Your browser doesn't support javascript.
Show: 20 | 50 | 100
Results 1 - 8 de 8
Filter
1.
J Clin Neurosci ; 89: 271-278, 2021 Jul.
Article in English | MEDLINE | ID: covidwho-1213386

ABSTRACT

Coronavirus Disease 19 (COVID-19) pandemic affects the worldwide healthcare system and our understanding of this disease grows rapidly. Although COVID-19 is a mainly respiratory disease, neurological manifestations are not uncommon. The aim of this review is to report on the etiology, clinical profile, location, and outcome of patients with intracerebral hemorrhage (ICH) and COVID-19. This review includes 36 studies examining ICH in the clinical presentation of COVID-19. Overall, 217 cases with intracranial hemorrhage, of which 188 ICHs, were reported. Generally, a low incidence of both primary and secondary ICH was found in 8 studies [106 (0.25%) out of 43,137 hospitalized patients with COVID-19]. Available data showed a median age of 58 years (range: 52-68) and male sex 64%, regarding 36 and 102 patients respectively. Furthermore, 75% of the patients were on prior anticoagulation treatment, 52% had a history of arterial hypertension, and 61% were admitted in intensive care unit. Location of ICH in deep structures/basal ganglia was ascertained in only 7 cases making arterial hypertension an improbable etiopathogenetic mechanism. Mortality was calculated at 52.7%. Disease related pathophysiologic mechanisms support the hypothesis that SARS-CoV2 can cause ICH, however typical ICH risk factors such as anticoagulation treatment, or admission to ICU should also be considered as probable causes. Physicians should strongly suspect the possibility of ICH in individuals with severe COVID-19 admitted to ICU and treated with anticoagulants. It is not clear whether ICH is related directly to COVID-19 or reflects expected comorbidity and/or complications observed in severely ill patients.


Subject(s)
COVID-19/diagnostic imaging , COVID-19/epidemiology , Cerebral Hemorrhage/diagnostic imaging , Cerebral Hemorrhage/epidemiology , Adult , Aged , Anticoagulants/pharmacology , Anticoagulants/therapeutic use , Blood Coagulation/drug effects , Blood Coagulation/physiology , COVID-19/drug therapy , Cerebral Hemorrhage/drug therapy , Hospitalization/trends , Humans , Hypertension/diagnostic imaging , Hypertension/drug therapy , Hypertension/epidemiology , Intensive Care Units/trends , Male , Middle Aged , Pandemics , Risk Factors , SARS-CoV-2
2.
J Med Virol ; 92(10): 2055-2066, 2020 10.
Article in English | MEDLINE | ID: covidwho-969528

ABSTRACT

Clinical and laboratory data on patients with coronavirus disease 2019 (COVID-19) in Beijing, China, remain extremely limited. In this study, we summarized the clinical characteristics of patients with COVID-19 from a designated hospital in Beijing. In total, 55 patients with laboratory-confirmed SARS-CoV-2 infection in Beijing 302 Hospital were enrolled in this study. Demographic data, symptoms, comorbidities, laboratory values, treatments, and clinical outcomes were all collected and retrospectively analyzed. A total of 15 (27.3%) patients had severe symptoms, the mean age was 44.0 years (interquartile range [IQR], 34.0-56.0), and the median incubation period was 7.5 days (IQR, 5.0-11.8). A total of 26 (47.3%) patients had exposure history in Wuhan of less than 2 weeks, whereas 20 (36.4%) patients were associated with familial clusters. Also, eighteen (32.7%) patients had underlying comorbidities including hypertension. The most common symptom of illness was fever (45; 81.8%); 51 (92.7%) patients had abnormal findings on chest computed tomography. Laboratory findings showed that neutrophil count, percentage of lymphocyte, percentage of eosinophil, eosinophil count, erythrocyte sedimentation rate, albumin, and serum ferritin are potential risk factors for patients with a poor prognosis. A total of 26 patients (47.3%) were still hospitalized, whereas 29 (52.7%) patients had been discharged. Compared with patients in Wuhan, China, the symptoms of patients in Beijing are relatively mild. Older age, more comorbidities, and more abnormal prominent laboratory markers were associated with a severe condition. On the basis of antiviral drugs, it is observed that antibiotics treatment, appropriate dosage of corticosteroid, and gamma globulin therapy significantly improve patients' outcomes. Early identification and timely medical treatment are important to reduce the severity of patients with COVID-19.


