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2.
Cardiol Rev ; 28(6): 308-311, 2020.
Artículo en Inglés | MEDLINE | ID: covidwho-867895

RESUMEN

Cardiac involvement as a complication of severe acute respiratory syndrome coronavirus 2 infection in children is a relatively new entity. We present our initial experience managing children with coronavirus disease 2019-related acute myocardial injury. The 3 patients presented here represent a spectrum of the cardiac involvement noted in children with coronavirus disease 2019-related multisystem inflammatory syndrome, including myocarditis presenting as cardiogenic shock or heart failure with biventricular dysfunction, valvulitis, coronary artery changes, and pericardial effusion.


Asunto(s)
Betacoronavirus , Infecciones por Coronavirus , Insuficiencia Cardíaca , Enfermedades de las Válvulas Cardíacas , Miocarditis , Pandemias , Manejo de Atención al Paciente/métodos , Derrame Pericárdico , Neumonía Viral , Síndrome de Respuesta Inflamatoria Sistémica , Adolescente , Betacoronavirus/aislamiento & purificación , Betacoronavirus/patogenicidad , Técnicas de Imagen Cardíaca/métodos , Niño , Preescolar , Vasos Coronarios/diagnóstico por imagen , Vasos Coronarios/patología , Infecciones por Coronavirus/diagnóstico , Infecciones por Coronavirus/fisiopatología , Infecciones por Coronavirus/terapia , Insuficiencia Cardíaca/etiología , Insuficiencia Cardíaca/terapia , Enfermedades de las Válvulas Cardíacas/diagnóstico , Enfermedades de las Válvulas Cardíacas/virología , Humanos , Miocarditis/terapia , Miocarditis/virología , Derrame Pericárdico/terapia , Derrame Pericárdico/virología , Neumonía Viral/diagnóstico , Neumonía Viral/fisiopatología , Neumonía Viral/terapia , Choque Cardiogénico/etiología , Choque Cardiogénico/terapia , Síndrome de Respuesta Inflamatoria Sistémica/diagnóstico , Síndrome de Respuesta Inflamatoria Sistémica/fisiopatología , Síndrome de Respuesta Inflamatoria Sistémica/terapia , Resultado del Tratamiento
3.
Rev. Fac. Cienc. Méd. Univ. Cuenca ; 38(1): 17-21, 2020. ilus, tab
Artículo en Español | LILACS (Américas) | ID: covidwho-864625

RESUMEN

Hasta abril de 2020, se contabilizaba una cifra cercana a los dos millones de contagiados con SARS-Cov-2 [1], diseminándose a centenares de países en todo el mundo. El impacto se ha visto reflejado en todos los estratos sociales, afectando a los más carenciados y ha develado las grandes debilidades de las estructuras sanitarias frente a pandemias, en la gran mayoría de los gobiernos. En el mes de diciembre de 2019 aparecen los primeros pacientes con neumonía viral en Wuhan, China. Epidemiológicamente, todos los pacientes habían visitado el mercado de productos exóticos de dicha ciudad. A fines del mismo mes, un joven médico oftalmólogo de Wuhan describe, virtualmente, a siete pacientes con sintomatología similar al SARS y recomienda a sus amigos usar equipos de protección, por este hecho fue castigado por las autoridades policiales y más tarde fallecería por COVID-19. En la primera semana de enero, 2020, las autoridades chinas anuncian que han identificado un nuevo coronavirus (Co-V) en los pacientes que estaban siendo tratados por neumonía viral.


Until April 2020, there was about two million people infected with SARS-Cov-2 [1], spreading to hundreds of countries around the world. The impact has been reflected in all social strata, affecting the neediest people and has revealed the great weaknesses of health structures to face the pandemics in the majority of governments. In December 2019, the first patients with viral pneumonia appear in Wuhan, China. Epidemiologically, all the patients had visited the market with exotic products in that city. At the end of the same month, a young ophthalmologist from Wuhan virtually describes seven patients with symptoms similar to SARS and recommends his friends to wear protective equipment, for this fact he was punished by the police authorities and later died by COVID- 19. In the first week of January, 2020, Chinese authorities announce that they have identified a new coronavirus (Co-V) in patients who were being treated for viral pneumonia. A correct diagnosis of infected people is important in the present pandemic; it is based on three fundamental aspects: clinic, complementary examinations and imaging


