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1.
Pediatric Nephrology ; 2022.
Article in English | EMBASE | ID: covidwho-1820930

ABSTRACT

Background: Patients with kidney diseases (KD) appear to be at particularly high risk for severe COVID-19. This study aimed to characterize the clinical outcomes and risk factors for COVID-19-related death in a large cohort of hospitalized pediatric patients with KD. Methods: We performed an analysis of all pediatric patients with KD and COVID-19 registered in SIVEP-Gripe, a Brazilian nationwide surveillance database, between February 16, 2020, and May 29, 2021. The primary outcome was time to death, which was evaluated considering discharge as a competitive risk by using cumulative incidence function. Results: Among 21,591 hospitalized patients with COVID-19, 290 cases (1.3%) had KD. Of these, 59 (20.8%) had a fatal outcome compared with 7.5% of the non-KD cohort (P < 0.001). Pediatric patients with KD had an increased hazard of death compared with the non-KD cohort (Hazard ratio [HR] = 2.85, 95% CI 2.21–3.68, P < 0.0001). After adjustment, the factors associated with the death among KD patients were living in Northeast (HR 2.16, 95% CI 1.13–4.31) or North regions (HR 3.50, 95% CI 1.57–7.80), oxygen saturation < 95% at presentation (HR 2.31, 95% CI 1.30–4.10), and presence of two or more associated comorbidities (HR 2.10, 95% CI 1.08–4.04). Conclusions: Children and adolescents with KD had a higher risk of death compared with the non-KD cohort. The higher risk was associated with low oxygen saturation at admission, living in socioeconomically disadvantaged regions, and presence of other pre-existing comorbidities. Graphical : A higher resolution version of the Graphical is available as Supplementary information [Figure not available: see fulltext.].

2.
Journal of Clinical and Diagnostic Research ; 16(4):OC24-OC27, 2022.
Article in English | EMBASE | ID: covidwho-1818677

ABSTRACT

Introduction: The portable Chest Radiograph (CXR) has an indispensable role in large scale screening and diagnosis of Coronavirus Disease 2019 (COVID-19), especially in developing countries with limited resources. It can help in predicting the severity of lung involvement in the patients infected with Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) infection, especially in areas where the Computed Tomography (CT) is unavailable. Aim: To determine the prognostic value of CXR at clinical presentation in assessing the disease severity and its correlation with inflammatory markers in COVID-19 hospitalised patients. Materials and Methods: This was a single-centre retrospective study, conducted at Sri Ramachandra Institute of Higher Education and Research, from October 2020 to December 2020, on hospitalised COVID-19 patients. Clinically, the patients were categorised as mild, moderate and severe, based on their peripheral oxygen saturation- more than 94%, between 90-93%, and less than or equal to 89%, respectively. Blood samples, drawn at presentation to the hospital tested for various inflammatory markers proven to be predictive of disease severity, were documented for the analysis purpose. The CXRs, done at the presentation, were scored based on the number of zones involved and type of abnormality present (ground glassing, consolidation and septal thickening). The CXRs were scored a minimum '0' to a maximum of '9'. Correlation between the radiograph score and inflammatory markers was further analysed. Results: Among the 456 study patients, 71% had mild, 15% had moderate and 14% had severe COVID-19 infection. The mean CXR score in each category was 1, 3 and 4, respectively (p-value <0.001). The study groups were grouped as mild and non mild (included the moderate and severe categories). A criterion CXR score of 2 was able to differentiate mild and non mild cases (sensitivity was 78.29%, specificity was 77.98%, positive predictive values was 58.38%, negative predictive values was 90.11%), with an accuracy of 78.1%. The inflammatory markers like Neutrophil Lymphocyte Ratio (NLR), Absolute Lymphocyte Counts (ALC), eosinophil%, D-dimer, Lactate Dehydrogenas (LDH), Erythrocyte Sedimentation Rate (ESR), C-Reactive Protein (CRP), and ferritin showed statistically significant difference between the two groups (p-value<0.001). Conclusion: The CXR can be used as a screening and predictive tool for disease severity in developing countries where access to Computed Tomography (CT) is limited. Given the possibility of subsequent waves of the COVID-19 pandemic and the risk of excessive radiation exposure from CT, CXR may be used as a reliable alternative.

