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  1. Kumbargere Nagraj S, Eachempati P, Paisi M, Nasser M, Sivaramakrishnan G, Francis T, et al.
    Cochrane Database Syst Rev, 2022 Aug 22;8(8):CD013826.
    PMID: 35994295 DOI: 10.1002/14651858.CD013826.pub2
    BACKGROUND: Aerosols and spatter are generated in a dental clinic during aerosol-generating procedures (AGPs) that use high-speed hand pieces. Dental healthcare providers can be at increased risk of transmission of diseases such as tuberculosis, measles and severe acute respiratory syndrome (SARS) through droplets on mucosae, inhalation of aerosols or through fomites on mucosae, which harbour micro-organisms. There are ways to mitigate and contain spatter and aerosols that may, in turn, reduce any risk of disease transmission. In addition to personal protective equipment (PPE) and aerosol-reducing devices such as high-volume suction, it has been hypothesised that the use of mouth rinse by patients before dental procedures could reduce the microbial load of aerosols that are generated during dental AGPs.

    OBJECTIVES: To assess the effects of preprocedural mouth rinses used in dental clinics to minimise incidence of infection in dental healthcare providers and reduce or neutralise contamination in aerosols.

    SEARCH METHODS: We used standard, extensive Cochrane search methods. The latest search date was 4 February 2022.

    SELECTION CRITERIA: We included randomised controlled trials and excluded laboratory-based studies. Study participants were dental patients undergoing AGPs. Studies compared any preprocedural mouth rinse used to reduce contaminated aerosols versus placebo, no mouth rinse or another mouth rinse. Our primary outcome was incidence of infection of dental healthcare providers and secondary outcomes were reduction in the level of contamination of the dental operatory environment, cost, change in mouth microbiota, adverse events, and acceptability and feasibility of the intervention.

    DATA COLLECTION AND ANALYSIS: Two review authors screened search results, extracted data from included studies, assessed the risk of bias in the studies and judged the certainty of the available evidence. We used mean differences (MDs) and 95% confidence intervals (CIs) as the effect estimate for continuous outcomes, and random-effects meta-analysis to combine data  MAIN RESULTS:  We included 17 studies with 830 participants aged 18 to 70 years. We judged three trials at high risk of bias, two at low risk and 12 at unclear risk of bias.  None of the studies measured our primary outcome of the incidence of infection in dental healthcare providers.  The primary outcome in the studies was reduction in the level of bacterial contamination measured in colony-forming units (CFUs) at distances of less than 2 m (intended to capture larger droplets) and 2 m or more (to capture droplet nuclei from aerosols arising from the participant's oral cavity). It is unclear what size of CFU reduction represents a clinically significant amount. There is low- to very low-certainty evidence that chlorhexidine (CHX) may reduce bacterial contamination, as measured by CFUs, compared with no rinsing or rinsing with water. There were similar results when comparing cetylpyridinium chloride (CPC) with no rinsing and when comparing CPC, essential oils/herbal mouthwashes or boric acid with water. There is very low-certainty evidence that tempered mouth rinses may provide a greater reduction in CFUs than cold mouth rinses. There is low-certainty evidence that CHX may reduce CFUs more than essential oils/herbal mouthwashes. The evidence for other head-to-head comparisons was limited and inconsistent.  The studies did not provide any information on costs, change in micro-organisms in the patient's mouth or adverse events such as temporary discolouration, altered taste, allergic reaction or hypersensitivity. The studies did not assess acceptability of the intervention to patients or feasibility of implementation for dentists.  AUTHORS' CONCLUSIONS: None of the included studies measured the incidence of infection among dental healthcare providers. The studies measured only reduction in level of bacterial contamination in aerosols. None of the studies evaluated viral or fungal contamination. We have only low to very low certainty for all findings. We are unable to draw conclusions regarding whether there is a role for preprocedural mouth rinses in reducing infection risk or the possible superiority of one preprocedural rinse over another. Studies are needed that measure the effect of rinses on infectious disease risk among dental healthcare providers and on contaminated aerosols at larger distances with standardised outcome measurement.

    Matched MeSH terms: Severe Acute Respiratory Syndrome*
  2. Loh LC, Chelliah A, Ang TH, Ali AM
    Med J Malaysia, 2004 Dec;59(5):659-64.
