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2.
Arch. argent. pediatr ; 119(3): e252-e255, Junio 2021. ilus
Article in English, Spanish | LILACS, BINACIS | ID: biblio-1248221

ABSTRACT

Las infecciones por coronavirus son habituales en los pacientes pediátricos. Por lo general, producen un cuadro clínico leve de infección del tracto respiratorio superior que no suele afectar a los pulmones, salvo en prematuros y niños con enfermedades crónicas de base. Excepcionalmente, afectan a otros órganos (corazón, cerebro, tracto gastrointestinal) e incrementan su gravedad.En relación con la coincidencia temporal con el inicio de la actual pandemia por el nuevo beta coronavirus (SARS-CoV-2), responsable de su enfermedad asociada (COVID-19), se presenta el caso clínico de un paciente de 5 años con fracaso multiorgánico y secuelas neurológicas por afectación bulbar y trombosis vascular ocasionados por un alfa coronavirus (CoV-NL63) debido a su gravedad y excepcionalidad


Coronavirus infections (CoV) are common in pediatric patients. In general, they produce a mild clinical presentation consisting of an upper respiratory tract infection that does not usually infect the lungs, with the exception of preterm infants and children with chronic diseases. These infections exceptionally affect other organs (heart, brain, gastrointestinal tract), thus increasing their severity.In relation to the temporal coincidence with the beginning of the current situation of pandemic by the new beta coronavirus SARS-CoV-2 responsible for its associated disease (COVID-19), this study presents a clinical case of a 5-year-old patient showing multiple-organ failure and neurological sequelae due to bulbar injury and vascular thrombosis caused by an alpha coronavirus (CoV-NL63) due to its severity and exceptionality


Subject(s)
Humans , Male , Child, Preschool , Respiratory Tract Infections/diagnosis , Coronavirus Infections/diagnosis , Coronavirus NL63, Human/isolation & purification , Multiple Organ Failure/virology , Respiratory Tract Infections/complications , Coronavirus Infections/complications , Diagnosis, Differential , Multiple Organ Failure/diagnosis
4.
Rev. cuba. reumatol ; 23(1): e870, tab
Article in Spanish | LILACS, CUMED | ID: biblio-1280402

ABSTRACT

Introducción: La COVID-19 causa una variada gama de manifestaciones clínicas. En pacientes con enfermedades reumáticas destacan, además de las manifestaciones respiratorias, las manifestaciones articulares, dermatológicas, generales y cardiovasculares. Objetivo: Identificar las manifestaciones cardiovasculares que con mayor frecuencia se presentan en pacientes con enfermedades reumáticas afectados por la COVID-19. Métodos: Se realizó una investigación básica, no experimental, con alcance exploratorio, descriptivo y explicativo de un universo constituido por 37 pacientes con diagnóstico previo de enfermedad reumática y diagnóstico confirmado de COVID-19. Se empleó la observación dirigida y la revisión documental como técnicas de investigación para identificar la presencia de manifestaciones cardiovasculares en este tipo de pacientes. Resultados: Predominaron las pacientes femeninas (59,56 por ciento), con diagnóstico de osteoartritis (72,97 por ciento) y artritis reumatoide (72,97 por ciento) y con comorbilidades asociadas (83,78 por ciento). La hipertensión arterial (61,29 por ciento) y el hipotiroidismo (38,71 por ciento) fueron las comorbilidades más frecuentes. El 70,27 por ciento de los pacientes presentaron manifestaciones cardiovasculares: hipertensión arterial (65,38 por ciento), trastornos del ritmo cardiaco (57,69 por ciento) y el síndrome de Raynaud (53,85 por ciento). El 80,0 por ciento de los pacientes masculinos presentaron manifestaciones cardiovasculares, al igual que el 80,64 por ciento de los casos con enfermedad reumática, COVID-19 y comorbilidades asociadas. Conclusiones: Las manifestaciones cardiovasculares se presentaron con elevada frecuencia en los pacientes reumáticos con diagnóstico de COVID-19, sobre todo pacientes masculinos con comorbilidades asociadas. Las manifestaciones cardiovasculares más frecuentes fueron la hipertensión arterial, los trastornos del ritmo y el síndrome de Raynaud(AU)


Introduction: COVID-19 generates a wide range of clinical manifestations in general. In patients with rheumatic diseases, in addition to respiratory manifestations, joint, dermatological, general and cardiovascular manifestations, among others, stand out. Objective: To identify the cardiovascular manifestations that most frequently occur in patients with rheumatic diseases and COVID-19. Methods: A basic, non-experimental research was carried out, with an exploratory, descriptive and explanatory scope. Universe made up of 37 patients with a previous diagnosis of rheumatic disease and a confirmed diagnosis of COVID-19. Directed observation and documentary review were used as research techniques to identify the presence of cardiovascular manifestations in this type of patient. Results: Predominance of female patients (59.56 percent), diagnosed with osteoarthritis (72.97 percent) and rheumatoid arthritis (72.97 percent) and with associated comorbidities (83.78 percent). Hypertension (61.29 percent) and hypothyroidism (38.71 percent) were the most frequent comorbidities. 70.27 percent of the patients presented cardiovascular manifestations, predominantly arterial hypertension (65.38 percent), rhythm disorders (57.69 percent) and Raynaud´s syndrome (53.85 percent). 80.0 percent of the male patients presented cardiovascular manifestations, as did 80.64 percent of the cases with rheumatic disease, COVID-19 and associated comorbidities. Conclusions: Cardiovascular manifestations occurred with high frequency in rheumatic patients diagnosed with COVID-19; being more frequent in male patients and with associated comorbidities. High blood pressure, rhythm disorders and Raynaud's syndrome were the most frequent(AU)