3.
Lung India ; 39(2):191-194, 2022.
Article in English | EMBASE | ID: covidwho-1818451

ABSTRACT

Pulmonary veno-occlusive disease (PVOD) is an important cause of pulmonary arterial hypertension (PAH) and is classified under idiopathic cause of PAH. Over a period of time, PVOD has been studied in detail in the western countries and various diagnostic criteria are formulated. Being a rapidly progressive disease, early diagnosis is of utmost importance which helps to initiate appropriate treatment. Recent studies suggest that PVOD has a genetic predisposition and has an autosomal recessive pattern of inheritance. Here, we discuss the case of siblings diagnosed with PVOD to have such genetic predisposition for this disease.

4.
Journal of Asthma and Allergy ; 15:353-362, 2022.
Article in English | EMBASE | ID: covidwho-1817663

ABSTRACT

Background and Objective: Objectively differentiating between wheezing episodes and other respiratory disorders will be helpful in treatment in office practice. The impulse oscillometry system has been useful in assessing airway resistance in children 3–6 years old. As the reference values are different in geographical regions the use of the impulse oscillometry is still limited. Comparison between the percent change in IOS parameters as compared to reference standards and changes in actual IOS parameters was done to diagnose wheezing episodes. Methodology: Three to six years old children with a history of fever, cough, cold, and/or breathlessness with noisy breathing and who were not on any regular medications, whose parents gave consent were recruited in the study. The children underwent an impulse oscillometry system examination as per the guidelines. The test was repeated after they were given nebulization by salbutamol (2.5 mg) (before COVID 19 pandemic). Final diagnosis was done by following patients for 7 days. Results: About 106 children were recruited in the study. Five children could not perform the IOS test. Eighteen children did not complete the follow-up. Hence, 83 children were analyzed. There were 47 males and 36 female patients. The change in actual values of AX, R5, and X20 showed statistically significant difference in wheezing episode group (p-value<0.001). The percentage change as compared to predicted values of R5 and X20 also showed a statistically significant difference in the wheezing episode group and the others group (p-value<0.001). Conclusion: The change in actual values of AX, R5, X20, and resonant frequency may help to differentiate wheezing episode from other respiratory diseases.

5.
Journal of Investigative Medicine High Impact Case Reports ; 10, 2022.
Article in English | EMBASE | ID: covidwho-1817132

ABSTRACT

Coccidioidomycosis (CM) is a fungal disease that results from inhalation of spores of Coccidioides immitis and C posadasii. If symptomatic, disease primarily manifests as community-acquired pneumonia;however, additional pulmonary manifestations such as pleural effusion, empyema, and cavitation may occur. Diabetic patients have an increased risk of severe and cavitary CM. Cavitary disease may erode vasculature and pulmonary parenchyma leading to further complications. Furthermore, chronic cavities can become colonized as well and develop superimposed infections. This is a case of cavitary CM in uncontrolled diabetic nonadherent to treatment presenting with hemoptysis and mycetoma.

6.
The New England Journal of Medicine ; 386(17):1627-1637, 2022.
Article in English | ProQuest Central | ID: covidwho-1815679

