[HTML][HTML] WHO declares COVID-19 a pandemic
D Cucinotta, M Vanelli - Acta bio medica: Atenei parmensis, 2020 - ncbi.nlm.nih.gov
D Cucinotta, M Vanelli
Acta bio medica: Atenei parmensis, 2020•ncbi.nlm.nih.govThe World Health Organization (WHO) on March 11, 2020, has declared the novel
coronavirus (COVID-19) outbreak a global pandemic (1). At a news briefing, WHO Director-
General, Dr. Tedros Adhanom Ghebreyesus, noted that over the past 2 weeks, the number
of cases outside China increased 13-fold and the number of countries with cases increased
threefold. Further increases are expected. He said that the WHO is “deeply concerned both
by the alarming levels of spread and severity and by the alarming levels of inaction,” and he …
coronavirus (COVID-19) outbreak a global pandemic (1). At a news briefing, WHO Director-
General, Dr. Tedros Adhanom Ghebreyesus, noted that over the past 2 weeks, the number
of cases outside China increased 13-fold and the number of countries with cases increased
threefold. Further increases are expected. He said that the WHO is “deeply concerned both
by the alarming levels of spread and severity and by the alarming levels of inaction,” and he …
The World Health Organization (WHO) on March 11, 2020, has declared the novel coronavirus (COVID-19) outbreak a global pandemic (1). At a news briefing, WHO Director-General, Dr. Tedros Adhanom Ghebreyesus, noted that over the past 2 weeks, the number of cases outside China increased 13-fold and the number of countries with cases increased threefold. Further increases are expected. He said that the WHO is “deeply concerned both by the alarming levels of spread and severity and by the alarming levels of inaction,” and he called on countries to take action now to contain the virus.“We should double down,” he said.“We should be more aggressive.” Among the WHO’s current recommendations, people with mild respiratory symptoms should be encouraged to isolate themselves, and social distancing is emphasized and these recommendations apply even to countries with no reported cases (2). Separately, in JAMA, researchers report that SARS-CoV-2, the virus that causes COVID-19, was most often detected in respiratory samples from patients in China. However, live virus was also found in feces. They conclude:“Transmission of the virus by respiratory and extrarespiratory routes may help explain the rapid spread of disease.”(3). COVID-19 is a novel disease with an incompletely described clinical course, especially for children. In a recente report W. Liu et al described that the virus causing Covid-19 was detected early in the epidemic in 6 (1.6%) out of 366 children (≤ 16 years of age) hospitalized because of respiratory infections at Tongji Hospital, around Wuhan. All these six children had previously been completely healthy and their clinical characteristics at admission included high fever (> 39 C) cough and vomiting (only in four). Four of the six patients had pneumonia, and only one required intensive care. All patients were treated with antiviral agents, antibiotic agents, and supportive therapies, and recovered after a median 7.5 days of hospitalization.(4). Risk factors for severe illness remain uncertain (although older age and comorbidity have emerged as likely important factors), the safety of supportive care strategies such as oxygen by high-flow nasal cannula and noninvasive ventilation are unclear, and the risk of mortality, even among critically ill patients, is uncertain. There are no proven effective specific treatment strategies, and the risk-benefit ratio for commonly used treatments such as corticosteroids is unclear (3, 5). Septic shock and specific organ dysfunction such as acute kidney injury appear to occur in a significant proportion of patients with COVID-19–related critical illness and are associated with increasing mortality, with management recommendations following available evidence-based guidelines (3). Novel COVID-19 “can often present as a common cold-like illness,” wrote Roman Wöelfel et al.(6). They report data from a study concerning nine young-to middle-aged adults in Germany who developed COVID-19 after close contact with a known case. All had generally mild clinical courses; seven had upper respiratory tract disease, and two had limited involvement of the lower respiratory tract. Pharyngeal virus shedding was high during the first week of symptoms, peaking on day 4. Additionally, sputum viral shedding persisted after symptom resolution. The German researchers say the current case definition for COVID-19, which emphasizes lower respiratory tract disease, may need to be adjusted (6). But they considered only young and “normal” subjecta where-
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