Subject(s)
COVID-19/physiopathology , Coronary Disease/physiopathology , Diabetes Mellitus/physiopathology , Hypertension/physiopathology , Kidney Failure, Chronic/physiopathology , Adrenal Cortex Hormones/therapeutic use , Adult , Age Factors , Antiviral Agents/therapeutic use , COVID-19/diagnostic imaging , COVID-19/therapy , COVID-19/virology , China , Comorbidity , Coronary Disease/diagnostic imaging , Coronary Disease/therapy , Coronary Disease/virology , Diabetes Mellitus/diagnostic imaging , Diabetes Mellitus/therapy , Diabetes Mellitus/virology , Eosinophils/pathology , Eosinophils/virology , Female , Ferritins/blood , Fever/physiopathology , Hospitalization , Hospitals , Humans , Hypertension/diagnostic imaging , Hypertension/therapy , Hypertension/virology , Immunoglobulins, Intravenous/therapeutic use , Infectious Disease Incubation Period , Kidney Failure, Chronic/diagnostic imaging , Kidney Failure, Chronic/therapy , Kidney Failure, Chronic/virology , Leukocyte Count , Lymphocytes/pathology , Lymphocytes/virology , Male , Middle Aged , Neutrophils/pathology , Neutrophils/virology , Retrospective Studies , Risk Factors , SARS-CoV-2/drug effects , SARS-CoV-2/pathogenicity , Severity of Illness Index , Tomography, X-Ray Computed
3.
J Med Virol ; 92(10): 2181-2187, 2020 10.
Article in English | MEDLINE | ID: covidwho-935110

ABSTRACT

Coronavirus disease 2019 (COVID-19) caused by severe acute respiratory syndrome-coronavirus 2 (SARS-CoV-2) is spreading at a rapid pace, and the World Health Organization declared it as pandemic on 11 March 2020. Mycoplasma pneumoniae is an "atypical" bacterial pathogen commonly known to cause respiratory illness in humans. The coinfection from SARS-CoV-2 and mycoplasma pneumonia is rarely reported in the literature to the best of our knowledge. We present a study in which 6 of 350 patients confirmed with COVID-19 were also diagnosed with M. pneumoniae infection. In this study, we described the clinical characteristics of patients with coinfection. Common symptoms at the onset of illness included fever (six [100%] patients); five (83.3%) patients had a cough, shortness of breath, and fatigue. The other symptoms were myalgia (66.6%), gastrointestinal symptoms (33.3%-50%), and altered mental status (16.7%). The laboratory parameters include lymphopenia, elevated erythrocyte sedimentation rate, C-reactive protein, lactate dehydrogenase, interleukin-6, serum ferritin, and D-dimer in all six (100%) patients. The chest X-ray at presentation showed bilateral infiltrates in all the patients (100%). We also described electrocardiogram findings, complications, and treatment during hospitalization in detail. One patient died during the hospital course.


Subject(s)
COVID-19/physiopathology , Hypertension/physiopathology , Mycoplasma pneumoniae/pathogenicity , Pneumonia, Mycoplasma/physiopathology , SARS-CoV-2/pathogenicity , Adult , Anti-Bacterial Agents/therapeutic use , Antiviral Agents/therapeutic use , COVID-19/diagnostic imaging , COVID-19/mortality , COVID-19/therapy , Coinfection , Comorbidity , Cough/physiopathology , Dyspnea/physiopathology , Fatigue/physiopathology , Female , Fever/physiopathology , Humans , Hypertension/diagnostic imaging , Hypertension/mortality , Hypertension/therapy , Lymphocytes/pathology , Lymphocytes/virology , Male , Middle Aged , Myalgia/physiopathology , Mycoplasma pneumoniae/drug effects , Pneumonia, Mycoplasma/diagnostic imaging , Pneumonia, Mycoplasma/mortality , Pneumonia, Mycoplasma/therapy , Retrospective Studies , SARS-CoV-2/drug effects , Severity of Illness Index , Survival Analysis , Tomography, X-Ray Computed , Treatment Outcome
4.
Am J Trop Med Hyg ; 102(6): 1198-1202, 2020 06.
Article in English | MEDLINE | ID: covidwho-601183

ABSTRACT

Patients with novel coronavirus disease (COVID-19) typically present with bilateral multilobar ground-glass opacification with a peripheral distribution. The utility of point-of-care ultrasound has been suggested, but detailed descriptions of lung ultrasound findings are not available. We evaluated lung ultrasound findings in 10 patients admitted to the internal medicine ward with COVID-19. All of the patients had characteristic glass rockets with or without the Birolleau variant (white lung). Thick irregular pleural lines and confluent B lines were also present in all of the patients. Five of the 10 patients had small subpleural consolidations. Point-of-care lung ultrasound has multiple advantages, including lack of radiation exposure and repeatability. Also, lung ultrasound has been shown to be more sensitive than a chest radiograph in detecting alveolar-interstitial syndrome. The utilization of lung ultrasound may also reduce exposure of healthcare workers to severe acute respiratory syndrome-coronavirus-2 and may mitigate the shortage of personal protective equipment. Further studies are needed to evaluate the utility of lung ultrasound in the diagnosis and management of COVID-19.