    PMID: 15889569 MyJurnal
    Severe Acute Respiratory Syndrome (SARS) epidemic illustrated the crucial role of infection surveillance and control measures in the combat of any highly transmissible disease. We conducted an interview survey of 121 medical staff 145 doctors, 46 staff nurses and 30 medical assistants) in a state hospital in Malaysia three months after the end of SARS epidemic (from October to December 2003). Staff was grouped according to those directly involved in the care of suspected SARS patients [S+ group n=41] and those who were not [S- group; n=80]. On hand washing following sneezing, coughing and touching patients, the proportions of medical staff that reported an increase after the SARS crisis were 22.3%, 16.5% and 45.5% respectively. On wearing masks, gloves, and aprons when meeting potentially infectious patients, the proportions that reported an increase were 39.7%, 47.1% and 32.2% respectively. Significantly more staff in S+ than S- group reported these increases. Sixty percent of staff was aware of changes in hospital infection control policies after SARS; 93.4% was aware of notifying procedures, and 81.8% was aware of whom to notify in the hospital. Regarding infection isolation ward, Infectious Control Nurse and Infection Control Committee Chairman in the hospital, the proportions of staff that could correctly name them were 39.7%, 38.3% and 15.7% respectively. Significantly more in S+ than S- group could do so. However, more than half the staff claimed ignorance on the knowledge of infection isolation ward (56.2%), Infection Control Nurse (57.9%) and Chairman (65.3%). Our findings demonstrated that SARS crisis had some positive impact on the infection control practices and awareness of medical staff especially on those with direct SARS involvement. Implications for future control of infectious diseases are obvious.
    Matched MeSH terms: Severe Acute Respiratory Syndrome/prevention & control; Severe Acute Respiratory Syndrome/transmission
  3. Loh LC, Ali AM, Ang TH, Chelliah A
    Med J Malaysia, 2004 Aug;59(3):431-2.
    PMID: 15727395
    Matched MeSH terms: Severe Acute Respiratory Syndrome/diagnosis*; Severe Acute Respiratory Syndrome/therapy
  4. Sun Z, Thilakavathy K, Kumar SS, He G, Liu SV
    PMID: 32138266 DOI: 10.3390/ijerph17051633
    Within last 17 years two widespread epidemics of severe acute respiratory syndrome (SARS) occurred in China, which were caused by related coronaviruses (CoVs): SARS-CoV and SARS-CoV-2. Although the origin(s) of these viruses are still unknown and their occurrences in nature are mysterious, some general patterns of their pathogenesis and epidemics are noticeable. Both viruses utilize the same receptor-angiotensin-converting enzyme 2 (ACE2)-for invading human bodies. Both epidemics occurred in cold dry winter seasons celebrated with major holidays, and started in regions where dietary consumption of wildlife is a fashion. Thus, if bats were the natural hosts of SARS-CoVs, cold temperature and low humidity in these times might provide conducive environmental conditions for prolonged viral survival in these regions concentrated with bats. The widespread existence of these bat-carried or -released viruses might have an easier time in breaking through human defenses when harsh winter makes human bodies more vulnerable. Once succeeding in making some initial human infections, spreading of the disease was made convenient with increased social gathering and holiday travel. These natural and social factors influenced the general progression and trajectory of the SARS epidemiology. However, some unique factors might also contribute to the origination of SARS in Wuhan. These factors are discussed in different scenarios in order to promote more research for achieving final validation.
    Matched MeSH terms: Severe Acute Respiratory Syndrome/epidemiology*; Severe Acute Respiratory Syndrome/transmission
  5. Haddad-Boubaker S, Ben Hamda C, Ghedira K, Mefteh K, Bouafsoun A, Boutiba-Ben Boubaker I, et al.
    PLoS One, 2021;16(11):e0259859.
