiv
IV. Other Patients were diagnosed based on National Health Commission of the People's Republic of China guidelines and the WHO interim guidance .
2020-03-30 Huynh et al The more I fear about COVID-19, the more I wear medical masks: A survey on risk perception and medical masks uses
medrxiv
IV. Other The legal behaviors in using medical masks in public have been finally promulgated by the Vietnamese Government after 47 days since the WHO declared the Public Health Emergency of International Concern (PHEIC) due to the COVID-19 pandemic.
2020-03-31 Calton et al Telemedicine in the Time of Coronavirus
Journal of Pain and Symptom Management
IV. Other The United States Department of Health and Human Services recently liberalized HIPAA compliance guidelines for the COVID-19 pandemic.
2020-04-01 Sultan et al AGA Institute Rapid Recommendations for Gastrointestinal Procedures During the COVID-19 Pandemic
Gastroenterology
I. Systematic Review

58, 59 First, the systematic reviews by Offeddu et al included a meta-analysis of 3 observational studies that showed a benefit in using N95 respirators over standard masks in protecting health care workers from SARS (OR = 0.86; 95% CI: 0.
These guidelines are not intended to impose a standard of care for individual institutions, healthcare systems or countries.
2020-04-01 Vogels et al Analytical sensitivity and efficiency comparisons of SARS-COV-2 qRT-PCR assays
medrxiv
IV. Prevalence Study Generation of RNA transcript standards for qRT-PCR validation A barrier to implementing and validating qRT-PCR molecular assays for SARS-CoV-2 detection was the availability of virus RNA standards.
2020-04-15 Musazzi et al New regulatory strategies to manage medicines shortages in Europe
International Journal of Pharmaceutics
IV. Prevalence Study Since fees and times for dossier variations vary significantly among the European Regulatory Authorities (EGA, 2015) , the extent of the regulatory incentives cannot be defined a priori at EU-level, but they should be calculated as percentages of current fee and regulatory time to be more adaptable to the different National settings (Fig.

According to the new regulatory provisions, the MAH should notify any shortages, including impending/anticipated supply interruptions, to the Regulatory Authorities of the affected European countries (EMA for medicinal products authorised by a centralised procedure).

For such products, manufacturer's resilience should be improved by more onerous provisions, such as the obligation for MAHs to qualify at least two suppliers of drug substance, the stockpiles' expansion and the implementation of the manufacturing technologies and risk assessment tools.

In this context, for justified public health reasons, the National Regulatory Authorities can adopt regulatory pathways to speed up the release of the marketing authorization (e.g., Art.
2020-07-31 Artika et al Pathogenic viruses: Molecular detection and characterization
Infection, Genetics and Evolution
IV. Prevalence Study A diagnostic virology laboratory must be set up to meet biosafety level 2 (BSL2) standards or above.

8 Approaches for encouraging and facilitating the production of elastomeric respirators, which can save thousands of N95 masks.

8.0.0.1 Highlights

8.0.0.2 Articles

Date Authors Title LOE(?) & Sample Matches
2020-01-28 Ming et al Breaking down of the healthcare system: Mathematical modelling for controlling the novel coronavirus (2019-nCoV) outbreak in Wuhan, China
biorxiv
IV. Computer Model A recent cluster randomised controlled trial , consisting of multiple region-varying medical settings, showed both N95 respirators and medical masks can effectively prevent influenza and other viral respiratory infections.
2020-02-12 Wu et al Facemask shortage and the coronavirus disease (COVID-19) outbreak: Reflection on public health measures
medrxiv
IV. Computer Model The situation of facemasks shortage might be more severe when considering the demand for different types of facemasks from healthcare workers (most required KN95/N95 respirators and medical protective masks) and the general population 29 .
2020-02-19 Wang et al Association between 2019-nCoV transmission and N95 respirator use
medrxiv
IV. Other In our study, we found N95 respirators, disinfection and hand washing can help to reduce the risk of 2019-nCoV infection in medical staffs.

N95 may be more effective for 2019-nCoV infections.
2020-02-24 Rasmussen et al Coronavirus Disease 2019 (COVID-19) and Pregnancy: What obstetricians need to know
American Journal of Obstetrics and Gynecology
IV. Other Eye protection and properly-fitted N95 respirators should be used.
2020-03-05 Xiao et al Taking the right measures to control COVID-19
The Lancet Infectious Diseases
IV. Prevalence Study Highfiltration masks such as N95 masks and protective clothing (goggles and gowns) should be used in hospitals where health-care workers are in direct contact with infected patients.
2020-03-07 Naicker et al The novel coronavirus 2019 epidemic and kidneys
Kidney International
IV. Prevalence Study

A study of 59 patients with COVID-19 found that 34% of patients developed massive albuminuria on the first day of admission, and 63% developed proteinuria during their stay in hospital 14 .
A N-95 fit-tested respirator and protective clothes and equipment are essential.
2020-03-13 Singhal et al A Review of Coronavirus Disease-2019 (COVID-19)
Indian J Pediatr
IV. Prevalence Study

The median age was 8 y 11 mo and in 28 children the infection was linked to a family member and 26 children had history of travel/residence to Hubei province in China.
Healthcare workers should be provided with fit tested N95 respirators and protective suits and goggles.
2020-03-14 Repici et al Coronavirus (COVID-19) outbreak: what the department of endoscopy should know
Gastrointestinal Endoscopy
IV. Prevalence Study In case of shortages, alternatives to respirators should be considered, including other classes of FFP respirators, elastomeric half-mask, and full face-piece air-purifying respirators.

More specifically the N95, filtering facepiece (FFP) 2, or FFP3 respirator is a protective device designed to achieve a very close facial fit and extremely efficient filtration of airborne particles (up to .3 mm) that can be inhaled through the nose or mouth.

After the gown, donning a filtering face-piece (N95, FFP2, or FFP3) respirator is recommended; it is crucial to perform a fitting test after the equipment has been put on the face.
2020-03-15 Yi et al COVID-19: what has been learned and to be learned about the novel coronavirus disease
Int J Biol Sci
IV. Prevalence Study

On February 11, 2020, a multi-center study on 8,866 patients including 4,021 confirmed COVID-19 patients presented a more updated illustration of the epidemic as follows ( UlBi-HX_rHPXa1qHA2bhdA).
The first line of defense that could be used to lower the risk of infection is through wearing face masks; both the use of surgical masks and N95 respirator masks (series # 1860s) helps control the spread of viruses .
2020-03-16 Kwon et al Drive-Through Screening Center for COVID-19: a Safe and Efficient Screening System against Massive Community Outbreak
J Korean Med Sci
IV. Other 5 Continuous work over 4 hours wearing a N95 respirator should be avoided.
2020-03-19 Zeri et al Contact lens practice in the time of COVID-19
Contact Lens and Anterior Eye
IV. Other Personal protective equipment such as eye protection (goggles or safety spectacles), water-resistant gloves with long tight-fitting cuffs, and surgical-style face masks (such as an N95 mask) should be adopted to reduce the likelihood of infection via either airborne or direct transmission .
2020-03-20 Feng et al Rational use of face masks in the COVID-19 pandemic
The Lancet Respiratory Medicine
IV. Other In parallel, urgent research on the duration of protection of face masks, the measures to prolong life of disposable masks, and the invention on reusable masks should be encouraged.

Notably, improper use of face masks, such as not changing disposable masks, could jeopardise the protective effect and even increase the risk of infection.
2020-03-23 Pu et al Screening and managing of suspected or confirmed novel coronavirus (COVID-19) patients: experiences from a tertiary hospital outside Hubei province
medrxiv
III-3. Time Series Analysis

The male patient has been discharged after repeated negative SARS-CoV-2 testing, whilst the two female patients have not yet met discharge criteria and remained hospitalized at the end of the study follow-up period (28 February 2020).
In order to solve the shortage of medical equipment, such as surgical masks, face shields, N95 masks, protective clothing and goggles, etc., the hospital distributed them to each department according to their needs.
2020-03-26 Rios et al Guidelines for preventing respiratory illness in older adults aged 60 years and above living in long-term care: A rapid review of clinical practice guidelines
medrxiv
IV. Prevalence Study

If one or more respiratory samples from ILI cases in a suspected outbreak returns a positive laboratory result for influenza, then an influenza outbreak is confirmed.
However, P2 respirators (known as N95 respirators or facemasks (USA equivalent rating)) protect the user against aerosols as well as droplets.
2020-03-26 Viswanath et al Working through the COVID-19 outbreak: Rapid review and recommendations for MSK and allied heath personnel
Journal of Clinical Orthopaedics and Trauma
IV. Other N95 masks are recommended for medium risk clinical encounters.
2020-03-27 Dinh et al Radiation Therapy in King County, Washington During The COVID-19 Pandemic: Balancing Patient Care, Transmission Mitigation and Resident Training
Advances in Radiation Oncology
IV. Other For treatments with anesthesia, the risk of aerosol transmission 74 is high, and airborne precautions are required (N-95 mask, face shield, gloves, gown, personal respirator 75 in some instances).
2020-03-27 Card et al UV Sterilization of Personal Protective Equipment with Idle Laboratory Biosafety Cabinets During the Covid-19 Pandemic
medrxiv
IV. Other Another concern of reusing N95 respirators is the UV-mediated degradation of polymers within the respirator.

As previously suggested, one method of preserving our current supply of N95 filtering face-piece respirators (FFRs) is through cycles of decontamination and reuse with ultraviolet germicidal irradiation (UVGI).

Personal protective equipment (PPE), including surgical masks and N95 respirators, is crucially important to the safety of both patients and medical personnel, particularly in the event of infectious pandemics.

Though the situation that necessitates the reuse of PPE is far from ideal, using presently-unused BSCs to sanitize N95 respirators has the potential to reduce the current PPE burden by 75%.
2020-03-27 Huang et al Special attention to nurses’ protection during the COVID-19 epidemic
Crit Care
IV. Other The PPE sets include (listed in the order they are to be put on) a disposable work hat, an N95 respirator, inner gloves, a protective eye mask, protective clothing, disposable waterproof shoe covers, disposable isolation gowns, outer gloves, and a face shield.
2020-03-29 Tan et al Response and Operating Room Preparation for the COVID-19 Outbreak: A Perspective from the National Heart Centre Singapore
Journal of Cardiothoracic and Vascular Anesthesia
IV. Other 29 At that time, hospitals were overwhelmed and resources such as N95 masks and gloves were scarce.
2020-03-30 Cramer et al Disposable N95 Masks Pass Qualitative Fit-Test But Have Decreased Filtration Efficiency after Cobalt-60 Gamma Irradiation
medrxiv
III-3. Time Series Analysis To alleviate this, many methods of N95 mask sterilization have been studied and proposed with the hope of being able to safely reuse masks.

One component of PPE that is in particular demand are disposable N95 face masks.
2020-03-31 Olivia Li et al Preparedness among Ophthalmologists: During and Beyond the COVID-19 Pandemic
Ophthalmology
IV. Other The face masks can be divided into N95 respirators and surgical masks, and both have different uses.

In a randomized clinical trial, the use of N95 respirators and surgical masks were found to have comparable outcomes in protection from influenza virus in outpatient settings 14 ; however, N95 respirators are the preferred option when dealing with PUIs or COVID-19 patients.
2020-03-31 Elwood et al SOGC Committee Opinion – COVID-19 in Pregnancy
Journal of Obstetrics and Gynaecology Canada
IV. Other  The use of N95 respirators is only required for aerosol-generating procedures (e.g., intubation).

 Use of N95 respirators should be reserved for aerosol-generating procedures (e.g., intubation).
2020-03-31 Wang et al COVID-19 in Hemodialysis Patients: A Report of 5 Cases
American Journal of Kidney Diseases
IV. Other Patients were required to wear surgical masks or N95 masks throughout the hemodialysis treatment.

The staff members who conducted the dialysis treatments wore face shields, N95 face masks, eye shields, disposable gowns, caps, and gloves.
2020-03-31 FINEGAN et al International Committee of the Red Cross (ICRC): General Guidance for the Management of the Dead Related to COVID-19
Forensic Science International: Synergy
IV. Other FFP3 masks or N95 respirators are currently considered best for preventing inhalation of aerosols and in case of splashes during the body handling process to protect the face, eyes, nose, and mouth (Table 1 ).
2020-03-31 Kampf et al Inactivation of coronaviruses by heat
Journal of Hospital Infection
IV. Other FFP masks or N95 masks) resulting in an evaluation of various procedures to reprocess them for a limited re-use.
2020-03-31 Lyu et al Expert consensus on the procedure of interventional diagnosis and treatment of cancer patients during the COVID-19 epidemic
Journal of Interventional Medicine
IV. Prevalence Study The janitors must wear isolation suits, disposable hats, N95 masks, and disposable gloves to disinfect and clean the surfaces of items and the floors of the operating room.
2020-03-31 Belingheri et al Beyond the assistance: additional exposure situations to COVID-19 for healthcare workers
Journal of Hospital Infection
IV. Other In some cases, such as in aerosol-generating procedures, WHO has recommended the use of FFP2 respirator masks .
2020-03-31 Bell et al 2020 year of the nurse and midwife: Meeting new challenges
International Emergency Nursing
IV. Other Already, concerns about acute shortages of supplies such as masks and gloves in hospitals and health care settings are growing, as media images of huge crowds wearing face masks may spur hoarding of these much needed medical supplies.
2020-04-01 Sultan et al AGA Institute Rapid Recommendations for Gastrointestinal Procedures During the COVID-19 Pandemic
Gastroenterology
I. Systematic Review

58, 59 First, the systematic reviews by Offeddu et al included a meta-analysis of 3 observational studies that showed a benefit in using N95 respirators over standard masks in protecting health care workers from SARS (OR = 0.86; 95% CI: 0.
Respiratory protection in health care for airborne precautions commonly follows two filtering device paths, N95 mask respirators and powered air-purifying respirators (PAPRs).

The available evidence was limited to low quality reports evaluating N95 protection in combination with face shield or surgical mask, mathematical models, experimental studies examining decontamination strategies for PPE preservation during pandemics, and laboratory tests evaluating durability and fit endurance of respirator masks.

Anecdotal reports on using SMs over N95 as a barrier to pathogens and extend the useful life of the N95 respirator has been published 65 .

Zamora and colleagues investigated the amount of contamination on the neck and face from individuals using a PAPR mask (in combination with N95) compared with a N95 mask alone 60 ; Individuals who used the PAPR-based strategy experienced a lower risk of face and neck contamination compared to N95 mask alone (RR = 0.08; 95% CI: 0.03-0.19).

64 These strategies were utilized during the SARS outbreak, but the effects of prolonged use of a combination of a face shield or surgical mask over an N95 mask have not been reported.

No direct evidence on the prolonged use or reuse of N95, N99, or PAPR masks in a COVID-19 pandemic was identified.

No direct evidence was found in regards to the safety of extended use of masks (surgical masks (SM) and N95) during a COVID-19 pandemic.
2020-04-01 Lakkireddy et al Guidance for Cardiac Electrophysiology During the Coronavirus (COVID-19) Pandemic from the Heart Rhythm Society COVID-19 Task Force; Electrophysiology Section of the American College of Cardiology; and the Electrocardiography and Arrhythmias Committee of the Council on Clinical Cardiology, American Heart Association
Heart Rhythm
IV. Prevalence Study Initial PPE recommendations in these patients included the use of fitted N95 or powered air purifying respirator (PAPR) masks, protective eyewear, gloves, and gowns.
2020-05-31 Chughtai et al Policies on the use of respiratory protection for hospital health workers to protect from coronavirus disease (COVID-19)
International Journal of Nursing Studies
IV. Other If respirators are not available, then masks should be used.

If respirators are not available, masks should be used.

Disposable medical or surgical masks are common types of face masks used by both health workers and general public.

9 Best telemedicine practices, barriers and faciitators, and specific actions to remove/expand them within and across state boundaries.

9.0.0.1 Highlights

9.0.0.2 Articles

Date Authors Title LOE(?) & Sample Matches
2020 Cascella et al Features, Evaluation and Treatment Coronavirus (COVID-19)
StatPearls
IV. Other Health organizations coordinate information flows and issues directives and guidelines to best mitigate the impact of the threat.
2020 Gao et al Efficient management of novel coronavirus pneumonia by efficient prevention and control in scientific manner
Zhonghua Jie He He Hu Xi Za Zhi
IV. Other Government and medical institutions across the country mobilized all kinds of resources and took a variety of measures to actively treat patients and stop the epidemic.
2020 Gralinski et al Return of the Coronavirus: 2019-nCoV
Viruses
IV. Prevalence Study

The novel CoV (2019-nCoV) was isolated from a single patient and subsequently verified in 16 additional patients .
This fact can be exacerbated by language barriers and off the record sources.
2020 Nesteruk et al Statistics-Based Predictions of Coronavirus Epidemic Spreading in Mainland China
Innovative Biosystems and Bioengineering
IV. Computer Model The optimal values of the parameters are:
2020-02-12 Ung et al Community pharmacist in public health emergencies: Quick to action against the coronavirus 2019-nCoV outbreak
Research in Social and Administrative Pharmacy
IV. Prevalence Study On January 5, 2020, the local government swiftly took the lead in coordinating and communicating actions across various sectors.
2020-02-23 Wang et al Epidemiological characteristics of 1212 COVID-19 patients in Henan, China
medrxiv
IV. Other Edges among patients represent relationship between relatives, friends or colleagues; Edges between patients and hospitals denote the patients were treated in the related hospitals; while edges among hospitals indicate the inter-hospital transfer treatments.
2020-02-28 Shah et al Guide to Understanding the 2019 Novel Coronavirus
Mayo Clinic Proceedings
IV. Other Health care professionals who encounter suspected cases should contact local infection control and public health offices regarding potential cases and appropriate next steps based on regional resources and protocols.
2020-02-28 Fadel et al Coronavirus outbreak: the role of companies in preparedness and responses
The Lancet Public Health
IV. Other Helped by their occupational practitioners, healthcare advisers, and safety professionals, companies that have a financial capacity and responsibilities (including governmental, federal, or state administrations) will thus have to prepare their business continuity planning for when cases of infected patients occur in the company.
2020-02-29 Rodríguez-Morales et al Going global – Travel and the 2019 novel coronavirus
Travel Medicine and Infectious Disease
IV. Other Good risk communication from official organizations helps travel health providers communicate and navigate risk with their clients.
2020-03-04 Chang et al Weaponized Interdependence: China's Economic Statecraft and Social Penetration against Taiwan
Orbis
IV. Prevalence Study Authoritarian regimes usually exercise their sharp power through four types of social exchanges: cultural exchange programs, academic/think tank cooperation, media, and publishing.
2020-03-04 Shattuck et al The Race to Zero?: China's Poaching of Taiwan's Diplomatic Allies
Orbis
IV. Other The capacity to engage in relations with other states is one of the criteria for statehood under international law-as reflected in the 1933 Montevideo Convention on the Rights and Duties of States, which lays out the criteria: "The state as a person of international law should possess the following qualifications: a.)

The countries do not have official state-to-state relations nor do they have formal embassies and consulates, but rather trade and cultural offices.
2020-03-05 Gilmour et al Progress towards Health for All: Time to End Discrimination and Marginalization
Int J Environ Res Public Health
IV. Prevalence Study Their review described reasons for this health crisis, including the lack of viable policies and responses from local government and international agencies, as well as cultural beliefs and health practices among African people.

