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1.
J Ayurveda Integr Med ; 13(1): 100397, 2022.
Article in English | MEDLINE | ID: covidwho-1838952

ABSTRACT

BACKGROUND: The corona virus disease 2019 (COVID-19), an acute respiratory disease, caused by a novel corona virus (SARS-CoV-2, previously known as 2019-nCoV), obtained worldwide attention. In this review, we explored the potential siddha strategies for COVID -19 infections. OBJECTIVES: To evaluate the additional benefits of siddha drugs Vasantha kusumakaram mathirai, Thippili rasayanam, Adathodai manapagu and Kabasura kudineer compared to the allopathic standard treatment of care alone in COVID-19 asymptomatic, mild - moderate cases. MATERIALS AND METHODS: The present study was an open label Two arm - randomized controlled interventional clinical study. The Group I patients were assigned to Siddha add on treatment whereas Group II subjects were assigned with standard treatment alone. The sample size was 100 for each group. RESULT: The average number of days taken for reduction of symptoms showed significant results (P < 0.001) in Siddha add on compared with standard treatment. The real - time polymerase chain reaction (RT-PCR) investigation turned negative for 78.33% in Siddha add on and 33.33% in standard treatment after 11-14 days. Similarly, CT chest, covid pattern lung involvement percentage showed highly significant reduction (P < 0.0001) in Siddha add on treatment. In addition, Neutrophil Lymphocyte Ratio (NLR) ratio, showed significant reduction (P < 0.01) when analyzed by Wilcoxon signed rank test, and Renal, Liver parameters were within the normal limits in Siddha add on Group for 25 samples in post treatment. CONCLUSION: Finally, it was concluded that Siddha add on Group showed accelerated recovery for COVID - 19 patients compared to standard Group. The synergistic effect of Siddha add on with standard treatment gave more promising results in the current study of COVID -19.

2.
Perfusion ; : 2676591211018983, 2021 May 27.
Article in English | MEDLINE | ID: covidwho-1820033

ABSTRACT

The outbreak of the novel coronavirus pandemic (COVID-19) has resulted in dramatic changes to the conduct of surgery both from a patient management perspective and in protecting healthcare providers. The current study reports on the status of COVID-19 infections in patients presenting for cardiac surgery with cardiopulmonary bypass (CPB) on circuit complications. A tracking process for monitoring the presence of COVID-19 in adult cardiac surgery patients was integrated into a case documentation system across United States hospitals where out-sourced perfusion services were provided. Assessment included infection status, testing technique employed, surgery status and CPB complications. Records from 5612 adult patients who underwent cardiac surgery between November 1, 2020 and January 18, 2021 from 176 hospitals were reviewed. A sub-cohort of coronary artery bypass graft patients (3283) was compared using a mixed effect binary logistic regression analysis. 4297 patients had negative test results (76.6%) while 49 (0.9%) tested positive for COVID-19, and unknown or no results were reported in 693 (12.4%) and 573 (10.2%) respectively. Coagulation complications were reported at 0.2% in the negative test results group versus 4.1% in the positive test result group (p < 0.001). Oxygenator gas exchange complications were 0.2% in the negative test results group versus 2.0% in the positive test results group (p = 0.088). Coronary artery bypass graft patients with a positive test had significantly higher risk for any CPB complication (p = 0.003) [OR 10.38, CI 2.18-49.53] then negative test patients [OR 0.01, CI 0.00-0.20]. The present study has shown that patients undergoing cardiac surgery with CPB who test positive for COVID-19 have higher CPB complication rate than those who test negative.

3.
Mayo Clin Proc Innov Qual Outcomes ; 2021 Apr 12.
Article in English | MEDLINE | ID: covidwho-1804780

ABSTRACT

OBJECTIVE: To conduct a comprehensive evaluation of coagulation profiles - via traditional and whole blood thromboelastometry tests - in COVID-19 positive vs. COVID-19 negative patients admitted to medical wards for acute pneumonia. PATIENTS AND METHODS: We enrolled all consecutive patients admitted to Internal Medicine wards of Padova University Hospital between 7 March and 30 April 2020 for COVID-19-related pneumonia (cases) vs. non-COVID-19 pneumonia (controls). A group of healthy subjects acted as baseline for thromboelastometry parameters. RESULTS: Fifty-six cases (mean age 64±15 yrs, M/F 37/19) and 56 controls (mean age 76±11 yrs, M/F 35/21) were enrolled. Cases and controls showed markedly hypercoagulable thromboelastometry profiles vs. healthy subjects, mainly characterized by a significantly shorter propagation phase of coagulation (Clot Formation Time, CFT) and significantly increased maximum clot firmness (MCF) (p <0.001 in all comparisons). COVID-19 patients with pneumonia had significantly shorter CFT and higher MCF (p <0.01 and <0.05, respectively in all comparisons) vs. controls. CONCLUSION: Patients admitted to internal medicine wards for COVID-19 pneumonia presented a markedly prothrombotic state, which seems peculiar to COVID-19 rather than pneumonia itself.