Subject(s)
Humans , Arthritis, Rheumatoid/complications , Signs and Symptoms , Cardiovascular Diseases/complications , Coronavirus Infections/complications , Early Diagnosis , Research Design
5.
Rev. medica electron ; 43(2): 3047-3060, mar.-abr. 2021. tab, graf
Article in Spanish | LILACS, CUMED | ID: biblio-1251925

ABSTRACT

RESUMEN Introducción: la neumonía por covid-19 es la enfermedad infecciosa que ha revolucionado al mundo en los últimos meses. El diagnóstico pasa por varios momentos: el cuadro clínico, la analítica sanguínea y las imágenes. La estratificación del riesgo de muerte es muy importante para optimizar los recursos. Objetivos: validar un modelo matemático cubano predictivo de mortalidad en pacientes ingresados por covid-19. Materiales y métodos: estudio de cohorte con 191 pacientes, que ingresaron graves en el Hospital Mayor de Crema, en la provincia de Cremona, región de Lombardía (Italia), en el período de abril a mayo de 2020. El universo estuvo constituido por 191 pacientes, y no se tomó muestra alguna. Las variables fueron: edad, estado del paciente, niveles de creatinina plasmática, frecuencia respiratoria, frecuencia cardiaca, presión arterial, niveles de oxígeno y de dióxido de carbono en sangre, valor del sodio y de hemoglobina. Resultados: mortalidad del 22 % en pacientes graves y críticos, con media de la edad (grupo 1: 59 años) (grupo 2: 73 años); t-Student = 0,00. Test de Hosmer-Lemenshow (0,766) con elevado ajuste. Sensibilidad = 93 %. Área bajo la curva = 0,957. Porcentaje de aciertos en la regresión logística de 86,4 % y en la red neuronal de 91,2 %. Media del modelo por grupos (grupo 1: 4 458) (grupo 2: 2 911) t-Student = 0,00. Conclusiones: el modelo demostró ser muy útil en el flujograma de pacientes atendidos con la covid-19. Permitió detectar tempranamente (a los cinco días del ingreso) los pacientes con alto riesgo de muerte y discriminar aquellos que no tendrían este riesgo, de manera que pudieran ser tratados en unidades de cuidados mínimos (AU).


ABSTRACT Introduction: COVID-19 pneumonia is an infectious disease that has revolutionized the world in the last months. The diagnosis goes thought several moments: clinical features, blood analytic and images. Death risk stratification is very important to optimize resources. Objective: to validate the Cuban mathematic predictive model of mortality in patients admitted due to COVID-19. Materials and methods: cohort study with 191 seriously-ill patients who were admitted to Maggiore di Crema Hospital, Cremona, Lombardy region, Italy, in the period April-May 2020. The universe were 191 patients and no sample was chosen. The variables were: age; patient's status; plasma creatinine levels; respiratory rate; heart rate; arterial pressure; blood oxygen and carbon dioxide levels; values of sodium and hemoglobin. Results: 22 % of mortality in seriously-ill and critical patients, with average age in Group 1: 59 years, in Group 2: 73 years; t-Student = 0.00. Hosmer-Lemenshow test (0.766) with high adjustment. Sensitivity= 93 %. Area below the curve=0.957. Success percentage in logistic regression of 86.4 % and 91.2 % in the neuronal net. Model media per groups: Group 1= 4 458; Group 2= 2 911, t-Student = 0.00. Conclusions: the model showed to be very useful in the flow chart of patients attended with COVID-19. It allowed to early detect the patients at high death risk five days from admission and discriminating those who were not at risk, in a way that they could be treated in minimal care units (AU).


Subject(s)
Humans , Male , Female , Coronavirus Infections/mortality , Patient Acuity , Forecasting/methods , Patients , Coronavirus Infections/complications , Coronavirus Infections/diagnosis , Aftercare/methods , Italy , Medical Missions
6.
Epidemiol. serv. saúde ; 30(1): e2020750, 2021. tab, graf
Article in English, Portuguese | LILACS, ColecionaSUS, SES-SP | ID: biblio-1142937

ABSTRACT

Objetivo: Descrever o perfil clínico-epidemiológico dos casos suspeitos de COVID-19 internados em hospital federal do Rio de Janeiro, RJ, Brasil, e identificar fatores associados ao óbito. Métodos: Estudo seccional, utilizando dados da vigilância epidemiológica local até a Semana Epidemiológica 27 de 2020. Empregou-se regressão logística. Resultados: Foram incluídos 376 casos internados suspeitos de COVID-19, dos quais 52,9% eram mulheres, 57,4% tinham 50 anos ou mais de idade e 80,1% exibiam comorbidades. Foram confirmados para COVID-19 195 casos (51,9%), cuja letalidade (37,9%) foi maior, comparada à dos descartados (24,2%). Na análise ajustada, associaram-se ao óbito, nos casos confirmados, ter 50 a 69 (OR=11,65 - IC95% 1,69;80,33) e 70 ou mais anos (OR=8,43 - IC95% 1,22;58,14), apresentar neoplasia (OR=4,34 - IC95% 1,28;14,76) e usar suporte ventilatório invasivo (OR=70,20 - IC95% 19,09;258,19). Conclusão: Houve elevada prevalência de comorbidades e letalidade; os principais fatores associados ao óbito foram idade, presença de neoplasia e suporte ventilatório invasivo.


