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1.
Current Tropical Medicine Reports ; 9(1), 2022.
Article in English | EMBASE | ID: covidwho-1821070

ABSTRACT

Purpose of Review: Cryptococcosis of the central nervous system due to Cryptococcus gattii species complex is a serious mycosis with worldwide distribution but of great importance in the tropics. This article aims to review the progress made in these regions in the knowledge of this disease and its etiological agent. Recent Findings: They can be summarized in the presence in apparently immunocompetent patients of autoantibodies against granulocyte-macrophage colony-stimulating factor (GM-CSF), which is a hidden risk factor for acquiring C. gattii infection;this finding strengthens the concept that C. gattii is an opportunistic pathogen. A greater knowledge of the clinical and molecular epidemiology of C. gattii infection and of the different environmental niches of this fungus in the tropics. The discovery of a new lineage of C. gattii, VGV, in environmental samples from Africa. Until now, the COVID-19 pandemic has not meant an increase in cryptococcosis cases. Summary: Advances have been made in the identification of risk factors for cryptococcosis due to C. gattii as well as in the knowledge of its etiological agent and its relationship with the environment. Remarkably, there have been no significant achievements in diagnosis and treatment notwithstanding the documented importance.

2.
Klinicka Biochemie a Metabolismus ; 29(3):151-155, 2021.
Article in English | EMBASE | ID: covidwho-1820639

ABSTRACT

Objectives: The aim of this study was to verify whether the RT-LAMP assay for SARS-CoV-2 determination can replace the RT-PCR assay. Design: Methodological study. Settings: Institute of Laboratory Medicine, Department of Clinical Biochemistry, University Hospital Ostrava. Material and methods: The study included 1018 samples of anonymized patients. Viral RNA isolation was performed using the Automated RNA Isolation Kit using an Agilent Bravo pipetting station. The isolated RNA samples were used to detect the virus by RT-PCR using the COVID-19 Multiplex RT-PCR Kit and reverse transcription and loop-mediated isothermal amplification (RT LAMP) using the AUMED test RT-LAMP Assay SARS-CoV-2. Results: 32.1 % of positive samples and 67.9 % of negative samples were detected by the RT-PCR method. In addition, 27.9 % of positive samples and 72.1 % of negative samples were detected by RT-LAMP method. Of the 327 positive samples identified by RT PCR, 247 samples were true positive, but 80 samples were false negative. It follows that the discrepancy of both tested methods was found to be 11.6 %. The RT-LAMP assay showed 94.50% specificity and 75.54% sensitivity. There was a substantial agreement between the two testing methods (k = 0.725). Conclusions: The tested RT-LAMP method, unlike RT-PCR, is not suitable for SARS-CoV-2 determination under current conditions.

3.
International Journal of Physiology, Pathophysiology and Pharmacology ; 14(1):48-54, 2022.
Article in English | EMBASE | ID: covidwho-1820561

ABSTRACT

Background: Reverse transcription-polymerase chain reaction (RT-PCR) is a standard technique for diagnosing coronavirus disease 2019 (COVID-19). The parameters for the diagnosis of COVID-19 included the his-tory of exposure to positive COVID-19 patients, clinical signs and symptoms related to the disease, inflammation factors in the blood test or positive antigen-antibody test, and chest computed tomography (CT) findings. The current study evaluated the chest CT scan findings in patients with respiratory problems following positive RT-PCR of COVID 19. Materials and methods: This cross-sectional study was performed on 120 patients referred to Ali Ibn-Abi Talib Hospital in Rafsanjan, Kerman Province, Iran, with respiratory symptoms between Dec-2019 to Dec-2020. Two radiologists reviewed the chest CT scans of these patients using the checklist that included parameters such as the types of involvement (consolidation/grand-glass/crazy paving, etc.) and the patterns of involvement (central/periph-eral), and the pleural findings. Results: The CT scan was conducted in 107 patients with a typical condition and 11 patients with an atypical form of the disease. The frequency of the typical CT image of COVID-19 in the male group was significantly higher than that in the female group (P=0.004). The frequency of reverse halo sign, septal thicken-ing, cardiomegaly, and crazy paving was significantly higher in males than in females (P≤0.05). Also, there was a significant difference between age groups based on the number of involved lobes (P=0.04). Conclusion: Chest CT scan is an important diagnostic method for COVID 19 with high sensitivity. The parameters in the CT scan are beneficial for the diagnosis of COVID 19. In addition, some characters in CT scans in the male gender are more specific.

