ABSTRACT
Objective: Coronavirus disease 2019 may be associated with a white spectrum of post recovery disease complications and health impairment. The objective of this study was to evaluate and assess the different perimeters of pulmonary Function Tests and late outcome of the disease after hospital discharge at 3 and 6 months among the patients admitted with swerve COVID Pneumonia. Method: Our analysis consisted of comparison of the FVC at 3 and 6 months after hospital discharge in order to evaluate the disease severity with time. Results: A total of 41 hospitalized patients had their Pulmonary Function Tests evaluated >70% of the patients had their FVC <80% at 3 months and >12% had their FVC <80% at 6 months. To study abnormality of spirometry in severe post COVID-19 patients who were discharge from ICU hospital and complete the follow up after one month 3, 6. CONCLUSION: In patients who developed moderate to severe pneumonia more than 70% had abnormal FVC at 3 months. These patients were to be identified and treated with optimal management and as a result only 12% of patients had long term impairment in FVC and long term sequel.
ABSTRACT
The objective of the study was to analyze the effectiveness of the "Monitoring" program for patients with new coronavirus infection and to evaluate its preparedness to work in emergency situations, as well as to substantiate the effectiveness of the program as a monitoring tool for patient care management in level 1 and level 2 medical treatment organizations when there is a shortage of intensive care beds at level 3 medical institutions. Materials and research methods. Materials of the research: normative legal documents regulating the order of application of telemedicine technologies in Russia and Kuzbass, including in the field of the Disaster Medicine Service, scientific publications, personal work experience in the organization of remote consultations. The research was based on the data on the provision of consultative medical care to the patients with the diagnoses "new coron-avirus infection” and "community-acquired pneumonia”, who were hospitalized in the intensive care departments of level 1 and level 2 medical treatment organisations. Research results and their analysis. The retrospective analysis of the calls to the monitoring center from the patients in severe condi-tion, being treated in level 1 and level 2 medical treatment organizations for the diagnoses of new coronavirus infection and pneu-monia, who needed monitoring by the specialists of the consulting center (mainly by intensive care specialists), was performed. Inclusion criteria in the study: adult patients with new coronavirus infection and pneumonia;receipt of call to the monitoring center during the study period – 01.11.2020-31.01.2022;availability of patient counseling using "Monitoring" program. Conclusion was made, that the system, linking major hospitals with local hospitals, which have the maximum load in periods of peak morbidity, through conducting emergency and urgent telemedicine consultations was created in Kuzbass. The analysis of the obtained data testifies to the effective work of the monitoring center for severe patients as a type of telemedicine tool when working in high alert mode. © Burnasyan FMBC FMBA.
ABSTRACT
Objective: Coronavirus disease 2019 may be associated with a white spectrum of post recovery disease complications and health impairment. The objective of this study was to evaluate and assess the different perimeters of pulmonary Function Tests and late outcome of the disease after hospital discharge at 3 and 6 months among the patients admitted with swerve COVID Pneumonia. Method(s): Our analysis consisted of comparison of the FVC at 3 and 6 months after hospital discharge in order to evaluate the disease severity with time. Result(s): A total of 41 hospitalized patients had their Pulmonary Function Tests evaluated >70% of the patients had their FVC <80% at 3 months and >12% had their FVC <80% at 6 months. To study abnormality of spirometry in severe post COVID-19 patients who were discharge from ICU hospital and complete the follow up after one month 3, 6. CONCLUSION(S): In patients who developed moderate to severe pneumonia more than 70% had abnormal FVC at 3 months. These patients were to be identified and treated with optimal management and as a result only 12% of patients had long term impairment in FVC and long term sequel. Copyright © 2022, Anka Publishers. All rights reserved.
ABSTRACT
Background. COVID-19 caused by SARS-CoV-2 virus was assigned as a pandemic by WHO. Fever, breathlessness, cough and expectoration indicates lung involvement in the form of pneumonia and its most common complications are pulmonary fibrosis, chronic respiratory failure and reduced quality of life. Incentive spirometry is the relevant therapy to enhance the normal lung function and improve quality of life. Aim. To find the effect of incentive spirometry on pulmonary function test in post COVID-19 pneumonia patients. Methodology. An experimental study with simple random sampling (lottery method) of 24 patients in age group (18-68 years). The participants were randomly divided into 2 groups. Group A received pharmacotherapy and incentive spirometry and Group B received only pharmacotherapy. Computerized spirometry and Diffusion lung capacity for carbon monoxide (DLCO) was used as diagnostic tool to measure pre & post test values for both groups. Intervention was given for 4 weeks and after 4 weeks, to analyze the spirometry values post-test was taken for both groups. Outcome measures. Forced expiratory volume in the first second (FEV1), Forced vital capacity (FVC), FEV1/FVC &DLCO. Results. Statistical analysis shows significant improvement (p < 0.05) between pretest and post test values on Pulmonary Function Tests (PFT) in both Group A&B whereas there was increase in the improvement in intervention group than control group. Conclusion. Incentive spirometry improved the lung volume and capacities on PFT in post COVID-19 pneumonia patients and also these patients have mainly restrictive lung pattern by the use of DLCO. © 2022, DJ Studio. All rights reserved.
