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Infecciones por Coronavirus/prevención & control , Pandemias/prevención & control , Equipo de Protección Personal/provisión & distribución , Neumonía Viral/prevención & control , Departamento de Compras en Hospital/estadística & datos numéricos , Betacoronavirus/aislamiento & purificación , COVID-19 , Infecciones por Coronavirus/epidemiología , Infecciones por Coronavirus/mortalidad , Infecciones por Coronavirus/virología , Inglaterra/epidemiología , Equipos y Suministros de Hospitales/estadística & datos numéricos , Equipos y Suministros de Hospitales/provisión & distribución , Empleados de Gobierno/legislación & jurisprudencia , Humanos , Equipo de Protección Personal/tendencias , Neumonía Viral/epidemiología , Neumonía Viral/mortalidad , Neumonía Viral/virología , SARS-CoV-2 , Medicina Estatal/organización & administraciónRESUMEN
Numerous cases of pneumonia from a novel coronavirus (SARS-CoV-2) emerged in Wuhan, China during December 2019.We determined the correlations of patient parameters with disease severity in patients with COVID-19.A total of 132 patients from Wuhan Fourth Hospital who had COVID-19 from February 1 to February 29 in 2020 were retrospectively analyzed.Ninety patients had mild disease, 32 had severe disease, and 10 had critical disease. The severe/critical group was older (Pâ<â.05), had a higher proportion of males (Pâ<â.05), and had a greater mortality rate (0% vs 61.9%, Pâ<â.05). The main symptoms were fever (nâ=â112, 84.8%) and cough (nâ=â96, 72.7%). Patients were treated with antiviral agents (nâ=â94, 71.2%), antibiotics (nâ=â92, 69.7%), glucocorticoids (nâ=â46, 34.8%), intravenous immunoglobulin (nâ=â38, 27.3%), and/or traditional Chinese medicine (nâ=â40, 30.3%). Patients in the severe/critical group received mechanical ventilation (nâ=â22, 16.7%) or high-flow nasal can-nula oxygen therapy (nâ=â6, 4.5%). Chest computed tomography (CT) indicated bilateral pneumonia in all patients. Relative to the mild group, the severe/critical group had higher levels of leukocytes, C-reactive protein (CRP), procalcitonin (PCT), D-dimer, B-type natriuretic peptide (BNP), liver enzymes, and myocardial enzymes (Pâ<â.05), and decreased levels of lymphocytes and blood oxygen partial pressure (Pâ<â.05).The main clinical symptoms of patients from Wuhan who had COVID-19 were fever and cough. Patients with severe/critical disease were more likely to be male and elderly. Disease severity correlated with increased leukocytes, CRP, PCT, BNP, D-dimer, liver enzymes, and myocardial enzymes, and with decreased lymphocytes and blood oxygen partial pressure.
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Infecciones por Coronavirus/epidemiología , Neumonía Viral/epidemiología , Adulto , Anciano , Betacoronavirus/aislamiento & purificación , COVID-19 , China/epidemiología , Infecciones por Coronavirus/sangre , Infecciones por Coronavirus/terapia , Femenino , Humanos , Masculino , Persona de Mediana Edad , Pandemias , Neumonía Viral/sangre , Neumonía Viral/terapia , Estudios Retrospectivos , SARS-CoV-2Asunto(s)
Betacoronavirus/aislamiento & purificación , Control de Enfermedades Transmisibles , Infecciones por Coronavirus , Pandemias , Neumonía Viral , COVID-19 , Control de Enfermedades Transmisibles/legislación & jurisprudencia , Control de Enfermedades Transmisibles/métodos , Control de Enfermedades Transmisibles/organización & administración , Infecciones por Coronavirus/epidemiología , Regulación Gubernamental , Humanos , India/epidemiología , Pandemias/estadística & datos numéricos , Neumonía Viral/epidemiología , SARS-CoV-2Asunto(s)
Lactancia Materna , Infecciones por Coronavirus , Control de Infecciones/métodos , Leche Humana , Pandemias , Neumonía Viral , Complicaciones Infecciosas del Embarazo , Sistemas de Apoyo Psicosocial , Betacoronavirus/inmunología , Betacoronavirus/aislamiento & purificación , Lactancia Materna/métodos , Lactancia Materna/psicología , COVID-19 , Infecciones por Coronavirus/epidemiología , Infecciones por Coronavirus/prevención & control , Infecciones por Coronavirus/transmisión , Femenino , Humanos , Recién Nacido , Transmisión Vertical de Enfermedad Infecciosa/prevención & control , Masculino , Leche Humana/inmunología , Leche Humana/virología , Pandemias/prevención & control , Neumonía Viral/epidemiología , Neumonía Viral/prevención & control , Neumonía Viral/transmisión , Atención Posnatal/métodos , Atención Posnatal/tendencias , Embarazo , Complicaciones Infecciosas del Embarazo/epidemiología , Complicaciones Infecciosas del Embarazo/prevención & control , SARS-CoV-2 , Estados UnidosAsunto(s)
