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1.
Early Hum Dev ; 166: 105552, 2022 03.
Article in English | MEDLINE | ID: covidwho-1683075

ABSTRACT

BACKGROUND: Partial oxygen saturation (SpO2) increases within minutes during transition from the intrauterine to extrauterine life. This study aims to determine the postnatal course of pulmonary regional oxygen saturation (rSO2) measured by Near-Infrared Spectroscopy (NIRS). METHODS: We conducted an observational study at the delivery room in infants above 35 weeks of gestation who did not need resuscitation and did not develop respiratory distress. Preductal pulse oximetry (Covidien NellcorTM) and right pulmonary apex oxygen saturation (raSO2) and basal oxygen saturation (rbSO2) (Covidien INVOSTM) were measured, starting from the postnatal third minute of life, until the 15th minute. The correlations between SpO2 and pulmonary rSO2 were analyzed. RESULTS: Of the 110 infants included in the study, 87 were term and 23 were late preterms. The gestational age and birth weight were 38.5 ± 1.36 weeks and 3285 ± 508 g, respectively. Median (5th-95th percentile) raSO2 and rbSO2 were 79% (58-95%) and 78% (46-95%) at the third minute, respectively. The rSO2 values measured from both sides increased and reached a steady-state around postnatal 9 min, similar to SpO2 values. The pulmonary NIRS values were significantly higher for babies born by C-Section compared to babies born by vaginal delivery (p < 0.05). CONCLUSION: We found that rSO2 measurements increased within minutes in the postnatal period in late preterm and term babies without respiratory distress and reached a plateau at the postnatal 9th minute. The normal values obtained from this preliminary study may be used to predict the prognosis of cases with respiratory distress.


Subject(s)
Oxygen , Female , Gestational Age , Humans , Infant , Infant, Newborn , Oximetry/methods , Pregnancy , Spectroscopy, Near-Infrared
2.
J Cyst Fibros ; 20 Suppl 3: 57-63, 2021 12.
Article in English | MEDLINE | ID: covidwho-1587342

ABSTRACT

BACKGROUND: Cystic fibrosis (CF) programs and people with CF (PwCF) employed various monitoring methods for virtual care during the COVID-19 pandemic. This paper characterizes experiences with remote monitoring across the U.S. CF community. METHODS: The CF Foundation (CFF) sponsored distribution of home spirometers (April 2020 to May 2021), surveys to PwCF and CF programs (July to September 2020), and a second program survey (April to May 2021). We used mixed methods to explore access, use, and perspectives regarding the use of remote monitoring in future care. RESULTS: By October 2020, 13,345 spirometers had been distributed, and 19,271 spirometers by May 2021. Programs (n=286) estimated proportions of PwCF with home devices increased over seven months: spirometers (30% to 70%), scales (50% to 70%), oximeters (5% to 10%) with higher estimates in adult programs for spirometers and oximeters. PwCF (n=378) had access to scales (89%), followed by oximeters (48%) and spirometers (47%), often using scales and oximeters weekly, and spirometers monthly. Over both surveys, some programs had no method to collect respiratory specimens for cultures associated with telehealth visits (47%, n=132; 41%, n=118). Most programs (81%) had a process for phlebotomy associated with a telehealth visit, primarily through off-site labs. Both PwCF and programs felt future care should advance remote monitoring and recommended improvements for access, training, and data collection systems. CONCLUSIONS: PwCF and programs experienced unprecedented access to remote monitoring and raised its importance for future care. Improvements to current systems may leverage these shared experiences to augment future care models.


