Special Issue "COVID-19: Current Challenges and Future Perspectives"

A special issue of Tropical Medicine and Infectious Disease (ISSN 2414-6366).

Deadline for manuscript submissions: 30 June 2021.

Special Issue Editors

Prof. Dr. Peter A. Leggat
E-Mail Website
Guest Editor
1. College of Public Health, Medical and Veterinary Sciences, Division of Tropical Health and Medicine, James Cook University, Townsville Qld 4811, Australia
2. School of Medicine, College of Medicine, Nursing and Health Sciences, National University of Ireland, Galway, Ireland
Interests: neglected tropical diseases; lymphatic filariasis; dengue; malaria; occupational health; travel medicine; emerging public health threats
Special Issues and Collections in MDPI journals
Prof. Dr. John Frean
E-Mail Website
Guest Editor
Deputy Director, Microbiology, and Parasitology Reference Laboratory, Centre for Emerging Zoonotic and Parasitic Diseases, National Institute for Communicable Diseases, University of the Witwatersrand, Johannesburg 2192, South Africa
Interests: parasitic and zoonotic infections; travel and tropical medicine
Prof. Dr. Lucille Blumberg
E-Mail Website
Guest Editor
Deputy Director, Epidemiology, and Medical Consultant, Centre for Emerging and Zoonotic Diseases, Head of the Public Health Surveillance and Response Division, National Institute for Communicable Diseases, Johannesburg, South Africa
Interests: viral haemorrhagic fevers (VHF); rabies; malaria; travel related infections

Special Issue Information

Dear Colleagues,

On March 11, 2020, the World Health Organization declared COVID-19 as a global pandemic and the disease now affects nearly every country and region. Caused by SARS-CoV-2, COVID-19 is presenting significant challenges to health systems and public health in both hemispheres, as well as the economies of each country. The morbidity and mortality of the infection caused by SARS-CoV-2 has been significant in a short period and initially overwhelmed many hospitals and clinics. It influences everyone, and countermeasures have been dramatic in their impact on employment, social systems, and mental health.

This Special Issue provides an avenue for authors from various disciplines to provide feedback on the response and our preparedness to COVID-19 globally, as well as to disseminate critical information about the SARS-CoV-2 virus and the associated COVID-19 Pandemic. We are accepting submissions from around the world, but we are particularly interested in submissions featuring perspectives from the Southern Hemisphere.

The scope of the issue shall encompass the following:

  • Original articles about COVID-19 (including epidemiology, modelling, clinical data, treatment, prevention, countermeasures, impact on tropical regions, response, and preparedness)
  • Original articles about SARS-CoV-2 (microbiology, virology, transmission, pathology, and vaccinology)
  • Perspectives about COVID-19 and SARS-CoV-2 (comparisons with past coronavirus outbreaks, impactful local initiatives, novel responses and commentaries)
  • Reviews on COVID-19 (based on systematic and narrative reviews)
  • Innovations (vaccine development, drug trials, and original countermeasures)

Prof. Dr. Peter A. Leggat
Prof. Dr. John Frean
Prof. Dr. Lucille Blumberg
Guest Editors

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All papers will be peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Tropical Medicine and Infectious Disease is an international peer-reviewed open access quarterly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 1600 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • coronavirus
  • countermeasures
  • COVID-19
  • Infectious disease
  • microbiology
  • origins
  • outbreak
  • pandemic
  • pathology
  • pneumonia
  • preparedness
  • psychological impacts
  • public health
  • response
  • SARS-CoV-2
  • severe respiratory distress syndrome
  • social effects
  • Southern Hemisphere
  • tropics
  • virology
  • zoonosis

Published Papers (18 papers)