Betacoronavirus , Técnicas de Laboratorio Clínico/normas , Infecciones por Coronavirus/diagnóstico , Técnicas para Inmunoenzimas , Neumonía Viral/diagnóstico , Betacoronavirus/genética , Betacoronavirus/inmunología , Betacoronavirus/aislamiento & purificación , COVID-19 , Prueba de COVID-19 , Ensayo de Inmunoadsorción Enzimática , Humanos , Inmunoglobulina G/análisis , Inmunoglobulina M/análisis , Cavidad Nasal/virología , Pandemias , ARN Viral/análisis , Reacción en Cadena de la Polimerasa de Transcriptasa Inversa , SARS-CoV-2 , Factores de Tiempo , Esparcimiento de VirusRESUMEN
ABSTRACT Introduction: The SARS-CoV-2 pandemic has been a major challenge for the international scientific community. Since its inception, studies aiming to describe pathophysiological aspects and clinical manifestations of the disease have been conducted, raising hypotheses and confirming possible associations. One aspect of this scientific medical production is the role of the ocular surface as a means of transmission and clinical presentation of viral syndrome. Objectives: To analyze the role of the ocular surface in transmission, pathophysiology, and clinical manifestations of SARS-CoV-2, by means of a systematic review. Methods: The search was carried out in three databases: Cochrane, PubMed Central Journals and MEDLINE, using the following descriptors: "COVID-19, ophthalmology". The filters last five years and studies on humans resulted in 32 studies; in that 12 were excluded for not meeting the purpose of the study. Results: There are still few published studies on the relation between SARS-CoV-2 and the ocular route. Most studies showed an association between the presence of nonspecific ocular manifestations and infection by the new coronavirus, with limitations in the number of patients analyzed and the methodology adopted. Hypotheses about the pathophysiological role are largely anchored in the association of SARS-CoV and the ocular surface evaluated in the past. Comments: The results found are still not sufficient to confirm the role of the ocular surface in the pathophysiology of the disease. Most of these preliminary studies are of considerable importance in raising hypotheses based on the medical analysis of the patients studied. However, larger studies with standardized methodology for diagnostic protocol and laboratory analysis of the individuals assessed are required.
RESUMO Introdução: A pandemia da SARS-CoV-2 tem sido um grande desafio para a comunidade científica internacional. Desde seu surgimento, estudos com a intenção de descrever os aspectos fisiopatológicos e as manifestações clínicas da doença vêm sendo conduzidos, levantando hipóteses e confirmando possíveis associações. Um dos temas dessa produção médica científica é o papel da superfície ocular como meio de transmissão e apresentação clínica da síndrome viral. Objetivo: Analisar o papel da superfície ocular na transmissão, na fisiopatologia e nas manifestações clínicas de SARS-CoV-2, através de uma revisão sistemática. Realizou-se a busca em três bancos de dados Cochrane Database, PubMed® e MEDLINE®, utilizando os descritores "COVID-19 e ophthalmology". Foram definidos como filtros o artigo ter sido publicado nos últimos 5 anos e estudo realizado em humanos, tendo sido encontrados 32 artigos. Destes, foram excluídos 12 por não corresponderem ao objetivo do estudo. Resultados: Ainda são poucos os estudos publicados sobre a relação entre o coronavírus 2 da síndrome respiratória aguda grave (SARS-CoV-2) e a via ocular. A maioria dos estudos mostrou associação entre a presença de manifestações oculares inespecíficas e a infecção pelo novo coronavírus, com limitações no número de pacientes analisados e na metodologia adotada. Hipóteses sobre o papel fisiopatológico se ancoram, em grande parte, na associação estudada entre o SARS-CoV-2 e a superfície ocular no passado. Comentários: Os resultados encontrados ainda não são suficientes para confirmar o papel da superfície ocular na fisiopatologia da doença. Grande parte desses estudos preliminares têm importância considerável ao levantar hipóteses baseadas na análise clínica dos pacientes estudados. No entanto, são necessários estudos maiores e com metodologia padronizada para protocolo diagnóstico e análise laboratorial dos indivíduos avaliados.