4.
Dubai Medical Journal ; : 7, 2022.
Article in English | Web of Science | ID: covidwho-1819946

ABSTRACT

Introduction: There is conflicting data about the rate of fever at admission and during hospitalization in COVID-19 pneumonia. We analyzed the rate of fever in our patients to find the diagnostic value of fever and to predict PCR status in COVID-19. Methods: It was a retrospective cross-sectional study conducted in the Health Sciences University Dr. Suat Seren Chest Diseases and Chest Surgery Training and Research Hospital, which was a tertiary chest diseases pandemic hospital in Izmir. We included 389 patients hospitalized for COVID-19 and analyzed them according to PCR status and presence of fever. Fever was defined as temperature over 38 degrees C. Results: Thirty-eight percentage of our patients complained of fever before admission. However, when they were admitted, only 13.6% of them had objective high fever. 26.5% had high fever during hospital stay. PCR-positive patients had less comorbidity. More of PCR-positive patients had fever in the course of hospitalization and their length of hospital stay was longer and mortality was higher. Although we expected to find a high sensitivity, the sensitivity of high fever in our settings was low. Sensitivity, specificity, positive, and negative predictive values of high fever at admission in predicting the positivity of the PCR test were 16.9%, 90.6%, 69.8%, and 45.8%, respectively. Sensitivity, specificity, positive, and negative predictive values of high fever during hospitalization to predict the positivity of PCR test were 36.1%, 85.9%, 76.7%, and 51.0%, respectively. Conclusion: 13.6% of our COVID-19 patients had objective high fever at admission. 26.5% had high fever during hospital stay. PCR-positive patients had less comorbidity. More PCR-positive patients had fever in the course of hospitalization and their length of hospital stay was longer and mortality was higher. Although we expected to find a high sensitivity, the sensitivity of high fever in our settings was lower than expected. Temperatures <38 degrees C at admission and during hospitalization determine 90.6% and 85.9% of the PCR-negative patients, respectively. These high specificity values imply that if the PCR test is negative, the patient's temperature is more likely to be lower than 38 degrees C.

5.
Pakistan Journal of Medical and Health Sciences ; 16(3):289-291, 2022.
Article in English | EMBASE | ID: covidwho-1819182

ABSTRACT

Introduction: Corona virus disease 2019 (COVID-19) is currently diagnosed mainly using reverse transcriptase polymerase chain reaction (RT-PCR). Yet a significant proportion of patients have negative RT-PCR result. A comparative study of RT-PCR negative patients with RT-PCR positive patients will help understand clinical characteristic and differences of this diseased population. Objective: To compare the clinical and laboratory features of RT-PCR Positive and RT-PCR negative patients admitted in high dependency unit. Patients and methods: In this retrospective cohort study, the data of 128 patients (59 patients with RT-PCR positive result and 69 patients with RT-PCR negative results) was obtained. These patients had been admitted in high dependency unit of a community hospital. Demographics, clinical characteristics and laboratory abnormalities were noted and a comparison was done using statistical analysis. Results: In our study-total 128 patients were enrolled out of which 68 (53.1%) were males and 60 (46.9%) were females. 59 (46.1%) patients were RT-PCR positive and 69 (53.9%) patients were RT-PCR negative. Median age was 55.34 years (18 to 95). No significant difference was noted in most of clinical symptoms (fever, sputum production, rhinorrhea, dyspnea, myalgia, nasal congestion, vomiting, diarrhea, urinary symptoms, altered level of consciousness), comorbidities (diabetes mellitus, hypertension, prior lung disease, prior ischemic heart disease, prior kidney disease), laboratory abnormalities (elevated creatinine, elevated liver enzymes, elevated ferritin, elevated C-reactive protein, elevated d-dimers, elevated procalcitonin, abnormal electrocardiogram). Cough was significantly found to be more prevalent in RT-PCR positive patients (p=0.042) and severe disease was also more prevalent in these patients significantly (p=0.000). Conclusion: Our study shows that patients admitted and diagnosed to be suffering from COVID-19 infection had remarkable similarities in clinical features and laboratory parameters regardless of RT-PCR status, however RT-PCR positive patients suffered from more severe pneumonia as compared to RT-PCR negative patients.

