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1.
Rev Soc Bras Med Trop ; 53: e20200494, 2020.
Artículo en Inglés | MEDLINE | ID: covidwho-740419

RESUMEN

Diagnosing cases of coronavirus disease (COVID-19) with only non-respiratory symptoms has been challenging. We reported the diagnosis of a child who tested positive for COVID-19 with abdominal pain/diarrhea and tracked his family cluster. One member of the family tested positive for COVID-19 on real-time reverse-transcription polymerase chain reaction assay and three other family members had anti-SARS-CoV-2 antibodies.


Asunto(s)
Infecciones por Coronavirus/diagnóstico , Coronavirus/aislamiento & purificación , Diarrea/diagnóstico , Pandemias , Neumonía Viral/diagnóstico , Dolor Abdominal/etiología , Betacoronavirus , Preescolar , Técnicas de Laboratorio Clínico , Análisis por Conglomerados , Trazado de Contacto , Diarrea/etiología , Fiebre/etiología , Humanos , Masculino , Faringitis/etiología
3.
Aging (Albany NY) ; 12(15): 15730-15740, 2020 08 15.
Artículo en Inglés | MEDLINE | ID: covidwho-721664

RESUMEN

BACKGROUND: SARS-CoV-2 has raged around the world since March, 2020. We aim to describe the clinical characteristics and risk factors of severe patients with COVID-19 in Guangzhou. RESULTS: The severity and mortality of COVID-19 was 10.4% and 0.3% respectively. And each 1-year increase in age (OR, 1.057; 95% CI, 1.018-1.098; P=0.004), Wuhan exposure history greater than 2 weeks (OR, 2.765; 95% CI, 1.040-7.355; P=0.042), diarrhea (OR, 24.349; 95% CI, 3.580-165.609; P=0.001), chronic kidney disease (OR, 6.966; 95% CI, 1.310-37.058; P = 0.023), myoglobin higher than 106 µg/L (OR, 8.910; 95% CI, 1.225-64.816; P=0.031), white blood cell higher than 10×109/L (OR, 5.776; 95% CI, 1.052-31.722; P=0.044), and C-reactive protein higher than 10 mg/L (OR, 5.362; 95% CI, 1.631-17.626; P=0.006) were risk factors for severe cases. CONCLUSION: Older age, Wuhan exposure history, diarrhea, chronic kidney disease, elevated myoglobin, elevated white blood cell and C-reactive protein were independent risk factors for severe patients with COVID-19 in Guangzhou. METHODS: We included 288 adult patients with COVID-19 and compared the data between severe and non-severe group. We used univariate and multivariate logistic regression methods to explore risk factors of severe cases.


Asunto(s)
Proteína C-Reactiva/análisis , Infecciones por Coronavirus , Diarrea , Recuento de Leucocitos/métodos , Mioglobina/análisis , Pandemias , Neumonía Viral , Insuficiencia Renal Crónica/epidemiología , Factores de Edad , Betacoronavirus/aislamiento & purificación , China/epidemiología , Infecciones por Coronavirus/sangre , Infecciones por Coronavirus/diagnóstico , Infecciones por Coronavirus/mortalidad , Infecciones por Coronavirus/fisiopatología , Diarrea/diagnóstico , Diarrea/etiología , Femenino , Humanos , Periodo de Incubación de Enfermedades Infecciosas , Masculino , Persona de Mediana Edad , Neumonía Viral/sangre , Neumonía Viral/diagnóstico , Neumonía Viral/diagnóstico por imagen , Neumonía Viral/etiología , Neumonía Viral/mortalidad , Neumonía Viral/fisiopatología , Factores de Riesgo , Índice de Severidad de la Enfermedad
4.
Blood ; 136(7): 914, 2020 08 13.
Artículo en Inglés | MEDLINE | ID: covidwho-713707
6.
Anal Chim Acta ; 1125: 57-65, 2020 Aug 15.
Artículo en Inglés | MEDLINE | ID: covidwho-626172