Objetivo: Describir el perfil clínico-epidemiológico de casos sospechosos de COVID-19 ingresados en hospital federal de Río de Janeiro, RJ, Brasil, y factores asociados al óbito. Métodos: Estudio transversal utilizando datos de la vigilancia epidemiológica local de casos sospechosos hospitalizados hasta la Semana Epidemiológica 27 de 2020 y regresión logística. Resultados: Se incluyeron 376 casos, de los cuales 52,9% era de mujeres, 57,4% tenía 50 años o más, 80,1% tenía comorbilidades. Se confirmó para COVID-19 un 51,9% . Los casos confirmados tuvieron una mayor letalidad (37,9%) que los descartados (24,2%). La mortalidad ajustada en los confirmados fue mayor en los grupos de edad de 50 a 69 años (OR=11,65 - IC95% 1,69; 80,33), 70 años o más (OR=8,43 - IC95% 1,22;58,14), con neoplasia (OR=4,34 - IC95% 1,28;14,76) y uso de soporte ventilatorio invasivo (OR=70,20 - IC95% 19,09;258,19). Conclusión: La mayor mortalidad se asoció con personas de edad avanzada, con neoplasias y uso de soporte ventilatorio invasivo.


Objective: To describe the clinical and epidemiological profile of suspected COVID-19 cases admitted to a federal hospital in Rio de Janeiro, RJ, Brazil, and to identify factors associated with death. Methods:This was a cross-sectional study using local epidemiological surveillance data as at epidemiological week 27 of 2020 and logistic regression. Results: 376 hospitalized suspected COVID-19 cases were included; 52.9% were female, 57.4% were 50 years old or over and 80.1% had comorbidities. 195 (51.9%) COVID-19 cases were confirmed and their lethality was higher (37.9%) than among discarded cases (24.2%). In the adjusted analysis, death among confirmed cases was associated with being in the 50-69 age group (OR=11.65 - 95%CI 1.69;80.33), being aged 70 or over (OR=8.43 - 95%CI 1.22;58.14), presence of neoplasms (OR=4.34 - 95%CI 1.28;14.76) and use of invasive ventilatory support (OR=70.20 - 95%CI 19.09;258.19). Conclusion: High prevalence of comorbidities and lethality was found; the main factors associated with death were being older, neoplasms and invasive ventilatory support.


Subject(s)
Humans , Male , Female , Infant , Child, Preschool , Child , Adolescent , Adult , Middle Aged , Aged , Aged, 80 and over , Coronavirus Infections/complications , Coronavirus Infections/mortality , Coronavirus Infections/epidemiology , Severe Acute Respiratory Syndrome/epidemiology , Hospitalization/statistics & numerical data , Brazil/epidemiology , Comorbidity , Cross-Sectional Studies , Hospital Mortality , Pandemics
7.
Acta Paul. Enferm. (Online) ; 34: eAPE02321, 2021. tab, graf
Article in Portuguese | LILACS, BDENF | ID: biblio-1152656

ABSTRACT

Resumo Objetivo: Identificar, na literatura científica, a relação da obesidade como fator de risco agravante para a morbidade por COVID-19. Métodos: Trata-se de um estudo bibliográfico, tipo revisão integrativa de literatura, nos idiomas português, inglês e espanhol, por meio da estratégia PICo, em cinco bases de dados,PubMed, Scopus, Web of Science, Embasee BVS, realizada de maio a junho de 2020. Os critérios de inclusão adotados foram: artigos primários realizados com adultos; disponíveis na íntegra; publicados durante o período de 2019 a 2020; nos idiomas português, inglês e espanhol. Os critérios de exclusão foram: relato de casos; casos clínicos; dissertações; teses; os já selecionados na busca em outra base de dados e que não respondessem à questão da pesquisa. Resultados: A seleção resultou em noveestudos, sendo que quatro estudos - 44,4% (E3, E5, E6 e E7) - apresentaram a prevalência de obesidade em adultos hospitalizados por COVID-19, dois estudos - 22,2% (E6, E9) - associaram a obesidade ao desenvolvimento da COVID-19 grave, três estudos - 33,3% (E1, E4 e E7) - associaram a obesidade à necessidade de ventilação mecânica e três estudos - 33,3% (E2, E4 e E8) - associaram a obesidade à mortalidade por COVID-19. Conclusão: A obesidade trata-se de uma doença crônica não transmissível, sendo um fator de risco considerado importante para o agravamento da doença COVID-19, no entanto, é passível de prevenção, pois hábitos saudáveis de vida podem reduzir o quadro grave de infecção por COVID-19.


Resumen Objetivo: Identificar en la literatura científica la relación de la obesidad como factor de riesgo agravante para la morbilidad por COVID-19. Métodos: Se trata de un estudio bibliográfico, tipo revisión integradora de literatura, en idioma portugués, inglés y español, por medio de la estrategia PICO, en cinco bases de datos: PubMed, Scopus, Web of Science, Embase y BVS, realizada de mayo a junio de 2020. Los criterios de inclusión adoptados fueron: artículos primarios realizados con adultos, con texto completo disponible, publicados durante el período de 2019 a 2020, en idioma portugués, inglés y español. Los criterios de exclusión fueron: relato de casos, casos clínicos, tesis de maestría y doctorado, los artículos ya seleccionados en la búsqueda en otra base de datos y los que no respondieran la pregunta de investigación. Resultados: La selección tuvo como resultado nueve estudios, de los cuales cuatro — 44,4% (E3, E5, E6 y E7) — presentaron prevalencia de obesidad en adultos hospitalizados por COVID-19; en dos estudios — 22,2% (E6, E9) — se relacionó la obesidad con el desarrollo de COVID-19 grave; en tres estudios — 33,3% (E1, E4 y E7) — se relacionó la obesidad con la necesidad de ventilación mecánica; y en tres estudios — 33,3% (E2, E4 y E8) — se relacionó la obesidad con la mortalidad por COVID-19. Conclusión: La obesidad se trata de una enfermedad crónica no transmisible y es considerada un factor de riesgo importante para el agravamiento de la enfermedad COVID-19. Sin embargo, la prevención es posible, ya que los hábitos de vida saludables pueden reducir el cuadro grave de infección por COVID-19.


