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1.
Diagnosis (Berl) ; 2022 Aug 18.
Article in English | MEDLINE | ID: covidwho-1993548

ABSTRACT

OBJECTIVES: SARS-CoV-2 (severe acute respiratory syndrome coronavirus 2) structure and host tropism have changed over time, and so has the involvement of throat structures. This infodemiological analysis is hence aimed at investigating the evolution of throat symptoms during the COVID-19 pandemic in the US. METHODS: We searched Google Trends using the medical search terms "ageusia", "hoarseness", "dysphonia", "pharyngitis" and "laryngitis", setting geographical location to "United States", within the past 5 years. The weekly Google Trends score for these symptoms, which reflects their national Web popularity, was divided in three parts, as "pre-COVID" (July 2017 to February 2020), COVID-19 "pre-Omicron" (March 2020 to November 2021), and COVID-19 "Omicron" (December 2021 to July 2022), and then compared. RESULTS: The volume of searches for ageusia increased in the pre-Omicron period and remained significantly higher also during Omicron prevalence, though a significant decrease (∼30%) occurred with Omicron lineages compared to previous strains. The Google searches for hoarseness and dysphonia were relatively similar between the pre-COVID and pre-Omicron periods, but then significantly increased during Omicron predominance. The Google searches for pharyngitis and laryngitis decreased in the pre-Omicron period, but then considerably increased following Omicron emergence. Omicron endemic spread could be significantly and independently predicted by the volume of searches for pharyngitis, laryngitis and hoarseness. CONCLUSIONS: The epidemiological burden of throat symptoms has considerably changed after Omicron emergence, with a lower likelihood of developing chemosensory dysfunctions and enhanced risk of throat involvement.

2.
Oral Dis ; 2022 Jul 24.
Article in English | MEDLINE | ID: covidwho-1956788
4.
EuropePMC; 2020.
Preprint in English | EuropePMC | ID: ppcovidwho-320274

ABSTRACT

Background: /Objectives: Recent studies show that obesity is a risk factor for hospital admission and for critical care need in patients with coronavirus disease 2019 (COVID-19).The aim was to determine whether obesity is a risk factor for unfavourable health outcomes in patients affected by COVID-19 admitted to ICU and to compare the observed trend of C-Reactive Protein (CRP) and Creatine Phosphokinase (CPK), as potential pathophysiological mechanisms linking disease severity with Body Mass Index (BMI). Subjects/Methods: 95 consecutive patients with COVID-19 (78 males and 18 females) were admitted to ICU and included in the study. Height, weight, BMI, Sequential Organ Failure Assessment (SOFA) and Acute Physiology and Chronic Health Evaluation II (APACHE II) scores, CRP, CPK, as well as ICU and hospital length of stay and comorbidities were evaluated. Results: : Participants with obesity had a lower 28 day survival rate from ICU admission than normal weight subjects. Cox proportional hazard model-derived estimates, adjusted for age, gender and comorbidity, confirmed the results of the survival analysis (HR:5.30,95%C.I.1.26-22.34). In the full adjusted model, age was independently associated with mortality (HR:1.13,95%C.I:1.05-1.21).Obese subjects showed longer hospital and ICU stay as compared with normal weight counterpart.Subjects with obesity showed significantly higher CRP and CPK levels than normal weight subjects. Conclusions: : Our study shows that in COVID-19 subjects admitted to ICU obesity is a risk factor for unfavourable health outcomes with higher mortality and longer hospital stay. The increase in CRP and CPK levels observed in this population could at least in part explain the unfavourable outcomes observed in individuals with obesity. In those subjects, careful management of any medical signs or symptoms and prompt intervention in case of suspected SARS-CoV-2 infection is necessary to prevent the progression of the disease towards severe outcomes and the increase of hospital treatment costs.