ABSTRACT

BackgroundNeonatal endotracheal intubation often involves more than one attempt, and oxygen desaturation is common. It is unclear whether nasal high-flow therapy, which extends the time to desaturation during elective intubation in children and adults receiving general anesthesia, can improve the likelihood of successful neonatal intubation on the first attempt.MethodsWe performed a randomized, controlled trial to compare nasal high-flow therapy with standard care (no nasal high-flow therapy or supplemental oxygen) in neonates undergoing oral endotracheal intubation at two Australian tertiary neonatal intensive care units. Randomization of intubations to the high-flow group or the standard-care group was stratified according to trial center, the use of premedication for intubation (yes or no), and postmenstrual age of the infant (≤28 or >28 weeks). The primary outcome was successful intubation on the first attempt without physiological instability (defined as an absolute decrease in the peripheral oxygen saturation of >20% from the preintubation baseline level or bradycardia with a heart rate of <100 beats per minute) in the infant.ResultsThe primary intention-to-treat analysis included the outcomes of 251 intubations in 202 infants;124 intubations were assigned to the high-flow group and 127 to the standard-care group. The infants had a median postmenstrual age of 27.9 weeks and a median weight of 920 g at the time of intubation. A successful intubation on the first attempt without physiological instability was achieved in 62 of 124 intubations (50.0%) in the high-flow group and in 40 of 127 intubations (31.5%) in the standard-care group (adjusted risk difference, 17.6 percentage points;95% confidence interval [CI], 6.0 to 29.2), for a number needed to treat of 6 (95% CI, 4 to 17) for 1 infant to benefit. Successful intubation on the first attempt regardless of physiological stability was accomplished in 68.5% of the intubations in the high-flow group and in 54.3% of the intubations in the standard-care group (adjusted risk difference, 15.8 percentage points;95% CI, 4.3 to 27.3).ConclusionsAmong infants undergoing endotracheal intubation at two Australian tertiary neonatal intensive care units, nasal high-flow therapy during the procedure improved the likelihood of successful intubation on the first attempt without physiological instability in the infant. (Funded by the National Health and Medical Research Council;Australian New Zealand Clinical Trials Registry number, ACTRN12618001498280.)

7.
The New England Journal of Medicine ; 386(17):1647-1657, 2022.
Article in English | ProQuest Central | ID: covidwho-1815674

ABSTRACT

A Man with Myalgias, Fever, and BradycardiaA 56-year-old man presented in early autumn with a 1-month history of myalgias and fever. His heart rate was 48 beats per minute. An electrocardiogram showed sinus bradycardia and complete heart block;cardiac imaging showed inflammatory changes in the epicardial fat abutting the noncoronary sinus of the aortic valve. A diagnostic test was performed.

8.
Regenerative Therapy ; 20:61-71, 2022.
Article in English | EMBASE | ID: covidwho-1815134

ABSTRACT

COVID-19 disease caused by the Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2), started in December 2019 in Wuhan, China, and quickly became the global pandemic. The high spread rate, relatively high mortality rate, and the lack of specific medicine have led researchers and clinicians worldwide to find new treatment strategies. Unfortunately, evidence shows that the virus-specific receptor Angiotensin-Converting Enzyme 2 (ACE-2) is present on the surface of most cells in the body, leading to immune system dysfunction and multi-organ failure in critically ill patients. In this context, the use of Mesenchymal Stem Cells (MSCs) and their secret has opened new therapeutic horizons for patients due to the lack of ACE2 receptor expression. MSCs exert their beneficial therapeutic actions, particularly anti-inflammatory and immunomodulatory properties, mainly through paracrine effects which are mediated by exosomes. Exosomes are bilayer nanovesicles that carry a unique cargo of proteins, lipids and functional nucleic acids based on their cell origin. This review article aims to investigate the possible role of exosomes and the underlying mechanism involved in treating COVID-19 disease based on recent findings.

