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2.
EBioMedicine ; 85: 104295, 2022 Nov.
Article in English | MEDLINE | ID: covidwho-2104816

ABSTRACT

BACKGROUND: A comparison of pneumonias due to SARS-CoV-2 and influenza, in terms of clinical course and predictors of outcomes, might inform prognosis and resource management. We aimed to compare clinical course and outcome predictors in SARS-CoV-2 and influenza pneumonia using multi-state modelling and supervised machine learning on clinical data among hospitalised patients. METHODS: This multicenter retrospective cohort study of patients hospitalised with SARS-CoV-2 (March-December 2020) or influenza (Jan 2015-March 2020) pneumonia had the composite of hospital mortality and hospice discharge as the primary outcome. Multi-state models compared differences in oxygenation/ventilatory utilisation between pneumonias longitudinally throughout hospitalisation. Differences in predictors of outcome were modelled using supervised machine learning classifiers. FINDINGS: Among 2,529 hospitalisations with SARS-CoV-2 and 2,256 with influenza pneumonia, the primary outcome occurred in 21% and 9%, respectively. Multi-state models differentiated oxygen requirement progression between viruses, with SARS-CoV-2 manifesting rapidly-escalating early hypoxemia. Highly contributory classifier variables for the primary outcome differed substantially between viruses. INTERPRETATION: SARS-CoV-2 and influenza pneumonia differ in presentation, hospital course, and outcome predictors. These pathogen-specific differential responses in viral pneumonias suggest distinct management approaches should be investigated. FUNDING: This project was supported by NIH/NCATS UL1 TR002345, NIH/NCATS KL2 TR002346 (PGL), the Doris Duke Charitable Foundation grant 2015215 (PGL), NIH/NHLBI R35 HL140026 (CSC), and a Big Ideas Award from the BJC HealthCare and Washington University School of Medicine Healthcare Innovation Lab and NIH/NIGMS R35 GM142992 (PS).


Subject(s)
COVID-19 , Influenza, Human , Pneumonia, Viral , Humans , SARS-CoV-2 , Influenza, Human/diagnosis , Influenza, Human/epidemiology , Retrospective Studies , Hospitals
3.
Psychiatr Danub ; 33(1): 18-26, 2021.
Article in English | MEDLINE | ID: covidwho-2100783

ABSTRACT

BACKGROUND: Patients with chronic mental illness are frequently hospitalized and discharged from psychiatry wards. This situation is referred to as the "revolving door phenomenon" (RDP). In addition to factors related to the patient and the disease, limited number of beds leading to shortened hospital stay are among the reasons associated with frequent hospitalization. This study aims to compare patients with RDP and patients with single hospitalization in terms of clinical, sociodemographic, and treatment-oriented characteristics in order to evaluate the risk factors causing frequent hospitalization. SUBJECTS AND METHODS: In this study, patients who were admitted and hospitalized between May 1, 2011 - May 1, 2016 were retrospectively evaluated from patient records. The RDP group consisted of 74 patients and the single-hospitalization group consisted of 59 patients who met inclusion criteria. RESULTS: The RDP group had significantly higher rates of male gender, ECT history, past suicide attempts, multiple drug treatment, clozapine use, legal incidents, and noncompliance to follow up following discharge compared to the single-hospitalization group (p<0.05). CONCLUSION: This study demonstrates that Turkey also has RDP patients with characteristics and hospitalization patterns similar to patients in countries with different cultural, social, and economic conditions. It is important to identify and correct factors that cause frequent hospitalization as it will reduce the burden of the health system as well as provide benefit to the patient.


Subject(s)
Bipolar Disorder , Psychotic Disorders , Schizophrenia , Bipolar Disorder/epidemiology , Hospitalization , Humans , Male , Mood Disorders , Psychotic Disorders/epidemiology , Retrospective Studies , Schizophrenia/epidemiology , Turkey/epidemiology
4.
Eur Rev Med Pharmacol Sci ; 26(20): 7695-7704, 2022 Oct.
Article in English | MEDLINE | ID: covidwho-2100859

ABSTRACT

OBJECTIVE: The majority of children experience a mild course of acute Coronavirus Disease 2019 (COVID-19). Only few studies have looked at long-term recovery from COVID-19 infection in children. The purpose of this study was to identify the predictors of long-COVID by performing a thorough analysis of the clinical, laboratory, and demographic characteristics of children with COVID-19. PATIENTS AND METHODS: Between August and October 2021, data were obtained retrospectively from the medical records of 251 children diagnosed with COVID-19 at a tertiary single-center hospital. The prognostic effects of admission-related factors were compared between patients who experienced long-lasting symptoms and those who did not. RESULTS: Long-COVID symptoms were noted in 12.4% of patients. Joint pain (7.6%), lumbago (4.8%), and headache (3.2%) were the most common symptoms. The mean onset of long-COVID symptoms was 1.35±0.49 months. The onset of long-COVID symptoms was 4 weeks after initial diagnosis in 64.5% of patients and 4-8 weeks later in 35.5% of the patients. The mean duration of long-COVID symptoms was 5.32±2.51 months. Children with long-COVID had higher leukocytes, neutrophils, monocytes, basophils, platelets, and D-dimer when compared with patients without long-COVID (p < 0.001). Leukocytes, neutrophils, monocytes, platelets, and D-dimer had the highest AUC in the ROC analysis (0.694, 0.658, 0.681, 0.667, and 0.612, respectively) and were statistically significant. CONCLUSIONS: Despite the majority of children with COVID-19 having mild or asymptomatic acute disease, the majority of long-COVID symptoms were associated with functional impairment between 1 and 9 months after the start of the infection. Increased leukocytes, monocytes, neutrophils, platelets, and D-dimer appear to be the most powerful laboratory predictors for long-COVID and monitoring these predictors may assist clinicians to identify and follow-up patients with higher risk for long-COVID.


