Your browser doesn't support javascript.
Show: 20 | 50 | 100
Results 1 - 20 de 56
Filter
Add filters

Document Type
Year range
1.
Int J Environ Res Public Health ; 18(21)2021 11 08.
Article in English | MEDLINE | ID: covidwho-1512319

ABSTRACT

Pandemic of coronavirus disease (COVID-19) is still pressing the healthcare systems worldwide. Thus far, the lack of available COVID-19-targeted treatments has led scientists to look through drug repositioning practices and exploitation of available scientific evidence for potential efficient drugs that may block biological pathways of SARS-CoV-2. Till today, several molecules have emerged as promising pharmacological agents, and more than a few medication protocols are applied during hospitalization. On the other hand, given the criticality of the disease, it is important for healthcare providers, especially those in COVID-19 clinics (i.e., nursing personnel and treating physicians), to recognize potential drug interactions that may lead to adverse drug reactions that may negatively impact the therapeutic outcome. In this review, focusing on patients with respiratory diseases (i.e., asthma or chronic obstructive pulmonary disease) that are treated also for COVID-19, we discuss possible drug interactions, their underlying pharmacological mechanisms, and possible clinical signs that healthcare providers in COVID-19 clinics may need to acknowledge as adverse drug reactions due to drug-drug interactions.


Subject(s)
COVID-19 , Respiration Disorders , Drug Interactions , Humans , Pandemics , SARS-CoV-2
2.
Sci Rep ; 11(1): 21807, 2021 11 08.
Article in English | MEDLINE | ID: covidwho-1506761

ABSTRACT

In this study, we compare the predictive value of clinical scoring systems that are already in use in patients with Coronavirus disease 2019 (COVID-19), including the Brescia-COVID Respiratory Severity Scale (BCRSS), Quick SOFA (qSOFA), Sequential Organ Failure Assessment (SOFA), Multilobular infiltration, hypo-Lymphocytosis, Bacterial coinfection, Smoking history, hyper-Tension, and Age (MuLBSTA) and scoring system for reactive hemophagocytic syndrome (HScore), for determining the severity of the disease. Our aim in this study is to determine which scoring system is most useful in determining disease severity and to guide clinicians. We classified the patients into two groups according to the stage of the disease (severe and non-severe) and adopted interim guidance of the World Health Organization. Severe cases were divided into a group of surviving patients and a deceased group according to the prognosis. According to admission values, the BCRSS, qSOFA, SOFA, MuLBSTA, and HScore were evaluated at admission using the worst parameters available in the first 24 h. Of the 417 patients included in our study, 46 (11%) were in the severe group, while 371 (89%) were in the non-severe group. Of these 417 patients, 230 (55.2%) were men. The median (IQR) age of all patients was 44 (25) years. In multivariate logistic regression analyses, BRCSS in the highest tertile (HR 6.1, 95% CI 2.105-17.674, p = 0.001) was determined as an independent predictor of severe disease in cases of COVID-19. In multivariate analyses, qSOFA was also found to be an independent predictor of severe COVID-19 (HR 4.757, 95% CI 1.438-15.730, p = 0.011). The area under the curve (AUC) of the BRCSS, qSOFA, SOFA, MuLBSTA, and HScore was 0.977, 0.961, 0.958, 0.860, and 0.698, respectively. Calculation of the BRCSS and qSOFA at the time of hospital admission can predict critical clinical outcomes in patients with COVID-19, and their predictive value is superior to that of HScore, MuLBSTA, and SOFA. Our prediction is that early interventions for high-risk patients, with early identification of high-risk group using BRCSS and qSOFA, may improve clinical outcomes in COVID-19.


Subject(s)
COVID-19/diagnosis , COVID-19/epidemiology , COVID-19/immunology , Adult , Aged , Area Under Curve , Coinfection/diagnosis , Female , Hospital Mortality , Humans , Intensive Care Units , Lymphocytosis , Male , Middle Aged , Observer Variation , Organ Dysfunction Scores , Patient Admission , Predictive Value of Tests , Prognosis , Regression Analysis , Respiration , Respiration Disorders , Risk Factors , SARS-CoV-2 , Severity of Illness Index , Smoking , Treatment Outcome
3.
Sci Rep ; 11(1): 21812, 2021 11 08.
Article in English | MEDLINE | ID: covidwho-1505841

