Is it easy for people to wear a respirator correctly?

Submitted by: ELee 65

No. The studies in this list for which we have identified answers are unanimous on this conclusion.
*Note that the latest study on this question is over 7 years old. A more recent study may provide a more relevant answer.
NOTE: New research on COVID-19 comes out nearly every day. The state of our knowledge may change quickly so take this answer with a grain of salt.
This short answer was generated by aggregating the answers that each of the 5 studies below gave to the question (as indicated by State of K members) and adjusting for source quality and other factors. If key studies are missing or the answers attributed to individual studies are incorrect, the above answer could be wrong. For medical questions, don't rely on the information here. Consult a medical professional.


Chart summary of 5 studies examining this question

All answers are assigned by State of K users. The label Couldn't Identify means that State of K was not able to determine whether a study answers the question "yes" or "no". This could be due to several factors. One possibility is that a study found some evidence to indicate that the answer to the question is "yes" and some evidence to indicate that the answer is "no". This often happens when a study uses two or more proxies to study the same phenomenon (i.e. firearm sales figures and self-reported firearm ownership rates as proxies for the prevalence of firearms) and the proxies yield different results when looking for correlations with another phenomenon (i.e. firearm-related deaths). Alternatively, the label may be applied if the phenomenon under study (i.e. whether breast milk improves cognitive function) is true for one group, but not another (i.e. true for girls, but not for boys). Yet another possibility is that a study found there was insufficient evidence to reach a conclusion regarding the question. Finally, the full text or abstract of a study may not have been written clearly or was inaccessible. This would make it difficult to determine how a study answered a question.

All labels of Literature Reviews and source quality are assigned by State of K. For academic journals, the label "Q[NUMBER]" is an indication of the quality of the publication. The "NUMBER" refer to the best quartile in which the journal appeared among all the subjects in which the journal was ranked by Scimago Institutions Rankings. For example, if a journal was ranked in the third quartile (Q3) in infectious diseases, but in the second quartile in Ebola studies (Q2), you would see "Q2". The best quartile is "Q1". Publications other than academic journals may be labeled as "Highly Regarded Sources". Government sources receive this label as do NGOs ranked by the TTCSP Global Go To Think Tank Index Reports. The information contained in a source that is labeled "highly regarded" or "Q1" is not necessarily more accurate than information contained in a source without that label, but these are rough guides to source quality.

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Do cloth masks reduce the risk of contracting viruses that cause respiratory disease?
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Does air pollution accelerate the spread of COVID-19?
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Does air pollution increase the severity of symptoms from COVID-19?
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SUMMARIES OF STUDIES
Total studies in list: 5
Sorted by publication year
1
Effectiveness of three just-in-time training modalities for N-95 mask fit testing
"Objective: To compare and contrast three different training modalities for fit testing N-95 respirator face masks.Design: Block randomized interventional study.Setting: Urban university.Participants: Two hundred eighty-nine medical students.Interventions: Students were randomly assigned to video, lecture, or slide show to evaluate the effectiveness of the methods for fit testing large groups of people.Main Outcome Measures: Ease of fit and success of fit for each instructional technique.Results: Mask 1 was a Kimberly-Clark duckbill N-95 respirator mask, and mask 2 was a 3M™ carpenters N-95 respirator mask. "Ease of fit" was defined as the ability to successfully don a mask in less than 30 seconds. "Success of fit" was defined as the ability to correctly don a mask in one try. There were no statistical differences by training modality for either mask regarding ease of fit or success of fit.Conclusion: There were no differences among video presentation, small group demonstration, and self-directed slide show just-in-time training modalities for ease of fit or success of fit N-95 respirator mask fitting. Further study is needed to explore more effective fit training modalities."
AUTHORS
Joe Suyama, MD
Genevieve Stoler, MD
David Jones, MD
PUBLISHED
2013 in American journal of disaster medicine
Q3
Couldn't Identify
Couldn't Identify
2
Evaluation of a Large-Scale Quantitative Respirator-Fit Testing Program for Healthcare Workers: Survey Results
"Objective: To present the evaluation of a large-scale quantitative respirator-fit testing program.Design: Concurrent questionnaire survey of fit testers and test subjects.Setting: Ambulatory care, home nursing care, and acute care hospitals across South Australia.Methods: Quantitative facial-fit testing was performed with TSI PortaCount instruments for healthcare workers (HCWs) who wore 5 different models of a disposable P2 (N95-equivalent) respirator. The questionnaire included questions about the HCW's age, sex, race, occupational category, main area of work, smoking status, facial characteristics, prior training and experience in use of respiratory masks, and number of attempts to obtain a respirator fit.Results: A total of 6,160 HCWs were successfully fitted during the period from January through July 2007. Of the 4,472 HCWs who responded to the questionnaire and were successfully fitted, 3,707 (82.9%) were successfully fitted with the first tested respirator, 551 (12.3%) required testing with a second model, and 214 (4.8%) required 3 or more tests. We noted an increased pass rate on the first attempt over time. Asians (excluding those from South and Central Asia) had the highest failure rate (16.3% [45 of 276 Asian HCWs were unsuccessfully fitted]), and whites had the lowest (9.8% [426 of 4,338 white HCWs]). Race was highly correlated with facial shape. Among occupational groups, doctors had the highest failure rate (13.4% [81 of 604 doctors]), but they also had the highest proportion of Asians. Prior education and/or training in respirator use were not associated with a higher pass rate.Conclusions: Certain facial characteristics were associated with higher or lower pass rates with regard to fit testing, and fit testers were able to select a suitable respirator on the basis of a visual assessment in the majority of cases. For the fit tester, training and experience were important factors; however, for the HCW being fitted, prior experience in respirator use was not an important factor."
AUTHORS
Irene J. Wilkinson
Junaid Ahmad
Suzanne Edwards
Dino Pisaniello
PUBLISHED
2010 in Infection Control & Hospital Epidemiology
High quality source
No
No
3
Respirator donning in post-hurricane New Orleans.
"We evaluated correctness of N95 filtering facepiece respirator donning by the public in post-hurricane New Orleans, where respirators were recommended for mold remediation. We randomly selected, interviewed, and observed 538 participants, using multiple logistic regression for analysis. Only 129 (24%) participants demonstrated proper donning. Errors included nose clip not tightened (71%) and straps incorrectly placed (52%); 22% put on the respirator upside down. Factors independently associated with proper donning were as follows: ever having used a mask or respirator (odds ratio [OR] 5.28; 95% confidence interval [CI], 1.79-22.64); ever having had a respirator fit test (OR 4.40; 95% CI, 2.52-7.81); being male (OR 2.44; 95% CI, 1.50-4.03); Caucasian race (OR 2.09; 95% CI, 1.32-3.33); having a certified respirator (OR 1.99, 95% CI, 1.20-3.28); and having participated in mold clean-up (OR 1.82; 95% CI,1.00-3.41). Interventions to improve respirator donning should be considered in planning for influenza epidemics and disasters."
AUTHORS
Jean Cox-Ganser
Margaret A Riggs
Kristin J Cummings
Nicole Edwards
Kathleen Kreiss
PUBLISHED
2007 in Emerging Infectious Diseases
High quality source
No
No
4
Tuberculosis Isolation Comparison of Written Procedures and Actual Practices in Three California Hospitals
"Objective: To evaluate implementation of healthcare worker exposure control measures for tuberculosis (TB)-patient isolation, as specified by Centers for Disease Control and Prevention (CDC) guidelines and the hospital's TB-control policy.Design: Prospective multihospital study comparing CDC guidelines and hospital policy for TB-patient isolation to once-weekly observations of TB-patient isolation practices over 14 consecutive weeks at each hospital.Setting: Three urban hospitals (two county, one private community) in counties in California with a high incidence rate of TB.Measurements: Work practices for TB-patient isolation were observed and ventilation performance of isolation rooms was assessed while patient rooms were in use for TB isolation.Results: Of 170 TB-patient rooms observed, 119 (70%) involved a patient in a designated TB isolation room, the room was under negative pressure, the door was closed, and a "respiratory precautions" sign was on the door; 32 patient-room units (19%) were not under negative pressure or not designated as negative-pressure rooms. Of 151 patient-room units mechanically capable of negative pressure at a prior point in time, 16 (11%) were not under negative pressure at the time of use. Of 67 patient-room units equipped with continuous monitoring devices, 8 (12%) involved devices that did not accurately reflect the direction of airflow. Of the 62 healthcare workers observed using a respirator for TB, 40 (65%) did not don the respirator properly.Conclusions: Implementing CDC guidelines for TB-patient isolation was feasible but imperfect in the three hospitals. Day-to-day work practices deviated from hospital policy. Prospectively quantifying the implementation of a hospital TB isolation policy while the room is in use may lead to improved estimates of risk and may help to identify and thereby prevent avoidable healthcare worker exposures to Mycobacterium tuberculosis aerosol. Auditing practices and verifying equipment performance is likely to identify unexpected problems in implementation of the TB control program."
AUTHORS
Patrice M. Sutton
Robert J. Harrison
Mark Nicas
PUBLISHED
2000 in Infection Control & Hospital Epidemiology
High quality source
No
No
5
The effect of respirator training on the ability of healthcare workers to pass a qualitative fit test.
"Objectives: To determine the effect of different methods of training on the ability of hospital workers to wear respirators and pass a qualitative fit test, and to compare the direct cost of the training.Design: 179 hospital employees were recruited for study and were stratified into three groups based on the type of training they received in the use of respirators. Employees in Group A received one-on-one training by the hospital's industrial hygienist and were fit tested as part of this training. Employees in Group B received classroom instruction and demonstration by infection control nurses in the proper use of respirators, but were not fit tested as part of training. Employees in Group C received no formal training. Each participant in our study underwent a subsequent qualitative fit test using irritant smoke to check for the employee's ability to adjust correctly the fit and seal of the respirator. The direct cost of each method of training was determined by accounting for the cost of trainers and the cost of employee-hours lost during training.Setting: 775-bed Veterans' Affairs hospital.Results: 94% of Group A participants (49 of 52) passed the qualitative fit test, compared to 91% of Group B participants (58 of 64) and 79% of Group C participants (50 of 63; P = .036, 2 x 3 chi-square). Group A had a significantly higher pass rate than Group C (P = .043), but Group B did not differ significantly from Group A or Group C. Location or professional status did not affect pass rate, but prior experience wearing respirators did. When the study groups were compared after stratifying for prior experience, we found no difference in pass rates, except when Groups A and B (those with any training) were combined and compared with Group C (107 of 116 versus 50 of 63, P = .05, Mantel-Haenszel chi-square). We estimate that the method of training involving individual instruction followed by fit testing took 20 minutes per employee to complete, compared to 10 minutes per six employee class for the method of classroom demonstration. The difference in direct cost between the two methods, applied to the training of 1,200 employees at our hospital, would be approximately $19,000 per year.Conclusion: Our study indicates that training in the proper use of respirators is important, but the method of training may not be, as the two methods we evaluated were nearly equivalent in their pass rates on fit testing (94% versus 91%). Fit testing as part of training may have enhanced the performance of our participants marginally, but was more time consuming and accounted for most of the excess cost."
AUTHORS
D Hannum
S M Markowitz
E S Wong
L Jones
S Morris
M Stewart et al
PUBLISHED
1996 in Infection Control and Hospital Epidemiology
High quality source
No
No