    PMID: 34807924 DOI: 10.1371/journal.pone.0259859
    Rhinoviruses (RV) are a major cause of Severe Acute Respiratory Infection (SARI) in children, with high genotypic diversity in different regions. However, RV type diversity remains unknown in several regions of the world. In this study, the genetic variability of the frequently circulating RV types in Northern Tunisia was investigated, using phylogenetic and phylogeographic analyses with a specific focus on the most frequent RV types: RV-A101 and RV-C45. This study concerned 13 RV types frequently circulating in Northern Tunisia. They were obtained from respiratory samples collected in 271 pediatric SARI cases, between September 2015 and November 2017. A total of 37 RV VP4-VP2 sequences, selected among a total of 49 generated sequences, was compared to 359 sequences from different regions of the world. Evolutionary analysis of RV-A101 and RV-C45 showed high genetic relationship between different Tunisian strains and Malaysian strains. RV-A101 and C45 progenitor viruses' dates were estimated in 1981 and 1995, respectively. Since the early 2000s, the two types had a wide spread throughout the world. Phylogenetic analyses of other frequently circulating strains showed significant homology of Tunisian strains from the same epidemic period, in contrast with earlier strains. The genetic relatedness of RV-A101 and RV-C45 might result from an introduction of viruses from different clades followed by local dissemination rather than a local persistence of an endemic clades along seasons. International traffic may play a key role in the spread of RV-A101, RV-C45, and other RVs.
    Matched MeSH terms: Severe Acute Respiratory Syndrome/epidemiology*; Severe Acute Respiratory Syndrome/virology
  6. Wibisono Y, Fadila CR, Saiful S, Bilad MR
    Polymers (Basel), 2020 Oct 28;12(11).
    PMID: 33126730 DOI: 10.3390/polym12112516
    Since the widespread of severe acute respiratory syndrome of coronavirus 2 (SARS-CoV-2) disease, the utilization of face masks has become omnipresent all over the world. Face masks are believed to contribute to an adequate protection against respiratory infections spread through micro-droplets among the infected person to non-infected others. However, due to the very high demands of face masks, especially the N95-type mask typically worn by medical workers, the public faces a shortage of face masks. Many papers have been published recently that focus on developing new and facile techniques to reuse and reinforce commercially available face masks. For instance, the N95 mask uses a polymer-based (membrane) filter inside, and the filter membrane can be replaced if needed. Another polymer sputtering technique by using a simple cotton candy machine could provide a cheap and robust solution for face mask fabrication. This review discuss the novel approaches of face mask reuse and reinforcement specifically by using membrane-based technology. Tuning the polymeric properties of face masks to enhance filterability and virus inactivity is crucial for future investigation.
    Matched MeSH terms: Severe Acute Respiratory Syndrome
  7. Sohayla M. Attalla, Kavitha Ashok Kumar, Sakinah Ruhi, Saw Aung, Fazna Saleem, Hassan O. Ads, et al.
    MyJurnal
    Coronaviruses were discovered in the mid-1960s then at 2002 in Foshan, China a new virus discovered to cause a Severe Acute Respiratory Syndrome (SARS-CoV) then at 2012 another strain was identified in Saudi Arabia causing the Middle East Respiratory Syndrome (MERS). In December 2019 in Wuhan, Hubei, SARS-CoV-2 (COVID-19) emerged to spread as pandemic. Being a series of the same family, the current research aimed to compare the characteristics of COVID-19 in relation to SARS and MERS regarding the origin and genomic structure, mode of transmission, distribution of cases along the world countries, infectivity and mortality rates together with the clinical presentation, diagnosis and treatment.
    Matched MeSH terms: Severe Acute Respiratory Syndrome
  8. Hisham, H., Quek, K.F.
    MyJurnal
    This survey was done to determine the knowledge, attitude and practice of preventive measures concerning Severe Acute Respiratory Syndrome (SARS) among Alor Gajah town community. The purpose of this study was to determine the knowledge level of SARS, to know their attitude towards SARS and health information provided, to know which sources that provide the best infomation about SARS and to identify the expectations and preferences of population on gaining health infomation. A cross-sectional study involving respondents age 18 and above staying in Alor Gajah town was done. The respondents were assessed using questionnaires comprising of 25 questions. A total 180 respondents had answered the questionnaire. All of them were aware of SARS with 93 .3% with high scores in the knowledge level. Furthermore, 9l .7% of respondents had high scores in their attitude towards SARS. About 98.9% of respondent got their information regarding SARS from television, and 83.9% of them believed the information given. Firty four percent choose television as the best method to convey information concerning SARS or other new emerging diseases. The knowledge and attitude of the respondents concerning SARS were good.