Subject(s)
Asthma/diagnostic imaging , Betacoronavirus/pathogenicity , Coronavirus Infections/diagnostic imaging , Hypertension/diagnostic imaging , Lung/diagnostic imaging , Obesity/diagnostic imaging , Pneumonia, Viral/diagnostic imaging , Adult , Aged , Asthma/pathology , Asthma/therapy , Asthma/virology , Betacoronavirus/genetics , COVID-19 , Coronavirus Infections/pathology , Coronavirus Infections/therapy , Coronavirus Infections/virology , Female , Humans , Hypertension/pathology , Hypertension/therapy , Hypertension/virology , Lung/drug effects , Lung/pathology , Lung/virology , Male , Middle Aged , Obesity/pathology , Obesity/therapy , Obesity/virology , Oxygen/therapeutic use , Pandemics , Pneumonia, Viral/pathology , Pneumonia, Viral/therapy , Pneumonia, Viral/virology , Point-of-Care Systems , Retrospective Studies , Reverse Transcriptase Polymerase Chain Reaction , SARS-CoV-2 , Ultrasonography
5.
Am J Trop Med Hyg ; 102(6): 1205-1207, 2020 06.
Article in English | MEDLINE | ID: covidwho-602003

ABSTRACT

The initial cases of novel coronavirus disease-19 (COVID-19) in a country are of utmost importance given their impact on healthcare providers, the country's preparedness response, and the initial molding of the public perception toward this pandemic. In Bhutan, the index case was a 76-year-old immunocompromised man who had traveled from the United States and entered Bhutan as a tourist. He presented initially with vague gastrointerestinal symptoms and later a cough. His atypical presentation led to a delay in diagnosis, but ultimately he was isolated and tested. On confirming the diagnosis of COVID-19, the patient was isolated in a separate hospital with a dedicated medical care team. All contacts were traced and quarantined. The patient's respiratory status deteriorated despite broad-spectrum antivirals, antibiotics, and intensive supportive care. He required intubation and was given a trial of intravenous immunoglobulin to modulate his likely aberrant immune response. Subsequently, the patient's clinical status improved, and after 8 days of hospitalization, he was transferred out of the country, where he recovered. This was a learning experience for the treating medical staff, the government, and the people of Bhutan.


Subject(s)
Betacoronavirus/pathogenicity , Coronavirus Infections/diagnostic imaging , Hyperlipidemias/diagnostic imaging , Hypertension/diagnostic imaging , Lung/diagnostic imaging , Pneumonia, Viral/diagnostic imaging , Aged , Anti-Bacterial Agents/therapeutic use , Antiviral Agents/therapeutic use , Betacoronavirus/drug effects , Bhutan , COVID-19 , Contact Tracing , Coronavirus Infections/drug therapy , Coronavirus Infections/immunology , Coronavirus Infections/pathology , Humans , Hyperlipidemias/drug therapy , Hyperlipidemias/immunology , Hyperlipidemias/pathology , Hypertension/drug therapy , Hypertension/immunology , Hypertension/pathology , Immunocompromised Host , Immunoglobulins, Intravenous/therapeutic use , Lung/drug effects , Lung/pathology , Lung/virology , Male , Pandemics , Pneumonia, Viral/drug therapy , Pneumonia, Viral/immunology , Pneumonia, Viral/pathology , SARS-CoV-2 , Tomography, X-Ray Computed , Travel , Treatment Outcome , Ultrasonography , United States
7.
J Med Virol ; 92(10): 2067-2073, 2020 10.
Article in English | MEDLINE | ID: covidwho-175870