ADDITIONAL STUDIES TO CONSIDER ADDING TO LIST
Total additional studies: 61
State of K's algorithms generated the list of studies below based on the studies that were added to the above list. Some of these studies may also examine: "Is it easy for people to wear a respirator correctly?" If a study examines this question, add it to the list by pressing the button.

Only add studies that examine the same question. Do not add studies that are merely on the same topic.

Sitagliptin: a potential drug for the treatment of SARS-CoV-2?
"Recently, an outbreak of fatal coronavirus, SARS-CoV-2, has emerged from China and is rapidly spreading worldwide. As the coronavirus pandemic rages, drug discovery and development become even more challenging. Drug repurposing of the antimalarial drug chloroquine and its hydroxylated form had demonstrated apparent effectiveness in the treatment of COVID-19 associated pneumonia in clinical trials. SARS-CoV-2 spike protein shares 31.9% sequence identity with the spike protein presents in the Middle East Respiratory Syndrome Corona Virus (MERS-CoV), which infects cells through the interaction of its spike protein with the DPP4 receptor found on macrophages. Sitagliptin, a DPP4 inhibitor, that is known for its antidiabetic, immunoregulatory, anti-inflammatory, and beneficial cardiometabolic effects has been shown to reverse macrophage responses in MERS-CoV infection and reduce CXCL10 chemokine production in AIDS patients. We suggest that Sitagliptin may be beneficial alternative for the treatment of COVID-19 disease especially in diabetic patients and patients with preexisting cardiovascular conditions who are already at higher risk of COVID-19 infection."
AUTHOR
Sanaa Bardaweel
PUBLISHED
2020 in Center for Open Science

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Mathematical modeling of the effectiveness of facemasks in reducing the spread of novel influenza A (H1N1).
"On June 11, 2009, the World Health Organization declared the outbreak of novel influenza A (H1N1) a pandemic. With limited supplies of antivirals and vaccines, countries and individuals are looking at other ways to reduce the spread of pandemic (H1N1) 2009, particularly options that are cost effective and relatively easy to implement. Recent experiences with the 2003 SARS and 2009 H1N1 epidemics have shown that people are willing to wear facemasks to protect themselves against infection; however, little research has been done to quantify the impact of using facemasks in reducing the spread of disease. We construct and analyze a mathematical model for a population in which some people wear facemasks during the pandemic and quantify impact of these masks on the spread of influenza. To estimate the parameter values used for the effectiveness of facemasks, we used available data from studies on N95 respirators and surgical facemasks. The results show that if N95 respirators are only 20% effective in reducing susceptibility and infectivity, only 10% of the population would have to wear them to reduce the number of influenza A (H1N1) cases by 20%. We can conclude from our model that, if worn properly, facemasks are an effective intervention strategy in reducing the spread of pandemic (H1N1) 2009."
AUTHORS
James M Hyman
Sara Y Del Valle
Samantha M Tracht
PUBLISHED
2010 in PLoS ONE

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It's easy to package correctly
You can view the abstract at: https://doi.org/10.1021/cen-v035n033.p060
PUBLISHED
1957 in Chemical & Engineering News

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It's easy to package correctly
You can view the abstract at: https://doi.org/10.1021/cen-v035n024.p100
PUBLISHED
1957 in Chemical & Engineering News

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It's easy to package correctly
You can view the abstract at: https://doi.org/10.1021/cen-v035n042.p008
PUBLISHED
1957 in Chemical & Engineering News

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Single-Frequency Ultrasound-Based Respiration Rate Estimation with Smartphones.
"Respiration monitoring is helpful in disease prevention and diagnosis. Traditional respiration monitoring requires users to wear devices on their bodies, which is inconvenient for them. In this paper, we aim to design a noncontact respiration rate detection system utilizing off-the-shelf smartphones. We utilize the single-frequency ultrasound as the media to detect the respiration activity. By analyzing the ultrasound signals received by the built-in microphone sensor in a smartphone, our system can derive the respiration rate of the user. The advantage of our method is that the transmitted signal is easy to generate and the signal analysis is simple, which has lower power consumption and thus is suitable for long-term monitoring in daily life. The experimental result shows that our system can achieve accurate respiration rate estimation under various scenarios."
AUTHORS
Linfei Ge
Jing Wei
Jin Zhang
PUBLISHED
2018 in Computational and Mathematical Methods in Medicine

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A multi-functional, portable device with wireless transmission for home monitoring of children with a learning disability
"A portable monitoring device was developed to assist in the management of children with a learning disability. The device was designed for continuous home monitoring of blood oxygen saturation, heart and respiration rates, and patient activity. It could be worn on a belt, while the patient continued normal activities. Data were stored on a multimedia card and automatically transmitted to a PC at prescribed intervals via a Bluetooth wireless link. From the PC the data were transmitted to a Web server, where the information was made available to the staff involved in the patient's care. Preliminary clinical studies were performed with nine patients (four with Down's syndrome, three with cerebral palsy and two with mental retardation). Patients and families considered the device easy to use and to wear. The monitoring device identified events of possible clinical interest. Although it was designed for monitoring children with a learning disability, it may also be useful with other groups, such as elderly people."
AUTHORS
M. Badanai
A. Tura
D. Longo
L. Quareni
PUBLISHED
2004 in Journal of Telemedicine and Telecare

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Does Wearing a Surgical Facemask or N95-Respirator Impair Radio Communication?
"Purpose: This study evaluated the impact wearing a surgical facemask or N95 air purifying respirator (N95) has on radio reception.

Methods: We compared the ability of a flight crewmember and a layperson sitting in a Bell 407 crew compartment and a dispatcher sitting in a communication center to accurately record 20 randomized aviation terms transmitted over the radio by a helicopter emergency medical services (HEMS) pilot wearing a surgical facemask and six different N95s with and without the aircraft engine operating.

Results: With the aircraft engine off, all terms (100% accuracy) were correctly identified, regardless of the absence or presence of the surgical facemask or N95 studied. With the aircraft engine on, the surgical facemask (3M-1826) and two N95 respirators (3M-1860, Safe Life Corp-150) maintained 100% accuracy. Remaining N95 accuracy was as follows: 3M-8511 and Kimberly-Clark PFR95 (98%), Inoyel-3212 (97%), and 3M-1870 (93%).

