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Article ; Online: COVID-19 in a Patient Presenting with Syncope and a Normal Chest X-ray.

Tapé, Chantal / Byrd, Katrina M / Aung, Su / Lonks, John R / Flanigan, Timothy P / Rybak, Natasha R

Rhode Island medical journal (2013)

2020 Volume 103, Issue 3, Page(s) 50–51

Abstract: SARS-CoV-2 is a novel virus that has now affected hundreds of thousands of individuals across the world. Amidst this global pandemic, maintaining a high index of suspicion, rapid testing capacity, and infection control measures are required to curtail ... ...

Abstract	SARS-CoV-2 is a novel virus that has now affected hundreds of thousands of individuals across the world. Amidst this global pandemic, maintaining a high index of suspicion, rapid testing capacity, and infection control measures are required to curtail the virus' rapid spread. While fever and respiratory symptoms have been commonly used to identify COVID-19 suspects, we present an elderly female who arrived to the hospital after a syncopal episode. She was afebrile with a normal chest X-ray and there was no suspicion of COVID-19. She then developed a fever and tested positive for COVID-19. Our unique case underscores the increasing diversity of COVID-19 presentations and potential for initial mis- diagnosis and delay in implementing proper precautions.
MeSH term(s)	Aged ; Betacoronavirus ; COVID-19 ; COVID-19 Testing ; Clinical Laboratory Techniques ; Coronavirus Infections/complications ; Coronavirus Infections/diagnosis ; Diagnostic Errors ; Female ; Fever/etiology ; Humans ; Pandemics ; Pneumonia, Viral/complications ; Pneumonia, Viral/diagnosis ; Radiography, Thoracic ; SARS-CoV-2 ; Syncope/etiology
Keywords	covid19
Language	English
Publishing date	2020-03-26
Publishing country	United States
Document type	Case Reports ; Journal Article
ZDB-ID	419430-5
ISSN	2327-2228 ; 0363-7913
ISSN (online)	2327-2228
ISSN	0363-7913
Database	MEDical Literature Analysis and Retrieval System OnLINE

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Jg. 1995 - 2021: Lesesall (1.OG)
ab Jg. 2022: Lesesaal (EG)

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Article ; Online: Tuberculosis: An Epidemic Perpetuated by Health Inequalities.

Szkwarko, Daria / Bouton, Tara C / Rybak, Natasha R / Carter, E Jane / Chiang, Silvia S

Rhode Island medical journal (2013)

2019 Volume 102, Issue 7, Page(s) 47–50

Abstract: Tuberculosis (TB) is the leading single-agent infectious disease killer worldwide. The World Health Organization (WHO)'s End TB Strategy aims to achieve tuberculosis (TB) elimination by 2030, and in September 2018, the United Nations General Assembly ... ...

Abstract	Tuberculosis (TB) is the leading single-agent infectious disease killer worldwide. The World Health Organization (WHO)'s End TB Strategy aims to achieve tuberculosis (TB) elimination by 2030, and in September 2018, the United Nations General Assembly held a High-Level Meeting on TB to address the urgency of the TB epidemic and the health inequalities that continue to propel it. The meeting endorsed an ambitious, comprehensive approach to the TB epidemic that incorporates universal health coverage and tackles the social determinants of this disease. In this article, we provide an overview of the key strategies promoted in this meeting and introduce work by five Rhode Island-based physicians that align with these goals.
MeSH term(s)	Adolescent ; Adult ; Child ; Communicable Disease Control/organization & administration ; Epidemics/prevention & control ; Global Health ; Goals ; Health Services Accessibility/organization & administration ; Health Services Research ; Health Status Disparities ; Humans ; Socioeconomic Factors ; Tuberculosis/epidemiology ; Tuberculosis/prevention & control ; World Health Organization
Language	English
Publishing date	2019-09-03
Publishing country	United States
Document type	Journal Article
ZDB-ID	419430-5
ISSN	2327-2228 ; 0363-7913
ISSN (online)	2327-2228
ISSN	0363-7913
Database	MEDical Literature Analysis and Retrieval System OnLINE

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Zs.A 222: Show issues

Location:
Je nach Verfügbarkeit (siehe Angabe bei Bestand)
bis Jg. 1994: Bestellungen von Artikeln über das Online-Bestellformular
Jg. 1995 - 2021: Lesesall (1.OG)
ab Jg. 2022: Lesesaal (EG)

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Article ; Online: Missed Tuberculosis Diagnoses: Analysis of Pediatric Autopsy Data From General Hospitals in Lviv, Ukraine.