Abstract Objective: To identify, in scientific literature, the relationship of obesity as an aggravating risk factor for morbidity by COVID-19. Methods: This is a bibliographic and integrative literature review study, in Brazilian Portuguese, English and Spanish languages, through PICo strategy, in the PubMed, Scopus, Web of Science, Embase and VHL databases, held from May to June 2020. Primary articles conducted with adults, available in full, published during the period 2019 to 2020, in Brazilian Portuguese, English and Spanish were included. Case reports, clinical cases, dissertations, theses, the already selected in the search in another database and that did not answer the question of the search were excluded. Results: The selection resulted in nine studies. Four studies - 44.4% (E3, E5, E6 and E7) - presented the prevalence of obesity in adults hospitalized by COVID-19. Two studies - 22.2% (E6, E9) - associated obesity with the development of severe COVID-19. Three studies - 33.3% (E1, E4 and E7) - associated obesity with the need for mechanical ventilation. Three studies - 33.3% (E2, E4 and E8) - associated obesity with mortality due to COVID-19. Conclusion: Obesity is a chronic non-communicable disease, being a risk factor considered important for the worsening of COVID-19 disease, however, it is preventable, because healthy lifestyle habits can reduce the severe picture of COVID-19 infection.


Subject(s)
Humans , Adult , Databases, Bibliographic , Coronavirus Infections/complications , Coronavirus Infections/physiopathology , Coronavirus Infections/epidemiology , Betacoronavirus , Inpatients , Obesity/complications , Obesity/prevention & control , Obesity/epidemiology , Risk Factors
8.
Rev. bras. cir. cardiovasc ; 35(6): 1003-1006, Nov.-Dec. 2020. tab, graf
Article in English | LILACS, SES-SP | ID: biblio-1144010

ABSTRACT

Abstract Since the beginning of the coronavirus disease (COVID-19) pandemic, in March 2020, the number of people infected with COVID-19 worldwide increases continuously. Brazil is being followed with great concern in the international media, as it can, very soon, be the epicenter of the pandemic. Initial surgical data suggest that patients who acquire COVID-19 in the perioperative period are prone to a higher morbidity and mortality, however, evidence in cardiac surgery is still scarce. This article aims to aggregate to the growing evidence suggesting that perioperative infection with severe acute respiratory syndrome coronavirus 2 contributes to a more morbid evolution of the case.


Subject(s)
Humans , Coronary Artery Bypass/mortality , Coronavirus Infections/complications , Brazil , Pandemics
10.
Rev. cuba. reumatol ; 22(3): e852, graf
Article in Spanish | LILACS, CUMED | ID: biblio-1149925

ABSTRACT

Al igual que en las enfermedades autoinmunes y reumáticas, las infecciones por virus pueden ser disparadores de mecanismos inmunopatogénicos. El SARSCoV-2 puede causar la liberación de citocinas y provocar un daño tisular grave, sobre todo pulmonar, con peligro para la vida. Se suma a ello el riesgo del uso de medicamentos inmunosupresores, empleados en los protocolos de tratamiento de las afecciones autoinmunes y también contra la infección viral de COVID-19. Hoy no contamos con conocimientos y evidencias científicas suficientemente sólidas para el enfrentamiento a la COVID-19, y cómo puede impactar entre los pacientes inmunodeprimidos por afecciones reumáticas. El Grupo Nacional de Atención y Enfrentamiento a la COVID-19 de la Sociedad Cubana de Reumatología se propuso elaborar un documento científico actualizado con las bases teórico-prácticas que permita acceder al conocimiento acerca de la infección por SARSCoV-2 y la COVID-19, y su repercusión sobre los pacientes con enfermedades autoinmunes y reumáticas para esbozar una estrategia de trabajo y ofrecer recomendaciones para los reumatólogos y pacientes cubanos. Se realizó un estudio de revisión y actualización acerca de la asociación entre las enfermedades reumáticas y autoinmunes y la COVID-19. Se emplearon las palabras clave enfermedades reumáticas, lupus eritematoso sistémico, artritis reumatoide, virus SARSCoV-2 y COVID-19. Se realizó una amplia búsqueda en MEDLINE y LILACS, y se revisaron más de 150 artículos, boletines de actualización de los sitios Web, páginas de salud de Cuba, resúmenes seleccionados por su calidad metodológica, revisiones y metaanálisis sobre el tema. A partir de la información recogida, se estableció una discusión y análisis considerando las principales experiencias internacionales, criterios de expertos, experiencias previas con otros virus en el Sistema de Salud de Cuba, con la participación de su red de científicos liderados por la Sociedad Cubana de Reumatología y su Grupo Nacional y el apoyo de la comunidad de reumatólogos(AU)


The outbreak of the infection by the new coronavirus SARSCoV-2, COVID-19, in December in Wuhan Province of China, has become a pandemic and health emergency given the deficiency of antiviral therapy for the acute respiratory syndrome that generates danger to life. The debut of the epidemic was in China, then the epicenter developed in Europe, northern Italy that suffered a severe blow. Worldwide, more than 10 million people are infected with the virus that has impacted on health systems until it practically collapsed, resulting in thousands of deaths. Today the epicenter of the pandemic has shifted to the Americas. Alarming figures highlight the United States of North America with some 2,737,600 infected and more than 128,471 deaths, followed by the South American giant Brazil with 1.3 million infections and 57,659 deaths. The Caribbean has a better setting. In Cuba, by the end of June, 2,340 cases of patients infected with deaths from COVID-19 were reported. We conducted a review, analysis and evaluation study of more than 150 articles from international journals, update bulletins of the WEB sites, health pages of the MINSAP of Cuba, and summaries selected for their methodological quality, and reviews, on the subject COVID-19 and autoimmune-rheumatic diseases by MEDLINE: database prepared by the National Library of Medicine of The USA contains bibliographic references and abstracts from more than 4,000 biomedical journals published in the United States and in 70 other countries, We also use Latin American and Caribbean Center for Information on Health Sciences: System, in Latin America and the Caribbean, since 1982. Our objective and results achieved have been to develop the theoretical-practical bases in an updated scientific document that allow access in an essential and summarized way to current knowledge about the infection by SACOV-2, COVID-19, and its repercussion and impact on patients suffering from rheumatic autoimmune diseases, and thus outline a coping and action strategy with recommendations for the Cuban rheumatologists in their health care work, and for patients as a guideline, given their well-founded concerns and fears given their underlying condition and the immunosuppressive drugs prescribed in an unfavorable context of a pandemic. The information is based on international experiences with the most published scientific evidence and those treasured national experiences in the face of similar situations of epidemics, faced by the vast health system and achievements of Cuban science(AU)