Asunto(s)
Humanos , Infecciones por Coronavirus/complicaciones , Pandemias/clasificación , Betacoronavirus/patogenicidad , Infecciones por Coronavirus/tratamiento farmacológico , Síndrome Respiratorio Agudo Grave
5.
Rev Med Virol ; 30(5): e2140, 2020 09.
Artículo en Inglés | MEDLINE | ID: covidwho-848179

RESUMEN

A knowledge-based cybernetic framework model representing the dynamics of SARS-CoV-2 inside the human body has been studied analytically and in silico to explore the pathophysiologic regulations. The following modeling methodology was developed as a platform to introduce a predictive tool supporting a therapeutic approach to Covid-19 disease. A time-dependent nonlinear system of ordinary differential equations model was constructed involving type-I cells, type-II cells, SARS-CoV-2 virus, inflammatory mediators, interleukins along with host pulmonary gas exchange rate, thermostat control, and mean pressure difference. This formalism introduced about 17 unknown parameters. Estimating these unknown parameters requires a mathematical association with the in vivo sparse data and the dynamic sensitivities of the model. The cybernetic model can simulate a dynamic response to the reduced pulmonary alveolar gas exchange rate, thermostat control, and mean pressure difference under a very critical condition based on equilibrium (steady state) values of the inflammatory mediators and system parameters. In silico analysis of the current cybernetical approach with system dynamical modeling can provide an intellectual framework to help experimentalists identify more active therapeutic approaches.


Asunto(s)
Betacoronavirus/patogenicidad , Infecciones por Coronavirus/inmunología , Interacciones Huésped-Patógeno/inmunología , Pulmón/inmunología , Dinámicas no Lineales , Neumonía Viral/inmunología , Proteínas de Fase Aguda/antagonistas & inhibidores , Proteínas de Fase Aguda/genética , Proteínas de Fase Aguda/inmunología , Antiinflamatorios/uso terapéutico , Antivirales/uso terapéutico , Betacoronavirus/efectos de los fármacos , Betacoronavirus/crecimiento & desarrollo , Temperatura Corporal , Infecciones por Coronavirus/tratamiento farmacológico , Infecciones por Coronavirus/patología , Infecciones por Coronavirus/virología , Citocinas/antagonistas & inhibidores , Citocinas/genética , Citocinas/inmunología , Células Epiteliales/efectos de los fármacos , Células Epiteliales/inmunología , Células Epiteliales/virología , Regulación de la Expresión Génica , Interacciones Huésped-Patógeno/efectos de los fármacos , Interacciones Huésped-Patógeno/genética , Humanos , Pulmón/efectos de los fármacos , Pulmón/virología , Macrófagos Alveolares/efectos de los fármacos , Macrófagos Alveolares/inmunología , Macrófagos Alveolares/virología , Pandemias , Peptidil-Dipeptidasa A/genética , Peptidil-Dipeptidasa A/inmunología , Neumonía Viral/tratamiento farmacológico , Neumonía Viral/patología , Neumonía Viral/virología , Intercambio Gaseoso Pulmonar/efectos de los fármacos , Intercambio Gaseoso Pulmonar/inmunología , Glicoproteína de la Espiga del Coronavirus/antagonistas & inhibidores , Glicoproteína de la Espiga del Coronavirus/genética , Glicoproteína de la Espiga del Coronavirus/inmunología
6.
Rev Med Virol ; 30(5): e2132, 2020 09.
Artículo en Inglés | MEDLINE | ID: covidwho-848176