ABSTRACT

An estimation of the impact of climatic conditions-measured with an index that combines temperature and humidity, the IPTCC-on the hospitalizations and deaths attributed to SARS-CoV-2 is proposed. The present paper uses weekly data from 54 French administrative regions between March 23, 2020 and January 10, 2021. Firstly, a Granger causal analysis is developed and reveals that past values of the IPTCC contain information that allow for a better prediction of hospitalizations or deaths than that obtained without the IPTCC. Finally, a vector autoregressive model is estimated to evaluate the dynamic response of hospitalizations and deaths after an increase in the IPTCC. It is estimated that a 10-point increase in the IPTCC causes hospitalizations to rise by 2.9% (90% CI 0.7-5.0) one week after the increase, and by 4.1% (90% CI 2.1-6.4) and 4.4% (90% CI 2.5-6.3) in the two following weeks. Over ten weeks, the cumulative effect is estimated to reach 20.1%. Two weeks after the increase in the IPTCC, deaths are estimated to rise by 3.7% (90% CI 1.6-5.8). The cumulative effect from the second to the tenth weeks reaches 15.8%. The results are robust to the inclusion of air pollution indicators.


Subject(s)
Air Pollutants , Air Pollution , COVID-19/epidemiology , COVID-19/mortality , Climate , Hospitalization/statistics & numerical data , SARS-CoV-2 , Algorithms , Bayes Theorem , Decision Making , France/epidemiology , Hospitals , Humans , Humidity , Infectious Disease Medicine , Reproducibility of Results , Respiration Disorders , Seasons , Temperature
4.
BMJ Open ; 11(10): e050362, 2021 10 12.
Article in English | MEDLINE | ID: covidwho-1462962

ABSTRACT

INTRODUCTION: Chronic respiratory diseases (CRDs) are common and disabling conditions that can result in social isolation and economic hardship for patients and their families. Pulmonary rehabilitation (PR) improves functional exercise capacity and health-related quality of life (HRQoL) but practical barriers to attending centre-based sessions or the need for infection control limits accessibility. Home-PR offers a potential solution that may improve access. We aim to systematically review the clinical effectiveness, completion rates and components of Home-PR for people with CRDs compared with Centre-PR or Usual care. METHODS AND ANALYSIS: We will search PubMed, CINAHL, Cochrane, EMBASE, PeDRO and PsycInfo from January 1990 to date using a PICOS search strategy (Population: adults with CRDs; Intervention: Home-PR; Comparator: Centre-PR/Usual care; Outcomes: functional exercise capacity and HRQoL; Setting: any setting). The strategy is to search for 'Chronic Respiratory Disease' AND 'Pulmonary Rehabilitation' AND 'Home-PR', and identify relevant randomised controlled trials and controlled clinical trials. Six reviewers working in pairs will independently screen articles for eligibility and extract data from those fulfilling the inclusion criteria. We will use the Cochrane risk-of-bias tool and Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach to rate the quality of evidence. We will perform meta-analysis or narrative synthesis as appropriate to answer our three research questions: (1) what is the effectiveness of Home-PR compared with Centre-PR or Usual care? (2) what components are used in effective Home-PR studies? and (3) what is the completion rate of Home-PR compared with Centre-PR? ETHICS AND DISSEMINATION: Research ethics approval is not required since the study will review only published data. The findings will be disseminated through publication in a peer-reviewed journal and presentation in conferences. PROSPERO REGISTRATION NUMBER: CRD42020220137.


Subject(s)
Pulmonary Disease, Chronic Obstructive , Respiration Disorders , Adult , Exercise , Humans , Meta-Analysis as Topic , Quality of Life , Systematic Reviews as Topic , Treatment Outcome
10.
Respirology ; 26(10): 1001-1003, 2021 10.
Article in English | MEDLINE | ID: covidwho-1334516
11.
Can J Diabetes ; 45(6): 524-530, 2021 Aug.
Article in English | MEDLINE | ID: covidwho-1317699