9.
Journal of Critical Care ; 69, 2022.
Article in English | ProQuest Central | ID: covidwho-1814662

ABSTRACT

PurposeAcute lung injury associated with COVID-19 contributes significantly to its morbidity and mortality. Though invasive mechanical ventilation is sometimes necessary, the use of high flow nasal oxygen may avoid the need for mechanical ventilation in some patients. For patients approaching the limits of high flow nasal oxygen support, addition of inhaled pulmonary vasodilators is becoming more common but little is known about its effects. This is the first descriptive study of a cohort of patients receiving inhaled epoprostenol with high flow nasal oxygen for COVID-19.Materials and methodsWe collected clinical data from the first fifty patients to receive inhaled epoprostenol while on high flow nasal oxygen at our institution. We compared the characteristics of patients who did and did not respond to epoprostenol addition.ResultsThe 18 patients that did not stabilize or improve following initiation of inhaled epoprostenol had similar rates of invasive mechanical ventilation as those who improved or stabilized (50% vs 56%). Rates of mortality were not significantly different between the two groups (17% and 31%).ConclusionsIn patients with COVID-19 induced hypoxemic respiratory failure, the use of inhaled epoprostenol with high flow nasal oxygen is feasible, but physiologic signs of response were not related to clinical outcomes.

10.
International Journal of Cardiovascular Imaging ; 2022.
Article in English | EMBASE | ID: covidwho-1813722

ABSTRACT

There are still many gaps in our knowledge regarding the direct cardiovascular injuries due to COVID-19 infection. In this study, we tried to find out the effect of SARS-CoV-2 infection on cardiac function in patients without any history of structural heart disease by electrocardiographic and echocardiographic evaluations. This was a cross-sectional study on patients with COVID-19 infection admitted to Imam Reza hospital, Mashhad, Iran between 14 April and 21 September 2020. COVID-19 infection was verified by a positive reverse-transcriptase polymerase chain reaction (PCR) assay for SARS-CoV-2 using nasopharyngeal/oropharyngeal samples. We enrolled all patients over 18 years old with definite diagnosis of COVID-19 infection. All patients underwent a comprehensive transthoracic echocardiography at the first week of admission. Clinical and imaging data were collected prospectively. In total, 142 patients were enrolled in this study. The mean age of participants was 60.69 ± 15.70 years (range: 30–90 years). Most patients were male (82, 57.7%). Multivariate analysis showed that O2 saturation at admission was independently a predictor of re-hospitalization (P < 0.001). RV size (P < 0.001), dyslipidemia (P < 0.001), ejection fraction (EF) (P < 0.001), age (P = 0.020), systolic blood pressure (P = 0.001), O2 saturation (P = 0.018) and diabetes (P = 0.025) independently predicted 30-days mortality. Echocardiography can be used for risk assessment in patients with COVID-19, especially in those with previous history of diabetes and dyslipidemia. The infection could result in ventricular dysfunction, even in those without previous history of structural heart disease.

11.
Clinical Case Reports ; 10(3), 2022.
Article in English | EMBASE | ID: covidwho-1813474

ABSTRACT

We report the case of a 51-year-old Caucasian woman who developed a pulmonary embolism in the absence of any pre-existing risk factors for VTE, 3 weeks following clozapine initiation for treatment resistant paranoid schizophrenia. She was initially misdiagnosed and treated for suspected COVID-19 infection.

12.
Pakistan Armed Forces Medical Journal ; 72(1):223, 2022.
Article in English | ProQuest Central | ID: covidwho-1812955

ABSTRACT

Objective: To evaluate the effectiveness of awake proning on bedside oxygen saturation in non-intubated severe COVID-19 cases and its association with high-resolution CT chest severity score. Study Design: Prospective observational study. Place and Duration of Study: Pak Emirates Military Hospital Pakistan, from Jun to Jul 2020. Methodology: This study was conducted on 150 laboratories confirmed SARS-CoV-2 infected cases with moderate to severe category pneumonia, requiring supplemental oxygen but not mechanical ventilation, admitted in the High Dependency Unit of the Military Hospital. Bedside oxygen saturation was recorded via pulse oximeter before and after proning of 10 minutes to evaluate whether oxygen saturation increased, decreased or remained the same post proning. Results: Out of 150 patients, it was observed that 67 (45%) patients showed 2% increase of oxygen saturation over 10 minutes of proning, 48 (32%) patients showed an increase of 1% while 20 (13%) patients showed an increase of 3%. It was also observed that 13 (14.7%) patients out of 88 patients, with HRCT severity score of >50% showed an increase of 3% compared to 7 (11%) patients out of 62 patients with HRCT severity score of <50%. Conclusion: At least 60% of the patients showed an improvement of 2% or more after 10 minutes of proning, which concluded that awake proning in non-intubated patients may help improve oxygen saturation.