Subject(s)
COVID-19 , Coronavirus Infections , Pneumonia, Viral , Child , Humans , Pandemics , Retrospective Studies
5.
Cir Cir ; 90(5): 678-683, 2022.
Article in English | MEDLINE | ID: covidwho-2100849

ABSTRACT

OBJECTIVE: To know the limitations that the students encountered during the undergraduate surgery course during COVID-19 pandemic. METHOD: Through an online questionnaire, students were asked about the evaluation of the undergraduate surgery course, the limitations encountered during the course, both those perceived by themselves, and the limitations they perceived in teachers. Questions were asked about the total evaluation of the surgery course and the clinical part of the course. RESULTS: 63 students of the subject of surgery were included. The most mentioned limitations of the students were the availability of schedule and teaching material. The most mentioned limitation in relation to the teachers was the lack of technical knowledge. A relationship was found between the evaluation of the course and the interaction between the teacher and the student. CONCLUSIONS: The medical education have undergone great changes, especially the clinical part. There are several limitations in this process that can be improved by teachers and students and the perception of the quality of the course is related to the degree of interaction that teachers had with the students.


OBJETIVO: Conocer las limitaciones que los estudiantes encontraron durante el curso de pregrado de cirugía durante la pandemia de COVID-19. MÉTODO: Mediante un cuestionario en línea, se interrogó a los estudiantes acerca de la evaluación del curso de cirugía de pregrado y las limitaciones encontradas durante el curso, tanto las percibidas por ellos mismos como las que percibieron en sus maestros. Se preguntó acerca de la evaluación total del curso de cirugía y de la parte clínica del curso. RESULTADOS: Se incluyeron 63 estudiantes de la materia de cirugía. Las limitaciones de los estudiantes más mencionadas fueron la disponibilidad de horario y de material didáctico. La limitación más mencionada en relación a los maestros fue la falta de conocimientos técnicos. Se encontró relación entre la evaluación del curso y la interacción que se tuvo entre el maestro y el estudiante. CONCLUSIONES: La educación en medicina ha sufrido grandes cambios, sobre todo la parte clínica. Existen diversas limitaciones en este proceso que pueden mejorarse por parte de maestros y estudiantes, y la percepción de la calidad del curso está relacionada con el grado de interacción que los maestros tuvieron con los estudiantes.


Subject(s)
COVID-19 , Humans , COVID-19/prevention & control , Pandemics/prevention & control , Retrospective Studies
6.
Cir Cir ; 90(5): 596-601, 2022.
Article in English | MEDLINE | ID: covidwho-2100848

ABSTRACT

OBJECTIVE: COVID-19 infection is characterized with elevation of inflammatory markers in bloodstream. A novel inflammatory marker, C-reactive protein (CRP)-to-lymphocyte ratio (CLR), is suggested to be associated with inflammation. We aimed to compare the CLR values of the deceased COVID-19 patients to the CLR of survived subjects. MATERIALS AND METHODS: The patients with COVID-19 whom presented to outpatient or inpatient clinics of AbantIzzet Baysal University Hospital were enrolled to the present retrospective study. Subjects were grouped as either deceased or survived. CLR values of the groups were compared. RESULTS: Study cohort was consisted of 568 subjects in deceased and 4753 patients in survived group. Median CLR of the deceased and survived groups were 90 (0.2-1679)% and 11 (0.2-1062)%, respectively (p < 0.001). The sensitivity (75%) and specificity (70%) of CLR (> 23.4% level) in detecting mortality were higher than those of CRP and ferritin (AUC 0.80, p < 0.001, 95% CI 0.78-0.82). CONCLUSION: We suggest that elevated CLR levels in COVID-19 patients on admission should alert physicians for poor outcome.


OBJETIVO: La infección por Covid-19 se caracteriza por elevación de marcadores inflamatorios en el torrente sanguíneo. Se sugiere que un nuevo marcador inflamatorio, la proporción de C-reactive protein (CRP) a linfocitos (CLR), está asociado con la inflamación. Nuestro objetivo fue comparar los valores de CLR de los pacientes fallecidos con Covid-19 con el CLR de los sujetos sobrevivientes. MATERIALES Y MÉTODOS: Los pacientes con Covid-19 que se presentaron en clínicas ambulatorias o de hospitalización del Hospital Universitario Abant Izzet Baysal se inscribieron en el presente estudio retrospectivo. Los sujetos se agruparon como fallecidos o sobrevivientes. Se compararon los valores de CLR de los grupos. RESULTADOS: La cohorte del estudio estuvo compuesta por 568 sujetos en el grupo fallecido y 4753 pacientes en el grupo sobreviviente. La mediana de CLR de los grupos fallecidos y sobrevivientes fue 90 (0.2-1679)% y 11 (0.2-1062)%, respectivamente (p < 0.001). La sensibilidad (75%) y la especificidad (70%) de CLR (nivel > 23.4%) en la detección de mortalidad fueron superiores a las de CRP y ferritina (AUC 0.80, p < 0.001, IC 95%: 0,78-0.82). CONCLUSIÓN: Sugerimos que los niveles elevados de CLR en pacientes con Covid-19 al ingreso deberían alertar a los médicos sobre un resultado deficiente.