They found language difficulties and intercultural understanding are barriers to properly accessing care and identified six key lessons for practices to facilitate health care access for Eritrean immigrants.
2020-03-09 Anderson et al How will country-based mitigation measures influence the course of the COVID-19 epidemic?
The Lancet
IV. Other How individuals respond to advice on how best to prevent transmission will be as important as government actions, if not more important.
2020-03-13 Bhagavathula et al Novel Coronavirus (COVID-19) Knowledge and Perceptions: A Survey of Healthcare Workers
medrxiv
III-2. Cross Sectional Control

A total of 529 HCWs participated, 453 of whom completed the study questionnaire (85.6% response rate), including 234 (51.6%) men and 219 (48.3%) women; most of the participants were below 44 years of age (82.4%).
Healthcare authorities have already initiated awareness and preparedness activities beyond borders.
2020-03-17 Bedford et al COVID-19: towards controlling of a pandemic
The Lancet
IV. Other First, countries need to rapidly and robustly increase their preparedness, readiness, and response actions based on their national risk assessment and the four WHO transmission scenarios 11 for countries with no cases, first cases, first clusters, and community transmission and spread (4Cs).
2020-03-18 Kandel et al Health security capacities in the context of COVID-19 outbreak: an analysis of International Health Regulations annual report data from 182 countries
The Lancet
IV. Prevalence Study Findings Of 182 countries, 52 (28%) had prevent capacities at levels 1 or 2, and 60 (33%) had response capacities at levels 1 or 2.
2020-03-20 Kriz et al Teaching-practice as a critical bridge for narrowing the research-practice gap
Industrial Marketing Management
III-3. Time Series Analysis

The wicked problem sessions attract over 40 participants (policy, practitioners, academics), with action research/ learning sessions limited to approximately 12 participants (practitioners and researchers).
The level of siloing within and across universities is embarrassing and not new.

Social stakeholders are cognisant of increased complexity and are looking to corporate practitioners to share the burden through taxation and pro-social actions, and to researchers for better solutions to such wicked issues.

indicated and we have further developed, the domains of the commons can only come closer if genuine efforts to change behaviours are taken beyond rhetoric to real incentives and actions.

The role of educators to profess has meant different things in different settings.
2020-03-20 Dewey et al Supporting Clinicians During the COVID-19 Pandemic
Ann Intern Med
IV. Other Other professional organizations, or organizations with access to community discussion boards, could develop similar venues for highlighting best practices in wellness.
2020-03-20 Escher et al An Ounce of Prevention: Coronavirus (COVID-19) and Mass Gatherings
PMC
IV. Prevalence Study Universal adoption of best practices for infection control is the surest way for governments to prepare for mass gatherings.
2020-03-23 Jin et al AI-assisted CT imaging analysis for COVID-19 screening: Building and deploying a medical AI system in four weeks
medrxiv
IV. Other To train the models, a team of six data annotators annotated the lesion regions (if there are any), lung boundaries, and the parts of the lungs for transverse section layers in all CT samples.
2020-03-24 Fessell et al Coronavirus Disease 2019 (COVID-19) and Beyond: Micropractices for Burnout Prevention and Emotional Wellness
Journal of the American College of Radiology
IV. Other In our experience, both physicians and managers hunger for skills and strategies to help successfully navigate their increasingly complex worlds.
2020-03-26 Martin et al An artificial intelligence-based first-line defence against COVID-19: digitally screening citizens for risks via a chatbot
biorxiv
IV. Prevalence Study These hotlines have struggled with the volume of callers, leading to wait times of hours or, even, an inability to contact health authorities.

At three symptoms, 99.1% of the possible combinations are returned within the top 10 results, and with four symptoms, all queries return COVID-19 within the top 10.
2020-03-26 Miao et al Early chest computed tomography to diagnose COVID-19 from suspected patients: A multicenter retrospective study
medrxiv
IV. Other The remaining combinations were around 25%.
2020-03-26 Rios et al Guidelines for preventing respiratory illness in older adults aged 60 years and above living in long-term care: A rapid review of clinical practice guidelines
medrxiv
IV. Prevalence Study

If one or more respiratory samples from ILI cases in a suspected outbreak returns a positive laboratory result for influenza, then an influenza outbreak is confirmed.
Regional health authorities (RHAs) and provincial health services organizations (PHSOs) are expected to develop regional policies and procedures based on these guidelines.
2020-03-26 Carico et al Community pharmacists and communication in the time of COVID-19: Applying the health belief model
Research in Social and Administrative Pharmacy
IV. Other As trusted, community-facing healthcare professionals, pharmacists are uniquely suited to bring about change in patient behaviors.Community pharmacists using HBM to reinforce COVID-19 mitigation behaviors should appropriately emphasize the severity and susceptibility of the threat, emphasize barriers to acting, help patients identify ways to overcome barriers to acting, and reinforce self-efficacy beliefs.
2020-03-27 Hsiang et al The Effect of Large-Scale Anti-Contagion Policies on the Coronavirus (COVID-19) Pandemic
medrxiv
III-3. Time Series Analysis

We did not collect city level health outcomes recorded prior to January 24, 2020 in provinces that had fewer than ten confirmed cases at that date.
These policies included closing schools, cancelling public and private events and gatherings, closing museums and other cultural institutions, closing non-essential commercial activities, and prohibiting the movement of people into or out of the municipalities.
2020-03-29 Thompson et al COVID-19 in Endoscopy: Time to do more?
Gastrointestinal Endoscopy
IV. Prevalence Study As part of the State of Emergency response in Massachusetts, telemedicine and virtual visit restrictions have greatly relaxed to promote usage across state lines and include new patient visits.
2020-03-30 O’Connell et al Midwives in a pandemic: A call for solidarity and compassion
Women and Birth
IV. Prevalence Study COVID-19 calls for a coming together, a blurring of traditional professional boundaries in ways that promote greater coordinated cooperation between all stakeholders.

Irrefutably midwives have the skills and experiences to do this in exemplary ways.
2020-03-30 Sinnott-Armstrong et al Evaluation of Group Testing for SARS-CoV-2 RNA
medrxiv
IV. Prevalence Study Hospitals, government offices, corporations, and educational institutions, across which many individuals cannot work from home , require self-isolation following positive results.
2020-03-30 Barari et al Evaluating COVID-19 Public Health Messaging in Italy: Self-Reported Compliance and Growing Mental Health Concerns
medrxiv
IV. Prevalence Study Possibilities include messaging about online collective exercises, social reading activities (e.g., Perusall.com for schools and universities), safe ways for people to get fresh air outside, classes (e.g., edx.org for online classes), or novel ways of bridging social capital between young and old, or even distribution of inexpensive tablets or laptops to ensure the whole population has video conferencing abilities.
2020-03-30 Yang et al In-flight Transmission Cluster of COVID-19: A Retrospective Case Series
medrxiv
IV. Other Among them, 5 (50%) patients had temperature between 37.3-39 , while 2 (20%) patients were above 39 .
2020-03-31 FINEGAN et al International Committee of the Red Cross (ICRC): General Guidance for the Management of the Dead Related to COVID-19
Forensic Science International: Synergy
IV. Other Internationally accepted best practices and procedures that promote the dignified and professional management of the dead and respectful engagement with people of different backgrounds, cultures and religions must be upheld.
2020-03-31 Cadogan et al On the frontline against COVID-19: Community pharmacists’ contribution during a public health crisis
Research in Social and Administrative Pharmacy
IV. Prevalence Study through social distancing and self-isolation requirements), employment and access to healthcare services which will ultimately create new barriers to medication adherence.
2020-03-31 Wittkowski et al The first three months of the COVID-19 epidemic: Epidemiological evidence for two separate strains of SARS-CoV-2 viruses spreading and implications for prevention strategies
medrxiv
IV. Prevalence Study A major problem with respiratory diseases is that one cannot stop all chains of infections within families, friends, neighbors, … .
2020-03-31 Adams et al Goals of Care in a Pandemic: Our Experience and Recommendations
Journal of Pain and Symptom Management
IV. Other Palliative care leaders will have unique perspectives and priorities which need to be communicated to hospital and health system leadership.
2020-03-31 Adolph et al Pandemic Politics: Timing State-Level Social Distancing Responses to COVID-19
medrxiv
III-3. Time Series Analysis

To show just how small this effect is, we compare a state with just four confirmed cases (the median among all state-days in our study period) to a state with 426 cases (the 95th percentile).
This approach allows us to statistically separate the impact of having a Republican governor or a Republican electorate from a series of potential confounders, including the number of confirmed COVID-19 cases in the state, state income, and cases and policies in neighboring states.
2020-03-31 Tey et al Navigating the challenges of the COVID-19 outbreak: perspectives from the radiation oncology service in singapore
Radiotherapy and Oncology
IV. Prevalence Study Within the workplace, care teams will have dedicated workspaces.
2020-03-31 Kao et al Highlights
Journal of the Formosan Medical Association
III-3. Time Series Analysis

3 retrospectively collected 67 patients with ATTR p.A97S to study their clinical profiles, echocardiography, and ECG findings.
The deviations between simulated and postsurgical Point A and Point B positions were within 1 mm in horizontal and vertical directions.
2020-04-01 Zhu et al Transmission Dynamics and Control Methodology of COVID-19: a Modeling Study
medrxiv
III-3. Time Series Analysis

3) , there are no more than 5 new cases every day from Dec 8 to Dec 28.
Among them, the number of hospital staff members would be up to 2950.
2020-04-30 Georgalakis et al A disconnected policy network: The UK's response to the Sierra Leone Ebola epidemic
Social Science & Medicine
IV. Other With the outbreak of Covid-19 in China at the end of 2019, its rapid spread overseas and predictions of more frequent and more deadly pandemics and epidemics in the future, the importance of breaking down barriers between policy actors, humanitarians, social scientists, doctors and medical scientists can only increase with time.

Ideas and knowledge do not simply flow within the network, given that dominant paradigms and political, social and cultural norms privilege better established knowledge communities (Tchilingirian, 2018) .

They have an authoritative claim to policy relevant expertise in a particular domain and Haas claims that policy actors will routinely place them above other interest groups in their level of expertise.
2020-12-31 Bai et al Chinese experts’ consensus on the Internet of Things-aided diagnosis and treatment of coronavirus disease 2019 (COVID-19)
Clinical eHealth
IV. Prevalence Study This consensus is appropriate for different specialists at all levels of hospitals and even managers at all levels of hospitals, local community development corporations, and public health centers.

10 Guidance on the simple things people can do at home to take care of sick people and manage disease.

10.0.0.1 Highlights

10.0.0.2 Articles

Date Authors Title LOE(?) & Sample Matches
2020-01-19 Chen et al A mathematical model for simulating the transmission of Wuhan novel Coronavirus
biorxiv
IV. Prevalence Study d) The people were divided into five departments: susceptible people (S P ), exposed people (E P ), symptomatic infected people (I P ), asymptomatic infected people (A P ), and removed people (R P ) including recovered and death people.
2020-02-03 Shaman et al Direct Measurement of Rates of Asymptomatic Infection and Clinical Care-Seeking for Seasonal Coronavirus
medrxiv
III-3. Time Series Analysis

We enrolled 214 healthy individuals from multiple locations in the Manhattan borough of NYC.
Medically attended illness, sick days at home and medicine uptake were defined as episodes in which the participants reported seeking care, staying home or taking medicines due to respiratory symptoms.
2020-02-06 Kupferschmidt et al Will novel virus go pandemic or be contained?
Science
IV. Other But to make confident predictions, they need to know much more about how easily the virus spreads, how sick it makes people, and whether infected people with no symptoms can still infect others.
2020-02-07 Patel et al Initial Public Health Response and Interim Clinical Guidance for the 2019 Novel Coronavirus Outbreak — United States, December 31, 2019–February 4, 2020
MMWR Morb Mortal Wkly Rep
IV. Other This includes everyday preventive actions such as washing your hands, covering your cough, and staying home when you are ill. Additional information and resources for this outbreak are available on the CDC website (https://www.cdc.
2020-02-10 Li et al A qualitative study of zoonotic risk factors among rural communities in southern China
Int Health
IV. Prevalence Study

We aimed to obtain a minimum sample size of 20 participants from each of the three provinces, for a total sample size of over 60 participants.
Illustrative quotes: individuals' knowledge, attitudes and practices regarding human-animal contact -'My family do not eat the sick animals, we will bury them.
2020-02-19 Chen et al Mental health care for medical staff in China during the COVID-19 outbreak
The Lancet Psychiatry
IV. Other Second, they did not want their families to worry about them and were afraid of bringing the virus to their home.
2020-02-20 Qian et al Psychological responses, behavioral changes and public perceptions during the early phase of the COVID-19 outbreak in China: a population based cross-sectional survey
medrxiv
III-2. Cross Sectional Control

17, 18 Before our survey, Wuhan confirmed 3,215 cases, 19 accounting for 27.3% of all cases across China; 20 Shanghai reported 153 cases, 68 (44.4%) of them from nonlocal residents.
Participants were asked "how likely do you think you will contract novel coronavirus infection over the next month" with five responses from very unlikely to very likely , and "how serious do you think the novel coronavirus infection would be if you contracted it" with five options from very mild to very serious .
2020-02-21 Richardson et al Baricitinib as potential treatment for 2019-nCoV acute respiratory disease
The Lancet
IV. Other We do not consider these drugs would be a safe therapy for a population of sick and infected people.
2020-02-24 Diagnosing COVID-19
C&EN Global Enterprise
IV. Other There, doctors and scientists are desperately struggling to find reliable ways to diagnose infected patients to help treat them and control the spread of the virus.
2020-02-28 Chen et al A mathematical model for simulating the phase-based transmissibility of a novel coronavirus
Infect Dis Poverty
IV. Computer Model susceptible people (S P ), exposed people (E P ), symptomatic infected people (I P ), asymptomatic infected people (A P ), and removed people (R P ) including recovered and death people.
2020-02-29 Hao et al Infection Dynamics of Coronavirus Disease 2019 (Covid-19) Modeled with the Integration of the Eyring Rate Process Theory and Free Volume Concept
medrxiv
IV. Other Our work provides a simple and straightforward approach to estimate how infection diseases evolve and how many people may be infected.
2020-03-03 Perl et al Managing Emerging Infectious Diseases: Should Travel Be the Fifth Vital Sign?
Ann Intern Med
IV. Other A simple, targeted travel history can help us put symptoms of infection in context and trigger us to take a more detailed history, do appropriate testing, and rapidly implement protective measures.
2020-03-05 Wilder-Smith et al Can we contain the COVID-19 outbreak with the same measures as for SARS?
The Lancet Infectious Diseases
IV. Prevalence Study

On Feb 18, 2020, the Chinese Center for Disease Control and Prevention published their data of the first 72 314 patients including 44 672 patients with confirmed COVID19.
10 Isolation is the separation of ill people from non infected people, and usually occurs in hospital settings, but could also be done at home for mild infections.
2020-03-05 Xiao et al The Effects of Social Support on Sleep Quality of Medical Staff Treating Patients with Coronavirus Disease 2019 (COVID-19) in January and February 2020 in China
Med Sci Monit
III-2. Cross Sectional Control Social support refers to the care and support that people feel they get from other people .
2020-03-12 Schwartz et al Climate Change, Covid-19, Preparedness, and Consciousness
EXPLORE
IV. Other No matter how convinced you are that this chain of crises won't touch you, or that you can handle it, you won't, and you can't.
2020-03-13 Harman et al The danger of stories in global health
The Lancet
IV. Other However, such evidence does not necessarily stack up if your lived reality is clinics that can be more than 50 km away from your home, are often understaffed, do not have basic supplies, may charge hidden fees and possibly detain you if you can't pay, and are the same place your aunty died in the past.

If the 2014-16 outbreak of Ebola taught us anything, it is if you want to understand how a disease spreads, look to the stories of the communities it affects.
2020-03-13 Singhal et al A Review of Coronavirus Disease-2019 (COVID-19)
Indian J Pediatr
IV. Prevalence Study

The median age was 8 y 11 mo and in 28 children the infection was linked to a family member and 26 children had history of travel/residence to Hubei province in China.
& Healthcare providers should take travel history of all patients with respiratory symptoms, and any international travel in the past 2 wks as well as contact with sick people who have travelled internationally.
2020-03-17 Hossain et al The effects of border control and quarantine measures on global spread of COVID-19
medrxiv
IV. Computer Model The results confirmed that if latent period is long, more ill people can move to other cities.
2020-03-20 Dewey et al Supporting Clinicians During the COVID-19 Pandemic
Ann Intern Med
IV. Other Leaders must also designate times for clinicians to take breaks, eat, and take medications.
2020-03-21 Choi et al Society of Cardiovascular Computed Tomography Guidance for Use of Cardiac Computed Tomography Amidst the COVID-19 Pandemic
Journal of Cardiovascular Computed Tomography
IV. Other Ensure that your sick leave policies are flexible and consistent with public health guidance and that employees are aware of these policies.

Encourage sick employees to stay home.
2020-03-22 Misra et al Doctors and Healthcare Workers at Frontline of Covid 19 Epidemic: Admiration, A Pat on the Back, and Need for Extreme Caution
Diabetes & Metabolic Syndrome: Clinical Research & Reviews
IV. Other When this doctor goes home, he does not talk to his wife or children, avoids touching any article at home, and goes to disinfect in bathroom first.
2020-03-23 Wilson et al Modelling the Potential Health Impact of the COVID-19 Pandemic on a Hypothetical European Country
medrxiv
IV. Other Sick people need hospitalisation 1% This estimate is highly uncertain.
2020-03-24 Portnoy et al Telemedicine in the Era of COVID-19
The Journal of Allergy and Clinical Immunology: In Practice
IV. Other As health care professionals, we must take appropriate measures to ensure that individuals with low-risk diseases, as well as the "worried well," do not take up our already limited health care resources while ensuring that those who are seriously ill receive appropriate triage and treatment.
2020-03-26 Rios et al Guidelines for preventing respiratory illness in older adults aged 60 years and above living in long-term care: A rapid review of clinical practice guidelines
medrxiv
IV. Prevalence Study

If one or more respiratory samples from ILI cases in a suspected outbreak returns a positive laboratory result for influenza, then an influenza outbreak is confirmed.
Evaluate and Manage HCP with Symptoms of Respiratory Illness Implement sick leave policies that are non-punitive, flexible, and consistent with public health policies that allow ill HCP to stay home.
2020-03-27 Weissgerber et al Mitigating the impact of conference and travel cancellations on researchers’ futures
PMC
IV. Other Scientists are working from home, often with children; others may be ill or caring for loved ones who are sick.
2020-03-27 Hsiang et al The Effect of Large-Scale Anti-Contagion Policies on the Coronavirus (COVID-19) Pandemic
medrxiv
III-3. Time Series Analysis

We did not collect city level health outcomes recorded prior to January 24, 2020 in provinces that had fewer than ten confirmed cases at that date.
To support employees working remotely or staying home when sick, a number of states have also mandated paid sick leave for those who are affected by .
2020-03-27 Rivera et al The Impact of COVID-19 on Radiation Oncology Clinics and Cancer Patients in the U.S.
Advances in Radiation Oncology
IV. Other In trying to prevent community spread to non-affected cancer patients, some clinics may consider alternatives to in person triage and visits for sick patients as mentioned by the CDC for outpatient facilities.
2020-03-27 Zhao et al A Social Network Model of the COVID-19 Pandemic
medrxiv
IV. Other Among sick contacts, 80% are traced by public health and quarantined at home.
2020-03-29 Shi et al Knowledge and attitudes of medical staff in Chinese psychiatric hospitals regarding COVID-19
Brain, Behavior, & Immunity - Health
IV. Prevalence Study

From February 1-15, 2020, the questionnaire link was sent to 200 psychiatrists and nurses, and 10 psychiatrist groups (approximately 20 chat groups of between 8 and 120 participants) from the author's Wechat account.
Independent predictors of willingness to care for patients included advanced training, experience of caring for patients with COVID-19, and the confidence to know the risk and how to protect themselves and their patients.
2020-03-30 Donsimoni et al Projecting the Spread of COVID19 for Germany
medrxiv
IV. Other In practice, individuals do not encounter sick individuals with this probability being equal to the share of sick individuals in society as sick individuals might stay at home or behave di¤erently (not shaking hands or similar) than non-sick individuals.

