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  • image/svg+xml art designer at PLoS, modified by Wikipedia users Nina, Beao, JakobVoss, and AnonMoos Open Access logo, converted into svg, designed by PLoS. This version with transparent background. http://commons.wikimedia.org/wiki/File:Open_Access_logo_PLoS_white.svg art designer at PLoS, modified by Wikipedia users Nina, Beao, JakobVoss, and AnonMoos http://www.plos.org/

    Cases with suspected or possible reinfection with SARS-CoV-2 have been recently reported in different countries. In many of these cases, it is uncertain if the individual’s Polymerase Chain Reaction (PCR) test remained positive for a long period of time following the first episode of infection or whether it represents a true reinfection.

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    Overview: This document and risk assessment tool provides practical guidance and recommendations to support the special role of religious leaders, faith-based organizations, and faith communities in COVID-19 education, preparedness, and response.

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      image/svg+xml art designer at PLoS, modified by Wikipedia users Nina, Beao, JakobVoss, and AnonMoos Open Access logo, converted into svg, designed by PLoS. This version with transparent background. http://commons.wikimedia.org/wiki/File:Open_Access_logo_PLoS_white.svg art designer at PLoS, modified by Wikipedia users Nina, Beao, JakobVoss, and AnonMoos http://www.plos.org/ PAHO COVID19arrow_drop_down
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    Authors: Colombia. Ministerio de Salud y Protección Social;
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      image/svg+xml art designer at PLoS, modified by Wikipedia users Nina, Beao, JakobVoss, and AnonMoos Open Access logo, converted into svg, designed by PLoS. This version with transparent background. http://commons.wikimedia.org/wiki/File:Open_Access_logo_PLoS_white.svg art designer at PLoS, modified by Wikipedia users Nina, Beao, JakobVoss, and AnonMoos http://www.plos.org/ PAHO COVID19arrow_drop_down
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    Authors: Wang, Yushu et al.;

    To the Editor, Recently, the associations between COVID‐19 and its comorbidities including hypertension, diabetes, obesity, cardiovascular disease, chronic obstructive pulmonary disease, chronic kidney disease, immunosuppression and other diseases have been reported in the many studies.1 However, there is no clear evidence about whether patients with asthma were at a higher risk of severe or fatal COVID‐19. Respiratory viral infections are one of the most common triggers for asthma exacerbations. Some studies have provided data about the prevalence of asthma in severe or fatal COVID‐19 patients.2-5 Higher levels of evidence are required to investigate the association between severe or fatal COVID‐19 and asthma. Thus, we performed this systematic review and meta‐analysis. We systematically conducted an electronic literature search in PubMed, EMBASE, Cochrane library, Web of Science and China National Knowledge Infrastructure (CNKI), using the keywords “asthma” or “respiratory diseases” AND “2019‐nCoV” or “novel coronavirus” or “coronavirus disease 2019” or “SARS‐CoV‐2” or “COVID‐19” from their inception up to 5 August 2020. The search was not restricted by language. Studies were selected if they fulfilled the following entry criteria: (a) patients must be diagnosed with COVID‐19 infection and (b) provided information of asthma with severe or non‐severe or between death and survivors. Abstracts, letters, case reports, literature review articles, letters to the editor and/or editorials were excluded. For each study, the following data were abstracted: name of the first author, country where the cohort was conducted, size of the cohort, numbers of males and females, age range or mean and outcomes of interest. The severity of the disease was mainly determined on the basis of symptom (eg patients with pulse oxygen saturation less than 90%, or required mechanical ventilation, or with acute respiratory distress syndrome, or admitted to intensive care unit). For non‐random controlled studies, a nine‐item Newcastle‐Ottawa Scale (NOS) was used as an assessment tool for selection, comparability and outcome assessment by two investigators (YW and GA). A total score of ≥7 indicated a high‐quality study, whereas a total score of <7 was considered to a low‐quality study. If necessary, the primary authors were contacted to retrieve further data. The literature search, eligible study selection and data extraction were performed independently by two authors (YW and GA). Any disagreements were resolved with a third investigator or by consensus. Review Manager 5.3 (Cochrane Collaboration) was used to calculate the individual and pooled odds ratio (OR) with their relative 95% confidence interval (95% CI). Heterogeneity among studies was assessed with Cochran's Q test and the I2 statistic, with an I2 < 25%, 25%‐50% and greater than 50% represented low, moderate and high heterogeneity, respectively. In addition, sensitivity analysis was conducted to evaluate the stability of the outcome and was performed by excluding 1 study at a time. P < .05 was considered statistically significant. This study is registered with PROSPERO, number CRD42020203058. In total, the search strategy retrieved 457 studies based on our search criteria. After exclusion of duplicate records and studies that did not fulfil our inclusion criteria, 72 articles remained and we further evaluated the full texts of these 72 literatures. Of these, we excluded 58 studies owing to lack of sufficient information for estimation of OR and not an outcome of interest. Finally, a total of 14 publications representing data from 17 694 participants were included in this meta‐analysis.1-14 The sample size of patients ranged from 69 to 9946. Six studies were from America, two studies from Mexico, two studies from China and four studies from other countries. Asthma is defined according to the patient's medical history. All studies were published in English. The details of each included study are presented in Table 1. The NOS scores of these studies ranged from 7 to 9, which indicated that all data sets were of high quality (Table S1). The meta‐analysis showed that patients with severe COVID‐19 disease were not associated with an increased risk of asthma than non‐severe COVID‐19 patients (OR = 1.36, 95% CI: 0.79‐2.34, P = .27; I2 = 77%) (Figure 1A). Moreover, asthma was not associated with increased risk of mortality in patients with COVID‐19 (OR = 1.03, 95% CI: 0.55‐1.93, P = .92; I2 = 76%) (Figure 1B). The subgroup analysis based on countries suggested no significant relationship between asthma and risk of severe COVID‐19 disease in America (OR = 1.30, 95% CI: 0.57 to 2.98, P = .53; I2 = 84%). Sensitivity analyses by omitting each study at a time did not significantly alter the direction of the overall estimates.

