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1.
Respiration ; 99(9): 755-763, 2020.
Artículo en Inglés | MEDLINE | ID: covidwho-910309

RESUMEN

BACKGROUND: Effective auscultations are often hard to implement in isolation wards. To date, little is known about the characteristics of pulmonary auscultation in novel coronavirus (COVID-19) pneumonia. OBJECTIVES: The aim of this study was to explore the features and clinical significance of pulmonary auscultation in COVID-19 pneumonia using an electronic stethoscope in isolation wards. METHODS: This cross-sectional, observational study was conducted among patients with laboratory-confirmed COVID-19 at Wuhan Red-Cross Hospital during the period from January 27, 2020, to February 12, 2020. Standard auscultation with an electronic stethoscope was performed and electronic recordings of breath sounds were analyzed. RESULTS: Fifty-seven patients with average age of 60.6 years were enrolled. The most common symptoms were cough (73.7%) during auscultation. Most cases had bilateral lesions (96.4%) such as multiple ground-glass opacities (69.1%) and fibrous stripes (21.8%). High-quality auscultation recordings (98.8%) were obtained, and coarse breath sounds, wheezes, coarse crackles, fine crackles, and Velcro crackles were identified. Most cases had normal breath sounds in upper lungs, but the proportions of abnormal breath sounds increased in the basal fields where Velcro crackles were more commonly identified at the posterior chest. The presence of fine and coarse crackles detected 33/39 patients with ground-glass opacities (sensitivity 84.6% and specificity 12.5%) and 8/9 patients with consolidation (sensitivity 88.9% and specificity 15.2%), while the presence of Velcro crackles identified 16/39 patients with ground-glass opacities (sensitivity 41% and specificity 81.3%). CONCLUSIONS: The abnormal breath sounds in COVID-19 pneumonia had some consistent distributive characteristics and to some extent correlated with the radiologic features. Such evidence suggests that electronic auscultation is useful to aid diagnosis and timely management of the disease. Further studies are indicated to validate the accuracy and potential clinical benefit of auscultation in detecting pulmonary abnormalities in COVID-19 infection.


Asunto(s)
Auscultación , COVID-19/fisiopatología , Pulmón/fisiopatología , Ruidos Respiratorios/fisiopatología , Adulto , Anciano , Anciano de 80 o más Años , Antibacterianos/uso terapéutico , Antivirales/uso terapéutico , COVID-19/diagnóstico , COVID-19/diagnóstico por imagen , COVID-19/terapia , China , Tos/fisiopatología , Estudios Transversales , Equipos y Suministros Eléctricos , Femenino , Glucocorticoides/uso terapéutico , Humanos , Pulmón/diagnóstico por imagen , Masculino , Persona de Mediana Edad , Terapia por Inhalación de Oxígeno , Respiración Artificial , SARS-CoV-2 , Sensibilidad y Especificidad , Índice de Severidad de la Enfermedad , Teléfono Inteligente , Espectrografía del Sonido , Esputo , Estetoscopios , Tomografía Computarizada por Rayos X , Adulto Joven , Tratamiento Farmacológico de COVID-19
2.
BMC Infect Dis ; 20(1): 723, 2020 Oct 02.
Artículo en Inglés | MEDLINE | ID: covidwho-810436

RESUMEN

BACKGROUND: The global pandemic of coronavirus disease 2019 (COVID-19) infection is ongoing and associated with high mortality. The aim of this study was to investigate the efficacy and safety of subcutaneous injection of interferon alpha-2b (IFN alpha-2b) combined with lopinavir/ritonavir (LPV/r) in the treatment of COVID-19 infection, compared with that of using LPV/r alone. METHODS: Patients diagnosed with laboratory-confirmed COVID-19 infection in Wuhan Red Cross hospital during the period from January 23, 2020 to March 19, 2020 were included. The length of stay, the time to viral clearance and adverse reactions during hospitalization were compared between patients using oral LPV/r and combined therapy of LPV/r and subcutaneous injection of IFN alpha-2b. RESULTS: A total of 22 patients were treated with LPV/r alone and 19 with combined therapy with subcutaneous injection of IFN alpha-2b. The average length of hospitalization in the combination group was shorter than that of LPV/r group (16 ± 9.7 vs 23 ± 10.5 days; P = 0.028). Moreover, the days of hospitalization in early intervention group decreased from 25 ± 8.5 days to 10 ± 2.9 days compared with delayed intervention group (P = 0.001). Combined therapy with IFN alpha-2b also significantly reduced the duration of detectable virus in the upper respiratory tract. No patient in each group was transferred to intensive care unit (ICU) or died during the treatment. There was no significant difference in the adverse effect composition between two groups. CONCLUSIONS: Subcutaneous injection of IFN alpha-2b combined with LPV/r shortened the length of hospitalization and accelerated viral clearance in COVID-19 patients, which deserves further investigation in clinical practice.


Asunto(s)
Betacoronavirus , Infecciones por Coronavirus/tratamiento farmacológico , Interferón alfa-2/uso terapéutico , Neumonía Viral/tratamiento farmacológico , Anciano , COVID-19 , Combinación de Medicamentos , Femenino , Humanos , Inyecciones Subcutáneas , Interferón alfa-2/administración & dosificación , Lopinavir/uso terapéutico , Masculino , Persona de Mediana Edad , Pandemias , Ritonavir/uso terapéutico , SARS-CoV-2 , Tratamiento Farmacológico de COVID-19
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