13.
Tunisie Medicale ; 99(7):764-766, 2021.
Article in English | EMBASE | ID: covidwho-1812897

ABSTRACT

The Coronavirus Disease 2019 (COVID-19) pandemic has displayed heterogeneity in disease manifestations and complications. This case report illustrates a rare issue : the spontaneous pneumomediastinum. A 73-year-old male presented with chills, and respiratory symptoms. A reverse transcriptase polymerase chain reaction (RT-PCR) test- confirmed COVID19. At admission, the patient was in severe respiratory distress. C reactive protein was 54 mg/l (normal: 0-5 mg/l), , troponin were negative, brain natriuretic peptid 55 pg/ml (normal range <100 pg/ml) and D-dimer 700 mcg/l (normal: 0-500 mcg/l). Arterial blood gases showed pH 7.49 (normal: 7.35-7.45), PCO2 33,8 mmHg (normal: 34-46 mmHg) and PO2 56 mmHg (normal: 80-97 mmHg) with 16 liter per minute of oxygen. Computed tomography of the chest (CT chest) showed diffuse groundglass opacities (60-70%) without pulmonary embolism. Diagnosis of acute respiratory distress syndrome (ARDS) was made. Low flow oxygen was provided (Oxygen saturation target ≥ 94%), intermediate dose of low molecular weight heparin and 8mg of dexamethason were administarted daily. On day 10, worsening hemodynamics and blood oxygen levels was noted. CT chest showed moderate bilateral pneumomediastinum, without pneumothorax, persistent groundglass opacities (75%) with early fibrosis elements. The patient recovered with no pulmonary sequelae. This case report encourages health workers to get used with infrequent clinical and radiological manifestations of COVID-19 that is still surprising the world.

14.
Nature Reviews. Cardiology ; 19(5):302-313, 2022.
Article in English | ProQuest Central | ID: covidwho-1805618

ABSTRACT

Patients with heart failure are at a higher risk of cardiovascular events compared with the general population, particularly during domestic or international travel. Patients with heart failure should adhere to specific recommendations during travel to lower their risk of developing heart failure symptoms. In this Review, we aim to provide clinicians with a set of guidelines for patients with heart failure embarking on national or international travel. Considerations when choosing a travel destination include travel distance and time, the season upon arrival, air pollution levels, jet lag and altitude level because all these factors can increase the risk of symptom development in patients with heart failure. In particular, volume depletion is of major concern while travelling given that it can contribute to worsening heart failure symptoms. Pre-travel risk assessment should be performed by a clinician 4–6 weeks before departure, and patients should receive advice on potential travel-related illness and on strategies to prevent volume depletion. Oxygen supplementation might be useful for patients who are very symptomatic. Upon arrival at the destination, potential drug-induced photosensitivity (particularly in tropical destinations) and risks associated with the local cuisine require consideration. Special recommendations are needed for patients with cardiac implantable electronic devices or left ventricular assist devices as well as for those who have undergone major cardiac surgery.In this Review, von Haehling and colleagues provide clinicians with practical recommendations for patients with heart failure who plan to travel, including guidelines for pre-travel risk assessment and special considerations for patients who have undergone recent surgery or have a cardiac implantable electronic device.