ABSTRACT

OBJECTIVES: Patients with diabetes are potentially at higher risk of mortality due to coronavirus disease-2019 (COVID-19). In this study, we aimed to compare the outcomes and severity of pulmonary involvement in COVID-19 patients with and without diabetes. METHODS: In this cohort study, we recruited patients with diabetes who were hospitalized due to COVID-19 during the period from February 2020 to May 2020. Hospitalized individuals without diabetes were enrolled as control subjects. All patients were followed for 90 days and clinical findings and patients' outcomes were reported. RESULTS: Over a period of 4 months, 127 patients with diabetes and 127 individuals without diabetes with a diagnosis of COVID-19 were recruited. Their mean age was 65.70±12.51 years. Mortality was higher in the group with diabetes (22.8% vs 15.0%; p=0.109), although not significantly. More severe pulmonary involvement (p=0.015), extended hospital stay (p<0.001) and greater need for invasive ventilation (p=0.029) were reported in this population. Stepwise logistic regression revealed that diabetes was not independently associated with mortality (p=0.092). Older age (odds ratio [OR], 1.054; p=0.003), aggravated pulmonary involvement on admission (OR, 1.149; p=0.001), presence of comorbidities (OR, 1.290; p=0.020) and hypothyroidism (OR, 6.576; p=0.021) were associated with mortality. Diabetic foot infection had a strong positive correlation with mortality (OR, 49.819; p=0.016), whereas insulin therapy had a negative correlation (OR, 0.242; p=0.045). CONCLUSIONS: The mortality rate due to COVID-19 did not differ significantly between patients with or without diabetes. Older age, macrovascular complications and presence of comorbidities could increase mortality in people with diabetes. Insulin therapy during hospitalization could attenuate the detrimental effects of hyperglycemia and improve prognosis of patients with COVID-19 and diabetes.


Subject(s)
COVID-19/mortality , Diabetes Mellitus, Type 2/mortality , Hospitalization/trends , Respiration Disorders/mortality , Severity of Illness Index , Adult , Aged , COVID-19/diagnostic imaging , COVID-19/therapy , Cohort Studies , Diabetes Mellitus, Type 2/diagnostic imaging , Diabetes Mellitus, Type 2/therapy , Female , Follow-Up Studies , Humans , Male , Middle Aged , Mortality/trends , Respiration Disorders/diagnostic imaging , Respiration Disorders/therapy
12.
Respir Investig ; 59(5): 679-682, 2021 Sep.
Article in English | MEDLINE | ID: covidwho-1309378

ABSTRACT

There is a concern that persons with underlying respiratory disease may have increased susceptibility to COVID-19 and/or increased severity/mortality if infected. However, information regarding such patients during the first wave of the epidemic is lacking in Japan. We surveyed chest physicians nationwide, and collected anonymous data concerning 1444 patients. Among COVID-19 patients, the prevalence of asthma, chronic obstructive pulmonary disease (COPD), and interstitial lung diseases (ILD) was 3.4%, 4.8%, and 1.5%, respectively. Among COVID-19 patients with these 3 comorbidities, exacerbation of the comorbidity occurred in 12.2%, 18.8%, and 36.4%, respectively, and mortality (6.2% overall) was 4.1%, 13.0%, and 31.8%, respectively. The prevalence of asthma among COVID-19 patients was not higher than that for the general population, and mortality in COVID-19 patients with asthma was not higher than mortality in COVID-19 patients without underlying respiratory disease. COVID-19 patients having COPD or ILD had relatively high mortality, especially for ILD.


Subject(s)
COVID-19 , Respiration Disorders/etiology , COVID-19/complications , Comorbidity , Humans , Japan/epidemiology , Prevalence , SARS-CoV-2
13.
Annu Rev Biomed Eng ; 23: 547-577, 2021 07 13.
Article in English | MEDLINE | ID: covidwho-1307981

ABSTRACT

The host-to-host transmission of respiratory infectious diseases is fundamentally enabled by the interaction of pathogens with a variety of fluids (gas or liquid) that shape pathogen encapsulation and emission, transport and persistence in the environment, and new host invasion and infection. Deciphering the mechanisms and fluid properties that govern and promote these steps of pathogen transmission will enable better risk assessment and infection control strategies, and may reveal previously underappreciated ways in which the pathogens might actually adapt to or manipulate the physical and chemical characteristics of these carrier fluids to benefit their own transmission. In this article, I review our current understanding of the mechanisms shaping the fluid dynamics of respiratory infectious diseases.