6.
Klimik Dergisi ; 35(1):14-20, 2022.
Article in Turkish | CAB Abstracts | ID: covidwho-1819127

ABSTRACT

Objective: The study aims to contribute to the literature by sharing the treatment process and results of patients who develop pneumothorax, pneumomediastinum, and subcutaneous emphysema, which are rarely seen in COVID-19 pneumonia, and to reveal the possible high mortality situation.

7.
Klimik Dergisi ; 35(1):54-57, 2022.
Article in Turkish | GIM | ID: covidwho-1819126

ABSTRACT

Although PCR is the most reliable test for the diagnosis of Covid-19 infection, false negative and positive results can also occur. Our case is a 32-year-old laboratory technician who applied with headache and malaise and her first Covid-19 PCR test was negative. It was repeated two days later, and the result was positive. Additional tests were also performed, and Parvovirus IgM antibody was also found to be positive. Four weeks later, while Covid-19 IgM and IgG test results were negative, the Parvovirus B19 IgG and IgM test results were positive. The Covid-19 PCR test was evaluated as false positive. We aimed to emphasize the need to consider other viral infections in the differential diagnosis even under pandemic conditions.

8.
Investigacion Clinica ; 62(Suplemento 2):43-57, 2021.
Article in Spanish | CAB Abstracts | ID: covidwho-1818975

ABSTRACT

In December 2019, the coronavirus disease COVID-19 began in China. Since then, millions of infections and deaths from this cause have been reported worldwide, particularly among health workers who have suffered the harsh onslaught of the pandemic in the context of healthcare systems collapsed by demand. In this sense, the objective of this work was to determine the prevalence, sociodemographic, epidemiological, and clinical characteristics of COVID-19 present in health workers of the "Instituto Aut..nomo Hospital Universitario de Los Andes" in M..rida-Venezuela. An observational, retrospective, single-center, documentary study was carried out, where 297 clinical-epidemiological records corresponding to 285 health workers were analyzed, in a period between March 16 and November 30, 2020. The records were separated into two groups, front-line workers and support workers. The overall positivity of the RT-PCRs performed was 31.6%. The frequency of positive confirmatory results was highest among support workers at 33.9%. Nursing staff had the highest positivity (39.5%). A seroprevalence of 34.3% was found in immunological tests. The prevalence of SARS-CoV-2 infection among health care workers was higher among support workers compared to front-line workers. Therefore, general and work-specific prevention strategies should be strengthened to limit the spread of SARS-CoV-2 among staff to ensure that they perform safely and effectively.

9.
Acta Veterinaria et Zootechnica Sinica ; 53(4):1310-1316, 2022.
Article in Chinese | EMBASE | ID: covidwho-1818722

ABSTRACT

Nebovirus (NeV) is an emerge diarrhea-causing virus in calves, the aim of this study is to establish an insulated isothermal RT-PCR(iiRT-PCR) for detecting NeV on field. Based on the RdRp sequences of NeV in GenBank database, a pair of primers and a fluorescent TaqMan probe were designed and synthesized. After optimizing the react system and condition, the iiRT-PCR method for detection of NeV was established. The iiRT-PCR assay could amplify specific fragment of NeV, without amplification of irrelevant pathogens, including bovine coronavirus, bovine norovirus, bovine rotavirus, bovine viral diarrhea virus, bovine torovirus, bovine Cryptosporidium parvum, bovine Eimeria. The intra- and inter-coefficients of variation were 3.07%-3.12% and 2.45%-3.01%, respectively, and the detection limit of viral nucleic acid of the assay was 5.38 copies•μL-1. One hundred and one calf diarrhea samples, collected from Hongyuan County, Ruoergai Prefecture, Xichang City, Liangshan Yi Autonomous Prefecture and Langzhong City in Sichuan Province during 2020-2021, were used to detect NeV, and 64.36% samples were detected as NeV positive. The study established an iiRT-PCR method for NeV detection with good specificity and reproducible as well as high sensitivity. Moreover, combined with the premixed detection reagent and PetNAD nucleic acid extraction kit, this assay could be used to NeV detect on-site, and only 1 hour from nucleic acid extraction to result report, which contribute to the fast detection for NeV.