15.
Embase; 2022.
Preprint in English | EMBASE | ID: ppcovidwho-333921

ABSTRACT

Background: Almost two years since the onset of the COVID-19 pandemic no predictive algorithm has been generally adopted, nor new tests identified to improve the prediction and management of SARS-CoV-2 infection. Methods: Retrospective observational analysis of the predictive performance of clinical parameters and laboratory tests in hospitalised patients with COVID-19. Outcomes were 28-day survival and maximal severity in a cohort of 1,579 patients and two validation cohorts of 598 and 434 patients. A pilot study conducted in a patient subgroup measured 17 cytokines and 27 lymphocyte phenotypes to explore additional predictive laboratory tests. Findings: 1) Despite a strong association of 22 clinical and laboratory variables with the outcomes, their joint prediction power was limited due to redundancy. 2) Eight variables: age, comorbidity index, oxygen saturation to fraction of inspired oxygen ratio, neutrophil-lymphocyte ratio, C-reactive protein, aspartate aminotransferase/alanine aminotransferase ratio, fibrinogen, and glomerular filtration rate captured most of the statistical predictive power. 3) The interpretation of clinical and laboratory variables was improved by grouping them in categories. 4) Age and organ damage-related tests were the best predictors of survival, and inflammatory-related tests were the best predictors of severity. 5) The pilot study identified several immunological tests (including chemokine ligand 10, chemokine ligand 2, and interleukin 1 receptor antagonist), that performed better than currently used tests. Conclusions: Currently used tests for clinical management of COVID-19 patients are of limited predictive value due to redundancy, as all measure aspects of two major processes: inflammation, and organ damage. There are no independent predictors based on the quality of the nascent adaptive immune response. Understanding the limitations of current tests would improve their interpretation and simplify clinical management protocols. A systematic search for better biomarkers is urgent and feasible.

16.
Open Access Macedonian Journal of Medical Sciences ; 10:265-269, 2022.
Article in English | EMBASE | ID: covidwho-1798867

ABSTRACT

BACKGROUND: COVID-19 is a respiratory tract infection caused by the coronavirus. Some patients with severe symptoms require hospital treatment needing oxygen support. The COVID-19 condition affects the hemodynamic status of the patient. AIM: This study aimed to analyze the effect of murottal surah Ar-Rahman therapy on the hemodynamic status of COVID-19 patients in A. Yani Islamic Hospital Surabaya. METHODS: This research design was a quasi-experiment with pre-test–post-test one group design without a control group. The population was the confirmed positive patient for COVID-19 who were treated in the Mina Room of A. Yani Islamic Hospital Surabaya from November 2020 to January 2021 with a total of 63 patients. The sample was 55 patients which were taken by purposive sampling. The variables in this study were the hemodynamic status, including blood pressure, respiration rate, heart rate, and oxygen saturation that were given murottal therapy Surah Ar-Rahman. Data were analyzed using Paired t-test and those that were not normally distributed by sign-test. RESULTS: The results of this study found that there were differences in the pre-post variables of systolic blood pressure (p = 0.000), heart rate (p = 0.000), respiration rate (p = 0.000), and oxygen saturation (p = 0.000). There was no difference in the diastolic blood pressure variable (p = 0.263). CONCLUSIONS: This study concluded that the Surah Ar-Rahman therapy murottal can be used and effective to improve hemodynamic status in conjunction with therapy from the medical team. This therapy is also very easy to use anywhere.

17.
Open Access Macedonian Journal of Medical Sciences ; 10(T8):41-46, 2022.
Article in English | EMBASE | ID: covidwho-1798853

ABSTRACT

BACKGROUND: In patients with coronavirus disease-19 (COVID-19), respiratory failure is a serious condition that requires immediate respiratory supports. Various clinical conditions can be determinant factors to the need for used of ventilators. AIM: The aim of the study was to determine factor related to the used of ventilators among COVID-19 patients transferred to intensive care unit Sardjito Hospital. METHODS: Using a cross-sectional design, a total of 171 of 300 medical records selected in accordance to the inclusion criteria. Association of each clinical characteristics and outcome variable used contingency coefficient and Spearman rank tests, while multivariate logistic regression model was performed for hypothesis testing. The area under curve (AUC) was test to determine model fit of the logistic approach. RESULTS: There was a significant correlation between age (p = 0.004), blood sugar levels (p < 0.001), and oxygen saturation (p < 0.001), and the used of ventilator. Patients with hypoxia and severe hypoxia had odds of using ventilation supports 5 times and 114 times (OR = 5.623) and (OR = 114.3). The AUC test indicated that null hypothesis was rejected. CONCLUSION: The clinical characteristics were associated with age, blood sugar levels, and oxygen saturation. Patients with COVID-19 who admitted to hospital with hypoxia and severe hypoxia increased the odds of the use ventilators.

