COVID-19: presentación clínica en adultos / COVID-19: clinical features in adult patients

Este artículo resume las diferentes formas de presentación clínica de la enfermedad COVID-19 causada por el virus SARS-Co-2 documentadas fundamentalmente en las tres principales revisiones sistemáticas disponibles. Entre las manifestaciones clínicas de frecuente aparición se destacan la fiebre (83 %), la tos (60 %) y la fatiga (38 %), seguidas por las mialgias (29 %), el aumento de la producción del esputo (27 %) y la disnea (25 %). Entre los hallazgos de laboratorio,predominan el aumento de los valores de proteína C reactiva (69 %), la linfopenia (57 %) y el aumento de los niveles de lactato-deshidrogenasa (52 %). Respecto de las manifestaciones radiológicas, tienen especial importancia las opacificaciones en vidrio esmerilado (80 %), la neumonía bilateral (73 %) y la afectación de tres lóbulos pulmonares o más (57 %).Si bien la evidencia sintetizada tiene limitaciones, permite una aproximación actualizada a los conocimientos disponibles sobre la clínica de esta nueva enfermedad en la población adulta. (AU)

This article summarizes the different forms of clinical presentation of COVID-19, caused by the SARS-Co-2 virus, synthesizing the information collected mainly by three published systematic reviews. Frequent clinical manifestations include fever(83 %), cough (60 %), and fatigue (38 %), followed by myalgia (29 %), increased sputum production (27 %) and dyspnea(25 %). Among the laboratory findings, the most common are the increase in C-reactive protein values (69 %), lymphopenia (57 %) and the increase in lactate dehydrogenase levels (52 %).. Most remarkable radiological features include ground glass opacifications (80 %), bilateral pneumonia (73 %) and the involvement of three or more lung lobes (57 %). Although the synthesized evidence has limitations, it allows an updated approach to the available knowledge about the clinical symptoms of this new disease in the adult population. (AU)

An increase in the cerebral infarction area during fatigue is mediated by il-6 through an induction of fibrinogen synthesis

OBJECTIVES: Our study aimed to investigate the impact of fatigue on the severity of stroke and to explore the underlying mechanisms. METHODS: Fatigued male rats underwent middle cerebral artery occlusion and the infarcted brain area was determined. Then, coagulation parameters were assessed in the fatigued group and a control group. In addition, the level of fibrinogen was determined in rats deprived of sleep for various numbers of days. To study whether interleukin-6 was involved in fibrinogen synthesis during fatigue, we also measured levels of interleukin-6 in rats deprived of sleep for various numbers of days. Furthermore, brain injury by middle cerebral artery occlusion was measured in wild-type mice, interleukin-6-/- mice and wild-type mice treated with bezafibrate. RESULTS: More severe cerebral infarction was observed in the fatigued rats, resulting in an infarct ratio of 23.4%. The infarct ratio was significantly increased in the fatigued rats compared with that in the control group (8%, p<0.05). The level of fibrinogen was increased significantly in the fatigued rats compared with that in the control group. In addition, a marked reduction in fibrinogen level was observed in the fatigued interleukin-6-/- mice compared to their wild-type counterparts, whereas no difference was observed between fatigued wild-type mice and interleukin-6-/- rats treated with recombinant human interleukin-6. The reduction in brain injury due to middle cerebral artery occlusion during fatigue was observed in interleukin-6-/- mice and wild-type mice treated with bezafibrate. CONCLUSION: Fatigue could increase stroke severity and was associated with the interleukin-6-induced expression of fibrinogen. .

In vivo Anti-fatigue activity of total flavonoids from sweet potato [Ipomoea batatas (L.) Lam.] leaf in mice.

The in vivo anti-fatigue activity of the total flavonoids from sweet potato [Ipomoea batatas (L.) Lam.] leaf was investigated in male Kunming mice. The total flavonoids from sweet potato leaf (TFSL) were orally administered at doses of 50, 100 and 200 mg/kg for 4 weeks and the anti-fatigue effect was studied using a weight-loaded swimming test, along with the determination of serum urea nitrogen (SUN), blood lactic acid (BLA) and hepatic and muscle glycogen contents. The results showed that TFSL had significant anti-fatigue effects. TFSL extended the exhaustive swimming time, effectively inhibited the increase of BLA, decreased the level of SUN and increased the hepatic and muscle glycogen content of mice. Thus, TFSL may have potential as an anti-fatigue agent.

A simplified method for the determination of blood lactic acid levels in occupational health practice.

Blood lactate assays are now widely used as measures of oxygen debt, especially in the areas of assessment of anaerobic power; assessment of fatigue; VO2(max) end-point determination, and rationalisation of work-rest cycles. A need exists for a method which will meet the following criteria: simplicity--single, small samples; rapidity, and feasibility with easily available instrument and chemicals. In order to develop such a method, the standard Barker and Summerson method was modified so as to use 0.02 ml of blood sample, and the following tests were carried out on 25 subjects at rest, and various levels of work: paired comparisons on analysis by macro and micro methods on the same sample of blood; paired comparisons on venous and capillary (fingertip) samples. In both cases, the paired values showed high correlation (0.99) and highly significant differences of means (P = 0.01 and 0.001, respectively). The regression equations obtained were also highly significant (P = 0.001). The combined equation was Y = 0.9655 X -0.4366; samples taken 2,4,5,6 and 10 mins after work showed that peak occurred in the 4th min sampling (2 vs 4 and 4 vs 6 min means significantly different at P = 0.05, and analysis of variance significant at (P = 0.001). It may be concluded that drawing, fingertip sample 4 mins after the end of work, analysing by the micro method, and using the regression equation will give the true peak blood lactate level, and satisfy the systems criteria defined.