Subject(s)
COVID-19 , Humans , C-Reactive Protein/analysis , Retrospective Studies , Lymphocytes/chemistry , Biomarkers
7.
Cir Cir ; 90(5): 670-677, 2022.
Article in English | MEDLINE | ID: covidwho-2100846

ABSTRACT

OBJECTIVE: To determine the clinical-demographic characteristics of patients recovered from COVID-19 in a third level rehabilitation service. METHOD: A cross-sectional and descriptive study of recovered COVID-19 patients in a rehabilitation service was carried out. Demographic, personal pathological history, his work activity and COVID-19 were taken, as well as alterations after the disease. Descriptive statistics were performed. RESULTS: 186 files were collected. The mean age was 48.04 ± 11.32 years. Male predominance was found (65.6%). 50% of the patients were health workers. The most common previous pathological conditions were sedentary lifestyle (73.7%) and diabetes mellitus (29%). 43.5% presented grade 3 dyspnea according to the modified Medical Research Council scale. There was a high prevalence of neuromuscular involvement, predominantly peripheral neuropathy (48.4%) and dysautonomia (46.2%). CONCLUSIONS: It was possible to determine the clinical-demographic characteristics of patients recovered from COVID-19 in a third-level rehabilitation service, such as age, sex, type of work, previous pathological conditions (diabetes mellitus and arterial hypertension), body mass index, dyspnea, hospitalization, and post-illness disorders. Further investigation of COVID-19 is needed in the development of conditions to different systems.


OBJETIVO: Determinar las características clínico-demográficas de pacientes recuperados de COVID-19 en un servicio de rehabilitación de tercer nivel. MÉTODO: Se realizó un estudio transversal y descriptivo de pacientes recuperados de COVID-19 en un servicio de rehabilitación. Se tomaron antecedentes demográficos, personales patológicos, de su actividad laboral y de COVID-19, así como alteraciones posteriores a la enfermedad. Se realizó estadística descriptiva. RESULTADOS: Se recolectaron 186 expedientes. La edad media fue de 48.04 ± 11.32 años. Se encontró predominio del sexo masculino (65.6%). El 50% de los pacientes eran trabajadores de la salud. Las condiciones patológicas previas más comunes fueron sedentarismo (73.7%) y diabetes mellitus (29%). El 43.5% presentaron disnea de grado 3 acorde a la escala Medical Research Council modificada. Existió alta prevalencia de compromiso neuromuscular, predominando la neuropatía periférica (48.4%) y la disautonomía (46.2%). CONCLUSIONES: Se logró determinar las características clínico-demográficas de pacientes recuperados de COVID-19 en un servicio de rehabilitación de tercer nivel, como la edad, el sexo, el tipo de trabajo, las condiciones patológicas previas (diabetes mellitus e hipertensión arterial), el índice de masa corporal, la disnea, la hospitalización y las alteraciones posteriores a la enfermedad. Es necesaria mayor investigación de la COVID-19 en el desarrollo de afecciones en diferentes sistemas.


Subject(s)
COVID-19 , Humans , Male , Adult , Middle Aged , Female , Cross-Sectional Studies , COVID-19/epidemiology , Dyspnea/etiology , Retrospective Studies
8.
In Vivo ; 36(6): 2823-2827, 2022.
Article in English | MEDLINE | ID: covidwho-2100683

ABSTRACT

BACKGROUND/AIM: COVID-19 is a concerning issue among in-center hemodialysis (HD) patients. To prevent COVID-19 diffusion in our HD facility, weekly rapid nasal antigen test screening was performed for all asymptomatic patients on chronic HD. This study aimed to assess the performance of weekly rapid antigen test in detecting SARS-CoV-2 infection among asymptomatic patients receiving HD. PATIENTS AND METHODS: A retrospective analysis was conducted in HD patients who underwent rapid antigen test screening from December 2021 to March 2022. The diagnosis of COVID-19 with rapid antigen test was always confirmed by reverse transcriptase-polymerase chain reaction (RT-PCR). RESULTS: During the observational period, 1,748 rapid antigen tests were performed in 220 HD patients. Mean age was 68.4±14.6 years. Fifteen (8.5%) patients resulted positive for SARS-CoV-2 infection using rapid antigen tests. The diagnosis was subsequently confirmed in 14 (93.3%) patients by RT-PCR. During the same period, 12 (5.4%) symptomatic patients, regularly screened with weekly rapid antigen test, resulted positive for SARS-CoV-2 infection using RT-PCR. Overall, weekly rapid antigen test screening identified 14 out of 26 (53.8%) COVID-19 cases and showed a positive predictive value of 93%. CONCLUSION: Weekly antigen test screening of asymptomatic patients on chronic HD detected around half of the COVID-19 cases in our population.


Subject(s)
COVID-19 , Humans , Middle Aged , Aged , Aged, 80 and over , COVID-19/diagnosis , COVID-19/epidemiology , SARS-CoV-2 , Retrospective Studies , COVID-19 Testing , Renal Dialysis , Sensitivity and Specificity
9.
In Vivo ; 36(6): 2813-2822, 2022.
Article in English | MEDLINE | ID: covidwho-2100682

ABSTRACT

BACKGROUND/AIM: The novel severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is responsible for generating a global pandemic with deadly consequences and life changes worldwide. With the appearance of the new variants of the virus, clinical manifestations have been reported in the pediatric population, some with severe evolution. The aim of this study was to identify the laboratory parameters necessary to establish an effective therapy. PATIENTS AND METHODS: In the period from August 2020 to September 2021, 234 pediatric patients met the inclusion criteria and were selected for the study. After confirming the COVID-19 diagnosis, laboratory parameters were analyzed and compared to the severity of the illness. RESULTS: Thrombocytopenia (p<0.001), leukocytosis (p<0.001), and lymphopenia (p<0.001) correlated with the severity of the disease. Also, D-dimer values were closely monitored due to the high association of this parameter with an unsatisfactory prognosis and a severe form of the disease. CONCLUSION: The D-dimer values and complete blood count are useful parameters in COVID-19 evaluation in children.