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Humanos , Infecciones Virales del Ojo/transmisión , Infecciones por Coronavirus/complicaciones , Infecciones por Coronavirus/transmisión , Oftalmopatías/virología , Manifestaciones Oculares , Lágrimas/virología , Conjuntivitis Viral/transmisión , Conjuntiva/virología , Ojo/virología , Betacoronavirus/aislamiento & purificación , SARS-CoV-2 , COVID-19Asunto(s)
Cesárea/métodos , Infecciones por Coronavirus , Parto Obstétrico/métodos , Control de Infecciones/métodos , Complicaciones del Trabajo de Parto/prevención & control , Pandemias , Atención Perinatal/métodos , Neumonía Viral , Complicaciones Infecciosas del Embarazo , Adulto , Betacoronavirus/aislamiento & purificación , COVID-19 , China/epidemiología , Infecciones por Coronavirus/complicaciones , Infecciones por Coronavirus/diagnóstico , Infecciones por Coronavirus/epidemiología , Infecciones por Coronavirus/terapia , Femenino , Humanos , Recién Nacido , Masculino , Complicaciones del Trabajo de Parto/etiología , Neumonía Viral/complicaciones , Neumonía Viral/diagnóstico , Neumonía Viral/epidemiología , Neumonía Viral/terapia , Embarazo , Complicaciones Infecciosas del Embarazo/epidemiología , Complicaciones Infecciosas del Embarazo/terapia , Complicaciones Infecciosas del Embarazo/virología , SARS-CoV-2RESUMEN
In December 2019, a novel coronavirus called severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) caused an outbreak of coronavirus disease 2019 (COVID-19). Severe complications have been reported to occur in 33% of patients with COVID-19 and include acute respiratory distress syndrome, acute renal failure, acute respiratory injury, septic shock, and severe pneumonia. Currently, there is no specific treatment or approved vaccine against COVID-19 and many clinical trials are currently investigating potential medications to treat COVID-19. The immunosuppressed status of some cancer patients (whether caused by the disease itself or the treatment) increases their risk of infection compared with the general population. This short review aims to focus on the impact of COVID-19 on a cancer patient and discuss management options and recommendation in addition to highlighting the currently available clinical guidelines and resources.
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Betacoronavirus/aislamiento & purificación , Infecciones por Coronavirus/complicaciones , Personal de Salud/normas , Neoplasias/patología , Neoplasias/terapia , Neumonía Viral/complicaciones , Guías de Práctica Clínica como Asunto/normas , COVID-19 , Infecciones por Coronavirus/virología , Manejo de la Enfermedad , Humanos , Incidencia , Neoplasias/epidemiología , Neoplasias/virología , Pandemias , Neumonía Viral/virología , SARS-CoV-2Asunto(s)
Betacoronavirus , Control de Enfermedades Transmisibles , Infecciones por Coronavirus , Transmisión de Enfermedad Infecciosa , Salud Global/estadística & datos numéricos , Pandemias , Neumonía Viral , Betacoronavirus/aislamiento & purificación , Betacoronavirus/patogenicidad , COVID-19 , Control de Enfermedades Transmisibles/métodos , Control de Enfermedades Transmisibles/organización & administración , Control de Enfermedades Transmisibles/normas , Infecciones por Coronavirus/epidemiología , Infecciones por Coronavirus/prevención & control , Infecciones por Coronavirus/transmisión , Transmisión de Enfermedad Infecciosa/prevención & control , Transmisión de Enfermedad Infecciosa/estadística & datos numéricos , Humanos , Internacionalidad , Mortalidad , Pandemias/prevención & control , Neumonía Viral/epidemiología , Neumonía Viral/prevención & control , Neumonía Viral/transmisión , Mejoramiento de la Calidad , SARS-CoV-2Asunto(s)
Betacoronavirus , Infecciones por Coronavirus/transmisión , Neumonía Viral/transmisión , Betacoronavirus/aislamiento & purificación , COVID-19 , China , Infecciones por Coronavirus/complicaciones , Infecciones por Coronavirus/diagnóstico por imagen , Femenino , Fiebre/etiología , Humanos , Masculino , Persona de Mediana Edad , Mialgia/epidemiología , Neumonía Viral/complicaciones , Neumonía Viral/diagnóstico por imagen , Radiografía Torácica , SARS-CoV-2 , Esposos , Taiwán , ViajeRESUMEN