RESUMEN

Porcine epidemic diarrhea virus (PEDV), porcine deltacoronavirus (PDCoV), and swine acute diarrhea syndrome-coronavirus (SADS-CoV) are three emerging and re-emerging coronaviruses (CoVs). Symptoms caused by these three viruses are extremely similar, including acute diarrhea, vomiting and even death in piglets. To date, strict biosecurity is still the most effective disease prevention and control measures, and the early detection of pathogens is the most important link. Here, we developed a microfluidic-RT-LAMP chip detection system for the first time, which could detected PEDV, PDCoV and SADS-CoV simultaneously, and had advantages of rapid, simple, sensitive, high-throughput, and accurate at point-of-care settings. The lowest detection limits of the microfluidic-RT-LAMP chip method are 101 copies/µL, 102 copies/µL and 102 copies/µL for PEDV, PDCoV and SADS-CoV, respectively. The whole detection procedure can be finished rapidly in 40 min without any cross-reaction with other common swine viruses. A total of 173 clinical swine fecal samples characterized with diarrheal symptoms were used to evaluate the performance of the newly developed system, which presented good stabilities (C.V.s<5%) and specificities (100%), and possessed sensitivities of 92.24%, 92.19% and 91.23% for PEDV, PDCoV and SADS-CoV respectively. In summary, the established microfluidic-RT-LAMP chip detection system could satisfy the demanding in field diagnoses, which was suitable for promotion in remote areas due to its fast, portable and cost-effective characters.


Asunto(s)
Coronavirus/genética , Técnicas de Amplificación de Ácido Nucleico/métodos , ARN Viral/análisis , Alphacoronavirus/genética , Alphacoronavirus/aislamiento & purificación , Animales , Coronavirus/aislamiento & purificación , Diarrea/diagnóstico , Diarrea/veterinaria , Diarrea/virología , Heces/virología , Dispositivos Laboratorio en un Chip , Límite de Detección , Técnicas de Amplificación de Ácido Nucleico/instrumentación , Sistemas de Atención de Punto , Virus de la Diarrea Epidémica Porcina/genética , Virus de la Diarrea Epidémica Porcina/aislamiento & purificación , ARN Viral/metabolismo , Reproducibilidad de los Resultados , Sensibilidad y Especificidad , Porcinos
7.
Int J Med Sci ; 17(9): 1142-1146, 2020.
Artículo en Inglés | MEDLINE | ID: covidwho-602628

RESUMEN

Objective: To analyze the blood test indicators of patients after infection of COVID-19 in Chongqing and analyze the clinical indicators of 8 patients with diarrhea. Materials and Methods: From January 26, 2019 to February 13, 2020, 70 patients diagnosed with 2019-nCoV according to the World Health Organization interim guidance for NCP and divided into diarrhea and non-diarrhea groups. The laboratory tests liver and kidney function, blood routine, coagulation function, and immune status. Results: The study population included 70 hospitalized patients with confirmed CONV-2019. NCP patients (43males and 27 females) with a mean age of 48.57±17.80 (9~82) years and only 4.3% of patients have lung-related diseases. The positive rate of ESR, CRP, PT, IL6, lymphocyte count, GGT, Prealbumin and CD4 was more than 50%. We further analyzed the differences between 8 diarrhea patients and 62 non-diarrhea patients. Among these indicators, only Lymphocyte, CRP, Prealbumin and Cystatin C positive rate is more than 50%. Although there is no statistical difference in GGT, 100% of the 7 patients tested decreased. Conclusion: Our data recommended that the ESR, CRP, PT, IL6, lymphocyte count, GGT, prealbumin and CD4 have important value in the diagnosis of COVID-19, and the decrease of GGT may be an important indicator for judging the intestinal dysfunction of patients.