Conclusions: In general, despite wearing a facemask, radio reception accuracy is high (>90%). However, aircraft engine noise and N95 type do appear to adversely affect the accuracy of radio reception. All HEMS pilots and crewmembers should be aware of these radio reception findings when using an N95 respirator during transport. A brief review of the surgical facemask and N95 effectiveness to prevent viral respiratory infections is provided.

"
AUTHORS
Cynthia Brandon
Diana L. Handrahan
Carol Rhoades
Craig Allen
William Butts
Frank Thomas
PUBLISHED
2011 in Air Medical Journal

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Cognitive Performance and Mood During Respirator Wear and Exercise
"The combined effects of respirator wear and low-intensity work on decision making and mood were assessed in eight subjects during 60 min of low-intensity treadmill walking with and without a respirator to determine whether the stresses of respirator wear negatively impact decision making. Subjects completed walks during no mask wear, wear of a respirator with high inspiratory resistance, and wear of a respirator with low resistance. Cognitive tasks included choice reaction (CHO), serial addition/subtraction (ADD), logical reasoning (LOG), and serial reaction (SER). Mood was measured using a questionnaire with 36 adjectives representing the factors of activity, anger, depression, fear, happiness, and fatigue. Data were obtained preexercise, after 20 and 40 min of walking, and postexercise. Combined respirator wear and low-intensity exercise did not affect accuracy, speed, or throughout in any of the cognitive tasks. Likewise, no significant effects of condition on the six mood factor scores were observed. These results show that the combination of respirator wear and low-level activity does not adversely alter cognitive performance or mood."
AUTHOR
David M. Caretti
PUBLISHED
1999 in American Industrial Hygiene Association Journal

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The Amsterdam Hip Protector Study: compliance and determinants of compliance.
"Hip protectors appear to be effective in reducing the incidence of hip fractures. However, compliance is often poor. Therefore, the objective of this study was to examine the compliance and determinants of compliance with external hip protectors. A prospective study was performed in residents from apartment houses for the elderly, homes for the elderly and nursing homes with a high risk for hip fracture (n=276). The study was performed within the framework of the Amsterdam Hip Protector Study, a randomized controlled trial examining the effect of external hip protectors on the incidence of hip fractures. Compliance was assessed by unannounced visits at 1, 6 and 12 months after inclusion in the study. During the visits, a member of the research team checked whether the participant was wearing the hip protector and, if so, whether it was worn correctly. Furthermore, data on potential determinants of compliance were collected by interviewing the participants or their nurses. Compliance was 60.8% after 1 month (n=217), 44.7% after 6 months (n=246), and 37.0% after 12 months (n=230). Of those wearing the hip protector, 86.7%, 91.7% and 96.5% of the participants were wearing the hip protector correctly after 1, 6 and 12 months respectively; and 14.8%, 16.1% and 8.8% respectively reported wearing the hip protector at night. Compliance after 12 months was predicted by the compliance after 1 month (RR=2.04; 90% CI: 1.05-3.96). Furthermore, people who experienced one or more falls in the half year before baseline had a lower probability of being compliant at 6 months (RR=0.72; 90% CI: 0.52-0.99). In conclusion, compliance is a very important issue in hip protector research and implementation. Although, the compliance percentages were moderately high during the unannounced visits in this study, not everyone was wearing the protector correctly and most participants did not wear the hip protector during the night."
AUTHORS
P Lips
L M Bouter
J H Smit
G Asma
N M van Schoor
PUBLISHED

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Development of CRISPR as a prophylactic strategy to combat novel coronavirus and influenza
"ABSTRACTThe outbreak of the coronavirus disease 2019 (COVID-19), caused by the Severe Acute Respiratory Syndrome coronavirus 2 (SARS-CoV-2), has infected more than 100,000 people worldwide with over 3,000 deaths since December 2019. There is no cure for COVID-19 and the vaccine development is estimated to require 12-18 months. Here we demonstrate a CRISPR-Cas13-based strategy, PAC-MAN (Prophylactic Antiviral CRISPR in huMAN cells), for viral inhibition that can effectively degrade SARS-CoV-2 sequences and live influenza A virus (IAV) genome in human lung epithelial cells. We designed and screened a group of CRISPR RNAs (crRNAs) targeting conserved viral regions and identified functional crRNAs for cleaving SARS-CoV-2. The approach is effective in reducing respiratory cell viral replication for H1N1 IAV. Our bioinformatic analysis showed a group of only six crRNAs can target more than 90% of all coronaviruses. The PAC-MAN approach is potentially a rapidly implementable pan-coronavirus strategy to deal with emerging pandemic strains."
AUTHORS
Laine Goudy
Lei S. Qi
Girija Dhamdhere
Xueqiu Lin
Timothy R. Abbott
David B. Lewis et al
PUBLISHED
2020 in Cold Spring Harbor Laboratory

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Lactoferrin as potential preventative and treatment for COVID-19
"The novel coronavirus 2019 (COVID-19) pandemic is rapidly advancing across the globe despite public and personal health measures. Antivirals and nutritional supplements have been proposed as potentially useful against SARS-CoV-2 (virus that causes COVID-19), but few have been clinically established. Lactoferrin (Lf) is a naturally occurring and non-toxic glycoprotein that is orally available as a nutritional supplement and has established in vitro anti-viral efficacy against a wide range of virus including SARS-CoV, a closely related corona virus to SARS-CoV-2 (virus that causes COVID-19). Furthermore, Lf possesses unique immunomodulatory and anti-inflammatory effects that maybe especially relevant to the pathophysiology of severe COVID-19 cases. We review the underlying biological mechanisms of Lf as antiviral and immune regulator, and propose its unique potential as preventative and adjunct treatment for COVID-19. We hope that further research and development of Lf nutritional supplementation would establish its role for COVID-19."
AUTHORS
Wei-Zen Sun
Raymond Chang
Tzi Bun Ng
PUBLISHED
2020 in Center for Open Science

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When Darkness Becomes a Ray of Light in the Dark Times: Understanding the COVID-19 via the Comparative Analysis of the Dark Proteomes of SARS-CoV-2, Human SARS and Bat SARS-Like Coronaviruses
"AbstractRecently emerged coronavirus designated as SARS-CoV-2 (also known as 2019 novel coronavirus (2019-nCoV) or Wuhan coronavirus) is a causative agent of coronavirus disease 2019 (COVID-19), which is rapidly spreading throughout the world now. More than 9,00,000 cases of SARS-CoV-2 infection and more than 47,000 COVID-19-associated mortalities have been reported worldwide till the writing of this article, and these numbers are increasing every passing hour. World Health Organization (WHO) has declared the SARS-CoV-2 spread as a global public health emergency and admitted that the COVID-19 is a pandemic now. The multiple sequence alignment data correlated with the already published reports on the SARS-CoV-2 evolution and indicated that this virus is closely related to the bat Severe Acute Respiratory Syndrome-like coronavirus (bat SARS-like CoV) and the well-studied Human SARS coronavirus (SARS CoV). The disordered regions in viral proteins are associated with the viral infectivity and pathogenicity. Therefore, in this study, we have exploited a set of complementary computational approaches to examine the dark proteomes of SARS-CoV-2, bat SARS-like, and human SARS CoVs by analysing the prevalence of intrinsic disorder in their proteins. According to our findings, SARS-CoV-2 proteome contains very significant levels of structural order. In fact, except for Nucleocapsid, Nsp8, and ORF6, the vast majority of SARS-CoV-2 proteins are mostly ordered proteins containing less intrinsically disordered protein regions (IDPRs). However, IDPRs found in SARS-CoV-2 proteins are functionally important. For example, cleavage sites in its replicase 1ab polyprotein are found to be highly disordered, and almost all SARS-CoV-2 proteins were shown to contain molecular recognition features (MoRFs), which are intrinsic disorder-based protein-protein interaction sites that are commonly utilized by proteins for interaction with specific partners. The results of our extensive investigation of the dark side of the SARS-CoV-2 proteome will have important implications for the structural and non-structural biology of SARS or SARS-like coronaviruses.SignificanceThe infection caused by a novel coronavirus (SARS-CoV-2) that causes severe respiratory disease with pneumonia-like symptoms in humans is responsible for the current COVID-19 pandemic. No in-depth information on structures and functions of SARS-CoV-2 proteins is currently available in the public domain, and no effective anti-viral drugs and/or vaccines are designed for the treatment of this infection. Our study provides the first comparative analysis of the order- and disorder-based features of the SARS-CoV-2 proteome relative to human SARS and bat CoV that may be useful for structure-based drug discovery."
AUTHORS
Rajanish Giri
Christopher J. Oldfield
Kundlik Gadhave
Bhuvaneshwari R. Gehi
Meenakshi Shegane
Taniya Bhardwaj et al
PUBLISHED
2020 in Cold Spring Harbor Laboratory