Kuzyk, Petro V / Padilla, Rachel / Rybak, Natasha R / Hoshovska, Iryna I / Kitov, Vasyl O / Savchyna, Mariia O / Jenkins, Helen E / Chiang, Silvia S / Horsburgh, Charles Robert / Dolynska, Maria / Petrenko, Vasyl / Gychka, Sergiy G

Journal of the Pediatric Infectious Diseases Society

2022 Volume 11, Issue 6, Page(s) 300–302

Abstract: We reviewed autopsy data from general hospitals in Lviv, Ukraine to understand pediatric mortality due to tuberculosis (TB). We identified 14 (0.6%) of 2345 autopsied children with unrecognized or untreated TB. More sensitive TB diagnostics for children ... ...

Abstract	We reviewed autopsy data from general hospitals in Lviv, Ukraine to understand pediatric mortality due to tuberculosis (TB). We identified 14 (0.6%) of 2345 autopsied children with unrecognized or untreated TB. More sensitive TB diagnostics for children and improved strategies for identifying which children require TB evaluation are urgently needed.
MeSH term(s)	Autopsy ; Child ; Hospitals, General ; Humans ; Tuberculosis/diagnosis ; Tuberculosis/epidemiology ; Ukraine/epidemiology
Language	English
Publishing date	2022-04-05
Publishing country	England
Document type	Journal Article
ZDB-ID	2668791-4
ISSN	2048-7207 ; 2048-7193
ISSN (online)	2048-7207
ISSN	2048-7193
DOI	10.1093/jpids/piac016
Database	MEDical Literature Analysis and Retrieval System OnLINE

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Article: COVID-19 in a Patient Presenting with Syncope and a Normal Chest X-ray

Tapé, Chantal / Byrd, Katrina M / Aung, Su / Lonks, John R / Flanigan, Timothy P / Rybak, Natasha R

R I Med J (2013)

Abstract	SARS-CoV-2 is a novel virus that has now affected hundreds of thousands of individuals across the world. Amidst this global pandemic, maintaining a high index of suspicion, rapid testing capacity, and infection control measures are required to curtail the virus' rapid spread. While fever and respiratory symptoms have been commonly used to identify COVID-19 suspects, we present an elderly female who arrived to the hospital after a syncopal episode. She was afebrile with a normal chest X-ray and there was no suspicion of COVID-19. She then developed a fever and tested positive for COVID-19. Our unique case underscores the increasing diversity of COVID-19 presentations and potential for initial mis- diagnosis and delay in implementing proper precautions.
Keywords	covid19
Publisher	WHO
Document type	Article
Note	WHO #Covidence: #32226962
Database	COVID19

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Article ; Online: Incidence and Mortality of Extrapulmonary Tuberculosis in Ukraine: Analysis of National Surveillance Data.

Khalife, Sara / Jenkins, Helen E / Dolynska, Mariia / Terleieva, Iana / Varchenko, Iurii / Liu, Tao / Carter, E Jane / Horsburgh, C Robert / Rybak, Natasha R / Petrenko, Vasyl / Chiang, Silvia S

Clinical infectious diseases : an official publication of the Infectious Diseases Society of America

2021 Volume 75, Issue 4, Page(s) 604–612

Abstract: Background: Improved understanding of the epidemiology and mortality risk factors of extrapulmonary tuberculosis (EPTB) may facilitate successful diagnosis and management.: Methods: We analyzed national surveillance data from Ukraine to characterize ... ...