Then the number of sick individuals does not increase that quickly.

If a large share of sick individuals show up at the general practitioner who does not test all individuals that display symptoms that might be caused by CoV-2, then the share r of individuals that are sick and reported is much lower than these 20%: We therefore set r = 0:1 and undertake robustness analyses further below.

Under the assumption that the share of sick and reported individuals out of the infected individuals is r = 0:1; the …nal number of reported sick individuals will be (right part of …gure) 5.5 million.
2020-03-30 Barari et al Evaluating COVID-19 Public Health Messaging in Italy: Self-Reported Compliance and Growing Mental Health Concerns
medrxiv
IV. Prevalence Study The focus now should move from explaining that citizens should stay at home to what they can do at home.

At this point, the Italian people understand how to keep themselves and others safe from the SARS-Cov-2 virus.

A third of respondents assigned to the control group received no message, a third received a message about social externalities with a prompt for reflection (" If you are infected with COVID-19, you are likely to infect 2,000 people -including your and your friends' parents and grandparents, who might die.
2020-03-30 Muller et al Mobility traces and spreading of COVID-19
medrxiv
IV. Computer Model This results in an issue for home locations: Our data model does not differentiate between "persons living in the same block" and "persons living in the same household".

The base case simulation does, however, include that 20% of the infected persons self-quarantaine, similar to staying at home when sick.
2020-03-30 Xu et al Analysis and Prediction of False Negative Results for SARS-CoV-2 Detection with Pharyngeal Swab Specimen in COVID-19 Patients: A Retrospective Study
medrxiv
III-2. Retrospective Cohort

In order to implement the out-of-sample prediction, 1,324 patients were randomly divided into training (1,059 cases) and validation samples (265 cases Table 2) .
The variables for which we intend to seek explanations and make predictions are: 1) outcome of the first nucleic acid test for diagnosed COVID-19 patients; and 2) time duration between getting sick and testing positive.
2020-03-30 Stangeland et al How to evaluate the success of the COVID-19 measures implemented by the Norwegian government by analyzing changes in doubling time
medrxiv
IV. Other In Norway, companies that could move their employees over to working from home were advised to do so.
2020-03-30 Ugarov et al Inclusive Costs of NPI Measures for COVID-19 Pandemic: Three Approaches
medrxiv
IV. Other While it seems weird to put a monetary estimate on life, people often do it implicitly while deciding to save time by speeding or deciding to save money by not investing in tornado shelters.
2020-03-31 Elwood et al SOGC Committee Opinion – COVID-19 in Pregnancy
Journal of Obstetrics and Gynaecology Canada
IV. Other Pregnant women and their loved ones will be looking to maternal care providers for information and guidance on how to prevent or manage infection with COVID-19.
2020-03-31 Zahiri et al Prediction of Peak and Termination of Novel Coronavirus Covid-19 Epidemic in Iran
medrxiv
IV. Computer Model Ultimately, people can prevent from spreading the disease by doing some things such as .
2020-03-31 Dalton et al Protecting the psychological health of children through effective communication about COVID-19
The Lancet Child & Adolescent Health
IV. Other 1 Parents would do anything to protect their children from distress and might avoid talking about difficult feelings and events.
2020-03-31 Weaver et al Applying Palliative Care Principles to Communicate with Children about COVID-19
Journal of Pain and Symptom Management
IV. Other Palliative care teams should talk with adults receiving palliative care about how they are discussing their own illness or diagnoses with their young family members, as children may be particularly fearful of the risk of losing their loved one in this time of mass messaging about human loss.
2020-03-31 Wu et al NetNCSP: Nonoverlapping closed sequential pattern mining
Knowledge-Based Systems
IV. Prevalence Study We can know that sup(P,S 1 )=2≥minsup.
2020-04-01 Shayak et al Transmission Dynamics of COVID-19 and Impact on Public Health Policy
medrxiv
IV. Computer Model Thus, new healthy people can be only be infected by those asymptomatic sick people who have fallen sick within the last 7-10 days, and not those who have fallen sick earlier.

First, recall that by our definition, sick people stay sick for all time.

11 Oral medications that might potentially work.

11.0.0.1 Highlights

11.0.0.2 Articles

Date Authors Title LOE(?) & Sample Matches
2020 Wu et al Analysis of therapeutic targets for SARS-CoV-2 and discovery of potential drugs by computational methods
Acta Pharmaceutica Sinica B
IV. Other Theoretically, the drugs found through these therapies would exhibit better anti-coronavirus effects, but the research procedure of new drug might cost several years, or even more than 10 years 11 .
2020-01-31 Koenig et al 2019-nCoV: The Identify-Isolate-Inform (3I) Tool Applied to a Novel Emerging Coronavirus
West J Emerg Med
IV. Prevalence Study

One preliminary, small-scale study of 41 patients in Wuhan China, reported 6 deaths (15% mortality) with a median age of 49.0 years.
In the future, antiviral medications may be available.
2020-02-21 Zhou et al Potential benefits of precise corticosteroids therapy for severe 2019-nCoV pneumonia
Signal Transduct Target Ther
IV. Other All patients had received treatments containing noninvasive oxygen therapy and antibiotics and/or antiviral agents before and after ICU admission, and hypoxemia was not improved by these treatments.

Additionally, pulse-dose therapy or long-term administration to high dose of corticosteroids in early stage were reported to be possibly harmful6,7,8.
2020-02-21 Cheng et al Scabies: Application of the Novel Identify-Isolate-Inform Tool for Detection and Management
West J Emerg Med
IV. Prevalence Study

36 Advising patients and parents of young patients to keep fingernails short and clean can assist with preventing secondary infections.
For classic scabies, topical permethrin or oral ivermectin are considered first-line treatments.
2020-02-24 Xu et al High expression of ACE2 receptor of 2019-nCoV on the epithelial cells of oral mucosa
Int J Oral Sci
IV. Other These findings indicated that oral cavity could be regarded as potentially high risk for 2019-nCov infectious susceptibility.
2020-02-25 yaqian et al Clinical and pathological characteristics of 2019 novel coronavirus disease (COVID-19): a systematic review
medrxiv
I. Systematic Review

Results: 34 COVID-19-related articles were eligible for this systematic review;Four of the articles were related to pathology.
In this review we found that in COVID-19, oxygen therapy, antiviral therapy, antibiotic therapy, the use of corticosteroids or immunoglobulin were in 56.1%, 51.2%, 62.9%, 22.0% and 16.8% of patients, respectively.
2020-02-27 Zhang et al Clinical characteristics of 82 death cases with COVID-19
medrxiv
III-2. Cross Sectional Control

Methods Clinical data on 82 death cases laboratory-confirmed as SARS-CoV-2 infection were obtained from a Wuhan local hospital′s electronic medical records according to previously designed standardized data collection forms.
21, 22 In our study, all patients received intravenous of antibiotics and anti-virus drugs.
2020-02-27 Chen et al Convalescent plasma as a potential therapy for COVID-19
The Lancet Infectious Diseases
IV. Other 4 However, other treatments might have an effect on the relationship between convalescent plasma and antibody level, including antiviral drugs, steroids, and intravenous immunoglobulin.
2020-02-27 Fan et al Clinical Features of COVID-19 Related Liver Damage
medrxiv
IV. Other The medications of COVID-19 patients before admission included antibiotics (Levofloxacin, Azithromycin, Cephalosporin), antiviral drugs (Arbidol, Oseltamivir, Acyclovir)and conventional febrifuge (Ibuprofen).
2020-03-02 Li et al The within-host viral kinetics of SARS-CoV-2
biorxiv
IV. Other We also analyze the drug therapy and its effect on the virus growth, and the result illustrates that early medication is effective for treatment.
2020-03-03 Yang et al The deadly coronaviruses: The 2003 SARS pandemic and the 2020 novel coronavirus epidemic in China
Journal of Autoimmunity
IV. Prevalence Study

In Wang's study , of the 36 patients in the ICU, four patients received high-flow oxygen therapy, 15 patients received non-invasive ventilation, and 17 patients received invasive ventilation (four patients switched to ECMO).
In Guan's study, 632 patients were given intravenous antibiotics, and 30 patients were given antifungal medications .

In Guan's study, 18.6% (204/1099) of patients were given systemic corticosteroids .
2020-03-03 Fu et al Understanding SARS-CoV-2-Mediated Inflammatory Responses: From Mechanisms to Potential Therapeutic Tools
Virologica Sinica
IV. Other Such treatment may also be combined with systemic anti-inflammatory drugs or corticosteroids.
2020-03-03 Yang et al Epidemiological and clinical features of COVID-19 patients with and without pneumonia in Beijing, China
medrxiv
III-3. Time Series Analysis

A total of 55 consecutive patients with laboratory-confirmed COVID-19 were enrolled in this study.
The disease course of severe patients might be prolonged by therapeutic regimens including corticosteroids.
2020-03-03 Gu et al COVID-19: Gastrointestinal manifestations and potential fecal-oral transmission
Gastroenterology
IV. Other 9 It is believed that SARS-associated hepatotoxicity may be likely with viral hepatitis or a secondary effect associated with drug toxicity due to high-dose consumption of antiviral medications, antibiotics and steroids, as well as immune system overreaction.
2020-03-05 Al-Tawfiq et al Remdesivir as a possible therapeutic option for the COVID-19
Travel Medicine and Infectious Disease
II. Randomized Controlled Trial

Another ongoing phase 3 randomized, double-blind, placebo-controlled, multicenter study is evaluating the efficacy and safety of remdesivir in 452 hospitalized adult patients with severe COVID-19 respiratory disease .
It had been suggested that remdesivir might be an option for the therapy of patients with COVID-19 .
2020-03-06 Xu et al Clinical findings in critical ill patients infected with SARS-Cov-2 in Guangdong Province, China: a multi-center, retrospective, observational study
medrxiv
IV. Prevalence Study

Demographic, Epidemiologic, and Baseline Characteristics of the Patients A total of 45 critically ill patients were identified with SARS-CoV-2 infections, the first case included was confirmed on January 14, 2020, and the last one was confirmed on February 20, 2020.
There were 15 (33.3%) patients administrated with vasoconstrictive agents, 19 (42.2%) with sedation and analgesia and 8 (17.8%) with neuromuscular blocking agents (table 4).
2020-03-10 Xu et al Clinical Characteristics of SARS-CoV-2 Pneumonia Compared to Controls in Chinese Han Population
medrxiv
IV. Prevalence Study

Results The study population included 69 hospitalized patients with confirmed SARS-CoV-2 pneumonia without comorbidities and 14,117 normal controls.
14 For the asymptomatic case, we speculate that the patient is currently taking HIV medications and the medication is interfering with the results of RT-PCR.
2020-03-11 Deng et al Arbidol combined with LPV/r versus LPV/r alone against Corona Virus Disease 2019: A retrospective cohort study
Journal of Infection
III-2. Retrospective Cohort

Baseline characteristics were generally similar between patients who received oral arbidol and LPV/r therapy, and those who received oral LPV/r only ( Table 1 ) , with the exception that organ dysfunction was present in four patients who were admitted and transferred to the ICU, ten patients treated with other antiviral drugs(the data are not yet public)and no abnormal radiological findings was present in nine patients ( Fig.
Patients, diagnosed after Jan 17, 2020, were given oral arbidol and LPV/r in the combination group and oral LPV/r only in the monotherapy group for 5–21 days.
2020-03-12 Pongpirul et al Journey of a Thai Taxi Driver and Novel Coronavirus
New England Journal of Medicine
IV. Other Additional medications were prescribed for treatment of the patient’s symptoms.
2020-03-12 Devaux et al New insights on the antiviral effects of chloroquine against coronavirus: what to expect for COVID-19?
International Journal of Antimicrobial Agents
IV. Other This molecule is available for oral administration in the form of hydroxychloroquine sulfate.
2020-03-13 Singhal et al A Review of Coronavirus Disease-2019 (COVID-19)
Indian J Pediatr
IV. Prevalence Study

The median age was 8 y 11 mo and in 28 children the infection was linked to a family member and 26 children had history of travel/residence to Hubei province in China.
Routine use of antibiotics and antivirals such as oseltamivir should be avoided in confirmed cases.
2020-03-15 Yi et al COVID-19: what has been learned and to be learned about the novel coronavirus disease
Int J Biol Sci
IV. Prevalence Study

On February 11, 2020, a multi-center study on 8,866 patients including 4,021 confirmed COVID-19 patients presented a more updated illustration of the epidemic as follows ( UlBi-HX_rHPXa1qHA2bhdA).
These therapies include current and potential treatments with antiviral drugs, immunosuppressants, steroids, plasma from recovered patients, Chinese medicine, and psychological support.
2020-03-15 Yang et al Targeting the Endocytic Pathway and Autophagy Process as a Novel Therapeutic Strategy in COVID-19
Int J Biol Sci
IV. Other In addition to its direct effects on CoVs, there is evidence of the combinational activity of CQ with other therapeutic agents for treatment of SARS, MERS and possibly COVID-19.
2020-03-17 Li et al First Cases of COVID-19 in Heart Transplantation From China
The Journal of Heart and Lung Transplantation
IV. Other Intravenous medications were then stopped, and oral administration of moxifloxacin 0.4 g/day and arbidol (a non-nucleoside antiviral and immunomodulating drug given for influenza), at a dose of 0.2 g three times a day was administered for 5 days.
2020-03-20 song et al Advance of Novel Coronavirus Registration Clinical Trial
medrxiv
IV. Prevalence Study In the BI study, the top three drugs in the study frequency were: cell therapy (n=15, 48.39%), plasma therapy (n=5, 16.13%), Thymosin (n=2, 6.45%) and M/P-AB (n=2, 6.45%).
2020-03-21 Rismanbaf et al Potential Treatments for COVID-19; a Narrative Literature Review
Arch Acad Emerg Med
III-3. Time Series Analysis

Also, according to Jian-ya et al., treatment of 51 COVID-19 patients with traditional Chinese medicine, interferon, Lopinavir, Ritonavir and short-term (3 to 5 days) corticosteroids was successful and resulted in recovery and discharge of 50 patients .
In addition to these medications, Tocilizumab has recently been suggested as a COVID-19 treatment.

Several articles have suggested medicines, potentially effective for the treatment of COVID-19 ( Table 1) .
2020-03-23 Panahi et al Risks of Novel Coronavirus Disease (COVID-19) in Pregnancy; a Narrative Review
Arch Acad Emerg Med
IV. Other No antiviral medications were given to mothers during pregnancy.
2020-03-23 Shaman et al Initial Simulation of SARS-CoV2 Spread and Intervention Effects in the Continental US
medrxiv
IV. Other 22.20040758 standard treatment (oxygen therapy, antiviral agents, antibacterial agents, and immunoglobulin, with or without corticosteroids), patients in the HCQ treatment group received additional oral HCQ (hydroxychloroquine sulfate tablets, Shanghai Pharma) 400 mg/d (200 mg/bid) between days 1 and 5 ( Figure 1) , patients in the control group with the standard treatment only.
2020-03-23 Luo et al Characteristics of patients with COVID-19 during epidemic ongoing outbreak in Wuhan, China
medrxiv
IV. Other Treatment measures evaluated in this research contained high-flow nasal cannula oxygen therapy (HFNC), non-invasive mechanical ventilation (NIMV) or invasive mechanical ventilation (IMV), blood purification treatment, application of antiviral agents, antibacterial agents, anti-fungal agents, corticosteroids, and immunoglobulin.
2020-03-24 Chavez et al Coronavirus Disease (COVID-19): A primer for emergency physicians
The American Journal of Emergency Medicine
IV. Prevalence Study

60 One study of 204 patients with confirmed COVID-19 suggests 48.5% of patients have gastrointestinal (GI) symptoms.
40 Over-resuscitation with intravenous fluids should be avoided, which can potentially worsen oxygenation.
2020-03-26 Gavillet et al Acute Leukemia in the Time of COVID-19
Leukemia Research
IV. Prevalence Study Targeted therapies could potentially be used.
2020-03-26 Zheng et al Recommendations and guidance for providing pharmaceutical care services during COVID-19 pandemic: A China perspective
Research in Social and Administrative Pharmacy
IV. Other Retail pharmacies in China provide some prescription medications, over-the-counter medications, 65 supplements, and health-related products and devices for sale.
2020-03-27 Chen et al Clinical Characteristics of Hospitalized Patients with SARS-CoV-2 and Hepatitis B virus Co-infection
medrxiv
IV. Prevalence Study

Approach & Results In this retrospective investigation, we included 123 COVID-19 patients admitted to Zhongnan Hospital of Wuhan University, Wuhan, China, from January 5 to March 7, 2020.
Antibiotic therapy, both orally and intravenous, were given as described in Table 1 .
2020-03-27 Wang et al Comorbidities and multi-organ injuries in the treatment of COVID-19
The Lancet
IV. Other Basic treatments were provided, such as antivirals, antibiotics, oxygen therapy, and glucocorticoids.
2020-03-27 Rivera et al The Impact of COVID-19 on Radiation Oncology Clinics and Cancer Patients in the U.S.
Advances in Radiation Oncology
IV. Other 15 At the other end of the spectrum, cancer patients with immunosuppression may require hospitalization and isolation precautions, thereby preventing the continuation of radiation treatments.
2020-03-28 Zhai et al The epidemiology, diagnosis and treatment of COVID-19
International Journal of Antimicrobial Agents
III-2. Matched Case Control

Another study later using the travel history and symptom onset of 88 confirmed cases had a similar mean incubation period, which was 6.4 days (95% CI: 5.6-7.7) .
Treatments, including antiviral agents, chloroquine and hydroxychloroquine, corticosteroids, antibodies, convalescent plasma transfusion and vaccines, will be discussed in this article.
2020-03-29 Kang et al Recent Progress in understanding 2019 Novel Coronavirus associated with Human Respiratory Disease: Detection, Mechanism and Treatment
International Journal of Antimicrobial Agents
IV. Prevalence Study These drugs and other potentially effective drugs are described here.
2020-03-30 Wang et al Genetic Profiles in Pharmacogenes Indicate Personalized Drug Therapy for COVID-19
medrxiv
IV. Prevalence Study

As many as 16 clinical trials related to chloroquine, and two clinical trials for mild and common patients and severe patients will be completed on April 30, 2020 (ChiCTR2000029898, ChiCTR2000029899), each clinical trial includes a total of 100 participants.
Many drugs showed potential for COVID-19 therapy.