4.
J Acquir Immune Defic Syndr ; 85(2): 123-126, 2020 10 01.
Article in English | MEDLINE | ID: covidwho-1806747

ABSTRACT

BACKGROUND: COVID-19 disease has spread globally and was declared a pandemic on March 11, 2020, by the World Health Organization. On March 10, the State of Michigan confirmed its first 2 cases of COVID-19, and the number of confirmed cases has reached 47,182 as of May 11, 2020, with 4555 deaths. SETTING: Currently, little is known if patients living with HIV (PLWH) are at a higher risk of severe COVID-19 or if their antiretrovirals are protective. This study presents epidemiologic and clinical features of COVID-19 infected PLWH in Detroit, Michigan. METHODS: This is a case series that included 14 PLWH with laboratory-confirmed COVID-19 infection who were evaluated at Henry Ford Hospital in Detroit, Michigan, between March 20, 2020, and April 30, 2020. RESULTS: Fourteen PLWH were diagnosed with COVID-19. Twelve patients were men and 2 were women; 13 patients were virally suppressed. Eight patients were hospitalized, and 6 patients were told to self-quarantine at home after their diagnoses. Three patients who were admitted expired during their hospital stay. No patient required bilevel positive airway pressure or nebulizer use in the emergency department, and none developed acute respiratory distress syndrome, pulmonary embolism, deep venous thrombosis, or a cytokine storm while on therapy for COVID-19. CONCLUSION: Although the clinical spectrum of COVID-19 among PLWH cannot be fully ascertained by this report, it adds to the data that suggest that HIV-positive patients with SARS-CoV-2 infection are not at a greater risk of severe disease or death as compared to HIV-negative patients.


Subject(s)
Coronavirus Infections/complications , HIV Infections/complications , Pneumonia, Viral/complications , African Americans , COVID-19 , Comorbidity , Coronavirus Infections/epidemiology , Coronavirus Infections/ethnology , Female , HIV Infections/epidemiology , HIV Infections/ethnology , Humans , Male , Pandemics , Pneumonia, Viral/epidemiology , Pneumonia, Viral/ethnology
5.
Crit Care Explor ; 2(6): e0144, 2020 Jun.
Article in English | MEDLINE | ID: covidwho-1795096

ABSTRACT

OBJECTIVES: Coronavirus disease 2019 is caused by severe acute respiratory syndrome-coronavirus-2 infection to which there is no community immunity. Patients admitted to ICUs have high mortality, with only supportive therapies available. Our aim was to profile plasma inflammatory analytes to help understand the host response to coronavirus disease 2019. DESIGN: Daily blood inflammation profiling with immunoassays. SETTING: Tertiary care ICU and academic laboratory. SUBJECTS: All patients admitted to the ICU suspected of being infected with severe acute respiratory syndrome-coronavirus-2, using standardized hospital screening methodologies, had daily blood samples collected until either testing was confirmed negative on ICU day 3 (coronavirus disease 2019 negative), or until ICU day 7 if the patient was positive (coronavirus disease 2019 positive). INTERVENTIONS: None. MEASUREMENTS AND MAIN RESULTS: Age- and sex-matched healthy controls and ICU patients that were either coronavirus disease 2019 positive or coronavirus disease 2019 negative were enrolled. Cohorts were well-balanced with the exception that coronavirus disease 2019 positive patients were more likely than coronavirus disease 2019 negative patients to suffer bilateral pneumonia. Mortality rate for coronavirus disease 2019 positive ICU patients was 40%. We measured 57 inflammatory analytes and then analyzed with both conventional statistics and machine learning. Twenty inflammatory analytes were different between coronavirus disease 2019 positive patients and healthy controls (p < 0.01). Compared with coronavirus disease 2019 negative patients, coronavirus disease 2019 positive patients had 17 elevated inflammatory analytes on one or more of their ICU days 1-3 (p < 0.01), with feature classification identifying the top six analytes between cohorts as tumor necrosis factor, granzyme B, heat shock protein 70, interleukin-18, interferon-gamma-inducible protein 10, and elastase 2. While tumor necrosis factor, granzyme B, heat shock protein 70, and interleukin-18 were elevated for all seven ICU days, interferon-gamma-inducible protein 10 transiently elevated on ICU days 2 and 3 and elastase 2 increased over ICU days 2-7. Inflammation profiling predicted coronavirus disease 2019 status with 98% accuracy, whereas elevated heat shock protein 70 was strongly associated with mortality. CONCLUSIONS: While many inflammatory analytes were elevated in coronavirus disease 2019 positive ICU patients, relative to healthy controls, the top six analytes distinguishing coronavirus disease 2019 positive ICU patients from coronavirus disease 2019 negative ICU patients were tumor necrosis factor, granzyme B, heat shock protein 70, interleukin-18, interferon-gamma-inducible protein 10, and elastase 2.