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Research

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Article
Operational Research to Assess the Real-Time Impact of COVID-19 on TB and HIV Services: The Experience and Response from Health Facilities in Harare, Zimbabwe
Trop. Med. Infect. Dis. 2021, 6(2), 94; https://doi.org/10.3390/tropicalmed6020094 - 31 May 2021
Cited by 1 | Viewed by 732
Abstract
When COVID-19 was declared a pandemic, there was concern that TB and HIV services in Zimbabwe would be severely affected. We set up real-time monthly surveillance of TB and HIV activities in 10 health facilities in Harare to capture trends in TB case [...] Read more.
When COVID-19 was declared a pandemic, there was concern that TB and HIV services in Zimbabwe would be severely affected. We set up real-time monthly surveillance of TB and HIV activities in 10 health facilities in Harare to capture trends in TB case detection, TB treatment outcomes and HIV testing and use these data to facilitate corrective action. Aggregate data were collected monthly during the COVID-19 period (March 2020–February 2021) using EpiCollect5 and compared with monthly data extracted for the pre-COVID-19 period (March 2019–February 2020). Monthly reports were sent to program directors. During the COVID-19 period, there was a decrease in persons with presumptive pulmonary TB (40.6%), in patients registered for TB treatment (33.7%) and in individuals tested for HIV (62.8%). The HIV testing decline improved in the second 6 months of the COVID-19 period. However, TB case finding deteriorated further, associated with expiry of diagnostic reagents. During the COVID-19 period, TB treatment success decreased from 80.9 to 69.3%, and referral of HIV-positive persons to antiretroviral therapy decreased from 95.7 to 91.7%. Declining trends in TB and HIV case detection and TB treatment outcomes were not fully redressed despite real-time monthly surveillance. More support is needed to transform this useful information into action. Full article
(This article belongs to the Special Issue COVID-19: Current Challenges and Future Perspectives)
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Article
Assessing the Impact of COVID-19 on TB and HIV Programme Services in Selected Health Facilities in Lilongwe, Malawi: Operational Research in Real Time
Trop. Med. Infect. Dis. 2021, 6(2), 81; https://doi.org/10.3390/tropicalmed6020081 - 19 May 2021
Cited by 1 | Viewed by 842
Abstract
When the COVID-19 pandemic was announced in March 2020, there was concern that TB and HIV programme services in Malawi would be severely affected. We set up real-time monthly surveillance of TB and HIV activities in eight health facilities in Lilongwe to see [...] Read more.
When the COVID-19 pandemic was announced in March 2020, there was concern that TB and HIV programme services in Malawi would be severely affected. We set up real-time monthly surveillance of TB and HIV activities in eight health facilities in Lilongwe to see if it was possible to counteract the anticipated negative impact on TB case detection and treatment and HIV testing. Aggregate data were collected monthly during the COVID-19 period (March 2020–February 2021) using an EpiCollect5 application and compared with monthly data collected during the pre-COVID-19 period (March 2019–February 2020); these reports were sent monthly to programme directors. During COVID-19, there was an overall decrease in persons presenting with presumptive pulmonary TB (45.6%), in patients registered for TB treatment (19.1%), and in individuals tested for HIV (39.0%). For presumptive TB, children and females were more affected, but for HIV testing, adults and males were more affected. During COVID-19, the TB treatment success rate (96.1% in pre-COVID-19 and 96.0% during COVID-19 period) and referral of HIV-positive persons to antiretroviral therapy (100% in pre-COVID-19 and 98.6% during COVID-19 period) remained high and largely unchanged. Declining trends in TB and HIV case detection were not redressed despite real-time monthly surveillance. Full article
(This article belongs to the Special Issue COVID-19: Current Challenges and Future Perspectives)
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Article
Assessing the Real-Time Impact of COVID-19 on TB and HIV Services: The Experience and Response from Selected Health Facilities in Nairobi, Kenya
Trop. Med. Infect. Dis. 2021, 6(2), 74; https://doi.org/10.3390/tropicalmed6020074 - 10 May 2021
Cited by 1 | Viewed by 820
Abstract
There was concern that the COVID-19 pandemic would adversely affect TB and HIV programme services in Kenya. We set up real-time monthly surveillance of TB and HIV activities in 18 health facilities in Nairobi so that interventions could be implemented to counteract anticipated [...] Read more.