Oxygen therapy, mechanical ventilation and drug therapy are recommended as major treatments, so that several drugs may be utilized simultaneously in such conditions.
2020-03-30 Chen et al Efficacy of hydroxychloroquine in patients with COVID-19: results of a randomized clinical trial
medrxiv
IV. Other 22.20040758 standard treatment (oxygen therapy, antiviral agents, antibacterial agents, and immunoglobulin, with or without corticosteroids), patients in the HCQ treatment group received additional oral HCQ (hydroxychloroquine sulfate tablets, Shanghai Pharma) 400 mg/d (200 mg/bid) between days 1 and 5 ( Figure 1) , patients in the control group with the standard treatment only.
2020-03-31 Cadogan et al On the frontline against COVID-19: Community pharmacists’ contribution during a public health crisis
Research in Social and Administrative Pharmacy
IV. Prevalence Study For example, access to medication on public health schemes may need to be increased and prescription copayments for patients who obtain their medications on such schemes may need to be reconsidered as these can also negatively impact on medication adherence.
2020-03-31 Zhang et al Treatment with convalescent plasma for critically ill patients with SARS-CoV-2 infection
Chest
IV. Other The antibody levels, however, were confounded by other treatments, such as antiviral drugs, steroids and intravenous immunoglobulin .
2020-03-31 Grech et al Unknown unknowns – COVID-19 and potential global mortality
Early Human Development
IV. Prevalence Study These estimates assume that a significant proportion of severe cases that would normally require relatively mild intervention (such as supplemental and non-invasive administration of oxygen, intravenous fluids, antibiotics for secondary infections etc) actually manage to access these therapies.
2020-04-01 Zaorsky et al Prostate Cancer Radiotherapy Recommendations in Response to COVID-19
Advances in Radiation Oncology
IV. Prevalence Study The same principles of the RADS framework apply, and the variable efficacy of palliative radiotherapy should be weighed against the risks of bringing patients in for radiotherapy, alternative treatment options (oral analgesics), use of radiotherapy to avoid treatments that may cause even greater exposure (surgery) or immunosuppression (systemic therapy).
2020-05-31 Zhang et al The use of anti-inflammatory drugs in the treatment of people with severe coronavirus disease 2019 (COVID-19): The Perspectives of clinical immunologists from China
Clinical Immunology
II. Randomized Controlled Trial

One study analyzed the lymphocyte subsets and cytokines in 123 patients, all patients had lymphcytopenia, The percentage of CD8 + T cell reduction were 28.43% and 61.9% in mild and severe group respectively, and the NK cell reduction were 34.31% and 47.62% respectively,in mild and severe groups.
Thirdly, some anti-inflammation medication such as JAK inhibitors also block INF-a production, which is important in fighting virus, and theoretically may not be suitable for the treatment of inflammatory CS caused by virus as COVID-19.
2020-06-30 Gupta et al Clinical considerations for patients with diabetes in times of COVID-19 epidemic
Diabetes & Metabolic Syndrome: Clinical Research & Reviews
IV. Other Dosage of oral anti-diabetic drugs may need to be reduced.
2020-08-05 Rodríguez-González et al An approach to the photocatalytic mechanism in the TiO2-nanomaterials microorganism interface for the control of infectious processes
Applied Catalysis B: Environmental
IV. Other The authors consider the dermal, intravenous, oral and nasal interactions as human exposure pathways.

12 Use of AI in real-time health care delivery to evaluate interventions, risk factors, and outcomes in a way that could not be done manually.

12.0.0.1 Highlights

12.0.0.2 Articles

Date Authors Title LOE(?) & Sample Matches
2020 LU et al Clinical analysis of 2019 coronavirus disease (COVID-19) on one case with living-related kidney transplantation
Chinese Journal of Organ Transplantation
IV. Prevalence Study Method The clinical diagnosis and treatment of one relative renal transplant recipient after the occurrence of COVID-19 were analyzed retrospectively, including the course of onset, clinical manifestations, blood routine test, renal function, lung CT scan, nucleic acid detection, outpatient and inpatient therapies and outcomes.
2020 LEI et al Clinical characteristics of COVID-19 in pregnancy: analysis of nine cases
Chinese Journal of Perinatal Medicine
IV. Other Their clinical data, including epidemiological history, clinical symptoms, laboratory examinations, chest CT, treatment, delivery mode, and pregnancy outcomes, were analyzed retrospectively.
2020 Jiang et al The possibility of using Lopinave/Litonawe (LPV/r) as treatment for novel coronavirus (2019-nCov)pneumonia: a quick systematic review based on earlier coronavirus clinical studies
Chinese Journal of Emergency Medicine
I. Systematic Review

</p><p><b>Results</b>Two hundred and thirty potential article were found by screening, and narrow down to forty-four articles for evaluation and fnally four studies were included.
Two reviewers independently review articles and extract data on study design, patients, diagnosis criteria, regimen, and clinical outcomes (mortality, morbidity, quality of life, steroids dosage, chest image and adverse responses).
2020-02-01 Zhu et al Clinical analysis of 10 neonates born to mothers with 2019-nCoV pneumonia
Translational Pediatrics
IV. Other RESULTS: Among these 9 pregnant women with confirmed 2019-nCoV infection, onset of clinical symptoms occurred before delivery in 4 cases, on the day of delivery in 2 cases, and after delivery in 3 cases.
2020-02-12 Liu et al Neutrophil-to-Lymphocyte Ratio Predicts Severe Illness Patients with 2019 Novel Coronavirus in the Early Stage
medrxiv
III-3. Time Series Analysis

This study was a prospective single-center study, which included 61 patients with 2019-nCoV infection treated at Beijing Ditan Hospital from January 13, 2020 to January 31, 2020.
After admission, the patients were re-examined for laboratory indexes and imaging examination, and recorded symptoms and signs, treatments and outcome events.
2020-02-19 Liu et al Online mental health services in China during the COVID-19 outbreak
The Lancet Psychiatry
IV. Other In addition, several artificial intelligence (AI) programmes have been put in use as interventions for psychological crises during the epidemic.

In general, online mental health services being used for the COVID-19 epidemic are facilitating the development of Chinese public emergency interventions, and eventually could improve the quality and effectiveness of emergency interventions.
2020-02-19 Duan et al Psychological interventions for people affected by the COVID-19 epidemic
The Lancet Psychiatry
IV. Prevalence Study 7,8 Therefore, we should consider the disease course, severity of clinical symptoms, place of treatment (eg, isolated at home, ordinary isolation ward, intensive care unit), and other factors to classify individuals who need psychological intervention and to formulate specific measures to improve the effectiveness of these interventions.
2020-02-24 Gostic et al Estimated effectiveness of symptom and risk screening to prevent the spread of COVID-19
eLife
III-3. Time Series Analysis

Depending on the screening strategy (arrival, departure or both) and assumed subclinical fraction (5%, 25%, or 50%), the probability of detecting at least the first two cases ranged from 0.02 to 0.11, and the probability of detecting three or more cases was never better than 0.04 ( Figure 3C ).
those without symptoms or knowledge of their exposure), several factors could potentially strengthen the screening measures described here.
2020-02-24 Yang et al Clinical course and outcomes of critically ill patients with SARS-CoV-2 pneumonia in Wuhan, China: a single-centered, retrospective, observational study
The Lancet Respiratory Medicine
III-2. Retrospective Cohort

Findings Of 710 patients with SARS-CoV-2 pneumonia, 52 critically ill adult patients were included.
Demographic data, symptoms, laboratory values, comorbidities, treatments, and clinical outcomes were all collected.
2020-02-24 Rasmussen et al Coronavirus Disease 2019 (COVID-19) and Pregnancy: What obstetricians need to know
American Journal of Obstetrics and Gynecology
IV. Other Delivery and pregnancy termination decisions should be based on gestational age, maternal condition, and fetal stability, and maternal wishes.
2020-02-27 Fan et al Clinical Features of COVID-19 Related Liver Damage
medrxiv
IV. Other A total of 148 cases were analyzed for clinical features, laboratory parameters (including liver function tests), medications and the length of stay.
2020-02-29 chen et al Hypokalemia and Clinical Implications in Patients with Coronavirus Disease 2019 (COVID-19)
medrxiv
IV. Prevalence Study

During the study period, 175 patients with COVID-19 were included, consisting of 92 women and 83 men ( Table 1 ).
Only a small proportion of cases were used to evaluate the treatment outcomes.
2020-03-05 Johnson et al Potential scenarios for the progression of a COVID-19 epidemic in the European Union and the European Economic Area, March 2020
Euro Surveill
IV. Prevalence Study Public health bodies and research institutions should continue to work together to continuously evaluate the situation, to address knowledge gaps and to assess the effectiveness of targeted interventions with new tests, treatments and vaccines as they are developed.
2020-03-06 Jiang et al How does the outbreak of 2019-nCoV spread in mainland China? A retrospective analysis of the dynamic transmission routes
medrxiv
IV. Computer Model The resulting "road-map" can help policy-markers and public-health officers retrospectively evaluate both the effectiveness and unexpected outcomes of their interventions.
2020-03-06 Wang et al Evolving Epidemiology and Impact of Non-pharmaceutical Interventions on the Outbreak of Coronavirus Disease 2019 in Wuhan, China
medrxiv
IV. Prevalence Study Finally, the impact of the interventions should be considered as a whole and we could not evaluate individual strategies by the epidemic curve.
2020-03-06 Shen et al Quantitative computed tomography analysis for stratifying the severity of Coronavirus Disease 2019
Journal of Pharmaceutical Analysis
IV. Other The severity of pneumonia was evaluated by radiologists and the computer tool separately.
2020-03-08 Qiu et al Outcome reporting from protocols of clinical trials of Coronavirus Disease 2019 (COVID-19): a review
medrxiv
IV. Prevalence Study In the 17 outcome domains of protocols of western medicine clinical trials, 5 outcome domains (adverse events/effects, delivery of care, economic, metabolism and nutrition outcomes, mortality/survival) consisted of only one outcome.

27 outcomes were provided one or more outcome measurement instruments.

27 (27/76, 35.53%) outcomes were provided one or more outcome measurement instruments.

These outcomes are relevant to the prognosis of disease and safety of therapy.
2020-03-12 Qiu et al Ginkgo leaf extract and dipyridamole injection for chronic cor pulmonale: a PRISMA-compliant meta-analysis of randomized controlled trials
Biosci Rep
I. Systematic Review

After title and abstract review, 246 articles were further excluded because they were not clinical trials (n = 171) or were unrelated studies (n = 59) or were reviews and meta-analysis (n = 7) or were meeting abstracts and case report (n = 9), leaving 81 studies as potentially relevant.
One or more outcome measures, including the therapeutic effect, or hemorheology or blood gas indexes, or adverse events must be included in each study.
2020-03-13 Chen et al Clinical characteristics and intrauterine vertical transmission potential of COVID-19 infection in nine pregnant women: a retrospective review of medical records
The Lancet
IV. Other Third, the risk of infection in pregnant women and the effects of the time or mode of delivery on pregnancy outcomes were not evaluated.
2020-03-16 Jain et al Systematic review and meta-analysis of predictive symptoms and comorbidities for severe COVID-19 infection
medrxiv
I. Systematic Review

Results Of the 2259 studies identified, 42 were selected after title and abstract analysis, and 7 studies (including 1813 COVID−19 patients) were chosen for inclusion.
To aid clinical assessment, risk stratification, efficient resource allocation, and targeted public health interventions, future research must aim to further define those at high-risk of severe illness with COVID−19.
2020-03-20 Gautret et al Hydroxychloroquine and azithromycin as a treatment of COVID-19: results of an open-label non-randomized clinical trial
International Journal of Antimicrobial Agents
IV. Other As for each treatment, the cost benefits of the risk should be evaluated individually.
2020-03-20 GAUTRET et al Hydroxychloroquine and Azithromycin as a treatment of COVID-19: preliminary results of an open-label non-randomized clinical trial
medrxiv
IV. Other As for each treatment, the cost benefits of the risk should be evaluated individually.
2020-03-23 Jin et al Development and Evaluation of an AI System for COVID-19
medrxiv
III-3. Time Series Analysis

A large dataset was constructed by collecting 970 CT volumes of 496 patients with confirmed COVID-19 and 260 negative cases from three hospitals in Wuhan, China, and 1,125 negative cases from two publicly available chest CT datasets.
a. PR curves was employed to assess the AI system performance of COVID-19 diagnosis.
2020-03-23 Panahi et al Risks of Novel Coronavirus Disease (COVID-19) in Pregnancy; a Narrative Review
Arch Acad Emerg Med
IV. Other Out of the 37 studied mothers, 2 had clinical manifestations of COVID-19 during delivery, 2 showed symptoms after delivery and the rest of them had symptoms of COVID-19 during hospitalization and prenatal delivery.
2020-03-23 Fu et al Association between Clinical, Laboratory and CT Characteristics and RT-PCR Results in the Follow-up of COVID-19 patients
medrxiv
IV. Other In the future, more effort should be made to investigate virus retention, CT outcomes and the clinical prognosis of COVID-19.
2020-03-23 Lai et al Factors Associated With Mental Health Outcomes Among Health Care Workers Exposed to Coronavirus Disease 2019
JAMA Netw Open
III-2. Cross Sectional Control Factors Associated With Mental Health Outcomes Among Health Care Workers Exposed to Coronavirus Disease 2019

Multivariable logistic regression analysis was performed to identify factors associated with mental health outcomes.
2020-03-23 Bai et al Predicting COVID-19 malignant progression with AI techniques
medrxiv
IV. Prevalence Study

Methods: A total of 133 consecutively mild COVID-19 patients at admission who was hospitalized in Wuhan Pulmonary Hospital from January 3 to February 13, 2020, were selected in this retrospective IRB-approved study.
The age, sex, exposure, comorbidity, signs and symptoms, laboratory results measured at admission, and serial CT imaging features of patients with and without severe/critical progression were separately summarized in Tables 1, 2, and 3.
2020-03-24 Yu et al Clinical features and obstetric and neonatal outcomes of pregnant patients with COVID-19 in Wuhan, China: a retrospective, single-centre, descriptive study
The Lancet Infectious Diseases
IV. Other Clinical features, treatments, and maternal and fetal outcomes were assessed.
2020-03-24 Portnoy et al Telemedicine in the Era of COVID-19
The Journal of Allergy and Clinical Immunology: In Practice
IV. Other Individuals with these conditions are particularly susceptible to COVID-19, and medication compliance and disease optimization are important ways to mitigate severity.
2020-03-24 Luo et al Management of pregnant women infected with COVID-19
The Lancet Infectious Diseases
IV. Other Further research is needed to assess the risk and to produce guidelines for delivery times and methods in patients with COVID-19.
2020-03-25 Di Mascio et al Outcome of Coronavirus spectrum infections (SARS, MERS, COVID 1 -19) during pregnancy: a systematic review and meta-analysis
American Journal of Obstetrics & Gynecology MFM
I. Systematic Review

Results 19 studies including 79 women were eligible for this systematic review: 41 pregnancies (51.9%) affected by COVID-19, 12 (15.2%) by MERS, and 26 (32.9%) by SARS.
The pregnancy outcomes observed were: 135
2020-03-26 Rios et al Guidelines for preventing respiratory illness in older adults aged 60 years and above living in long-term care: A rapid review of clinical practice guidelines
medrxiv
IV. Prevalence Study

If one or more respiratory samples from ILI cases in a suspected outbreak returns a positive laboratory result for influenza, then an influenza outbreak is confirmed.
03 Although not regulatory in scope, these guidelines support infection prevention and control (IP&C) professionals, health care organizations and health care providers in developing, implementing and evaluating IP&C policies, procedures and programs to improve the quality and safety of health care and patient outcomes.
2020-03-26 Carico et al Community pharmacists and communication in the time of COVID-19: Applying the health belief model
Research in Social and Administrative Pharmacy
IV. Other The HBM has been used for decades to study vaccination, medication adherence, diabetes self-care, condom use, and other behaviors that require modification of a patient's actions to mitigate a threat to health.
2020-03-26 Tan et al Viral Kinetics and Antibody Responses in Patients with COVID-19
medrxiv
III-3. Time Series Analysis

A total of 1 260 samples from all 67 patients were collected, including 377 nasopharyngeal swab, 221 sputum, 220 stool, 231 urine and 211 plasma samples ( Table 2) .
The routes and duration of viral shedding, antibody response, and their associations with disease severity and clinical manifestations were systematically evaluated.
2020-03-26 Zhang et al Clinical characteristics of COVID-19-infected cancer patients: A retrospective case study in three hospitals within Wuhan, China
Annals of Oncology
III-2. Retrospective Cohort

Results 28 COVID-19-infected cancer patients were included; 17 (60.7%) patients were male.
Univariate and multivariate analyses were performed to assess the risk factors associated with severe events defined as a condition requiring admission to an intensive care unit, the use of mechanical ventilation, or death.
2020-03-27 Giovannoni et al The COVID-19 pandemic and the use of MS Disease-Modifying Therapies
Multiple Sclerosis and Related Disorders
IV. Prevalence Study

Reassuringly, five patients on natalizumab infected with dengue virus cleared the virus without complications similar to those on fingolimod (Fragoso et al., 2016b) .
This decision should be made according to individual factors such as disease severity and activity.
2020-03-27 Abraham et al Heart Failure Collaboratory Statement on Clinical Trials in the Landscape of COVID-19
JACC: Heart Failure
IV. Prevalence Study Statistical monitoring methods should be considered that can remotely evaluate trial safety and conduct.
2020-03-27 Alvarez et al Modeling COVID-19 epidemics in an Excel spreadsheet: Democratizing the access to first-hand accurate predictions of epidemic outbreaks
medrxiv
IV. Computer Model As previously stated, the use of simple/user-friendly models to 393 evaluate in (practically) real time the effectiveness of containment strategies or programs 394 may be a powerful tool for analyzing and facing epidemic events 6,12 .
2020-03-27 Wenbao et al Transmission dynamics of SARS-COV-2 in China: impact of public health interventions
medrxiv
IV. Other However, the impact of the public health interventions in China needs to be evaluated.
2020-03-30 Fan et al Medical treatment of 55 patients with COVID-19 from seven cities in northeast China who fully recovered: a single-center, retrospective, observational study
medrxiv
IV. Other Demographic information, symptoms, laboratory indicators, treatment processes, and clinical outcomes were collected.
2020-03-30 Xie et al Development and external validation of a prognostic multivariable model on admission for hospitalized patients with COVID-19
medrxiv
III-2. Retrospective Cohort

Second cohort of 151 patients admitted to Jinyintan hospital who were included in a previous study were reused for model validation.
Nine variables commonly measured in these acute settings were considered for model development, including age, biomarkers and comorbidities.
2020-03-30 Wang et al Coronavirus Disease 2019 in elderly patients: characteristics and prognostic factors based on 4-week follow-up
Journal of Infection
IV. Prevalence Study

Of the included 339 patients, lymphocytopenia were found in 211 cases (63.2%).
Data of demographics, clinical features, comorbidities, laboratory tests and complications were collected and compared for different outcomes.
2020-03-30 Ding et al A Multi-hospital Study in Wuhan, China:Protective Effects of Non-menopause and Female Hormones on SARS-CoV-2 infection
medrxiv
III-3. Time Series Analysis

To determine the correlation between menstruation and disease progression, 435 patients who offered their complete menstruation history were included.
Sex differences in severity and composite endpoints (admission to intensive care unit (ICU), use of mechanical ventilation, or death) of COVID-19 patients were compared.
2020-04-01 Pourhomayoun et al Predicting Mortality Risk in Patients with COVID-19 Using Artificial Intelligence to Help Medical Decision-Making
medrxiv
IV. Prevalence Study

In this study, we used documented data of 117,000 patients world-wide with laboratory-confirmed COVID-19.
Artificial Intelligence (AI) has been shown to be an effective tool in predicting medical conditions and adverse events, and help caregivers with medical decision-making - .
2020-07-31 Lippi et al Thrombocytopenia is associated with severe coronavirus disease 2019 (COVID-19) infections: A meta-analysis
Clinica Chimica Acta
I. Systematic Review

The clinical severity was defined as the composite of ICU admission, use of mechanical ventilation or death in two studies , ICU admission in two studies , progression towards ARDS in one study , death in three studies , and need of mechanical ventilation in the remaining study .
In order to optimize patient care and resource allocation during this pandemic, biomarkers are urgently needed for stratifying patients' risk and for actively monitoring illness severity.

