COVID-19 can suddenly become severe: a case series from Tokyo, Japan

Nakamura, Keiji; Ide, Satoshi; Saito, Sho; Iwamoto, Noriko; Kutsuna, Satoshi; Moriyama, Yuki; Suzuki, T.; M, Ota; Nomoto, Hidetoshi; Mizoue, Tetsuya; Hojo, Masayuki; Jin, Tao; Asai, Yasufumi; Terada, Mari; Akiyama, Yutaro; Miyazato, Yusuke; Nakamoto, Takato; Wakimoto, Yuji; Ujiie, Mugen; Yamamoto, Kei; Ishikane, Masahiro; Morioka, Shigefumi; Hayakawa, Kayoko; Sugiyama, Haruhito; Ohmagari, Norio

doi:10.35772/ghm.2020.01054

Cited by 11 publications

(10 citation statements)

References 7 publications

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“…Dyspnea is the most common symptom of the severe form of the disease and is often accompanied by hypoxemia [16,17]. In patients who have a fever for >7 days, the condition may worsen suddenly [18]. Therefore, the extension of the fever period may be one of the factors affecting the severity of COVID-19.…”

Section: Discussionmentioning

confidence: 99%

Early favipiravir treatment was associated with early defervescence in non-severe COVID-19 patients

Fujii

Ibe

Ishigo

et al. 2021

Journal of Infection and Chemotherapy

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Introduction The antiviral drug favipiravir has been shown to have in vitro antiviral activity against severe-acute-respiratory-syndrome-coronavirus-2 (SARS-CoV-2). In this study, we investigated the clinical benefits and initiation of favipiravir treatment in patients with non-severe coronavirus-disease-2019 (COVID-19). Methods This study was a single-center retrospective cohort study. Receiver operating characteristic curves were drawn to calculate the area under the curve, and the optimal cut-off values for the time to initiate favipiravir treatment were calculated to predict defervescence within seven days. Univariate and multivariate Cox regression analyses were performed to identify potential influencing factors of defervescence. This was defined as a body temperature of less than 37 °C for at least 2 days. Results Data from 41 patients were used for the efficacy assessment. The days from the onset of fever to defervescence showed a positive correlation with the duration from the onset of fever to initiation of favipiravir treatment (r=0.548, P <0.001). The optimal cut-off value was the administration of favipiravir on day 4. Patients were assigned to two groups based on the optimal cut-off value from onset to initiation of favipiravir treatment: early treatment group (within 4-days) and late treatment group (more than 4-days). In the multivariate analysis, when adjusted for age, sex, and days from onset to initiation of favipiravir treatment, the significant factors were male sex and days of initiation of the favipiravir treatment. Conclusions We recommend that if favipiravir is to be used for treatment, it should be initiated as early as possible.

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Section: Discussionmentioning

confidence: 99%

Early favipiravir treatment was associated with early defervescence in non-severe COVID-19 patients

Fujii

Ibe

Ishigo

et al. 2021

Journal of Infection and Chemotherapy

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“…The diagnostic approaches for COVID-19 include nucleic acid detection, chest computed tomographic (CT), epidemiological history and clinical manifestations. It presents a wide range of clinical presentation, from asymptomatic or mildly symptomatic patients to those requiring intensive care (4)(5)(6). Currently, hundreds of clinical trials on a wide variety of treatments against COVID-19 are being conducted around the world (7).…”

Section: Introductionmentioning

confidence: 99%

Shifting workstyle to teleworking as a new normal in face of COVID-19: analysis with the model introducing intercity movement and behavioral pattern

Karako¹,

Song²,

Chen³

et al. 2020

Ann Transl Med

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Background: Instead of the complete lockdown, since the outbreak of coronavirus disease 2019 , Japan has been trying to control the infection by self-restraint request policy. It seems that the number of infected people has subsided, however, the increasing human activities again in the resumption of economy may lead to the second wave of infections. Here, we analyzed the major factors behind the success control of the first outbreak in Japan and the potential risk of the second wave. Methods: Employing a localized stochastic transition model, we analyze the real data and the results of simulation in Tokyo from March 1 to July 31. In the model, population is divided into three compartments: susceptible, infected, and removed; and area into three zones: crowded, mid and uncrowded. Different zones have different infection probabilities characterized by the number of people gathered there. The flow of the infection simulation in one day consists of three steps: (I) intercity movement of population, (II) isolating infected people, and (III) zone shifting following group behavioral patterns.Results: The major cause for the success of controlling the first outbreak in Tokyo is demonstrated through our simulation to be the early request of self-restraint as well as the early detection of infected people. Meanwhile, the observation that the increasing human activities again in the resumption of economy will lead to the second wave of infections is also found in the simulation with an extended period. Based on the analysis of intercity movement and behavioral pattern on Tokyo where normally about 2.9 million people come from the surrounding cities to the central area by using the public railway system every day, results showed that turning the workstyle of 55% of working people ranging in age from 20 to 64 years old into teleworking (remote work) may control the spread of infection without significant economic damage. Meanwhile, to keep about 75% of the normal activity level and to advocate the shift to telework are indispensable because a sudden resumption of activity from the lockdown sate can rapidly spread infection. Conclusions:As a new normal in face of COVID-19 for Tokyo and other cities that with a high population density, shifting the workstyle of 55% of working people to teleworking and to reduce 25% time staying in the high infection risk area could be an effective measure to control the spread of infection while maintaining a certain level of economic activity.

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“…The spread index of this virus, as estimated by most studies, is between 2.24 and 3.58, which is slightly higher than SARS [31] . COVID-19 can quickly progress from mild to severe [32] . Classical public health measures, including isolation, quarantine, social distancing, and community containment, are effective to curb this pandemic [33] .…”

Section: Discussionmentioning

confidence: 99%

Safety and efficacy of artemisinin-piperaquine for treatment of COVID-19: an open-label, non-randomised and controlled trial

Mei

et al. 2021

International Journal of Antimicrobial Agents

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COVID-19 can suddenly become severe: a case series from Tokyo, Japan

Cited by 11 publications

References 7 publications

Early favipiravir treatment was associated with early defervescence in non-severe COVID-19 patients

Early favipiravir treatment was associated with early defervescence in non-severe COVID-19 patients

Shifting workstyle to teleworking as a new normal in face of COVID-19: analysis with the model introducing intercity movement and behavioral pattern

Safety and efficacy of artemisinin-piperaquine for treatment of COVID-19: an open-label, non-randomised and controlled trial

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