Sidst opdateret 19.05.2020
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Version 3 (06.04.2020)
Denne vejledning er tiltænkt initial diagnostik og behandling af formodet COVID-19. Virussygdommen er først beskrevet i januar 2020, og der er endnu sparsom evidens på en række områder. Denne retningslinje vil løbende blive opdateret, som ny evidens kommer frem. Der er ikke foretaget en gradering af evidensniveau.
Sundhedsstyrelsens side om COVID-19
Sundhedsstyrelsens retningslinjer for håndtering af COVID-19
Sundhedsstyrelsens COVID-19: Risikovurdering, strategi og tiltag ved epidemi i Danmark
Sundhedsstyrelsens vejledning: Personer med øget risiko for alvorligt COVID-19 sygdomsforløb
Dansk Selskab for Infektionsmedicins dokument: Patienter med øget risiko for et alvorligt COVID-19 sygdomsforløb
Klik her for flere resultater
Nature Medicine, Published online: 29 May 2020; doi:10.1038/d41591-020-00022-0Nature Medicine summarizes all the research you need to know this week to keep on top of how science is responding to the COVID-19 pandemic.
Largent E, Lynch H.
AbstractA variety of trials are in development and underway to examine potential interventions for the treatment and prophylaxis of novel coronavirus disease 2019 (COVID-19). How should we think about offering payment to participants in these trials? Payment for research participation is ethically contentious even under ideal circumstances, and pandemics are far from ideal. Here, we review the three functions of research payment—reimbursement, compensation, and incentive—and identify heightened and novel ethical concerns in the context of a global pandemic. We argue that COVID-19 trial participants should usually be offered reimbursement for research-related expenses, as well as compensation for their time and effort, as is true for other types of research under usual circumstances. Given increased risk of undue influence against pandemic background conditions, incentive payment should be avoided unless essential to recruitment and retention in important trials whose social value outweighs this risk. Where essential, however, incentives can be ethically permissible, so long as reasonable efforts are made to minimize the possibility of undue influence.
Wigginton, N. S., Cunningham, R. M., Katz, R. H., Lidstrom, M. E., Moler, K. A., Wirtz, D., Zuber, M. T.
A gradual, stepwise approach to reopening, informed by public health expertise, will be essential
To estimate the burden of coronavirus disease 2019 (COVID-19) in Egypt, Ashleigh R Tuite and colleagues1 used the same model of exported case detection used by Fraser and colleagues for the H1N1 outbreak in Mexico.2 However, Tuite and colleagues neither clarified nor verified the assumptions of this exported case-detection model. First, the authors used data from the UN World Tourism Organization (UNWTO) on the average length of stay in Egypt by tourists (11·6 days), which is not accurate for the following reasons: we contacted UNWTO to verify the most recent estimates, and the average length of stay by tourists in Egypt was 11·6 days in 2018, 7·78 days in 2017, 6·1 days in 2016, 9 days in 2015, and 10 days in 2014, with no estimates available for February, 2020; the UNWTO estimates combine the length of stays of domestic and international tourists, including visitors from several countries other than the USA, Canada, France, and Taiwan; and for Egypt, a country with rapid changes in the political, economic, and tourism fields, it would be inaccurate to confidently consider these incomplete statistical data for the present model of February, 2020.
Robert Verity, Lucy Okell, Ilaria Dorigatti, Peter Winskill, Charlie Whittaker, Patrick Walker, Christl Donnelly, Neil Ferguson, Azra Ghani
We are grateful for Simon Wood and colleagues' comments on our study,1 which explore some important sensitivities in the data that were available early in the COVID-19 pandemic. Wood and colleagues' re-analysis puts more weight on the Diamond Princess outbreak data, arriving at an infection fatality ratio (IFR) in the range 0·23–0·65%, whereas our analysis used data from repatriation flights out of Wuhan, leading to an IFR in the range 0·39–1·33%. Both datasets are opportunistic, and neither is perfectly representative of the underlying population of interest.