13 Best practices and critical challenges and innovative solutions and technologies in hospital flow and organization, workforce protection, workforce allocation, community-based support resources, payment, and supply chain management to enhance capacity, efficiency, and outcomes.

13.0.0.1 Highlights

13.0.0.2 Articles

Date Authors Title LOE(?) & Sample Matches
2020-02-14 Di Marco et al Opinion: Sustainable development must account for pandemic risk
Proceedings of the National Academy of Sciences
IV. Prevalence Study The targeting and harming of healthcare workers, treatment centers, and critical infrastructure (e.g., the power supply) has decreased populationlevel effectiveness of containment measures .
2020-02-19 Duan et al Psychological interventions for people affected by the COVID-19 epidemic
The Lancet Psychiatry
IV. Prevalence Study This situation can be resolved by improving relevant policies, strengthening personnel training, optimising organisational and management policies, and constantly reviewing experiences in practice.
2020-02-29 Lee et al Wuhan novel coronavirus (COVID-19): why global control is challenging?
Public Health
IV. Other 12 Disinvestment in health protection is risky as it is not easy to build up health protection infrastructure, skills, and workforce rapidly.

Unfortunately, in resource-constrained settings, investment in this critical health protection infrastructure is a low priority compared with other health priorities.
2020-03-10 O’Connell et al The impact of point-of-care testing for influenza A and B on patient flow and management in a medical assessment unit of a general hospital
BMC Res Notes
III-3. Time Series Analysis

RESULTS: The results of the correlation study with a cohort of 54 patients revealed the Abbott ID NOW POCT has 92% sensitivity for the detection of Influenza A, while specificity was 100% for both Influenza A and B.
OBJECTIVES: Timely implementation of influenza infection control and treatment can significantly reduce the impact on Hospital resources and patient management when demand is at peak.
2020-03-10 Chan et al Research Frontiers of Health Emergency and Disaster Risk Management: What Do We Know So Far?
Int J Environ Res Public Health
IV. Prevalence Study highlighted the development need for relevant research methodologies, risk communication approaches, health data management strategies, practical health emergency study ethical guidelines, bridging global research capacity disparities, and infrastructure constraints, to ensure knowledge advancement in Health-EDRM.

Existing surveillance databases, new study tools, and innovation methodologies may help to identify population health risks and support Health-EDRM policy development.
2020-03-11 Wong et al Preparing for a COVID-19 pandemic: a review of operating room outbreak response measures in a large tertiary hospital in Singapore
Canadian Journal of Anesthesia/Journal canadien d'anesthésie
IV. Other To prepare for a pandemic, hospitals need a strategy to manage their space, staff, and supplies so that optimum care is provided to patients.
2020-03-12 Wang et al Effects of Chinese strategies for controlling the diffusion and deterioration of novel coronavirus-infected pneumonia in China
medrxiv
IV. Computer Model These strategies supply experience and guidelines for other countries to control the COVID-19 epidemic.
2020-03-13 Lei et al Protocol of a randomized controlled trial testing inhaled Nitric Oxide in mechanically ventilated patients with severe acute respiratory syndrome in COVID-19 (SARS-CoV-2).
medrxiv
II. Randomized Controlled Trial The combined effect of the high transmission and the reported high incidence of severe disease in symptomatic patients poses a threat to healthcare systems involved in the outbreaks in different ways, including: cumulative casualties, increased need for hospital and ICU beds causing work overload for all the healthcare staff and often forcing hospitals to shut down all elective surgical activity; high social and economic costs, dramatically reduction of the productivity by the rigorous quarantine requirements and strategies for curtailing disease spreading, which made economic pain that disrupt supply chains and stock markets .
2020-03-13 Remuzzi et al COVID-19 and Italy: what next?
The Lancet
IV. Other Our analysis might help political leaders and health authorities to allocate enough resources, including personnel, beds, and intensive care facilities, to manage the situation in the next few days and weeks.
2020-03-15 Xiang et al The COVID-19 outbreak and psychiatric hospitals in China: managing challenges through mental health service reform
Int J Biol Sci
IV. Other In addressing these challenges, future community mental health system reform is necessary to re-balance the system by re-distributing resources from hospital-centric services to community-based and primary care services.

Clearly, preventive measures such as the provision of adequate medical supplies and protective equipment, public education on the risks of COVID-19 for hospital staff and patients, and restricting family visits to hospitals, are essential to reduce the likelihood of disease transmission in major psychiatric hospitals.

In order to establish community-based mental health services nationwide, this project integrated the resources in psychiatric hospitals and existing community psychiatric services and trained mental health professionals in the development of individual service plans .
2020-03-17 Bedford et al COVID-19: towards controlling of a pandemic
The Lancet
IV. Other Activities to accomplish these goals vary and are based on national risk assessments that many times include estimated numbers of patients requiring hospitalisation and availability of hospital beds and ventilation support.
2020-03-18 Kandel et al Health security capacities in the context of COVID-19 outbreak: an analysis of International Health Regulations annual report data from 182 countries
The Lancet
IV. Prevalence Study 30 An effec tive response to an outbreak depends not only on the availability of adequate human resources and financing, but also on the ability to manage emergency logistics (including the handling of supply chains for essential products that are required during an emergency).

Enabling function index C1.3-financing mechanism and funds for timely response to public health emergencies Availability and accessibility of financing mechanisms is essential for prevention, detection, and control of infectious disease outbreaks.
2020-03-18 Legido-Quigley et al The resilience of the Spanish health system against the COVID-19 pandemic
The Lancet Public Health
IV. Other Second, long-term underinvestment in health services, as seen in many countries following the 2008 financial crisis, impairs their resilience by depleting their ability to respond to surges in need for health care with sufficient health professionals, intensive care unit beds, protective equipment, diagnostic test kits, and mechanical ventilators.

First, additional financial resources are needed to support regional health systems, each with different initial resources and current challenges.
2020-03-19 Zhao et al A systematic approach is needed to contain COVID-19 globally
Science Bulletin
IV. Prevalence Study Secondly, governments of countries need to strive for a unified and equitable allocation of resources and to improve the efficiency of resource distribution through coordinated management.
2020-03-19 Tolksdorf et al Influenza-associated pneumonia as reference to assess seriousness of coronavirus disease (COVID-19)
Euro Surveill
IV. Prevalence Study

described clinical courses and outcomes of 52 critically ill patients in a hospital in Wuhan .
Hospitals should prepare for high utilisation of ventilation and intensive care resources.

This can only be implemented if hospitals prepare for high utilisation of ventilation and intensive care resources.
2020-03-20 Matthay et al Treatment for severe acute respiratory distress syndrome from COVID-19
The Lancet Respiratory Medicine
III-2. Cross Sectional Control The authors describe pragmatic approaches to the challenges of delivering ECMO to patients with COVID-19, including training health-care personnel, resolving equipment and facilities issues, implementing systems for infection control and personal protection, providing overall support for health-care staff, and mitigating ethical issues.
2020-03-20 Ramanathan et al 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
IV. Prevalence Study Hospital operations teams and regional tracking of disposables can help with the distribution of these supplies on the basis of need.

Operators should be familiar with the ECMO cannula sizes and dilators and be able to deal with cannulation complications while wearing PPE Developing organisations that support systems, equipment, facilities, and personnel is crucial to ensure optimal patient care, as well as family and staff safety during outbreaks of emerging infectious diseases.
2020-03-23 Milne et al The Effectiveness of Social Distancing in Mitigating COVID-19 Spread: a modelling analysis
medrxiv
IV. Other This approach aims to lessen the daily pressure on health care personnel and hospital facilities, such as intensive care beds, and to lower mortality rates.
2020-03-23 Vu et al Financing Vaccines for Global Health Security
medrxiv
IV. Prevalence Study We have sized the financing deficit for this portfolio and propose several potential solutions, including price increases, enhanced public-private partnerships, and subscription models through which individuals would pay annual fees to obtain access to a portfolio of vaccines in the event of an outbreak.

The cost and risk of R&D programs and uniquely unpredictable demand for EID vaccines have discouraged vaccine developers, and government and nonprofit agencies have been unable to provide timely or sufficient incentives for their development and sustained supply.
2020-03-24 Simcock et al COVID-19: Global Radiation Oncology’s Targeted Response for Pandemic Preparedness
Clinical and Translational Radiation Oncology
IV. Prevalence Study

During the weekend over 121 individuals from 17 countries and 6 continents contributed to the online discussion.
Departments need contingency planning to create capacity and continue essential treatments despite a reduced workforce.
2020-03-24 Hoe GAN et al Preventing intra-hospital infection and transmission of COVID-19 in healthcare workers
Safety and Health at Work
IV. Other In a public health crisis, there is global demand for PPE resources but often insufficient supplies, as is the case for COVID-19 .
2020-03-24 Haines et al National UK programme of community health workers for COVID-19 response
The Lancet
IV. Other 6 For a future scaled workforce, there will be financial implications, but the costs should be affordable.
2020-03-26 Zheng et al Recommendations and guidance for providing pharmaceutical care services during COVID-19 pandemic: A China perspective
Research in Social and Administrative Pharmacy
IV. Other During the pandemic, the public mostly rely on community pharmacies to get adequate supply of supply the demand", as suggested in FIP's "Information and interim guidelines for pharmacists 130 and the pharmacy workforce" for COVID-19 outbreak .

Results Community pharmacy management teams shall support PC services by providing adequate supply of COVID-19 related medications and preventative products, following environment regulations, and providing sufficient staff trainings.
2020-03-26 Rios et al Guidelines for preventing respiratory illness in older adults aged 60 years and above living in long-term care: A rapid review of clinical practice guidelines
medrxiv
IV. Prevalence Study

If one or more respiratory samples from ILI cases in a suspected outbreak returns a positive laboratory result for influenza, then an influenza outbreak is confirmed.
03 Although not regulatory in scope, these guidelines support infection prevention and control (IP&C) professionals, health care organizations and health care providers in developing, implementing and evaluating IP&C policies, procedures and programs to improve the quality and safety of health care and patient outcomes.

Manitoba Health Seniors and Active Living, 2019; Country: Canada, Sponsor: Not reported Scope: these guidelines support infection prevention and control (IP&C) professionals, health care organizations and health care providers in developing, implementing and evaluating IP&C policies, procedures and programs to improve the quality and safety of health care and patient outcomes Active surveillance for additional cases should be implemented as soon as possible when one healthcare-associated laboratoryconfirmed influenza case is identified in a hospital or one case of laboratory-confirmed influenza is identified in a long-term care facility (A-III).
2020-03-27 Christian et al COVID-19 in Canada: Predictions for the future and control lessons from Asia
medrxiv
IV. Other These numbers will pose significant threats to ICU bed capacity, and the ability of hospitals to provide front-line medical staff with maximum personal protective equipment (PPE).
2020-03-30 Murray et al Forecasting COVID-19 impact on hospital bed-days, ICU-days, ventilator-days and deaths by US state in the next 4 months
medrxiv
IV. Computer Model Design, Setting, and Participants: This study used data on confirmed COVID-19 deaths by day from WHO websites and local and national governments; data on hospital capacity and utilization for US states; and observed COVID-19 utilization data from select locations to develop a statistical model forecasting deaths and hospital utilization against capacity by state for the US over the next 4 months.
2020-03-30 Ross et al Maximizing the Calm Before the Storm: Tiered Surgical Response Plan for Novel Coronavirus (COVID-19)
Journal of the American College of Surgeons
III-2. Cross Sectional Control

Utilizing these methods, in the first week of implementation, out of 21 scheduled ACS clinic patients, we have already identified 19 patients able to be managed by virtual or telephone visits (91% reduction in clinic visit exposure).
Optimal disaster response necessitates knowledge, preparedness and coordination to ensure adequate resource availability and allocation.
2020-03-30 Thomas et al Physiotherapy management for COVID-19 in the acute hospital setting: clinical practice recommendations
Journal of Physiotherapy
IV. Prevalence Study

12 In adult patients with COVID-19 and severe ARDS, prone ventilation for 12 to 16 hours per day is recommended.
Workforce planning should include consideration for pandemic-specific requirements such as additional workload from donning and doffing PPE, and the need to allocate staff to key non-clinical duties such as enforcing infection control procedures.
2020-03-31 Cadogan et al On the frontline against COVID-19: Community pharmacists’ contribution during a public health crisis
Research in Social and Administrative Pharmacy
IV. Prevalence Study In addition to protecting continuity of medication supply at the community pharmacy level, it is equally important that patients maintain adherence to their current medication regimens in order to prevent any deterioration in their current health status that could ultimately place additional demand on currently overburdened health services.
2020-03-31 Adams et al Goals of Care in a Pandemic: Our Experience and Recommendations
Journal of Pain and Symptom Management
IV. Other Palliative teams should continuously monitor need and develop a surge plan for staffing and prioritization which might include utilizing outpatient and community providers and creating a plan for 24/7 accessibility.
2020-03-31 Fausto et al Creating a Palliative Care Inpatient Response Plan for COVID19 – The UW Medicine Experience
Journal of Pain and Symptom Management
IV. Other The strategy was developed by our palliative care programs with input from the healthcare system leadership.
2020-03-31 Calton et al Telemedicine in the Time of Coronavirus
Journal of Pain and Symptom Management
IV. Other Next steps include ensuring equitable access to affordable telemedicine technology for vulnerable populations through creative solutions and financing, and dedicated attention to telemedicine evaluation and quality improvement.
2020-04-01 Lakkireddy et al Guidance for Cardiac Electrophysiology During the Coronavirus (COVID-19) Pandemic from the Heart Rhythm Society COVID-19 Task Force; Electrophysiology Section of the American College of Cardiology; and the Electrocardiography and Arrhythmias Committee of the Council on Clinical Cardiology, American Heart Association
Heart Rhythm
IV. Prevalence Study Recommendations related to PPE may continue to change based on supply chain, contingency and/or crisis capacity status.
2020-04-01 Shayak et al Transmission Dynamics of COVID-19 and Impact on Public Health Policy
medrxiv
IV. Computer Model For impactful epidemic management, societies need to model their strategies, develop an advanced surveillance system for early detection of cases, facilitate implementation of preventive interventions, and enable effective coordination of healthcare professionals, public health authorities, policy makers and government.
2020-04-01 Castro et al Demand for hospitalization services for COVID-19 patients in Brazil
medrxiv
IV. Other This 30 suggests that solutions adopted by the Brazilian government must aim at expanding the available 31 capacity (e.g., makeshift hospitals), and not simply prioritizing the allocation of available 32 We conducted forward simulations of the demand for hospital beds, ICU beds, and mechanical 77 ventilators by health macro-region in Brazil.
2020-04-01 Abhari et al COVID-19 Epidemic in Switzerland: Growth Prediction and Containment Strategy Using Artificial Intelligence and Big Data
medrxiv
IV. Other The primary goal of public authorities is to manage the outbreak so as to avoid overwhelming the health care system, in addition to buy time in order to bring online more capacity and resources that can handle the current and potential future peaks in the demand for emergency services.
2020-04-15 Musazzi et al New regulatory strategies to manage medicines shortages in Europe
International Journal of Pharmaceutics
IV. Prevalence Study These strategies permit to improve MAH sustainability and to ensure a proper supply for the patient demand.
2020-04-30 Kapata et al Is Africa prepared for tackling the COVID-19 (SARS-CoV-2) epidemic. Lessons from past outbreaks, ongoing pan-African public health efforts, and implications for the future
International Journal of Infectious Diseases
IV. Other Increased governmental and donor investments are required to advance locally led, world-class public health work with surveillance, data and analytics capabilities and further expanding state-of-the-art laboratory capacities with more J o u r n a l P r e -p r o o f trained personnel to sustain capacity to rapidly respond to outbreaks at their source.
2020-07-31 Artika et al Pathogenic viruses: Molecular detection and characterization
Infection, Genetics and Evolution
IV. Prevalence Study The program might cover improving laboratory facilities, ensuring availability of required equipment, building human resource capacity and ensuring quality laboratory management.