RESUMEN

YouTube is the second most popular website in the world and is increasingly being used as a platform for disseminating health information. Our aim was to evaluate the content-quality and audience engagement of YouTube videos pertaining to the SARS (severe acute respiratory syndrome)-CoV-2 virus which causes the Coronavirus Disease 2019 (COVID-19), during the early phase of the pandemic. We chose the first 30 videos for seven different search phrases: "2019 nCoV," "SARS CoV-2," "COVID-19 virus," "coronavirus treatment," "coronavirus explained," "what is the coronavirus" and "coronavirus information." Video contents were evaluated by two independent medical students with more than 5 years of experience using the DISCERN instrument. Qualitative data, quantitative data and upload source for each video was noted for a quality and audience engagement analysis. Out of the total 210 videos, 137 met our inclusion criteria and were evaluated. The mean DISCERN score was 31.33 out of 75 possible points, which indicates that the quality of YouTube videos on COVID-19 is currently poor. There was excellent reliability between the two raters (intraclass correlation coefficient = 0.96). 55% of the videos discussed prevention, 49% discussed symptoms and 46% discussed the spread of the virus. Most of the videos were uploaded by news channels (50%) and education channels (40%). The quality of YouTube videos on SARS-CoV-2 and COVID-19 is poor, however, we have listed the top-quality videos in our article as they may be effective tools for patient education during the pandemic.


Asunto(s)
Betacoronavirus/patogenicidad , Infecciones por Coronavirus/epidemiología , Pandemias , Participación del Paciente/tendencias , Neumonía Viral/epidemiología , Medios de Comunicación Sociales , Infecciones por Coronavirus/diagnóstico , Infecciones por Coronavirus/patología , Infecciones por Coronavirus/transmisión , Humanos , Difusión de la Información , Educación del Paciente como Asunto/métodos , Neumonía Viral/diagnóstico , Neumonía Viral/patología , Neumonía Viral/transmisión , Salud Pública/educación , Control de Calidad
7.
BMC Infect Dis ; 20(1): 747, 2020 Oct 12.
Artículo en Inglés | MEDLINE | ID: covidwho-846600

RESUMEN

BACKGROUND: Sudden exacerbations and respiratory failure are major causes of death in patients with severe coronavirus disease 2019(COVID-19) pneumonia, but indicators for the prediction and treatment of severe patients are still lacking. METHODS: A retrospective analysis of 67 collected cases was conducted and included approximately 67 patients with COVID-19 pneumonia who were admitted to the Suzhou Fifth People's Hospital from January 1, 2020 to February 8, 2020. The epidemiological, clinical and imaging characteristics as well as laboratory data of the 67 patients were analyzed. RESULTS: The study found that fibrinogen (FIB) was increased in 45 (65.2%) patients, and when FIB reached a critical value of 4.805 g/L, the sensitivity and specificity、DA, helping to distinguish general and severe cases, were 100 and 14%、92.9%, respectively, which were significantly better than those for lymphocyte count and myoglobin. Chest CT images indicated that the cumulative number of lung lobes with lesions in severe patients was significantly higher than that in general patients (P < 0.05), and the cumulative number of lung lobes with lesions was negatively correlated with lymphocyte count and positively correlated with myoglobin and FIB. Our study also found that there was no obvious effect of hormone therapy in patients with severe COVID-19. CONCLUSIONS: Based on the retrospective analysis, FIB was found to be increased in severe patients and was better than lymphocyte count and myoglobin in distinguishing general and severe patients. The study also suggested that hormone treatment has no significant effect on COVID-19.


Asunto(s)
Técnicas de Laboratorio Clínico , Infecciones por Coronavirus/epidemiología , Infecciones por Coronavirus/patología , Neumonía Viral/epidemiología , Neumonía Viral/patología , Adulto , Betacoronavirus/patogenicidad , China/epidemiología , Infecciones por Coronavirus/diagnóstico , Femenino , Fibrinógeno/análisis , Hospitalización , Humanos , Pulmón/patología , Recuento de Linfocitos , Masculino , Persona de Mediana Edad , Pandemias , Neumonía Viral/diagnóstico , Estudios Retrospectivos , Sensibilidad y Especificidad
9.
JCO Glob Oncol ; 6: 1428-1438, 2020 09.
Artículo en Inglés | MEDLINE | ID: covidwho-844422