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Highly regarded source
An Analysis of 38 Pregnant Women with COVID-19, Their Newborn Infants, and Maternal-Fetal Transmission of SARS-CoV-2: Maternal Coronavirus Infections and Pregnancy Outcomes
" The emergence of a novel coronavirus, termed SARS-CoV-2, and the potentially life-threating respiratory disease that it can produce, COVID-19, has rapidly spread across the globe creating a massive public health problem. Previous epidemics of many emerging viral infections have typically resulted in poor obstetrical outcomes including maternal morbidity and mortality, maternal-fetal transmission of the virus, and perinatal infections and death. This communication reviews the effects of two previous coronavirus infections - severe acute respiratory syndrome (SARS) caused by SARS-CoV and Middle East respiratory syndrome (MERS) caused by MERS-CoV - on pregnancy outcomes. In addition, it analyzes literature describing 38 pregnant women with COVID-19 and their newborns in China to assess the effects of SARS-CoV-2 on the mothers and infants including clinical, laboratory and virologic data, and the transmissibility of the virus from mother to fetus. This analysis reveals that unlike coronavirus infections of pregnant women caused by SARS and MERS, in these 38 pregnant women COVID-19 did not lead to maternal deaths. Importantly, and similar to pregnancies with SARS and MERS, there were no confirmed cases of intrauterine transmission of SARS-CoV-2 from mothers with COVID-19 to their fetuses. All neonatal specimens tested, including in some cases placentas, were negative by rt-PCR for SARS-CoV-2. At this point in the global pandemic of COVID-19 infection there is no evidence that SARS-CoV-2 undergoes intrauterine or transplacental transmission from infected pregnant women to their fetuses. Analysis of additional cases is necessary to determine if this remains true. "
AUTHOR
David A. Schwartz
PUBLISHED
2020 in Archives of Pathology & Laboratory Medicine

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In search of feasible interventions for the prevention and cure of novel Coronavirus disease 2019
"COVID-19 (coronavirus disease 2019) is a public health emergency of international concern caused by Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2). As of this time, there is no known effective pharmaceutical, phytopharmaceutical or traditional medicine for cure or prevention of COVID-19, although it is urgently needed. Based on the current understanding of the disease molecular mechanisms from the closest relatives of SARS-CoV-2 as well as novel Coronavirus SARS-CoV-2, I attempt to translate this knowledge into identifying some naturally occurring plant based substances and Ayurvedic medicinal herbs that could feasibly be used as preventive as well as treatment options for COVID-19."
AUTHOR
Sunil Verma
PUBLISHED
2020 in Center for Open Science

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Virus-host interactome and proteomic survey of PMBCs from COVID-19 patients reveal potential virulence factors influencing SARS-CoV-2 pathogenesis
"The ongoing coronavirus disease (COVID-19) pandemic caused by Severe Acute Respiratory Syndrome Coronavirus-2 (SARS-CoV-2) is a global public health concern due to relatively easy person-to-person transmission and the current lack of effective antiviral therapy. However, the exact molecular mechanisms of SARS-CoV-2 pathogenesis remain largely unknown. We exploited an integrated proteomics approach to systematically investigate intra-viral and virus-host interactomes for the identification of unrealized SARS-CoV-2 host targets and participation of cellular proteins in the response to viral infection using peripheral blood mononuclear cells (PBMCs) isolated from COVID-19 patients. Using this approach, we elucidated 251 host proteins targeted by SARS-CoV-2 and more than 200 host proteins that are significantly perturbed in COVID-19 derived PBMCs. From the interactome, we further identified that non-structural protein nsp9 and nsp10 interact with NKRF, a NF-kB repressor, and may precipitate the strong IL-8/IL-6 mediated chemotaxis of neutrophils and overexuberant host inflammatory response observed in COVID-19 patients. Our integrative study not only presents a systematic examination of SARS-CoV-2-induced perturbation of host targets and cellular networks to reflect disease etiology, but also reveals insights into the mechanisms by which SARS-CoV-2 triggers cytokine storms and represents a powerful resource in the quest for therapeutic intervention."
AUTHORS
Zixuan Xiao
Ping Wu
Chengrong Liu
Xiaoxu Tian
Mingquan Guo
Jingjiao Li et al
PUBLISHED
2020 in Cold Spring Harbor Laboratory

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Highly regarded source
An Analysis of 38 Pregnant Women with COVID-19, Their Newborn Infants, and Maternal-Fetal Transmission of SARS-CoV-2: Maternal Coronavirus Infections and Pregnancy Outcomes
"The emergence of a novel coronavirus, termed SARS-CoV-2, and the potentially life-threatening respiratory disease that it can produce, COVID-19, has rapidly spread across the globe creating a massive public health problem. Previous epidemics of many emerging viral infections have typically resulted in poor obstetrical outcomes including maternal morbidity and mortality, maternal-fetal transmission of the virus, and perinatal infections and death. This communication reviews the effects of two previous coronavirus infections - severe acute respiratory syndrome (SARS) caused by SARS-CoV and Middle East respiratory syndrome (MERS) caused by MERS-CoV - on pregnancy outcomes. In addition, it analyzes literature describing 38 pregnant women with COVID-19 and their newborns in China to assess the effects of SARS-CoV-2 on the mothers and infants including clinical, laboratory and virologic data, and the transmissibility of the virus from mother to fetus. This analysis reveals that unlike coronavirus infections of pregnant women caused by SARS and MERS, in these 38 pregnant women COVID-19 did not lead to maternal deaths. Importantly, and similar to pregnancies with SARS and MERS, there were no confirmed cases of intrauterine transmission of SARS-CoV-2 from mothers with COVID-19 to their fetuses. All neonatal specimens tested, including in some cases placentas, were negative by rt-PCR for SARS-CoV-2. At this point in the global pandemic of COVID-19 infection there is no evidence that SARS-CoV-2 undergoes intrauterine or transplacental transmission from infected pregnant women to their fetuses. Analysis of additional cases is necessary to determine if this remains true."
AUTHOR
Schwartz DA
PUBLISHED
2020 in Archives of Pathology & Laboratory Medicine

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No SARS-CoV-2 in expressed prostatic secretion of patients with coronavirus disease 2019: a descriptive multicentre study in China
"Abstract
Purpose: The aim of the present study was to assess whether SARS-CoV-2 can be detected in the expressed prostatic secretion (EPS) of patients with corona virus disease 2019 (COVID-19).
Methods: 18 cases of COVID-19, and 5 suspected cases, were selected from three medical centers to detect the RNA expression of SARS-CoV-2 in their EPS with RT-PCR.
Results: Results were negative in all EPS samples for SARS-CoV-2 of suspected and confirmed patients.
Conclusions: No SARS-CoV-2 was expressed in EPS of patients with COVID-19."
AUTHORS
jinfei tian
qingyou zheng
weihe quan
yong zhao
haijia xu
hao chu et al
PUBLISHED
2020 in Cold Spring Harbor Laboratory

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Structural Basis of SARS-CoV-2 3CLpro and Anti-COVID-19 Drug Discovery from Medicinal Plants
"The recent outbreak of coronavirus disease 2019 (COVID-19) caused by SARS-CoV-2 in December 2019 raised global health concerns. The viral 3-chymotrypsin-like cysteine protease (3CLpro) enzyme, which controls coronavirus replication and is essential for its life cycle, is a proven drug discovery target in the case of severe acute respiratory syndrome coronavirus (SARS-CoV) and middle east respiratory syndrome coronavirus (MERS-CoV). Recent studies revealed that the genome sequence of SARS-CoV-2 is very similar to that of SARS-CoV. Therefore, herein, we analysed the 3CLpro sequence, constructed a 3D homology model, and screened it against a medicinal plant library containing 32,297 potential anti-viral phytochemicals/traditional Chinese medicinal compounds. Our analyses revealed that the top nine hits may serve as potential anti- SARS-CoV-2 lead molecules for further optimisation and drug development to control COVID-19."
AUTHORS
Muhammad Tahir ul Qamar
Mubarak A. Alamri
Ling-Ling Chen
Safar M. Alqahtani
PUBLISHED
2020 in MDPI AG

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Evaluating the control of tuberculosis among healthcare workers: adherence to CDC guidelines of three urban hospitals in California.
"Objective: To evaluate adherence to components of the Centers for Disease Control and Prevention (CDC) guidelines for preventing the transmission of Mycobacterium tuberculosis in healthcare facilities.

Design: Multihospital study using direct observation and a standardized questionnaire.

Setting: Three urban hospitals (two county hospitals and one private community hospital) in counties in California with a high number and incidence rate of tuberculosis (TB) cases.