Subject(s)
Communicable Diseases/physiopathology , Communicable Diseases/transmission , Hydrodynamics , Respiration Disorders/physiopathology , Aerosols , COVID-19/transmission , History, 19th Century , History, 20th Century , History, 21st Century , Humans , Infectious Disease Medicine/history , Physical Distancing , Respiratory System/physiopathology , Respiratory System/virology , Rheology , SARS-CoV-2 , Saliva , Ventilation
14.
Int J Mol Sci ; 22(7)2021 Apr 01.
Article in English | MEDLINE | ID: covidwho-1299439

ABSTRACT

The endocannabinoid system (ECS) employs a huge network of molecules (receptors, ligands, and enzymatic machinery molecules) whose interactions with other cellular networks have still not been fully elucidated. Endogenous cannabinoids are molecules with the primary function of control of multiple metabolic pathways. Maintenance of tissue and cellular homeostasis by functional fine-tuning of essential metabolic pathways is one of the key characteristics of the ECS. It is implicated in a variety of physiological and pathological states and an attractive pharmacological target yet to reach its full potential. This review will focus on the involvement of ECS in glucose and lipid metabolism, food intake regulation, immune homeostasis, respiratory health, inflammation, cancer and other physiological and pathological states will be substantiated using freely available data from open-access databases, experimental data and literature review. Future directions should envision capturing its diversity and exploiting pharmacological options beyond the classical ECS suspects (exogenous cannabinoids and cannabinoid receptor monomers) as signaling through cannabinoid receptor heteromers offers new possibilities for different biochemical outcomes in the cell.


Subject(s)
Endocannabinoids/metabolism , Metabolic Networks and Pathways , Receptors, Cannabinoid/metabolism , Animals , Appetite Regulation , Carbohydrate Metabolism , Endocannabinoids/immunology , Humans , Lipid Metabolism , Neoplasms/etiology , Neoplasms/metabolism , Respiration Disorders/immunology , Respiration Disorders/metabolism
15.
Sci Rep ; 11(1): 13854, 2021 07 05.
Article in English | MEDLINE | ID: covidwho-1297314

ABSTRACT

To describe the long-term health outcomes of patients with COVID-19 and investigate the potential risk factors. Clinical data during hospitalization and at a mean (SD) day of 249 (15) days after discharge from 40 survivors with confirmed COVID-19 (including 25 severe cases) were collected and analyzed retrospectively. At follow-up, severe cases had higher incidences of persistent symptoms, DLCO impairment, and higher abnormal CT score as compared with mild cases. CT score at follow-up was positively correlated with age, LDH level, cumulative days of oxygen treatment, total dosage of glucocorticoids used, and CT peak score during hospitalization. DLCO% at follow-up was negatively correlated with cumulative days of oxygen treatment during hospitalization. DLCO/VA% at follow-up was positively correlated with BMI, and TNF-α level. Among the three groups categorized as survivors with normal DLCO, abnormal DLCO but normal DLCO/VA, and abnormal DLCO and DLCO/VA, survivors with abnormal DLCO and DLCO/VA had the lowest serum IL-2R, IL-8, and TNF-α level, while the survivors with abnormal DLCO but normal DLCO/VA had the highest levels of inflammatory cytokines during hospitalization. Altogether, COVID-19 had a greater long-term impact on the lung physiology of severe cases. The long-term radiological abnormality maybe relate to old age and the severity of COVID-19. Either absent or excess of inflammation during COVID-19 course would lead to the impairment of pulmonary diffusion function.


Subject(s)
COVID-19/epidemiology , Lung/virology , Respiration Disorders/virology , SARS-CoV-2/pathogenicity , Survivors , Adult , Aged , Follow-Up Studies , Humans , Lung/physiopathology , Male , Middle Aged , Respiration Disorders/physiopathology , Respiratory Physiological Phenomena , Retrospective Studies , Survivors/statistics & numerical data
16.
Curr Res Transl Med ; 69(4): 103300, 2021 10.
Article in English | MEDLINE | ID: covidwho-1294187

ABSTRACT

Heparin has served as a mainstream anticoagulant for over eight decades. Clinically heparin-derived compounds significantly contribute to prevention and treatment of thrombotic events complicated in numerous medical conditions such as venous thromboembolism, coronary artery disease and extracorporeal circulation processes. Moreover in recent years, various off-labeled efficacious potentials of heparin beyond anti-coagulation are dramatically emerging, and increasingly investigated in clinical studies. Herein this article presents a comprehensive update on the expanded applications of heparin agents, covering the pregnant clinic, respiratory inflammation, renal disease, sepsis, pancreatitis, among others. It aims to maximize the beneficial profile of a pharmaceutical product through medical re-purposing development, exemplified by heparin, to address the unmet clinical needs of severe illness including coronavirus disease 2019 (COVID-19).