6.
Crit Care Explor ; 2(6): e0155, 2020 Jun.
Article in English | MEDLINE | ID: covidwho-1795092

ABSTRACT

OBJECTIVES: Renal replacement therapy in coronavirus disease 2019 patients is complicated by increased activation of the coagulation system. This may worsen the quality of hemodialysis and contribute to a shortage of dialysis machines as well as plastic disposables during the pandemic. This study describes a simple and safe protocol of anticoagulation with low-molecular-weight heparin in combination with bedside sustained low-efficiency hemodialysis in coronavirus disease 2019 patients. DESIGN: Monocentric observational cross-over trial investigating sustained low-efficiency hemodialysis with unfractionated heparin following sustained low-efficiency hemodialysis with low-molecular-weight heparin. SETTING: Coronavirus disease 2019-ICU in a German Tertiary Care University Hospital. PATIENTS: Three consecutive severe coronavirus disease 2019 patients receiving nine sustained low-efficiency hemodialysis therapies with unfractionated heparin followed by 18 sustained low-efficiency hemodialysis therapies with low-molecular-weight heparin. INTERVENTIONS: Switch from IV unfractionated heparin to subcutaneous low-molecular-weight heparin enoxaparin in therapeutic doses for patients receiving bedside sustained low-efficiency hemodialysis. MEASUREMENTS AND MAIN RESULTS: Nine renal replacement therapy sessions in patients anticoagulated with high doses of unfractionated heparin had to be discontinuated prematurely because of clotting of tubes or membrane and poor quality of hemodialysis. In the same patients, the switch to anticoagulation with therapeutic doses of the low-molecular-weight heparin enoxaparin allowed undisturbed bedside sustained low-efficiency hemodialysis for at least 12 hours. Quality of hemodialysis was excellent, no bleeding event was observed. CONCLUSIONS: Systemic anticoagulation with subcutaneous enoxaparin provides an effective and safe renal replacement procedure in critically ill patients with coronavirus disease 2019 and hypercoagulability. The protocol reduces the risk of filter clotting, blood loss, and poor dialysis quality and may also prevent systemic thromboembolism.

7.
Curr Psychol ; : 1-8, 2021 May 12.
Article in English | MEDLINE | ID: covidwho-1748411

ABSTRACT

As in the whole world, the Novel Coronavirus (COVID-19) pandemic poses many threats to healthcare workers in our country too, which leads to anxiety in healthcare workers. This study was conducted to explore the anxiety levels of healthcare workers during the COVID-19 pandemic. The study is a cross-sectional study. The population consisted of health care workers employed in hospitals in seven regions in Turkey. All volunteer healthcare workers were included in the study, and 356 healthcare workers responded to the questionnaire. The data were collected using the State Anxiety Inventory and a questionnaire created by the researchers using an online questionnaire between 10 May 2020 and 15 May 2020. In the evaluation of the data, mean, standard deviation, percentages, t-test, one-way ANOVA, Pearson correlation, and multiple regression analysis were used. 33% of healthcare workers did not have anxiety, 50% had mild, and 17% had severe anxiety. The anxiety scores of those who were nurses (p < 0.001), who were working in the emergency room (p < 0.001), who were involved in treatment for COVID-19 patients (p = 0.040), who left their homes to prevent transmission to their families and relatives during the pandemic (p = 0.038), and whose working hours had changed (p = 0.036) were found to be significantly higher. It was observed that there was a positive and significant relationship between the fear of death and disease transmission, uncertainty, loneliness, anger, and hopelessness, and anxiety levels in healthcare workers. The main factors that significantly affected the anxiety levels of healthcare workers were male gender, weekly working hours, the presence of chronic diseases, and feelings of anger and uncertainty. In conclusion, during the COVID-19 pandemic, healthcare workers experienced some negative emotions, their anxiety levels increased, and they were psychologically affected. Planning psychosocial interventions for healthcare workers in the high-risk group will make significant contributions to the health system.