Abstract	Background: Improved understanding of the epidemiology and mortality risk factors of extrapulmonary tuberculosis (EPTB) may facilitate successful diagnosis and management. Methods: We analyzed national surveillance data from Ukraine to characterize EPTB subtypes (ie, localized in different anatomic sites). We calculated annual reported incidence, stratified by age, sex, and human immunodeficiency virus (HIV) status. Using Cox regression, we estimated mortality risk factors. Results: Between January 2015 and November 2018, 14 062 adults/adolescents (≥15 years) and 417 children (<15 years) had EPTB with or without concomitant pulmonary TB. The most commonly reported EPTB subtypes were pleural, peripheral lymph node, and osteoarticular. Most EPTB subtype notifications peaked at age 30-39 years and were higher in males. In adults/adolescents, most peripheral TB lymphadenitis, central nervous system (CNS) TB, and abdominal TB occurred in those with untreated HIV. CNS TB notifications in people without HIV peaked before age 5 years. Adults/adolescents with CNS TB (adjusted hazard ratio [aHR]: 3.22; 95% CI: 2.89-3.60) and abdominal TB (aHR: 1.83; 95% CI: 1.59-2.11) were more likely to die than those with pulmonary TB. Children with CNS TB were more likely to die (aHR: 88.25; 95% CI: 43.49-179.10) than those with non-CNS TB. Among adults/adolescents, older age and HIV were associated with death. Rifampicin resistance was associated with mortality in pleural, peripheral lymph node, and CNS TB. Conclusions: We identified the most common EPTB subtypes by age and sex, patterns of EPTB disease by HIV status, and mortality risk factors. These findings can inform diagnosis and care for people with EPTB.
MeSH term(s)	Adolescent ; Adult ; Child ; Child, Preschool ; HIV Infections/complications ; HIV Infections/epidemiology ; Humans ; Incidence ; Male ; Tuberculosis/diagnosis ; Tuberculosis, Pulmonary/epidemiology ; Ukraine/epidemiology
Language	English
Publishing date	2021-12-04
Publishing country	United States
Document type	Journal Article ; Research Support, Non-U.S. Gov't ; Research Support, N.I.H., Extramural
ZDB-ID	1099781-7
ISSN	1537-6591 ; 1058-4838
ISSN (online)	1537-6591
ISSN	1058-4838
DOI	10.1093/cid/ciab1018
Database	MEDical Literature Analysis and Retrieval System OnLINE

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Zs.A 1505: Show issues			Location: Je nach Verfügbarkeit (siehe Angabe bei Bestand) bis Jg. 1994: Bestellungen von Artikeln über das Online-Bestellformular Jg. 1995 - 2021: Lesesall (1.OG) ab Jg. 2022: Lesesaal (EG)
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Article: Clinical manifestations and epidemiology of adolescent tuberculosis in Ukraine.

Chiang, Silvia S / Dolynska, Maria / Rybak, Natasha R / Cruz, Andrea T / Aibana, Omowunmi / Sheremeta, Yana / Petrenko, Vasyl / Mamotenko, Andrii / Terleieva, Iana / Horsburgh, C Robert / Jenkins, Helen E

ERJ open research

2020 Volume 6, Issue 3

Abstract: Background: During adolescence, childhood and adult forms of tuberculosis (TB) overlap, resulting in diverse disease manifestations. Knowing which patient characteristics are associated with which manifestations may facilitate diagnosis and enhance ... ...

Abstract	Background: During adolescence, childhood and adult forms of tuberculosis (TB) overlap, resulting in diverse disease manifestations. Knowing which patient characteristics are associated with which manifestations may facilitate diagnosis and enhance understanding of TB pathophysiology. Methods: In this cross-sectional study, we included 10-19-year-olds in Ukraine's national TB registry who started TB treatment between 2015 and 2018. Using multivariable regression, we estimated associations between patient characteristics and four presentations of TB: pleural, extrathoracic, cavitary and rifampicin-resistant (RR). We also described the epidemiology of adolescent TB in Ukraine. Results: Among 2491 adolescent TB cases, 88.4% were microbiologically confirmed. RR-TB was confirmed in 16.9% of new and 29.7% of recurrent cases. Of 88 HIV-infected adolescents, 59.1% were not on antiretroviral therapy at TB diagnosis. Among 10-14-year-olds, boys had more pleural disease (adjusted OR (aOR) 2.12, 95% CI: 1.08-4.37). Extrathoracic TB was associated with age 15-19 years (aOR 0.26, 95% CI: 0.18-0.37) and HIV (aOR 3.25, 95% CI: 1.55-6.61 in 10-14-year-olds; aOR 8.18, 95% CI: 3.58-17.31 in 15-19-year-olds). Cavitary TB was more common in migrants (aOR 3.53, 95% CI: 1.66-7.61) and 15-19-year-olds (aOR 4.10, 95% CI: 3.00-5.73); among 15-19-year-olds, it was inversely associated with HIV (aOR 0.32, 95% CI: 0.13-0.70). RR-TB was associated with recurrent disease (aOR 1.87, 95% CI: 1.08-3.13), urban residence (aOR 1.27, 95% CI: 1.01-1.62) and cavitation (aOR 2.98, 95% CI: 2.35-3.78). Conclusions: Age, sex, HIV and social factors impact the presentation of adolescent TB. Preventive, diagnostic and treatment activities should take these factors into consideration.
Language	English
Publishing date	2020-09-14
Publishing country	England
Document type	Journal Article
ZDB-ID	2827830-6
ISSN	2312-0541
ISSN	2312-0541
DOI	10.1183/23120541.00308-2020
Database	MEDical Literature Analysis and Retrieval System OnLINE

