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3.
BMC Nephrol ; 22(1): 323, 2021 09 27.
Article in English | MEDLINE | ID: covidwho-1440916

ABSTRACT

BACKGROUND: This is a case report of an asymptomatic SARS-CoV-2 infection associated with new-onset nephrotic syndrome in a pediatric patient. This is the third case of new-onset nephrotic syndrome in children associated with SARS-CoV-2 infection, but is the first case report describing a new-onset nephrotic syndrome presentation in a patient who had asymptomatic COVID-19 infection. CASE PRESENTATION: This is a case of a previously healthy 5 year old female who presented with new-onset nephrotic syndrome in the setting of an asymptomatic COVID-19 infection. She presented with progressive edema, and laboratory findings were significant for proteinuria and hypercholesterolemia. She was treated with albumin, diuretics, and corticosteroid therapy, and achieved clinical remission of her nephrotic syndrome within 3 weeks of treatment. Though she was at risk of hypercoagulability due to her COVID-19 infection and nephrotic syndrome, she was not treated with anticoagulation, and did not develop any thrombotic events. CONCLUSIONS: Our case report indicates that SARS-CoV-2 infection could be a trigger for nephrotic syndrome, even in the absence of overt COVID-19 symptoms.


Subject(s)
Asymptomatic Infections , COVID-19 , Nephrotic Syndrome , Patient Care Management/methods , Remission Induction/methods , COVID-19/complications , COVID-19/diagnosis , COVID-19/physiopathology , Child, Preschool , Edema/diagnosis , Edema/etiology , Female , Humans , Hypercholesterolemia/diagnosis , Hypercholesterolemia/etiology , Nephrotic Syndrome/blood , Nephrotic Syndrome/etiology , Nephrotic Syndrome/therapy , Nephrotic Syndrome/urine , Proteinuria/diagnosis , Proteinuria/etiology , SARS-CoV-2/isolation & purification , Treatment Outcome
8.
J Cardiovasc Med (Hagerstown) ; 22(9): 693-700, 2021 09 01.
Article in English | MEDLINE | ID: covidwho-1339455

ABSTRACT

AIMS: We performed a systematic review to summarize the clinical features, diagnostic methods, treatment, and outcomes of coronavirus disease 2019 (COVID-19) patients with pericarditis. METHODS: We searched electronic databases from inception to 17 December 2020. Studies that reported clinical data on patients with COVID-19 and pericarditis were included. Descriptive statistics were used for categorical and continuous variables [mean ±â€Šstandard deviation or median (interquartile range)]. As an exploratory analysis, differences between patients with acute pericarditis and myopericarditis were compared. RESULTS: A total of 33 studies (32 case reports and 1 case series) involving 34 patients were included. The mean age was 51.6 ±â€Š19.5 years and 62% of patients were men. Sixty-two percentage of patients were diagnosed with myopericarditis. The most frequent electrocardiographic pattern (56%) was diffuse ST-elevation and PR depression. Pericardial effusion and cardiac tamponade were reported in 76 and 35% of cases, respectively. The median values of C-reactive protein [77 mg/dl (12-177)] and white blood cells [12 335 cells/µl (5625-16 500)] were above the normal range. Thirty-eight percent and 53% of patients were treated with nonsteroidal anti-inflammatory drugs (NSAIDs) and colchicine, respectively. These drugs were more frequently used in patients with acute pericarditis compared with myopericarditis. The in-hospital mortality was 6% without a significant difference between both groups. CONCLUSION: Our review shows that COVID-19 patients with pericarditis had similar clinical features to other viral cardiotropic infections. However, NSAIDs and colchicine were used in half or less of the cases. Overall, the short-term prognosis was good across groups.


Subject(s)
COVID-19 , Patient Care Management , Pericarditis , COVID-19/complications , COVID-19/epidemiology , COVID-19/physiopathology , COVID-19/therapy , Case-Control Studies , Female , Humans , Male , Middle Aged , Patient Care Management/methods , Patient Care Management/statistics & numerical data , Pericarditis/diagnosis , Pericarditis/drug therapy , Pericarditis/etiology , Pericarditis/physiopathology , Prognosis , SARS-CoV-2/isolation & purification
11.
Dermatol Clin ; 39(4): 609-618, 2021 Oct.
Article in English | MEDLINE | ID: covidwho-1330740

ABSTRACT

COVID-19 has created challenges across medicine, including in medical education, with deeply rooted impacts in the dermatology residency experience. Its effects are both acute and chronic, including: shifts to virtual education and conferences, skewed clinical experiences, negatively impacted wellness, and uncertainty in the future. As educators and mentors, it is important to recognize and address these issues so that we may remain transparent, adaptable, and engaged as we continue to build a better tomorrow for our resident trainees.