Measurements: The ventilation performance of treatment and TB-patient isolation rooms was assessed. Questionnaire data regarding TB control policy and procedures were obtained through interviews with the person(s) responsible for each program component; review of written TB control plans, training, and educational materials; and attendance at hospital TB control meetings and trainings.

Results: Twenty-eight percent of isolation rooms tested (7/25) were under positive pressure; 83% of rooms tested (20/24) had six or more nominal air changes per hour (ACH), but supply air did not mix rapidly with room air. Therefore, the nominal ACH likely overestimated the effective ACH and the subsequent protection provided. In virtually all rooms tested (26/27), air potentially containing M tuberculosis aerosol moved toward, rather than away from, likely worker locations. None of the hospitals regularly checked the performance of engineering controls. Only one hospital adhered to the CDC minimum requirements for respiratory protection. Training of healthcare workers generally was underutilized as a TB prevention measure. Hospitals did not provide comprehensive counseling regarding the need for healthcare workers to know their immune status and the risks associated with M tuberculosis infection in an immunocompromised individual. Employee representatives did not have a voice in TB-related decision making.

Conclusions: Important aspects of day-to-day TB control practice did not conform to the written TB control policy. Subsequent to the identification of TB patients, healthcare workers at all three hospitals were potentially exposed to M tuberculosis aerosol due to breaches in negative-pressure isolation, the limitations of dilution ventilation, and the failure to maintain engineering controls and to implement respiratory protection controls fully. These findings lend support to the Occupational Safety and Health Administration's policy presumption that, absent clear evidence to the contrary, newly acquired healthcare-worker M tuberculosis infections are work-related.

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AUTHORS
M Nicas
P M Sutton
R J Harrison
F Reinisch
PUBLISHED
1998 in Infection Control and Hospital Epidemiology

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Evaluation of respiratory protection programs and practices in California hospitals during the 2009-2010 H1N1 influenza pandemic.
"Background: Emergence of the novel 2009 influenza A H1N1 virus in California led to an evaluation of hospital respiratory protection programs (RPPs) and practices by the California Department of Public Health during the 2009-2010 influenza season.

Methods: Onsite evaluation of 16 hospitals consisted of interviews with managers and health care workers about RPPs and practices, review of written RPPs, and limited observations of personnel using respirators. Data were analyzed using descriptive statistics.

Results: All hospitals had implemented policies requiring the minimum use of N95 filtering facepiece respirators when working with patients with H1N1 virus infection; 95.5% of health care workers (n = 199) reported they would wear at least this level of protection when in close contact with a patient with confirmed or suspected H1N1 virus infection. However, evaluation of written RPPs indicated deficiencies in required areas, most commonly in recordkeeping, designation of a program administrator, program evaluation, employee training, and fit testing procedures.

Conclusions: Health care workers were aware of respiratory protection required when providing care for patients with confirmed or suspected H1N1 virus infection. Hospitals should improve written RPPs, fully implement written procedures, and conduct periodic program evaluation to ensure effectiveness of respirator use for health care worker protection. Increased accessibility of resources tailored for hospital respirator program administrators may be helpful.

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AUTHORS
Stella Beckman
Maryann D'Alessandro
Suzi Goldmacher
Debra Novak
Jennifer Zipprich
Barbara Materna et al
PUBLISHED
2013 in American Journal of Infection Control

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Quality Assurance Practices in Obstetric Care: A Survey of Hospitals in California.
"Objective: To assess hospital practices in obstetric quality management activities and identify institutional characteristics associated with utilization of evidence-supported practices.

Methods: Data for this study came from a statewide survey of obstetric hospitals in California regarding their organization and delivery of perinatal care. We analyzed responses from 185 hospitals that completed quality assurance sections of the survey to assess their practices in a broad spectrum of quality enhancement activities. The association between institutional characteristics and adoption of evidence-supported practices (ie, those supported by prior literature or recommended by professional organizations as beneficial for improving birth outcome or patient safety) was examined using bivariate analysis and appropriate statistical tests.

Results: Most hospitals regularly audited adherence to written protocols regarding critical areas of care; however, 77.7% and 16.8% reported not having written guidelines on diagnosis of labor arrest and management of abnormal fetal heart rate, respectively. Private nonprofit hospitals were more likely to have a written protocol for management of abnormal fetal heart rate (P=.002). One in 10 hospitals (9.7%) did not regularly review cases with significant morbidity or mortality, and only 69.0% regularly tracked indications for cesarean delivery. Moreover, 26.3%, 14.3%, and 8.7% of the hospitals reported never performing interprofessional simulations for eclampsia, shoulder dystocia, or postpartum hemorrhage, respectively. Teaching status was associated with more frequent simulations in these three areas (P≤.04 for all), while larger volume was associated with more frequent simulations for eclampsia (P=.04).

Conclusion: Hospitals in California engage in a wide range of practices to assure or improve quality of obstetric care, but substantial variation in practice exists among hospitals. There is opportunity for improvement in adoption of evidence-supported practices.

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AUTHORS
Xiao Xu
Grace Villarin Dueñas
Jessica L Illuzzi
Lisbet S Lundsberg
Holly K Grossetta Nardini
Christian M Pettker et al
PUBLISHED
2018 in Obstetrics and Gynecology

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Detection of Mycobacterium tuberculosis in gastric aspirates collected from children: hospitalization is not necessary.
"Objective: To compare the yields of gastric aspirates collected for culture of Mycobacterium tuberculosis from children evaluated as outpatients versus inpatients and to determine factors associated with a positive culture.

Methods: Retrospective study of 100 children <12 years of age with tuberculosis diagnosed at a pediatric referral hospital or in one of two tuberculosis control programs in California.

Results: Of the 100 children who had tuberculosis, 80 had at least one gastric aspirate collected. M tuberculosis was isolated from 33 (41%) of the 80 children who had a gastric aspirate; 4 children had a positive culture from an aspirate subsequent to the first. Inpatients had a higher proportion of positive gastric aspirates than that of children who had aspirates collected as outpatients (48% vs 37%); however, this difference was not statistically significant. Resistance to isoniazid was found in three isolates (9%) of children all of whose presumptive source case had a susceptible strain of M tuberculosis. Characteristics that were associated with an approximately 50% yield from gastric aspirates were identification of a source case, age <2 years, birth in the United States, symptomatic tuberculosis, and pulmonary disease.

Conclusions: The culture of M tuberculosis from gastric aspirates of children in the outpatient setting has a yield comparable to aspirates collected from hospitalized children. Collection of gastric aspirates in the outpatient setting will reduce both the cost and the inconvenience of the procedure. Although the yield from gastric aspirates is relatively low, important information including drug susceptibility patterns may be obtained. tuberculosis, gastric aspirate, children.

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AUTHORS
A M Loeffler
M N Lobato
P C Hopewell
B Cole
K Furst
PUBLISHED
1998 in PEDIATRICS

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Workplace violence prevention programs in hospital emergency departments.
"Objective: Hospital violence is a growing concern, yet little is known about existing programs. This study compared workplace violence programs in high-risk emergency departments among a representative sample of 116 hospitals in California and 50 hospitals in New Jersey.

Methods: Information was collected through interviews, a facility walk-through, and review of written policies, procedures, and training material. Programs were scored on the components of training, policies and procedures, security, and environmental approaches.

Results: California had significantly higher scores for training and policies and procedures, but there was no difference for security and environmental approaches. Program component scores were not highly correlated. For example, hospitals with a strong training program were not more likely to have strong policies and procedures.

Conclusions: Most hospitals in California and New Jersey had implemented a workplace violence prevention program, but important gaps were found.

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AUTHORS
Veerasathpurush Allareddy
Corinne Peek-Asa
James Blando
Emily OHagan
Suzi Goldmacher
David Valiante et al
PUBLISHED
2007 in Journal of Occupational and Environmental Medicine

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Written Procedures for Hospitals
You can view the abstract at: https://doi.org/10.1093/milmed/127.5.431
AUTHORS
Louis E. Mudgett
Joseph Karlton Owen
PUBLISHED
1962 in Military Medicine

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Improved tuberculosis infection control practices in Maryland acute care hospitals.
"Background: In 1992 and 1993, the Maryland Hospital Association and the Maryland Department of Health and Mental Hygiene conducted 2 surveys of tuberculosis prevention practices in Maryland hospitals that showed poor compliance with the 1990 Centers for Disease Control and Prevention's guidelines for preventing transmission of tuberculosis in health care facilities.

Objective: The objective of this study was to assess compliance in 1997 with the Centers for Disease Control and Prevention's guidelines in Maryland acute care hospitals.

Methods: A written questionnaire with 3 components-Infection Control, Employee Health, and Microbiology Laboratory-was mailed to 56 Maryland acute care hospitals.