RESUMEN

PURPOSE: The COVID-19 pandemic affected health care systems globally and resulted in the interruption of usual care in many health care facilities, exposing vulnerable patients with cancer to significant risks. Our study aimed to evaluate the impact of this pandemic on cancer care worldwide. METHODS: We conducted a cross-sectional study using a validated web-based questionnaire of 51 items. The questionnaire obtained information on the capacity and services offered at these centers, magnitude of disruption of care, reasons for disruption, challenges faced, interventions implemented, and the estimation of patient harm during the pandemic. RESULTS: A total of 356 centers from 54 countries across six continents participated between April 21 and May 8, 2020. These centers serve 716,979 new patients with cancer a year. Most of them (88.2%) reported facing challenges in delivering care during the pandemic. Although 55.34% reduced services as part of a preemptive strategy, other common reasons included an overwhelmed system (19.94%), lack of personal protective equipment (19.10%), staff shortage (17.98%), and restricted access to medications (9.83%). Missing at least one cycle of therapy by > 10% of patients was reported in 46.31% of the centers. Participants reported patient exposure to harm from interruption of cancer-specific care (36.52%) and noncancer-related care (39.04%), with some centers estimating that up to 80% of their patients were exposed to harm. CONCLUSION: The detrimental impact of the COVID-19 pandemic on cancer care is widespread, with varying magnitude among centers worldwide. Additional research to assess this impact at the patient level is required.


Asunto(s)
Instituciones Oncológicas/estadística & datos numéricos , Infecciones por Coronavirus/prevención & control , Accesibilidad a los Servicios de Salud/estadística & datos numéricos , Oncología Médica/estadística & datos numéricos , Neoplasias/terapia , Pandemias/prevención & control , Neumonía Viral/prevención & control , Betacoronavirus/patogenicidad , Instituciones Oncológicas/normas , Infecciones por Coronavirus/epidemiología , Infecciones por Coronavirus/transmisión , Infecciones por Coronavirus/virología , Estudios Transversales , Carga Global de Enfermedades , Accesibilidad a los Servicios de Salud/normas , Humanos , Control de Infecciones/normas , Cooperación Internacional , Oncología Médica/normas , Neumonía Viral/epidemiología , Neumonía Viral/transmisión , Neumonía Viral/virología , Encuestas y Cuestionarios/estadística & datos numéricos
10.
Cancer Cytopathol ; 128(10): 679-680, 2020 10.
Artículo en Inglés | MEDLINE | ID: covidwho-840101
13.
J Med Internet Res ; 22(8): e21257, 2020 08 20.
Artículo en Inglés | MEDLINE | ID: covidwho-836108

RESUMEN

BACKGROUND: The coronavirus disease (COVID-19) pandemic is an important health crisis worldwide. Several strategies were implemented to combat COVID-19, including wearing masks, hand hygiene, and social distancing. The impact of these strategies on COVID-19 and other viral infections remains largely unclear. OBJECTIVE: We aim to investigate the impact of implemented infectious control strategies on the incidences of influenza, enterovirus infection, and all-cause pneumonia during the COVID-19 pandemic. METHODS: We utilized the electronic database of the Taiwan National Infectious Disease Statistics System and extracted incidences of COVID-19, influenza virus, enterovirus, and all-cause pneumonia. We compared the incidences of these diseases from week 45 of 2016 to week 21 of 2020 and performed linear regression analyses. RESULTS: The first case of COVID-19 in Taiwan was reported in late January 2020 (week 4). Infectious control strategies have been promoted since late January. The influenza virus usually peaks in winter and decreases around week 14. However, a significant decrease in influenza was observed after week 6 of 2020. Regression analyses produced the following results: 2017, R2=0.037; 2018, R2=0.021; 2019, R2=0.046; and 2020, R2=0.599. A dramatic decrease in all-cause pneumonia was also reported (R2 values for 2017-2020 were 0.435, 0.098, 0.352, and 0.82, respectively). Enterovirus had increased by week 18 in 2017-2019, but this was not observed in 2020. CONCLUSIONS: Using this national epidemiological database, we found a significant decrease in cases of influenza, enterovirus, and all-cause pneumonia during the COVID-19 pandemic. Wearing masks, hand hygiene, and social distancing may contribute not only to the prevention of COVID-19 but also to the decline of other respiratory infectious diseases. Further studies are warranted to elucidate the causal relationship.