10.
Journal of Clinical and Diagnostic Research ; 16(4):DC01-DC05, 2022.
Article in English | EMBASE | ID: covidwho-1818679

ABSTRACT

Introduction: Ever since the Coronavirus Disease 2019 (COVID-19) pandemic hit, there have been constant efforts to develop rapid, sensitive and specific diagnostic methods to detect the virus in order to curb the further spread of the disease. There is an array of tests available for the detection of Severe Acute Respiratory Syndrome Coronavirus-2 (SARS-CoV-2). Time being a very crucial factor, Rapid Antigen Testing (RAT) is very helpful in detecting the virus. Aim: To discuss the importance of rapid testing among symptomatic and asymptomatic cases in different age groups and gender with association to infection. Materials and Methods: This retrospective study was conducted in Department of Microbiology, Autonomous State Medical College and SNM Hospital, Firozabad, Uttar Pradesh, India, from April 2020-August 2021. A total of 16,258 samples were collected from symptomatic patients having Influenza Like Illness (ILI), Severe Acute Respiratory Illness (SARI), those seeking hospitalisation, contacts (symptomatic and asymptomatic) and travellers were subjected to antigen detection by the Standard Q COVID-19 antigen kit following proper precautions. The cases were divided into Group A of patients who presented with symptoms ≤7 days, Group B of patients who presented with signs and symptoms >7 days and group C comprised of asymptomatic patients. The Chi-square test was done to test the statistical significance of association of symptomatic patients with outcome of the antigen test. Results: Of the total 16,258 samples tested, the maximum number of positive cases were found in the age group 30-39 years (p-value <0.05) followed by 20-29 years. The least number of positive cases (six) was found in the higher (90 years) and lower (below 9 years) age groups. No significant impact was found on the positivity rates on the basis of gender. The percentage positivity as detected by rapid antigen was 2% and maximum patients were found in the group having symptoms <7 days (p<0.05). Conclusion: Rapid Antigen Detection Test (RADT) for SARS-CoV-2 is a simple, portable, fast and easy to perform test. It could be easily used in rural areas as it does not require special laboratory set up. It could be used for mass testing and helped as a good epidemiological tool. However, few symptomatic cases which could not be detected by rapid testing had to be cross checked with Real Time-Reverse Transcriptase Polymerase Chain Reaction (RT-PCR). Thus, when used in conjunction with molecular methods, the sensitivity of the test increased.

11.
Flora ; 26(4):620-627, 2021.
Article in English | EMBASE | ID: covidwho-1818591

ABSTRACT

Introduction: Many studies have shown the advantages of monitoring wastewater in the evaluation of microbiological pathogens circulating in the community. It was aimed to detect of SARS-CoV-2 RNA with a simple concentration method in wastewater in this study. Materials and Methods: In our study, 7 wastewater samples were investigated, which were collected from the Urban Wastewater Treatment Plant (WWTP) of Çorum, between October to November 2020. Sorbent bags were left in water for 24 hours. Then they were used to trap and concentrate the virus. Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) RNA detected by using reverse transcription-quantitative polymerase chain reaction (RT-qPCR) assays. Results: As a result, 3 of the 7 samples taken were positive for N and ORF1ab target gene regions. Conclusion: This is the first study reporting the detection of SARS-CoV-2 RNA in wastewater with different concentration and capture method.