    Matched MeSH terms: Severe Acute Respiratory Syndrome
  9. Peeri NC, Shrestha N, Rahman MS, Zaki R, Tan Z, Bibi S, et al.
    Int J Epidemiol, 2020 Jun 01;49(3):717-726.
    PMID: 32086938 DOI: 10.1093/ije/dyaa033
    OBJECTIVES: To provide an overview of the three major deadly coronaviruses and identify areas for improvement of future preparedness plans, as well as provide a critical assessment of the risk factors and actionable items for stopping their spread, utilizing lessons learned from the first two deadly coronavirus outbreaks, as well as initial reports from the current novel coronavirus (COVID-19) epidemic in Wuhan, China.

    METHODS: Utilizing the Centers for Disease Control and Prevention (CDC, USA) website, and a comprehensive review of PubMed literature, we obtained information regarding clinical signs and symptoms, treatment and diagnosis, transmission methods, protection methods and risk factors for Middle East respiratory syndrome (MERS), severe acute respiratory syndrome (SARS) and COVID-19. Comparisons between the viruses were made.

    RESULTS: Inadequate risk assessment regarding the urgency of the situation, and limited reporting on the virus within China has, in part, led to the rapid spread of COVID-19 throughout mainland China and into proximal and distant countries. Compared with SARS and MERS, COVID-19 has spread more rapidly, due in part to increased globalization and the focus of the epidemic. Wuhan, China is a large hub connecting the North, South, East and West of China via railways and a major international airport. The availability of connecting flights, the timing of the outbreak during the Chinese (Lunar) New Year, and the massive rail transit hub located in Wuhan has enabled the virus to perforate throughout China, and eventually, globally.

    CONCLUSIONS: We conclude that we did not learn from the two prior epidemics of coronavirus and were ill-prepared to deal with the challenges the COVID-19 epidemic has posed. Future research should attempt to address the uses and implications of internet of things (IoT) technologies for mapping the spread of infection.

    Matched MeSH terms: Severe Acute Respiratory Syndrome/epidemiology*; Severe Acute Respiratory Syndrome/transmission; Severe Acute Respiratory Syndrome/virology
  10. Loh LC, Ali AM, Ang TH, Chelliah A
    Malays J Med Sci, 2006 Jul;13(2):30-6.
    PMID: 22589602 MyJurnal
    The emergence of severe acute respiratory syndrome (SARS) had caused fear and anxiety of unprecedented proportion. To examine the impact of SARS on the medical students in a private medical university, a self-reporting questionnaire study was carried out to assess the factual knowledge, anxiety level and perception of the crisis, among the students. The two-week study (between 12 and 23 May, 2003) was carried out three weeks after the first reported SARS-related death in Malaysia. Ninety-one Phase I (junior) and 113 Phase II (senior) students completed the questionnaires. A large majority of students of Phase I and II were correct in their factual knowledge and were sensible in their perception of the future and the handling of the crisis by government(s). However, phase 1 students expressed significantly greater degree of anxiety compared to Phase II in relation to attendance and personal protection in hospital, and in meeting people coughing in public places. The lesser degree of anxiety expressed by phase II senior students may be due in part, to a more realistic assessment of SARS risk brought about by maturity, time spent in hospital and interaction with clinical lecturers and medical staff.
    Matched MeSH terms: Severe Acute Respiratory Syndrome
  11. Hazreen AM, Myint Myint S, Farizah H, Abd Rashid M, Chai CC, Dymna VK, et al.
    Med J Malaysia, 2005 Jun;60(2):180-7.
    PMID: 16114158
    To assess the level of knowledge, attitude and practice (KAP) on SARS and its preventive measures among the rural population of Kuala Kangsar district. This KAP study was also done to identify the expectation and preference of rural population upon obtaining health information. This is a cross-sectional study of 201 households from four villages in Kuala Kangsar. Face-to-face interview was done regarding knowledge, attitude and practice on SARS and its preventive measures. Statistical analyses were performed with SPSS (Version 10.0). A scoring system was used to assess the level of knowledge, attitude and practice towards SARS. Ninety one percent of the study population was aware of SARS. Majority of them have good attitude towards SARS based on the formulated scoring system. Television was found to be the first hand information about SARS and most preferred source of information by the rural population. Knowledge and attitude of respondents concerning SARS were good. Television was found to be the preference among the rural population in obtaining health information.