Asunto(s)
Betacoronavirus/patogenicidad , Infecciones por Coronavirus/psicología , Coronavirus/patogenicidad , Infecciones por Enterovirus/prevención & control , Higiene de las Manos/métodos , Control de Infecciones/métodos , Gripe Humana/prevención & control , Máscaras/tendencias , Pandemias/prevención & control , Neumonía Viral/psicología , Neumonía/prevención & control , Infecciones por Enterovirus/epidemiología , Humanos , Incidencia , Gripe Humana/epidemiología , Neumonía/epidemiología , Estudios Retrospectivos , Distancia Social
14.
J Med Internet Res ; 22(8): e19706, 2020 08 21.
Artículo en Inglés | MEDLINE | ID: covidwho-836085

RESUMEN

BACKGROUND: In the four months after the discovery of the index case of coronavirus disease (COVID-19), several studies highlighted the psychological impact of COVID-19 on frontline health care workers and on members of the general public. It is evident from these studies that individuals experienced elevated levels of anxiety and depression in the acute phase, when they first became aware of the pandemic, and that the psychological distress persisted into subsequent weeks. It is becoming apparent that technological tools such as SMS text messages, web-based interventions, mobile interventions, and conversational agents can help ameliorate psychological distress in the workplace and in society. To our knowledge, there are few publications describing how digital tools have been used to ameliorate psychological symptoms among individuals. OBJECTIVE: The aim of this review was to identify existing SMS text message, web-based, mobile, and conversational agents that the general public can access to ameliorate the psychological symptoms they are experiencing during the COVID-19 pandemic. METHODS: To identify digital tools that were published specifically for COVID-19, a search was performed in the PubMed and MEDLINE databases from the inception of the databases through June 17, 2020. The following search strings were used: "NCOV OR 2019-nCoV OR SARS-CoV-2 OR Coronavirus OR COVID19 OR COVID" and "mHealth OR eHealth OR text". Another search was conducted in PubMed and MEDLINE to identify existing digital tools for depression and anxiety disorders. A web-based search engine (Google) was used to identify if the cited web-based interventions could be accessed. A mobile app search engine, App Annie, was used to determine if the identified mobile apps were commercially available. Results: A total of 6 studies were identified. Of the 6 identified web-based interventions, 5 websites (83%) could be accessed. Of the 32 identified mobile interventions, 7 apps (22%) could be accessed. Of the 7 identified conversational agents, only 2 (29%) could be accessed. RESULTS: A total of 6 studies were identified. Of the 6 identified web-based interventions, 5 websites (83%) could be accessed. Of the 32 identified mobile interventions, 7 apps (22%) could be accessed. Of the 7 identified conversational agents, only 2 (29%) could be accessed. CONCLUSIONS: The COVID-19 pandemic has caused significant psychological distress. Digital tools that are commercially available may be useful for at-risk individuals or individuals with pre-existing psychiatric symptoms.


Asunto(s)
Betacoronavirus/patogenicidad , Infecciones por Coronavirus/psicología , Coronavirus/patogenicidad , Trastornos Mentales/etiología , Neumonía Viral/psicología , Humanos , Pandemias
15.
J Med Internet Res ; 22(8): e19673, 2020 08 19.
Artículo en Inglés | MEDLINE | ID: covidwho-836083