Subject(s)
COVID-19 , Thrombocytopenia , Humans , Child , SARS-CoV-2 , Retrospective Studies , COVID-19 Testing , Biomarkers
11.
Biomedica ; 42(Sp. 2): 59-72, 2022 10 31.
Article in English, Spanish | MEDLINE | ID: covidwho-2100348

ABSTRACT

Introducción. Desde el primer reporte en la provincia de Wuhan (China) en el año 2019, el SARS-CoV-2 se ha diseminado por todo el mundo, provocando un enorme impacto en la salud pública. Para su diagnóstico, la Organización Mundial de la Salud ha incentivado el desarrollo de pruebas rápidas, de simple ejecución, sensibles y específicas, que complementan la RT-qPCR como prueba de referencia. La prueba RT-LAMP ha mostrado ser una excelente alternativa para la detección del SARS-CoV-2 en diferentes biofluidos. OBJETIVO: Validar la técnica RT-LAMP colorimétrica en muestras de hisopado nasofaríngeo previamente confirmadas por RT-qPCR, usando el protocolo Charité, Berlín, Alemania. Materiales y métodos. Un total de 153 muestras de hisopado nasofaríngeo de individuos con sospecha de COVID-19 se sometieron a RT-qPCR y RT-LAMP, usando un estuche comercial colorimétrico (NEB, Germany). La RT-LAMP se practicó con las muestras de ARN extraídas del hisopado nasofaríngeo y con muestras crudas sin previa extracción de ARN. El resultado fue evaluado por un simple cambio de color en la reacción. RESULTADOS: La sensibilidad y especificidad de la técnica RT-LAMP para detectar el gen N del SARS-CoV-2 mediante un set de cebadores previamente reportados (set de Broughton), arrojó valores de 0,97 (0,85-1,00) y 0,81 (0,65-0,92), respectivamente, con un intervalo de confianza del 95%. Otro set de cebadores dirigidos contra otra región del mismo gen (set de Lalli) arrojó valores de sensibilidad y especificidad de 0,96 (0,78-1,00) y 0,77 (0,55-0,92), respectivamente. Sin previa extracción de ARN, se encontró que la sensibilidad fue del 0,95 (0,74-1,00) y la especificidad del 0,88 (0,64-0,99). CONCLUSIONES: Estos resultados evidencian que la técnica RT-LAMP podría considerarse una prueba diagnóstica rápida, de fácil ejecución, libre de equipos sofisticados, sensible y específica, para el diagnóstico del SARS-CoV-2 en muestras de hisopados nasofaríngeos.


Introducción. Desde el primer reporte en la provincia de Wuhan (China) en el año 2019, el SARS-CoV-2 se ha diseminado por todo el mundo, provocando un enorme impacto en la salud pública. Para su diagnóstico, la Organización Mundial de la Salud ha incentivado el desarrollo de pruebas rápidas, de simple ejecución, sensibles y específicas, que complementan la RT-qPCR como prueba de referencia. La prueba RT-LAMP ha mostrado ser una excelente alternativa para la detección del SARS-CoV-2 en diferentes biofluidos. Objetivo. Validar la técnica RT-LAMP colorimétrica en muestras de hisopado nasofaríngeo previamente confirmadas por RT-qPCR, usando el protocolo Charité, Berlín, Alemania. Materiales y métodos. Un total de 153 muestras de hisopado nasofaríngeo de individuos con sospecha de COVID-19 se sometieron a RT-qPCR y RT-LAMP, usando un estuche comercial colorimétrico (NEB, Germany). La RT-LAMP se practicó con las muestras de ARN extraídas del hisopado nasofaríngeo y con muestras crudas sin previa extracción de ARN. El resultado fue evaluado por un simple cambio de color en la reacción. Resultados. La sensibilidad y especificidad de la técnica RT-LAMP para detectar el gen N del SARS-CoV-2 mediante un set de cebadores previamente reportados (set de Broughton), arrojó valores de 0,97 (0,85-1,00) y 0,81 (0,65-0,92), respectivamente, con un intervalo de confianza del 95%. Otro set de cebadores dirigidos contra otra región del mismo gen (set de Lalli) arrojó valores de sensibilidad y especificidad de 0,96 (0,78-1,00) y 0,77 (0,55-0,92), respectivamente. Sin previa extracción de ARN, se encontró que la sensibilidad fue del 0,95 (0,74-1,00) y la especificidad del 0,88 (0,64-0,99). Conclusiones. Estos resultados evidencian que la técnica RT-LAMP podría considerarse una prueba diagnóstica rápida, de fácil ejecución, libre de equipos sofisticados, sensible y específica, para el diagnóstico del SARS-CoV-2 en muestras de hisopados nasofaríngeos.


