Clinical course of 2019 novel coronavirus disease (COVID-19) in individuals present during the outbreak on the Diamond Princess cruise ship

Kato, Hideaki; Shimizu, Hiroyuki; Shibue, Yasushi; Hosoda, Tomohiro; Iwabuchi, Kazuya; Nagamine, Kotaro; Saito, Hiroki; Sawada, Reimin; Oishi, Takayuki; Tsukiji, Jun; Fujita, Hiroyuki; Furuya, Ryosuke; Masuda, Makoto; Akasaka, Osamu; Yu, I.; Sakamoto, Mitsuo; Sakai, Kazuya; Uchiyama, Mitsuaki; Watanabe, Hiroki; Yamada, Nobuhiro; Higa, Ryoko; Sasaki, Akira; Tanaka, Katsuaki; Toyoda, Yukitoshi; Shinsuke, Hamanaka; Miyazawa, Naoki; Shimizu, Atsuko; Fukase, Fumie; Iwai, Shinichi; Komase, Yuko; Kawasaki, Tsutomu; Nagata, Ikuo; Nakayama, Yusuke; Takei, Toshinobu; Kimura, Kensuke; Kunisaki, Reiko; Kudo, Makoto; Takeuchi, Ichiro; Nakajima, Hitoshi

doi:10.1016/j.jiac.2020.05.005

Cited by 48 publications

(49 citation statements)

References 9 publications

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“…The first patient (REMRQ0001) was admitted to the Royal Liverpool University Hospital on 23 February 2020. The patient was a member of staff from the Diamond Princes cruise ship that had an outbreak of SARS-CoV-2 leading to passengers developing COVID-19 [ 12 , 13 ]. The patient was asymptomatic but was screened for SARS-CoV-2 on 20 February 2020, left the ship on 21 February and was repatriated from Japan on 22 February 2020.…”

Section: Resultsmentioning

confidence: 99%

Amplicon-Based Detection and Sequencing of SARS-CoV-2 in Nasopharyngeal Swabs from Patients With COVID-19 and Identification of Deletions in the Viral Genome That Encode Proteins Involved in Interferon Antagonism

Moore

Penrice-Randal

Alruwaili

et al. 2020

Viruses

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Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is the causative agent of coronavirus disease 2019 (COVID-19). Sequencing the viral genome as the outbreak progresses is important, particularly in the identification of emerging isolates with different pathogenic potential and to identify whether nucleotide changes in the genome will impair clinical diagnostic tools such as real-time PCR assays. Although single nucleotide polymorphisms and point mutations occur during the replication of coronaviruses, one of the biggest drivers in genetic change is recombination. This can manifest itself in insertions and/or deletions in the viral genome. Therefore, sequencing strategies that underpin molecular epidemiology and inform virus biology in patients should take these factors into account. A long amplicon/read length-based RT-PCR sequencing approach focused on the Oxford Nanopore MinION/GridION platforms was developed to identify and sequence the SARS-CoV-2 genome in samples from patients with or suspected of COVID-19. The protocol, termed Rapid Sequencing Long Amplicons (RSLAs) used random primers to generate cDNA from RNA purified from a sample from a patient, followed by single or multiplex PCRs to generate longer amplicons of the viral genome. The base protocol was used to identify SARS-CoV-2 in a variety of clinical samples and proved sensitive in identifying viral RNA in samples from patients that had been declared negative using other nucleic acid-based assays (false negative). Sequencing the amplicons revealed that a number of patients had a proportion of viral genomes with deletions.

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Section: Resultsmentioning

confidence: 99%

Amplicon-Based Detection and Sequencing of SARS-CoV-2 in Nasopharyngeal Swabs from Patients With COVID-19 and Identification of Deletions in the Viral Genome That Encode Proteins Involved in Interferon Antagonism

Moore

Penrice-Randal

Alruwaili

et al. 2020

Viruses

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show abstract

“…11 Ideally, every region should have their own prevalence study, such as in the state of Rio Grande do Sul, 12 where a populational study found that just 20% of all COVID-19 cases were confirmed. Considering the average duration of the infection is 15 days, 13 it is possible to affirm that the prevalence of coronavirus infections in Rio Grande do Sul is five times the number of cases confirmed in the last 15 days.…”

Section: Prevalence Of Coronavirus In the Regionsmentioning

confidence: 96%

“…Another option for estimating prevalence in an area where populational studies are not available is to calculate the prevalence rate based on the number of hospitalized patients. The Diamond Princess cruise ship 13 is probably the most controlled incidence to evaluate the percentage of patients infected by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) who will need hospitalization. After screening 3618 of 3711 individuals on board, 696 individuals (19.2%) were confirmed positive for COVID-19.…”

Section: Prevalence Of Coronavirus In the Regionsmentioning

confidence: 99%

“…Of these, 70 patients were transferred to the study's participating hospitals for further medical care. 13 Considering the Japanese high standards of confirmation, it is fair to affirm that approximately 10% (70/696) of infected patients will require hospitalization. Thus, the prevalence of COVID-19 in one area is approximately 10 times the number of hospitalized patients in the last 15 days.…”