Subject(s)
Humans , Arthritis, Rheumatoid/complications , Autoimmune Diseases/complications , Adaptation, Psychological , Coronavirus Infections/complications , Lupus Erythematosus, Systemic/complications , Immunosuppressive Agents/adverse effects , Immunosuppressive Agents/therapeutic use
11.
Rev. cuba. med. mil ; 49(4): e918, tab
Article in Spanish | LILACS, CUMED | ID: biblio-1156512

ABSTRACT

Introducción: La COVID-19 se ha caracterizado por un amplio espectro de manifestaciones y formas clínicas que comprenden desde enfermedad ligera hasta la muerte. Es de suma importancia identificar a aquellos con mayores probabilidades de desarrollar las complicaciones. Objetivo: Identificar factores de riesgo para desarrollar complicaciones en los pacientes atendidos con la COVID-19. Métodos: Fueron revisadas las 250 historias clínicas de pacientes ingresados por la COVID-19. Se recopilaron edad, sexo, antecedentes patológicos personales, exámenes de laboratorio y la presencia o no de complicaciones. Se utilizó ji cuadrado para identificar relación entre las complicaciones y el sexo. Fue calculado el Odds Ratio (OR) para complicaciones por grupos de edad, antecedentes patológicos personales y parámetros humorales. Resultados: El distrés respiratorio fue más frecuente en hombres (p = 0,023). Los grupos de edad más afectados fueron de 60 a 79 años y de 80 años y más (OR = 4,85 y 30,53 respectivamente). Fueron factores de riesgo los antecedentes de hipertensión arterial, cardiopatía isquémica, diabetes mellitus, insuficiencia renal crónica y demencia (OR = 4,48; 4,22; 8,75; 17,98 y 10,39 respectivamente). Predispusieron a complicaciones, hematocrito y linfocitos bajo, así como neutrófilos, glucemia, creatinina, ASAT, GGT y LDH altos. Conclusiones: El mayor riesgo de complicaciones lo tuvieron pacientes mayores de 60 años, con enfermedades cardiovasculares, diabetes mellitus, insuficiencia renal y demencia. La presencia de hematocrito y linfocitos bajo, o neutrófilos, glucemia, creatinina, ASAT, GGT y LDH altos, alerta sobre posibles complicaciones(AU)


Introduction: COVID-19 has been characterized by a wide spectrum of manifestations and clinical forms that range from mild illness to death. Identifying those most likely to develop complications is critical. Objective: To identify risk factors for developing complications in patients treated with COVID-19. Methods: 250 medical records of patients admitted for COVID-19 were reviewed. Age, sex, personal pathological history, laboratory tests and the presence or absence of complications were collected. Chi-square was used to identify the relationship between complications and sex. The Odds Ratio (OR) was calculated for complications by age groups, personal pathological history, and humoral parameters. Results: Respiratory distress was more frequent in men (p=0.023). The most affected age groups were 60 to 79 years and 80 years and over (OR=4.85 and 30.53 respectively). Risk factors were the history of arterial hypertension, ischemic heart disease, diabetes mellitus, chronic kidney insufficiency and dementia (OR=4.48, 4.22, 8.75, 17.98 and 10.39 respectively). Low hematocrit and lymphocytes were predisposed to complications, as well as high neutrophils, glycaemia, creatinine, ASAT, GGT and LDH. Conclusions: The highest risk of complications was in patients older than 60 years, with cardiovascular diseases, diabetes mellitus, kidney insufficiency and dementia. The presence of low hematocrit and lymphocytes, or high neutrophils, glycaemia, creatinine, ASAT, GGT and LDH, alerts you to possible complications(AU)


Subject(s)
Humans , Male , Female , Risk Factors , Myocardial Ischemia/complications , Coronavirus Infections/complications , Coronavirus Infections/diagnosis , Diabetes Complications/diagnosis , Renal Insufficiency, Chronic/complications , Hypertension
12.
Rev. Hosp. Ital. B. Aires (2004) ; 40(4): 227-232, dic. 2020. ilus, tab
Article in Spanish | LILACS | ID: biblio-1145596

ABSTRACT

La enfermedad producida por el nuevo coronavirus SARS-CoV-2 se identificó por primera vez en diciembre de 2019 en la ciudad de Wuhan, en la República Popular China, y en pocos meses se convirtió en una pandemia. Desde el comienzo ha sido un desafío mundial, que amenazó la salud pública y obligó a tomar medidas estrictas de aislamiento social. Como consecuencia de la emergencia sanitaria se ha producido una reducción importante de la actividad asistencial, que puso en riesgo el acceso y la continuidad de los métodos anticonceptivos, exponiendo a mujeres a embarazos no intencionales. Los derechos sexuales y reproductivos resultan esenciales y deben garantizarse siempre. (AU)


The disease caused by the new coronavirus SARS-CoV-2 was identified for the first time in December 2019 in the city of Wuhan, in the People's Republic of China, and within a few months it became a pandemic. From the beginning, it has been a global challenge, threatening public health, having to take strict measures of social isolation. As a consequence of the health emergency, there has been a significant reduction in healthcare activity, putting access and continuity of contraceptive methods at risk, exposing women to unintended pregnancies. Sexual and reproductive rights are essential and must always be guaranteed. (AU)