ABSTRACT

This retrospective study aimed to analysis clinical characteristics and outcomes of cancer patients with novel coronavirus disease-19 (COVID-19). Medical records, laboratory results and radiologic findings of 52 cancer patients with COVID-19 were collected, clinical characteristics and outcomes were summarized. A total of 52 cancer patients with COVID-19 were included. Median age of 52 cancer patients with COVID-19 was 63 years (34-98). Thirty-three (63.5%) patients were mild and 19 (36.5%) were severe/critical. Lung cancer was the most frequent cancer type (10, 19.2%). The common symptoms were as follows: fever (25%), dry cough (17.3%), chest distress (11.5%), and fatigue (9.6%). There were 33 (63.5%) patients had comorbidities, the most common symptom was hypertension (17, 51.5%). Twenty-six (78.8%) patients developed pneumonia on admission. Lymphocytes (0.6 × 109/L) decreased in both mild and severe/critical patients. Median levels of D-dimer, C-reactive protein, procalcitonin, and lactate dehydrogenase were 2.8 mg/L, 70.5 mg/L, 0.3 ng/mL, and 318 U/L, respectively, which increased significantly in severe/critical patients compared with the mild patients. Interleukin-6 (12.6 pg/mL) increased in both mild and severe/critical patients, there was a significant difference between them. Complications were observed in 29 (55.8%) patients, such as liver injury (19, 36.5%), acute respiratory distress syndrome (9, 17.3%), sepsis (8, 15.4%), myocardial injury (8, 15.4%), renal insufficiency (4, 7.7%), and multiple organ dysfunction syndrome (3, 5.8%). Eleven (21.2%) patients with cancer died. The infection rate of severe acute respiratory syndrome coronavirus 2 in patients with cancer was higher than the general population, cancer patients with COVID-19 showed deteriorating conditions and poor outcomes.


Subject(s)
COVID-19/physiopathology , Coronary Disease/physiopathology , Diabetes Mellitus/physiopathology , Hypertension/physiopathology , Neoplasms/physiopathology , Adrenal Cortex Hormones/therapeutic use , Adult , Age Factors , Aged , Aged, 80 and over , Antineoplastic Agents/therapeutic use , Antiviral Agents/therapeutic use , COVID-19/diagnostic imaging , COVID-19/mortality , COVID-19/therapy , China , Comorbidity , Coronary Disease/diagnostic imaging , Coronary Disease/mortality , Coronary Disease/therapy , Cough/physiopathology , Diabetes Mellitus/diagnostic imaging , Diabetes Mellitus/mortality , Diabetes Mellitus/therapy , Fatigue/physiopathology , Female , Fever/physiopathology , Humans , Hypertension/diagnostic imaging , Hypertension/mortality , Hypertension/therapy , Immunoglobulins, Intravenous/therapeutic use , Lymphocytes/pathology , Lymphocytes/virology , Male , Middle Aged , Neoplasms/diagnostic imaging , Neoplasms/mortality , Neoplasms/therapy , Retrospective Studies , Risk Factors , SARS-CoV-2/drug effects , SARS-CoV-2/pathogenicity , Severity of Illness Index , Survival Analysis , Tomography, X-Ray Computed , Treatment Outcome
8.
Am J Trop Med Hyg ; 102(6): 1208-1209, 2020 06.
Article in English | MEDLINE | ID: covidwho-107974

ABSTRACT

The early shortage of novel coronavirus disease (COVID-19) tests in the United States led many hospitals to first screen for common respiratory pathogens, and only if this screen was negative to proceed with COVID-19 testing. We report a case of a 56-year-old woman with severe acute respiratory syndrome-coronavirus-2 (SARS-CoV-2) coinfection with group A Streptococcus. The initial testing strategy resulted in delays in both diagnosis and implementation of appropriate precautions. Underlined is the importance of testing for both SARS-CoV-2 and other common respiratory pathogens during the current pandemic.


Subject(s)
Betacoronavirus/pathogenicity , Chronic Pain/diagnostic imaging , Coronavirus Infections/diagnostic imaging , Hypertension/diagnostic imaging , Lung/diagnostic imaging , Pneumonia, Viral/diagnostic imaging , Streptococcal Infections/diagnostic imaging , Antibodies, Monoclonal, Humanized/therapeutic use , Azithromycin/therapeutic use , Betacoronavirus/drug effects , Betacoronavirus/isolation & purification , COVID-19 , Ceftriaxone/therapeutic use , Chicago , Chronic Pain/immunology , Chronic Pain/pathology , Chronic Pain/therapy , Coinfection , Coronavirus Infections/immunology , Coronavirus Infections/pathology , Coronavirus Infections/therapy , Extracorporeal Membrane Oxygenation , Female , Humans , Hydroxychloroquine/therapeutic use , Hypertension/immunology , Hypertension/pathology , Hypertension/therapy , Lung/drug effects , Lung/pathology , Lung/virology , Middle Aged , Pandemics , Pneumonia, Viral/immunology , Pneumonia, Viral/pathology , Pneumonia, Viral/therapy , SARS-CoV-2 , Streptococcal Infections/immunology , Streptococcal Infections/pathology , Streptococcal Infections/therapy , Streptococcus pyogenes/drug effects , Streptococcus pyogenes/isolation & purification , Streptococcus pyogenes/pathogenicity , Tomography, X-Ray Computed , Treatment Outcome
SELECTION OF CITATIONS
SEARCH DETAIL