Subject(s)
COVID-19 , Cystic Fibrosis , Equipment and Supplies/supply & distribution , Home Care Services , Monitoring, Physiologic/methods , Spirometry , Adult , COVID-19/epidemiology , COVID-19/prevention & control , Child , Cystic Fibrosis/diagnosis , Cystic Fibrosis/epidemiology , Cystic Fibrosis/therapy , Delivery of Health Care/organization & administration , Delivery of Health Care/trends , Health Services Accessibility/organization & administration , Health Services Accessibility/standards , Home Care Services/organization & administration , Home Care Services/standards , Humans , Models, Organizational , Needs Assessment , Oximetry/instrumentation , Oximetry/methods , Quality Improvement , SARS-CoV-2 , Spirometry/instrumentation , Spirometry/methods , Telemedicine/methods , Telemedicine/standards , United States/epidemiology
3.
S Afr Med J ; 111(10): 950-956, 2021 09 03.
Article in English | MEDLINE | ID: covidwho-1478411

ABSTRACT

BACKGROUND: The phenomenon of silent hypoxaemia has been described in patients with COVID-19 pneumonia, which is characterised by low oxygen saturation levels of <90% in those who appear clinically well and do not show signs of significant respiratory distress. OBJECTIVES: To assess the impact on clinical outcomes for high-risk COVID-19 patients using a pulse oximeter to monitor oxygen saturation levels in a home setting. METHODS: We performed a retrospective cohort analysis using data from a large South African insurance administrator. Patients were categorised as high risk, based on age and specific underlying clinical conditions, or from predictive models derived from medical scheme administrative claims data. The impact of pulse oximetry home monitoring on COVID-19 clinical outcomes was investigated by the use of Cox proportional hazard models. RESULTS: Between 2 March 2020 and 31 October 2020, of 38 660 patients analysed, 8 115 were in the intervention group. The 60-day mortality rate for the evaluated high-risk population was 1.35%. After adjusting for age and comorbidity differences, the intervention group was found to have an adjusted hazard ratio of 0.52 (p<0.0001). No statistical significance was found between the intervened and control groups for admission to hospital, admission to intensive care unit (ICU) and use of mechanical ventilation. The intervention group had a lower median C-reactive protein (CRP) level on admission (p=0.03). After adjustment for admission CRP levels, elevated CRP was associated with an increased mortality (p<0.0001), while the statistical significance in mortality between the intervention and the control group was lost. CONCLUSIONS: High-risk COVID-19 patients who used a pulse oximeter to monitor oxygen saturation levels had significantly lower mortality rates compared with other high-risk patients. The mortality benefit may be explained by earlier presentation to hospital, as suggested by lower initial CRP levels.


Subject(s)
COVID-19/physiopathology , Hospitalization/statistics & numerical data , Oximetry/methods , Adult , C-Reactive Protein/metabolism , COVID-19/mortality , Cohort Studies , Female , Humans , Intensive Care Units/statistics & numerical data , Male , Middle Aged , Respiration, Artificial/statistics & numerical data , Retrospective Studies , Severity of Illness Index , South Africa
4.
Chest ; 161(4): 971-978, 2022 Apr.
Article in English | MEDLINE | ID: covidwho-1439285

ABSTRACT

BACKGROUND: Pulse oximeters may produce less accurate results in non-White patients. RESEARCH QUESTION: Do pulse oximeters detect arterial hypoxemia less effectively in Black, Hispanic, and/or Asian patients than in White patients in respiratory failure and about to undergo extracorporeal membrane oxygenation (ECMO)? STUDY DESIGN AND METHODS: Data on adult patients with respiratory failure readings 6 h before ECMO were provided by the Extracorporeal Life Support Organization registry. Data was collected from 324 centers between January 2019 and July 2020. Our primary analysis was of rates of occult hypoxemia-low arterial oxygen saturation (Sao2 ≤ 88%) on arterial blood gas measurement despite a pulse oximetry reading in the range of 92% to 96%. RESULTS: The rate of pre-ECMO occult hypoxemia, that is, arterial oxygen saturation (Sao2) ≤ 88%, was 10.2% (95% CI, 6.2%-15.3%) for 186 White patients with peripheral oxygen saturation (Spo2) of 92% to 96%; 21.5% (95% CI, 11.3%-35.3%) for 51 Black patients (P = .031 vs White); 8.6% (95% CI, 3.2%-17.7%) for 70 Hispanic patients (P = .693 vs White); and 9.2% (95% CI, 3.5%-19.0%) for 65 Asian patients (P = .820 vs White). Black patients with respiratory failure had a statistically significantly higher risk of occult hypoxemia with an OR of 2.57 (95% CI, 1.12-5.92) compared with White patients (P = .026). The risk of occult hypoxemia for Hispanic and Asian patients was equivalent to that of White patients. In a secondary analysis of patients with Sao2 ≤ 88% despite Spo2 > 96%, Black patients had more than three times the risk compared with White patients (OR, 3.52; 95% CI, 1.12-11.10; P = .032). INTERPRETATION: Compared with White patients, the prevalence of occult hypoxemia was higher in Black patients than in White patients about to undergo ECMO for respiratory failure, but it was comparable in Hispanic and Asian patients compared with White patients.


