Your browser doesn't support javascript.
Mostrar: 20 | 50 | 100
Resultados 1 - 20 de 35
Filtrar
Añadir filtros

Base de datos
Intervalo de año
1.
Clinics (Sao Paulo) ; 75: e2209, 2020.
Artículo en Inglés | MEDLINE | ID: covidwho-749235

RESUMEN

OBJECTIVES: To assess the outcomes of pediatric patients with laboratory-confirmed coronavirus disease (COVID-19) with or without multisystem inflammatory syndrome in children (MIS-C). METHODS: This cross-sectional study included 471 samples collected from 371 patients (age<18 years) suspected of having severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. The study group comprised 66/371 (18%) laboratory-confirmed pediatric COVID-19 patients: 61 (92.5%) patients tested positive on real-time reverse transcription-polymerase chain reaction tests for SARS-CoV-2, and 5 (7.5%) patients tested positive on serological tests. MIS-C was diagnosed according to the criteria of the Center for Disease Control. RESULTS: MIS-C was diagnosed in 6/66 (9%) patients. The frequencies of diarrhea, vomiting, and/or abdominal pain (67% vs. 22%, p=0.034); pediatric SARS (67% vs. 13%, p=0.008); hypoxemia (83% vs. 23%, p=0.006); and arterial hypotension (50% vs. 3%, p=0.004) were significantly higher in patients with MIS-C than in those without MIS-C. The frequencies of C-reactive protein levels >50 mg/L (83% vs. 25%, p=0.008) and D-dimer levels >1000 ng/mL (100% vs. 40%, p=0.007) and the median D-dimer, troponin T, and ferritin levels (p<0.05) were significantly higher in patients with MIS-C. The frequencies of pediatric intensive care unit admission (100% vs. 60%, p=0.003), mechanical ventilation (83% vs. 7%, p<0.001), vasoactive agent use (83% vs. 3%, p<0.001), shock (83% vs. 5%, p<0.001), cardiac abnormalities (100% vs. 2%, p<0.001), and death (67% vs. 3%, p<0.001) were also significantly higher in patients with MIS-C. Similarly, the frequencies of oxygen therapy (100% vs. 33%, p=0.003), intravenous immunoglobulin therapy (67% vs. 2%, p<0.001), aspirin therapy (50% vs. 0%, p<0.001), and current acute renal replacement therapy (50% vs. 2%, p=0.002) were also significantly higher in patients with MIS-C. Logistic regression analysis showed that the presence of MIS-C was significantly associated with gastrointestinal manifestations [odds ratio (OR)=10.98; 95%CI (95% confidence interval)=1.20-100.86; p=0.034] and hypoxemia [OR=16.85; 95%CI=1.34-211.80; p=0.029]. Further univariate analysis showed a positive association between MIS-C and death [OR=58.00; 95%CI=6.39-526.79; p<0.0001]. CONCLUSIONS: Pediatric patients with laboratory-confirmed COVID-19 with MIS-C had a severe clinical spectrum with a high mortality rate. Our study emphasizes the importance of investigating MIS-C in pediatric patients with COVID-19 presenting with gastrointestinal involvement and hypoxemia.


Asunto(s)
Infecciones por Coronavirus/complicaciones , Infecciones por Coronavirus/mortalidad , Coronavirus , Pandemias , Neumonía Viral/complicaciones , Neumonía Viral/mortalidad , Síndrome de Respuesta Inflamatoria Sistémica/epidemiología , Síndrome de Respuesta Inflamatoria Sistémica/virología , Dolor Abdominal/etiología , Betacoronavirus , Niño , Infecciones por Coronavirus/diagnóstico , Infecciones por Coronavirus/terapia , Estudios Transversales , Diarrea/etiología , Fiebre/etiología , Glucocorticoides/uso terapéutico , Humanos , Inmunoglobulinas Intravenosas/uso terapéutico , Masculino , Síndrome Mucocutáneo Linfonodular/epidemiología , Síndrome Mucocutáneo Linfonodular/terapia , Síndrome Mucocutáneo Linfonodular/virología , Neumonía Viral/diagnóstico , Neumonía Viral/terapia , Respiración Artificial , Índice de Severidad de la Enfermedad , Síndrome de Respuesta Inflamatoria Sistémica/terapia , Vómitos/etiología
2.
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
4.
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
5.
J Investig Med High Impact Case Rep ; 8: 2324709620949307, 2020.
Artículo en Inglés | MEDLINE | ID: covidwho-708945

RESUMEN

The novel coronavirus disease has brought the world to standstill with high infectivity and rapid transmission. The disease caused by novel coronavirus is termed as coronavirus disease 2019 (COVID-19). We present the case of a renal transplant patient who was infected with COVID-19 through community spread and presented with fever and gastrointestinal symptoms. Transplant recipients are particularly vulnerable because of the immunosuppressed state. These patients can shed a virus for a prolonged period and can have a higher load of the virus. There have been no COVID-19 cases transmitted through organ donation. Preinfection immunological impairment can aggravate the severity of the infection. The transplant team plays a crucial role in donor and recipient evaluation and guiding the timing of the transplant. Although specific published data are lacking with regard to transplant recipients, they should follow the same precautions as the general population, like avoiding nonessential travel and practice social distancing.