8.
J Thromb Thrombolysis ; 53(2): 321-334, 2022 Feb.
Article in English | MEDLINE | ID: covidwho-1729348

ABSTRACT

OBJECTIVE: We aimed to investigate both the impact of COVID-19 pandemic on ST-segment elevation myocardial infarction (STEMI) admission, and demographic, angiographic, procedural characteristics, and in-hospital clinical outcomes of patients with COVID-19 positive STEMI in Turkey. METHODS: This was a multi-center and cross-sectional observational study. The study population included 1788 STEMI patients from 15 centers in Turkey. The patients were divided into two groups: COVID-19 era (March 11st-May 15st, 2020; n = 733) or pre- COVID-19 era group (March 11st-May 15st, 2019; n = 1055). Also, the patients in COVID-19 era were grouped as COVID-19 positive (n = 65) or negative (n = 668). RESULTS: There was a 30.5% drop in STEMI admission during COVID-19 era in comparison to pre-COVID-19 era. The patients admitted to the medical centers during COVID-19 era had a longer symptom-to-first medical contact time [120 (75-240) vs. 100 (60-180) minutes, p < 0.001]. COVID-19 positive STEMI patients had higher thrombus grade and lower left ventricular ejection fraction compared to COVID-19 negative patients. COVID-19 positive patients had higher mortality (28% vs. 6%, p < 0.001) and cardiogenic shock (20% vs. 7%, p < 0.001) rates compared with those without COVID-19. Matching based on propensity scores showed higher mortality and high thrombus grade in STEMI patients who were infected by SARS-COV-2 (each p < 0.05). CONCLUSIONS: We detected significantly lower STEMI hospitalization rates and significant delay in duration of symptom onset to first medical contact in the context of Turkey during the COVID-19 outbreak. Moreover, high thrombus grade and mortality were more common in COVID-19 positive STEMI patients.


Subject(s)
COVID-19 , ST Elevation Myocardial Infarction , COVID-19/epidemiology , Cross-Sectional Studies , Hospitalization/statistics & numerical data , Humans , Pandemics , Registries , SARS-CoV-2 , ST Elevation Myocardial Infarction/diagnosis , ST Elevation Myocardial Infarction/mortality , Stroke Volume , Time-to-Treatment , Turkey/epidemiology , Ventricular Function, Left
9.
Nutrients ; 12(5)2020 May 09.
Article in English | MEDLINE | ID: covidwho-1725875

ABSTRACT

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) causes coronavirus disease 2019 (COVID-19), with a clinical outcome ranging from mild to severe, including death. To date, it is unclear why some patients develop severe symptoms. Many authors have suggested the involvement of vitamin D in reducing the risk of infections; thus, we retrospectively investigated the 25-hydroxyvitamin D (25(OH)D) concentrations in plasma obtained from a cohort of patients from Switzerland. In this cohort, significantly lower 25(OH)D levels (p = 0.004) were found in PCR-positive for SARS-CoV-2 (median value 11.1 ng/mL) patients compared with negative patients (24.6 ng/mL); this was also confirmed by stratifying patients according to age >70 years. On the basis of this preliminary observation, vitamin D supplementation might be a useful measure to reduce the risk of infection. Randomized controlled trials and large population studies should be conducted to evaluate these recommendations and to confirm our preliminary observation.


Subject(s)
Coronavirus Infections/blood , Pneumonia, Viral/blood , Vitamin D/analogs & derivatives , Age Factors , Aged , Aged, 80 and over , Betacoronavirus/isolation & purification , COVID-19 , Coronavirus Infections/diagnosis , Dietary Supplements , Female , Humans , Male , Middle Aged , Pandemics , Pneumonia, Viral/diagnosis , Polymerase Chain Reaction , Retrospective Studies , SARS-CoV-2 , Switzerland , Vitamin D/administration & dosage , Vitamin D/blood
10.
Vox Sang ; 117(1): 80-86, 2022 Jan.
Article in English | MEDLINE | ID: covidwho-1627321