Subject(s)
Humans , Female , Pneumonia, Viral/complications , Coronavirus Infections/complications , Hormonal Contraception/methods , Pneumonia, Viral/pathology , Pregnancy, Unwanted , Coronavirus Infections/pathology , Contraceptive Agents/administration & dosage , Contraceptive Agents/classification , Contraceptive Agents/supply & distribution , Reproductive Rights , Disseminated Intravascular Coagulation/etiology , Venous Thromboembolism/etiology , Pandemics , Betacoronavirus , Health Services Accessibility
13.
Braz. j. otorhinolaryngol. (Impr.) ; 86(6): 781-792, Nov.-Dec. 2020. tab, graf
Article in English | LILACS | ID: biblio-1142605

ABSTRACT

Abstract Introduction: The SARS-CoV-2 virus causes COVID-19, and it is responsible for the largest pandemic since the 1918 H1N1 influenza outbreak. The classic symptoms of the disease have been well defined by the World Health Organization; however, olfactory/gustatory disorders have been reported in some studies, but there are still several missing points in the understanding and in the consensus about the clinical management of these cases. Objective: To identify evidence in the scientific literature about olfactory/gustatory disorders, their clinical presentation, prevalence and possible specific treatments associated with COVID-19. Methods: A systematic review of articles published up to April 25, 2020 was performed in Medline, Cochrane Clinical Trials, ScienceDirect, Lilacs, Scopus and Google Schoolar, OpenGrey.eu, DissOnline, The New York Academy of Medicine and Reasearch Gate. Inclusion criteria: (1) Studies on patients with COVID-19; (2) Records of COVID-19 signs/symptoms, and olfactory/gustatory functions. Exclusion criteria: (1) Studies on non-human coronavirus; (2) Review articles; (3) Experimental studies (in animals or in vitro); (4) Olfactory/gustatory disorders initiated prior to SARS-CoV-2 infection. The risk assessment of bias of the selected studies was performed using the Newcastle-Ottawa scale. Results: Six articles from the 1788 records met the inclusion criteria and were analyzed. A total of 1457 patients of different ethnicities were assessed; of them, 885 (60.7%) and 822 (56.4%) had smell and taste disorders, respectively, with women being most often affected. There were olfactory/gustatory disorders even without nasal obstruction/rhinorrhea and beginning even before the signs/symptoms of COVID-19; the recovery of smell/taste, when it occurs, usually happened in the first two weeks after COVID-19 resolution. There is evidence that olfactory/gustatory disorders are strong predictors of infection by SARS-CoV-2, and it is possible to recommend patient isolation, as early as of the medical consultation, preventing the spread of the virus. No scientific evidence has been identified for effective treatments for any of the disorders. Conclusion: Olfactory/gustatory disorders may occur at varying intensities and prior to the general symptoms of COVID-19 and should be considered as part of the clinical features of COVID-19, even in mild cases. There is still no scientific evidence of specific treatments for such disorders in COVID-19 disease.


Resumo Introdução: O vírus SARS-CoV-2 causa a COVID-19 e é responsável pela maior pandemia desde o surto de influenza H1N1 de 1918. Os sintomas clássicos da doença já foram bem definidos pela Organização Mundial da Saúde; entretanto, distúrbios olfativo-gustativos têm sido relatados em alguns estudos, mas ainda com várias lacunas no entendimento e no consenso sobre a condução clínica desses casos. Objetivo: Identificar evidências na literatura científica sobre os distúrbios olfativo-gustativos acerca da apresentação clínica, prevalência e possíveis tratamentos específicos associados à COVID-19. Método: Revisão sistemática de artigos publicados até 25 de abril de 2020 nas bases de dados: Medline, Cochrane Clinical Trials, ScienceDirect, Lilacs, Scopus e Google Schoolar, OpenGrey.eu, DissOnline, The New York Academy of Medicine e Research Gate. Foram critérios de inclusão: 1) Estudos com indivíduos com COVID-19; 2) Registro dos sinais/sintomas da COVID-19 e das funções olfativo-gustativa. Foram critérios de exclusão: 1) Estudos sobre coronavírus não humano; 2) Artigos de revisão; 3) Estudos experimentais (em animais ou in vitro); 4) Distúrbios olfativos-gustativos iniciados previamente à infecção pelo SARS-CoV-2. A avaliação de risco de viés dos estudos selecionados foi feita por meio da escala de Newcastle-Ottawa. Resultados: Seis artigos dos 1.788 registros foram selecionados. Um total de 1.457 pacientes de diversas etnias foi avaliado; desses, 885 (60,7%) apresentaram perda do olfato e 822 (56,4%) perda do paladar, sendo as mulheres as mais afetadas. Os distúrbios olfativo-gustativos estiveram presentes mesmo sem obstrução nasal/rinorreia e com início mesmo antes dos sinais/sintomas clínicos da COVID-19; a recuperação do olfato/paladar, quando ocorre, geralmente se dá nas duas primeiras semanas após a resolução da doença. Há evidências de que os distúrbios olfativo-gustativos sejam fortes preditores de infecção pelo SARS-CoV-2, podendo-se recomendar o isolamento do paciente, já a partir da consulta médica, para evitar a disseminação do vírus. Não foram identificadas evidências científicas para tratamentos eficazes para qualquer dos distúrbios. Conclusão: Podem ocorrer distúrbios olfativo-gustativos em intensidades variáveis e prévios aos sintomas gerais da COVID-19, devem ser considerados como parte dos sintomas da doença, mesmo em quadros leves. Não há ainda evidências científicas de tratamentos específicos para tais distúrbios na COVID-19.