Asunto(s)
Betacoronavirus/aislamiento & purificación , Infecciones por Coronavirus/complicaciones , Diarrea/diagnóstico , Neumonía Viral/complicaciones , gamma-Glutamiltransferasa/sangre , Adolescente , Adulto , Factores de Edad , Anciano , Anciano de 80 o más Años , Biomarcadores/sangre , Niño , Infecciones por Coronavirus/sangre , Infecciones por Coronavirus/diagnóstico , Infecciones por Coronavirus/virología , Diarrea/sangre , Diarrea/virología , Femenino , Humanos , Masculino , Persona de Mediana Edad , Pandemias , Neumonía Viral/sangre , Neumonía Viral/diagnóstico , Neumonía Viral/virología , Adulto Joven
8.
BMJ Case Rep ; 13(6)2020 Jun 16.
Artículo en Inglés | MEDLINE | ID: covidwho-601611

RESUMEN

A 33-year-old man presented repeatedly with severe abdominal pain and diarrhoea. Renal colic was suspected, and he was admitted for pain management. Questioning elicited an additional history of sore throat and mild, dry cough. Inflammatory markers were mildly raised (C reactive protein (CRP) 40 mg/L). Initial nasopharyngeal swabs were negative for severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) by PCR. CT of the kidneys, ureters and bladder (CT KUB) was normal; however, CT of the thorax showed multifocal bilateral peripheral areas of consolidation consistent with COVID-19 infection. He developed respiratory compromise and was transferred to the intensive care unit (ICU). Sputum was positive for SARS-CoV-2 by PCR, and culture grew Yersinia enterocolitica He recovered following supportive management and treatment with piperacillin-tazobactam.


Asunto(s)
Dolor Abdominal , Betacoronavirus/aislamiento & purificación , Infecciones por Coronavirus , Pulmón/diagnóstico por imagen , Pandemias , Combinación Piperacilina y Tazobactam/administración & dosificación , Neumonía Viral , Dolor Abdominal/diagnóstico , Dolor Abdominal/etiología , Adulto , Antibacterianos/administración & dosificación , Infecciones por Coronavirus/diagnóstico , Infecciones por Coronavirus/fisiopatología , Infecciones por Coronavirus/terapia , Cuidados Críticos/métodos , Diagnóstico Diferencial , Diarrea/diagnóstico , Diarrea/etiología , Humanos , Masculino , Neumonía Viral/diagnóstico , Neumonía Viral/etiología , Neumonía Viral/fisiopatología , Neumonía Viral/terapia , Esputo/microbiología , Tomografía Computarizada por Rayos X/métodos , Resultado del Tratamiento , Yersinia enterocolitica/aislamiento & purificación
10.
Virulence ; 11(1): 707-718, 2020 01 01.
Artículo en Inglés | MEDLINE | ID: covidwho-517705

RESUMEN

With the outbreak of the recent severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in 2019, coronaviruses have become a global research hotspot in the field of virology. Coronaviruses mainly cause respiratory and digestive tract diseases, several coronaviruses are responsible for porcine diarrhea, such as porcine epidemic diarrhea virus (PEDV), porcine deltacoronavirus (PDCoV), and emerging swine acute diarrhea syndrome coronavirus (SADS-CoV). Those viruses have caused huge economic losses and are considered as potential public health threats. Porcine torovirus (PToV) and coronaviruses, sharing similar genomic structure and replication strategy, belong to the same order Nidovirales. Here, we developed a multiplex TaqMan-probe-based real-time PCR for the simultaneous detection of PEDV, PDCoV, PToV, and SADS-CoV for the first time. Specific primers and TaqMan fluorescent probes were designed targeting the ORF1a region of PDEV, PToV, and SADS-CoV and the ORF1b region of PDCoV. The method showed high sensitivity and specificity, with a detection limit of 1 × 102 copies/µL for each pathogen. A total of 101 clinical swine samples with signs of diarrhea were analyzed using this method, and the result showed good consistency with conventional reverse transcription PCR (RT-PCR). This method improves the efficiency for surveillance of these emerging and reemerging swine enteric viruses and can help reduce economic losses to the pig industry, which also benefits animal and public health.