BACKGROUND: The coronavirus disease (COVID)-19 epidemic is evolving rapidly. Healthcare workers are at increased risk for infection, and specific requirements for their protection are advisable to ensure the functioning of the basic healthcare system, including the availability of general practitioners (GPs). Understanding the transmission risk is particularly important for guiding evidence-based protective measures in the primary healthcare setting. METHODS: Healthcare worker contacts of an initially undiagnosed COVID-19 case, who were without personal protective equipment, in particular not wearing facemasks, were screened with nasopharyngeal swabs and polymerase chain reaction tests for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), irrespective of respiratory symptoms or fever seven days after initial contact. The details of exposure to the index case were obtained during routine contact investigation after unintentional pathogen exposure. RESULTS: Twenty-one healthcare workers reported contacts with the index case. Three healthcare workers reported respiratory symptoms (cough) or low-grade fever within 4 days. None of them tested positive for SARS-CoV-2 at the time of symptom onset. All 21 healthcare workers tested SARS-CoV-2 negative 7 days after initial index case contact, including the three healthcare workers with previous symptoms. Ten of the 21 healthcare workers reported a cumulative exposure time of >15 minutes. Longer cumulative contact times were associated with more individual contacts, reduced contact time per contact and activities with physical patient contact. The closest relative of the index patient tested SARS-CoV-2 positive 2 days after the index case presented at the hospital emergency department. CONCLUSION: We found a low risk of SARS-CoV-2 transmission in a primary care setting. These findings are compatible with previous reports of the highest transmission probability in household settings with prolonged close contacts. The current protective measures for healthcare workers, including strict adherence to basic standard hygiene and facemasks, offer considerable protection during short periods of contact with symptomatic COVID-19 cases by diminishing the risk of direct and indirect transmission.
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Infecciones por Coronavirus/transmisión , Transmisión de Enfermedad Infecciosa de Paciente a Profesional/estadística & datos numéricos , Neumonía Viral/transmisión , Atención Primaria de Salud/estadística & datos numéricos , Adolescente , Adulto , Anciano , Betacoronavirus/aislamiento & purificación , COVID-19 , Trazado de Contacto , Infecciones por Coronavirus/epidemiología , Femenino , Humanos , Masculino , Persona de Mediana Edad , Pandemias , Neumonía Viral/epidemiología , SARS-CoV-2 , Suiza/epidemiología , Adulto JovenAsunto(s)
Linfocitos B/inmunología , Betacoronavirus/inmunología , Infecciones por Coronavirus/inmunología , Síndrome de Liberación de Citoquinas/inmunología , Inmunidad Celular , Neumonía Viral/inmunología , Linfocitos T/inmunología , Anticuerpos Neutralizantes/inmunología , Anticuerpos Neutralizantes/metabolismo , Anticuerpos Antivirales/inmunología , Anticuerpos Antivirales/metabolismo , Linfocitos B/metabolismo , Betacoronavirus/aislamiento & purificación , COVID-19 , Infecciones por Coronavirus/complicaciones , Infecciones por Coronavirus/epidemiología , Infecciones por Coronavirus/virología , Humanos , Memoria Inmunológica , Pandemias , Neumonía Viral/complicaciones , Neumonía Viral/epidemiología , Neumonía Viral/virología , SARS-CoV-2 , Índice de Severidad de la EnfermedadAsunto(s)
Número Básico de Reproducción/estadística & datos numéricos , Infecciones por Coronavirus , Transmisión de Enfermedad Infecciosa/estadística & datos numéricos , Monitoreo Epidemiológico , Pandemias , Neumonía Viral , Betacoronavirus/aislamiento & purificación , Sesgo , COVID-19 , Infecciones por Coronavirus/epidemiología , Infecciones por Coronavirus/prevención & control , Infecciones por Coronavirus/transmisión , Transmisión de Enfermedad Infecciosa/prevención & control , Mediciones Epidemiológicas , Salud Global , Humanos , Pandemias/prevención & control , Pandemias/estadística & datos numéricos , Neumonía Viral/epidemiología , Neumonía Viral/prevención & control , Neumonía Viral/transmisión , SARS-CoV-2 , Suiza/epidemiologíaRESUMEN