Subject(s)
COVID-19 , SARS-CoV-2 , Humans , SARS-CoV-2/genetics , China , Retrospective Studies
12.
Biomedica ; 42(Sp. 2): 48-58, 2022 10 31.
Article in English, Spanish | MEDLINE | ID: covidwho-2100347

ABSTRACT

Introducción. El síndrome respiratorio agudo grave causado por el nuevo coronavirus SARSCoV-2 es causa de la emergencia sanitaria por la pandemia de COVID-19. Si bien el humano es el el principal huésped vulnerable, en estudios experimentales y reportes de infección natural, se han encontrado casos de zoonosis inversa de SARS-CoV-2 en animales. OBJETIVO: Evaluar la infección natural por SARS-CoV-2 en gatos y perros de propietarios con diagnóstico de COVID-19 en el Valle de Aburrá, Antioquia, Colombia. Materiales y métodos. La circulación del SARS-CoV-2 se evaluó por RT-qPCR y RT-PCR en muestras de frotis nasofaríngeos y orofaríngeos de gatos y perros cuyos propietarios se encontraban dentro del periodo de los 14 días de aislamiento. Los casos positivos se verificaron amplificando fragmentos de los genes RdRp, N y E; se secuenció el gen RdRp y se analizó filogenéticamente. RESULTADOS: De 80 animales evaluados, seis gatos y tres perros fueron casos confirmados de infección natural por SARS-CoV-2. Los animales no presentaron signos clínicos y sus propietarios, que padecían la infección, reportaron únicamente signos leves de la enfermedad sin complicaciones clínicas. En el análisis de una de las secuencias, se encontró un polimorfismo de un solo nucleótido (SNP) con un cambio en la posición 647, con sustitución del aminoácido serina (S) por una isoleucina (I). Los casos se presentaron en los municipios de Caldas, Medellín y Envigado. CONCLUSIONES: Se infiere que la infección natural en los gatos y perros se asocia al contacto directo con un paciente con COVID-19. No obstante, no es posible determinar la virulencia del virus en este huésped, ni su capacidad de transmisión  zoonótica o entre especie.


Introducción. El síndrome respiratorio agudo grave causado por el nuevo coronavirus SARSCoV-2 es causa de la emergencia sanitaria por la pandemia de COVID-19. Si bien el humano es el el principal huésped vulnerable, en estudios experimentales y reportes de infección natural, se han encontrado casos de zoonosis inversa de SARS-CoV-2 en animales. Objetivo. Evaluar la infección natural por SARS-CoV-2 en gatos y perros de propietarios con diagnóstico de COVID-19 en el Valle de Aburrá, Antioquia, Colombia. Materiales y métodos. La circulación del SARS-CoV-2 se evaluó por RT-qPCR y RT-PCR en muestras de frotis nasofaríngeos y orofaríngeos de gatos y perros cuyos propietarios se encontraban dentro del periodo de los 14 días de aislamiento. Los casos positivos se verificaron amplificando fragmentos de los genes RdRp, N y E; se secuenció el gen RdRp y se analizó filogenéticamente. Resultados. De 80 animales evaluados, seis gatos y tres perros fueron casos confirmados de infección natural por SARS-CoV-2. Los animales no presentaron signos clínicos y sus propietarios, que padecían la infección, reportaron únicamente signos leves de la enfermedad sin complicaciones clínicas. En el análisis de una de las secuencias, se encontró un polimorfismo de un solo nucleótido (SNP) con un cambio en la posición 647, con sustitución del aminoácido serina (S) por una isoleucina (I). Los casos se presentaron en los municipios de Caldas, Medellín y Envigado. Conclusiones. Se infiere que la infección natural en los gatos y perros se asocia al contacto directo con un paciente con COVID-19. No obstante, no es posible determinar la virulencia del virus en este huésped, ni su capacidad de transmisión zoonótica o entre especie.


Subject(s)
COVID-19 , SARS-CoV-2 , Humans , RNA-Dependent RNA Polymerase , Colombia/epidemiology , Retrospective Studies
13.
Biomedica ; 42(Sp. 2): 78-99, 2022 10 31.
Article in English, Spanish | MEDLINE | ID: covidwho-2100346

ABSTRACT

Neuroimmunology is a discipline that increasingly broadens its horizons in the understanding of neurological diseases. At the same time, and in front of the pathophysiological links of neurological diseases and immunology, specific diagnostic and therapeutic approaches have been proposed. Despite the important advances in this discipline, there are multiple dilemmas that concern and filter into clinical practice. This article presents 15 controversies and a discussion about them, which are built with the most up-to-date evidence available. The topics included in this review are: steroid decline in relapses of multiple sclerosis; therapeutic recommendations in MS in light of the SARS-CoV-2 pandemic; evidence of vaccination in multiple sclerosis and other demyelinating diseases; overview current situation of isolated clinical and radiological syndrome; therapeutic failure in multiple sclerosis, as well as criteria for suspension of disease-modifying therapies; evidence of the management of mild relapses in multiple sclerosis; recommendations for prophylaxis against Strongyloides stercolaris; usefulness of a second course of immunoglobulin in the Guillain-Barré syndrome; criteria to differentiate an acute-onset inflammatory demyelinating chronic polyneuropathy versus Guillain-Barré syndrome; and, the utility of angiotensin-converting enzyme in neurosarcoidosis. In each of the controversies, the general problem is presented, and specific recommendations are offered that can be adopted in daily clinical practice.


La neuroinmunología es una disciplina que cada vez amplía más sus horizontes en la comprensión de las enfermedades neurológicas. Contemporáneamente, y a la luz de los nexos fisiopatológicos de las enfermedades neurológicas y la inmunología, se han planteado enfoques diagnósticos y terapéuticos específicos. A pesar de los importantes avances de esta disciplina, existen múltiples dilemas que le conciernen y se filtran en la práctica clínica. En esta revisión, se presentan y discuten 15 controversias, las cuales se construyen con la información clínica disponible más actualizada. Los temas incluidos son: disminución de esteroides en recaídas de esclerosis múltiple; recomendaciones terapéuticas en esclerosis múltiple a la luz de la pandemia por el SARS-CoV-2; evidencia de vacunación en esclerosis múltiple y en otras enfermedades desmielinizantes; panorama actual del síndrome clínico y radiológico aislado; y fallas terapéuticas en esclerosis múltiple; además, criterios para suspender las terapias modificadoras de la enfermedad; evidencia del manejo en recaídas leves; recomendaciones para la profilaxis contra Strongyloides stercolaris; utilidad de un segundo ciclo de inmunoglobulina en el síndrome de Guillain-Barré; criterios para diferenciar una polineuropatía crónica desmielinizante inflamatoria de inicio agudo de un síndrome de Guillain-Barré y, utilidad de la enzima convertidora de angiotensina en neurosarcoidosis. En cada una de las controversias, se presenta la problemática general y se ofrecen recomendaciones específicas que pueden adoptarse en la práctica clínica diaria.