Asunto(s)
Betacoronavirus , Infecciones por Coronavirus/fisiopatología , Trasplante de Riñón/efectos adversos , Neumonía Viral/fisiopatología , Infecciones por Coronavirus/complicaciones , Diarrea/etiología , Fatiga/etiología , Femenino , Humanos , Persona de Mediana Edad , Trasplante de Órganos , Pandemias , Neumonía Viral/complicaciones , Receptores de Trasplantes
6.
J Coll Physicians Surg Pak ; 30(6): 40-42, 2020 Jun.
Artículo en Inglés | MEDLINE | ID: covidwho-690668

RESUMEN

Coronavirus disease 19 (COVID-19) is a viral pneumonia caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). The disease started as an epidemic in China in December 2019 that later achieved a pandemic potential spreading to over 210 countries with more than 3.5 million confirmed cases and close to 250,000 deaths till date. Its symptoms most commonly include, dry cough, fever, myalgia, and fatigue. As the number of new cases keeps on rising, many patients have been documented with gastrointestinal manifestations such as diarrhoea, vomiting and abdominal pain. We report a case of a 23-year-old female who presented with the primary complaint of diarrhoea, after positive contact history with a COVID-19 patient. Key Words: SARS-CoV-2, COVID-19, Pneumonia, ARDS, Diarrhoea.


Asunto(s)
Infecciones por Coronavirus/diagnóstico , Coronavirus/aislamiento & purificación , Diarrea/etiología , Neumonía Viral/diagnóstico , Azitromicina/uso terapéutico , Betacoronavirus , Coronavirus/genética , Infecciones por Coronavirus/tratamiento farmacológico , Tos/etiología , Femenino , Fiebre/etiología , Humanos , Hidroxicloroquina/uso terapéutico , Pandemias/prevención & control , Neumonía Viral/tratamiento farmacológico , Reacción en Cadena de la Polimerasa de Transcriptasa Inversa , Resultado del Tratamiento , Adulto Joven
7.
Am J Case Rep ; 21: e925753, 2020 Jul 29.
Artículo en Inglés | MEDLINE | ID: covidwho-690362

RESUMEN

BACKGROUND The novel COVID-19 disease caused by the SARS-CoV-2 virus is a highly infectious disease that originated in Wuhan, China, and has rapidly spread throughout the world. In addition to respiratory complications, the virus has also been implicated in damage to other organ systems as well as coagulopathy. The present report describes the first presumptive case of COVID-19-associated acute superior mesenteric artery thrombosis and acute intestinal ischemia. CASE REPORT A 55-year old man presented to the emergency department with nausea, generalized abdominal pain and diarrhea; he denied having a fever or any respiratory symptoms. Computed tomography (CT) of the abdomen and pelvis revealed bilateral pulmonary ground-glass opacities. He tested positive for SARS-CoV-2, and was treated with hydroxychloroquine, azithromycin and ceftriaxone, and was discharged home after five days of inpatient treatment. One week later, the patient returned with recurrent nausea, vomiting and worsening diffuse abdominal pain. A CT scan of the abdomen showed a 1.6-cm clot, causing high grade narrowing of the proximal superior mesenteric artery and bowel ischemia. The patient emergently underwent exploratory laparotomy, thromboembolectomy and resection of the ischemic small bowel. A post-operative complete hypercoagulable workup was unrevealing. CONCLUSIONS Despite the absence of respiratory symptoms, patients infected with SARS-CoV-2 may show atypical presentations, such as gastrointestinal symptoms. Clinicians managing patients with suspected or confirmed SARS-CoV-2 infection during the COVID-19 pandemic should monitor these patients for potential complications that may arise from this disease.


