Your browser doesn't support javascript.
Show: 20 | 50 | 100
Results 1 - 20 de 14.657
Filter
Add filters

Document Type
Year range
1.
Clin Infect Dis ; 2020 Jul 10.
Article in English | MEDLINE | ID: covidwho-1621567

ABSTRACT

Hospitalized patients with COVID-19 experiencing respiratory symptoms have different complications (inflammatory, co-infection and thrombotic) that are identifiable by analytics patterns. Personalized treatment decisions decreased early mortality (OR 0.144, CI 0.03-0.686; p=0.015). Increasing age (OR 1.06; p=0.038) and therapeutic effort limitation (OR 9.684; p<0.001) were associated with higher mortality.

2.
Clin Infect Dis ; 2020 Jul 01.
Article in English | MEDLINE | ID: covidwho-1621566

ABSTRACT

We are learning that the host response to SARS-CoV-2 infection is complex and highly dynamic. Effective initial host defense in the lung is associated with mild symptoms and disease resolution. Viral evasion of the immune response can lead to refractory alveolar damage, ineffective lung repair mechanisms, and systemic inflammation with associated organ dysfunction. The immune response in these patients is highly variable and can include moderate to severe systemic inflammation and/or marked systemic immune suppression. There is unlikely to be a "one size fits all" approach to immunomodulation in patients with COVID-19.  We believe that a personalized, immunophenotype-driven approach to immunomodulation that may include anti-cytokine therapy in carefully selected patients and immunostimulatory therapies in others is the shortest path to success in the study and treatment of patients with critical illness due to COVID-19.

3.
Clin Infect Dis ; 2020 May 30.
Article in English | MEDLINE | ID: covidwho-1621564

ABSTRACT

Calls for adherence to evidence-based medicine have emerged during the initial wave of the COVID-19 pandemic but reports of outcomes are lacking. This retrospective study of a single-institution cohort including 135 patients with confirmed COVID-19 demonstrates positive outcomes when institutional standards of care consist of evidence-based supportive therapies.

4.
Indian J Otolaryngol Head Neck Surg ; : 1-5, 2020 Nov 09.
Article in English | MEDLINE | ID: covidwho-1616248

ABSTRACT

Background This study outlines the unique modifications to surgical tracheostomy procedure to combat the extraordinary situation the world has found itself in due to COVID 19 pandemic. We explain the modifications employed to the operative setup, anesthetic considerations and surgical procedure to enable us to provide timely and safe tracheostomy to the COVID ICU patients requiring it, while simultaneously maximally protecting our surgical personnel from the deadly exposure. Methods- We conducted 55 surgical tracheostomies in severely sick ICU patients with the modifications deemed fit to achieve safe procedure for both the patient and the operating team. We analyzed the hospital record data of these patients and the surgical teams COVID 19 status to assesss the efficacy of our procedural modifications. Discussion- The COVID 19 pandemic has thrown the entire medical fraternity into a dilemma as to how to provide the best possible care to the patients while protecting ourselves from its grip. Severely sick COVID patients often require tracheostomy for improved prognosis. We performed bedside open surgical tracheostomy and induced transient apnoea periprocedur along with carinal intubation. By making these simple and cost effective modifications to the procedure, we have ensured that patients get tracheostomised as and when required but not at the cost of the health and lives of our health care workers.