12.
Archivos Venezolanos de Farmacologia y Terapeutica ; 41(1):8-12, 2022.
Article in Spanish | EMBASE | ID: covidwho-1818550

ABSTRACT

COVID-19 is an infectious disease caused by the SARS-CoV-2 virus that was first identified in December 2019 in the city of Wuhan, Hubei province in the People’s Republic of China, the virus is transmitted from one person to another in the respiratory secretions that are dispersed when the infected person coughs, speaks or sneezes. With 10.93 deaths per million people from coronavirus as of April 6, 2020, Ecuador has one of the highest mortality rates from COVID-19 in Latin America, with only 7.46 Polymerase Chain Reaction tests. (RT-PCR) per 10,000 people. Pediatric cases were rare in the first days of the COVID-19 outbreak, but with the appearance of family aggregation, they began to appear, registering the first cases on March 27th. The pediatric group is always susceptible to upper respiratory tract infections because their immune system is developing. This report describes the epi-demiological situation of pediatric patients in Ecuador, where it was shown that adolescents aged 15 to 18 years were more susceptible to contracting COVID-19 and the group with the highest mortality was from 0 to 9 years old, it was also shown that of the total diagnostic tests performed, 63.6% were RT-PCR tests and 36.3% were rapid tests.

13.
Vaccines ; 10(3), 2022.
Article in English | EMBASE | ID: covidwho-1818217

ABSTRACT

(1) Background: Booster vaccinations for SARS-CoV-2 convalescents are essential for achieving herd immunity. For the first time, this study examined the influencing factors of vaccination willingness among SARS-CoV-2 infected individuals and identified vaccination-hesitant subgroups. (2) Methods: Individuals with positive SARS-CoV-2 PCR results were recruited by telephone. They completed an online questionnaire during their home isolation in Germany. This questionnaire assessed the vaccination willingness and its influencing factors. (3) Results: 224 home-isolated individuals with acute SARS-CoV-2 infection were included in the study. Vaccination willingness of home-isolated SARS-CoV-2 infected individuals with asymptomatic or moderate course was 54%. The following factors were associated with significantly lower vaccination willingness: younger age, foreign nationality, low income, low trust in vaccination effectiveness, fear of negative vaccination effects, low trust in the governmental pandemic management, low subjective informativeness about SARS-CoV-2, support of conspiracy theories. (4) Conclusions: The vaccination willingness of home-isolated SARS-CoV-2 infected individuals with asymptomatic or moderate symptomatic course was low. Motivational vaccination campaigns should be adapted to individuals with acute SARS-CoV-2 infection and consider the vaccination-hesitant groups. Vaccination education should be demand-driven, low-threshold, begin during the acute infection phase, and be guided for example by the established 5C model (“confidence, complacency, constraints, calculation, collective responsibility”).

14.
Cardiogenetics ; 12(2):133-141, 2022.
Article in English | EMBASE | ID: covidwho-1818054

ABSTRACT

Eosinophilic pancarditis (EP) is a rare, often unrecognized condition caused by endomyocardial infiltration of eosinophil granulocytes (referred as eosinophilic myocarditis, EM) associated with pericardial involvement. EM has a variable clinical presentation, ranging from asymptomatic cases to acute cardiogenic shock requiring mechanical circulatory support (MCS) or chronic restrictive cardiomyopathy at high risk of progression to dilated cardiomyopathy (DCM). EP is associated with high in‐hospital mortality, particularly when associated to endomyocardial thrombosis, coronary arteries vasculitis or severe left ventricular systolic dysfunction. To date, there is a lack of consensus about the optimal diagnostic algorithm and clinical management of patients with biopsy‐proven EP. The differential diagnosis includes hypersensitivity myocarditis, eosinophil granulomatosis with polyangiitis (EGPA), hypereosinophilic syndrome, parasitic infections, pregnancy‐related hypereosinophilia, malignancies, drug overdose (particularly clozapine) and Omenn syndrome (OMIM 603554). To our knowledge, we report the first case of pancarditis associated to eosinophilic granulomatosis with polyangiitis (EGPA) with negative anti‐neutrophil cytoplasmic antibodies (ANCA). Treatment with steroids and azathioprine was promptly started. Six months later, the patient developed a relapse: treatment with subcutaneous mepolizumab was added on the top of standard therapy, with prompt disease activity remission. This case highlights the role of a multimodality approach for the diagnosis of cardiac involvement associated to systemic immune disorders.