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    El Ministerio de Salud de Costa Rica establece como obligatorio la aplicación de estos lineamientos en los lugares donde se brindan funciones de atención directa e indirecta de personas, en los servicios de salud públicos y privados, así como en los tres niveles de gestión del Ministerio de Salud. Debido a que los conocimientos generales y la situación epidemiológica de este nuevo coronavirus se encuentran en una condición evolutiva y dinámica, tanto en el contexto local como internacional, estos lineamientos se revisarán de forma periódica y se publicará la versión vigente en la página web del Ministerio de Salud.

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    Introduction: Conflict-induced displacement makes affected populations more vulnerable to HIV transmission. However, this vulnerability does not always necessarily translate into more HIV infections. The extent to which conflict and displacement affect HIV transmission depends upon numerouscompeting and interacting factors such as loss of livelihoods; availability of education; the type and the length of conflict; the living arrangements and conditions of internally displaced persons (IDPs), whether formal or informal settlement; the context of their new location; and access to health services, including HIV and sexual and reproductive health programs. These factors also have direct implications for HIV vulnerability. Vulnerability results from individual and societal factors that affect adversely one’s ability to exert control over one’s own health. The factors pertaining to the quality of coverage of services and programs also influence HIV vulnerability. The characteristics of the HIV epidemic, the prevalence in the local populations, the interactions with armed forces, the occurrence of sexual violence and the risk behaviours associated with the new situations conditions of IDPs directly affect the risk of HIV transmission. HIV risk is defined as the probability that a person may acquire HIV infection by, for example, unprotected sex with partners or injecting drug use with shared needles and syringes...

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    Authors: Verdejo, Catalina et al.;

    Objetivo: Proporcionar un resumen oportuno, riguroso y continuamente actualizado de la evidencia disponible sobre el papel de los macrólidos para el tratamiento de pacientes con COVID-19. Diseño: Revisión sistemática viva. Base de datos: La búsqueda de evidencia se realizó en el repositorio centralizado L·OVE (Living OVerview of Evidence) COVID-19; una plataforma que mapea las preguntas PICO para identificar la evidencia en la base de datos Epistemonikos. En respuesta a la emergencia de COVID-19, L·OVE se adaptó para ampliar el rango de evidencia que cubre y hoy se mantiene a través de búsquedas regulares en 39 bases de datos. Métodos: Se incluyeron estudios experimentales que evaluaban el efecto de los macrólidos, como monoterapia o en combinación con otros fármacos, versus placebo o ningún tratamiento en pacientes con sospecha o confirmación de COVID-19. Se buscó identificar experimentos clínicos aleatorizados que evaluaran macrólidos en infecciones causadas por otros coronavirus, como MERS-CoV y SARS-CoV. Dos revisores examinaron de forma independiente la elegibilidad de cada estudio, extrajeron los datos y evaluaron el riesgo de sesgo. Se evaluó el efecto de los macrólidos sobre la mortalidad por todas las causas; necesidad de ventilación mecánica invasiva; oxigenación por membrana extracorpórea, duración de la estancia hospitalaria, insuficiencia respiratoria, eventos adversos graves, tiempo hasta la negatividad de la RT-PCR del SARS-CoV-2. La certeza de la evidencia para cada desenlace se evaluó siguiendo la aproximación GRADE. Esta revisión se mantendrá viva y disponible abiertamente durante la pandemia de COVID-19. Se someterán actualizaciones de su publicación cada vez que cambien las conclusiones o cuando haya actualizaciones sustanciales. Resultados: Se identificó un experimento clínico aleatorio que evaluó el uso de azitromicina en combinación con hidroxicloroquina en comparación con el uso de hidroxicloroquina sola, en pacientes hospitalizados por COVID 19. Las estimaciones para todos los resultados evaluados resultaron en un poder estadístico insuficiente para llegar a conclusiones válidas. La calidad de la evidencia para los resultados principales fue baja a muy baja. Conclusiones: El uso de macrólidos en el tratamiento de pacientes con COVID 19 no ha mostrado efectos beneficiosos en comparación con el tratamiento estándar. La evidencia para todos los desenlaces no es concluyente. Se necesitan estudios sobre un mayor número de pacientes con COVID 19, para determinar los efectos del uso de macrólidos sobre los desenlaces relacionados con la enfermedad.