Asunto(s)
Infecciones por Coronavirus/complicaciones , Intestinos/irrigación sanguínea , Isquemia/virología , Oclusión Vascular Mesentérica/virología , Neumonía Viral/complicaciones , Trombosis/virología , Dolor Abdominal/etiología , Betacoronavirus , Diarrea/etiología , Embolectomía , Humanos , Infarto/diagnóstico , Infarto/cirugía , Infarto/virología , Intestinos/diagnóstico por imagen , Intestinos/cirugía , Isquemia/diagnóstico por imagen , Isquemia/cirugía , Masculino , Arteria Mesentérica Superior/diagnóstico por imagen , Arteria Mesentérica Superior/cirugía , Oclusión Vascular Mesentérica/diagnóstico por imagen , Oclusión Vascular Mesentérica/cirugía , Persona de Mediana Edad , Pandemias , Trombectomía , Trombosis/diagnóstico por imagen , Trombosis/cirugía , Tomografía Computarizada por Rayos X
8.
Medicine (Baltimore) ; 99(28): e21293, 2020 Jul 10.
Artículo en Inglés | MEDLINE | ID: covidwho-647147

RESUMEN

BACKGROUND: In the beginning of December 2019, the novel coronavirus pneumonia was first detected in Wuhan, China. Its widespread infectivity and strong pathogenicity has posed a great threat to public health, seriously affecting social production and life. Accumulating evidence suggests that gastrointestinal symptoms, such as diarrhea, are common among patients with COVID-19. Tuina (massage) therapy is 1 of the widely employed complementary and alternative medicine interventions in the world. It can act on the subcutaneous muscular layer, enhance the local blood circulation and tissue metabolism of the skin, thus exert its effects on digestive systems and alleviate aversive diarrhea symptoms. This systematic review and meta-analysis will summarize the current evidence of tuina (massage) used as an intervention for diarrhea symptoms in COVID-19. METHODS: We will search the following electronic databases for randomized controlled trials to evaluate the effectiveness and safety of massage therapy in treating exercise-induced fatigue: China National Knowledge Infrastructure, Wanfang and Pubmed Database, Cochrane Central Register of Controlled Trials, Cumulative Index of Nursing and Allied Health Literature, Excerpta Medica database and MEDLINE. Each database will be searched from inception to June 2020. The entire process will include study selection, data extraction, risk of bias assessment and meta-analyses. RESULTS: This proposed study will evaluate the effectiveness and safety of massage therapy for diarrhea symptoms in COVID-19 patients. The outcomes will include the improvement of diarrhea symptoms and adverse effect. CONCLUSIONS: This proposed systematic review will evaluate the existing evidence on the effectiveness and safety of massage therapy for diarrhea symptoms in COVID-19 patients.Dissemination and ethics: The results of this review will be disseminated through peer-reviewed publication. Because all of the data used in this systematic review and meta-analysis has been published, this review does not require ethical approval. Furthermore, all data will be analyzed anonymously during the review process.


Asunto(s)
Infecciones por Coronavirus , Diarrea , Fatiga , Masaje/métodos , Pandemias , Neumonía Viral , Betacoronavirus/aislamiento & purificación , Infecciones por Coronavirus/complicaciones , Infecciones por Coronavirus/fisiopatología , Infecciones por Coronavirus/terapia , Diarrea/etiología , Diarrea/fisiopatología , Diarrea/terapia , Fatiga/etiología , Fatiga/prevención & control , Humanos , Metaanálisis como Asunto , Neumonía Viral/complicaciones , Neumonía Viral/fisiopatología , Neumonía Viral/terapia , Proyectos de Investigación , Revisiones Sistemáticas como Asunto , Resultado del Tratamiento
9.
Clin Gastroenterol Hepatol ; 18(8): 1753-1759.e2, 2020 07.
Artículo en Inglés | MEDLINE | ID: covidwho-613156

RESUMEN

BACKGROUND & AIMS: We compared clinical, laboratory, radiological, and outcome features of patients with SARS-CoV-2 infection (COVID-19) with pneumonia, with vs without diarrhea. METHODS: We performed a retrospective, single-center analysis of 84 patients with SARS-CoV-2 pneumonia in Wuhan Union Hospital, China, from January 19 through February 7, 2020. Cases were confirmed by real-time reverse-transcriptase PCR of nasal and pharyngeal swab specimens for SARS-CoV-2 RNA. Blood samples were analyzed for white blood cell count, lymphocyte count, alanine aminotransferase, creatine kinase, lactate dehydrogenase, D-dimer, C-reactive protein, and in some cases, immunoglobulins, complement, lymphocyte subsets, and cytokines. Virus RNA was detected in stool samples by real-time PCR. RESULTS: Of the 84 patients with SARS-CoV-2 pneumonia, 26 (31%) had diarrhea. The duration of fever and dyspnea in patients with diarrhea was significantly longer than those without diarrhea (all P < .05). Stool samples from a higher proportion of patients with diarrhea tested positive for virus RNA (69%) than from patients without diarrhea (17%) (P < .001). As of February 19, a lower proportion of patients with diarrhea had a negative result from the latest throat swab for SARS-CoV-2 (77%) than patients without diarrhea (97%) (P = .010), during these patients' hospitalization. Of 76 patients with a negative result from their latest throat swab test during hospitalization, a significantly higher proportion of patients with diarrhea had a positive result from the retest for SARS-CoV-2 in stool (45%) than patients without diarrhea (20%) (P = .039). CONCLUSIONS: At a single center in Wuhan, China, 31% of patients with SARS-CoV-2 pneumonia had diarrhea. A significantly higher proportion of patients with diarrhea have virus RNA in stool than patients without diarrhea. Elimination of SARS-CoV-2 from stool takes longer than elimination from the nose and throat.