14 Efforts to define the natural history of disease to inform clinical care, public health interventions, infection prevention control, transmission, and clinical trials

14.0.0.1 Highlights

14.0.0.2 Articles

Date Authors Title LOE(?) & Sample Matches
2020 Keshavarz et al Novel Coronavirus Disease 2019 (COVID-19): An Emerging Infectious Disease in the 21st Century
Iranian South Medical Journal
IV. Other We extracted data on the epidemiology, pathogenesis, virology, clinical manifestations, transmission routes, diagnosis, treatment, and prevention measures.
2020 Kui et al Clinical characteristics of novel coronavirus cases in tertiary hospitals in Hubei Province
Chin Med J (Engl)
IV. Prevalence Study

In addition, none of the 137 patients included in this study had a clear history of exposure to Wuhan Huanan Seafood Wholesale Market, suggesting that the virus is capable of secondary or tertiary transmission.
This study aims to investigate its epidemiologic history, and analyzed the clinical characteristics, treatment regimens, and prognosis of patients infected with 2019-nCoV during this outbreak.
2020 LEI et al Clinical characteristics of COVID-19 in pregnancy: analysis of nine cases
Chinese Journal of Perinatal Medicine
IV. Other Their clinical data, including epidemiological history, clinical symptoms, laboratory examinations, chest CT, treatment, delivery mode, and pregnancy outcomes, were analyzed retrospectively.
2020 Schwartz et al Potential Maternal and Infant Outcomes from (Wuhan) Coronavirus 2019-nCoV Infecting Pregnant Women: Lessons from SARS, MERS, and Other Human Coronavirus Infections
Viruses
IV. Prevalence Study

A case-control study to determine the effects of SARS on pregnancy compared 10 pregnant and 40 non-pregnant women with the infection at the Princess Margaret Hospital in Hong Kong .
Recommendations are also made for the consideration of pregnant women in the design, clinical trials, and implementation of future 2019-nCoV vaccines.
2020 XU et al Advices on the prevention and control of nosocomial infection of novel coronavirus within children’s hospitals
Chinese Journal of Hospital Administration
IV. Other These measures are proposed to provide a guidance for the prevention and control of 2019-nCoV nosocomial infection in the pediatric outpatient and ward.
2020-01-26 Liu et al Time-varying transmission dynamics of Novel Coronavirus Pneumonia in China
biorxiv
III-3. Time Series Analysis

We estimated the doubling time, basic reproduction number (R0) and time-varying reproduction number (Rt) of NCP and SARS.Measurements and main resultsAs of February 7, 2020, 34,598 NCP cases were identified in China, and daily confirmed cases decreased after February 4.
Our findings are critical to optimize prevention and control measures during the ongoing epidemic of NCP, as well as guide clinical management.
2020-02-03 Early Epidemiological and Clinical Characteristics of 28 Cases of Coronavirus Disease in South Korea
Osong Public Health Res Perspect
IV. Prevalence Study

RESULTS: There were 16 patients that entered Korea from foreign countries: Wuhan, China (11 patients), Zhuhai, China, (1 patient), Singapore (2 patients), Japan (1 patient), and Thailand (1 patient).
The epidemiological and clinical characteristics of all 28 cases were analyzed in response to this disease.
2020-02-05 He et al Integrative Bioinformatics Analysis Provides Insight into the Molecular Mechanisms of 2019-nCoV
medrxiv
IV. Other These results may help us understand the pathogenesis and design therapeutic strategies for 2019-nCoV.
2020-02-07 Patel et al Initial Public Health Response and Interim Clinical Guidance for the 2019 Novel Coronavirus Outbreak — United States, December 31, 2019–February 4, 2020
MMWR Morb Mortal Wkly Rep
IV. Other Information learned from these investigations will help inform response actions.
2020-02-13 Zhao et al Epidemic size of novel coronavirus-infected pneumonia in the Epicenter Wuhan: using data of five-countries' evacuation action
medrxiv
I. Systematic Review Chinese health authorities did an immediate investigation to characterize and control the disease, including isolation of suspected cases, monitoring of close contacts, collection of epidemiological and clinical data from confirmed patients, and development of diagnostic and treatment procedures .
2020-02-19 Klepac et al Contacts in context: large-scale setting-specific social mixing matrices from the BBC Pandemic project
medrxiv
IV. Prevalence Study

The main dataset used in this study consisted of 36,155 participants reporting 378,559 contacts.
These data have been 1 widely used to understand the epidemiology of infectious diseases and inform policy-relevant disease modelling .
2020-02-21 Heymann et al Data sharing and outbreaks: best practice exemplified
The Lancet
IV. Other Chinese health authorities did an immediate investigation to characterise and control the disease, including isolation of people suspected to have the disease, close monitoring of contacts, epidemiological and clinical data collection from patients, and development of diagnostic and treatment procedures.

This information includes routes of transmission and transmissibility, the natural history of infection in humans, the populations at risk, the successful clinical practices that are being used to manage patients, the laboratory information needed to diagnose patients, and the genetic sequence information used to assess viral stability.
2020-02-23 Lu et al A descriptive study of the impact of diseases control and prevention on the epidemics dynamics and clinical features of SARS-CoV-2 outbreak in Shanghai, lessons learned for metropolis epidemics prevention
medrxiv
III-3. Time Series Analysis

The study was approved by SHPHC ethics committee and oral consent was obtained from 110 patients.
Main outcome measure: Prevention and control measures taken by Shanghai government, epidemiological, demographic, clinical, laboratory and radiology data were collected.
2020-02-27 Peng et al Outbreak of a new coronavirus: what anaesthetists should know
British Journal of Anaesthesia
IV. Prevalence Study

The median age of infected individuals is between 49 and 56 yr. 1 13 Children are rarely diagnosed with 2019-nCoV, a phenomenon that has not yet been explained.
Hospital infection prevention and control programmes aid with case identification through screening and testing, and they execute isolation infection prevention measures to ensure healthcare settings are safe from infection transmission.
2020-02-27 Al-Tawfiq et al Asymptomatic coronavirus infection: MERS-CoV and SARS-CoV-2 (COVID-19)
Travel Medicine and Infectious Disease
IV. Other Such studies will enhance the understanding of the pathogenesis of these emerging viruses and will inform policy makers to make scientifically sound recommendations.
2020-03-03 Yang et al The deadly coronaviruses: The 2003 SARS pandemic and the 2020 novel coronavirus epidemic in China
Journal of Autoimmunity
IV. Prevalence Study

In Wang's study , of the 36 patients in the ICU, four patients received high-flow oxygen therapy, 15 patients received non-invasive ventilation, and 17 patients received invasive ventilation (four patients switched to ECMO).
The other aim is to review the epidemiology, pathogenesis, clinical characteristics, diagnosis and management of patients infected with SARS-CoV-2 to better understand this deadly coronavirus and suggest prevention, treatment and management strategies.
2020-03-03 Qi et al Epidemiological and clinical features of 2019-nCoV acute respiratory disease cases in Chongqing municipality, China: a retrospective, descriptive, multiple-center study
medrxiv
IV. Prevalence Study

Methods:In this retrospective, descriptive, multiple-center study, total of 267 patients with COVID-19 confirmed by real-time RT-PCR in Chongqing from Jan 19 to Feb 16, 2020 were recruited.
The epidemiological, demographic, clinical, laboratory, radiological, treatment and outcomes data from confirmed COVID-19 patients' medical and nursing records were obtained and analyzed.
2020-03-05 Spiteri et al First cases of coronavirus disease 2019 (COVID-19) in the WHO European Region, 24 January to 21 February 2020
Euro Surveill
IV. Prevalence Study The surveillance objectives were to: describe the key epidemiological and clinical characteristics of COVID-19 cases detected in Europe; inform country preparedness; and improve further case detection and management.
2020-03-06 Baker et al Estimating the burden of United States workers exposed to infection or disease: a key factor in containing risk of COVID-19 infection
medrxiv
IV. Other Understanding which occupational groups are exposed to infection and disease in the workplace can help to inform public health risk response and management for COVID-19, and subsequent infectious disease outbreaks.
2020-03-06 Rudman et al Active Monitoring of Persons Exposed to Patients with Confirmed COVID-19 — United States, January–February 2020
MMWR. Morbidity and Mortality Weekly Report
IV. Other The aims of these efforts were to ensure rapid evaluation and care of patients, limit further transmission, and better understand risk factors for transmission.
2020-03-08 Ganyani et al Estimating the generation interval for COVID-19 based on symptom onset data
medrxiv
IV. Other In order to plan intervention strategies aimed at bringing disease outbreaks such as the COVID-19 outbreak under control as well as to monitor disease outbreaks, public health officials depend on insights about key disease transmission parameters which are typically obtained from mathematical or statistical modelling.
2020-03-10 Cortegiani et al A systematic review on the efficacy and safety of chloroquine for the treatment of COVID-19
Journal of Critical Care
I. Systematic Review

Results We included six articles (one narrative letter, one in-vitro study, one editorial, expert consensus paper, two national guideline documents) and 23 ongoing clinical trials in China.
Meanwhile, the recommendations for "Clinical management of severe acute respiratory infection when novel coronavirus (2019-nCoV) infection is suspected", published by the WHO, confirm that there is currently no evidence from RCTs to inform on specific drug treatment of COVID-19 and that unlicensed treatments should be administered only in the context of ethically-approved clinical trials or the Monitored Emergency Use of Unregistered Interventions Framework (MEURI), under strict monitoring .
2020-03-12 Kujawski et al First 12 patients with coronavirus disease 2019 (COVID-19) in the United States
medrxiv
IV. Prevalence Study

Five patients received only outpatient care and were isolated at home (Patients 1-5), and seven were hospitalized (Patients 6-12) ( Figure 1 ).
Further investigations are needed to understand clinical course, immunologic response, SARS-CoV-2 RNA detection, virus culture, and transmission, to inform clinical management and public health strategies to prevent disease spread.

Specimen collection is ongoing to inform both clinical management and infection prevention and control practices, and findings will be updated as more information becomes available.
2020-03-12 Zhang et al Fecal specimen diagnosis 2019 Novel Coronavirus-Infected Pneumonia
Journal of Medical Virology
IV. Other These results may help to understand the clinical diagnosis and the changes of clinical parameters of COVID-19.
2020-03-12 Liu et al Patients of COVID-19 may benefit from sustained lopinavir-combined regimen and the increase of eosinophil may predict the outcome of COVID-19 progression
International Journal of Infectious Diseases
IV. Other Abstract Objectives To explore the epidemiological information, clinical characteristics, therapeutic outcomes and temporal progression of laboratory findings in 2019-coronavirus disease (COVID-19) patients exposed to lopinavir.
2020-03-13 Wu et al Risk Factors Associated With Acute Respiratory Distress Syndrome and Death in Patients With Coronavirus Disease 2019 Pneumonia in Wuhan, China
JAMA Internal Medicine
III-2. Retrospective Cohort

Design, Setting, and Participants Retrospective cohort study of 201 patients with confirmed COVID-19 pneumonia admitted to Wuhan Jinyintan Hospital in China between December 25, 2019, and January 26, 2020.
Epidemiological, demographic, clinical, laboratory, management, treatment, and outcome data were also collected and analyzed.
2020-03-16 Jain et al Systematic review and meta-analysis of predictive symptoms and comorbidities for severe COVID-19 infection
medrxiv
I. Systematic Review

Results Of the 2259 studies identified, 42 were selected after title and abstract analysis, and 7 studies (including 1813 COVID−19 patients) were chosen for inclusion.
To aid clinical assessment, risk stratification, efficient resource allocation, and targeted public health interventions, future research must aim to further define those at high-risk of severe illness with COVID−19.
2020-03-16 Liu et al Active or latent tuberculosis increases susceptibility to COVID-19 and disease severity
medrxiv
IV. Prevalence Study

Among the 36 confirmed COVID-19 patients from Shenyang, Liaoning province, China, included in this study, the most common symptoms at presentation were cough (61.11%), dyspnea (33.33%), .
Main Outcome and Measures: Epidemiological, demographic, clinical, radiological, and laboratory data were collected.
2020-03-17 Bedford et al COVID-19: towards controlling of a pandemic
The Lancet
IV. Other Comparative analysis of different quarantine strategies and contexts for their effectiveness and social acceptability Enhance and develop an ethical framework for outbreak response that includes better equity for access to interventions for all countries Promote the development of point-of-care diagnostic tests Determine the best ways to apply knowledge about infection prevention and control in health-care settings in resource-constrained countries (including identification of optimal personal protective equipment) and in the broader community, specifically to understand behaviour among different vulnerable groups Support standardised, best evidence-based approach for clinical management and better outcomes and implement randomised, controlled trials for therapeutics and vaccines as promising agents emerge Validation of existing serological tests, including those that have been developed by commercial entities, and establishment of biobanks and serum panels of well characterised COVID-19 sera to support such efforts Complete work on animal models for vaccine and therapeutic research and development include some identified by the global community and by the Research and Development Blueprint Scientific Advisory Group.
2020-03-18 Dhama et al COVID-19, an emerging coronavirus infection: advances and prospects in designing and developing vaccines, immunotherapeutics, and therapeutics
Hum Vaccin Immunother
IV. Other The main measure in clinical management is focused on alleviating clinical symptoms and supportive care.

Although research is in progress to improve prevention, treatment, and control of COVID-19, the documented clinical data on different therapeutic approaches for CoVs are scarce.
2020-03-18 Jin et al Core Outcome Set for Clinical Trials on Coronavirus Disease 2019 (COS-COVID)
Engineering
IV. Prevalence Study

The consensus meeting was held on 24 February 2020, and involved 20 participants.
The clinical efficacy and safety evaluation of medical interventions are usually based on the measurement and analysis of certain clinical outcomes.
2020-03-20 Solaimanzadeh et al Acetazolamide, Nifedipine and Phosphodiesterase Inhibitors: Rationale for Their Utilization as Adjunctive Countermeasures in the Treatment of Coronavirus Disease 2019 (COVID-19)
PMC
IV. Other Matching clinical dispositions can be considered in efforts to develop therapeutic interventions.
2020-03-20 song et al Advance of Novel Coronavirus Registration Clinical Trial
medrxiv
IV. Prevalence Study These results imply that different interventions have an impact on the design of clinical trials.
2020-03-20 Belhadi et al A brief review of antiviral drugs evaluated in registered clinical trials for COVID-19
medrxiv
II. Randomized Controlled Trial

Phase IV trials were the most commonly reported study type (n=27, 23%).
These results might inform the adaptation of existing clinical trials and the development of additional trials.

The results will inform about the antiviral agents that are used, their dosing and duration, the inclusion and exclusion criteria for patients, the outcomes that will be evaluated, as well as the design of the clinical trials.
2020-03-23 Tian et al Clinical characteristics and reasons of different duration from onset to release from quarantine for patients with COVID-19 Outside Hubei province, China.
medrxiv
IV. Other Methods: 37 cases diagnosed adult COVID-19 cases of general characteristics, history of epidemiology, chronic underlying diseases,clinical symptoms and complications, chest CT, biochemical monitoring, severity assessment, treatment and outcome were retrospectively analyzed, and according to the duration from onset to release from quarantine were divided into 20-day group and > 20-day group, compare the similarities and differences between the two groups.
2020-03-23 Wang et al Effectiveness and cost-effectiveness of public health measures to control COVID-19: a modelling study
medrxiv
IV. Prevalence Study Our study provided the assessment of different measures to control community transmission of COVID-19.
2020-03-26 Rios et al Guidelines for preventing respiratory illness in older adults aged 60 years and above living in long-term care: A rapid review of clinical practice guidelines
medrxiv
IV. Prevalence Study

If one or more respiratory samples from ILI cases in a suspected outbreak returns a positive laboratory result for influenza, then an influenza outbreak is confirmed.
03 Although not regulatory in scope, these guidelines support infection prevention and control (IP&C) professionals, health care organizations and health care providers in developing, implementing and evaluating IP&C policies, procedures and programs to improve the quality and safety of health care and patient outcomes.
2020-03-27 Pinto et al ACE2 Expression is Increased in the Lungs of Patients with Comorbidities Associated with Severe COVID-19
medrxiv
IV. Other A better understanding of the link between these conditions and COVID-19 infection is required to inform better treatment and prevention interventions.
2020-03-27 Qiu et al Core Outcome Set for Traditional Chinese and Western Medicine Clinical Trials of COVID-19
medrxiv
IV. Prevalence Study 76 outcomes were identified from TCM clinical trials, 126 outcomes were identified from Western medicine clinical trials.
2020-03-27 Lescure et al Clinical and virological data of the first cases of COVID-19 in Europe: a case series
The Lancet Infectious Diseases
III-3. Time Series Analysis

11 The five patients in this case series, at different stages of infection, include two patients with a mild disease at admission and a secondary worsening that resulted in their admission to an intensive care unit (ICU), one initially severely ill patient directly admitted to an ICU for an acute respiratory failure, and two patients with a mild disease diagnosed very early after infection.
These findings will contribute to better understanding of the natural history of the disease and in tailoring treatment strategies.
2020-03-27 Joynt et al Understanding COVID-19: what does viral RNA load really mean?
The Lancet Infectious Diseases
IV. Other In a pandemic, prevention of disease transmission is key.
2020-03-30 Kapoor et al Role of Chloroquine and Hydroxychloroquine in the Treatment of COVID-19 Infection- A Systematic Literature Review
medrxiv
I. Systematic Review

Results: We included 19 publications (Five published articles, three letters/correspondence, one commentary, five pre-proofs of accepted articles, one abstract of yet to be published article, and four were pre-prints (not yet peer-reviewed) articles) in this systematic review.
In order to death with the health emergency create by COVID-19, the national administration of scientific research should improve management and coordination for improving the study quality based on clinical trial guidelines.
2020-03-30 Wang et al Coronavirus Disease 2019 in elderly patients: characteristics and prognostic factors based on 4-week follow-up
Journal of Infection
IV. Prevalence Study

Of the included 339 patients, lymphocytopenia were found in 211 cases (63.2%).
The present study aims to describe the clinical characteristics and to investigate the prognostic factors of the elderly patients with COVID-19, which might provide evidence for the risk stratification and help to improve the clinical practice and reduce fatality.
2020-03-30 Liu et al The comparative superiority of IgM-IgG antibody test to real-time reverse transcriptase PCR detection for SARS-CoV-2 infection diagnosis
medrxiv
IV. Other Demographic data, symptoms, clinical examination, laboratory tests, and clinical outcomes were collected.
2020-03-30 Deng et al A Genomic Survey of SARS-CoV-2 Reveals Multiple Introductions into Northern California without a Predominant Lineage
medrxiv
IV. Other However, real-time genomic epidemiology data of COVID-19 to inform public health interventions in California have been lacking.
2020-04-01 Xie et al Insight into 2019 novel coronavirus — an updated intrim review and lessons from SARS-CoV and MERS-CoV
International Journal of Infectious Diseases
IV. Prevalence Study Awareness of the biological features of 2019-nCoV should be updated in time and needs to be comprehensively summarized to help optimize control measures and make therapeutic decisions.