Simon N Wood, Ernst C Wit, Matteo Fasiolo, Peter J Green
Knowing the infection fatality ratio (IFR) is crucial for epidemic management: for immediate planning, for balancing the life-years saved against those lost to the consequences of management, and for considering the ethics of paying substantially more to save a life-year from the epidemic than from other diseases. Impressively, Robert Verity and colleagues1 rapidly assembled case data and used statistical modelling to infer the IFR for COVID-19. We have attempted an in-depth statistical review of their paper, eschewing statistical nit-picking, but attempting to identify the extent to which the (necessarily compromised) data are more informative about the IFR than are the modelling assumptions.
Matthew M Kavanagh, Ngozi A Erondu, Oyewale Tomori, Victor J Dzau, Emelda A Okiro, Allan Maleche, Ifeyinwa C Aniebo, Umunya Rugege, Charles B Holmes, Lawrence O Gostin
Coronavirus disease 2019 (COVID-19) has revealed how strikingly unprepared the world is for a pandemic and how easily viruses spread in our interconnected world. A governance crisis is unfolding alongside the pandemic as health officials around the world compete for access to scarce medical supplies. As governments of African countries, and those in low-income and middle-income countries around the world, seek to avoid potentially catastrophic epidemics and learn from what has worked in other countries, testing and other medical resources are of concern.
Hillard S Kaplan, Benjamin C Trumble, Jonathan Stieglitz, Roberta Mendez Mamany, Maguin Gutierrez Cayuba, Leonardina Maito Moye, Sarah Alami, Thomas Kraft, Raul Quispe Gutierrez, Juan Copajira Adrian, Randall C Thompson, Gregory S Thomas, David E Michalik, Daniel Eid Rodriguez, Michael D Gurven
Indigenous communities worldwide share common features that make them especially vulnerable to the complications of and mortality from COVID-19. They also possess resilient attributes that can be leveraged to promote prevention efforts. How can indigenous communities best mitigate potential devastating effects of COVID-19? In Bolivia, where nearly half of all citizens claim indigenous origins, no specific guidelines have been outlined for indigenous communities inhabiting native communal territories.
Amitava Banerjee, Laura Pasea, Steve Harris, Arturo Gonzalez-Izquierdo, Ana Torralbo, Laura Shallcross, Mahdad Noursadeghi, Deenan Pillay, Neil Sebire, Chris Holmes, Christina Pagel, Wai Keong Wong, Claudia Langenberg, Bryan Williams, Spiros Denaxas, Harry Hemingway
We provide policy makers, researchers, and the public a simple model and an online tool for understanding excess mortality over 1 year from the COVID-19 pandemic, based on age, sex, and underlying condition-specific estimates. These results signal the need for sustained stringent suppression measures as well as sustained efforts to target those at highest risk because of underlying conditions with a range of preventive interventions. Countries should assess the overall (direct and indirect) effects of the pandemic on excess mortality.
Francisco J de Abajo, Sara Rodríguez-Martín, Victoria Lerma, Gina Mejía-Abril, Mónica Aguilar, Amelia García-Luque, Leonor Laredo, Olga Laosa, Gustavo A Centeno-Soto, Maria Ángeles Gálvez, Miguel Puerro, Esperanza González-Rojano, Laura Pedraza, Itziar de Pablo, Francisco Abad-Santos, Leocadio Rodríguez-Mañas, Miguel Gil, Aurelio Tobías, Antonio Rodríguez-Miguel, Diego Rodríguez-Puyol, MED-ACE2-COVID19 study group
RAAS inhibitors do not increase the risk of COVID-19 requiring admission to hospital, including fatal cases and those admitted to intensive care units, and should not be discontinued to prevent a severe case of COVID-19.
Ivan Fan-Ngai Hung, Kwok-Cheung Lung, Eugene Yuk-Keung Tso, Raymond Liu, Tom Wai-Hin Chung, Man-Yee Chu, Yuk-Yung Ng, Jenny Lo, Jacky Chan, Anthony Raymond Tam, Hoi-Ping Shum, Veronica Chan, Alan Ka-Lun Wu, Kit-Man Sin, Wai-Shing Leung, Wai-Lam Law, David Christopher Lung, Simon Sin, Pauline Yeung, Cyril Chik-Yan Yip, Ricky Ruiqi Zhang, Agnes Yim-Fong Fung, Erica Yuen-Wing Yan, Kit-Hang Leung, Jonathan Daniel Ip, Allen Wing-Ho Chu, Wan-Mui Chan, Anthony Chin-Ki Ng, Rodney Lee, Kitty Fung, Alwin Yeung, Tak-C
Early triple antiviral therapy was safe and superior to lopinavir–ritonavir alone in alleviating symptoms and shortening the duration of viral shedding and hospital stay in patients with mild to moderate COVID-19. Future clinical study of a double antiviral therapy with interferon beta-1b as a backbone is warranted.