Subject(s)
Extracorporeal Membrane Oxygenation , Racism , Respiratory Insufficiency , Adult , Humans , Hypoxia/diagnosis , Hypoxia/etiology , Oximetry/methods , Oxygen , Respiratory Insufficiency/diagnosis , Respiratory Insufficiency/therapy , Retrospective Studies
5.
Anaesthesia ; 77(2): 143-152, 2022 02.
Article in English | MEDLINE | ID: covidwho-1429480

ABSTRACT

Pulse oximetry is used widely to titrate oxygen therapy and for triage in patients who are critically ill. However, there are concerns regarding the accuracy of pulse oximetry in patients with COVID-19 pneumonitis and in patients who have a greater degree of skin pigmentation. We aimed to determine the impact of patient ethnicity on the accuracy of peripheral pulse oximetry in patients who were critically ill with COVID-19 pneumonitis by conducting a retrospective observational study comparing paired measurements of arterial oxygen saturation measured by co-oximetry on arterial blood gas analysis (SaO2 ) and the corresponding peripheral oxygenation saturation measured by pulse oximetry (Sp O2 ). Bias was calculated as the mean difference between SaO2 and Sp O2 measurements and limits of agreement were calculated as bias ±1.96 SD. Data from 194 patients (135 White ethnic origin, 34 Asian ethnic origin, 19 Black ethnic origin and 6 other ethnic origin) were analysed consisting of 6216 paired SaO2 and Sp O2 measurements. Bias (limits of agreement) between SaO2 and Sp O2 measurements was 0.05% (-2.21-2.30). Patient ethnicity did not alter this to a clinically significant degree: 0.28% (1.79-2.35), -0.33% (-2.47-2.35) and -0.75% (-3.47-1.97) for patients of White, Asian and Black ethnic origin, respectively. In patients with COVID-19 pneumonitis, Sp O2 measurements showed a level of agreement with SaO2 values that was in line with previous work, and this was not affected by patient ethnicity.


Subject(s)
COVID-19/physiopathology , Oximetry/methods , Oximetry/standards , /physiology , COVID-19/therapy , Critical Care/methods , Female , Humans , Male , Middle Aged , Oxygen Inhalation Therapy/methods , Reproducibility of Results , Retrospective Studies , SARS-CoV-2
8.
Chest ; 160(1): e9-e12, 2021 07.
Article in English | MEDLINE | ID: covidwho-1122270

ABSTRACT

Patients with COVID-19 report severe respiratory symptoms consistent with ARDS. The clinical presentation of ARDS in COVID-19 is often atypical, as patients with COVID-19 exhibit a disproportionate hypoxemia compared with relatively preserved lung mechanics. This pattern is more similar to neonatal respiratory distress syndrome secondary to surfactant deficiency, which has been shown to benefit from exogenous surfactant. We present our experience with exogenous surfactant treatment in a patient with COVID-19 experiencing COVID-19-related ARDS. The patient responded with improved oxygenation, and we believe surfactant was the catalyst for the successful extubation and clinical improvement of the patient.