    Matched MeSH terms: Severe Acute Respiratory Syndrome/epidemiology*
  12. von Overbeck J
    J Insur Med, 2003;35(3-4):165-73.
    PMID: 14971089
    Severe acute respiratory syndrome (SARS) reminds us that sudden disease emergence is a permanent part of our world--and should be anticipated in our planning. Historically the emergence of new diseases has had little or no impact beyond a small, localized cluster of infections. However, given just the right conditions, a highly virulent pathogen can suddenly spread across time and space with massive consequences, as has occurred on several occasions in human history. In the wake of the SARS outbreak, we are now forced to confront the unpleasant fact that human activities are increasing the frequency and severity of these kinds of emergences. The idea of more frequent biological "invasions" with economic and societal impacts comparable to SARS, presents stakeholders in and the global economy with unprecedented new risks, challenges and even opportunities. As a major contributor to economic stability, the insurance industry must follow these trends very closely and develop scenarios to anticipate these events.
    Matched MeSH terms: Severe Acute Respiratory Syndrome/epidemiology*; Severe Acute Respiratory Syndrome/prevention & control
  13. Cavaljuga S, Faulde M, Scharninghausen JJ
    Bosn J Basic Med Sci, 2003 May;3(2):46-55.
    PMID: 16223373
    At this moment, public health authorities, physicians and scientists around the world are struggling to cope with a severe and rapidly spreading new disease in humans called severe acute respiratory syndrome, or SARS. According to World Health Organisation (WHO) this appears to be the first severe and easily transmissible new disease to emerge in the 21st century. Though much about the disease remains poorly understood, including the details of the causative virus, we do know that it has features that allow it to spread rapidly along international air travel routes. As of 10 May 2003, a cumulative 7296 probable SARS cases with 526 deaths have been reported from 30 countries on three continents (WHO, ProMED). In the past week, more than 1000 new probable cases and 96 deaths were reported globally. This represents an increase of 119 new cases and 8 new deaths compared with 9 May 2003 (China (85), Taiwan (23), and Hong Kong (7) represented the overwhelming majority, with one additional case each reported from France, Malaysia, Singapore, and the United States). Only in China, as of 10 May 2003 (WHO) total of 4884 with 235 deaths have been reported. Some outbreaks have reassuring features.
    Matched MeSH terms: Severe Acute Respiratory Syndrome
  14. Abdul-Kadir MA, Lim LT
    BMJ Open Ophthalmol, 2020;5(1):e000630.
    PMID: 33195813 DOI: 10.1136/bmjophth-2020-000630
    The 2019 novel coronavirus which causes severe acute respiratory syndrome (SARS) known as SARS-CoV-2 still remains as a global pandemic since its discovery and continues to spread across the world, given how highly contagious the virus is. We reviewed various articles that explore eye involvement in COVID-19 and other human coronaviruses, its human manifestations in comparison to animal studies and potential mechanism of viral entry into the eye surface. Evidence of animal studies depicted various complications of coronaviruses infection into the eyes, in both anterior and posterior segments of the eye. Conjunctival inflammation remains uncommon in association with COVID-19, with other ophthalmic findings. The risk of transmission via the ocular surface remains likely low, though it is inarguably present based on preliminary finding of viral load in ocular samples and expression of ACE2 on the ocular surface. Testing the tears sample for diagnosing SARS-CoV-2 was unreliable due to limitations of the testing kits and conflicting evidence of the viral titre in the ocular samples. Further larger, more precise and specific studies are required to allow us to better understand the pattern of virulence underlying the associations of SARS-CoV-2 in the eye despite its rare occurrence. This review article aims to enhance better awareness among clinicians regarding ocular manifestations associated with COVID-19 and necessary precautions should be implemented to minimise the risk of person-to-person especially in the nosocomial setting.