Results: Seventy-three percent of the surveys were returned. One hundred percent of responding hospitals with tuberculosis isolation rooms reported negative pressure ventilation, 6 air exchanges per hour, and air exhausted to the outside or through high-efficiency particulate air filters. One hundred percent of the responding hospitals reported providing National Institute for Occupational Safety and Health-approved respiratory protection for health care workers; this compared with 24% in 1992 (P <.01). One hundred percent of the responding hospitals reported performing at least annual tuberculin skin testing; this compared with 50% in 1992 (P <. 01).

Conclusions: The survey results demonstrate excellent compliance with the 1994 Centers for Disease Control and Prevention recommendations for tuberculosis control in Maryland acute care hospitals, even in those facilities determined to be at minimal to low risk for tuberculosis exposure. The proposed Occupational Safety and Health Administration regulations are unlikely to further reduce the risk of tuberculosis exposure to health care workers in Maryland acute care hospitals.

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AUTHORS
E Israel
E P Fuss
N Baruch
M C Roghmann
PUBLISHED
2000 in American Journal of Infection Control

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Nursing Practice in California Hospitals; A Report Based on a Study of Actual Practice in Forty California Hospitals. [Volume I]
You can view the abstract at: https://doi.org/10.2307/3460615
AUTHORS
California State Nurses' Association
Louis J. Kroeger
Marion J. Wright
PUBLISHED
1954 in The American journal of nursing

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Respirator Donning in Post-Hurricane New Orleans
You can view the abstract at: https://doi.org/10.3201/eid1305.061490
AUTHORS
Jean Cox-Ganser
Margaret A. Riggs
Nicole Edwards
Kristin J. Cummings
Kathleen Kreiss
PUBLISHED
2007 in Emerging Infectious Diseases

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Trends in mental illness and suicidality after Hurricane Katrina.
"A representative sample of 815 pre-hurricane residents of the areas affected by Hurricane Katrina was interviewed 5-8 months after the hurricane and again 1 year later as the Hurricane Katrina Community Advisory Group (CAG). The follow-up survey was carried out to study patterns-correlates of recovery from hurricane-related post-traumatic stress disorder (PTSD), broader anxiety-mood disorders and suicidality. The Trauma Screening Questionnaire screening scale of PTSD and the K6 screening scale of anxiety-mood disorders were used to generate DSM-IV prevalence estimates. Contrary to results in other disaster studies, where post-disaster mental disorder typically decreases with time, prevalence increased significantly in the CAG for PTSD (20.9 vs 14.9% at baseline), serious mental illness (SMI; 14.0 vs 10.9%), suicidal ideation (6.4 vs 2.8%) and suicide plans (2.5 vs 1.0%). The increases in PTSD-SMI were confined to respondents not from the New Orleans Metropolitan Area, while the increases in suicidal ideation-plans occurred both in the New Orleans sub-sample and in the remainder of the sample. Unresolved hurricane-related stresses accounted for large proportions of the inter-temporal increases in SMI (89.2%), PTSD (31.9%) and suicidality (61.6%). Differential hurricane-related stress did not explain the significantly higher increases among respondents from areas other than New Orleans, though, as this stress was both higher initially and decreased less among respondents from the New Orleans Metropolitan Area than from other areas affected by the hurricane. Outcomes were only weakly related to socio-demographic variables, meaning that high prevalence of hurricane-related mental illness remains widely distributed in the population nearly 2 years after the hurricane."
AUTHORS
S Galea
R J Ursano
M J Gruber
S Wessely
R C Kessler
N A Sampson
PUBLISHED
2008 in Molecular Psychiatry

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Sediment from hurricane katrina: potential to produce pulmonary dysfunction in mice.
"On August 29, 2005, Hurricane Katrina made landfall along the Gulf Coast as a Category 3 hurricane. The associated storm surge and heavy rainfall resulted in major flooding throughout the New Orleans area. As the flood waters receded, thick sediment was left covering the ground and coating the interior of homes. This sediment was dispersed into the air and inhaled as dust by returning residents and workers. Our objective in this study was to evaluate the potential pulmonary effects associated with the respirable particulate matter (PM) derived from Hurricane Katrina (HK-PM) in mice. Samples of PM were collected from several locations along the Gulf Coast on September 30 and October 2, 2005 and had a mean aerodynamic diameter ranging from 3-5 mum). Chemical analysis and cytotoxicity assays were performed for all HK-PM samples. A few samples with varying levels of cytotoxicity were chosen for an acute inhalation exposure study. Airborne PM10 levels recorded in the New Orleans area post-Katrina were variable, ranging from 70 mug/m3 in Gentilly to 688 mug/m3 in Lakeview (residential areas). Mice exposed to one of these samples developed significant pulmonary inflammation and airways resistance and hyperresponsiveness to methacholine challenge. These studies demonstrate that dispersion of certain Katrina sediment samples through either natural (e.g., wind) or mechanical (e.g., vehicles) processes promotes airflow obstruction in mice."
AUTHORS
Dahui You
David Becnel
Terry Ahlert
Dana Troxclair
Kai Wang
Melissa Daly et al
PUBLISHED
2008 in International Journal of Clinical and Experimental Medicine

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Eight Months Later: Hurricane Katrina Aftermath Challenges Facing the Infectious Diseases Section of the Louisiana State University Health Science Center
"The effects of Hurricane Katrina have caused the long-term sequelae of a diminished patient base, of a reduced number of available health care professionals, and of closing hospitals in New Orleans, Louisiana. These changes have substantially impacted the academic infrastructure of New Orleans. This article outlines the post-Katrina response of the Louisiana State University Health Science Center (LSUHSC) Infectious Diseases Section and Health Care Services Division to maintain existing HIV and infectious diseases programs. Although several challenges delayed the immediate reopening of the New Orleans location of the HIV Outpatient Program clinic, the LSUHSC Infectious Diseases Section and Health Care Services Division established clinics outside New Orleans for the care of HOP patients immediately following the hurricane. The HOP clinic reopened in New Orleans (in a temporary location) in early November 2005. Several recommendations for academic clinical, training, and research programs are outlined, to assist other centers that might face disaster aftermath challenges."
PUBLISHED
2006 in Clinical Infectious Diseases

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Post-Katrina mortality in the greater New Orleans area, Louisiana.
"Objectives: Death rates in the Greater New Orleans area were examined by month from 2002 to 2006 to assess whether mortality increased after Hurricane Katrina.

Methods: Finalized death data from the Louisiana Office of Vital Statistics and the most recent population estimates were used to calculate annual mortality rates in the Greater New Orleans area by month for 2002-2006. Causes of death were also examined for changes.

Results: There was no significant increase in the death rates in the Greater New Orleans area post-Katrina. The only excesses were seen in Orleans Parish from January to June 2006. In the latter months of 2006, rates decreased to those of previous years. Mortality rates for the Greater New Orleans (GNO) area during the same time period showed no increase. In the first months of 2006, deaths due to septicemia and accidents increased significantly in Orleans Parish and returned to normal in the latter half of 2006. Causes of death in the GNO area showed no significant change after Katrina.

Conclusions: There was no significant or lasting increase in morality rates in the Greater New Orleans area following Hurricane Katrina.

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AUTHORS
Raoult C Ratard
Joanna Eavey
PUBLISHED
2008 in The Journal of the Louisiana State Medical Society : official organ of the Louisiana State Medical Society

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The effect of Hurricane Katrina on the prevalence of health impairments and disability among adults in New Orleans: differences by age, race, and sex.
"We examined the effects of Hurricane Katrina on disability-related measures of health among adults from New Orleans, U.S.A., in the year after the hurricane, with a focus on differences by age, race, and sex. Our analysis used data from the American Community Survey to compare disability rates between the pre-Katrina population of New Orleans with the same population in the year after Katrina (individuals were interviewed for the study even if they relocated away from the city). The comparability between the pre- and post-Katrina samples was enhanced by using propensity weights. We found a significant decline in health for the adult population from New Orleans in the year after the hurricane, with the disability rate rising from 20.6% to 24.6%. This increase in disability reflected a large rise in mental impairments and, to a lesser extent, in physical impairments. These increases were, in turn, concentrated among young and middle-aged black females. Stress-related factors likely explain why young and middle-aged black women experienced worse health outcomes, including living in dwellings and communities that suffered the most damage from the hurricane, household breakup, adverse outcomes for their children, and higher susceptibility."
AUTHORS
Jesse Gregory
Narayan Sastry
PUBLISHED
2013 in Social science & medicine (1982)

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Children's respiratory health and mold levels in New Orleans after Katrina: A preliminary look
"Background: When the federal levee system broke after Hurricane Katrina, 80 percent of New Orleans, approximately 134,000 homes, flooded. As repopulation and revitalization activities continue, exposure to mold and other respiratory irritants has emerged as a major health concern; however, there has been no study examining children's respiratory health and indoor mold levels in the post-Katrina environment.