18.
Acta Medica Mediterranea ; 38(2):1099-1102, 2022.
Article in English | EMBASE | ID: covidwho-1798617

ABSTRACT

Objective: In this example, the patient accidentally fell from 8 meters high, causing trauma to the patient’s chest with tracheal laceration and ‘white lung’ in both lungs. The patient lost respiratory function and was using a breathing machine with 100% pure oxygen while still maintaining 80% oxygen saturation. Routine tracheal intubation under general anaesthesia could potentially cause patient death during the operation. The objective was to assess the use of extracorporeal membrane oxygenation (ECMO) in surgery to repair the patient’s tracheal laceration. Methods: The thoracic surgery department applied hybrid surgery combined with ECMO to rescue the patient. With the support of ECMO, the patient’s intraoperative vital signs were stable, blood oxygen saturation was 100% and the surgery for repairing the laceration with fibreoptic bronchoscopy was successfully completed. Results: The patient recovered and was discharged from hospital. Conclusion: ECMO has successfully treated many critically ill COVID-19 patients during the pandemic, but this is the first time in China that ECMO has been applied to patients suffering from multiple critical injuries such as chest trauma and tracheal laceration.

19.
Med Klin Intensivmed Notfmed ; 2022 Apr 14.
Article in German | MEDLINE | ID: covidwho-1797664

ABSTRACT

Oxygen is essential for energy production and thus for the survival of human cells. If oxygen delivery is disrupted due to illness, injury or changes in environmental factors, the human body is to a certain extent able to activate compensatory mechanisms to ensure adequate delivery of oxygen for the function and integrity of the cells and organ systems. If these compensatory mechanisms are exhausted or overloaded, there is a risk of functional failure of cells and organ systems. In clinical practice, it is often difficult to decide whether the body's own compensation mechanisms are still sufficient or whether more invasive therapy options and their side effects should be used to prevent organ damage. The aim of this review is to reiterate the basic physiological mechanisms of oxygen delivery to cells, to show how insufficient oxygen can be detected, and to highlight the current state of studies and guidelines on target oxygen levels. Although the coronavirus disease 2019 (COVID-19) pandemic has brought recent attention to the pathophysiology and therapeutic strategies of oxygenation disorders, little new knowledge regarding oxygen targets has emerged from this pandemic. Thus, the previously recommended oxygen target values remain unchanged.

20.
Ann Med Surg (Lond) ; 76: 103439, 2022 Apr.
Article in English | MEDLINE | ID: covidwho-1797209

ABSTRACT

Introduction: Thin-section chest computed tomography is an important diagnostic test and utilized to determine the severity of lung involvement in COVID-19 pneumonia. The goal of this study is to examine the relationship between CT severity and the oxygen saturation level of individuals with COVID-19. Method: This is a single-center retrospective study of COVID-19 patients that were admitted at a COVID-19 hospital. Patients confirming COVID-19 with PCR testing, patients undergoing lung CT-scan and measures of capillary oxygen saturation using pulse oximetry at the time of admission were all included. Result: The total number of the cases were 105. The age was classified into four age groups, with the majority of them falling into the fourth to sixth decade of life (42, 40%). Diabetes was the most common comorbidity disease (29, 27.6%). Pulse oximetry showed hypoxemia in 87 (82.9%) cases. The most common CT finding was ground glass opacities (GGO) (45, 42.9%). The data showed a significant positive correlation between oxygen saturation and CT severity in patients infected with covid-19. Conclusion: These findings support the importance of using pulse oximetry to monitor COVID-19 patients in order to evaluate or even estimate their clinical situations.

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