    Matched MeSH terms: Severe Acute Respiratory Syndrome
  15. Durga Darshene Kunasegran, Kohila Gengatharan, Rani Thanuja Logeswaran, Viknesuwary Subramaniam, Durgadas Govind Naik
    MyJurnal
    Coronaviruses are known to cause fatal diseases like Severe Acute Respiratory Syndrome (SARS), Middle East Respiratory Syndrome (MERS) and recently recognised coronavirus disease 19 (COVID-19). It is an infectious disease caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), a single-stranded RNA virus. This review is done to study the clinical presentation, comorbid conditions in COVID-19 patients. The relevant articles were searched in PubMed, Science direct and special issues in JAMA, and the New England Journal of Medicine. Only selected papers were used for data extraction and synthesis. The exact source of current pandemic of Covid-19 is not known. The main clinical symptoms include fever, dry cough, myalgia, dyspnoea. Other symptoms presented are headache, malaise, chills/rigor and diarrhoea. The mortality rate was high in above 60 years of age with the comorbid conditions. The data analysis revealed varied mortality rates in different regions. The mortality rate of COVID-19 has been highest among elderly individuals with the comorbid conditions.
    Matched MeSH terms: Severe Acute Respiratory Syndrome
  16. Nurul Azmawati, M., Hariz, M.S., Mohd Dzulkhairi, M.R., Shalinawati, R., Ilina, I.
    Medicine & Health, 2018;13(2):48-57.
    MyJurnal
    Ebola virus disease (EVD), Severe Acute Respiratory Syndrome Coronavirus (SARS-CoV), rabies and Nipah infections were examples of diseases that were related to bats and shook the world with a series of outbreak and epidemic. Through the understanding of bats as potential public health risk, awareness had become vital to prevent another outbreak. This pilot study was done to evaluate the appropriateness of the questionnaires and to determine preliminary data on knowledge, attitude and practices of bats-related infections. Residents of a village were recruited by randomly choosing houses from a list obtained from the local head village. Knowledge, attitude and practice were assessed using a 56-items questionnaire. The study recruited 100 respondents. The questionnaire’s Cronbach Alpha score was 0.817. Majority of the respondents were found to have good knowledge (71%), attitude (99%) and practice (64%) relating to bat-related infection. There was a weak positive correlation between knowledge and practice towards bat-related infections among residents of the study population. Majority (80%) of respondents did not aware that bats can cause rabies, and 84% did not know about rabies vaccination. The result of this pilot study provides a limited but valuable insight into bat-related infection. Overall, respondents had good knowledge, attitude and practice scores towards bats-related infection. However, more awareness is needed to key areas lacking such as in educating awareness about rabies in bats.
    Matched MeSH terms: Severe Acute Respiratory Syndrome
  17. Khalaj-Hedayati A
    J Immunol Res, 2020;2020:7201752.
    PMID: 32695833 DOI: 10.1155/2020/7201752
    The recent outbreak of the novel coronavirus disease, COVID-19, has highlighted the threat that highly pathogenic coronaviruses have on global health security and the imminent need to design an effective vaccine for prevention purposes. Although several attempts have been made to develop vaccines against human coronavirus infections since the emergence of Severe Acute Respiratory Syndrome coronavirus (SARS-CoV) in 2003, there is no available licensed vaccine yet. A better understanding of previous coronavirus vaccine studies may help to design a vaccine for the newly emerged virus, SARS-CoV-2, that may also cover other pathogenic coronaviruses as a potentially universal vaccine. In general, coronavirus spike protein is the major antigen for the vaccine design as it can induce neutralizing antibodies and protective immunity. By considering the high genetic similarity between SARS-CoV and SARS-CoV-2, here, protective immunity against SARS-CoV spike subunit vaccine candidates in animal models has been reviewed to gain advances that can facilitate coronavirus vaccine development in the near future.
    Matched MeSH terms: Severe Acute Respiratory Syndrome/immunology; Severe Acute Respiratory Syndrome/prevention & control; Severe Acute Respiratory Syndrome/virology
  18. Nair AM, Shilpa PH, Shekhar V, Tiwari RVC, Shaik I, Dasari B, et al.
    J Family Med Prim Care, 2020 Jul;9(7):3200-3204.