Subject(s)
Humans , Male , Female , Pneumonia, Viral/complications , Coronavirus Infections/complications , Influenza A Virus, H1N1 Subtype , Pandemics , Olfaction Disorders/etiology , Olfaction Disorders/epidemiology , Smell , Taste Disorders/etiology , Taste Disorders/epidemiology , Nutrition Surveys , Betacoronavirus
14.
Rev. enferm. UERJ ; 28: e50721, jan.-dez. 2020.
Article in English, Portuguese | LILACS, BDENF | ID: biblio-1103402

ABSTRACT

Objetivo: apresentar atualizações para a ressuscitação cardiopulmonar em pacientes suspeitos e confirmados com COVID-19. Método: revisão compreensiva da literatura, com síntese narrativa das evidências de diretrizes e recomendações da Organização Mundial de Saúde, Associação de Medicina Intensiva Brasileira, American Heart Association, Resuscitation Council UK, American College of Surgions Committee on Trauma e National Association of Emergency Medical Technicians. Resultados: as principais atualizações trazem informações sobre especificidades das manobras de ressuscitação cardiopulmonar; preparação do ambiente, recursos humanos e materiais, reconhecimento da parada cardiorrespiratória e ações iniciais; estratégias de ventilação e acesso invasivo da via aérea; ajustes do ventilador mecânico e manobras de ressuscitação cardiopulmonar em pacientes pronados. Considerações finais: profissionais de saúde envolvidos no atendimento à parada cardiorrespiratória de pacientes suspeitos e/ou confirmados com COVID-19 podem encontrar inúmeros desafios, portanto devem seguir com rigor o protocolo estabelecido para maximizar a efetividade das manobras de ressuscitação e minimizar o risco de contágio pelo vírus e sua disseminação.


Objective: to present updates for cardiopulmonary resuscitation in suspected and confirmed patients with COVID-19. Method: comprehensive literature review with narrative synthesis of the evidence of guidelines and recommendations from World Health Organization, Associação de Medicina Intensiva Brasileira, American Heart Association, Resuscitation Council UK, American College of Surgions Committee on Trauma and National Association of Emergency Medical Technicians. Results: the main updates bring information about the specifics of cardiopulmonary resuscitation maneuvers; preparation of the environment and human and material resources, recognition of cardiorespiratory arrest and initial actions; ventilation and invasive airway access strategies; mechanical ventilator adjustments and cardiopulmonary resuscitation maneuvers in patients in the prone position. Final considerations: health professionals involved in the care of cardiorespiratory arrest of suspected and/or confirmed patients with COVID-19 can face numerous challenges, so they must strictly follow the protocol established to maximize the effectiveness of resuscitation maneuvers and minimize the risk of contagion by the virus and its spread.


Objetivo: apresentar actualizaciones para la reanimación cardiopulmonar en pacientes sospechos os y confirmados con COVID-19. Método: revisión exhaustiva de la literatura con síntesis narrativa de la evidencia de guías y recomendaciones de la Organización Mundial de la Salud, Associação de Medicina Intensiva Brasileira, American Heart Association, Resuscitation Council UK, American College of Surgions Committee on Trauma and National Association of Emergency Medical Technicians. Resultados: las principales actualizaciones aportan información sobre los detalles de las maniobras de reanimación cardiopulmonar; preparación del medio ambiente y recursos humanos y materiales, reconocimiento de paro cardiorrespiratorio y acciones iniciales; estrategias de ventilación y acceso invasivo a las vías aéreas; ajustes del ventilador mecánico y maniobras de reanimación cardiopulmonar en pacientes en decúbito prono. Consideraciones finales: los profesionales de la salud involucrados en la atención del paro cardiorrespiratorio de pacientes sospechosos y/o confirmados con COVID-19 pueden enfrentar numerosos desafíos, por lo que deben seguir estrictamente el protocolo establecido para maximizar la efectividad de las maniobras de reanimación y minimizar el riesgo de contagio por el virus y supropagación.


Subject(s)
Humans , Male , Female , Cardiopulmonary Resuscitation/standards , Coronavirus Infections/complications , Betacoronavirus , Heart Arrest/etiology , Respiration, Artificial/methods , Clinical Protocols/standards , Cardiopulmonary Resuscitation/methods , Containment of Biohazards/standards , Heart Arrest/rehabilitation , Heart Massage/methods , Nursing, Team/standards
16.
Rev. cuba. invest. bioméd ; 39(4): e844, oct.-dic. 2020.
Article in Spanish | LILACS, CUMED | ID: biblio-1156458

ABSTRACT

En la esclerosis múltiple se pierde la tolerancia inmunológica a las vainas de mielina. Los virus pueden intervenir en su etiopatogenia. La actual pandemia de COVID-19 puede incrementar los casos y exacerbar los brotes de esclerosis múltiple(AU)


Multiple sclerosis causes the loss of immune tolerance to myelin sheaths. Viruses may be involved in its pathogenesis. The current COVID-19 pandemic may increase the number of cases and exacerbate the outbreaks of this disease(AU)


Subject(s)
Humans , Male , Female , Coronavirus Infections/complications , Multiple Sclerosis/etiology , Multiple Sclerosis/epidemiology , Disease Outbreaks/prevention & control
17.
Rev. medica electron ; 42(6): 2474-2486, nov.-dic. 2020. tab
Article in Spanish | LILACS, CUMED | ID: biblio-1150031