Subject(s)
Biological Products/administration & dosage , COVID-19 , Critical Care/methods , Hypoxia , Patient Positioning/methods , Antiviral Agents/administration & dosage , COVID-19/blood , COVID-19/diagnostic imaging , COVID-19/physiopathology , COVID-19/therapy , Drug Monitoring/methods , Extracorporeal Membrane Oxygenation/methods , Humans , Hypoxia/etiology , Hypoxia/therapy , Lung/diagnostic imaging , Male , Middle Aged , Oximetry/methods , Pulmonary Surfactants/administration & dosage , Respiration, Artificial/methods , SARS-CoV-2/isolation & purification , Treatment Outcome
9.
Intern Emerg Med ; 16(7): 1959-1965, 2021 10.
Article in English | MEDLINE | ID: covidwho-1107867

ABSTRACT

During the first outbreak of Coronavirus disease 2019 (COVID-19) Emergency Departments (EDs) were overcrowded. Hence, the need for a rapid and simple tool to support clinical decisions, such as the ROX index (Respiratory rate - OXygenation), defined as the ratio of peripheral oxygen saturation and fraction of inspired oxygen, to respiratory rate. The aim of the study was to evaluate the accuracy of the ROX index in predicting hospitalization and mortality in patients with a diagnosis of COVID-19 in the ED. The secondary outcomes were to assess the number of readmissions and the variations in the ROX index between the first and the second admission. This was an observational prospective monocentric study, carried out in the ED of Sant'Orsola-Malpighi Hospital in Bologna, Italy. Five hundred and fifty-four consecutive patients with COVID-19 were enrolled and the ROX index was calculated. Patients were followed until hospital discharge or death. A ROX index value < 25.7 was associated with hospitalization (area under the curve [AUC] = 0.737, 95% CI 0.696-0.779, p < 0.001). The ROX index < 22.3 was statistically related to higher 30-day mortality (AUC = 0.764, 95% CI 0.708-0.820, p < 0.001). Eight patients were discharged and returned to the ED within the subsequent 7 days, their mean ROX index was 30.3 (6.2; range 21.9-39.4) at the first assessment and 24.6 (5.5; 14.5-29.5) at the second assessment, (p = 0.012). The ROX index, together with laboratory, imaging and clinical findings, correlated with the need for hospital admission, mechanical ventilation and mortality risk in COVID-19 patients.


Subject(s)
COVID-19/diagnosis , Emergency Service, Hospital , Oximetry/methods , Respiratory Rate/physiology , Severity of Illness Index , Adult , Aged , Humans , Male , Middle Aged , Organ Dysfunction Scores , Prospective Studies
10.
Cardiol Young ; 30(9): 1339-1342, 2020 Sep.
Article in English | MEDLINE | ID: covidwho-1082976
11.
Obstet Gynecol ; 136(5): 1025-1029, 2020 11.
Article in English | MEDLINE | ID: covidwho-1059683

ABSTRACT

BACKGROUND: There are limited data regarding treatment options for pregnant women with severe coronavirus disease 2019 (COVID-19). CASE: A 35-year-old primigravid patient at 22 weeks of gestation presented with 7 days of fever, cough, anosmia, and dyspnea. Nasopharyngeal swab was positive for the novel coronavirus severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), and a chest X-ray demonstrated bilateral patchy infiltrates. Laboratory evaluation was notable for marked elevation of interleukin-6 and C-reactive protein concentrations. On hospital day 3, owing to increased dyspnea and oxygen requirement, the patient was treated with tocilizumab followed by 5 days of remdesivir. She responded well, recovered to room air, and was discharged home after a 9-day hospitalization. CONCLUSION: Tocilizumab and remdesivir may be effective for treatment of severe COVID-19 in pregnancy, but additional data are needed to guide risk-benefit considerations.