There was concern that the COVID-19 pandemic would adversely affect TB and HIV programme services in Kenya. We set up real-time monthly surveillance of TB and HIV activities in 18 health facilities in Nairobi so that interventions could be implemented to counteract anticipated declining trends. Aggregate data were collected and reported monthly to programme heads during the COVID-19 period (March 2020–February 2021) using EpiCollect5 and compared with monthly data collected during the pre-COVID period (March 2019–February 2020). During the COVID-19 period, there was an overall decrease in people with presumptive pulmonary TB (31.2%), diagnosed and registered with TB (28.0%) and in those tested for HIV (50.5%). Interventions to improve TB case detection and HIV testing were implemented from August 2020 and were associated with improvements in all parameters during the second six months of the COVID-19 period. During the COVID-19 period, there were small increases in TB treatment success (65.0% to 67.0%) and referral of HIV-positive persons to antiretroviral therapy (91.2% to 92.9%): this was more apparent in the second six months after interventions were implemented. Programmatic interventions were associated with improved case detection and treatment outcomes during the COVID-19 period, suggesting that monthly real-time surveillance is useful during unprecedented events. Full article
(This article belongs to the Special Issue COVID-19: Current Challenges and Future Perspectives)
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Article
A Case Series Describing the Recurrence of COVID-19 in Patients Who Recovered from Initial Illness in Bangladesh
Trop. Med. Infect. Dis. 2021, 6(2), 41; https://doi.org/10.3390/tropicalmed6020041 - 31 Mar 2021
Viewed by 1339
Abstract
To date, severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) has infected over 80 million people globally. We report a case series of five clinically and laboratory confirmed COVID-19 patients from Bangladesh who suffered a second episode of COVID-19 illness after 70 symptom-free days. The [...] Read more.
To date, severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) has infected over 80 million people globally. We report a case series of five clinically and laboratory confirmed COVID-19 patients from Bangladesh who suffered a second episode of COVID-19 illness after 70 symptom-free days. The International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), is a leading public health research institution in South Asia. icddr, b staff were actively tested, treated and followed-up for COVID-19 by an experienced team of clinicians, epidemiologists, and virologists. From 21 March to 30 September 2020, 1370 icddr,b employees working at either the Dhaka (urban) or Matlab (rural) clinical sites were tested for COVID-19. In total, 522 (38%) were positive; 38% from urban Dhaka (483/1261) and 36% from the rural clinical site Matlab (39/109). Five patients (60% male with a mean age of 41 years) had real-time reverse transcription-polymerase chain reaction (rRT-PCR) diagnosed recurrence (reinfection) of SARS-CoV-2. All had mild symptoms except for one who was hospitalized. Though all cases reported fair risk perceptions towards COVID-19, all had potential exposure sources for reinfection. After a second course of treatment and home isolation, all patients fully recovered. Our findings suggest the need for COVID-19 vaccination and continuing other preventive measures to further mitigate the pandemic. An optimal post-recovery follow-up strategy to allow the safe return of COVID-19 patients to the workforce may be considered. Full article
(This article belongs to the Special Issue COVID-19: Current Challenges and Future Perspectives)
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Communication
Malaria in the Time of COVID-19: Do Not Miss the Real Cause of Illness
Trop. Med. Infect. Dis. 2021, 6(2), 40; https://doi.org/10.3390/tropicalmed6020040 - 26 Mar 2021
Viewed by 931
Abstract
We report a case of Plasmodium falciparum malaria in a patient asymptomatically co-infected with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). In the current ongoing coronavirus pandemic, co-infections with unrelated life-threatening febrile conditions may pose a particular challenge to clinicians. The current situation [...] Read more.
We report a case of Plasmodium falciparum malaria in a patient asymptomatically co-infected with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). In the current ongoing coronavirus pandemic, co-infections with unrelated life-threatening febrile conditions may pose a particular challenge to clinicians. The current situation increases the risk for cognitive biases in medical management. Full article
(This article belongs to the Special Issue COVID-19: Current Challenges and Future Perspectives)
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Communication
If Not COVID-19 What Is It? Analysis of COVID-19 versus Common Respiratory Viruses among Symptomatic Health Care Workers in a Tertiary Infectious Disease Referral Hospital in Manila, Philippines
Trop. Med. Infect. Dis. 2021, 6(1), 39; https://doi.org/10.3390/tropicalmed6010039 - 19 Mar 2021
Viewed by 1272
Abstract
The COVID-19 global pandemic is entering its second year. In this short report we present additional results as a supplement to our previous paper on COVID-19 and common respiratory virus screening for healthcare workers (HCWs) in a tertiary infectious disease referral hospital in [...] Read more.