Objective: The Children's Respiratory Health Study was designed as a preliminary examination of indoor air levels of mold, children's lung function, and common indices of respiratory health in a select sample of children returning to live in New Orleans immediately after Hurricane Katrina.

Methods: Children were recruited from a private primary school in the Garden District of New Orleans. Respiratory health questionnaire and spirometric data were collected on children 7 to 14 years of age, and mold air sampling was conducted at baseline and again after 2 months.

Conclusions: There was an overall decrease in mold levels and respiratory symptoms over the study period, and indoor mold levels were low despite reported hurricane damage.

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AUTHORS
Elizabeth Holt
Ginger L. Chew
Felicia A. Rabito
Michael P. Kiernan
Shahed Iqbal
PUBLISHED
2008 in Journal of Allergy and Clinical Immunology

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Tuberculosis control activities after Hurricane Katrina--New Orleans, Louisiana, 2005.
"On August 29, 2005, when Hurricane Katrina struck the U.S. Gulf Coast, 130 Louisiana residents in the greater New Orleans area were known to be undergoing treatment for tuberculosis (TB) disease. Standard treatment and cure of TB requires a multidrug regimen administered under directly observed therapy (DOT) for at least 6 months. This report updates previous information and summarizes TB cases reported as of December 31, 2005, among persons undergoing TB treatment in the New Orleans area when Hurricane Katrina made landfall and among persons who were evacuated and subsequently received a diagnosis of TB in other parts of the country. By October 13, 2005, through intensive local, state, and national efforts involving both government and private sector partners, all 130 TB patients from the New Orleans area had been located and, if still indicated, had resumed TB treatment. As a result of heightened public health surveillance among Hurricane Katrina evacuees, six other New Orleans evacuees began treatment (i.e., two persons with known TB and four with previously undiagnosed TB) after arriving in other states. The success of these post-disaster TB control measures affirms the utility of alternative data sources during health-related emergencies and the importance of maintaining a strong TB control component in the public health sector."
PUBLISHED
2006 in MMWR. Morbidity and mortality weekly report

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Medical treatment at Louis Armstrong New Orleans International Airport after hurricane Katrina: The experience of disaster medical assistance teams WA-1 and OR-2
"In the week following Hurricane Katrina, over 3000 patients were evacuated by air from a triage and medical treatment station at the Louis Armstrong New Orleans International Airport. This represents the largest air evacuation in history. Over 24,000 additional evacuees were transported from the airport to shelters. Disaster Medical Assistance Teams (DMATs) from several US states were deployed to the Louis Armstrong New Orleans International Airport to provide medical care to those evacuated from New Orleans. Despite warning from the US National Weather Service of catastrophic damage to New Orleans, adequate medical staffing was not attained at the airport triage station until 6 days after the hurricane struck. Organizational lapses, including inadequate medical and operational planning, understaffing of medical personnel, and failure to utilize Incident Command System, diminished the effectiveness of the Hurricane Katrina New Orleans Medical Operation."
AUTHORS
Helen C. Miller
Jonathan Jui
Christopher Sanford
Kathleen A. Jobe
PUBLISHED
2007 in Travel Medicine and Infectious Disease

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Cognitive Performance During Respirator Wear in the Absence of Other Stressors
"Reaction time, decision-making speed, and response accuracy were measured in 12 male and 5 female subjects performing computer-controlled tasks under nonexercise conditions during two 3.5-hour days, one with and one without (control) wearing a respirator, to assess the effects of respirator wear alone on cognitive performance. Tasks included measures of simple and choice reaction time (CRT), serial pattern matching, lexical discrimination (LD), visual selective attention, rapid visual scanning, and form discrimination (FD). Anxiety levels were assessed along with reaction time measures obtained at the start of each test day and after 1, 2, and 3 hours of testing. Reaction time and response accuracy did not differ significantly between respirator and control trials and were not changed over time. However, mean decision-making times were significantly faster during respirator wear compared to control for the LD (0.17 +/- 0.04 versus 0.19 +/- 0.05 sec) and FD (0.32 +/- 0.10 versus 0.36 +/- 0.12 sec) CRT tasks. Females exhibited significantly faster reaction times than males, but no differences within sex groups were observed between control and respirator trials. Response accuracy and decision-making speed did not differ within and between male and female groups for any reaction time tasks during respirator wear. The improvements in decision-making time observed during respirator wear probably reflect the effect of the respirator to increase arousal and improve focusing of attention by excluding peripheral visual stimuli. Furthermore, the results suggest that respirator wear over a relatively short period in the absence of other stressors should not inhibit cognitive function."
AUTHORS
Wade D. Kuhlmann
David M. Caretti
Leslie A. Bay-Hansen
PUBLISHED
1995 in American Industrial Hygiene Association Journal

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Clinical pulmonary function and industrial respirator wear
"This investigation was the initial step in determining a clinical pulmonary test which could be used to evaluate workers as to their suitability to industrial respirator wear. Sixty subjects, 12 superior, 37 normal, and 11 moderately impaired with respect to lung function tests were evaluated with a battery of clinical pulmonary tests while wearing an industrial respirator. The respirator was a full-face mask (MSA-Ultravue) "demand" breathing type equipped with an inspiratory resistance of 85 mm H2O at 85 L/min air flow and an expiratory resistance of 25 mmH2O at 85 L/min air flow. Comparisons of these tests were made between the three groups of subjects both with and without a respirator. It appears that those lung tests which measure the flow characteristics of the lung especially those that are effort dependent are more susceptible to change as a result of respirator wear. Hence, the respirator affects the person with superior lung function to a greater degree than the moderately impaired person. It was suggested that the clinical test of 15 second maximum voluntary ventilations (MVV.25) may be the test of choice for determining worker capability in wearing an industrial respirator."
AUTHORS
BARBARA SKAGGS
ROBERT GARMON
KIMBERLY PAGE
PETER B. RAVEN
RAYMOND F. MOSS
PUBLISHED
1981 in American Industrial Hygiene Association Journal

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An investigation of respiration while wearing back belts.
"The research was conducted to evaluate the frequency of respiration during a repetitive lifting task when abdominal compression occurs from wearing a back belt. Three back belts were evaluated in this study: a nylon back belt, an inflatable back belt and an elastic vest. Analysis of the data revealed that the frequency of respiration increased while wearing the back belts at rest and while performing a repetitive lifting task. A statistically significant increase in the frequency of respiration was found while wearing the nylon back belt during the lifting task."
AUTHORS
C Mealins
L L Crumpton
T N Soh
P L Parker
PUBLISHED
1997 in Applied Ergonomics

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Respiratory protection during high-fidelity simulated resuscitation of casualties contaminated with chemical warfare agents
"Emergency room personnel are threatened by secondary poisoning when treating victims affected by chemical warfare agents. Therefore, resuscitation skills practised with respiratory protection equipment in place require evaluation. We investigated the influence of wearing air-purifying respirators on the simulated resuscitation of chemical warfare agent casualties. We studied 22 anaesthetic trainees in a simulated resuscitation scenario requiring five set tasks, either unprotected, wearing a binocular visor respirator or a panoramic visor respirator in a randomised, crossover study. Treatment times did not differ between the three groups, with mean (SD) times to complete the tasks being 122 (8) s without a mask, 126 (7) s when wearing the panoramic visor mask and 129 (8) s when wearing the binocular respirator mask. All anaesthetists preferred the panoramic visor in terms of visual orientation but 88% of them rated the binocular mask as being more comfortable. Modern respirators have a negligible effect on simulated resuscitation scenarios for victims affected by chemical warfare agents. Panoramic visor respirators allow better visual orientation for anaesthetists during simulated resuscitation."
AUTHORS
W. Eichler
M. Heringlake
K. Prior
A. Brinker
J. Runte
J. Schumacher
PUBLISHED

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Occupational respiratory health: a survey of Wisconsin workers who wear respirators.
"Context: Little is known about Wisconsin workers who wear respirators and the prevalence of work-related asthma (WRA) in that population. To understand this problem, we questioned workers who wear respirators.

Objectives: The primary objective was to learn more about the health experiences of workers who wear respirators. A secondary objective was to evaluate the utility of the survey in WRA surveillance.

Design: A survey was mailed to an opportunistic sample of workers who received medical evaluation for respirator fit testing.

Participants: Surveys were sent to 1356 workers medically evaluated to wear a respirator; 192 surveys were completed and returned.

Results: The majority of respondents were men who have been medically evaluated for respirator wear an average of 3 times during their career. Every time, most respirator medical evaluations used 3 evaluation tools: questionnaire, physical exam and breathing test. Thirty-two percent of survey respondents had some asthma symptoms while at work in the last 30 days, and half reported discussing these symptoms with a physician. Lifetime prevalence of asthma as determined by this survey was 18%. Lifetime prevalence for WRA amongthis population was 3% (18% among those with asthma).