INTRODUCTION: The pandemic caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has exposed vulnerable populations to an unprecedented global health crisis. The knowledge gained from previous human coronavirus outbreaks suggests that pregnant women and their fetuses are particularly susceptible to poor outcomes. The objective of this study was to summarize the clinical manifestations and maternal and perinatal outcomes of COVID-19 during pregnancy. MATERIAL AND METHODS: We searched databases for all case reports and series from 12 February to 4 April 2020. Multiple terms and combinations were used including COVID-19, pregnancy, maternal mortality, maternal morbidity, complications, clinical manifestations, neonatal morbidity, intrauterine fetal death, neonatal mortality and SARS-CoV-2. Eligibility criteria included peer-reviewed publications written in English or Chinese and quantitative real-time polymerase chain reaction (PCR) or dual fluorescence PCR-confirmed SARS-CoV-2 infection. Unpublished reports, unspecified date and location of the study or suspicion of duplicate reporting, cases with suspected COVID-19 that were not confirmed by a laboratory test, and unreported maternal or perinatal outcomes were excluded. Data on clinical manifestations, maternal and perinatal outcomes including vertical transmission were extracted and analyzed. RESULTS: Eighteen articles reporting data from 108 pregnancies between 8 December 2019 and 1 April 2020 were included in the current study. Most reports described women presenting in the third trimester with fever (68%) and coughing (34%). Lymphocytopenia (59%) with elevated C-reactive protein (70%) was observed and 91% of the women were delivered by cesarean section. Three maternal intensive care unit admissions were noted but no maternal deaths. One neonatal death and one intrauterine death were also reported. CONCLUSIONS: Although the majority of mothers were discharged without any major complications, severe maternal morbidity as a result of COVID-19 and perinatal deaths were reported. Vertical transmission of the COVID-19 could not be ruled out. Careful monitoring of pregnancies with COVID-19 and measures to prevent neonatal infection are warranted.
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Betacoronavirus/aislamiento & purificación , Cesárea/estadística & datos numéricos , Infecciones por Coronavirus , Pandemias , Neumonía Viral , Complicaciones Infecciosas del Embarazo , COVID-19 , Infecciones por Coronavirus/complicaciones , Infecciones por Coronavirus/diagnóstico , Infecciones por Coronavirus/epidemiología , Infecciones por Coronavirus/fisiopatología , Femenino , Humanos , Lactante , Recién Nacido , Transmisión Vertical de Enfermedad Infecciosa/estadística & datos numéricos , Mortalidad Materna , Pandemias/estadística & datos numéricos , Mortalidad Perinatal , Neumonía Viral/complicaciones , Neumonía Viral/diagnóstico , Neumonía Viral/epidemiología , Neumonía Viral/fisiopatología , Embarazo , Complicaciones Infecciosas del Embarazo/mortalidad , Complicaciones Infecciosas del Embarazo/fisiopatología , Complicaciones Infecciosas del Embarazo/virología , Resultado del Embarazo , SARS-CoV-2RESUMEN
Following the rapid dissemination of COVID-19 cases in Switzerland, large-scale non-pharmaceutical interventions (NPIs) were implemented by the cantons and the federal government between 28 February and 20 March 2020. Estimates of the impact of these interventions on SARS-CoV-2 transmission are critical for decision making in this and future outbreaks. We here aim to assess the impact of these NPIs on disease transmission by estimating changes in the basic reproduction number (R0) at national and cantonal levels in relation to the timing of these NPIs. We estimated the time-varying R0 nationally and in eleven cantons by fitting a stochastic transmission model explicitly simulating within-hospital dynamics. We used individual-level data from more than 1000 hospitalised patients in Switzerland and public daily reports of hospitalisations and deaths. We estimated the national R0 to be 2.8 (95% confidence interval 2.1–3.8) at the beginning of the epidemic. Starting from around 7 March, we found a strong reduction in time-varying R0 with a 86% median decrease (95% quantile range [QR] 79–90%) to a value of 0.40 (95% QR 0.3–0.58) in the period of 29 March to 5 April. At the cantonal level, R0 decreased over the course of the epidemic between 53% and 92%. Reductions in time-varying R0 were synchronous with changes in mobility patterns as estimated through smartphone activity, which started before the official implementation of NPIs. We inferred that most of the reduction of transmission is attributable to behavioural changes as opposed to natural immunity, the latter accounting for only about 4% of the total reduction in effective transmission. As Switzerland considers relaxing some of the restrictions of social mixing, current estimates of time-varying R0 well below one are promising. However, as of 24 April 2020, at least 96% (95% QR 95.7–96.4%) of the Swiss population remains susceptible to SARS-CoV-2. These results warrant a cautious relaxation of social distance practices and close monitoring of changes in both the basic and effective reproduction numbers.