Subject(s)
COVID-19/epidemiology , Dermatology/education , Fellowships and Scholarships/trends , Internship and Residency/trends , Patient Care Management/trends , Skin Diseases/therapy , Attitude of Health Personnel , Humans , Social Perception
13.
Natl Med J India ; 33(5): 298-301, 2020.
Article in English | MEDLINE | ID: covidwho-1289146

ABSTRACT

India has the largest global burden of new cases of tuberculosis (TB) and deaths due to TB. These occur predominantly in the poor who suffer catastrophic costs during diagnosis and treatment. The National Tuberculosis Elimination Programme has ambitious goals of 80% reduction of incidence of TB, 90% reduction in mortality due to TB by 2025 and 0% occurrence of catastrophic costs to households affected by TB by 2020. The Covid-19 pandemic and the resulting disruption to TB services are expected to worsen the situation. There are gaps in case finding at the peripheral level and access to care at the higher level for patients with TB. An estimated 32% patients with active TB do not access diagnostic services, while catastrophic costs associated with hospitalization are a barrier to access for seriously ill patients. Deaths due to TB in India occur largely at home and not in medical facilities, and are preventable with appropriate inpatient care. The Ayushman Bharat scheme with its Health and Wellness Centres (HWCs) and coverage for inpatient care under the Pradhan Mantri Jan Arogya Yojana (PM-JAY) can facilitate, the achievement of the goals of TB elimination. The HWCs provide an opportunity to close the case-finding gap as first point of contact by enabling sputum transport services to the designated microscopy centres. This will facilitate case detection, reduce diagnostic delays, and decrease community transmission and the incidence of TB. The benefit package of PM-JAY can cover patients with pulmonary TB, inpatient evaluation for other forms of TB, enhance the allocation for treatment and cover management of comorbid conditions such as severe undernutrition, anaemia, HIV and diabetes.


Subject(s)
COVID-19 , Communicable Disease Control/organization & administration , Early Diagnosis , Hospitalization , Patient Care Management , Tuberculosis , Universal Health Insurance , COVID-19/epidemiology , COVID-19/prevention & control , Health Expenditures , Health Services Accessibility/standards , Health Services Accessibility/statistics & numerical data , Health Services Needs and Demand , Humans , India/epidemiology , Mortality , Patient Care Management/methods , Patient Care Management/organization & administration , Patient Care Management/trends , Public Health/methods , Public Health/trends , Quality Improvement/organization & administration , SARS-CoV-2 , Time-to-Treatment , Tuberculosis/diagnosis , Tuberculosis/economics , Tuberculosis/mortality , Tuberculosis/therapy
14.
S Afr Fam Pract (2004) ; 63(1): e1-e5, 2021 06 10.
Article in English | MEDLINE | ID: covidwho-1273560

ABSTRACT

BACKGROUND: Coronavirus disease 2019 (COVID-19) is a public health crisis that threatens the current health system. The sudden expansion in the need for inpatient and intensive care facilities raised concerns about optimal clinical management and resource allocation. Despite the pressing need for evidence to make context-specific decisions on COVID-19 management, evidence from South Africa remained limited. This study aimed to describe the clinical characteristics and outcomes of COVID-19 hospitalised patients. METHODS: A retrospective cross-sectional study design was used to evaluate the clinical outcomes of hospitalised adult patients (≥ 18 years old) with laboratory-confirmed COVID-19 illness at Mthatha Regional Hospital (MRH), Eastern Cape. RESULTS: Of the 1814 patients tested for COVID-19 between 20 March 2020 and 31 July 2020 at MRH, two-thirds (65.4%) were female. About two-thirds (242) of the 392 patients (21.6%) who tested positive for this disease were hospitalised and one-third (150) were quarantined at home. The mean age of the patients tested for COVID-19 was 42.6 years and there was no difference between males and females. The mean age of hospitalised patients was 55.5 years and the mean age of hospitalised patients who died (61.3 years) was much higher than recovered (49.5 years). Overall, 188 (77.6%) hospitalised patients had clinical comorbidity on admission. Diabetes (36.8%) and hypertension (33.1%) were the most common comorbidities amongst COVID-19 hospitalised patients. CONCLUSION: The majority of the patients who were hospitalised for COVID-19 were elderly and had high baseline comorbidities. Advance age and underlying comorbidities (diabetes, hypertension and HIV) were associated with high mortality in hospitalised COVID-19 patients.


