Monitoring respiratory infections in covid-19 epidemics

Chan, Ka Hung; Lee, Pak Wing; Chan, Crystal; Lam, Hubert; Ho, Pak Leung

doi:10.1136/bmj.m1628

Cited by 45 publications

(48 citation statements)

References 7 publications

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“…This shift is a double-edged sword in the mosaic of autoimmunity. The positive side is reflected by a reduction in airborne infectious disease with a documented shortening of the influenza season in the northern hemisphere by about six weeks [84]. This may reduce the occurrence of subsequent effects of influenza infection on RMDs.…”

Section: Population Behavioral Modification With Covid-19mentioning

confidence: 99%

Autoimmune and rheumatic musculoskeletal diseases as a consequence of SARS-CoV-2 infection and its treatment

et al. 2020

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The coronavirus disease-2019 (COVID-19) pandemic is likely to pose new challenges to the rheumatology community in the near and distant future. Some of the challenges, like the severity of COVID-19 among patients on immunosuppressive agents, are predictable and are being evaluated with great care and effort across the globe. A few others, such as atypical manifestations of COVID-19 mimicking rheumatic musculoskeletal diseases (RMDs) are being reported. Like in many other viral infections, severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) infection can potentially lead to an array of rheumatological and autoimmune manifestations by molecular mimicry (cross-reacting epitope between the virus and the host), bystander killing (virus-specific CD8 + T cells migrating to the target tissues and exerting cytotoxicity), epitope spreading, viral persistence (polyclonal activation due to the constant presence of viral antigens driving immune-mediated injury) and formation of neutrophil extracellular traps. In addition, the myriad of antiviral drugs presently being tried in the treatment of COVID-19 can result in several rheumatic musculoskeletal adverse effects. In this review, we have addressed the possible spectrum and mechanisms of various autoimmune and rheumatic musculoskeletal manifestations that can be precipitated by COVID-19 infection, its therapy, and the preventive strategies to contain the infection. Keywords Coronavirus disease-2019 (COVID-19) • Rheumatic musculoskeletal diseases (RMDs) • Autoimmunity • Rheumatology Abbreviations AAV Anti-neutrophil cytoplasmic antibodyassociated vasculitis ACE2 Angiotensin-converting enzyme 2 ANA Antinuclear antibodies AIDS Acquired immunodeficiency syndrome APCs Antigen-presenting cells APS Antiphospholipid antibody syndrome ARDS Acute respiratory distress syndrome CAHA Coronavirus-associated hemostatic lung abnormality CART Chimeric antigen receptor T cell CCL2 Chemokine (C-C motif) ligand 2 CK Creatine kinase COVID-19 Coronavirus disease-2019 CSF Cerebrospinal fluid CRS Cytokine release syndrome CXCL8 C-X-C motif chemokine ligand 8 DADA-2 Deficiency of adenosine deaminase-2 DIC Disseminated intravascular coagulation Rheumatology INTERNATIONAL Sanket Shah and Debashish Danda have contributed equally as first authors.

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Section: Population Behavioral Modification With Covid-19mentioning

confidence: 99%

Autoimmune and rheumatic musculoskeletal diseases as a consequence of SARS-CoV-2 infection and its treatment

et al. 2020

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“…Masking was not specifically defined but was generally understood by the public as surgical masks, while some may use re-useable mask [ 16 , 17 ]. Social distancing was widely practised by Hong Kong citizens, with some government policy since 25th January 2020 including closure of all schools, work from home policy for most government employees, closure of recreational business and bars, and ban on gathering of more than four people in public places ([ 18 ], Fig. 1 ).…”

Section: Introductionmentioning

confidence: 99%

Significant reduction in hospital admissions for acute exacerbation of chronic obstructive pulmonary disease in Hong Kong during coronavirus disease 2019 pandemic

Chan

Fung

Kwok

et al. 2020

Respiratory Medicine

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Background Chronic respiratory diseases are risk factors for severe disease in coronavirus disease 2019 (COVID-19). Respiratory tract infection is one of the commonest causes of acute exacerbation of chronic obstructive pulmonary disease (AECOPD). There has not been evidence suggesting the link between COVID-19 and AECOPD, especially in places with dramatic responses in infection control with universal masking and aggressive social distancing. Methods This is a retrospective study to assess the number of admissions of AECOPD in the first three months of 2020 in Queen Mary Hospital with reference to the admissions in past five years. Log-linear model was used for statistical inference of covariates, including percentage of masking, air quality health index and air temperature. Results The number of admissions for AECOPD significantly decreased by 44.0% (95% CI 36.4%–52.8%, p < 0.001) in the first three months of 2020 compared with the monthly average admission in 2015–2019. Compare to same period of previous years, AECOPD decreased by 1.0% with each percent of increased masking (p < 0.001) and decreased by 3.0% with increase in 1 °C in temperature (p = 0.045). The numbers of admissions for control diagnoses (heart failure, intestinal obstruction and iron deficiency anaemia) in the same period in 2020 were not reduced. Conclusions The number of admissions for AECOPD decreased in first three months of 2020, compared with previous years. This was observed with increased masking percentage and social distancing in Hong Kong. We postulated universal masking and social distancing during COVID-19 pandemics both contributed in preventing respiratory tract infections hence AECOPD.

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“…Given the high level of income inequality and the long battle against COVID-19, Hong Kong serves as an ideal setting to study the association of time to diagnosis of COVID-19 with SEP and geographical accessibility to care. Due to its proximity to Wuhan, China and it being an international travel hub, Hong Kong has been combating COVID-19 outbreaks since January 2020 ( Chan et al, 2020 ). Even before the first infected case was identified, various measures had been implemented in Hong Kong to control the transmission of COVID-19 ( Wong et al, 2020 ; Cowling et al, 2020 ).…”

Section: Introductionmentioning

confidence: 99%

Association of time to diagnosis with socioeconomic position and geographical accessibility to healthcare among symptomatic COVID-19 patients: A retrospective study in Hong Kong

Yan

Zhao

et al. 2020

Health & Place

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Early diagnosis is important to control COVID-19 outbreaks. This study aimed to assess how individual and area socioeconomic position and geographical accessibility to healthcare services were associated with the time to diagnosis among symptomatic COVID-19 patients in Hong Kong. Multivariable generalized linear regression was used to estimate the associations while adjusting for sociodemographic characteristics and case classification. This study found living in public rental houses and living in area with low education were associated with longer time to diagnosis in the first wave of infections. Specifically, the risk of delayed diagnosis for public rental house residents was mitigated by the higher density of public clinics/hospitals but was slightly increased by the higher density of private medical practitioners nearby. No such relations were found in the second wave of infections when the surveillance measures were enhanced. Given the grave impact of pandemics around the world, our findings call on taking inequalities into account when public health policies are being devised.

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Monitoring respiratory infections in covid-19 epidemics

Abstract: Ka Hung Chan and colleagues argue that monitoring influenza-like illness could be a complementary approach to assessing the effectiveness of general infection control measures against covid-19

Cited by 45 publications

References 7 publications

Autoimmune and rheumatic musculoskeletal diseases as a consequence of SARS-CoV-2 infection and its treatment

Autoimmune and rheumatic musculoskeletal diseases as a consequence of SARS-CoV-2 infection and its treatment

Significant reduction in hospital admissions for acute exacerbation of chronic obstructive pulmonary disease in Hong Kong during coronavirus disease 2019 pandemic

Association of time to diagnosis with socioeconomic position and geographical accessibility to healthcare among symptomatic COVID-19 patients: A retrospective study in Hong Kong

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