5.
Clin Chem Lab Med ; 60(3): 332-337, 2022 02 23.
Article in English | MEDLINE | ID: covidwho-1547000

ABSTRACT

Coronavirus disease 2019 (COVID-19) is an infectious respiratory condition sustained by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), which manifests prevalently as mild to moderate respiratory tract infection. Nevertheless, in a number of cases the clinical course may deteriorate, with onset of end organ injury, systemic dysfunction, thrombosis and ischemia. Given the clinical picture, baseline assessment and serial monitoring of blood lactate concentration may be conceivably useful in COVID-19. We hence performed a systematic literature review to explore the possible association between increased blood lactate levels, disease severity and mortality in COVID-19 patients, including comparison of lactate values between COVID-19 and non-COVID-19 patients. We carried out an electronic search in Medline and Scopus, using the keywords "COVID-19" OR "SARS-CoV-2" AND "lactate" OR "lactic acid" OR "hyperlactatemia", between 2019 and present time (i.e. October 10, 2021), which allowed to identify 19 studies, totalling 6,459 patients. Overall, we found that COVID-19 patients with worse outcome tend to display higher lactate values than those with better outcome, although most COVID-19 patients in the studies included in our analysis did not have sustained baseline hyperlactatemia. Substantially elevated lactate values were neither consistently present in all COVID-19 patients who developed unfavourable clinical outcomes. These findings suggest that blood lactate monitoring upon admission and throughout hospitalization may be useful for early identification of higher risk of unfavourable COVID-19 illness progression, though therapeutic decisions based on using conventional hyperlactatemia cut-off values (i.e., 2.0 mmol/L) upon first evaluation may be inappropriate in patients with SARS-CoV-2 infection.


Subject(s)
COVID-19 , Hyperlactatemia , Lactic Acid/blood , COVID-19/blood , Hospitalization , Humans , Hyperlactatemia/virology , SARS-CoV-2
6.
Diagnosis (Berl) ; 9(2): 195-198, 2021 09 02.
Article in English | MEDLINE | ID: covidwho-1394592

ABSTRACT

With the ongoing coronavirus disease 2019 (COVID-19) pandemic continuing worldwide, mass screening of severe acute respiratory distress syndrome coronavirus 2 (SARS-CoV-2) infection is a cornerstone of strategies for limiting viral spread within communities. Although mass screening of body temperature with handheld, non-contact infrared thermometers and thermal imagine scanners is now widespread in a kaleidoscope of social and healthcare settings for the purpose of detecting febrile individuals bearing SARS-CoV-2 infection, this strategy carries some drawbacks, which will be highlighted and discussed in this article. These caveats basically include high rate of asymptomatic SARS-CoV-2 infections, the challenging definition of "normal" body temperature, variation of measured values according to the body district, false negative cases due to antipyretics, device inaccuracy, impact of environmental temperature, along with the low specificity of this symptom for screening COVID-19 in patients with other febrile conditions. Some pragmatic suggestions will also be endorsed for increasing accuracy and precision of mass screening of body temperature. These encompass the regular assessment of body temperature (possibly twice) with validated devices, which shall be constantly monitored over time and used following manufacturer's instructions, the definition of a range of "normal" body temperatures in the local population, patients interrogation on usual body temperature, measurement standardization of one body district, allowance of sufficient environmental acclimatization before temperature check, integration with contact history and other clinical information, along with exclusion of other causes of increased body temperature. We also endorse the importance of individual and primary care physician's regular and repeated check of personal body temperature.


Subject(s)
COVID-19 , Body Temperature , Fever/diagnosis , Humans , Mass Screening , Pandemics/prevention & control , SARS-CoV-2
7.
Front Cell Infect Microbiol ; 11: 683409, 2021.
Article in English | MEDLINE | ID: covidwho-1370984