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    Authors: Allen, Claire;

    What is this? The COVID-19 pandemic is placing a strain on healthcare services and resources. Existing research on expanding healthcare professionals’ roles, such as prescribing by nurses, may provide useful information for policy makers. In this systematic review, the authors searched for experimental studies evaluating nurse-initiated medication interventions in emergency care settings. They did not restrict by type or language of publication and included studies published up to 2016. They included one randomized trial and four quasi-experimental studies (total: 1272 participants). There was one study from each of Australia, Hong Kong, the Netherlands, Saudi Arabia and Sweden. The nurse-initiated medications were salbutamol for respiratory conditions and analgesia for painful conditions. What was found: Nurse-initiated medications were found to be safe, timely, effective, patient-centred and efficient in emergency care settings. Nurse-initiated medications in emergency care settings had no effects on adverse events, waiting time to see a doctor, or length of stay. The effects of nurse-initiated medications (or other non-medical prescribing) in other conditions settings are uncertain.

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    13th March, 2020 - ST. JOHN’S, Antigua and Barbuda – 13th March, 2020Prime Minister the Hon. Gaston Browne today announced that the country has recorded its first confirmation of someone who has contracted the coronavirus (COVID-19). “I want to emphasize that there is no need for fear or panic, arising from this case. The person concerned is in self isolation at home, and a regime has been put in place today, not only to continue such isolation, but also to treat the condition,” noted the Prime Minister. He called on the nation to be more sensible in their behaviour and be their brother’s keeper. “Let us conjoin our efforts to prevent the spread of Covid 19 within the domestic population,” he said. “Considering the challenges of Covid 19, to include the economic impact and potential threat to our food security, we have to work diligently and collectively as a nation, of one people, with a common destiny to confront these challenges,” PM Browne concluded.

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    Cases with suspected or possible reinfection with SARS-CoV-2 have been recently reported in different countries. In many of these cases, it is uncertain if the individual’s Polymerase Chain Reaction (PCR) test remained positive for a long period of time following the first episode of infection or whether it represents a true reinfection.

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    Overview: This document and risk assessment tool provides practical guidance and recommendations to support the special role of religious leaders, faith-based organizations, and faith communities in COVID-19 education, preparedness, and response.

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    Authors: Colombia. Ministerio de Salud y Protección Social;
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    Authors: Wang, Yushu et al.;