David Chiriboga, Juan Garay, Paulo Buss, Rocío Sáenz Madrigal, Laetitia Charmaine Rispel
Widespread reports of disproportionate impact of the COVID-19 pandemic among already vulnerable communities worldwide, from New York City to New Orleans and Chicago, to the shocking pictures of bodies lying in the streets in Ecuador, represent a prelude of the impact in low-income and middle-income countries, home to more than 80% of the world's population. Disadvantaged people are at higher risk of infection and death from COVID-19, and they have less access to care due to systems that treat health as a commodity and not a human right.
On April 14, 2020, a Chinese official announced at a press conference that indications of three patent herbal drugs were approved to be expanded to include COVID-19 symptoms.1 This included Lianhuaqingwen capsules and Jinhuaqinggan granules for mild conditions, and Xuebijing (injectable) for severe conditions.
Colin T Brewster, Jia Choong, Clare Thomas, David Wilson, Naiem Moiemen
Steam inhalation is traditionally used as a home remedy for common colds and upper respiratory tract infections. The evidence base of the practice is weak, with unproven theories that the steam loosens mucus, opens nasal passages, and reduces mucosal inflammation, or that the heat inhibits replication of viruses.1,2
The health system in Iquitos is stretched and the true number of COVID-19 cases and deaths is unclear. Barbara Fraser reports from Lima.
Richard Cash, Vikram Patel
For the first time in the post-war history of epidemics, there is a reversal of which countries are most heavily affected by a disease pandemic. By early May, 2020, more than 90% of all reported deaths from coronavirus disease 2019 (COVID-19) have been in the world's richest countries; if China, Brazil, and Iran are included in this group, then that number rises to 96%. The rest of the world—historically far more used to being depicted as the reservoir of pestilence and disease that wealthy countries sought to protect themselves from, and the recipient of generous amounts of advice and modest amounts of aid from rich governments and foundations—looks on warily as COVID-19 moves into these regions.
How do we make sense of this pandemic? The first interpretations are now appearing. Slavoj Žižek is a prolific philosopher and cultural theorist. He is the first to produce a volume of reflections—Pandemic! COVID-19 Shakes the World (Polity, 2020). Žižek doubts the epidemic will make us wiser: he insists that “we should resist the temptation to treat the ongoing epidemic as something that has a deeper meaning”. Despite these cautions, we still have an important question to answer: “What is wrong with our system that we were caught unprepared by the catastrophe despite scientists warning us about it for years?” We must accept that “The coronavirus epidemic itself is clearly not just a biological phenomenon which affects humans: to understand its spread, one has to consider human cultural choices…economy and global trade, the thick network of international relations, ideological mechanisms of fear and panic.” Žižek opens his investigation in China—“China thwarts the freedoms of its citizens.” He endorses the view of Li Wenliang, the ophthalmologist who was censored by Wuhan authorities for sharing information about the new SARS-CoV-2 virus and who later died from COVID-19: “There should be more than one voice in a healthy society.” China dealt assertively and successfully with the outbreak in Wuhan.
Yemen's health system has been devastated by years of conflict and COVID-19 deaths are reported to be surging in Aden. Sharmila Devi reports.
Hans Henri P Kluge, Kremlin Wickramasinghe, Holly L Rippin, Romeu Mendes, David H Peters, Anna Kontsevaya, Joao Breda
Moving towards universal health coverage, promoting health and wellbeing, and protecting against health emergencies are the WHO global priorities1 that are shared by the proposed WHO European Programme of Work 2020–25.2 The coronavirus disease 2019 (COVID-19) pandemic has underlined the importance of interconnecting these strategic priorities. Of the six WHO regions, the European region is the most affected by non-communicable disease (NCD)-related morbidity and mortality3 and the growth of the NCDs is concerning.