7.
J Clin Gastroenterol ; 56(1): e38-e46, 2022 01 01.
Article in English | MEDLINE | ID: covidwho-1605073

ABSTRACT

OBJECTIVE: The authors investigated the incidence, risk factors, clinical characteristics, and outcomes of upper gastrointestinal bleeding (UGB) in patients with coronavirus disease 2019 (COVID-19), who were attending the emergency department (ED), before hospitalization. METHODS: We retrospectively reviewed all COVID-19 patients diagnosed with UGB in 62 Spanish EDs (20% of Spanish EDs, case group) during the first 2 months of the COVID-19 outbreak. We formed 2 control groups: COVID-19 patients without UGB (control group A) and non-COVID-19 patients with UGB (control group B). Fifty-three independent variables and 4 outcomes were compared between cases and controls. RESULTS: We identified 83 UGB in 74,814 patients with COVID-19 who were attending EDs (1.11%, 95% CI=0.88-1.38). This incidence was lower compared with non-COVID-19 patients [2474/1,388,879, 1.78%, 95% confidence interval (CI)=1.71-1.85; odds ratio (OR)=0.62; 95% CI=0.50-0.77]. Clinical characteristics associated with a higher risk of COVID-19 patients presenting with UGB were abdominal pain, vomiting, hematemesis, dyspnea, expectoration, melena, fever, cough, chest pain, and dysgeusia. Compared with non-COVID-19 patients with UGB, COVID-19 patients with UGB more frequently had fever, cough, expectoration, dyspnea, abdominal pain, diarrhea, interstitial lung infiltrates, and ground-glass lung opacities. They underwent fewer endoscopies in the ED (although diagnoses did not differ between cases and control group B) and less endoscopic treatment. After adjustment for age and sex, cases showed a higher in-hospital all-cause mortality than control group B (OR=2.05, 95% CI=1.09-3.86) but not control group A (OR=1.14, 95% CI=0.59-2.19) patients. CONCLUSIONS: The incidence of UGB in COVID-19 patients attending EDs was lower compared with non-COVID-19 patients. Digestive symptoms predominated over respiratory symptoms, and COVID-19 patients with UGB underwent fewer gastroscopies and endoscopic treatments than the general population with UGB. In-hospital mortality in COVID-19 patients with UGB was increased compared with non-COVID patients with UGB, but not compared with the remaining COVID-19 patients.


Subject(s)
COVID-19 , Gastrointestinal Hemorrhage/diagnosis , Gastrointestinal Hemorrhage/epidemiology , Gastrointestinal Hemorrhage/etiology , Gastroscopy , Humans , Incidence , Retrospective Studies , Risk Factors , SARS-CoV-2
8.
Clin Hemorheol Microcirc ; 75(1): 7-11, 2020.
Article in English | MEDLINE | ID: covidwho-1581406

ABSTRACT

There is growing evidence that COVID-19 not only affects the lungs but beyond that the endothelial system. Recent studies showed that this can lead to microcirculatory impairments and in consequence to functional disorders of all inner organs. The combination of endothelial dysfunction with a generalized inflammatory state and complement elements may together contribute to the overall pro-coagulative state described in COVID-19 patients leading to venular as well as to arteriolar occlusions.


Subject(s)
Betacoronavirus/pathogenicity , Coronavirus Infections/pathology , Endothelium, Vascular/virology , Pneumonia, Viral/pathology , COVID-19 , Coronavirus Infections/virology , Endothelium, Vascular/pathology , Humans , Pandemics , Pneumonia, Viral/virology , SARS-CoV-2
9.
Stem Cell Investig ; 7: 11, 2020.
Article in English | MEDLINE | ID: covidwho-1579497

ABSTRACT

The COVID-19 pandemic has presented with debilitating respiratory consequences especially more pronounced in high risk individuals. Individuals with underlying systemic diseases are more prone and vulnerable to suffer severe consequences of SARS-CoV-2 infectivity. The pathophysiological changes identified cytokine storm mechanism for out setting the series of adverse clinical conditions. Thereby, associating it with high mortality rates. This warrants urgent consideration of divergent modalities such as the cellular therapy. Cellular therapy (CT) is a new medical paradigm wherein cellular material is administered to patients for therapeutic purposes. In this regard, mesenchymal stem cells (MSCs) have yielded the most promising results among stromal vascular fraction (SVF); placental cells; natural killer (NK) cell and platelet lysate respectively. Following the administration of the CT as per preferred route, these play pivotal role in modifying the microenvironment of the lung tissue with their distinct sets of mechanism. Evidences have shown how their immunomodulatory action repairs and prevents lung injury which in turn improvise the compliance of lungs. In this review article we have discussed these emerging novel approaches and their target step serving as a ray of hope to combat severe form of COVID-19. Currently these aren't approved for preventing or treating COVID-19 cases, however clinical trials are afoot to dispense the utmost understanding in terms of efficacy and safety concerns.