15 Efforts to develop a core clinical outcome set to maximize usability of data across a range of trials

15.0.0.1 Highlights

15.0.0.2 Articles

Date Authors Title LOE(?) & Sample Matches
2020 Wu et al The outbreak of COVID-19: An overview
Journal of the Chinese Medical Association : JCMA
IV. Prevalence Study

Of the 59 suspected cases, 41 patients were confirmed by nextgeneration sequencing or real-time reverse transcription-polymerase chain reaction (RT-PCR).
9 However, randomized controlled trials are needed to determine the safety and efficacy of this drug for treatment of patients with 2019-nCoV infection.
2020 Wu et al Overview of The 2019 Novel Coronavirus (2019-nCoV): The Pathogen of Severe Specific Contagious Pneumonia (SSCP)
J Chin Med Assoc
IV. Prevalence Study

Of the 59 suspected cases, 41 patients were confirmed by nextgeneration sequencing or real-time reverse transcription-polymerase chain reaction (RT-PCR).
9 However, randomized controlled trials are needed to determine the safety and efficacy of this drug for treatment of patients with 2019-nCoV infection.
2020-02-05 Zhou et al Network-based Drug Repurposing for Human Coronavirus
medrxiv
IV. Other Our approach can minimize the translational gap between preclinical testing results and clinical outcomes, which is a significant problem in the rapid development of efficient treatment strategies for the emerging 2019-nCoV outbreak.
2020-02-07 Kruse et al Therapeutic strategies in an outbreak scenario to treat the novel coronavirus originating in Wuhan, China
F1000Res
IV. Prevalence Study

Like some of the therapeutic options discussed below, the ability to express any lead candidates in lower organisms for protein expression (bacteria, yeast, insect cells) would facilitate faster production of therapy for patients 19 .
Ultimately, clinical trials in patients would need to investigate these potential issues.
2020-02-23 Hou et al Development and Evaluation of A CRISPR-based Diagnostic For 2019-novel Coronavirus
medrxiv
IV. Other Among these, the set that targeted Orf1ab 198 showed the best overall performance of sensitivity and specificity, and therefore, was used to 199 develop CRISPR-nCoV in this study for further evaluation (data not shown).
2020-02-26 Yang et al Clinical characteristics and imaging manifestations of the 2019 novel coronavirus disease (COVID-19):A multi-center study in Wenzhou city, Zhejiang, China
Journal of Infection
III-2. Retrospective Cohort

The symptoms of these 12 patients included fever (8 patients), cough (3 patients), expectoration (1 patient), headache (1 patient), sore throat (2 patients), snotty (1 patient), diarrhea (1 patient).
Randomized controlled trial are being rapidly initiated to assess the efficacy and safety of antiviral drugs.
2020-02-27 Chen et al Convalescent plasma as a potential therapy for COVID-19
The Lancet Infectious Diseases
IV. Other 1 However, randomised clinical trials are needed to evaluate the safety and efficacy of remdesivir in the treatment of COVID-19.
2020-02-27 Reusken et al Authors’ response: Plenty of coronaviruses but no SARS-CoV-2
Euro Surveill
IV. Other Therefore, we maintain that the urgent implementation and monitoring of diagnostic capacities and capabilities for SARS-CoV-2 in Europe is proportional to the containment and expected mitigation phase of the global public health response and is critical for care of local patients.
2020-02-28 Fisher et al Q&A: The novel coronavirus outbreak causing COVID-19
BMC Med
IV. Other Phase 1 trials for safety and immunogenicity in human populations are likely within 3 months.
2020-03-02 Metsky et al CRISPR-based surveillance for COVID-19 using genomically-comprehensive machine learning design
biorxiv
IV. Prevalence Study We hope that the comprehensiveness and high predicted sensitivity and specificity of our designs will enable many groups to proceed rapidly and successfully from assay testing through deployment.
2020-03-05 Al-Tawfiq et al Remdesivir as a possible therapeutic option for the COVID-19
Travel Medicine and Infectious Disease
II. Randomized Controlled Trial

Another ongoing phase 3 randomized, double-blind, placebo-controlled, multicenter study is evaluating the efficacy and safety of remdesivir in 452 hospitalized adult patients with severe COVID-19 respiratory disease .
Given the broad-spectrum anti-CoV activity of remdesivir that were demonstrated in pre-clinical studies; a randomized, controlled, double blind clinical trial is planned to evaluate the efficacy and safety of remdesivir in hospitalized patients with mild or moderate COVID-19 respiratory disease and this trial has already involved 308 hospitalized adult patients.
2020-03-06 Henry et al Preliminary epidemiological analysis on children and adolescents with novel coronavirus disease 2019 outside Hubei Province, China: an observational study utilizing crowdsourced data
medrxiv
IV. Prevalence Study

Results: A total of 82 patients were included.
Further efforts should be made to collect follow up data on patient outcomes.
2020-03-07 Naicker et al The novel coronavirus 2019 epidemic and kidneys
Kidney International
IV. Prevalence Study

A study of 59 patients with COVID-19 found that 34% of patients developed massive albuminuria on the first day of admission, and 63% developed proteinuria during their stay in hospital 14 .
The safety and efficacy of Trastuzumab in COVID-19 infection is undergoing evaluation by a multicenter randomized controlled trial (ChiCTR2000029765).
2020-03-08 Qiu et al Outcome reporting from protocols of clinical trials of Coronavirus Disease 2019 (COVID-19): a review
medrxiv
IV. Prevalence Study The number of outcomes in different outcome domains in protocols of western medicine clinical trials is shown in Figure 7 .

These outcomes are relevant to the prognosis of disease and safety of therapy.
2020-03-09 Shetty et al Mesenchymal Stem Cell Infusion Shows Promise for Combating Coronavirus (COVID-19)- Induced Pneumonia
Aging Dis
IV. Prevalence Study

A new study published by the journal "Aging & Disease" by a team led by Dr. Zhao reports that intravenous administration of clinical-grade human mesenchymal stem cells (MSCs) into seven patients with Coronavirus Disease 2019 (COVID-19) resulted in improved functional outcomes and facilitated recovery .
Safety and efficacy have been shown in many clinical trials.
2020-03-12 Liu et al Research and Development on Therapeutic Agents and Vaccines for COVID-19 and Related Human Coronavirus Diseases
ACS Cent Sci
IV. Other 55 Additional collaboration in the areas of antiviral discovery processes and clinical trial performance will enhance patients' access to drug candidates with improved therapeutic potential and ideally reduce the amount of time required to bring these drugs to market.
2020-03-12 Kujawski et al First 12 patients with coronavirus disease 2019 (COVID-19) in the United States
medrxiv
IV. Prevalence Study

Five patients received only outpatient care and were isolated at home (Patients 1-5), and seven were hospitalized (Patients 6-12) ( Figure 1 ).
31 Because remdesivir use was not given as part of a randomized controlled trial, we are unable to assess its effectiveness or safety.
2020-03-16 Zhou et al Network-based drug repurposing for novel coronavirus 2019-nCoV/SARS-CoV-2
Cell Discov
IV. Other Our approach can minimize the translational gap between preclinical testing results and clinical outcomes, which is a significant problem in the rapid development of efficient treatment strategies for the emerging 2019-nCoV/SARS-CoV-2 outbreak.
2020-03-17 Bedford et al COVID-19: towards controlling of a pandemic
The Lancet
IV. Other Comparative analysis of different quarantine strategies and contexts for their effectiveness and social acceptability Enhance and develop an ethical framework for outbreak response that includes better equity for access to interventions for all countries Promote the development of point-of-care diagnostic tests Determine the best ways to apply knowledge about infection prevention and control in health-care settings in resource-constrained countries (including identification of optimal personal protective equipment) and in the broader community, specifically to understand behaviour among different vulnerable groups Support standardised, best evidence-based approach for clinical management and better outcomes and implement randomised, controlled trials for therapeutics and vaccines as promising agents emerge Validation of existing serological tests, including those that have been developed by commercial entities, and establishment of biobanks and serum panels of well characterised COVID-19 sera to support such efforts Complete work on animal models for vaccine and therapeutic research and development include some identified by the global community and by the Research and Development Blueprint Scientific Advisory Group.
2020-03-17 Adhikari et al Epidemiology, causes, clinical manifestation and diagnosis, prevention and control of coronavirus disease (COVID-19) during the early outbreak period: a scoping review
Infect Dis Poverty
III-2. Cross Sectional Control

In China, 11 791 cases were confirmed and 17 988 cases were suspected in 34 provinces as of 24:00, 31 January 2020 (Fig.
There are six clinical trials registered in both the International Clinical Trials Registry platform and the Chinese Clinical Trial Registry to evaluate the efficacy or safety of targeted medicine in the treatment or prognosis of COVID-19 (Additional file 2) .
2020-03-18 Jin et al Core Outcome Set for Clinical Trials on Coronavirus Disease 2019 (COS-COVID)
Engineering
IV. Prevalence Study

The consensus meeting was held on 24 February 2020, and involved 20 participants.
This study aimed to develop a core outcome set (COS) for clinical trials on COVID-19 in order to tackle the outcome issues.

In order to overcome these problems, experts in evidence-based medicine and clinical research methodology have put forward strategies to develop core outcome sets (COSs).

In 2010, the Core Outcome Measures in Effectiveness Trials (COMET) Initiative y was launched to promote research on COS by developing methodological guidelines.

First, the development of the outcome pool was only based on clinical trial protocols listed in two registry platforms.

Clinical trial registry websites (chictr.org.cn and clinicaltrials.gov) were searched to retrieve clinical trial protocols and outcomes in order to form an outcome pool.
2020-03-18 Xie et al Effect of large-scale testing platform in prevention and control of the COVID-19 pandemic: an empirical study with a novel numerical model
medrxiv
IV. Computer Model Conclusions: Large-scale and standardized clinical testing platform with nucleic acid testing, high-throughput sequencing and immunoprotein assessment capabilities need to be implemented simultaneously in order to maximize the effect of quarantine and minimize the duration and cost.
2020-03-18 Cai et al Experimental Treatment with Favipiravir for COVID-19: An Open-Label Control Study
Engineering
III-1. Pseudo-Randomized Controlled Trial

For the 35 patients enrolled in the FPV arm and the 45 patients in the control arm, all baseline characteristics were comparable between the two arms.
In this pilot study of a non-randomized control trial, we found that FPV showed significantly better treatment effects on COVID-19 in terms of disease progression and viral clearance; if causal, these results should be important information for establishing standard treatment guidelines to combat the SARS-CoV-2 infection.
2020-03-19 Waksman et al CRT 2020, COVID-19 and beyond
Cardiovascular Revascularization Medicine
IV. Other Experts from around the world gathered together and concluded that more randomized clinical trials are needed to determine the optimal treatment of these patients.
2020-03-20 Belhadi et al A brief review of antiviral drugs evaluated in registered clinical trials for COVID-19
medrxiv
II. Randomized Controlled Trial

Phase IV trials were the most commonly reported study type (n=27, 23%).
These results might inform the adaptation of existing clinical trials and the development of additional trials.

Lopinavir/ritonavir is tested in 15 clinical trials in this review.

Reporting as much details as possible is key to have consistent clinical trials and to enhance the reproducibility of the results, especially as studies are more often associated with a low number of planned inclusions and composite or weak outcomes that can limit the efficacy assessment of the treatments.
2020-03-20 song et al Advance of Novel Coronavirus Registration Clinical Trial
medrxiv
IV. Prevalence Study These results imply that different interventions have an impact on the design of clinical trials.
2020-03-20 Chen et al Favipiravir versus Arbidol for COVID-19: A Randomized Clinical Trial
medrxiv
IV. Prevalence Study

For 42 patients with hypertension and/or diabetes in the favipiravir group, 28 had a fever and 25 had a cough; of 35 patients with hypertension and/or diabetes in the All rights reserved.
Main Outcomes and Measures: The primary outcome was 7 day′s clinical recovery rate.
2020-03-23 Vu et al Financing Vaccines for Global Health Security
medrxiv
IV. Prevalence Study While there are a number of methods for modeling the outcome of clinical trials with certain scientific elements in common, we numerically estimate the performance of our EID vaccine portfolio by modeling projects as pairwise correlated Bernoulli trials.
2020-03-24 Bian et al Meplazumab treats COVID-19 pneumonia: an open-labelled, concurrent controlled add-on clinical trial
medrxiv
IV. Prevalence Study

11 hospitalized patients who met the inclusion criteria and with no exclusion criteria signs were collected as concurrent control in the same period.
Therefore, confirmation from larger scale and randomized, double-blind, placebocontrolled trial is required to fully assess the efficacy and safety of meplazumab in patients with COVID-19 pneumonia.
2020-03-24 Lu et al A New, Simple Projection Model for COVID-19 Pandemic
medrxiv
IV. Other This projection model aims to achieve two major tasks of epidemic control: one is to assess the effectiveness of government intervention, the level of cooperation from the public and the efficiency of healthcare system; second is to track and give a decent prediction of the growth and number of infections.
2020-03-26 Hu et al Risk Factors Associated with Clinical Outcomes in 323 COVID-19 Patients in Wuhan, China
medrxiv
III-2. Retrospective Cohort

At the end of the study, 252 patients had recovered and were discharged, 35 patients had died (overall case fatality rate, 10.8%), and 36 patients were still hospitalized.
Overall, our study provides useful data to guide early clinical decision making to reduce mortality and improve clinical outcomes of COVID-19.
2020-03-26 Rios et al Guidelines for preventing respiratory illness in older adults aged 60 years and above living in long-term care: A rapid review of clinical practice guidelines
medrxiv
IV. Prevalence Study

If one or more respiratory samples from ILI cases in a suspected outbreak returns a positive laboratory result for influenza, then an influenza outbreak is confirmed.
03 Although not regulatory in scope, these guidelines support infection prevention and control (IP&C) professionals, health care organizations and health care providers in developing, implementing and evaluating IP&C policies, procedures and programs to improve the quality and safety of health care and patient outcomes.
2020-03-27 Wynants et al Systematic review and critical appraisal of prediction models for diagnosis and prognosis of COVID-19 infection
medrxiv
I. Systematic Review

Based on nine of the 15 studies that reported study dates, data were collected between 8 th December 2019 and 3 rd March 2020.
Data (IPD) from multiple countries and healthcare systems may facilitate better understanding of the generalizability and implementation prediction models across different settings and populations, and may greatly improve their applicability and robustness in routine care.
2020-03-27 Amirian et al Current knowledge about the antivirals remdesivir (GS-5734) and GS-441524 as therapeutic options for coronaviruses
One Health
II. Randomized Controlled Trial

A preprint of a case series on the first 12 COVID-19 patients in the U.S. (who had disease onset between January 14 and 29, 2020) recently became available, though it had not been peerreviewed at the time of writing .
Multiple clinical trials are underway on the use of remdesivir for treatment of COVID-19 .
2020-03-27 Qiu et al Core Outcome Set for Traditional Chinese and Western Medicine Clinical Trials of COVID-19
medrxiv
IV. Prevalence Study Conclusion: A COS for COVID-19 may improve consistency of outcome reporting in clinical trials, which may help identify valued interventions after comparing different trials when the researchers report the same outcomes.

Methods: A preliminary list of outcomes were developed after a systematic review of protocols of clinical trials for COVID-19.
2020-03-28 Zhai et al The epidemiology, diagnosis and treatment of COVID-19
International Journal of Antimicrobial Agents
III-2. Matched Case Control

Another study later using the travel history and symptom onset of 88 confirmed cases had a similar mean incubation period, which was 6.4 days (95% CI: 5.6-7.7) .
The efficacy and safety of convalescent plasma therapy in patients with COVID-19 infection should be further evaluated in well-designed clinical trials.
2020-03-30 Beck et al Predicting commercially available antiviral drugs that may act on the novel coronavirus (SARS-CoV-2) through a drug-target interaction deep learning model
Computational and Structural Biotechnology Journal
IV. Other But, this prediction also needs to be validated in vitro, in vivo, and in a wide range of clinical trials for efficacy and safety.
2020-03-31 Zhang et al Treatment with convalescent plasma for critically ill patients with SARS-CoV-2 infection
Chest
IV. Other Although all the four patients (including a pregnant woman) recovered from SARS-CoV-2 infection eventually, randomized trials are needed to eliminate the effect of other treatments and investigate the safety and efficacy of convalescent plasma therapy.
2020-04-01 Liu et al Respiratory rehabilitation in elderly patients with COVID-19: A randomized controlled study
Complementary Therapies in Clinical Practice
II. Randomized Controlled Trial

Among them, 9 patients disagreed with this study, 3 patients with FEV1 ≤ 70%, 4 patients severe heart disease, and the remaining 76 patients were randomized.
With the experience of improved and discharged COVID-19 patients, timely respiratory rehabilitation intervention may improve prognosis, maximize functional preservation and improve quality of life (QoL), but there lacks of studies worldwide exploring the outcome of this intervention.
2020-04-01 Braunstein et al Breast radiotherapy under COVID-19 pandemic resource constraints -- approaches to defer or shorten treatment from a Comprehensive Cancer Center in the United States
Advances in Radiation Oncology
II. Randomized Controlled Trial

Of note, NSABP-B39 also included 800 patients with ER-breast cancer who exhibited excellent local control, suggesting that APBI may be reasonable among this group.
A large body of literature, including several landmark prospective trials, has established the safety and efficacy of APBI among appropriately selected patients.
2020-04-30 Sohrabi et al World Health Organization declares global emergency: A review of the 2019 novel coronavirus (COVID-19)
International Journal of Surgery
IV. Prevalence Study

To date, 85 individuals have tested positive resulting in the UK public health risk for viral infection being raised from low to moderate .
However, a randomized multicentre controlled clinical trial is currently underway to assess the efficacy and safety of abidole in patients with COVID-19 (ChiCTR2000029573).
2020-07-31 Shereen et al COVID-19 infection: Origin, transmission, and characteristics of human coronaviruses
Journal of Advanced Research
IV. Prevalence Study

In 2001 the samples were isolated from the healthy persons of Hongkong and the molecular assessment showed 2.5% frequency rate of antibodies against SARS-coronavirus.
SARS-CoV-2 infected patients were also used to conduct randomized clinical trials .

16 Efforts to determine adjunctive and supportive interventions that can improve the clinical outcomes of infected patients (e.g. steroids, high flow oxygen)

16.0.0.1 Highlights

16.0.0.2 Articles

Date Authors Title LOE(?) & Sample Matches
2020 Pingzheng Mo et al Clinical characteristics of refractory COVID-19 pneumonia in Wuhan, China | Clinical Infectious Diseases | Oxford Academic
Clinical Infectious Diseases
IV. Other Refractory COVID-19 patients were more likely to receive oxygen, mechanical ventilation, expectorant, and adjunctive treatment including corticosteroid, antiviral drugs and immune enhancer (P<0.05).
2020 Kang et al Personal knowledge on novel coronavirus pneumonia
Chin Med J (Engl)
IV. Other Even though several clinical studies have assessed the use of corticosteroids in acute respiratory distress syndrome (ARDS) and severe viral pneumonia, it remains unclear whether corticosteroids treatment can decrease mortality and improve patients' outcomes.
2020 Amodio et al Outbreak of Novel Coronavirus (SARS-Cov-2): First Evidences From International Scientific Literature and Pending Questions
Healthcare (Basel)
IV. Prevalence Study Similarly, there is no single specific antiviral therapy; COVID-19 and the main treatments are supportive care (e.g., supportive therapy and monitoring-oxygen therapy and fluid management).
2020 Minjin Wang et al A precision medicine approach to managing Wuhan Coronavirus pneumonia
Precision Clinical Medicine
IV. Prevalence Study

As of January 29, 2020, the virus had been diagnosed in more than 7,000 patients in China and 77 outside this country.
However, in patients with sepsis, antimicrobial treatment should be provided within 1 hour of the onset of sepsis; (e) Other treatments: oxygen should be given to patients with a low blood oxygen saturation and avoid the longterm use of corticosteroids for treating viral pneumonia or ARDS.
2020 Xia et al Non-invasive respiratory support for patients with novel coronavirus pneumonia: clinical efficacy and reduction in risk of infection transmission
Chin Med J (Engl)
IV. Prevalence Study

A recent retrospective epidemiological study of 99 COVID-19 pneumonia patients in China revealed that NPPV is the most commonly used mechanical ventilation method for acute respiratory failure.
To reduce respiratory symptoms and improve prognosis, respiratory support is the most important means of life support, and noninvasive respiratory support systems, including various conventional oxygen therapies, non-invasive positive pressure ventilation (NPPV), and high-flow nasal cannula (HFNC), are most commonly used.
2020 Habibzadeh et al The Novel Coronavirus: A Bird's Eye View
Int J Occup Environ Med
IV. Prevalence Study

19 Although 27 patients were initially announced to be afflicted with this mysterious disease, the number rose to 41 with seven critically ill patients; one death was noted in the subsequent report on Janu-ary 11, 2020.
42 However, isolation and supportive care including oxygen therapy, fluid management, and administration of antimicrobials for treatment of secondary bacterial infections to alleviate the symptoms and prevent end-organ dysfunction is currently recommended by WHO for suspected and confirmed cases requiring hospital admission.
2020 Xu et al Clinical findings in a group of patients infected with the 2019 novel coronavirus (SARS-Cov-2) outside of Wuhan, China: retrospective case series
BMJ
III-3. Time Series Analysis