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Article ; Online: SARS-CoV-2 and HIV coinfection: clinical experience from Rhode Island, United States.

Byrd, Katrina M / Beckwith, Curt G / Garland, Joseph M / Johnson, Jennie E / Aung, Su / Cu-Uvin, Susan / Farmakiotis, Dimitrios / Flanigan, Timothy / Gillani, Fizza S / Macias-Gil, Raul / Mileno, Maria / Ramratnam, Bharat / Rybak, Natasha R / Sanchez, Martha / Tashima, Karen / Mylonakis, Eleftherios / Kantor, Rami

Journal of the International AIDS Society

2020 Volume 23, Issue 7, Page(s) e25573

Abstract: Introduction: Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) has infected >6 million people worldwide since December 2019. Global reports of HIV/SARS-CoV-2 coinfection are limited. To better understand the impact of the coronavirus disease ...

Abstract	Introduction: Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) has infected >6 million people worldwide since December 2019. Global reports of HIV/SARS-CoV-2 coinfection are limited. To better understand the impact of the coronavirus disease 2019 (COVID-19) pandemic on persons with HIV and improve their care, we present an outpatient and inpatient clinical experience of HIV/SARS-CoV-2 coinfection from Rhode Island, US. Methods: We describe outpatient and inpatient preparedness for the COVID-19 pandemic, and present a case series of all known patients with HIV/SARS-CoV-2 coinfection at The Miriam Hospital and Rhode Island Hospital, and The Miriam Hospital Infectious Diseases and Immunology Center, in Providence, Rhode Island, US. Results and discussion: The Infectious Diseases and Immunology Center rapidly prepared for outpatient and inpatient care of persons with HIV and SARS-CoV-2. Between 30 March and 20 May 2020, 27 patients with HIV were diagnosed with SARS-CoV-2. Twenty were male, six female and one transgender female; average age was 49 years; 13/27 were Hispanic and 6/27 were African American. All had HIV viral load <200 copies/mL and were on antiretroviral therapy with CD4 count range 87 to 1441 cells/µL. Twenty-six of the 27 had common COVID-19 symptoms for one to twenty-eight days and most had other co-morbidities and/or risk factors. Nine of the 27 were hospitalized for one to thirteen days; of those, three lived in a nursing home, six received remdesivir through a clinical trial or emergency use authorization and tolerated it well; eight recovered and one died. Overall, 17% of known Center people had HIV/SARS-CoV-2 coinfection, whereas the comparable state-wide prevalence was 9%. Conclusions: We highlight challenges of outpatient and inpatient HIV care in the setting of the COVID-19 pandemic and present the largest detailed case series to date from the United States on HIV/SARS-CoV-2 coinfection, adding to limited global reports. The aggregated clinical findings suggest that the clinical presentation and outcomes of COVID-19 appear consistent with those without HIV. Whether SARS-CoV-2 infection is more frequent among persons with HIV remains to be determined. More data are needed as we develop our understanding of how HIV and antiretroviral therapy are affected by or have an impact on this pandemic.
MeSH term(s)	Adult ; Aged ; Ambulatory Care/standards ; Betacoronavirus ; COVID-19 ; Coinfection/epidemiology ; Coronavirus Infections/complications ; Coronavirus Infections/epidemiology ; Female ; HIV Infections/complications ; HIV Infections/epidemiology ; Hospitalization ; Humans ; Inpatients ; Male ; Middle Aged ; Outpatients ; Pandemics ; Pneumonia, Viral/complications ; Pneumonia, Viral/epidemiology ; Rhode Island/epidemiology ; Risk Factors ; SARS-CoV-2 ; Telemedicine ; United States
Keywords	covid19
Language	English
Publishing date	2020-08-17
Publishing country	Switzerland
Document type	Journal Article
ZDB-ID	2467110-1
ISSN	1758-2652 ; 1758-2652
ISSN (online)	1758-2652
ISSN	1758-2652
DOI	10.1002/jia2.25573
Database	MEDical Literature Analysis and Retrieval System OnLINE