Subject(s)
Adenosine Monophosphate/analogs & derivatives , Alanine/analogs & derivatives , Antibodies, Monoclonal, Humanized/administration & dosage , Coronavirus Infections , Lung/diagnostic imaging , Pandemics , Pneumonia, Viral , Pregnancy Complications, Infectious , Adenosine Monophosphate/administration & dosage , Adult , Alanine/administration & dosage , Antiviral Agents/administration & dosage , Betacoronavirus/isolation & purification , C-Reactive Protein/analysis , COVID-19 , Coronavirus Infections/blood , Coronavirus Infections/diagnosis , Coronavirus Infections/drug therapy , Coronavirus Infections/physiopathology , Female , Humans , Interleukin-6/blood , Oximetry/methods , Pneumonia, Viral/blood , Pneumonia, Viral/diagnosis , Pneumonia, Viral/drug therapy , Pneumonia, Viral/etiology , Pneumonia, Viral/physiopathology , Pregnancy , Pregnancy Complications, Infectious/blood , Pregnancy Complications, Infectious/diagnosis , Pregnancy Complications, Infectious/drug therapy , Radiography, Thoracic/methods , SARS-CoV-2 , Treatment Outcome
13.
J Intern Med ; 289(5): 738-746, 2021 05.
Article in English | MEDLINE | ID: covidwho-1054555

ABSTRACT

BACKGROUND: Published reports on tocilizumab in COVID-19 pneumonitis show conflicting results due to weak designs or heterogeneity in critical methodological issues. METHODS: This open-label trial, structured according to Simon's optimal design, aims to identify factors predicting which patients could benefit from anti-IL6 strategies and to enhance the design of unequivocal and reliable future randomized trials. A total of 46 patients with COVID-19 pneumonia needing of oxygen therapy to maintain SO2 > 93% and with recent worsening of lung function received a single infusion of tocilizumab. Clinical and biological markers were measured to test their predictive values. Primary end point was early and sustained clinical response. RESULTS: Twenty-one patients fulfilled pre-defined response criteria. Lower levels of IL-6 at 24 h after tocilizumab infusion (P = 0.049) and higher baseline values of PaO2/FiO2 (P = 0.008) predicted a favourable response. CONCLUSIONS: Objective clinical response rate overcame the pre-defined threshold of 30%. Efficacy of tocilizumab to improve respiratory function in patients selected according to our inclusion criteria warrants investigations in randomized trials.


Subject(s)
Antibodies, Monoclonal, Humanized , Biomarkers, Pharmacological/analysis , COVID-19 , Drug Monitoring/methods , Interleukin-6 , Pneumonia, Viral , Aged , Antibodies, Monoclonal, Humanized/administration & dosage , Antibodies, Monoclonal, Humanized/pharmacokinetics , COVID-19/diagnosis , COVID-19/epidemiology , COVID-19/physiopathology , COVID-19/therapy , Female , Humans , Immunologic Factors/administration & dosage , Immunologic Factors/pharmacokinetics , Infusions, Intravenous , Interleukin-6/antagonists & inhibitors , Interleukin-6/blood , Italy/epidemiology , Male , Oximetry/methods , Oxygen Inhalation Therapy/methods , Pneumonia, Viral/drug therapy , Pneumonia, Viral/epidemiology , Pneumonia, Viral/etiology , Predictive Value of Tests , Respiratory Function Tests/methods , SARS-CoV-2/isolation & purification , Treatment Outcome
14.
Monaldi Arch Chest Dis ; 90(4)2020 Dec 23.
Article in English | MEDLINE | ID: covidwho-1000398

ABSTRACT

COVID-19 pneumonia has a significant case fatality rate and no effective antiviral drugs are available even after 9 months of the pandemic. The spectrum of COVID-19 disease ranges from asymptomatic cases to severe ARDS with myriad manifestations. Here we report a case of a male patient with severe COVID-19 ARDS who improved after receiving standard therapy but again 'deteriorated' after being stepped down to ward. He complained of worsening shortness of breath and hypoxemia which was found to be mainly positional. After ruling out other causes, he was labeled as a case of platypnea-orthodeoxia syndrome due to underlying lung involvement.  It is important to be aware of this condition in the context of COVID-19 which can be easily diagnosed bedside with pulse oximetry.