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Betacoronavirus/aislamiento & purificación , Control de Enfermedades Transmisibles , Infecciones por Coronavirus , Transmisión de Enfermedad Infecciosa , Pandemias/estadística & datos numéricos , Neumonía Viral , COVID-19 , Control de Enfermedades Transmisibles/métodos , Control de Enfermedades Transmisibles/organización & administración , Control de Enfermedades Transmisibles/estadística & datos numéricos , Enfermedades Transmisibles Emergentes/prevención & control , Infecciones por Coronavirus/epidemiología , Infecciones por Coronavirus/prevención & control , Infecciones por Coronavirus/transmisión , Transmisión de Enfermedad Infecciosa/prevención & control , Transmisión de Enfermedad Infecciosa/estadística & datos numéricos , Hospitalización/estadística & datos numéricos , Humanos , Modelos Estadísticos , Mortalidad , Pandemias/prevención & control , Neumonía Viral/epidemiología , Neumonía Viral/prevención & control , Neumonía Viral/transmisión , SARS-CoV-2 , Agrupamiento Espacio-Temporal , Procesos EstocásticosAsunto(s)
Betacoronavirus/aislamiento & purificación , Infecciones por Coronavirus , Obesidad , Pandemias , Neumonía Viral , Factores de Edad , Índice de Masa Corporal , COVID-19 , Comorbilidad , Infecciones por Coronavirus/diagnóstico , Infecciones por Coronavirus/epidemiología , Necesidades y Demandas de Servicios de Salud , Humanos , Obesidad/epidemiología , Obesidad/terapia , Neumonía Viral/diagnóstico , Neumonía Viral/epidemiología , Factores de Riesgo , SARS-CoV-2 , Índice de Severidad de la Enfermedad , Reino Unido/epidemiologíaRESUMEN
The coronavirus disease 2019 (COVID-19), the result of an infection with the new virus, SARS-CoV-2, is rapidly spreading worldwide. It is largely unknown whether the occurrence of COVID-19 in patients with rheumatic immune diseases has some specific manifestations, or makes them more prone to rapidly progress into severe COVID-19. In this case report, we describe the clinical features of 5 rheumatic immune disease patients with the concomitant presence of COVID-19. Amongst these patients, 4 had rheumatoid arthritis (RA) and 1 had systemic sclerosis (SSc). Two patients had a history of close contact with a COVID-19 patient. The age of the patients ranged between 51 and 79 years. Fever (80%), cough (80%), dyspnea (40%), and fatigue (20%) were the most common presenting symptoms. Laboratory investigations revealed leukopenia and lymphopenia in 2 patients. In all the patients, chest computerized tomography (CT) revealed patchy ground glass opacities in the lungs. During the hospital stay, the condition of two patients remained the same (i.e., mild COVID-19), two patients progressed to the severe COVID-19, and one patient worsened to the critically ill COVID-19. These patients were treated with antiviral agents for COVID-19, antibiotics for secondary bacterial infections, and immunomodulatory agents for rheumatic immune diseases. All the patients responded well, were cured of COVID-19, and subsequently discharged.