15.
Frontiers in Pediatrics ; 9, 2021.
Article in English | EMBASE | ID: covidwho-1817994

ABSTRACT

Objective: We sought to compare the clinical characteristics of pediatric respiratory tract infection and respiratory pathogen isolations during the coronavirus disease (COVID-19) pandemic to those of cases in 2018 and 2019. Methods: Our study included all children from 28 days to 15 years old with respiratory tract infections who were admitted to the Department of Respiration, in the Children's Hospital of Soochow University, between January 2018 and December 2020. Human rhinovirus (HRV) and human metapneumovirus (hMPV) were detected by reverse transcription polymerase chain reaction (RT-PCR). Mycoplasma pneumoniae (MP) and human bocavirus (HBoV) were detected by real-time fluorescence quantitative polymerase chain reaction (qPCR);In parallel, Mycoplasma pneumoniae was detected by enzyme-linked immunosorbent assays, and bacteria were detected by culture in blood, bronchoalveolar lavage specimen, and pleural fluid. Results: Compared to 2018 and 2019, the pathogen detection rate was significantly lower in 2020. With regard to infections caused by single pathogens, in 2020, the detection rates of MP were the lowest and those of HRV were the highest when compared to those in 2018 and 2019. Meanwhile, the positive rates of respiratory syncytial virus (RSV) and hMPV reported in 2020 were less than those recorded in 2018 but similar to those recorded in 2019. Also, the 2020 rate of adenovirus (ADV) was lower than that recorded in 2019, but similar to that recorded in 2018. There were no statistical differences in the positive rates of HBoV and PIV III over the 3 years surveyed. Infections in infants were significantly less common in 2020, but no significant difference was found among children aged 1 to 3 years. The detection rate of pathogens in children old than 5 years in 2020 was significantly lower than those recorded in the previous 2 years. Notably, the pathogen detection rates in the first and second quarters of 2020 were similar to those recorded in the previous 2 years;however, the rates were reduced in the third and fourth quarters of 2020. As for co-infections, the positive rate was at its lowest in 2020. In the previous 2 years, viral–MP was the most common type of mixed infection. By contrast, in 2020, viral–viral infections were the most common combination. Conclusion: The pathogen detection rate was significantly reduced in Suzhou City during the COVID-19 pandemic. Public interventions may help to prevent respiratory pathogen infections in children.

16.
Frontiers in Medicine ; 9, 2022.
Article in English | EMBASE | ID: covidwho-1817974

ABSTRACT

Background: Severe COVID-19 pneumonia requiring intensive care treatment remains a clinical challenge to date. Dexamethasone was reported as a promising treatment option, leading to a reduction of mortality rates in severe COVID-19 disease. However, the effect of dexamethasone treatment on cardiac injury and pulmonary embolism remains largely elusive. Methods: In total 178 critically ill COVID-19 patients requiring intensive care treatment and mechanical ventilation were recruited in three European medical centres and included in the present retrospective study. One hundred thirteen patients (63.5%) were treated with dexamethasone for a median duration of 10 days (IQR 9–10). Sixty five patients (36.5%) constituted the non-dexamethasone control group. Results: While peak inflammatory markers were reduced by dexamethasone treatment, the therapy also led to a significant reduction in peak troponin levels (231 vs. 700% indicated as relative to cut off value, p = 0.001). Similar, dexamethasone resulted in significantly decreased peak D-Dimer levels (2.16 mg/l vs. 6.14 mg/l, p = 0.002) reflected by a significant reduction in pulmonary embolism rate (4.4 vs. 20.0%, p = 0.001). The antithrombotic effect of dexamethasone treatment was also evident in the presence of therapeutic anticoagulation (pulmonary embolism rate: 6 vs. 34.4%, p < 0.001). Of note, no significant changes in baseline characteristics were observed between the dexamethasone and non-dexamethasone group. Conclusion: In severe COVID-19, anti-inflammatory effects of dexamethasone treatment seem to be associated with a significant reduction in myocardial injury. Similar, a significant decrease in pulmonary embolism, independent of anticoagulation, was evident, emphasizing the beneficial effect of dexamethasone treatment in severe COVID-19.