ABSTRACT

Objective: To investigate the presence of bacteria and fungi in bronchial aspirate (BA) samples from 43 mechanically ventilated patients with severe COVID-19 disease. Methods: Detection of SARS-CoV-2 was performed using Allplex 2019-nCoV assay kits. Isolation and characterisation of bacteria and fungi were carried out in BA specimens treated with 1X dithiothreitol 1% for 30 min at room temperature, using standard culture procedures. Results: Bacterial and/or fungal superinfection was detected in 25 out of 43 mechanically ventilated patients, generally after 7 days of hospitalisation in an intensive care unit (ICU). Microbial colonisation (colony forming units (CFU) <1000 colonies/ml) in BA samples was observed in 11 out of 43 patients, whereas only 7 patients did not show any signs of bacterial or fungal growth. Pseudomonas aeruginosa was identified in 17 patients. Interestingly, 11 out of these 17 isolates also showed carbapenem resistance. The molecular analysis demonstrated that resistance to carbapenems was primarily related to OprD mutation or deletion. Klebsiella pneumoniae was the second most isolated pathogen found in 13 samples, of which 8 were carbapenemase-producer strains. Conclusion: These data demonstrate the detection of bacterial superinfection and antimicrobial resistance in severe SARS-CoV-2-infected patients and suggest that bacteria may play an important role in COVID-19 evolution. A prospective study is needed to verify the incidence of bacterial and fungal infections and their influence on the health outcomes of COVID-19 patients.


Subject(s)
COVID-19 , Pharmaceutical Preparations , Superinfection , Anti-Bacterial Agents/pharmacology , Anti-Bacterial Agents/therapeutic use , Humans , Intensive Care Units , Microbial Sensitivity Tests , RNA, Viral , Respiration, Artificial , SARS-CoV-2 , Superinfection/drug therapy
9.
Immunol Res ; 69(6): 553-557, 2021 12.
Article in English | MEDLINE | ID: covidwho-1345196

ABSTRACT

The persistence of neurological symptoms after SARS-CoV-2 infection, as well as the presence of late axonal damage, is still unknown. We performed extensive systemic and neurological follow-up evaluations in 107 out of 193 consecutive patients admitted to the COVID-19 medical unit, University Hospital of Verona, Italy between March and June 2020. We analysed serum neurofilament light chain (NfL) levels in all cases including a subgroup (n = 29) of patients with available onset samples. Comparisons between clinical and biomarker data were then performed. Neurological symptoms were still present in a significant number (n = 49) of patients over the follow-up. The most common reported symptoms were hyposmia (n = 11), fatigue (n = 28), myalgia (n = 14), and impaired memory (n = 11) and were more common in cases with severe acute COVID-19. Follow-up serum NfL values (15.2 pg/mL, range 2.4-62.4) were within normal range in all except 5 patients and did not differentiate patients with vs without persistent neurological symptoms. In patients with available onset and follow-up samples, a significant (p < 0.001) decrease of NfL levels was observed and was more evident in patients with a severe acute disease. Despite the common persistence of neurological symptoms, COVID-19 survivors do not show active axonal damage, which seems a peculiar feature of acute SARS-CoV-2 infection.


Subject(s)
Axons/pathology , COVID-19/pathology , Nervous System Diseases/pathology , Adult , Aged , Aged, 80 and over , Ageusia/pathology , Ageusia/virology , Anosmia/pathology , Anosmia/virology , Axons/virology , Disease Progression , Fatigue/pathology , Fatigue/virology , Female , Humans , Italy , Male , Memory Disorders/pathology , Memory Disorders/virology , Middle Aged , Myalgia/pathology , Myalgia/virology , Nervous System Diseases/virology , Neurofilament Proteins/blood , SARS-CoV-2
10.
Int J Surg Case Rep ; 80: 105619, 2021 Mar.
Article in English | MEDLINE | ID: covidwho-1085542

ABSTRACT

INTRODUCTION: Facial trauma are an important cause of serious ocular morbidity. In particular domestic trauma are a small part of total. COVID-19 pandemic has been influencing our life in a way never seen before, people need to remain at home due to lockdown restrictions. In this scenario we are seeing an increase in the percentage of domestic facial trauma. In other hand pandemic has influenced the possibility of hospitalization, so daily based procedures increased their importance in global treatment planning. CASE PRESENTATION: A 58 yo man presented to our ward with a foreign body in left eyebrow. Trauma happened during gardening. CLINICAL DISCUSSION: The importance of imaging to perform the right procedure has become more important during pandemic to reduce time of hospitalization. CONCLUSION: CT scan and ophtalmology consult have been the guideline to avoid a more invasive treatment which was performed in an outpatient regimen with local anesthesia.