Subject(s)
COVID-19 , Dyspnea , Hypoxia , Lung , Patient Positioning/methods , Pneumonia, Viral , Aged , COVID-19/diagnosis , COVID-19/physiopathology , COVID-19 Nucleic Acid Testing , Clinical Deterioration , Diagnosis, Differential , Dyspnea/diagnosis , Dyspnea/etiology , Humans , Hypoxia/diagnosis , Hypoxia/etiology , Lung/diagnostic imaging , Lung/physiopathology , Male , Oximetry/methods , Oxygen Inhalation Therapy/methods , Patient Care Management , Pneumonia, Viral/diagnosis , Pneumonia, Viral/etiology , Pneumonia, Viral/physiopathology , Pneumonia, Viral/therapy , Respiratory Function Tests/methods , SARS-CoV-2/isolation & purification , Syndrome , Tomography, X-Ray Computed/methods
16.
Respir Res ; 21(1): 249, 2020 Sep 24.
Article in English | MEDLINE | ID: covidwho-792826

ABSTRACT

In the article "The pathophysiology of 'happy' hypoxemia in COVID-19," Dhont et al. (Respir Res 21:198, 2020) discuss pathophysiological mechanisms that may be responsible for the absence of dyspnea in patients with COVID-19 who exhibit severe hypoxemia. The authors review well-known mechanisms that contribute to development of hypoxemia in patients with pneumonia, but are less clear as to why patients should be free of respiratory discomfort despite arterial oxygen levels commonly regarded as life threatening. The authors propose a number of therapeutic measures for patients with COVID-19 and happy hypoxemia; we believe readers should be alerted to problems with the authors' interpretations and recommendations.


Subject(s)
Coronavirus Infections/physiopathology , Dyspnea/prevention & control , Hypoxia/physiopathology , Oxygen/blood , Pneumonia, Viral/physiopathology , COVID-19 , Coronavirus Infections/epidemiology , Coronavirus Infections/therapy , Female , Humans , Hypoxia/epidemiology , Male , Oximetry/methods , Pandemics , Pneumonia, Viral/epidemiology , Pneumonia, Viral/therapy , Prognosis , Risk Assessment , Treatment Outcome
17.
J Clin Sleep Med ; 16(12): 2109-2111, 2020 12 15.
Article in English | MEDLINE | ID: covidwho-721969

ABSTRACT

NONE: This is a case series of 3 patients with moderate-severe OSA who were PAP-intolerant and underwent implantation of the hypoglossal nerve stimulator. All patients recorded baseline overnight pulse oximetry without the hypoglossal nerve stimulator and at least 1 night at each hypoglossal nerve stimulator setting as they up-titrated the device at home. Because of the impact of the novel coronavirus on sleep laboratories, all patients proceeded directly to type 3 sleep studies performed at a single setting determined by a combination of self-reported improvement and pulse oximetry data.


Subject(s)
Electric Stimulation Therapy/methods , Hypoglossal Nerve/physiology , Oximetry/methods , Sleep Apnea, Obstructive/therapy , Adult , Female , Humans , Male , Middle Aged
18.
Sensors (Basel) ; 20(17)2020 Aug 28.
Article in English | MEDLINE | ID: covidwho-740500