Asunto(s)
Enfermedades Transmisibles Emergentes/veterinaria , Infecciones por Coronaviridae/veterinaria , Coronaviridae/aislamiento & purificación , Reacción en Cadena de la Polimerasa , Enfermedades de los Porcinos/diagnóstico , Animales , Coinfección/diagnóstico , Coinfección/veterinaria , Enfermedades Transmisibles Emergentes/diagnóstico , Coronaviridae/genética , Infecciones por Coronaviridae/diagnóstico , Diarrea/diagnóstico , Diarrea/veterinaria , Sistemas de Lectura Abierta/genética , Reacción en Cadena de la Polimerasa/normas , ARN Viral/genética , Reproducibilidad de los Resultados , Sensibilidad y Especificidad , Porcinos
12.
Ned Tijdschr Geneeskd ; 1642020 Apr 08.
Artículo en Holandés | MEDLINE | ID: covidwho-256224

RESUMEN

Clinical characteristics and outcomes among older patients with a SARS-CoV-2 infection differ greatly from those seen in younger patients. Here we highlight atypical presentations of this fulminant infectious disease COVID-19, based on a clinical case and a cohort of 19 patients admitted to a geriatric ward. The degree of frailty, resilience and number of co-morbidities caused COVID-19 to present as acute geriatric syndrome events such as falls, delirium and dehydration in these patients. Clinical laboratory results considered typical for COVID-19 were present less often in this frail older population. As in other countries, morbidity and mortality is most severe among frail male patients; therefore, assessment of changes suggestive of typical acute geriatric syndromes in frail older patients with chronic diseases should lead to a careful clinical examination for a SARS-CoV-2 infection. Protocols for diagnosis, and contact isolation measures, should take these atypical presentations into account.


Asunto(s)
Betacoronavirus , Infecciones por Coronavirus/diagnóstico , Neumonía Viral/diagnóstico , Accidentes por Caídas , Anciano , Anciano de 80 o más Años , Estudios de Cohortes , Delirio/diagnóstico , Diarrea/diagnóstico , Femenino , Hospitalización , Humanos , Masculino , Pandemias
13.
Am J Gastroenterol ; 115(6): 916-923, 2020 06.
Artículo en Inglés | MEDLINE | ID: covidwho-77893

RESUMEN

OBJECTIVES: Coronavirus disease 2019 (COVID-19) most commonly presents with respiratory symptoms, including cough, shortness of breath, and sore throat. However, digestive symptoms also occur in patients with COVID-19 and are often described in outpatients with less severe disease. In this study, we sought to describe the clinical characteristics of COVID-19 patients with digestive symptoms and mild disease severity. METHODS: We identified COVID-19 patients with mild disease and one or more digestive symptoms (diarrhea, nausea, and vomiting), with or without respiratory symptoms, and compared them with a group presenting solely with respiratory symptoms. We followed up patients clinically until they tested negative for COVID-19 on at least 2 sequential respiratory tract specimens collected ≥24 hours apart. We then compared the clinical features between those with digestive symptoms and those with respiratory symptoms. RESULTS: There were 206 patients with low severity COVID-19, including 48 presenting with a digestive symptom alone, 69 with both digestive and respiratory symptoms, and 89 with respiratory symptoms alone. Between the 2 groups with digestive symptoms, 67 presented with diarrhea, of whom 19.4% experienced diarrhea as the first symptom in their illness course. The diarrhea lasted from 1 to 14 days, with an average duration of 5.4 ± 3.1 days and a frequency of 4.3 ± 2.2 bowel movements per day. Concurrent fever was found in 62.4% of patients with a digestive symptom. Patients with digestive symptoms presented for care later than those with respiratory symptoms (16.0 ± 7.7 vs 11.6 ± 5.1 days, P < 0.001). Nevertheless, patients with digestive symptoms had a longer duration between symptom onset and viral clearance (P < 0.001) and were more likely to be fecal virus positive (73.3% vs 14.3%, P = 0.033) than those with respiratory symptoms. DISCUSSION: We describe a unique subgroup of COVID-19 patients with mild disease severity marked by the presence of digestive symptoms. These patients are more likely to test positive for viral RNA in stool, to have a longer delay before viral clearance, and to experience delayed diagnosis compared with patients with only respiratory symptoms.