Subject(s)
COVID-19/drug therapy , Drug Repositioning , Heparin/therapeutic use , SARS-CoV-2 , Abortion, Habitual/prevention & control , Burns/drug therapy , COVID-19/blood , COVID-19/complications , Female , Forecasting , Heparin/pharmacology , Humans , Neoplasms/blood , Neoplasms/complications , Nephrotic Syndrome/drug therapy , Pancreatitis/drug therapy , Pregnancy , Pregnancy Complications/drug therapy , Respiration Disorders/drug therapy , Sepsis/drug therapy , Thromboembolism/prevention & control , Thrombophilia/drug therapy , Thrombophilia/etiology
17.
Thorax ; 76(7): 726-728, 2021 07.
Article in English | MEDLINE | ID: covidwho-1270899

ABSTRACT

Acute admission to hospital for an exacerbation of chronic respiratory disease (CRD) may impair skeletal muscle mass and function. We measured quadriceps thickness (Qthick), as a surrogate marker of muscle mass, at hospital admission, discharge, 6 weeks and 3 months in 55 patients with CRD. Qthick fell by 8.3% during the period of hospitalisation, which was sustained at 6 weeks, and only partially recovered at 3 months. Sustained loss was most marked in patients readmitted during the follow-up period. Acute reduction in quadriceps muscle mass occurs during hospitalisation, with prolonged and variable recovery, which is prevented with subsequent hospital readmission.


Subject(s)
Patient Admission/statistics & numerical data , Quadriceps Muscle/physiopathology , Respiration Disorders/complications , Sarcopenia/etiology , Aged , Chronic Disease , Disease Progression , Female , Follow-Up Studies , Humans , Male , Prognosis , Quality of Life , Respiration Disorders/physiopathology , Retrospective Studies , Risk Factors , Sarcopenia/physiopathology
18.
Curr Opin Pediatr ; 33(3): 302-310, 2021 06 01.
Article in English | MEDLINE | ID: covidwho-1211436

ABSTRACT

PURPOSE OF REVIEW: Pediatric coronavirus disease 2019 (COVID-19) respiratory disease is a distinct entity from adult illness, most notable in its milder phenotype. This review summarizes the current knowledge of the clinical patterns, cellular pathophysiology, and epidemiology of COVID-19 respiratory disease in children with specific attention toward factors that account for the maturation-related differences in disease severity. RECENT FINDINGS: Over the past 14 months, knowledge of the clinical presentation and pathophysiology of COVID-19 pneumonia has rapidly expanded. The decreased disease severity of COVID-19 pneumonia in children was an early observation. Differences in the efficiency of viral cell entry and timing of immune recognition and response between children and adults remain at the center of ongoing research. SUMMARY: The clinical spectrum of COVID-19 respiratory disease in children is well defined. The age-related differences protecting children from severe disease and death remain incompletely understood.


Subject(s)
COVID-19 , Respiration Disorders , Respiratory Tract Diseases , Adult , Child , Humans , SARS-CoV-2 , Severity of Illness Index
20.
Expert Rev Respir Med ; 15(8): 1083-1088, 2021 08.
Article in English | MEDLINE | ID: covidwho-1159749

ABSTRACT

OBJECTIVE: This study explored the change in mortality rates of respiratory disease during the corona virus disease 2019 (COVID-19) pandemic. METHODS: Death data of registered residents of Suzhou from 2014 to 2020 were collected and the weekly mortality rates due to respiratory disease and all deaths were analyzed. The differences in mortality rates during the pandemic and the same period in previous years were compared. RESULTS: Before the pandemic, the crude mortality rate (CMR) and standardized mortality rate (SMR) of Suzhou residents including respiratory disease, were not much different from those in previous years. During the emergency period, the CMR of Suzhou residents was 180.2/100,000 and the SMR was 85.5/100,000, decreasing by 9.1% and 14.6%, respectively; the CMR of respiratory disease was 16.4/100,000 and the SMR was 6.8/100,000, down 41.4% and 44.9%, respectively. Regardless of the mortality rates of all deaths or respiratory disease, the rates were higher in males than in females, although males had aslightly greater decrease in all deaths during the emergency period compared with females, and the opposite was true for respiratory disease. CONCLUSION: During the pandemic, the death rate of residents decreased, especially that due to respiratory disease.


Subject(s)
COVID-19 , Respiration Disorders , Female , Humans , Male , Pandemics , SARS-CoV-2
SELECTION OF CITATIONS
SEARCH DETAIL
...