RESUMEN

BACKGROUND: Coronavirus disease (COVID-19) is a serious infectious disease that causes severe respiratory illness. This pandemic represents a serious public health risk. Therefore, early and accurate diagnosis is essential to control disease progression. Radiological examination plays a crucial role in the early identification and management of infected patients. OBJECTIVE: The aim of this review was to identify the diagnostic value of different imaging modalities used for diagnosis of COVID-19. METHODS: A comprehensive literature search was conducted using the PubMed, Scopus, Web of Science, and Google Scholar databases. The keywords diagnostic imaging, radiology, respiratory infection, pneumonia, coronavirus infection and COVID-19 were used to identify radiology articles focusing on the diagnosis of COVID-19 and to determine the diagnostic value of various imaging modalities, including x-ray, computed tomography (CT), ultrasound, and nuclear medicine for identification and management of infected patients. RESULTS: We identified 50 articles in the literature search. Studies that investigated the diagnostic roles and imaging features of patients with COVID-19, using either chest CT, lung ultrasound, chest x-ray, or positron emission topography/computed tomography (PET/CT) scan, were discussed. Of these imaging modalities, chest x-ray and CT scan are the most commonly used for diagnosis and management of COVID-19 patients, with chest CT scan being more accurate and sensitive in identifying COVID-19 at early stages. Only a few studies have investigated the roles of ultrasound and PET/CT scan in diagnosing COVID-19. CONCLUSIONS: Chest CT scan remains the most sensitive imaging modality in initial diagnosis and management of suspected and confirmed patients with COVID-19. Other diagnostic imaging modalities could add value in evaluating disease progression and monitoring critically ill patients with COVID-19.


Asunto(s)
Betacoronavirus/patogenicidad , Infecciones por Coronavirus/diagnóstico por imagen , Coronavirus/patogenicidad , Neumonía Viral/diagnóstico por imagen , Tomografía Computarizada por Rayos X/métodos , Humanos , Pandemias
16.
Signal Transduct Target Ther ; 5(1): 219, 2020 10 06.
Artículo en Inglés | MEDLINE | ID: covidwho-834861

RESUMEN

Convalescent plasma (CP) transfusion has been indicated as a promising therapy in the treatment for other emerging viral infections. However, the quality control of CP and individual variation in patients in different studies make it rather difficult to evaluate the efficacy and risk of CP therapy for coronavirus disease 2019 (COVID-19). We aimed to explore the potential efficacy of CP therapy, and to assess the possible factors associated with its efficacy. We enrolled eight critical or severe COVID-19 patients from four centers. Each patient was transfused with 200-400 mL of CP from seven recovered donors. The primary indicators for clinical efficacy assessment were the changes of clinical symptoms, laboratory parameters, and radiological image after CP transfusion. CP donors had a wide range of antibody levels measured by serology tests which were to some degree correlated with the neutralizing antibody (NAb) level. No adverse events were observed during and after CP transfusion. Following CP transfusion, six out of eight patients showed improved oxygen support status; chest CT indicated varying degrees of absorption of pulmonary lesions in six patients within 8 days; the viral load was decreased to a negative level in five patients who had the previous viremia; other laboratory parameters also tended to improve, including increased lymphocyte counts, decreased C-reactive protein, procalcitonin, and indicators for liver function. The clinical efficacy might be associated with CP transfusion time, transfused dose, and the NAb levels of CP. This study indicated that CP might be a potential therapy for severe patients with COVID-19.


Asunto(s)
Anticuerpos Neutralizantes/administración & dosificación , Anticuerpos Antivirales/administración & dosificación , Betacoronavirus/patogenicidad , Infecciones por Coronavirus/terapia , Neumonía Viral/terapia , Adulto , Anciano , Antivirales/uso terapéutico , Betacoronavirus/inmunología , Biomarcadores/sangre , Proteína C-Reactiva/metabolismo , Técnicas de Laboratorio Clínico , Infecciones por Coronavirus/diagnóstico , Infecciones por Coronavirus/diagnóstico por imagen , Infecciones por Coronavirus/inmunología , Infecciones por Coronavirus/patología , Progresión de la Enfermedad , Femenino , Humanos , Inmunización Pasiva/métodos , Pruebas de Función Hepática , Masculino , Persona de Mediana Edad , Pandemias , Neumonía Viral/diagnóstico por imagen , Neumonía Viral/inmunología , Neumonía Viral/patología , Polipéptido alfa Relacionado con Calcitonina/sangre , Índice de Severidad de la Enfermedad , Tomografía Computarizada por Rayos X , Carga Viral
18.
ACS Nano ; 14(4): 3822-3835, 2020 04 28.
Artículo en Inglés | MEDLINE | ID: covidwho-832348

RESUMEN

COVID-19 has spread globally since its discovery in Hubei province, China in December 2019. A combination of computed tomography imaging, whole genome sequencing, and electron microscopy were initially used to screen and identify SARS-CoV-2, the viral etiology of COVID-19. The aim of this review article is to inform the audience of diagnostic and surveillance technologies for SARS-CoV-2 and their performance characteristics. We describe point-of-care diagnostics that are on the horizon and encourage academics to advance their technologies beyond conception. Developing plug-and-play diagnostics to manage the SARS-CoV-2 outbreak would be useful in preventing future epidemics.