17.
Asian Journal of Medical and Biological Research ; 8(1):16-23, 2022.
Article in English | CAB Abstracts | ID: covidwho-1817917

ABSTRACT

The severity of Coronavirus disease-2019 (COVID-19) varies among individuals and some influential factors leads to critical infections and death. This study aimed to assess various clinical data of hospitalized patients and identify the determinants of critical COVID-19 infection. This was a cross-sectional study among hospitalized COVID-19 patients confirmed by reverse transcription polymerase chain reaction (RT-PCR). Data was collected from a single Centre between January to April 2021 by experienced physicians of Ad-din Medical College Hospital. All of the laboratory tests were performed by technical experts and the data was analyzed by Statistical package for the social sciences software. Among the study participants 25% were Intensive care unit (ICU) patients and the mean age of them were higher (59 years) than non-ICU (55 years) patients. Our analysis has identified diabetes mellitus (AOR=2.5, 95%CI: 1.1-5.4) and ischemic heart disease (AOR=3.1, 95%CI: 1.1-8.9) as significant predictor of critical outcome (ICU admission). Anemia (AOR=3.3, 95%CI: 1.5-7.4), lymphopenia (AOR=2.9, 95%CI: 1.2-7.1), and thrombocytopenia (AOR=4.2, 95%CI: 2.7-12.9) was also associated critical outcome. Biomarkers of kidney injury (creatinine, blood urea nitrogen), liver damage (alanine transaminase, aspartate aminotransferase, fibrinogen) and electrolyte imbalance (sodium and potassium level) were also significantly associated with critical infection. A higher d-dimer level (2.5) was the most important predictor (AOR=11.5, 95%CI: 5.4-24.6) of critical COVID 19 infections. The study has revealed socio-demographic, comorbidity, and radiological risk factors of critical COVID-19 infections. The identified risk factors would be considered for decision making during the treatment process.

18.
Egyptian Journal of Radiology and Nuclear Medicine ; 53(1), 2022.
Article in English | EMBASE | ID: covidwho-1817311

ABSTRACT

Background: Coronavirus disease 2019 (COVID-19) caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), which was declared a pandemic by the World Health Organization on 11 March 2020 has been reported in most countries around the world since its origins in Wuhan, China. As of September 2021, there have been over 229 million cases of COVID-19 reported worldwide, with over 4.7 million COVID-19–associated deaths. Body: The devastating second wave of the COVID-19 pandemic in India has seen a rise in various extrapulmonary manifestations. One of key components in the pathogenesis of COVID-19 is downregulation of ACE-2, which is expressed on many organs and counterbalances the pro-inflammatory effects of ACE/angiotensin-II axis. This leads to influx of inflammatory cells into alveoli, increased vascular permeability and activation of prothrombotic mediators. Imaging findings such as ground glass opacities, interlobular septal thickening, vascular dilatation and pulmonary thrombosis correlate well with the pathogenesis. Conclusion: We hypothesize that the systemic complications of COVID-19 are caused by either direct viral invasion or effect of cytokine storm leading to inflammation and thrombosis or a combination of both. Gaining insights into pathobiology of SARS-CoV-2 will help understanding the various multisystemic manifestations of COVID-19. To date, only a few articles have been published that comprehensively describe the pathophysiology of COVID-19 along with its various multisystemic imaging manifestations.