The COVID-19 global pandemic is entering its second year. In this short report we present additional results as a supplement to our previous paper on COVID-19 and common respiratory virus screening for healthcare workers (HCWs) in a tertiary infectious disease referral hospital in Manila, Philippines. We sought to understand what etiologic agents could explain the upper/lower respiratory tract infection-like (URTI/LRTI-like) symptoms exhibited by 88% of the 324 HCWs tested. Among the patients who had URTI/LRTI-like symptoms, only seven (2%) were positive for COVID-19, while 38 (13%) of the symptomatic participants were identified positive for another viral etiologic agent. Rhinovirus was the most common infection, with 21 (9%) of the symptomatic participants positive for rhinovirus. Based on these results, testing symptomatic HCWs for common respiratory illnesses in addition to COVID-19 should be considered during this time of global pandemic. Full article
(This article belongs to the Special Issue COVID-19: Current Challenges and Future Perspectives)
Article
SARS-CoV-2 Seroprevalence Post-First Wave among Primary Care Physicians in Catania (Italy)
Trop. Med. Infect. Dis. 2021, 6(1), 21; https://doi.org/10.3390/tropicalmed6010021 - 09 Feb 2021
Cited by 1 | Viewed by 1093
Abstract
Family physicians or pediatricians and general practitioners (GPs) work in non-hospital settings. GPs usually visit many patients, frequently at their homes, with low potential, if any, to control the work setting. Particularly during the initial phases of the COVID-19 outbreak, they were not [...] Read more.
Family physicians or pediatricians and general practitioners (GPs) work in non-hospital settings. GPs usually visit many patients, frequently at their homes, with low potential, if any, to control the work setting. Particularly during the initial phases of the COVID-19 outbreak, they were not informed about the occurrence of SARS-CoV-2-infected patients, with inadequate information regarding the risk, a lack of suitable protective measures and, in some cases, deficient or poor accessibility to personal protective equipment (PPE). During the first wave of COVID-19, primary care physicians were on the front line and isolated the first cases of the disease. The present study aims to estimate the seroprevalence of SARS-CoV-2 in a cohort of 133 GPs working in Catania (Italy) after the first wave of COVID-19. Serological analysis revealed a low seroprevalence (3%) among GPs. The low seroprevalence highlighted in the results can be attributed to correct management of patients by GPs in the first wave. It is now hoped that mass vaccination, combined with appropriate behavior and use of PPE, can help further reduce the risk of COVID-19 disease. Full article
(This article belongs to the Special Issue COVID-19: Current Challenges and Future Perspectives)
Article
Investing in Operational Research Capacity Building for Front-Line Health Workers Strengthens Countries’ Resilience to Tackling the COVID-19 Pandemic
Trop. Med. Infect. Dis. 2020, 5(3), 118; https://doi.org/10.3390/tropicalmed5030118 - 16 Jul 2020
Viewed by 1374
Abstract
(1) Introduction. The Structured Operational Research and Training IniTiative (SORT IT) supports countries to build operational research capacity for improving public health. We assessed whether health workers trained through SORT IT were (1) contributing to the COVID-19 pandemic response and if so, (2) [...] Read more.
(1) Introduction. The Structured Operational Research and Training IniTiative (SORT IT) supports countries to build operational research capacity for improving public health. We assessed whether health workers trained through SORT IT were (1) contributing to the COVID-19 pandemic response and if so, (2) map where and how they were applying their SORT IT skills. (2) Methods. An online questionnaire survey of SORT IT alumni trained between 2009 and 2019. (3) Results. Of 895 SORT IT alumni from 93 countries, 652 (73%) responded to the survey and 417 were contributing to the COVID-19 response in 72 countries. Of those contributing, 307 (74%) were applying their SORT IT skills to tackle the pandemic in 60 countries and six continents including Africa, Asia, Europe, South Pacific and North/South America. Skills were applied to all the pillars of the emergency response with the highest proportions of alumni applying their skills in data generation/analysis/reporting (56%), situation analysis (55%) and surveillance (41%). Skills were also being used to mitigate the health system effects of COVID-19 on other diseases (27%) and in conducting research (26%). (4) Conclusion. Investing in people and in research training ahead of public health emergencies generates downstream dividends by strengthening health system resilience for tackling pandemics. It also strengthens human resources for health and the integration of research within health systems. Full article
(This article belongs to the Special Issue COVID-19: Current Challenges and Future Perspectives)
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Review