Twenty of the 62 patients (32%) had underlying diseases-seven (11%) had liver disease, five (8%) Of the 33 patients with symptoms for more than 10 days after illness onset, 13 (39%) had underlying diseases: four (12%) patients had liver disease, four (12%) had hypertension, and one each had chronic obstructive pulmonary disease (3%), diabetes (3%), and cerebrovascular disease (3%).
Whether the use of antivirals, antibiotics, or steroids affects the prognosis of patients remains unknown.
2020-02-03 Wu et al A new coronavirus associated with human respiratory disease in China
Nature
IV. Other Although a combination of antibiotic, antiviral and glucocorticoid therapy was administered, the patient exhibited respiratory failure and was given high-flow non-invasive ventilation.
2020-02-20 Ling et al COVID-19: A critical care perspective informed by lessons learnt from other viral epidemics
Anaesthesia Critical Care & Pain Medicine
IV. Other Specific treatments such as the use of corticosteroids to control the inflammatory response, and antivirals, particularly the combination of lopinavir/ritonavir and ribavirin have been used, but are unproven to improve outcomes .
2020-02-21 Chen et al Epidemiological and clinical characteristics of 99 cases of 2019 novel coronavirus pneumonia in Wuhan, China: a descriptive study
The Lancet
IV. Other Use of intra venous immunoglobulin is recommended to enhance the ability of antiinfection for severely ill patients and steroids (methylprednisolone 1-2 mg/kg per day) are recommended for patients with ARDS, for as short a duration of treatment as possible.
2020-02-21 Zhou et al Potential benefits of precise corticosteroids therapy for severe 2019-nCoV pneumonia
Signal Transduct Target Ther
IV. Other There is no fixed clinical guideline for the use of corticosteroids in critically ill patients in ICU.
2020-02-24 Yang et al Clinical course and outcomes of critically ill patients with SARS-CoV-2 pneumonia in Wuhan, China: a single-centered, retrospective, observational study
The Lancet Respiratory Medicine
III-2. Retrospective Cohort

Findings Of 710 patients with SARS-CoV-2 pneumonia, 52 critically ill adult patients were included.
Mechanical ventilation is the main supportive treatment for critically ill patients.
2020-02-25 yaqian et al Clinical and pathological characteristics of 2019 novel coronavirus disease (COVID-19): a systematic review
medrxiv
I. Systematic Review

Results: 34 COVID-19-related articles were eligible for this systematic review;Four of the articles were related to pathology.
In this review we found that in COVID-19, oxygen therapy, antiviral therapy, antibiotic therapy, the use of corticosteroids or immunoglobulin were in 56.1%, 51.2%, 62.9%, 22.0% and 16.8% of patients, respectively.
2020-02-27 Zhang et al Clinical characteristics of 82 death cases with COVID-19
medrxiv
III-2. Cross Sectional Control

Methods Clinical data on 82 death cases laboratory-confirmed as SARS-CoV-2 infection were obtained from a Wuhan local hospital′s electronic medical records according to previously designed standardized data collection forms.
9 Oxygen therapy, mechanical ventilation, intravenous antibiotics and antiviral therapy were usually applied in clinical management, but presently there were no effective drugs for improving the clinical outcome of COVID-19, especially for severe cases.
2020-02-27 Chen et al Convalescent plasma as a potential therapy for COVID-19
The Lancet Infectious Diseases
IV. Other 4 However, other treatments might have an effect on the relationship between convalescent plasma and antibody level, including antiviral drugs, steroids, and intravenous immunoglobulin.
2020-03-03 Yang et al Epidemiological and clinical features of COVID-19 patients with and without pneumonia in Beijing, China
medrxiv
III-3. Time Series Analysis

A total of 55 consecutive patients with laboratory-confirmed COVID-19 were enrolled in this study.
The disease course of severe patients might be prolonged by therapeutic regimens including corticosteroids.
2020-03-04 Memish et al Middle East respiratory syndrome
The Lancet
II. Randomized Controlled Trial

A retrospective study of 136 patients with MERS found that macrolide therapy resulted in no reduction in mortality or faster MERS-CoV RNA clearance compared with those who were not treated with macrolides.
Therapies used for severely ill patients with MERS have included convalescent plasma, corticosteroids, antiviral agents (eg, interferons and ribavirin), and protease inhibitors, or combination of members from these groups.
2020-03-06 Zhang et al Clinical features and outcomes of 221 patients with COVID-19 in Wuhan, China
medrxiv
III-2. Cross Sectional Control

The study population included a total of 221 admitted patients with confirmed COVID-19 infection in Zhongnan Hospital of Wuhan University, between January 2, 2019 and and 62 (28.1%), respectively.
Treatment strategies included: effective oxygen therapy according to the severity of hypoxemia (nasal catheter/mask oxygen inhalation, high-flow nasal cannula (HFNC) and non-invasive ventilation (NIV)), supportive treatment to ensure sufficient energy intake and balance for electrolytes and acid-base levels, antiviral treatment (including All rights reserved.
2020-03-10 Lippi et al Cardiac troponin I in patients with coronavirus disease 2019 (COVID-19): Evidence from a meta-analysis
Progress in Cardiovascular Diseases
I. Systematic Review

One additional study could be identified from reading the reference list of the three selected documents, so that 4 studies were finally included in our meta-analysis.
Urgent studies shall also be planned to define whether or not echocardiographic testing and other adjunctive cardioprotective therapies such as corticosteroids, other anti-inflammatory agents, immunosuppressants, antivirals (antiviral agents and/or interferons) and/or immunomodulatory therapy (immunoglobulins) may be advisable in patients with significant elevation of cardiac injury biomarkers.
2020-03-11 Zhou et al Clinical course and risk factors for mortality of adult inpatients with COVID-19 in Wuhan, China: a retrospective cohort study
The Lancet
III-2. Retrospective Cohort

Before Jan 11, 2020, SARS-CoV-2 RNA detection results were not available in the electronic medical records, from which data for this study were obtained retrospectively; therefore, this study includes 29 of the 41 patients originally reported on.
Lack of effective antivirals, inadequate adherence to standard supportive therapy, and high-dose corticosteroid use might have also contributed to the poor clinical outcomes in some patients.
2020-03-12 Kujawski et al First 12 patients with coronavirus disease 2019 (COVID-19) in the United States
medrxiv
IV. Prevalence Study

Five patients received only outpatient care and were isolated at home (Patients 1-5), and seven were hospitalized (Patients 6-12) ( Figure 1 ).
Patient 9 required high-flow nasal cannula oxygen supplementation and intensive care monitoring.
2020-03-12 Chen et al Retrospective Analysis of Clinical Features in 101 Death Cases with COVID-19
medrxiv
IV. Other 84(83.17%) patients were treated with non-invasive ventilator or high-flow oxygen therapy, and 77(76.24%), invasive mechanical ventilation.
2020-03-13 Singhal et al A Review of Coronavirus Disease-2019 (COVID-19)
Indian J Pediatr
IV. Prevalence Study

The median age was 8 y 11 mo and in 28 children the infection was linked to a family member and 26 children had history of travel/residence to Hubei province in China.
In the case series of 99 hospitalized patients with COVID-19 infection from Wuhan, oxygen was given to 76%, noninvasive ventilation in 13%, mechanical ventilation in 4%, extracorporeal membrane oxygenation (ECMO) in 3%, continuous renal replacement therapy (CRRT) in 9%, antibiotics in 71%, antifungals in 15%, glucocorticoids in 19% and intravenous immunoglobulin therapy in 27% .
2020-03-14 Aslam et al COVID-19: Yet Another Coronavirus Challenge in Transplantation
The Journal of Heart and Lung Transplantation
IV. Other The treatment for the patient with severe disease included withholding baseline immunosuppression and treating with high dose corticosteroids and pooled immunoglobulin infusions.
2020-03-15 Yi et al COVID-19: what has been learned and to be learned about the novel coronavirus disease
Int J Biol Sci
IV. Prevalence Study

On February 11, 2020, a multi-center study on 8,866 patients including 4,021 confirmed COVID-19 patients presented a more updated illustration of the epidemic as follows ( UlBi-HX_rHPXa1qHA2bhdA).
Use of steroids: As described above, steroids are immunosuppressant commonly used as an adjunctive therapy for infectious diseases to reduce the severity of inflammatory damage .

Thus, respiratory support is critical to relieve the symptoms and save lives and includes general oxygen therapy, high-flow oxygen, noninvasive ventilation, and invasive mechanical ventilation depending on the severity of the disease.
2020-03-15 Yang et al Traditional Chinese Medicine in the Treatment of Patients Infected with 2019-New Coronavirus (SARS-CoV-2): A Review and Perspective
Int J Biol Sci
II. Randomized Controlled Trial

systematically reviewed eight randomized controlled trials, and concluded that, by combination with conventional medicine, TCM showed the beneficial effects such as decrease of mortality and relief of symptom, as well as control of fungal infections in patients with SARS.
Due to the absence of a specific antiviral therapeutics and vaccine, main treatment strategy for COVID-19 is supportive care, which is supplemented by the combination of broad-spectrum antibiotics, antivirals, corticosteroids and convalescent plasma (Table 1) .
2020-03-16 Mo et al Clinical characteristics of refractory COVID-19 pneumonia in Wuhan, China
Clinical Infectious Diseases
IV. Other Refractory COVID-19 patients were more likely to receive oxygen, mechanical ventilation, expectorant, and adjunctive treatment including corticosteroid, antiviral drugs and immune enhancer (P<0.05).
2020-03-16 Zhang et al Clinical Characteristics of 34 Children with Coronavirus Disease-2019 in the West of China: a Multiple-center Case Series
medrxiv
IV. Prevalence Study

In this case series, data from 34 paediatric patients with COVID-19 were analyzed, including 14 male patients (41.18%) and 20 female patients (58.82%).
Multimodality therapies were employed, including antibiotic therapy (88.24%), antiviral therapy (82.35%), interferon-α nebulization (82.35%), corticosteroid therapy (14.71%), and oxygen inhalation supportive therapy (8.82%) ( Table 3) .
2020-03-18 Dhama et al COVID-19, an emerging coronavirus infection: advances and prospects in designing and developing vaccines, immunotherapeutics, and therapeutics
Hum Vaccin Immunother
IV. Other According to WHO guidelines, infected patients will receive supportive care including oxygen therapy, fluid therapy, and antibiotics for treating secondary bacterial infections.
2020-03-18 Cai et al Experimental Treatment with Favipiravir for COVID-19: An Open-Label Control Study
Engineering
III-1. Pseudo-Randomized Controlled Trial

For the 35 patients enrolled in the FPV arm and the 45 patients in the control arm, all baseline characteristics were comparable between the two arms.
Standard care included oxygen inhalation, oral or intravenous rehydration, electrolyte correction, antipyretics, analgesics, and antiemetic drugs.
2020-03-20 Solaimanzadeh et al Acetazolamide, Nifedipine and Phosphodiesterase Inhibitors: Rationale for Their Utilization as Adjunctive Countermeasures in the Treatment of Coronavirus Disease 2019 (COVID-19)
PMC
IV. Other Rather, supportive care as well as adjunctive countermeasures may assist patients in surviving viral illness.
2020-03-20 Yang et al Effect of continuous renal replacement therapy on all-cause mortality in COVID-19 patients undergoing invasive mechanical ventilation: a retrospective cohort study
medrxiv
III-2. Retrospective Cohort

In a study of 52 critically ill patients in Wuhan, 32 (61.5%) patients died at 28 days and the mortality rate was 81.1% (30/37) in patients requiring mechanical ventilation.
12 Continuous renal replacement therapy (CRRT) is a great help in critically ill patients not only to control of electrolyte, acid-base derangements but also to remove inflammatory mediators and improves oxygenation in fluid overload.
2020-03-23 Rios et al Effectiveness and safety of antiviral or antibody treatments for coronavirus
medrxiv
III-2. Matched Case Control

The four cases reports/series 29,45,46,48 that included immunosuppressed patients with MERS (5 patients) and unspecified coronavirus (2 patients) reported 3 deaths all in patients with hematological malignancies treated with foscarnet (n=1) and oseltamivir (n=2).
Of the 21 studies reporting this outcome, one was a randomized trial 6 comparing ribavirin supplemented with hydrocortisone to ribavirin alone; three were cohort studies 14, 15, 17 comparing oseltamivir to steroid treatment alone, ribavirin with continuous steroid treatment to ribavirin with high-dose 'pulse' steroids, and ribavirin to steroid and/or antibiotic treatment; three were retrospective studies 19,20,25 examining the effectiveness of ribavirin and oseltamivir alone or in combination with other drugs; and 14 were case reports/series 33,34,37,40,42,44,45,47,50,51,53,55-57 examining ribavirin, oseltamivir, lopinavir/ritonavir alone or in combination with steroids or antibiotics.

Additional therapies used in the studies included a variety of broad spectrum antibiotics (n=30), steroids including hyrdcortisone, methylprednisone, or prednisolone (n=39) or various interferons (n=12; Appendix 3).
2020-03-23 Leung et al ACE-2 Expression in the Small Airway Epithelia of Smokers and COPD Patients: Implications for COVID-19
medrxiv
III-3. Time Series Analysis

As of March 13, 2020, there have been 144,064 laboratory-confirmed cases of COVID-19 worldwide with 5,397 deaths worldwide .
First, the study was cross-sectional and as such, we could not determine whether interventions such as inhaled corticosteroids or bronchodilators (for those with COPD) could modulate ACE-2 gene expression in the airways.
2020-03-23 Luo et al Characteristics of patients with COVID-19 during epidemic ongoing outbreak in Wuhan, China
medrxiv
IV. Other Treatment measures evaluated in this research contained high-flow nasal cannula oxygen therapy (HFNC), non-invasive mechanical ventilation (NIMV) or invasive mechanical ventilation (IMV), blood purification treatment, application of antiviral agents, antibacterial agents, anti-fungal agents, corticosteroids, and immunoglobulin.

High-flow nasal cannula oxygen therapy (HFNC) and mechanical ventilation are recommended for patients with ARDS.
2020-03-23 Duan et al The feasibility of convalescent plasma therapy in severe COVID-19 patients: a pilot study
medrxiv
II. Randomized Controlled Trial

The neutralizing antibody titers of five patients increased and four patients remained atthe same level after CP transfusion.SARS-CoV-2 RNA, assayed by reverse transcriptase-polymerase chain reaction (RT-PCR), was positive in seven patients and negative in three cases before CP transfusion.
All patients were admitted to the intensive care unit (ICU) and received antiviral therapy and other supportive care, while somepatients received antibiotic treatment, antifungal treatment, glucocorticoid and oxygen support at the appropriate situation.
2020-03-23 Fu et al Association between Clinical, Laboratory and CT Characteristics and RT-PCR Results in the Follow-up of COVID-19 patients
medrxiv
IV. Other Three (5.8%) patients needed intensive unit care, and 4 (7.7%) patients required non-invasive mechanical ventilation or high-flow oxygen therapy.
2020-03-24 Yu et al Clinical features and obstetric and neonatal outcomes of pregnant patients with COVID-19 in Wuhan, China: a retrospective, single-centre, descriptive study
The Lancet Infectious Diseases
IV. Other In our study, most patients were treated with ribavirin, corticosteroids, and antibiotics.
2020-03-25 Boelig et al Labor and Delivery Guidance for COVID-19
American Journal of Obstetrics & Gynecology MFM
IV. Prevalence Study Generally, steroid use evaluated in these studies is higher than a two day course of steroids, however given the association between steroids and worsening morbidity of viral pneumonia and specifically COVID-19, steroids for fetal lung maturity should be used judiciously.
2020-03-28 Tan et al The cardiovascular burden of coronavirus disease 2019 (COVID-19) with a focus on congenital heart disease
International Journal of Cardiology
IV. Other While the use of steroids has not been recommended in the general treatment of COVID-19 , there have been reports of patients recovering from fulminant myocarditis with intravenous immunoglobulin and steroids .
2020-03-28 Zhai et al The epidemiology, diagnosis and treatment of COVID-19
International Journal of Antimicrobial Agents
III-2. Matched Case Control

Another study later using the travel history and symptom onset of 88 confirmed cases had a similar mean incubation period, which was 6.4 days (95% CI: 5.6-7.7) .
The clinical outcomes of coronavirus and similar outbreaks do not support the use of corticosteroids.
2020-03-30 Gao et al Highly pathogenic coronavirus N protein aggravates lung injury by MASP-2-mediated complement over-activation
medrxiv
III-3. Time Series Analysis

Sera 5 from 10 mild patients (5 males and 5 females), with an average of 5612.1 years old and an average 26.39.1 days of illness, and sera from 18 severe patients (7 males and 11 females), with an average of 72.410.1 years old and an average 40.1512.74 days of illness, were assayed.
Supportive care was provided, including high-flow nasal oxygen (HFNO) to target SpO2>95% (Fig.
2020-03-30 An et al Clinical characteristics of the recovered COVID-19 patients with re-detectable positive RNA test
medrxiv
IV. Other And no antibiotics, steroids, antiviral agents and continuous supplemental oxygenation were required in these RP patients.
2020-03-30 Gómez et al Recomendaciones de consenso respecto al soporte respiratorio no invasivo en el paciente adulto con insuficiencia respiratoria aguda secundaria a infección por SARS-CoV-2*
Archivos de Bronconeumología
IV. Other The document provides clinical recommendations for the noninvasive respiratory support (noninvasive ventilation, high flow oxygen therapy with nasal cannula) in any patient with suspected or confirmed presentation of COVID-19 with acute respiratory failure.
2020-03-31 Zhang et al Treatment with convalescent plasma for critically ill patients with SARS-CoV-2 infection
Chest
IV. Other The antibody levels, however, were confounded by other treatments, such as antiviral drugs, steroids and intravenous immunoglobulin .
2020-04-01 Indolfi et al In Italy, the unexpected pandemic of Covid 19 has caused a never seen before the disaster in terms of hospitalizations and deaths.
JACC: Case Reports
IV. Other Medical therapy in these patients is empirical although chloroquine, azithromycin, high-dose steroids, tocilizumab, lopinavir/ritonavir, heparin, and other drugs have been empirically tested.
2020-04-01 Xu et al Traditional Chinese Medicine treatment of COVID-19
Complementary Therapies in Clinical Practice
IV. Other Supportive therapies are mainly used in clinical practice, such as oxygen therapy, antiviral therapy and corticosteroid therapy, because there is no specific effective treatment 3 .
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Levels of Evidence in Epidemiology
LevelRating Criteria
IEvidence obtained from a systematic review or meta-analysis of all relevant randomized, controlled trials
IIEvidence obtained from at least one properly designed randomized, controlled trial
III-1Evidence obtained from well-designed pseudorandomized controlled trials (without proper randomization)
III-2Evidence obtained from comparative studies with concurrent controls and allocation not randomized (cohort studies), case-control studies, or interrupted time series with a control group
III-3Evidence obtained from comparative studies with historical control, 2 or more single-arm studies, or interrupted time series without a parallel control group
IVEvidence obtained from descriptive case series, either before testing or before and after testing