ABSTRACT

The non-invasive estimation of blood oxygen saturation (SpO2) by pulse oximetry is of vital importance clinically, from the detection of sleep apnea to the recent ambulatory monitoring of hypoxemia in the delayed post-infective phase of COVID-19. In this proof of concept study, we set out to establish the feasibility of SpO2 measurement from the ear canal as a convenient site for long term monitoring, and perform a comprehensive comparison with the right index finger-the conventional clinical measurement site. During resting blood oxygen saturation estimation, we found a root mean square difference of 1.47% between the two measurement sites, with a mean difference of 0.23% higher SpO2 in the right ear canal. Using breath holds, we observe the known phenomena of time delay between central circulation and peripheral circulation with a mean delay between the ear and finger of 12.4 s across all subjects. Furthermore, we document the lower photoplethysmogram amplitude from the ear canal and suggest ways to mitigate this issue. In conjunction with the well-known robustness to temperature induced vasoconstriction, this makes conclusive evidence for in-ear SpO2 monitoring being both convenient and superior to conventional finger measurement for continuous non-intrusive monitoring in both clinical and everyday-life settings.


Subject(s)
Ear Canal , Hypoxia/diagnosis , Monitoring, Physiologic/instrumentation , Oximetry/instrumentation , Photoplethysmography/instrumentation , Wearable Electronic Devices , Adult , Betacoronavirus/physiology , COVID-19 , Coronavirus Infections/blood , Coronavirus Infections/diagnosis , Coronavirus Infections/therapy , Equivalence Trials as Topic , Feasibility Studies , Female , Fingers , Humans , Hypoxia/blood , Male , Monitoring, Physiologic/methods , Oximetry/methods , Oxygen/analysis , Oxygen/blood , Pandemics , Photoplethysmography/methods , Pneumonia, Viral/blood , Pneumonia, Viral/diagnosis , Pneumonia, Viral/therapy , SARS-CoV-2 , Young Adult
20.
Front Med ; 14(5): 664-673, 2020 Oct.
Article in English | MEDLINE | ID: covidwho-696783

ABSTRACT

The Coronavirus disease 2019 (COVID-19) caused by SARS-CoV-2 was identified in December 2019. The symptoms include fever, cough, dyspnea, early symptom of sputum, and acute respiratory distress syndrome (ARDS). Mesenchymal stem cell (MSC) therapy is the immediate treatment used for patients with severe cases of COVID-19. Herein, we describe two confirmed cases of COVID-19 in Wuhan to explore the role of MSC in the treatment of COVID-19. MSC transplantation increases the immune indicators (including CD4 and lymphocytes) and decreases the inflammation indicators (interleukin-6 and C-reactive protein). High-flow nasal cannula can be used as an initial support strategy for patients with ARDS. With MSC transplantation, the fraction of inspired O2 (FiO2) of the two patients gradually decreased while the oxygen saturation (SaO2) and partial pressure of oxygen (PO2) improved. Additionally, the patients' chest computed tomography showed that bilateral lung exudate lesions were adsorbed after MSC infusion. Results indicated that MSC transplantation provides clinical data on the treatment of COVID-19 and may serve as an alternative method for treating COVID-19, particularly in patients with ARDS.


Subject(s)
Betacoronavirus/isolation & purification , Coronavirus Infections , Critical Care/methods , Mesenchymal Stem Cell Transplantation/methods , Pandemics , Pneumonia, Viral , Adult , Aged , Blood Cells/physiology , Blood Coagulation Tests/methods , COVID-19 , COVID-19 Testing , China , Clinical Laboratory Techniques/methods , Combined Modality Therapy , Coronavirus Infections/diagnosis , Coronavirus Infections/drug therapy , Coronavirus Infections/epidemiology , Coronavirus Infections/physiopathology , Coronavirus Infections/therapy , Female , Humans , Male , Monitoring, Immunologic/methods , Oximetry/methods , Pneumonia, Viral/diagnosis , Pneumonia, Viral/epidemiology , Pneumonia, Viral/physiopathology , Pneumonia, Viral/therapy , Preliminary Data , SARS-CoV-2 , Severity of Illness Index , Symptom Assessment/methods , Treatment Outcome
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