Subject(s)
COVID-19 , Communicable Disease Control , Diabetes Mellitus/epidemiology , Hospitalization/statistics & numerical data , Hypertension/epidemiology , COVID-19/epidemiology , COVID-19/prevention & control , COVID-19/therapy , Communicable Disease Control/methods , Communicable Disease Control/organization & administration , Comorbidity , Cross-Sectional Studies , Female , Hospital Mortality , Humans , Intensive Care Units/statistics & numerical data , Male , Middle Aged , Outcome and Process Assessment, Health Care , Patient Care Management/methods , SARS-CoV-2/isolation & purification , South Africa/epidemiology
16.
J Am Geriatr Soc ; 69(10): 2741-2744, 2021 10.
Article in English | MEDLINE | ID: covidwho-1262362

ABSTRACT

BACKGROUND: Because of the COVID-19 pandemic, the ongoing D-CARE pragmatic trial of two models of dementia care management needed to transition to all data collection by telephone. METHODS: For the first 1069 D-CARE participants, we determined the feasibility of administering a short 3-item version of the Montreal Cognitive Assessment (MoCA) to persons with dementia by telephone and examined the correlation with the full 12-item version. RESULTS: The 3-item version could be administered by telephone in approximately 6 min and was highly correlated with the full MoCA (r = 0.78, p < 0.0001). CONCLUSIONS: This brief version of the MoCA was feasible to collect by telephone and could be used as an alternative to the full MoCA, particularly if the purpose of cognitive assessment is characterization of study participants.


Subject(s)
COVID-19 , Dementia , Mental Status and Dementia Tests , Patient Care Management , Telemedicine/methods , Aged , Aged, 80 and over , COVID-19/epidemiology , COVID-19/prevention & control , Cognitive Dysfunction/diagnosis , Dementia/diagnosis , Dementia/psychology , Dementia/therapy , Female , Humans , Infection Control/methods , Interviews as Topic/methods , Male , Patient Care Management/methods , Patient Care Management/trends , Reproducibility of Results , SARS-CoV-2
17.
Can J Aging ; 39(3): 333-343, 2020 09.
Article in English | MEDLINE | ID: covidwho-1261985

ABSTRACT

The COVID-19 pandemic and subsequent state of public emergency have significantly affected older adults in Canada and worldwide. It is imperative that the gerontological response be efficient and effective. In this statement, the board members of the Canadian Association on Gerontology/L'Association canadienne de gérontologie (CAG/ACG) and the Canadian Journal on Aging/La revue canadienne du vieillissement (CJA/RCV) acknowledge the contributions of CAG/ACG members and CJA/RCV readers. We also profile the complex ways that COVID-19 is affecting older adults, from individual to population levels, and advocate for the adoption of multidisciplinary collaborative teams to bring together different perspectives, areas of expertise, and methods of evaluation in the COVID-19 response.


Subject(s)
Aging , Communicable Disease Control/methods , Coronavirus Infections , Health Services for the Aged/organization & administration , Pandemics , Patient Care Management , Patient Care Team , Pneumonia, Viral , Aged , Aging/physiology , Aging/psychology , Betacoronavirus/isolation & purification , COVID-19 , Canada/epidemiology , Coronavirus Infections/epidemiology , Coronavirus Infections/therapy , Health Services Needs and Demand , Humans , Interdisciplinary Communication , Mental Health , Patient Care Management/methods , Patient Care Management/standards , Patient Care Management/trends , Patient Care Team/organization & administration , Patient Care Team/standards , Pneumonia, Viral/epidemiology , Pneumonia, Viral/therapy , Quality Improvement , SARS-CoV-2
18.
Can J Cardiol ; 37(8): 1260-1262, 2021 08.
Article in English | MEDLINE | ID: covidwho-1252584

ABSTRACT

It is now widely recognized that COVID-19 illness can be associated with significant intermediate and potentially longer-term physical limitations. The term, "long COVID-19" is used to define any patient with persistent symptoms after acute COVID-19 infection (ie, after 4 weeks). It is postulated that cardiac injury might be linked to symptoms that persist after resolution of acute infection, as part of this syndrome. The Canadian Cardiovascular Society Rapid Response Team has generated this document to provide guidance to health care providers on the optimal management of patients with suspected cardiac complications of long COVID-19.


Subject(s)
COVID-19/complications , Cardiology , Hypoxia/therapy , Myocarditis/therapy , Patient Care Management , COVID-19/epidemiology , COVID-19/physiopathology , COVID-19/therapy , Canada , Cardiology/methods , Cardiology/trends , Humans , Hypoxia/etiology , Myocardial Ischemia/etiology , Myocardial Ischemia/physiopathology , Myocardial Ischemia/therapy , Myocarditis/etiology , Myocarditis/physiopathology , Myocarditis/virology , Patient Care Management/methods , Patient Care Management/organization & administration , Patient Care Team/organization & administration
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