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Article ; Online: SARS‐CoV‐2 and HIV coinfection

Byrd, Katrina M / Beckwith, Curt G / Garland, Joseph M / Johnson, Jennie E / Aung, Su / Cu‐Uvin, Susan / Farmakiotis, Dimitrios / Flanigan, Timothy / Gillani, Fizza S / Macias‐Gil, Raul / Mileno, Maria / Ramratnam, Bharat / Rybak, Natasha R / Sanchez, Martha / Tashima, Karen / Mylonakis, Eleftherios / Kantor, Rami

Journal of the International AIDS Society

clinical experience from Rhode Island, United States

2020 Volume 23, Issue 7

Keywords	Public Health, Environmental and Occupational Health ; Infectious Diseases ; covid19
Language	English
Publisher	Wiley
Publishing country	us
Document type	Article ; Online
ZDB-ID	2467110-1
ISSN	1758-2652
ISSN	1758-2652
DOI	10.1002/jia2.25573
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article: SARS-CoV-2 and HIV coinfection: clinical experience from Rhode Island, United States

J Int AIDS Soc

Abstract: INTRODUCTION: Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) has infected >6 million people worldwide since December 2019. Global reports of HIV/SARS-CoV-2 coinfection are limited. To better understand the impact of the coronavirus disease ... ...

Abstract	INTRODUCTION: Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) has infected >6 million people worldwide since December 2019. Global reports of HIV/SARS-CoV-2 coinfection are limited. To better understand the impact of the coronavirus disease 2019 (COVID-19) pandemic on persons with HIV and improve their care, we present an outpatient and inpatient clinical experience of HIV/SARS-CoV-2 coinfection from Rhode Island, US. METHODS: We describe outpatient and inpatient preparedness for the COVID-19 pandemic, and present a case series of all known patients with HIV/SARS-CoV-2 coinfection at The Miriam Hospital and Rhode Island Hospital, and The Miriam Hospital Infectious Diseases and Immunology Center, in Providence, Rhode Island, US. RESULTS AND DISCUSSION: The Infectious Diseases and Immunology Center rapidly prepared for outpatient and inpatient care of persons with HIV and SARS-CoV-2. Between 30 March and 20 May 2020, 27 patients with HIV were diagnosed with SARS-CoV-2. Twenty were male, six female and one transgender female; average age was 49 years; 13/27 were Hispanic and 6/27 were African American. All had HIV viral load <200 copies/mL and were on antiretroviral therapy with CD4 count range 87 to 1441 cells/µL. Twenty-six of the 27 had common COVID-19 symptoms for one to twenty-eight days and most had other co-morbidities and/or risk factors. Nine of the 27 were hospitalized for one to thirteen days; of those, three lived in a nursing home, six received remdesivir through a clinical trial or emergency use authorization and tolerated it well; eight recovered and one died. Overall, 17% of known Center people had HIV/SARS-CoV-2 coinfection, whereas the comparable state-wide prevalence was 9%. CONCLUSIONS: We highlight challenges of outpatient and inpatient HIV care in the setting of the COVID-19 pandemic and present the largest detailed case series to date from the United States on HIV/SARS-CoV-2 coinfection, adding to limited global reports. The aggregated clinical findings suggest that the clinical presentation and outcomes of COVID-19 appear consistent with those without HIV. Whether SARS-CoV-2 infection is more frequent among persons with HIV remains to be determined. More data are needed as we develop our understanding of how HIV and antiretroviral therapy are affected by or have an impact on this pandemic.
Keywords	covid19
Publisher	WHO
Document type	Article
Note	WHO #Covidence: #609401
Database	COVID19

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