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AIMS: We investigate how fasting blood glucose (FBG) levels affect the clinical severity in coronavirus disease 2019 (COVID-19) patients, pneumonia patients with sole bacterial infection, and pneumonia patients with concurrent bacterial and fungal infections. METHODS: We enrolled 2761 COVID-19 patients, 1686 pneumonia patients with bacterial infections, and 2035 pneumonia patients with concurrent infections. We used multivariate logistic regression analysis to assess the associations between FBG levels and clinical severity. RESULTS: FBG levels in COVID-19 patients were significantly higher than in other pneumonia patients during hospitalisation and at discharge (all p < 0.05). Among COVID-19 patients, the odds ratios of acute respiratory distress syndrome (ARDS), respiratory failure (RF), acute hepatitis/liver failure (AH/LF), length of stay, and intensive care unit (ICU) admission were 12.80 (95% CI, 4.80-37.96), 5.72 (2.95-11.06), 2.60 (1.20-5.32), 1.42 (1.26-1.59), and 5.16 (3.26-8.17) times higher in the FBG ≥7.0 mmol/L group than in FBG < 6.1 mmol/L group, respectively. The odds ratios of RF, AH/LF, length of stay, and ICU admission were increased to a lesser extent in pneumonia patients with sole bacterial infection (3.70 [2.21-6.29]; 1.56 [1.17-2.07]; 0.98 [0.88-1.11]; 2.06 [1.26-3.36], respectively). The odds ratios of ARDS, RF, AH/LF, length of stay, and ICU admission were increased to a lesser extent in pneumonia patients with concurrent infections (3.04 [0.36-6.41]; 2.31 [1.76-3.05]; 1.21 [0.97-1.52]; 1.02 [0.93-1.13]; 1.72 [1.19-2.50], respectively). Among COVID-19 patients, the incidence rate of ICU admission on day 21 in the FBG ≥ 7.0 mmol/L group was six times higher than in the FBG < 6.1 mmol/L group (12.30% vs. 2.21%, p < 0.001). Among other pneumonia patients, the incidence rate of ICU admission on day 21 was only two times higher. CONCLUSIONS: Elevated FBG levels at admission predict subsequent clinical severity in all pneumonia patients regardless of the underlying pathogens, but COVID-19 patients are more sensitive to FBG levels, and suffer more severe clinical complications than other pneumonia patients.
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BACKGROUND: The differential diagnosis between novel coronavirus pneumonia patients (NCPP) and influenza patients (IP) remains a challenge in clinical practice. METHODS: Between January 2018 and March 2020, 1,027 NCPP and 1,140 IP were recruited from Tongji hospital. Routine blood examination, biochemical indicators and coagulation function analysis were simultaneously performed in all participants. RESULTS: There was no sex predominance in NCPP. The NCPP were frequently encountered in the sixth and seventh decades of life. The mean age of NCPP (56±16 years) was higher than IP (47±17 years), but without statistical difference. Although most results of routine laboratory tests between NCPP and IP had no significant differences, some laboratory tests showed an obvious change in NCPP. It was observed that NCPP had significantly decreased white blood cells, alkaline phosphatase and d-dimer compared with IP. However, the results of lactate dehydrogenase, erythrocyte sedimentation rate and fibrinogen were significantly increased in NCPP compared with IP. The diagnostic model based on a combination of 18 routine laboratory indicators showed an area under the curve of 0.796 (95% CI, 0.777-0.814), with a sensitivity of 46.93% and specificity of 90.09% when using a cut-off value of 0.598. CONCLUSIONS: Some routine laboratory results had statistical difference between NCPP and IP. A diagnostic model based on a combination of routine laboratory results provided an adjunct approach in the differential diagnosis between NCPP and IP.