19.
Blood Purification ; 50(SUPPL 1):4, 2021.
Article in English | EMBASE | ID: covidwho-1816953

ABSTRACT

Background: Approximately 5 to 10% of patients with AKI require RRT during their stay in the intensive care unit (ICU). The mortality ranges from 30 to 70% so we consider it as high. A common factor that these patients present is hemodynamic instability. Continuous renal replacement therapy (CRRT) has provided physicians with a versatile tool for the care of critically ill patients with hemodynamic instability with indications for RRT such as acid-base disorders, fluid and electrolyte abnormalities, uremia, and / or fluid overload. The CRRT presents different modalities for its application and allows the use of different membranes and cartridges, which is why it is frequently used in patients with multiple organ failure and sepsis with different indication, based upon De basal disease and the need for extracorporeal support. The pathophysiological understanding of this last entity has generated new strategies as a measure for the decrease of inflammatory cytosines. For these reasons, the TRRC has earned a place in the ICU during the SARS-CoV-2 pandemic. Currently, a mortality of 50% is described in the patient with critical Covid-19 and a decrease in it has been reported when they undergo CRRT with the use of the oXiris® membrane. Therefore, the following study was carried out to describe our experience with the oXiris® membrane in patients with Covid-19 in the ICU of a tertiary hospital in northeast Mexico. Methods: Observational, retrospective, and analytical study. Thirteen patients older than 18 years hospitalized in the ICU with a diagnosis of Covid-19 by real-time PCR test were included, who required CRRT with the oXiris® filter between January 2020 and August 2021. Sociodemographic data, number of days total hospital stay (EIH) and ICU;duration and specifications of the TRRC, and its outcome. Results: 13 patients were included, of which 10 were men (76.9%). The mean age was 59.4 ± 12.9 years. The most frequent comorbidities were arterial hypertension (53.8%) and type 2 diabetes mellitus (38.4%);in 7 and 5 patients, respectively. The mean EIH was 60.3 ± 44.9 and 45.8 ± 30 days in the ICU. The median duration of the days with CRRT was 8 (3-11). The main indication for the initiation of CRRT was anuria (61.5%), followed by fluid overload (23%) and uremia (15.4%). Of the total population, 4 (30.7%) recovered kidney function, 5 (38.4%) were discharged with intermittent hemodialysis, and 8 (61.5%) died. In the first 48 hours of the initiation of CRRT with oXiris® the vasopressor requirements decreases besides the creatinine and urea. Conclusions: Despite the use of the oXiris® filter in the patient with critical covid-19, mortality exceeds 50%, even if there is a good response in hemodynamical improvement at the begging of the therapy. We consider that this outcome is dependent on multiple comorbidities and clinical situations not included, so its application should continue to be investigated.

20.
Clinical Cancer Research ; 27(6 SUPPL 1), 2021.
Article in English | EMBASE | ID: covidwho-1816940

ABSTRACT

Background: The COVID-19 pandemic had enormous consequences in Brazil and worldwide. Patients with cancer affected by COVID-19 are at a higher risk of developing complications and worse outcomes compared to a non-cancer population, particularly the ones on active systemic treatment. Considering the COVID-19 high transmissibility in asymptomatic and presymptomatic patients, we sought to determine the prevalence of COVID-19 infection in patients with solid cancers receiving systemic therapy in a Brazilian public health hospital. Furthermore, we interrogated if socioeconomic status (SES) was associated with prevalence. Methods: Consecutive asymptomatic patients undergoing treatment for solid tumors at the chemotherapy and infusion center of Hospital de Base were enrolled. Patients were prospectively tested for SARS-CoV2 RNA real-time polymerase chain reaction with nasal and oropharyngeal swabs immediately prior to treatment. A socioeconomic survey was performed prior to testing. Demographic and socioeconomic characteristics were summarized in means, medians, and proportions. Results: From October 6 to 13, 2020, 148 asymptomatic patients were identified. Of those, 41 were excluded (16 had hematological malignancies, 15 declined testing, 10 were not on active systemic treatment) leaving 107 eligible patients. The mean age of the population was 58 years-old (SD± 12.6);55% were female and 90% were self-identified as White. The most common cancer sites were gastrointestinal tract (37%) and breast (25%). Most patients had metastatic disease (62.9%) and were on a anticancer treatment involving chemotherapy (62.9%). Regarding to SES, 70% of our population had either primary school or were illiterate as their highest educational level. In terms of monthly income, 88% had a personal income inferior to U$390 and 92% a household income inferior to U$585. Of 107 patients tested, only one (0.9%) was positive for COVID-19. This is a 48 years-old man living in an urban area, with primary school educational level and a monthly personal income inferior to U$390. Conclusion: Despite a high prevalence of COVID19 in Brazil, our cohort demonstrated a low prevalence of COVID19 (0.9%) amongst asymptomatic patients with cancer. We hypothesize that patients with cancer, independently of their SES, are aware of the increased risk of developing severe disease and are adherent to physical distancing, masking, and hygiene measures. LF and BB are co-senior authors.

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