Subject(s)
COVID-19 , SARS-CoV-2 , Humans , Retrospective Studies
14.
Biomedica ; 42(Sp. 2): 14-18, 2022 10 31.
Article in English, Spanish | MEDLINE | ID: covidwho-2100344

ABSTRACT

Durante dos años y medio, tanto en Colombia como en el resto del mundo, hemos enfrentado la pandemia generada por el SARS-CoV-2, agudizando los múltiples problemas de salud pública que venían cursando a manera de sindemias. Tal es el caso de las enfermedades crónicas no transmisibles asociadas, entre otros factores, a los malos hábitos alimenticios, especialmente por el gran consumo de alimentos ultraprocesados y bebidas azucaradas. En julio del 2021, se aprobó la Ley 2120, por medio de la cual se adoptaron medidas para fomentar entornos alimentarios saludables. Entre estas medidas, también se promueve que los alimentos empacados, procesados y que afectan negativamente la salud humana, tengan un sello que identifique sus componentes y valor nutricional para informar a los consumidores sobre el producto que están comprando o consumiendo. Entre las enfermedades más prevalentes en Colombia que afectan la salud bucal, se encuentran las caries y las periodontitis, ambas con factores de riesgo comunes con las enfermedades crónicas no transmisibles. Dados sus costos y prevalencia, dichas enfermedades crónicas no transmisibles resultan primordiales desde un enfoque de gestión del riesgo en salud pública, siendo, quizá, su gravedad mayor durante la pandemia generada por el SARS CoV-2. Asimismo, se especula que la población confinada pudo llegar a consumir más comida chatarra durante la pandemia del COVID-19 en comparación con otros períodos, además, porque en aquellos con enfermedades crónicas no transmisibles, el confinamiento obligado se asocia con mayor sedentarismo y con un menor número de controles médicos regulares, asuntos que se han reportado previamente. La promulgación de la ley de comida chatarra no va a cambiar los hábitos de alimentación de los colombianos "de la noche a la mañana" y, por esto, se necesita con urgencia implementar procesos de educación y sensibilización frente a los efectos adversos de los alimentos procesados y ultraprocesados en la salud.


Durante dos años y medio, tanto en Colombia como en el resto del mundo, hemos enfrentado la pandemia generada por el SARS-CoV-2, agudizando los múltiples problemas de salud pública que venían cursando a manera de sindemias. Tal es el caso de las enfermedades crónicas no transmisibles asociadas, entre otros factores, a los malos hábitos alimenticios, especialmente por el gran consumo de alimentos ultraprocesados y bebidas azucaradas. En julio del 2021, se aprobó la Ley 2120, por medio de la cual se adoptaron medidas para fomentar entornos alimentarios saludables. Entre estas medidas, también se promueve que los alimentos empacados, procesados y que afectan negativamente la salud humana, tengan un sello que identifique sus componentes y valor nutricional para informar a los consumidores sobre el producto que están comprando o consumiendo. Entre las enfermedades más prevalentes en Colombia que afectan la salud bucal, se encuentran las caries y las periodontitis, ambas con factores de riesgo comunes con las enfermedades crónicas no transmisibles. Dados sus costos y prevalencia, dichas enfermedades crónicas no transmisibles resultan primordiales desde un enfoque de gestión del riesgo en salud pública, siendo, quizá, su gravedad mayor durante la pandemia generada por el SARS CoV-2. Asimismo, se especula que la población confinada pudo llegar a consumir más comida chatarra durante la pandemia del COVID-19 en comparación con otros períodos, además, porque en aquellos con enfermedades crónicas no transmisibles, el confinamiento obligado se asocia con mayor sedentarismo y con un menor número de controles médicos regulares, asuntos que se han reportado previamente. La promulgación de la ley de comida chatarra no va a cambiar los hábitos de alimentación de los colombianos "de la noche a la mañana" y, por esto, se necesita con urgencia implementar procesos de educación y sensibilización frente a los efectos adversos de los alimentos procesados y ultraprocesados en la salud.


Subject(s)
COVID-19 , Humans , Colombia/epidemiology , SARS-CoV-2 , Retrospective Studies
15.
J Am Acad Orthop Surg ; 30(22): e1474-e1482, 2022 Nov 15.
Article in English | MEDLINE | ID: covidwho-2100238