Section: Prevalence Of Coronavirus In the Regionsmentioning

confidence: 99%

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Perioperative Cancer Care in the Context of Limited Resources during the COVID-19 Pandemic: Brazilian Society of Surgical Oncology Recommendations

et al. 2020

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Background. As the COVID-19 pandemic moves from rich to poor nations, the healthcare systems of developing countries have to deal with this extra burden. As cancer care cannot stop and surgery is the main mechanism for cure and palliation, it is important to provide safe and rational access to cancer surgery during the COVID-19 pandemic. Methods. From April 1st to May 1st, the committee of the Brazilian Society of Surgical Oncology (BSSO) was responsible for reviewing the literature and writing recommendations for perioperative cancer care in the context of limited resources during the pandemic. The recommendations were submitted to the BSSO board of directors. The orientations that were not consensual were removed and the suggestions were added to the text. From May 15 to 30th, the committee revised the recommendations, aligned them with the objectives of the work and standardize the text. Discussion. The rational use of resources to reduce the risk of surgical cancer patients being operated on during the incubation period of a corona virus infection is important in this context. Prevalence of corona virus in the region, the need for surgery, surgical complexity, patient age and comorbidities, and availability of corona virus testing are central aspects in this matter and are discussed. Conclusions. We present a protocol, focused on the patients' outcomes, for safe and rational use of resources to reduce the risk of surgical cancer patients being operated on during the virus incubation period, in the context of areas with limited resources.

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“…Since February 2020, we have treated patients with COVID-19 at Yokohama City University Hospital, a tertiary-level hospital, owing to the outbreak on the "Diamond Princess" cruise ship docked in Yokohama Bay. 17,18 A select team (Team COVID-19) was deployed for the treatment of patients with moderate to severe COVID-19 and with suspected COVID-19. One focus of Team COVID is on preventing in-hospital infections and medical staff infections, with reference to protocols that were previously launched during the epidemic of a novel type of in uenza in 2002 to 2003.…”

Section: Introductionmentioning

confidence: 99%

Real-world evaluation of a computed tomography-first triage strategy for suspected Coronavirus disease 2019 in outpatients with fever in Japan: an observational cohort study

Miyake

Higurashi

Jono

et al. 2020

Preprint

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Background: The Coronavirus disease 2019 pandemic continues to spread worldwide. Because of the absence of reliable rapid diagnostic systems, patients with symptoms of Coronavirus disease 2019 are treated as suspected of the disease. Use of computed tomography findings in Coronavirus disease 2019 are expected to be a reasonable method for triaging patients, and computed tomography-first triage strategies have been proposed. However, clinical evaluation of a computed tomography-first triage protocol is lacking.The aim of this study is to investigate the real-world efficacy and limitations of a computed tomography-first triage strategy in patients with suspected Coronavirus disease 2019.Methods: This was a single-center cohort study evaluating outpatients with fever who received medical examination at Yokohama City University Hospital, prospectively registered between 9 February and 5 May 2020. We treated according to the computed tomography-first triage protocol. The primary outcome was efficacy of the computed tomography-first triage protocol for patients with fever in an outpatient clinic. Efficacy of the computed tomography-first triage protocol for outpatients with fever was evaluated using sensitivity, specificity, positive predictive value, and negative predictive value. We conducted additional analyses of the isolation time of feverish outpatients and final diagnoses.Results: In total, 108 consecutive outpatients with fever were examined at our hospital. Using the computed tomography-first triage protocol, 48 (44.9%) patients were classified as suspected Coronavirus disease 2019. Nine patients (18.8%) in this group were positive for severe acute respiratory syndrome coronavirus 2 using polymerase chain reaction; no patients in the group considered less likely to have Coronavirus disease 2019 tested positive for the virus. The sensitivity, specificity, positive predictive value, and negative predictive value of our computed tomography-first triage protocol for Coronavirus disease 2019 were 100%, 60.2%, 18.8%, and 100%, respectively. The protocol significantly shortened the duration of isolation for the not-suspected versus the suspected group (70.5 vs. 1037.0 minutes, P < .001). Conclusions: Our computed tomography-first triage protocol was acceptable for screening patients with suspected Coronavirus disease 2019. This protocol will be helpful for appropriate triage, especially in areas where polymerase chain reaction is inadequate.

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Clinical course of 2019 novel coronavirus disease (COVID-19) in individuals present during the outbreak on the Diamond Princess cruise ship

Cited by 48 publications

References 9 publications

Amplicon-Based Detection and Sequencing of SARS-CoV-2 in Nasopharyngeal Swabs from Patients With COVID-19 and Identification of Deletions in the Viral Genome That Encode Proteins Involved in Interferon Antagonism

Amplicon-Based Detection and Sequencing of SARS-CoV-2 in Nasopharyngeal Swabs from Patients With COVID-19 and Identification of Deletions in the Viral Genome That Encode Proteins Involved in Interferon Antagonism

Perioperative Cancer Care in the Context of Limited Resources during the COVID-19 Pandemic: Brazilian Society of Surgical Oncology Recommendations

Real-world evaluation of a computed tomography-first triage strategy for suspected Coronavirus disease 2019 in outpatients with fever in Japan: an observational cohort study

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