ABSTRACT

BACKGROUND AND OBJECTIVES: Shortage of blood during the severe acute respiratory syndrome-COV-2 (SARs-COV-2) pandemic impacted transfusion practice. The primary aim of the study is to assess management of acute haemolytic crisis (AHC) in glucose-6-phosphate dehydrogenase(G6PD)- deficient children during SARs-COV-2 pandemic, and then to assess blood donation situation and the role of telemedicine in management. METHODS: Assessment of G6PD-deficient children attending the Emergency Department (ER) with AHC from 1 March 2020 for 5 months in comparison to same period in the previous 2 years, in three paediatric haematology centres. AHC cases presenting with infection were tested for SARs-COV-2 using RT-PCR. Children with Hb (50-65 g/L) and who were not transfused, were followed up using telemedicine with Hb re-checked in 24 h. RESULTS: A 45% drop in ER visits due to G6PD deficiency-related AHC during SARs-COV-2 pandemic in comparison to the previous 2 years was observed. 10% of patients presented with fever and all tested negative for COVID-19 by RT-PCR. 33% of patients had Hb < 50 g/L and were all transfused. 50% had Hb between 50 and 65 g/L, half of them (n = 49) did not receive transfusion and only two patients (4%) required transfusion upon follow up. A restrictive transfusion strategy was adopted and one of the reasons was a 39% drop in blood donation in participating centres. CONCLUSION: Fewer G6PD-deficient children with AHC visited the ER during SARs-COV-2 and most tolerated lower Hb levels. Telemedicine was an efficient tool to support their families. A restrictive transfusion strategy was clear in this study.


Subject(s)
COVID-19 , Glucosephosphate Dehydrogenase Deficiency , Blood Transfusion , Child , Glucosephosphate Dehydrogenase , Glucosephosphate Dehydrogenase Deficiency/epidemiology , Humans , Pandemics , SARS-CoV-2
11.
J Pediatr Hematol Oncol ; 44(1): e296-e298, 2022 01 01.
Article in English | MEDLINE | ID: covidwho-1603356

ABSTRACT

INTRODUCTION: Roseola infantum is always considered to be among the differential diagnosis of young patients with fever and leukopenia whom to be strictly isolated with the preliminary diagnosis of COVID-19 until otherwise proven during the pandemic. RESULTS: Human herpes virus-6 (HHV-6) polymerase chain reaction (PCR) blood test was performed in 4 of 7 patients with a clinical diagnosis of roseola infantum and all found to be HHV-6 PCR positive. The most striking laboratory finding in all patients was leukopenia. HHV-6 PCR tests were found to be positive. Severe acute respiratory syndrome coronavirus-2 testing were found to be negative in all patients. CONCLUSION: During the peak of the pandemic, children continued to present with fever because of viral infections other than COVID-19.


Subject(s)
Exanthema Subitum/diagnosis , Herpesvirus 6, Human/isolation & purification , COVID-19/diagnosis , Child, Preschool , Female , Humans , Infant , Leukopenia/diagnosis , Male , SARS-CoV-2/isolation & purification
12.
Clin Infect Dis ; 73(12): 2283-2293, 2021 12 16.
Article in English | MEDLINE | ID: covidwho-1592629

ABSTRACT

BACKGROUND: Venous thromboembolism (VTE) is a potentially fatal complication of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection, and thromboprophylaxis should be balanced against risk of bleeding. This study examined risks of VTE and major bleeding in hospitalized and community-managed SARS-CoV-2 patients compared with control populations. METHODS: Using nationwide population-based registries, 30-day risks of VTE and major bleeding in SARS-CoV-2 positive patients were compared with those of SARS-CoV-2 test-negative patients and with an external cohort of influenza patients. Medical records of all COVID-19 patients at 6 departments of infectious diseases in Denmark were reviewed in detail. RESULTS: The overall 30-day risk of VTE was 0.4% (40/9460) among SARS-CoV-2 patients (16% hospitalized), 0.3% (649/226 510) among SARS-CoV-2 negative subjects (12% hospitalized), and 1.0% (158/16 281) among influenza patients (59% hospitalized). VTE risks were higher and comparable in hospitalized SARS-CoV-2 positive (1.5%), SARS-CoV-2 negative (1.8%), and influenza patients (1.5%). Diagnosis of major bleeding was registered in 0.5% (47/9460) of all SARS-CoV-2 positive individuals and in 2.3% of those hospitalized. Medical record review of 582 hospitalized SARS-CoV-2 patients observed VTE in 4% (19/450) and major bleeding in 0.4% (2/450) of ward patients, of whom 31% received thromboprophylaxis. Among intensive care patients (100% received thromboprophylaxis), risks were 7% (9/132) for VTE and 11% (15/132) for major bleeding. CONCLUSIONS: Among people with SARS-CoV-2 infection in a population-based setting, VTE risks were low to moderate and were not substantially increased compared with SARS-CoV-2 test-negative and influenza patients. Risk of severe bleeding was low for ward patients, but mirrored VTE risk in the intensive care setting.