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Review
Defusing COVID-19: Lessons Learned from a Century of Pandemics
Trop. Med. Infect. Dis. 2020, 5(4), 182; https://doi.org/10.3390/tropicalmed5040182 - 30 Nov 2020
Cited by 1 | Viewed by 1421
Abstract
Amidst the COVID-19 global pandemic of 2020, identifying and applying lessons learned from previous influenza and coronavirus pandemics may offer important insight into its interruption. Herein, we conducted a review of the literature of the influenza pandemics of the 20th century; and of [...] Read more.
Amidst the COVID-19 global pandemic of 2020, identifying and applying lessons learned from previous influenza and coronavirus pandemics may offer important insight into its interruption. Herein, we conducted a review of the literature of the influenza pandemics of the 20th century; and of the coronavirus and influenza pandemics of the 21st century. Influenza and coronavirus pandemics are zoonoses that spread rapidly in consistent seasonal patterns during an initial wave of infection and subsequent waves of spread. For all of their differences in the state of available medical technologies, global population changes, and social and geopolitical factors surrounding each pandemic, there are remarkable similarities among them. While vaccination of high-risk groups is advocated as an instrumental mode of interrupting pandemics, non-pharmacological interventions including avoidance of mass gatherings, school closings, case isolation, contact tracing, and the implementation of infection prevention strategies in healthcare settings represent the cornerstone to halting transmission. In conjunction with lessons learned from previous pandemics, the public health response to the COVID-19 pandemic constitutes the basis for delineating best practices to confront future pandemics. Full article
(This article belongs to the Special Issue COVID-19: Current Challenges and Future Perspectives)
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Review
Efficacy and Safety of Lopinavir/Ritonavir for Treatment of COVID-19: A Systematic Review and Meta-Analysis
Trop. Med. Infect. Dis. 2020, 5(4), 180; https://doi.org/10.3390/tropicalmed5040180 - 28 Nov 2020
Cited by 8 | Viewed by 1533
Abstract
(Background) Lopinavir-ritonavir (LPV/RTV) is a human immunodeficiency virus (HIV) antiviral combination that has been considered for the treatment of COVID-19 disease. (Aim) This systematic review aimed to assess the efficacy and safety of LPV/RTV in COVID-19 patients in the published research. (Methods) A [...] Read more.
(Background) Lopinavir-ritonavir (LPV/RTV) is a human immunodeficiency virus (HIV) antiviral combination that has been considered for the treatment of COVID-19 disease. (Aim) This systematic review aimed to assess the efficacy and safety of LPV/RTV in COVID-19 patients in the published research. (Methods) A protocol was developed based on the Preferred Reporting Items for Systematic reviews and Meta-Analysis (PRISMA) statement. Articles were selected for review from 8 electronic databases. This review evaluated the effects of LPV/RTV alone or in combination with standard care ± interferons/antiviral treatments compared to other therapies, regarding duration of hospital stay, risk of progressing to invasive mechanical, time to virological cure and body temperature normalization, cough relief, radiological progression, mortality and safety. (Results) A consensus was reached to select 32 articles for full-text screening; only 14 articles comprising 9036 patients were included in this study; and eight of these were included for meta-analysis. Most of these studies did not report positive clinical outcomes with LPV/RTV treatment. In terms of virological cure, three studies reported less time in days to achieve a virological cure for LPV/RTV arm relative to no antiviral treatment (−0.81 day; 95% confidence interval (CI), −4.44 to 2.81; p = 0.007, I2 = 80%). However, the overall effect was not significant (p = 0.66). When comparing the LPV/RTV arm to umifenovir arm, a favorable affect was observed for umifenovir arm, but not statically significant (p = 0.09). In terms of time to body normalization and cough relief, no favorable effects of LPV/RTV versus umifenovir were observed. The largest trials (RECOVERY and SOLIDARITY) have shown that LPV/RTV failed to reduce mortality, initiation of invasive mechanical ventilation or hospitalization duration. Adverse events were reported most frequently for LPV/RTV (n = 84) relative to other antivirals and no antiviral treatments. (Conclusions) This review did not reveal any significant advantage in efficacy of LPV/RTV for the treatment of COVID-19 over standard care, no antivirals or other antiviral treatments. This result might not reflect the actual evidence. Full article
(This article belongs to the Special Issue COVID-19: Current Challenges and Future Perspectives)
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Review
Prognosis of COVID-19 in Patients with Liver and Kidney Diseases: An Early Systematic Review and Meta-Analysis
Trop. Med. Infect. Dis. 2020, 5(2), 80; https://doi.org/10.3390/tropicalmed5020080 - 15 May 2020
Cited by 39 | Viewed by 3959
Abstract
The mortality and severity in COVID-19 is increased in patients with comorbidities. The aim of this study was to evaluate the severity and mortality in COVID-19 patients with underlying kidney and liver diseases. We retrieved data on the clinical features and primary composite [...] Read more.
The mortality and severity in COVID-19 is increased in patients with comorbidities. The aim of this study was to evaluate the severity and mortality in COVID-19 patients with underlying kidney and liver diseases. We retrieved data on the clinical features and primary composite end point of COVID-19 patients from Medline and Embase which had been released from inception by the April 16, 2020. The data on two comorbidities, liver diseases and chronic kidney disease, were pooled and statistically analysed to explain the associated severity and mortality rate. One hundred and forty-two abstracts were screened, and 41 full articles were then read. In total, 22 studies including 5595 COVID-19 patients were included in this study with case fatality rate of 16%. The prevalence of liver diseases and chronic kidney disease (CKD) were 3% (95% CI; 2–3%) and 1% (95% CI; 1–2%), respectively. In patients with COVID-19 and underlying liver diseases, 57.33% (43/75) of cases were severe, with 17.65% mortality, while in CKD patients, 83.93% (47/56) of cases were severe and 53.33% (8/15) mortality was reported. This study found an increased risk of severity and mortality in COVID-19 patients with liver diseases or CKD. This will lead to better clinical management and inform the process of implementing more stringent preventative measures for this group of patients. Full article
(This article belongs to the Special Issue COVID-19: Current Challenges and Future Perspectives)
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Other