11.
J Oral Microbiol ; 13(1): 1853451, 2020 Nov 29.
Article in English | MEDLINE | ID: covidwho-1575938

ABSTRACT

The oral cavity, as the entry point to the body, may play a critical role in the pathogenesis of SARS-CoV-2 infection that has caused a global outbreak of the coronavirus disease 2019 (COVID-19). Available data indicate that the oral cavity may be an active site of infection and an important reservoir of SARS-CoV-2. Considering that the oral surfaces are colonized by a diverse microbial community, it is likely that viruses have interactions with the host microbiota. Patients infected by SARS-CoV-2 may have alterations in the oral and gut microbiota, while oral species have been found in the lung of COVID-19 patients. Furthermore, interactions between the oral, lung, and gut microbiomes appear to occur dynamically whereby a dysbiotic oral microbial community could influence respiratory and gastrointestinal diseases. However, it is unclear whether SARS-CoV-2 infection can alter the local homeostasis of the resident microbiota, actively cause dysbiosis, or influence cross-body sites interactions. Here, we provide a conceptual framework on the potential impact of SARS-CoV-2 oral infection on the local and distant microbiomes across the respiratory and gastrointestinal tracts ('oral-tract axes'), which remains largely unexplored. Studies in this area could further elucidate the pathogenic mechanism of SARS-CoV-2 and the course of infection as well as the clinical symptoms of COVID-19 across different sites in the human host.

14.
Indian J Crit Care Med ; 24(11): 1143-1144, 2020 Nov.
Article in English | MEDLINE | ID: covidwho-1575140

ABSTRACT

How to cite this article: Nair PR, Maitra S, Ray BR, Anand RK, Baidya DK, Subramaniam R. Neutrophil-to-lymphocyte Ratio and Platelet-to-lymphocyte Ratio as Predictors of the Early Requirement of Mechanical Ventilation in COVID-19 Patients. Indian J Crit Care Med 2020;24(11):1143-1144.

15.
Anaesthesist ; 2020 Nov 27.
Article in English | MEDLINE | ID: covidwho-1574765

ABSTRACT

Since December 2019 a novel coronavirus (severe acute respiratory syndrome coronavirus 2, SARS-CoV-2) has rapidly spread around the world resulting in an acute respiratory illness pandemic. The immense challenges for clinicians and hospitals as well as the strain on many healthcare systems has been unprecedented.The majority of patients present with mild symptoms of coronavirus disease 2019 (COVID-19); however, 5-8% become critically ill and require intensive care treatment. Acute hypoxemic respiratory failure with severe dyspnea and an increased respiratory rate (>30/min) usually leads to intensive care unit (ICU) admission. At this point bilateral pulmonary infiltrates are typically seen. Patients often develop a severe acute respiratory distress syndrome (ARDS).So far, remdesivir and dexamethasone have shown clinical effectiveness in severe COVID-19 in hospitalized patients. The main goal of supportive treatment is to ascertain adequate oxygenation. Invasive mechanical ventilation and repeated prone positioning are key elements in treating severely hypoxemic COVID-19 patients.Strict adherence to basic infection control measures (including hand hygiene) and correct use of personal protection equipment (PPE) are essential in the care of patients. Procedures that lead to formation of aerosols should be carried out with utmost precaution and preparation.

18.
20.
Clin Nucl Med ; 47(1): e17-e19, 2022 Jan 01.
Article in English | MEDLINE | ID: covidwho-1570159

ABSTRACT

ABSTRACT: We report 3 patients with COVID-19 findings in 68Ga-PSMA PET/CT taken for staging. The first patient, A 64-year-old man with prostate cancer, who had COVID-19 in November 2020 and whose treatment was completed, was observed to continue with COVID-19 findings in 68Ga-PSMA PET/CT in December 2020 before surgery. Other patients were asymptomatic for the disease. It was determined that a PSMA uptake in the lungs corresponding to the CT findings of COVID-19 had increased in 68Ga-PSMA PET/CT.


Subject(s)
COVID-19 , Prostatic Neoplasms , Edetic Acid , Gallium Isotopes , Gallium Radioisotopes , Humans , Lung/pathology , Male , Middle Aged , Neoplasm Staging , Positron Emission Tomography Computed Tomography , Prostatic Neoplasms/diagnostic imaging , Prostatic Neoplasms/pathology , SARS-CoV-2
SELECTION OF CITATIONS
SEARCH DETAIL
...