Subject(s)
COVID-19 , Venous Thromboembolism , Anticoagulants , Cohort Studies , Hemorrhage/epidemiology , Humans , SARS-CoV-2 , Venous Thromboembolism/epidemiology
13.
Ann Med ; 53(1): 337-344, 2021 12.
Article in English | MEDLINE | ID: covidwho-1575678

ABSTRACT

BACKGROUND: To minimise the risk of COVID-19 transmission, an ambulant screening protocol for COVID-19 in patients before admission to the hospital was implemented, combining the SARS CoV-2 reverse-transcriptase polymerase chain reaction (RT-PCR) on a nasopharyngeal swab, a chest computed tomography (CT) and assessment of clinical symptoms. The aim of this study was to evaluatethe diagnostic yield and the proportionality of this pre-procedural screeningprotocol. METHODS: In this mono-centre, prospective, cross-sectional study, all patients admitted to the hospital between 22nd April 2020 until 14th May 2020 for semi-urgent surgery, haematological or oncological treatment, or electrophysiological investigationunderwent a COVID-19 screening 2 days before their procedure. At a 2-week follow-up, the presence of clinical symptoms was evaluated by telephone as a post-hoc evaluation of the screening approach.Combined positive RT-PCR assay and/or positive chest CT was used as gold standard. Post-procedural outcomes of all patients diagnosed positive for COVID-19 were assessed. RESULTS: In total,528 patients were included of which 20 (3.8%) were diagnosed as COVID-19 positive and 508 (96.2%) as COVID-19 negative. 11 (55.0%) of COVID-19 positive patients had only a positive RT-PCR assay, 3 (15.0%) had only a positive chest CT and 6 (30%) had both a positive RT-PCR assay and chest CT. 10 out of 20 (50.0%) COVID-19 positive patients reported no single clinical symptom at the screening. At 2 week follow-up, 50% of these patients were still asymptomatic. 37.5% of all COVID-19 negative patients were symptomatic at screening. In the COVID-19 negative group without symptoms at screening, 78 (29.3%) patients developed clinical symptoms at a 2-week follow-up. CONCLUSION: This study suggests that routine chest CT and assessment of self-reported symptoms have limited value in the preprocedural COVID-19 screening due to low sensitivity and/or specificity.


Subject(s)
COVID-19 Testing/methods , COVID-19/diagnosis , Mass Screening/methods , Patient Admission , Adult , Aged , COVID-19/epidemiology , Cross-Sectional Studies , Female , Follow-Up Studies , Humans , Male , Middle Aged , Prospective Studies , Reverse Transcriptase Polymerase Chain Reaction , Sensitivity and Specificity , Tomography, X-Ray Computed
14.
Infect Dis Now ; 51(5): 435-439, 2021 Aug.
Article in English | MEDLINE | ID: covidwho-1574384

ABSTRACT

INTRODUCTION: Coronavirus disease 2019 (COVID-19) has spread rapidly across the world. Given the sharply increased infection rate, the number of pregnant women and children with COVID-19 is correspondingly on the rise. SARS-CoV-2 infection is transmitted through droplets; though hypothesized, other transmission routes have not been confirmed. As of now, it remains unclear whether and how SARS-CoV-2 can possibly be transmitted from the mother to the fetus. METHOD: This study examines the medical records of 30 neonates born to women with COVID-19, the objective being to provide documented information on maternal-child transmission and infant outcomes. RESULTS: Out of the 30 newborns, 28 had negative PCR test results for SARS-CoV-2; among their mothers, fifteen had fever, nine had cough and twenty had delivered by cesarean section. The median birth term was 37wk2dy, and twenty of the neonates were male. Most of them were asymptomatic, except for the three who presented with shortness of breath. Two of them were intubated and both died, the first because of severe sepsis and the second due to severe hyaline membrane disease. As regards the two infected neonates, the first represents a probable case of congenital SARS-CoV-2 infection, which appears unlikely in the second case. The outcome for both of them was good, without any complications. CONCLUSION: Maternal-fetal transmission of the SARS- CoV-2 virus was not detected in the majority of the reported cases, although two of 30 neonates had positive qRT-PCR test results. Our study supports the hypothesis that though it seldom actually occurs, in utero SARS-CoV-2 vertical transmission is possible.