ABSTRACT

BACKGROUND: The severe acute respiratory syndrome coronavirus 2 (COVID-19) pandemic has continued to generate notable disruption in elective total hip arthroplasty (THA) and total knee arthroplasty (TKA). The purpose of this study was to determine whether there is any difference in patient characteristics, revenue, and clinical outcomes in patients undergoing THA and TKA after the start of the pandemic. METHODS: We reviewed a consecutive series of 26,493 patients undergoing primary and revision THA and TKA by 48 surgeons in a single arthroplasty practice. We compared demographics, comorbidities, outcomes, and surgeon revenue from THA and TKA procedures from March 2020 to February 2021 with a prepandemic group undergoing a procedure from March 2019 to February 2020. RESULTS: There was a 20% decline in the volume of all cases in the pandemic group ( 11,688 versus 14,664 , P < 0.001). The postpandemic cohort had shorter length of stay (1.58 versus 1.70 days, P = 0.007), had higher rates of home discharge (98% versus 91%, P < 0.001), and were more likely to have their procedure done at an outpatient facility (21% versus 7%, P < 0.001). Even among patients older than 65 years, more pandemic patients underwent a procedure as an outpatient (19% versus 7%, P < 0.001), with no difference in complications or readmissions. Total surgeon charges and payments declined by 17.6% and 16.3%, respectively, during the pandemic ( P = 0.010). CONCLUSION: Although the COVID-19 pandemic resulted in a notable reduction in surgical volume and revenue loss for our practice, we found a marked shift of arthroplasty patients to outpatient facilities with increased rates of home discharge without compromising patient safety.


Subject(s)
Arthroplasty, Replacement, Hip , Arthroplasty, Replacement, Knee , COVID-19 , Humans , Arthroplasty, Replacement, Knee/adverse effects , Pandemics , Patient Readmission , Length of Stay , Postoperative Complications/etiology , Arthroplasty, Replacement, Hip/adverse effects , Retrospective Studies
16.
Niger J Clin Pract ; 25(10): 1660-1665, 2022 Oct.
Article in English | MEDLINE | ID: covidwho-2100049

ABSTRACT

Aim and Background: Because of there is no sufficient evidence showing a relationship between blood types and severity of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection, this study was planned to investigate the effects of ABO blood group on the clinical outcomes of SARS-CoV-2 infection. Patients and Methods: The data of the patients were examined retrospectively. The patients who were hospitalized in wards or intensive care unit, constituted the study group. The patients who presented to the hospital because of other causes and whose blood type examinations were performed, were included in the control group. Results: The study group consisted of 406 six patients were diagnosed with SARS-CoV-2 infection. Control group consisted of 38079 patients whose blood group was determined for any reason in the same period. The rate of Rh negativity was significantly higher in the patient group (p = 0,01). Hospitalization duration in intensive care was significantly longer in the blood type A and AB groups compared to the blood type O group (p = 0,03). Conclusion: Our results are in agreement with other studies suggesting that blood group O individuals are somewhat more resistant to clinically overt infection with SARS-CoV-2 than other blood groups. In addition, Rh negativity may also be an individual risk factor for SARS-CoV-2 infection.


Subject(s)
COVID-19 , Humans , SARS-CoV-2 , Retrospective Studies , Blood Grouping and Crossmatching , ABO Blood-Group System
17.
Niger J Clin Pract ; 25(10): 1745-1750, 2022 Oct.
Article in English | MEDLINE | ID: covidwho-2100047

ABSTRACT

Background: The C-reactive protein (CRP)/albumin ratio (CAR) is one of the new tools to assess the severity of inflammation. It is used to determine clinical severity and prognosis in many diseases. Aim: The present study aimed to investigate the relationship between C-reactive protein (CRP)/albumin ratio (CAR) and prognosis in pregnant patients with more severe COVID-19 infection. Retrospective study. Patients and Methods: The study was conducted in a retrospective manner by scanning the files of pregnant patients who had a positive polymerase chain reaction test result and were hospitalized in Adiyaman Training and Research Hospital. The patients were divided into two groups: patients who were admitted to the intensive care unit and patients who were not admitted. CRP/albumin ratio (CAR) levels were compared between these two groups. The cut-off value was determined in the prediction of intensive-care admission and poor prognosis. Results: 117 patient files were reviewed. 13 patients were followed up with intensive care, whereas 104 patients completed their treatment in the service. The CAR levels of the patients admitted to intensive care were significantly higher (P < 0.01). In the estimation of intensive-care admission, the CAR level was determined to be 0.970 in the area under the curve with 100% sensitivity and 86.5% specificity in the receiver operating characteristic (ROC) curve. The cut-off CAR level was calculated as 1.8. Conclusion: CAR is a valuable biomarker for predicting prognosis, as well as follow-ups of pregnant COVID-19 patients.


Subject(s)
C-Reactive Protein , COVID-19 , Humans , Pregnancy , Female , C-Reactive Protein/analysis , Retrospective Studies , Prognosis , Albumins
18.
Zhonghua Er Ke Za Zhi ; 60(11): 1168-1171, 2022 Nov 02.
Article in Chinese | MEDLINE | ID: covidwho-2099942

ABSTRACT

Objective: To summarize the application experience and the therapeutic effect of Nirmatrelvir-Ritonavir (trade name: Paxlovid) for COVID-19 in children. Methods: A retrospective analysis was performed on the clinical data, including collecting the clinical manifestations and clinical outcomes, dynamically monitoring the blood routine, hepatic and renal function and SARS-CoV-2 nucleic acid results, and observing the related side effects during the treatment, etc, of 3 cases with COVID-19 treated with Paxlovid admitted to Shanghai Children's Hospital (designated referral hospital for SARS-CoV-2 infection in Shanghai) from May 1st to June 1st, 2022. Results: The 3 cases were 12, 14, 17 years of age, among which 2 cases were males, 1 case was female. All 3 cases were mild cases with underlying diseases and risk of developing into severe COVID-19, with symptoms of high fever, sore throat and dry cough. The treatment of Paxlovid at 3rd day of symptom onset contributed to the symptom-free after 1-2 days and negative results of SARS-CoV-2 nucleic acid after 2-4 days. All patients had no adverse manifestations of gastrointestinal tract and nervous system but a case had little skin rashes, which recovered after the withdrawal of Paxlovid. Three cases had normal hepatic and renal function during the Paxlovid treatment. At 3 months after discharge, no clinical manifestations of post-COVID syndrome were found in all 3 cases. Conclusion: Paxlovid was effective and relatively safe in the treatment of 3 children with COVID-19.


