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1.
Tanaffos ; 19(4): 291-299, 2020 Dec.
Article in English | MEDLINE | ID: covidwho-1801409

ABSTRACT

BACKGROUND: Inflammatory mediators are an important component in the pathophysiology of the coronavirus disease 2019 (COVID-19). This study aimed to assess the effects of reducing inflammatory mediators using hemoperfusion (HP) and continuous renal replacement therapy (CRRT) on the mortality of patients with COVID-19. MATERIALS AND METHODS: Twelve patients with confirmed diagnosis of COVID-19 were included. All patients had acute respiratory distress syndrome (ARDS). Patients were divided into three groups, namely, HP, CRRT and HP+CRRT. The primary outcome was mortality and the secondary outcomes were oxygenation and reduction in inflammatory mediators at the end of the study. RESULTS: Patients were not different at baseline in demographics, inflammatory cytokine levels, and the level of acute phase reactants. Half of the patients (3 out of 6) in the HP+CRRT group survived along with the survival of one patient (1 out of 2) in the HP group. All four patients in the CRRT group died. Serum creatinine (SCr), Interleukin-1 (IL1), Interleukin-6 (IL6), Interleukin-8 (IL8), partial pressure of oxygen (PaO2), O2 saturation (O2 sat), and hemodynamic parameters improved over time in HP+CRRT and CRRT groups, but no significant difference was observed in the HP group (All Ps > 0.05). CONCLUSION: Combined HP and CRRT demonstrated the best result in terms of mortality, reduction of inflammatory mediators and oxygenation. Further investigations are needed to explore the role of HP+CRRT in COVID-19 patients.

2.
EuropePMC; 2021.
Preprint in English | EuropePMC | ID: ppcovidwho-322366

ABSTRACT

Coronavirus disease 2019 (COVID-19) first emerged in Wuhan, China in December 2019, and since then the frequency of bacterial and fungal coinfections has been continuously rising. While invasive pulmonary aspergillosis is increasingly being recognized in association with COVID-19, there is limited information with regards to COVID-19 associated mucormycosis. Here, we describe a 50-year-old woman with uncontrolled diabetes who received systemic corticosteroids and remdesevir during her admission for COVID-19. Few days after discharge, the patient was readmitted due to facial swelling and numbness, and a diagnosis of COVID-19 associated rhinosinusitis mucormycosis due to Rhizopus arrhizus (formerly Rhizopus oryzae ) was confirmed with sequencing of the internal transcribed spacer (ITS) region of the ribosomal DNA. This report aims to address the importance of short-term follow-up in COVID-19 patients who have received systemic corticosteroids, particularly those with predisposing conditions, as early detection and prompt, aggressive treatment is essential for the management of invasive fungal infections.

3.
Am J Trop Med Hyg ; 105(2): 449-453, 2021 Jul 08.
Article in English | MEDLINE | ID: covidwho-1371040

ABSTRACT

COVID-19 first emerged in Wuhan, China, in December 2019. Since that time, the frequency of bacterial and fungal coinfections has been continuously increasing. Although invasive pulmonary aspergillosis is being increasingly recognized in association with COVID-19, there is limited information regarding COVID-19-associated mucormycosis. We describe a 50-year-old woman with uncontrolled diabetes who received systemic corticosteroids and remdesevir during her admission for COVID-19. A few days after discharge, the patient was readmitted because of facial swelling and numbness, and a diagnosis of COVID-19-associated rhinosinusitis mucormycosis caused by Rhizopus arrhizus (formerly called Rhizopus oryzae) was confirmed with sequencing of the internal transcribed spacer region of the ribosomal DNA. This report aimed to address the importance of short-term follow-up for COVID-19 patients who have received systemic corticosteroids, particularly those with predisposing conditions, because early detection and prompt, aggressive treatment are essential for the management of invasive fungal infections.


Subject(s)
Adrenal Cortex Hormones/therapeutic use , COVID-19/complications , COVID-19/drug therapy , Rhinitis/etiology , Rhizopus oryzae/pathogenicity , SARS-CoV-2/drug effects , Sinusitis/etiology , Adrenal Cortex Hormones/administration & dosage , Adrenal Cortex Hormones/adverse effects , DNA, Fungal/genetics , DNA, Ribosomal Spacer/genetics , Diabetes Mellitus , Fatal Outcome , Female , Humans , Invasive Fungal Infections/etiology , Middle Aged , Mucormycosis , Rhinitis/diagnosis , Rhinitis/microbiology , Sinusitis/diagnosis , Sinusitis/microbiology
4.
Eur J Pharmacol ; 897: 173947, 2021 Apr 15.
Article in English | MEDLINE | ID: covidwho-1188517

ABSTRACT

The aim of this study was to evaluate the clinical effects of dexamethasone administration in patients with mild to moderate acute respiratory distress syndrome (ARDS) due to coronavirus disease 2019 (COVID-19). The study included 50 patients who were randomly assigned to the dexamethasone group or control group. Dexamethasone was administered at a dose of 20 mg/day from day 1-5 and then at 10 mg/day from day 6-10. The need for invasive mechanical ventilation, death rate, duration of clinical improvement, length of hospital stay, and radiological changes in the computed tomography scan were assessed. The results revealed that 92% and 96% of patients in the dexamethasone and control groups, respectively, required noninvasive ventilation (P = 0.500). Among them, 52% and 44% of patients in the dexamethasone and control groups, respectively, required invasive mechanical ventilation (P = 0.389). At the end of the study, 64% of patients in the dexamethasone group and 60% of patients in the control group died (P = 0.500); the remaining patients were discharged from the hospital during the 28-day follow-up period. The median length of hospital stay was 11 days in the dexamethasone group and 6 days in the control group (P = 0.036) and the median length of hospital stay was 7 days in the dexamethasone group and 3 days in the control group (P < 0.001). No significant differences were observed in the other outcomes. This study showed that corticosteroid administration had no clinical benefit in patients with COVID-19-induced mild to moderate ARDS.


Subject(s)
Anti-Inflammatory Agents/therapeutic use , COVID-19/complications , COVID-19/drug therapy , Dexamethasone/therapeutic use , Respiratory Distress Syndrome/drug therapy , Respiratory Distress Syndrome/etiology , Adult , Aged , Anti-Inflammatory Agents/administration & dosage , COVID-19/mortality , Dexamethasone/administration & dosage , Female , Humans , Length of Stay , Male , Middle Aged , Negative Results , Respiration, Artificial , Respiratory Distress Syndrome/mortality , Tomography, X-Ray Computed , Treatment Failure
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