    PMID: 33102270 DOI: 10.4103/jfmpc.jfmpc_496_20
    Recently coronavirus outbreak which started in Wuhan, China, has caused international concern that has affected more than 29 lakh people worldwide and with no vaccine or specific antiviral drugs present as well as oblivious testing of carriers who are generally asymptomatic, the use of general health intervention techniques are failing to comply. As compared to other epidemics like severe acute respiratory syndrome-coronavirus (SARS-CoV) and the Middle-East respiratory syndrome (MERS-CoV), coronavirus (also named as COVID-19) exhibit mild symptoms in the majority of cases. But in the case of a vulnerable population, it can prove to be life-threatening. Relying on proper barrier technique, use of chest computed tomography scans, managing co-morbid conditions of susceptible patients, identifying the pattern of disease spread as well as the use of polymerase chain reaction to assess the specificity of cases will eventually prove to be efficacious since most of the positive cases are asymptomatic at the beginning which poses a challenge to the primary health care physicians. The development of vaccines will also take some time so it is better to know about COVID-19 better and also follow quarantine restrictions properly till then. In this review, we try to put forward all the relevant studies which have been published by the end of March 2020 so as to summarize the natural history, diagnosis as well as treatment strategies for eradicating COVID-19, which will help in managing this pandemic.
    Matched MeSH terms: Severe Acute Respiratory Syndrome
  19. Xi S, Li Y, Yue L, Gong Y, Qian L, Liang T, et al.
    Front Pharmacol, 2020;11:582322.
    PMID: 33192523 DOI: 10.3389/fphar.2020.582322
    Viral pneumonia is one kind of acute respiratory tract infection caused by the virus. There have been many outbreaks of viral pneumonia with high contagiousness and mortality both in China and abroad, such as the great influenza in 1918, the severe acute respiratory syndrome (SARS) coronavirus in 2003, the Influenza A (H1N1) virus in 2009, and the Middle East Respiratory Syndrome coronavirus (MERS-CoV) in 2012 and the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in 2019. These outbreaks and/or pandemic have significant impact on human life, social behaviors, and economic development. Moreover, no specific drug has been developed for these viruses. Traditional Chinese medicine (TCM) plays an important role in the treatment of viral pneumonia during these outbreaks especially in SARS and SARS-CoV-2 because studies suggest that TCM formulations may target several aspects of the disease and may have lesser side effects than manufactured pharmaceuticals. In recent years, a lot of clinicians and researchers have made a series of in-depth explorations and investigations on the treatment of viral pneumonia with TCM, which have understood TCM therapeutic mechanisms more specifically and clearly. But critical analysis of this research in addition to further studies are needed to assess the potential of TCM in the treatment of viral pneumonia.
    Matched MeSH terms: Severe Acute Respiratory Syndrome
  20. Rahman S, Singh K, Dhingra S, Charan J, Sharma P, Islam S, et al.
    Ther Clin Risk Manag, 2020;16:1007-1022.
    PMID: 33116550 DOI: 10.2147/TCRM.S272908
    COVID-19 pandemic is inducing acute respiratory distress syndrome, multi-organ failure, and eventual death. Respiratory failure is the leading cause of mortality in the elderly population with pre-existing medical conditions. This group is particularly vulnerable to infections due to a declined immune system, comorbidities, geriatric syndrome, and potentially inappropriate polypharmacy. These conditions make the elderly population more susceptible to the harmful effects of medications and the deleterious consequences of infections, including MERS-CoV, SARS-CoV, and SARS-CoV-2. Chronic diseases among elderlies, including respiratory diseases, hypertension, diabetes, and coronary heart diseases, present a significant challenge for healthcare professionals. To comply with the clinical guidelines, the practitioner may prescribe a complex medication regimen that adds up to the burden of pre-existing treatment, potentially inducing adverse drug reactions and leading to harmful side-effects. Consequently, the geriatric population is at increased risk of falls, frailty, and dependence that enhances their susceptibility to morbidity and mortality due to SARS-CoV-2 respiratory syndrome, particularly interstitial pneumonia. The major challenge resides in the detection of infection that may present as atypical manifestations in this age group. Healthy aging can be possible with adequate preventive measures and appropriate medication regimen and follow-up. Adherence to the guidelines and recommendations of WHO, CDC, and other national/regional/international agencies can reduce the risks of SARS-CoV-2 infection. Better training programs are needed to enhance the skill of health care professionals and patient's caregivers. This review explains the public health implications associated with polypharmacy on the geriatric population with pre-existing co-morbidities during the COVID-19 pandemic.
    Matched MeSH terms: Severe Acute Respiratory Syndrome
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