ABSTRACT

RESUMEN Introducción: desde los finales del año pasado en Wuhan, se informó de una neumonía de etiología desconocida, que llevó a la Organización Mundial de la Salud a declarar la infección por SARS-CoV-2, como una emergencia sanitaria denominándola como enfermedad por coronavirus 2019 (COVID-19). En Cuba se confeccionó un programa de enfrentamiento, en el cual la atención hospitalaria, siguió un riguroso protocolo de atención a pacientes positivos de la COVID-19, en áreas de cuidados mínimos, intensivos o progresivos. Objetivo: caracterizar clínica/epidemiológica pacientes positivos de la COVID-19, ingresados en el Hospital "Amalia Simoni". Materiales y métodos: se realizó un estudio descriptivo, transversal de 1 066 ingresos en el Hospital "Amalia Simoni", de marzo-mayo del 2020. Se revisaron historias clínicas y se obtuvo: edad, sexo, procedencia, sintomatología, comorbilidades y evolución epidemiológica. Datos que se evaluaron mediante estadísticas descriptivas. Resultados: se halló un predominio de edad media, sin diferencias de sexo, predominaron los casos de la ciudad de Camagüey y de los municipios con mayor urbanización. Prevalecieron la tos y la fiebre, además de la mitad de los casos sin comorbilidades, con solo un pequeño porcentaje de casos confirmados. Conclusiones: con un enfoque basado en la medicina preventiva en los casos estudiados, predominó la edad media, de procedencia de áreas urbanizadas con mayor población y aglomeraciones sociales. Se destacó que el ingreso precoz, basada en la pesquisa de la Atención Primaria logró disminuir los casos confirmados a un pequeño porcentaje, al igual que los graves y un solo fallecido (AU).


ABSTRACT Introduction: from the end of the last year in Wuhan, China, it was informed an unknown etiology pneumonia leading the World Health Organization to declare the infection with SARS-CoV-2 a sanitary emergency naming it coronavirus disease 2019 (Covid-19). A confrontation program was elaborated in Cuba, in which hospital care followed a rigorous protocol to take care to Covid-19-positive patients in areas of minimal, intensive and progressive care. Objective: to clinically/epidemiologically characterize Covid-19-positive patients admitted in the Hospital "Amalia Simoni". Materials and methods: a cross-sectional, descriptive study was carried out in 1 066 patients admitted in the Hospital "Amalia Simoni" in the period March-May 2020. Clinical records were reviewed and data gathered were age, sex, origin, symptomatology, co-morbidities and epidemiological evolution, data obtained through descriptive statistics. Results: it was found the predominance of medium age, without sex differences; the cases of patients from the city of Camaguey and from the municipalities with biggest urbanization predominated. Cough and fever prevailed; half of cases did not have comorbidities, and only a little percent of cases was confirmed. Conclusions: with an approach based in preventive medicine, medium age, and provenance from urban areas with bigger population and social concentrations predominated in the studied cases. It was showed that precocious admission, based on the Primary Health Care screening, succeeded in diminish confirmed cases to a little percent, as diminished the seriously ill ones; only one patient died (AU).


Subject(s)
Humans , Male , Female , Patients , Coronavirus Infections/epidemiology , Critical Pathways/standards , Patient Isolation/methods , Signs and Symptoms , Clinical Evolution , Sensitivity and Specificity , Coronavirus Infections/complications , Coronavirus Infections/diagnosis
19.
Int. j. odontostomatol. (Print) ; 14(4): 555-560, dic. 2020.
Article in Spanish | LILACS | ID: biblio-1134537

ABSTRACT

RESUMEN: El 8 de enero de 2020, el Centro Chino para el Control y Prevención de Enfermedades anunció oficialmente la identificación de una nueva cepa de coronavirus (SARS-CoV-2) como el patógeno causante de la pandemia mundial de COVID-19. Las principales manifestaciones clínicas producidas por SARS-CoV-2 se encuentran ampliamente descritas en la literatura, sin embargo, la información acerca de las alteraciones que podrían producirse a nivel oral, es escasa. Se ha sugerido que la cavidad oral es un perfecto hábitat para la invasión por SARS-CoV-2 debido a la especial afinidad que tiene el virus por células con los receptores para la enzima convertidora de angiotensina (ECA2) como son las del tracto respiratorio, mucosa oral, lengua y glándulas salivales, pudiendo afectar, de este modo, el funcionamiento de las glándulas salivales, las sensaciones del gusto, olfato y la integridad de la mucosa oral. El nuevo coronavirus tendría la capacidad de alterar el equilibrio de la microbiota oral, lo que sumado a un sistema inmune deprimido permitiría la colonización por infecciones oportunista. Se ha establecido que un correcto higiene oral podría disminuir la incidencia y gravedad de las principales complicaciones del COVID-19. El objetivo de este estudio es realizar una revisión y análisis de la evidencia disponible en relación a las manifestaciones orales a nivel de las mucosas, trastornos de las glándulas salivales y alteraciones en el sistema olfatorio y gustativo en el contexto de la infección por SARS-CoV-2.


ABSTRACT: On January 8, 2020, the Chinese Center for Disease Control and Prevention officially reported the identification of a new strain of coronavirus (SARS-CoV-2) as the pathogen causing the global COVID-19 pandemic. The main clinical manifestations produced by SARS-CoV-2 are well described in the literature. However, the information about oral manifestations is limited. It has been suggested that the oral cavity is a perfect habitat for SARS-CoV-2 invasion due to the special affinity that the virus has for cells with the receptors for the converted angiotensin enzyme (ACE2), present in the respiratory tract, oral mucosal, tongue and salivary glands, thus being able to affect the functioning of the salivary glands, sensations of taste, smell and integrity of the oral mucosa. The new coronavirus could have the ability to alter the balance of the oral microbiota, which added to a depressed immune system would allow opportunistic infections colonization. It has been established that correct oral hygiene could decrease the incidence and severity of the main complications of COVID-19. The objective of this study is to review and analyze the available evidence in relation to oral manifestations at the mucosa, salivary glands disorders and olfactory and gustatory alterations in the context of SARS-CoV-2 infection.


Subject(s)
Humans , Coronavirus Infections/complications , Mouth Diseases/etiology , Oral Health/standards , Betacoronavirus
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