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Perspective
Real-Time Operational Research: Case Studies from the Field of Tuberculosis and Lessons Learnt
Trop. Med. Infect. Dis. 2021, 6(2), 97; https://doi.org/10.3390/tropicalmed6020097 - 08 Jun 2021
Viewed by 432
Abstract
Real-time operational research can be defined as research on strategies or interventions to assess if they are feasible, working as planned, scalable and effective. The research involves primary data collection, periodic analysis during the conduct of the study and dissemination of the findings [...] Read more.
Real-time operational research can be defined as research on strategies or interventions to assess if they are feasible, working as planned, scalable and effective. The research involves primary data collection, periodic analysis during the conduct of the study and dissemination of the findings to policy makers for timely action. This paper aims to illustrate the use of real-time operational research and discuss how to make it happen. Four case studies are presented from the field of tuberculosis. These include (i) mis-registration of recurrent tuberculosis in Malawi; (ii) HIV testing and adjunctive cotrimoxazole to reduce mortality in TB patients in Malawi; (iii) screening TB patients for diabetes mellitus in India; and (iv) mitigating the impact of COVID-19 on TB case detection in capital cities in Kenya, Malawi and Zimbabwe. The important ingredients of real-time operational research are sound ethics; relevant research; adherence to international standards of conducting and reporting on research; consideration of comparison groups; timely data collection; dissemination to key stakeholders; capacity building; and funding. Operational research can improve the delivery of established health interventions and ensure the deployment of new interventions as they become available, irrespective of diseases. This is particularly important when public health emergencies, including pandemics, threaten health services. Full article
(This article belongs to the Special Issue COVID-19: Current Challenges and Future Perspectives)
Case Report
SARS-CoV-2 Infection and CMV Dissemination in Transplant Recipients as a Treatment for Chagas Cardiomyopathy: A Case Report
Trop. Med. Infect. Dis. 2021, 6(1), 22; https://doi.org/10.3390/tropicalmed6010022 - 10 Feb 2021
Viewed by 1337
Abstract
Coronavirus disease 2019 (COVID-19) is caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). COVID-19 has infected over 90 million people worldwide, therefore it is considered a pandemic. SARS-CoV-2 infection can lead to severe pneumonia, acute respiratory distress syndrome (ARDS), septic shock, and/or [...] Read more.
Coronavirus disease 2019 (COVID-19) is caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). COVID-19 has infected over 90 million people worldwide, therefore it is considered a pandemic. SARS-CoV-2 infection can lead to severe pneumonia, acute respiratory distress syndrome (ARDS), septic shock, and/or organ failure. Individuals receiving a heart transplantation (HT) may be at higher risk of adverse outcomes attributable to COVID-19 due to immunosuppressives, as well as concomitant infections that may also influence the prognoses. Herein, we describe the first report of two cases of HT recipients with concomitant infections by SARS-CoV-2, Trypanosoma cruzi, and cytomegalovirus (CMV) dissemination, from the first day of hospitalization due to COVID-19 in the intensive care unit (ICU) until the death of the patients. Full article
(This article belongs to the Special Issue COVID-19: Current Challenges and Future Perspectives)
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Brief Report
COVID-19-Induced Thrombosis in Patients without Gastrointestinal Symptoms and Elevated Fecal Calprotectin: Hypothesis Regarding Mechanism of Intestinal Damage Associated with COVID-19
Trop. Med. Infect. Dis. 2020, 5(3), 147; https://doi.org/10.3390/tropicalmed5030147 - 16 Sep 2020
Cited by 9 | Viewed by 1092
Abstract
Background: Patients with coronavirus infectious disease 2019 (COVID-19) and gastrointestinal symptoms showed increased values of fecal calprotectin (FC). Additionally, bowel abnormalities were a common finding during abdominal imaging of individuals with COVID-19 despite being asymptomatic. The current pilot study aims at evaluating FC [...] Read more.