Subject(s)
COVID-19/transmission , Infectious Disease Transmission, Vertical , Pregnancy Complications, Infectious/virology , Adult , COVID-19/diagnosis , Cesarean Section/statistics & numerical data , Female , Fever/epidemiology , Humans , Infant, Newborn , Male , Mothers , Polymerase Chain Reaction , Pregnancy , Pregnancy Complications, Infectious/diagnosis , Pregnancy Outcome , Pregnant Women , SARS-CoV-2/isolation & purification
15.
Int J Infect Dis ; 113 Suppl 1: S7-S12, 2021 Dec.
Article in English | MEDLINE | ID: covidwho-1573985

ABSTRACT

The October 2020 Global TB report reviews TB control strategies and United Nations (UN) targets set in the political declaration at the September 2018 UN General Assembly high-level meeting on TB held in New York. Progress in TB care and prevention has been very slow. In 2019, TB remained the most common cause of death from a single infectious pathogen. Globally, an estimated 10.0 million people developed TB disease in 2019, and there were an estimated 1.2 million TB deaths among HIV-negative people and an additional 208, 000 deaths among people living with HIV. Adults accounted for 88% and children for 12% of people with TB. The WHO regions of South-East Asia (44%), Africa (25%), and the Western Pacific (18%) had the most people with TB. Eight countries accounted for two thirds of the global total: India (26%), Indonesia (8.5%), China (8.4%), the Philippines (6.0%), Pakistan (5.7%), Nigeria (4.4%), Bangladesh (3.6%) and South Africa (3.6%). Only 30% of the 3.5 million five-year target for children treated for TB was met. Major advances have been development of new all oral regimens for MDRTB and new regimens for preventive therapy. In 2020, the COVID-19 pandemic dislodged TB from the top infectious disease cause of mortality globally. Notably, global TB control efforts were not on track even before the advent of the COVID-19 pandemic. Many challenges remain to improve sub-optimal TB treatment and prevention services. Tuberculosis screening and diagnostic test services need to be ramped up. The major drivers of TB remain undernutrition, poverty, diabetes, tobacco smoking, and household air pollution and these need be addressed to achieve the WHO 2035 TB care and prevention targets. National programs need to include interventions for post-tuberculosis holistic wellbeing. From first detection of COVID-19 global coordination and political will with huge financial investments have led to the development of effective vaccines against SARS-CoV2 infection. The world now needs to similarly focus on development of new vaccines for TB utilizing new technological methods.


Subject(s)
COVID-19 , Tuberculosis, Miliary , Adult , Child , Humans , Nigeria , Pandemics , RNA, Viral , SARS-CoV-2
16.
Infect Drug Resist ; 13: 2681-2687, 2020.
Article in English | MEDLINE | ID: covidwho-1557264

ABSTRACT

PURPOSE: To determine whether new pulmonary lesions will develop in COVID-19 patients with negative initial chest CT findings and to investigate their CT features and outcome during treatment. PATIENTS AND METHODS: Data were collected retrospectively from 29 patients who had tested positive for COVID-19 by reverse-transcription polymerase chain reaction testing but negative by initial chest CT from January 22 to February 17, 2020. Clinical manifestations, laboratory indicators, and follow-up CT data were evaluated. RESULTS: Among 317 confirmed COVID-19 patients, 29 (9.1%) (mean ± SD, 38.5 ± 20.5 years; 12 women) with negative initial chest CT findings were evaluated. New pulmonary lesions developed in 10 (34.5%) patients on follow-up CT. Mean time from onset of new lesions to initial CT was 5.8 ± 3.0 days (range: 2-12 days). New lesions (mean involved lobes and segments: 2.5 ± 1.6 [range: 1-5] and 4.5 ± 4.5 [range: 1-13]) were mainly spherical/patchy ground-glass opacities frequently located in the left lower lobe (9, 90.0%). Among the 10 patients, lesions in 6 (60.0%) indicated progression after occurrence, and those in 10 (100.0%) indicated significant absorption on latest CT. When new lesions developed, 6 (60.0%) patients developed new symptoms or had aggravated symptoms and 3 (30.0%) had decreased lymphocyte count. Patients with worsening symptoms had higher involvement of lung segments (mean: 6.5 ± 5.0, range: 1-13) than asymptomatic patients (mean: 1.5 ± 0.6, range: 1-2) (P = 0.057). CONCLUSION: In COVID-19 patients with negative initial chest CT findings, new pulmonary lesions may develop during treatment. Repeat CT is necessary for monitoring the disease, especially when patients have worsening symptoms or laboratory indicators.