Asunto(s)
Betacoronavirus/patogenicidad , Técnicas de Laboratorio Clínico , Infecciones por Coronavirus/diagnóstico , Neumonía Viral/diagnóstico , Pruebas en el Punto de Atención , Teléfono Inteligente , Humanos , Aplicaciones Móviles , Técnicas de Amplificación de Ácido Nucleico , Pandemias , Vigilancia de la Población , Reacción en Cadena en Tiempo Real de la Polimerasa , Tomografía Computarizada por Rayos X , Proteínas Virales/análisis
20.
Rev Int Androl ; 18(3): 117-123, 2020.
Artículo en Español | MEDLINE | ID: covidwho-826748

RESUMEN

OBJECTIVE: The main objective of this revision is to summarize the current existing evidence of the potential adverse effects of SARS-CoV-2 on the male reproductive system and provide the recommendations of the Asociación Española de Andrología, Medicina Sexual y Reproductiva (ASESA) concerning the implications of COVID-19 infection in the management of male infertilty patients and testicular endocrine dysfunction. METHODS: A comprehensive systematic literature search of the databases of PubMed, Web of Science, Embase, Medline, Cochrane and MedRxiv, was carried out. RESULTS: The presence of orchitis as a potential complication of the infection by SARS-CoV-2 has not yet been confirmed. One study reported that 19% of males with COVID-19 infection had scrotal symptoms suggestive of viral orchitis which could not be confirmed. It is possible that the virus, rather than infecting the testes directly, may induce a secondary autoimmune response leading to autoimmune orchitis. COVID-19 has been associated with coagulation disorders and thus the orchitis could be the result of segmental vasculitis. Existing data concerning the presence of the virus in semen are contradictory. Only one study reported the presence of RNA in 15.8% of patients with COVID-19. However, the presence of nucleic acid or antigen in semen is not synonyms of viral replication capacity and infectivity. It has been reported an increase in serum levels of LH in males with COVID-19 and a significant reduction in the T/LH and FSH/LH ratios, consistent with subclinical hypogonadism. CONCLUSIONS: The findings of recent reports related to the potential effects of COVID-19 infection on the male reproductive system are based on poorly designed, small sample size studies that provide inconclusive, contradictory results. Since there still exists a theoretical possibility of testicular damage and male infertilty as a result of the infection by COVID-19, males of reproductive age should be evaluated for gonadal function and semen analysis. With regard to the sexual transmission of the virus, there is not sufficient evidence to recommend asymptomatic couples to abstein from having sex in order to protect themselves from being infected by the virus. Additional studies are needed to understand the long-term effects of SARS-CoV-2 on male reproductive function, including male fertility potential and endocrine testicular function.


Asunto(s)
Betacoronavirus , Infecciones por Coronavirus/complicaciones , Pandemias , Neumonía Viral/complicaciones , Salud Reproductiva , Salud Sexual , Adulto , Betacoronavirus/aislamiento & purificación , Betacoronavirus/patogenicidad , Betacoronavirus/fisiología , Hormona Folículo Estimulante/sangre , Humanos , Hipogonadismo/sangre , Hipogonadismo/etiología , Inmunoglobulina G/análisis , Leucocitos , Hormona Luteinizante/sangre , Masculino , Orquitis/etiología , Orquitis/virología , Próstata/virología , ARN Viral/análisis , Reacción en Cadena de la Polimerasa de Transcriptasa Inversa , Semen/virología , Preservación de Semen , España , Testículo/inmunología , Testículo/patología , Testículo/virología , Testosterona/sangre , Vasculitis/etiología , Adulto Joven
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