Asunto(s)
Betacoronavirus/aislamiento & purificación , Infecciones por Coronavirus , Diarrea , Enfermedades del Sistema Digestivo , Pandemias , Neumonía Viral , ARN Viral/análisis , China/epidemiología , Técnicas de Laboratorio Clínico/métodos , Infecciones por Coronavirus/complicaciones , Infecciones por Coronavirus/diagnóstico , Infecciones por Coronavirus/epidemiología , Diarrea/diagnóstico , Diarrea/etiología , Enfermedades del Sistema Digestivo/diagnóstico , Enfermedades del Sistema Digestivo/fisiopatología , Enfermedades del Sistema Digestivo/virología , Heces/virología , Femenino , Humanos , Masculino , Persona de Mediana Edad , Evaluación de Resultado en la Atención de Salud , Neumonía Viral/complicaciones , Neumonía Viral/diagnóstico , Neumonía Viral/epidemiología , Índice de Severidad de la Enfermedad , Evaluación de Síntomas/métodos
15.
Gastroenterology ; 159(1): 81-95, 2020 07.
Artículo en Inglés | MEDLINE | ID: covidwho-40729

RESUMEN

BACKGROUND & AIMS: Infection with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) causes coronavirus disease 2019 (COVID-19), which has been characterized by fever, respiratory, and gastrointestinal symptoms as well as shedding of virus RNA into feces. We performed a systematic review and meta-analysis of published gastrointestinal symptoms and detection of virus in stool and also summarized data from a cohort of patients with COVID-19 in Hong Kong. METHODS: We collected data from the cohort of patients with COVID-19 in Hong Kong (N = 59; diagnosis from February 2 through February 29, 2020),and searched PubMed, Embase, Cochrane, and 3 Chinese databases through March 11, 2020, according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. We analyzed pooled data on the prevalence of overall and individual gastrointestinal symptoms (loss of appetite, nausea, vomiting, diarrhea, and abdominal pain or discomfort) using a random effects model. RESULTS: Among the 59 patients with COVID-19 in Hong Kong, 15 patients (25.4%) had gastrointestinal symptoms, and 9 patients (15.3%) had stool that tested positive for virus RNA. Stool viral RNA was detected in 38.5% and 8.7% among those with and without diarrhea, respectively (P = .02). The median fecal viral load was 5.1 log10 copies per milliliter in patients with diarrhea vs 3.9 log10 copies per milliliter in patients without diarrhea (P = .06). In a meta-analysis of 60 studies comprising 4243 patients, the pooled prevalence of all gastrointestinal symptoms was 17.6% (95% confidence interval [CI], 12.3-24.5); 11.8% of patients with nonsevere COVID-19 had gastrointestinal symptoms (95% CI, 4.1-29.1), and 17.1% of patients with severe COVID-19 had gastrointestinal symptoms (95% CI, 6.9-36.7). In the meta-analysis, the pooled prevalence of stool samples that were positive for virus RNA was 48.1% (95% CI, 38.3-57.9); of these samples, 70.3% of those collected after loss of virus from respiratory specimens tested positive for the virus (95% CI, 49.6-85.1). CONCLUSIONS: In an analysis of data from the Hong Kong cohort of patients with COVID-19 and a meta-analysis of findings from publications, we found that 17.6% of patients with COVID-19 had gastrointestinal symptoms. Virus RNA was detected in stool samples from 48.1% patients, even in stool collected after respiratory samples had negative test results. Health care workers should therefore exercise caution in collecting fecal samples or performing endoscopic procedures in patients with COVID-19, even during patient recovery.


Asunto(s)
Betacoronavirus/aislamiento & purificación , Infecciones por Coronavirus/prevención & control , Diarrea/virología , Heces/virología , Pandemias/prevención & control , Neumonía Viral/prevención & control , Carga Viral , Betacoronavirus/genética , Betacoronavirus/patogenicidad , Técnicas de Laboratorio Clínico , Infecciones por Coronavirus/diagnóstico , Infecciones por Coronavirus/epidemiología , Infecciones por Coronavirus/transmisión , Diarrea/diagnóstico , Diarrea/epidemiología , Endoscopía Gastrointestinal/normas , Tracto Gastrointestinal/diagnóstico por imagen , Tracto Gastrointestinal/virología , Hong Kong/epidemiología , Humanos , Control de Infecciones/normas , Transmisión de Enfermedad Infecciosa de Paciente a Profesional/prevención & control , Neumonía Viral/diagnóstico , Neumonía Viral/epidemiología , Neumonía Viral/transmisión , Prevalencia , ARN Viral/aislamiento & purificación
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