Background: Patients with coronavirus infectious disease 2019 (COVID-19) and gastrointestinal symptoms showed increased values of fecal calprotectin (FC). Additionally, bowel abnormalities were a common finding during abdominal imaging of individuals with COVID-19 despite being asymptomatic. The current pilot study aims at evaluating FC concentrations in patients without gastrointestinal symptoms. Methods: we enrolled 25 consecutive inpatients with COVID-19 pneumonia, who were admitted without gastrointestinal symptoms and a previous history of inflammatory bowel disease. Results: At admission, 21 patients showed increased FC with median values of 116 (87.5; 243.5) mg/kg despite absent gastrointestinal symptoms. We found a strong positive correlation between FC and D-Dimer (r = 0.745, p < 0.0001). Two patients developed bowel perforation. Conclusion: our findings may change the current understanding of COVID-19 intestinal-related disease pathogenesis, shedding new light on the potential role of thrombosis and the consequent hypoxic intestinal damage. Full article
(This article belongs to the Special Issue COVID-19: Current Challenges and Future Perspectives)
Viewpoint
Malaria and COVID-19: Common and Different Findings
Trop. Med. Infect. Dis. 2020, 5(3), 141; https://doi.org/10.3390/tropicalmed5030141 - 06 Sep 2020
Cited by 15 | Viewed by 3295
Abstract
Malaria and COVID-19 may have similar aspects and seem to have a strong potential for mutual influence. They have already caused millions of deaths, and the regions where malaria is endemic are at risk of further suffering from the consequences of COVID-19 due [...] Read more.
Malaria and COVID-19 may have similar aspects and seem to have a strong potential for mutual influence. They have already caused millions of deaths, and the regions where malaria is endemic are at risk of further suffering from the consequences of COVID-19 due to mutual side effects, such as less access to treatment for patients with malaria due to the fear of access to healthcare centers leading to diagnostic delays and worse outcomes. Moreover, the similar and generic symptoms make it harder to achieve an immediate diagnosis. Healthcare systems and professionals will face a great challenge in the case of a COVID-19 and malaria syndemic. Here, we present an overview of common and different findings for both diseases with possible mutual influences of one on the other, especially in countries with limited resources. Full article
(This article belongs to the Special Issue COVID-19: Current Challenges and Future Perspectives)
Viewpoint
Impact of the COVID-19 Pandemic on Tuberculosis Control: An Overview
Trop. Med. Infect. Dis. 2020, 5(3), 123; https://doi.org/10.3390/tropicalmed5030123 - 24 Jul 2020
Cited by 8 | Viewed by 2169
Abstract
Throughout history, pandemics of viral infections such as HIV, Ebola and Influenza have disrupted health care systems, including the prevention and control of endemic diseases. Such disruption has resulted in an increased burden of endemic diseases in post-pandemic periods. The current coronavirus disease [...] Read more.
Throughout history, pandemics of viral infections such as HIV, Ebola and Influenza have disrupted health care systems, including the prevention and control of endemic diseases. Such disruption has resulted in an increased burden of endemic diseases in post-pandemic periods. The current coronavirus disease 2019 (COVID-19) pandemic could cause severe dysfunction in the prevention and control of tuberculosis (TB), the infectious disease that causes more deaths than any other, particularly in low- and middle-income countries where the burden of TB is high. The economic and health crisis created by the COVID-19 pandemic as well as the public health measures currently taken to stop the spread of the virus may have an impact on household TB transmission, treatment and diagnostic services, and TB prevention and control programs. Here, we provide an overview of the potential impact of COVID-19 on TB programs and disease burden, as well as possible strategies that could help to mitigate the impact. Full article
(This article belongs to the Special Issue COVID-19: Current Challenges and Future Perspectives)
Case Report
Treatment of Severe COVID-19 with Tocilizumab Mitigates Cytokine Storm and Averts Mechanical Ventilation during Acute Respiratory Distress: A Case Report and Literature Review
Trop. Med. Infect. Dis. 2020, 5(3), 112; https://doi.org/10.3390/tropicalmed5030112 - 03 Jul 2020
Cited by 10 | Viewed by 3713
Abstract