    To the Editor, Recently, the associations between COVID‐19 and its comorbidities including hypertension, diabetes, obesity, cardiovascular disease, chronic obstructive pulmonary disease, chronic kidney disease, immunosuppression and other diseases have been reported in the many studies.1 However, there is no clear evidence about whether patients with asthma were at a higher risk of severe or fatal COVID‐19. Respiratory viral infections are one of the most common triggers for asthma exacerbations. Some studies have provided data about the prevalence of asthma in severe or fatal COVID‐19 patients.2-5 Higher levels of evidence are required to investigate the association between severe or fatal COVID‐19 and asthma. Thus, we performed this systematic review and meta‐analysis. We systematically conducted an electronic literature search in PubMed, EMBASE, Cochrane library, Web of Science and China National Knowledge Infrastructure (CNKI), using the keywords “asthma” or “respiratory diseases” AND “2019‐nCoV” or “novel coronavirus” or “coronavirus disease 2019” or “SARS‐CoV‐2” or “COVID‐19” from their inception up to 5 August 2020. The search was not restricted by language. Studies were selected if they fulfilled the following entry criteria: (a) patients must be diagnosed with COVID‐19 infection and (b) provided information of asthma with severe or non‐severe or between death and survivors. Abstracts, letters, case reports, literature review articles, letters to the editor and/or editorials were excluded. For each study, the following data were abstracted: name of the first author, country where the cohort was conducted, size of the cohort, numbers of males and females, age range or mean and outcomes of interest. The severity of the disease was mainly determined on the basis of symptom (eg patients with pulse oxygen saturation less than 90%, or required mechanical ventilation, or with acute respiratory distress syndrome, or admitted to intensive care unit). For non‐random controlled studies, a nine‐item Newcastle‐Ottawa Scale (NOS) was used as an assessment tool for selection, comparability and outcome assessment by two investigators (YW and GA). A total score of ≥7 indicated a high‐quality study, whereas a total score of <7 was considered to a low‐quality study. If necessary, the primary authors were contacted to retrieve further data. The literature search, eligible study selection and data extraction were performed independently by two authors (YW and GA). Any disagreements were resolved with a third investigator or by consensus. Review Manager 5.3 (Cochrane Collaboration) was used to calculate the individual and pooled odds ratio (OR) with their relative 95% confidence interval (95% CI). Heterogeneity among studies was assessed with Cochran's Q test and the I2 statistic, with an I2 < 25%, 25%‐50% and greater than 50% represented low, moderate and high heterogeneity, respectively. In addition, sensitivity analysis was conducted to evaluate the stability of the outcome and was performed by excluding 1 study at a time. P < .05 was considered statistically significant. This study is registered with PROSPERO, number CRD42020203058. In total, the search strategy retrieved 457 studies based on our search criteria. After exclusion of duplicate records and studies that did not fulfil our inclusion criteria, 72 articles remained and we further evaluated the full texts of these 72 literatures. Of these, we excluded 58 studies owing to lack of sufficient information for estimation of OR and not an outcome of interest. Finally, a total of 14 publications representing data from 17 694 participants were included in this meta‐analysis.1-14 The sample size of patients ranged from 69 to 9946. Six studies were from America, two studies from Mexico, two studies from China and four studies from other countries. Asthma is defined according to the patient's medical history. All studies were published in English. The details of each included study are presented in Table 1. The NOS scores of these studies ranged from 7 to 9, which indicated that all data sets were of high quality (Table S1). The meta‐analysis showed that patients with severe COVID‐19 disease were not associated with an increased risk of asthma than non‐severe COVID‐19 patients (OR = 1.36, 95% CI: 0.79‐2.34, P = .27; I2 = 77%) (Figure 1A). Moreover, asthma was not associated with increased risk of mortality in patients with COVID‐19 (OR = 1.03, 95% CI: 0.55‐1.93, P = .92; I2 = 76%) (Figure 1B). The subgroup analysis based on countries suggested no significant relationship between asthma and risk of severe COVID‐19 disease in America (OR = 1.30, 95% CI: 0.57 to 2.98, P = .53; I2 = 84%). Sensitivity analyses by omitting each study at a time did not significantly alter the direction of the overall estimates.

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    El Ministerio de Salud de Costa Rica establece como obligatorio la aplicación de estos lineamientos en los lugares donde se brindan funciones de atención directa e indirecta de personas, en los servicios de salud públicos y privados, así como en los tres niveles de gestión del Ministerio de Salud. Debido a que los conocimientos generales y la situación epidemiológica de este nuevo coronavirus se encuentran en una condición evolutiva y dinámica, tanto en el contexto local como internacional, estos lineamientos se revisarán de forma periódica y se publicará la versión vigente en la página web del Ministerio de Salud.

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    Introduction: Conflict-induced displacement makes affected populations more vulnerable to HIV transmission. However, this vulnerability does not always necessarily translate into more HIV infections. The extent to which conflict and displacement affect HIV transmission depends upon numerouscompeting and interacting factors such as loss of livelihoods; availability of education; the type and the length of conflict; the living arrangements and conditions of internally displaced persons (IDPs), whether formal or informal settlement; the context of their new location; and access to health services, including HIV and sexual and reproductive health programs. These factors also have direct implications for HIV vulnerability. Vulnerability results from individual and societal factors that affect adversely one’s ability to exert control over one’s own health. The factors pertaining to the quality of coverage of services and programs also influence HIV vulnerability. The characteristics of the HIV epidemic, the prevalence in the local populations, the interactions with armed forces, the occurrence of sexual violence and the risk behaviours associated with the new situations conditions of IDPs directly affect the risk of HIV transmission. HIV risk is defined as the probability that a person may acquire HIV infection by, for example, unprotected sex with partners or injecting drug use with shared needles and syringes...

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