Despite over 100 000 confirmed cases and infections in every country, the passage of COVID-19 through the African continent remains somewhat enigmatic. High numbers of deaths were expected in the region due to fragile health systems, lack of access to preventive measures, barriers to testing, and potentially vulnerable populations. But, according to WHO, Africa is the least affected region globally, with 1·5% of the world's reported COVID-19 cases and 0·1% of the world's deaths. Although comparisons are inaccurate, mortality rates have been lower compared with outbreaks of similar size elsewhere.
The clinical presentation of European patients with mild-to-moderate Covid-19 infection is still unknown.
There is no specific antiviral therapy recommended for coronavirus disease 2019 (COVID-19). In vitro studies indicate that the antiviral effect of chloroquine diphosphate (CQ) requires a high concentration of the drug.
Since the outbreak of coronavirus disease (COVID-19) in Wuhan in December 2019, by March 10, 2020, a total of 80,932 confirmed cases have been reported in China. Two consecutively negative RT-PCR test results in respiratory tract specimens is required for the evaluation of discharge from hospital, and oropharyngeal swabs were the most common sample. However, false negative results occurred in the late stage of hospitalization, and avoiding false negative result is critical essential.
Coronavirus disease 2019 (COVID-19) or severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), a novel coronavirus strain disease, has recently emerged in China and rapidly spread worldwide. This novel strain is highly transmittable and severe disease has been reported in up to 16% of hospitalized cases. More than 600,000 cases have been confirmed and the number of deaths is constantly increasing. COVID-19 hospitalized patients, especially those suffering from severe respiratory or systemic manifestations, fall under the spectrum of the acutely ill medical population, which is at increased venous thromboembolism risk. Thrombotic complications seem to emerge as an important issue in patients infected with COVID-19. Preliminary reports on COVID-19 patients' clinical and laboratory findings include thrombocytopenia, elevated D-dimer, prolonged prothrombin time, and disseminated intravascular coagulation. As the pandemic is spreading and the whole picture is yet unknown, we highlight the importance of coagulation disorders in COVID-19 infected patients and review relevant data of previous coronavirus epidemics caused by the severe acute respiratory syndrome coronavirus 1 (SARS-CoV-1) and the Middle East Respiratory Syndrome coronavirus (MERS-CoV).
The pandemic of coronavirus disease 2019 (COVID-19) caused by the novel severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) presents an unprecedented challenge to identify effective drugs for prevention and treatment. Given the rapid pace of scientific discovery and clinical data generated by the large number of people rapidly infected by SARS-CoV-2, clinicians need accurate evidence regarding effective medical treatments for this infection.
The novel severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is the cause of a rapidly spreading illness, Coronavirus Disease 2019 (COVID-19), affecting thousands of people around the world. Urgent guidance for clinicians caring for the sickest of these patients is needed.
No therapeutics have yet been proven effective for the treatment of severe illness caused by SARS-CoV-2.
The 2019 novel coronavirus (2019-nCoV) causing an outbreak of pneumonia in Wuhan, Hubei province of China was isolated in January 2020. This study aims to investigate its epidemiologic history, and analyze the clinical characteristics, treatment regimens, and prognosis of patients infected with 2019-nCoV during this outbreak.
Northern European Conference on Travel Medicine (NECTM) 2020
Mødet udskudt på grund af COVID-19
3.06.2020 - 5.06.2020
ASM Microbe 2020
Aflyst på grund af COVID-19
18.06.2020 - 22.06.2020
Ph.d. forsvar ved Kristina Langholz Kristensen
International AIDS Conference (AIDS) 2020
6.07.2020 - 10.07.2020
International Liver Congress (ILC) 2020
27.08.2020 - 29.08.2020
COVID-19 retningslinje (2020)
National handlingsplan for antibiotika til mennesker (2017)
Retningslinjer til sundhedsprofessionelle vedr. håndtering af infektion med zikavirus (2019)
Antiviral behandling af hiv smittede personer (2019)
Unusual dermatomycoses caused by Nannizzia nana : the geophilic origin of human infections
1.06.2020Latest Results for Infection
Drusen in dense deposit disease: not just age-related macular degeneration
The health-related determinants of politics
Cost-effectiveness of transitional US plans for universal health care
Towards more balanced representation in Lancet Commissions
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