17.
J Thromb Thrombolysis ; 52(4): 1207-1211, 2021 Nov.
Article in English | MEDLINE | ID: covidwho-1525575

ABSTRACT

Coronavirus disease 2019 (COVID-19) is associated with a high incidence of venous and arterial thromboembolic events. The role of anticoagulation (AC) prior to hospital admission and how different types of oral AC influences the outcome of COVID-19 is currently unknown. This observational study compares the outcome in COVID-19 patients with prior use of direct oral anticoagulants (DOAC) or vitamin K antagonists (VKA), and without prior use of AC. We collected the baseline characteristics and outcomes of COVID-19 patients presented to the emergency department of Bernhoven Hospital, the Netherlands. The primary outcome was all-cause mortality within 30 days and analyzed in a multivariable Cox proportional hazards model including age, sex, symptom duration, home medication, and comorbidities. We included 497 patients, including 57 patients with DOAC (11%) and 53 patients with VKA (11%). Patients with AC had a lower body temperature and lower C-reactive protein levels. Comparing the primary outcome in patients with AC (DOAC or VKA) and no AC, the adjusted hazard ratio (aHR) was 0.64 (95% CI 0.42-0.96, P = 0.03). Comparing DOAC and no AC, the aHR was 0.53 (95% CI 0.32-0.89, P = 0.02) and comparing VKA and no AC, the aHR was 0.77 (95% CI 0.47-1.27, P = 0.30). In a subgroup analysis of DOAC, all nine patients with prior use of dabigatran survived within 30 days. In this observational study, the prior use of AC is associated with a better survival of COVID-19. DOAC, especially dabigatran, might have additional beneficial effects.


Subject(s)
Anticoagulants , COVID-19 , Dabigatran , Survival Rate , Administration, Oral , Anticoagulants/therapeutic use , COVID-19/mortality , Dabigatran/therapeutic use , Fibrinolytic Agents , Humans , Netherlands , Vitamin K/antagonists & inhibitors
18.
J Clin Med ; 10(8)2021 Apr 19.
Article in English | MEDLINE | ID: covidwho-1526843

ABSTRACT

There is limited data on the effect of the novel coronavirus disease (COVID-19) caused by severe acute respiratory syndrome-coronavirus-2 (SARS-CoV-2) on pediatric rheumatology. We examined the prevalence of antibodies against SARS-CoV-2 in children with juvenile idiopathic arthritis (JIA) and a negative history of COVID-19 and the correlation of the presence of these antibodies with disease activity measured by juvenile arthritis disease activity score (JADAS). In total, 62 patients diagnosed with JIA, under treatment with various antirheumatic drugs, and 32 healthy children (control group) were included. Serum samples were analyzed for inflammatory markers and antibodies and their state evaluated with the juvenile arthritis disease activity score (JADAS). JIA patients do not have a higher seroprevalence of anti-SARS-CoV-2 antibodies than healthy subjects. We found anti-SARS-CoV-2 antibodies in JIA patients who did not have a history of COVID-19. The study showed no unequivocal correlation between the presence of SARS-CoV-2 antibodies and JIA activity; therefore, this relationship requires further observation. We also identified a possible link between patients' humoral immune response and disease-modifying antirheumatic treatment, which will be confirmed in follow-up studies.

19.
Int J Lab Hematol ; 43 Suppl 1: 137-141, 2021 Jul.
Article in English | MEDLINE | ID: covidwho-1526369

ABSTRACT

INTRODUCTION: Eosinopenia has been observed during infection with the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), the causative agent of COVID-19. This study evaluated the role of eosinopenia as a diagnostic and prognostic indicator in COVID-19 infection. METHODS: Information on 429 patients with confirmed COVID-19, admitted to Apollo Hospitals, Chennai, India between 04 June 2020 to 15 August 2020, was retrospectively collected through electronic records and analysed. RESULTS: 79.25% of the patients included in the study had eosinopenia on admission. The median eosinophil count in COVID-19-positive patients was 0.015 × 109 /L, and in negative patients, it was 0.249 × 109 /L. Eighteen per cent of the positive patients presented with 0 eosinophil count. Eosinopenia for early diagnosis of COVID-19 had a sensitivity of 80.68% and specificity of 100% with an accuracy of 85.24. Role of eosinopenia in prognostication of COVID-19 was found to be insignificant. There was no statistically significant difference between the median eosinophil counts in survivors and nonsurvivors. Eosinophil trends during the course of disease were found to be similar between survivors and nonsurvivors. CONCLUSIONS: Eosinopenia on admission is a reliable and convenient early diagnostic marker for COVID-19 infection, helping in early identification, triaging and isolation of the patients till nucleic acid test results are available. Role of eosinopenia as a prognostic indicator is insignificant.


Subject(s)
COVID-19 Testing/methods , COVID-19/blood , Eosinophils , Leukocyte Count , Leukopenia/etiology , Area Under Curve , Biomarkers , COVID-19/diagnosis , COVID-19/mortality , Eosinophilia/blood , Eosinophilia/etiology , Humans , India , Leukopenia/blood , Prognosis , ROC Curve , Retrospective Studies , Selection Bias , Sensitivity and Specificity , Survival Analysis
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