Conclusions: This survey was an efficient and effective way to learn more about workers' respirator experiences and to determine the prevalence of asthma in this population. Few differences existed between those with asthma and those without. However, some differences were noted between those with asthma and those with WRA. Data also suggest that the respirator medical evaluation process provides an opportunity for health practitioners to discuss asthma and asthma prevention with workers.

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AUTHORS
Henry Anderson
Madeline Oguss
Pamela Rogers
PUBLISHED
2010 in WMJ : official publication of the State Medical Society of Wisconsin

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Literature review
Respiratory protection in the mining industry.
"Because respirators may have adverse effects on an individual, it is important that the occupational physician understand these effects and appropriate respirator use in the mining industry. Few studies have been performed on the effects of respirator wear among workers who may have some physiologic impairment. This chapter reviews the relevant regulations, types of respirators used in the mining industry, and the various effects of their use, as well as provides reasonable guidelines for determining fitness to wear these devices."
AUTHORS
T K Hodous
N L Turner
PUBLISHED
1993 in Occupational medicine (Philadelphia, Pa.)

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Cognitive Performance During Long-Term Respirator Wear While at Rest
"Cognitive performance was studied in six male and three female subjects exposed to two randomly administered 10-hour measurement periods, a control condition without a respirator and a respirator wear trial requiring continuous wear, under nonexercise conditions. Reaction time and decision-making speed were assessed using a series of simple and choice reaction time tasks at the start of each test iteration and after hours 2, 4, 6, 8, and 10 of testing. Subject anxiety levels were assessed along with reaction time measures. Visual tracking ability was measured after each hour of testing. Reaction time and decision-making speed did not differ significantly between control and respirator conditions at any time throughout the 10 hours of testing. Female volunteers exhibited significantly faster reaction times and decision-making speeds than males independent of respirator wear conditions and time of measurement. Subject anxiety increased significantly from initial measurements after 8 hours of testing for each condition, but no differences were observed between conditions at any time. Respirator wear did not detrimentally influence visual tracking ability. These findings suggest that respirator wear over a relatively long time period under nonexercise conditions should not significantly inhibit cognitive function."
AUTHOR
David M. Caretti
PUBLISHED
1997 in AIHA Journal

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Effects of respirators on performance of physical, psychomotor and cognitive tasks
"Possible work decrements caused by respirator usage were examined. A battery of physical, psychomotor and cognitive tasks was used to investigate the effects of respirator wear on 12 subjects. A repeated measures experimental design was used to study the effects of three types of respirators: a disposable dust mask; an air purifying half-mask; and a full-face airline mask. Performance while wearing a mask was compared to the control condition without a respirator. The results from the physical work task of riding a bicycle ergometer indicated approximately a 10% increase in oxygen consumption when subjects wore half and full-face masks in comparison to when they performed the tasks without a mask. The results indicate that wearing the respirators did not have a significant effect on the performance of cognitive tasks but did affect significantly the performance of psychomotor tasks such as steadiness of work performance and movements requiring accurate control for positioning of objects."
AUTHORS
GEORGE MCCABE
GAVRIEL SALVENDY
CLNDELYN EBERTS
NEIL J. ZIMMERMAN
PUBLISHED

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Respirator Performance Ratings for Speech Intelligibility
"A respirator degrades speech intelligibility and thus interferes with the ability of the wearer to communicate. The magnitude of this degradation is not well-studied and can vary as a function of numerous parameters. This study investigated the performance degradation of speech intelligibility in low-level noise for different speaker-listener distances and message sets (single words or predictable sentences) that occurred while wearing a respirator compared with not wearing a respirator. Thirteen speaker-listener pairs with normal hearing and speech were used. Speaker-listener separation distances were 0.61, 1.22, 1.83, 2.44, 3.05, and 3.66 m (2, 4, 6, 8, 10, and 12 ft) for the respirator condition and 1.22, 2.44, 3.05, 6.1, 9.15, and 12.2 m (4, 8, 10, 20, 30, and 40 ft) for the no-respirator condition. The means of the scores were used to determine the speech performance rating for both the single-word and sentence comprehension tests. The performance rating expresses the percentage of performance that can be expected while wearing a respirator compared with not wearing a respirator. Scores were interpolated linearly at distances at which no data were obtained. As expected, the speech performance rating was higher for the sentence comprehension test than for the single-word comprehension test at each distance. At a distance of 12.2 m, the speech performance rating for the sentence comprehension was 70%. For the single-word comprehension test, the speech performance rating was zero for distances greater than 9.1 m."
AUTHORS
Grace H. Yeni-Komshian
Karen M. Coyne
Arthur T. Johnson
Cathryn R. Dooly
PUBLISHED
1998 in American Industrial Hygiene Association Journal

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Literature review
Novel Coronavirus: Current Understanding of Clinical Features, Diagnosis, Pathogenesis, and Treatment Options
FUNDERS
American University of Sharjah
"Since December 2019, coronavirus disease 2019 (COVID-19) caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has resulted in devastating consequences worldwide and infected more than 350,000 individuals and killed more than 16,000 people. SARS-CoV-2 is the seventh member of the coronavirus family to affect humans. Symptoms of COVID-19 include fever (88%), cough (68%), vomiting (5%) and diarrhoea (3.7%), and transmission of SARS-CoV-2 is thought to occur from human to human via respiratory secretions released by the infected individuals when coughing and sneezing. COVID-19 can be detected through computed tomography scans and confirmed through molecular diagnostics tools such as polymerase chain reaction. Currently, there are no effective treatments against SARS-CoV-2, hence antiviral drugs have been used to reduce the development of respiratory complications by reducing viral load. The purpose of this review is to provide a comprehensive update on the pathogenesis, clinical aspects, diagnosis, challenges and treatment of SARS-CoV-2 infections."
AUTHORS
Naveed Ahmed Khan
Mohammad Ridwane Mungroo
Ruqaiyyah Siddiqui
PUBLISHED
2020 in Pathogens

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Mutated COVID-19, May Foretells Mankind in a Great Risk in the Future
"Corona virus disease 2019 SARS-CoV-2 (COVID-19) is a zoonotic virus causing a variety of severe of respiratory diseases. SARS-CoV-2 is closest to SARS-CoV and MERS-CoV in structure. The highly prevalence of COVID-19 is due to the lack onset of symptoms. Our study aimed to present an overview of the virus in terms of structure, epidemiology, symptoms, treatment, and prevention. Conduct the differences of whole genome sequence and some viral proteins to determine the gap and the change alternation of nucleotides and amino acids sequences. We evaluate 11 complete genome sequence of different coronavirus using BAST and MAFFT software. We also selected 7 types of structural proteins. We were conclude that COVID-19 might be created new mutations specifically in glycoproteins hence requires caution and complete preparation by health authorities."
AUTHOR
Ali A. Dawood
PUBLISHED
2020 in New Microbes and New Infections

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Molecular immune pathogenesis and diagnosis of COVID-19
FUNDERS
National Natural Science Foundation of China , Fundamental Research Funds for the Central Universities
"Coronavirus disease 2019 (COVID-19) is a kind of viral pneumonia with an unusual outbreak in Wuhan, China, in December 2019, which is caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). The emergence of SARS-CoV-2 has been marked as the third introduction of a highly pathogenic coronavirus into the human population after the severe acute respiratory syndrome coronavirus (SARS-CoV) and the Middle East respiratory syndrome coronavirus (MERS-CoV) in the twenty-first century. In this minireview, we provide a brief introduction of the general features of SARS-CoV-2 and discuss current knowledge of molecular immune pathogenesis, diagnosis and treatment of COVID-19 on the base of the present understanding of SARS-CoV and MERS-CoV infections, which may be helpful in offering novel insights and potential therapeutic targets for combating the SARS-CoV-2 infection."
AUTHORS
Liesu Meng
Xiaowei Li
Manman Geng
Shemin Lu
Yizhao Peng
PUBLISHED
2020 in Journal of Pharmaceutical Analysis

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QUESTIONS TO CONSIDER
Are cloth masks as effective as surgical masks at reducing the risk of contracting viruses that cause respiratory disease?
6 studies
Submitted by: MChoi 148

Can you contract COVID-19 twice?
5 studies
Submitted by: JAloni 117

Do adults get sick from COVID-19 more often than children?
10 studies
Submitted by: JLjilijana 85

Do cloth masks reduce the risk of contracting viruses that cause respiratory disease?
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Submitted by: JAloni 117

Does air pollution accelerate the spread of COVID-19?
7 studies
Submitted by: JLjilijana 85

Does air pollution increase the severity of symptoms from COVID-19?
6 studies
Submitted by: KKrista 83

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