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Antivirales/uso terapéutico , Artritis Reumatoide , Infecciones por Coronavirus , Inmunomodulación , Pandemias , Neumonía Viral , Esclerodermia Sistémica , Anciano , Artritis Reumatoide/diagnóstico , Artritis Reumatoide/epidemiología , Artritis Reumatoide/terapia , Betacoronavirus/aislamiento & purificación , Recuento de Células Sanguíneas/métodos , COVID-19 , Infecciones por Coronavirus/diagnóstico , Infecciones por Coronavirus/epidemiología , Infecciones por Coronavirus/inmunología , Infecciones por Coronavirus/terapia , Enfermedad Crítica/terapia , Progresión de la Enfermedad , Femenino , Humanos , Pulmón/diagnóstico por imagen , Masculino , Persona de Mediana Edad , Neumonía Viral/diagnóstico , Neumonía Viral/epidemiología , Neumonía Viral/inmunología , Neumonía Viral/terapia , SARS-CoV-2 , Esclerodermia Sistémica/diagnóstico , Esclerodermia Sistémica/epidemiología , Esclerodermia Sistémica/terapia , Evaluación de Síntomas/métodos , Tomografía Computarizada por Rayos X/métodos , Resultado del TratamientoRESUMEN
It has been hypothesized that bacille Calmette-Guerin (BCG), the anti-tuberculosis vaccine, can be protective against Covid-19. Using data of performed swabs and RT-PCR results for SARS-CoV-2 in the Reggio Emilia province (Emilia-Romagna Region, Northern Italy) from March 6th to March 26th, 2020, we computed age, gender, and place of birth (Italy or abroad) specific risk of being tested, prevalence of positive tests, and probability of testing positive given that a swab has been taken during the epidemic peak. We report that immigrants resident in Reggio Emilia province, mostly coming from Countries with high BCG vaccination coverage, and Italians had a similar prevalence of infection (odds ratio - OR 0.99; 95%CI 0.82-1.20) and similar probability of being tested (OR 0.93; 95%CI 0.81-1.10). Our data do not support the hypothesis that immigrants from Countries where BCG vaccination is recommended have a lower risk of Covid-19 infection.
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Betacoronavirus , Infecciones por Coronavirus/epidemiología , Emigrantes e Inmigrantes/estadística & datos numéricos , Pandemias , Neumonía Viral/epidemiología , Adulto , África/etnología , Anciano , Asia/etnología , Vacuna BCG , Betacoronavirus/aislamiento & purificación , COVID-19 , Prueba de COVID-19 , Técnicas de Laboratorio Clínico , Infecciones por Coronavirus/diagnóstico , Infecciones por Coronavirus/etnología , Infecciones por Coronavirus/prevención & control , Femenino , Humanos , Italia/epidemiología , Masculino , Persona de Mediana Edad , Nasofaringe/virología , Pandemias/prevención & control , Neumonía Viral/diagnóstico , Neumonía Viral/etnología , Neumonía Viral/prevención & control , Polonia/etnología , Prevalencia , Utilización de Procedimientos y Técnicas , SARS-CoV-2 , Cobertura de VacunaciónAsunto(s)
Infecciones por Coronavirus/prevención & control , Pandemias/prevención & control , Neumonía Viral/prevención & control , Betacoronavirus/aislamiento & purificación , COVID-19 , Trazado de Contacto/métodos , Infecciones por Coronavirus/epidemiología , Humanos , Neumonía Viral/epidemiología , Administración en Salud Pública/métodos , Cuarentena/métodos , SARS-CoV-2 , Vietnam/epidemiologíaRESUMEN
OBJECTIVES: To report the methods and findings of two complete autopsies of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) positive individuals who died in Oklahoma (United States) in March 2020. METHODS: Complete postmortem examinations were performed according to standard procedures in a negative-pressure autopsy suite/isolation room using personal protective equipment, including N95 masks, eye protection, and gowns. The diagnosis of coronavirus disease 2019 (COVID-19) was confirmed by real-time reverse transcriptase polymerase chain reaction testing on postmortem swabs. RESULTS: A 77-year-old obese man with a history of hypertension, splenectomy, and 6 days of fever and chills died while being transported for medical care. He tested positive for SARS-CoV-2 on postmortem nasopharyngeal and lung parenchymal swabs. Autopsy revealed diffuse alveolar damage and chronic inflammation and edema in the bronchial mucosa. A 42-year-old obese man with a history of myotonic dystrophy developed abdominal pain followed by fever, shortness of breath, and cough. Postmortem nasopharyngeal swab was positive for SARS-CoV-2; lung parenchymal swabs were negative. Autopsy showed acute bronchopneumonia with evidence of aspiration. Neither autopsy revealed viral inclusions, mucus plugging in airways, eosinophils, or myocarditis. CONCLUSIONS: SARS-CoV-2 testing can be performed at autopsy. Autopsy findings such as diffuse alveolar damage and airway inflammation reflect true virus-related pathology; other findings represent superimposed or unrelated processes.