Subject(s)
COVID-19 , Nucleic Acids , Child , Male , Humans , Female , SARS-CoV-2 , Ritonavir/therapeutic use , Retrospective Studies , China
19.
Zhonghua Er Ke Za Zhi ; 60(11): 1158-1162, 2022 Nov 02.
Article in Chinese | MEDLINE | ID: covidwho-2099939

ABSTRACT

Objective: To analyze the clinical characteristics of the neonates infected with SARS-CoV-2 during the Omicron outbreak in Shanghai 2022. Methods: In this retrospective case series study, all the 16 neonates with SARS-CoV-2 Omicron infection who were admitted to the neonatal unit in Shanghai Public Health Clinical Center from March 1st to May 31st, 2022 were enrolled. Their epidemiological history, clinical manifestations, nucleic acid cycle threshold (Ct) value and outcomes were analyzed. Based on maternal vaccination, they were divided into vaccinated group and unvaccinated group. Rank sum test and Chi-square test were used for the comparison between the groups. Results: Among the 16 neonates, 10 were male, and 6 were female. All the infants were full-term. The infection was confirmed at the age of 12.5 (8.0, 20.5) days. All the neonates had a history of exposure to infected family members, and thus horizontal transmission was the primary mode. Four infants were asymptomatic, 12 were symptomatic, and there were no severe or critical cases. The most common clinical manifestation was fever (11 cases), with the highest temperature of 38.1 (37.9, 38.3) ℃ and a course of 1-5 days. Other clinical manifestations included nasal obstruction (3 cases), runny nose (2 cases), cough (2 cases), poor feeding (2 cases), vomiting (1 case), and mild tachypnea (1 case). The complete blood counts of all neonates were within the normal range, and the C-reactive protein increased slightly in 1 infant. Chest imaging was performed in 2 infants, showing mild focal exudative changes. Nucleic acid turned negative (Ct value ≥35) within 7-15 days after diagnosis. All neonates fully recovered after supportive treatment, and the length of hospitalization was 13 (10, 14) days. In the telephone follow-up 2 weeks after discharge for all 16 cases, no infant showed reoccurrence of clinical manifestations or nucleic acid reactivation. Maternal vaccination was not significantly correlated with symptomatic infection or the persistence of positive nucleic acid result in neonates (all P>0.05). Conclusions: Horizontal transmission is the primary mode for neonatal SARS-CoV-2 Omicron infection. Neonatal infections are usually mild or asymptomatic, with good short-term outcomes. And their clinical manifestations and laboratory examinations are nonspecific.


Subject(s)
COVID-19 , Nucleic Acids , Infant, Newborn , Male , Female , Humans , SARS-CoV-2 , Retrospective Studies , China/epidemiology , Fever , Disease Outbreaks
20.
Zhonghua Er Ke Za Zhi ; 60(11): 1163-1167, 2022 Nov 02.
Article in Chinese | MEDLINE | ID: covidwho-2099938

ABSTRACT

Objective: To summarize the management and short-term outcomes of neonates delivered by mothers infected with SARS-CoV-2 Omicron variant. Methods: A retrospective study was performed on 158 neonates born to mothers infected with SARS-CoV-2 Omicron variant admitted to the isolation ward of Children's Hospital of Fudan University from March 15th, 2022 to May 30th, 2022. The postnatal infection control measures for these neonates, and their clinical characteristics and short-term outcomes were analyzed. They were divided into maternal symptomatic group and maternal asymptomatic group according to whether their mothers had SARS-CoV-2 symptoms. The clinical outcomes were compared between the 2 groups using Rank sum test and Chi-square test. Results: All neonates were under strict infection control measures at birth and after birth. Of the 158 neonates, 75 (47.5%) were male. The gestational age was (38+3±1+3) weeks and the birth weight was (3 201±463)g. Of the neonates included, ten were preterm (6.3%) and the minimum gestational age was 30+1 weeks. Six neonates (3.8%) had respiratory difficulty and 4 of them were premature and required mechanical ventilation. All 158 neonates were tested negative for SARS-COV-2 nucleic acid by daily nasal swabs for the first 7 days. A total of 156 mothers (2 cases of twin pregnancy) infected with SARS-CoV-2 Omicron variant, the time from confirmed SARS-CoV-2 infection to delivery was 7 (3, 12) days. Among them, 88 cases (56.4%) showed clinical symptoms, but none needed intensive care treatment. The peripheral white blood cell count of the neonates in maternal symptomatic group was significantly higher than that in maternal symptomatic group (23.0 (18.7, 28.0) × 109 vs. 19.6 (15.4, 36.6) × 109/L, Z=2.44, P<0.05). Conclusions: Neonates of mothers infected with SARS-CoV-2 Omicron variant during third trimester have benign short-term outcomes, without intrauterine infection through vertical transmission. Strict infection control measures at birth and after birth can effectively protect these neonates from SARS-CoV-2 infection.


Subject(s)
COVID-19 , Pregnancy Complications, Infectious , Female , Humans , Infant , Infant, Newborn , Male , Pregnancy , Mothers , Pregnancy Complications, Infectious/diagnosis , Pregnancy Complications, Infectious/prevention & control , Retrospective Studies , SARS-CoV-2
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