ABSTRACT
In the present study we attempted to assess whether a relationship exists between laboratory signs of hemopoietic stress and fatal outcome in coronavirus disease (COVID)-19—positive intensive care unit (ICU) and non-ICU patients. Prospectively collected data of 206 COVID-19 patients (95 ICU and 111 non-ICU) were retrospectively analyzed. Beside comparing routine laboratory parameters, the analysis focused on nucleated red blood cell count (NRBC), red cell distribution width (RCDW), immature granulocyte count (IG), mean platelet volume (MPV) and platelet distribution width (PDW). In the total COVID cohort higher NRBC, RCDW, IG, MPV and PDW values were observed in patients with fatal outcome as compared to survivors. Significant differences could be observed between non-ICU and critically ill patients in NRBC (medians and interquartile range (IQR): 10/0–20/ vs. 20/10–60/ g/L, p < 0.001), IG (0.16/0.04–0.39/ vs. 0.42 /0.20–0.75/ g/L, p < 0.001), MPV (10.9 ± 1.2 vs. 11.4 ± 1.2 fL, p < 0.01) and PDW (14.5/11.6-44.7/ vs. 19.9/13.7–57.7/ fL, p < 0.001), respectively. In the ICU subgroup, RDW and MPV were higher among patients who died. Severe acute respiratory syndrome after coronavirus infection (SARS-CoV-2 infection) causes perturbation of hemopoiesis. Laboratory parameters referring to hemopoietic stress may serve as useful predictors of poor outcome in hospitalized COVID-19 patients needing intensive care. [ FROM AUTHOR] Copyright of Signa Vitae is the property of Pharmamed Mado Ltd. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full . (Copyright applies to all s.)
ABSTRACT
There is currently no proven effective therapy for COVID-19. Here we discuss the drugs most investigated for the treatment of the disease. All the listed therapies are experimental at this stage. However, due to the severe healthcare effects of the pandemic and the potentially fatal outcome of COVID-19 patients treated in the intensive care units, their off-label use should none-the-less be considered. Orv Hetil. 2020; 161(17): 685688.
Subject(s)
Betacoronavirus , Coronavirus Infections/drug therapy , Pneumonia, Viral/drug therapy , COVID-19 , Humans , Intensive Care Units , Off-Label Use , Pandemics , SARS-CoV-2 , COVID-19 Drug TreatmentABSTRACT
In critically ill COVID-19 patients, the failure of the cardiorespiratory system can be due to one of the following: (1) cytokine storm, haemophagocytosis septic shock, (2) unmanageable hypoxemia, (3) isolated organ failure or as part of multi-organ failure. Herein we give an overview of the therapeutic options for treating or preventing these disease states. In recent years, CytoSorb-haemoperfusion to remove cytokines has shown promising results in the treatment of septic shock. Inhalational nitric oxide (iNO), inhalational epoprostenol and veno-venous extracorporeal membrane oxygenation (ECMO) are options in severe hypoxemia that is unresponsive to conventional mechanical ventilation. Renal failure is a frequent component of the multi-organ failure usually seen with disease progression and necessitates starting one of the available continuous renal replacement modalities. Orv Hetil. 2020; 161(17): 704709.
Subject(s)
Acute Kidney Injury , Coronavirus Infections/therapy , Critical Care , Extracorporeal Membrane Oxygenation , Hypoxia , Pneumonia, Viral/therapy , Acute Kidney Injury/etiology , Acute Kidney Injury/therapy , Betacoronavirus , COVID-19 , Coronavirus Infections/complications , Critical Illness , Cytokines/metabolism , Hemoperfusion , Humans , Hypoxia/etiology , Hypoxia/therapy , Nitric Oxide/administration & dosage , Pandemics , Pneumonia, Viral/complications , Renal Replacement Therapy , SARS-CoV-2ABSTRACT
The coronavirus pandemic is a serious challenge for healthcare workers worldwide. The virus is spread through the air by droplets of moisture when people cough or sneeze and it has a very high virulence. Procedures generating airway aerosols are dangerous for every participant of patient care. Mortality of COVID-19 is above 10%, thus cardiopulmonary resuscitation is an often needed intervention in this patient group. Resuscitation is an aerosol-generating process and thus carries the risk of contamination. The goal of this article is to give a practice-based overview of the specialities of cardiopulmonary resuscitation in coronavirus-infected patients. Orv Hetil. 2020. 161(17): 710712.
Subject(s)
Betacoronavirus , Coronavirus Infections , Coronavirus , Pandemics , Pneumonia, Viral , Resuscitation/methods , COVID-19 , Coronavirus Infections/complications , Coronavirus Infections/therapy , Humans , Pneumonia, Viral/complications , Pneumonia, Viral/therapy , SARS-CoV-2ABSTRACT
The coronavirus pandemic is a serious challenge for healthcare workers worldwide. The virus is spread through the air by droplets of moisture when people cough or sneeze and it has a very high virulence. Procedures generating airway aerosols are dangerous for every participant of patient care. The serious form of coronavirus infection can cause progressive respiratory failure. The best treatment is early endotracheal intubation and invasive mechanical ventilation. Intubation is an aerosol-generating process and thus carries the risk of contamination. Additionally the airway management of this patient population is usually difficult. The goal of this article is to give a practice-based overview of the peculiarities of airway management in coronavirus-infected patients with special regard to infection control and patient safety considerations. Orv Hetil. 2020; 161(17): 696703.
Subject(s)
Airway Management , Coronavirus Infections/therapy , Pandemics , Coronavirus Infections/epidemiology , HumansABSTRACT
Caring for those affected by the coronavirus outbreak of December 2019 imposed a heavy burden on healthcare systems. Not only because some patients require intensive care, but because patients with any form of the disease may need surgical intervention. Managing these cases is a major challenge for anesthesiologists. The purpose of this summary is to present the practical aspects of anesthetic and perioperative care for patients requiring surgical treatment. Orv Hetil. 2020; 161(17): 692695.
Subject(s)
Anesthesia , Betacoronavirus , Coronavirus Infections , Pandemics , Perioperative Care , Pneumonia, Viral , Anesthesia/methods , Anesthesiology/standards , COVID-19 , Coronavirus Infections/complications , Coronavirus Infections/epidemiology , Humans , Pneumonia, Viral/complications , Pneumonia, Viral/epidemiology , SARS-CoV-2ABSTRACT
In December 2019, a novel outbreak of pneumonia was reported in Wuhan city, China. Initially, the zoonitic infection spread from human to human, causing a pandemic. This viral disease (COVID-19) can appear in a variety of forms, from asymptomatic through the spectrum of mild symptoms to severe respiratory failure, requiring intensive care. Caring for this latter group of patients puts a significant burden on health care. The purpose of this summary is to present the practical aspects of intensive care for patients requiring respiratory support and mechanical ventilation. Orv Hetil. 2020; 161(17): 678684.