COVID-19, caused by the novel severe acute respiratory coronavirus 2 (SARS-CoV-2), emerged in Wuhan, China, in 2019 and has resulted in the current pandemic. The disease continues to pose a major therapeutic challenge. Patient mortality is ultimately caused by acute respiratory distress syndrome [...] Read more.
COVID-19, caused by the novel severe acute respiratory coronavirus 2 (SARS-CoV-2), emerged in Wuhan, China, in 2019 and has resulted in the current pandemic. The disease continues to pose a major therapeutic challenge. Patient mortality is ultimately caused by acute respiratory distress syndrome (ARDS). Cytokine release syndrome (or “cytokine storm”) is likely to be a contributing factor to ARDS in many patients. Because interleukin 6 (IL-6) is known to play a key role in inflammation, IL-6 receptor inhibitors such as tocilizumab may potentially treat COVID-19 by attenuating cytokine release. We present the case of a 48-year-old male with severe COVID-19, on the verge of meeting intubation requirements, who needed progressive oxygen support for respiratory distress. The patient was treated with a non-weight-based dosage of tocilizumab to prevent the onset of a cytokine storm. We chose to administer an IL-6 inhibitor because of the gradually increasing levels of acute phase reactants identified on serial blood draws, as well as his declining respiratory status. The treatment was well-tolerated in conjunction with standard drug therapies for COVID-19 (hydroxychloroquine, azithromycin, and zinc). The patient subsequently experienced marked improvements in his respiratory symptoms and overall clinical status over the following days. We believe that tocilizumab played a substantial role in his ability to avert clinical decline, particularly the need for mechanical ventilation. Ultimately, the patient was downgraded from the ICU and discharged within days. We highlight the potential of IL-6 inhibitors to prevent the progression of respiratory disease to a point requiring ventilator support. This case underscores the potential importance of early serial measurements of IL-6 and cytokine storm-associated acute phase reactants, such as ferritin, D-dimer, and C-reactive protein, in guiding clinical decision-making in the management of patients with suspected COVID-19. Conclusion: The early, proactive identification of serum acute phase reactants should be implemented in the treatment of COVID-19 in order to screen for a primary contributor to mortality—the cytokine storm. This screening, when followed by aggressive early treatment for cytokine storm, may have optimal therapeutic benefits and obviate the need for mechanical ventilation, thereby decreasing mortality. Additionally, we review current evidence regarding cytokine release syndrome in COVID-19 and the use of IL-6 receptor inhibition as a therapeutic strategy, and examine other reported cases in the literature describing IL-6 antagonist treatment for patients with COVID-19. Full article
(This article belongs to the Special Issue COVID-19: Current Challenges and Future Perspectives)
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Commentary
Challenges in Tuberculosis Clinical Trials in the Face of the COVID-19 Pandemic: A Sponsor’s Perspective
Trop. Med. Infect. Dis. 2020, 5(2), 86; https://doi.org/10.3390/tropicalmed5020086 - 27 May 2020
Cited by 4 | Viewed by 1729
Abstract
The COVID-19 pandemic has caused unforeseen and extreme changes in societal and health system functioning not previously experienced in most countries in a lifetime. The impact of the pandemic on clinical trials can be especially profound given their complexities and operational requirements. The [...] Read more.
The COVID-19 pandemic has caused unforeseen and extreme changes in societal and health system functioning not previously experienced in most countries in a lifetime. The impact of the pandemic on clinical trials can be especially profound given their complexities and operational requirements. The STREAM Clinical Trial is the largest trial for MDR-TB ever conducted. Currently operating in seven countries, the trial had 126 participants on treatment and 312 additional participants in active follow up as of March 31, 2020. Areas of particular concern during this global emergency include treatment continuity, supply chain management and participant safety monitoring. This commentary highlights some of the challenges faced due to the pandemic and the steps taken to protect the safety of trial participants and the integrity of the trial. Full article
(This article belongs to the Special Issue COVID-19: Current Challenges and Future Perspectives)
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