11.
Nutr Metab Cardiovasc Dis ; 31(3): 762-768, 2021 03 10.
Article in English | MEDLINE | ID: covidwho-1065504

ABSTRACT

BACKGROUND AND AIMS: Recent studies show that obesity is a risk factor for hospital admission and for critical care need in patients with coronavirus disease 2019 (COVID-19). The aim was to determine whether obesity is a risk factor for unfavourable health outcomes in patients affected by COVID-19 admitted to ICU. METHODS AND RESULTS: 95 consecutive patients with COVID-19 (78 males and 18 females) were admitted to ICU and included in the study. Height, weight, BMI, Sequential Organ Failure Assessment (SOFA) and Acute Physiology and Chronic Health Evaluation II (APACHE II) scores, CRP, CPK, ICU and hospital length of stay and comorbidities were evaluated. Participants with obesity had a lower 28 day survival rate from ICU admission than normal weight subjects. Cox proportional hazard model-derived estimates, adjusted for age, gender and comorbidity, confirmed the results of the survival analysis (HR:5.30,95%C.I.1.26-22.34). Obese subjects showed longer hospital and ICU stay as compared with normal weight counterpart.Subjects with obesity showed significantly higher CRP and CPK levels than normal weight subjects. CONCLUSION: In individuals with obesity, careful management and prompt intervention in case of suspected SARS-CoV-2 infection is necessary to prevent the progression of the disease towards severe outcomes and the increase of hospital treatment costs.


Subject(s)
COVID-19/epidemiology , COVID-19/mortality , Obesity/epidemiology , APACHE , Adult , Aged , Aged, 80 and over , Body Mass Index , Critical Illness , Female , Hospitalization/statistics & numerical data , Humans , Intensive Care Units , Length of Stay/statistics & numerical data , Male , Middle Aged , Obesity/mortality , Proportional Hazards Models , Risk Factors , SARS-CoV-2 , Severity of Illness Index
13.
Clin Exp Dent Res ; 7(1): 101-108, 2021 02.
Article in English | MEDLINE | ID: covidwho-813309

ABSTRACT

OBJECTIVES: The aim of this narrative review was to collect all findings from literature about oral signs and symptoms of COVID-19, in order to draw a picture of oral involvement of this challenging viral infection, to help oral professionals in a better triage and early diagnosis. MATERIAL AND METHODS: The search for international literature was made including articles written in English and reporting about oral manifestations in patients with a diagnosis of COVID-19. The publication time was limited to 2019 and 2020, up to May 20, 2020. A narrative review was performed. RESULTS: Twenty-three articles were included in this review. Three different oral manifestations were found: taste alteration, oral blister and ulcers, and oral lesions associated with Kawasaki-like diseases (erythema, bleeding of lips, "strawberry tongue"). The higher expression of Angiotensin-converting enzyme 2 in the oral cavity and in endothelial cells might be responsible for oral manifestation and the major report of signs and symptoms in the occidental countries. CONCLUSIONS: Detecting oral signs and symptoms of COVID-19 could be useful to perform a better preliminary triage in dental setting, and in recognizing possible early manifestations of the disease. However, considering the outbreak of COVID-19 and the consequent difficulty of undergoing oral examinations, the oral manifestations might be misdiagnosed; then, we would encourage oral professionals to perform other studies about this topic.


Subject(s)
COVID-19/complications , Mouth Diseases/virology , SARS-CoV-2/isolation & purification , COVID-19/transmission , COVID-19/virology , Humans , Mouth Diseases/epidemiology , Mouth Diseases/pathology , Prognosis
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