Asunto(s)
Betacoronavirus/aislamiento & purificación , Portador Sano/virología , Infecciones por Coronavirus/complicaciones , Infecciones por Coronavirus/patología , Diarrea/epidemiología , Diarrea/etiología , Neumonía Viral/complicaciones , Neumonía Viral/patología , Adulto , Anciano , Recuento de Células Sanguíneas , Análisis Químico de la Sangre , China , Diarrea/patología , Heces/virología , Femenino , Hospitales , Humanos , Masculino , Persona de Mediana Edad , Mucosa Nasal/virología , Pandemias , Faringe/virología , ARN Viral/análisis , Reacción en Cadena en Tiempo Real de la Polimerasa , Estudios Retrospectivos , Adulto Joven
10.
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
12.
Am J Gastroenterol ; 115(8): 1153-1155, 2020 08.
Artículo en Inglés | MEDLINE | ID: covidwho-525850

Asunto(s)
Infecciones por Coronavirus/fisiopatología , Enfermedades del Sistema Digestivo/fisiopatología , Neumonía Viral/fisiopatología , Dolor Abdominal/etiología , Dolor Abdominal/metabolismo , Dolor Abdominal/fisiopatología , Dolor Abdominal/terapia , Atención Ambulatoria , Anorexia/etiología , Anorexia/metabolismo , Anorexia/fisiopatología , Anorexia/terapia , Antibacterianos/efectos adversos , Antipiréticos/efectos adversos , Antivirales/efectos adversos , Betacoronavirus , Enfermedad Hepática Inducida por Sustancias y Drogas/etiología , Enfermedad Hepática Inducida por Sustancias y Drogas/metabolismo , Enfermedad Hepática Inducida por Sustancias y Drogas/fisiopatología , Enfermedad Hepática Inducida por Sustancias y Drogas/terapia , China , Infecciones por Clostridium/diagnóstico , Infecciones por Clostridium/tratamiento farmacológico , Infecciones por Coronavirus/complicaciones , Infecciones por Coronavirus/metabolismo , Infecciones por Coronavirus/terapia , Diarrea/etiología , Diarrea/metabolismo , Diarrea/fisiopatología , Diarrea/terapia , Enfermedades del Sistema Digestivo/etiología , Enfermedades del Sistema Digestivo/metabolismo , Enfermedades del Sistema Digestivo/terapia , Endoscopía del Sistema Digestivo , Gastroenterología , Humanos , Hepatopatías/etiología , Hepatopatías/metabolismo , Hepatopatías/fisiopatología , Hepatopatías/terapia , Náusea/etiología , Náusea/metabolismo , Náusea/fisiopatología , Náusea/terapia , Pandemias , Neumonía Viral/complicaciones , Neumonía Viral/metabolismo , Neumonía Viral/terapia , Probióticos/uso terapéutico , Sociedades Médicas , Vómitos/etiología , Vómitos/metabolismo , Vómitos/fisiopatología
15.
Virulence ; 11(1): 482-485, 2020 12.
Artículo en Inglés | MEDLINE | ID: covidwho-343283

RESUMEN

Since its outbreak in Wuhan, Hubei Province China, 2019-coronavirus infected disease (COVID-19) had been widely spread all over the world, the control of which calls for a better understanding of its epidemiology and clinical characteristics. We included 12 confirmed cases of COVID-19 in First Affiliated Hospital of Jilin University from 23 January 2020 to 11 February 2020, which were retrospectively analyzed for epidemiological, demographic, clinical, laboratory, and radiological features. All the patients were confirmed by nucleic acid detection, the average age of whom was 45.25 years (range, 23-79 years). Most patients had a history of Wuhan traveling or had contact with Wuhan travelers or infected cases. Obvious family cluster was observed. Clinical manifestations included fever (12/12), fatigue (10/12), cough (6/12), sore throat (4/12), headache (3/12), and diarrhea (2/12). Only three out of eight patients had pneumonia manifestation on radiography. Most patients had a normal white blood cell (WBC) count and normal or reduced lymphocyte (LY) count. Pneumonia changes were observed in all the four patients who underwent a chest CT scan. Only one elderly patient developed severe pneumonia, while all the rest were mild disease and had a self-limiting course.


Asunto(s)
Infecciones por Coronavirus/epidemiología , Infecciones por Coronavirus/patología , Neumonía Viral/epidemiología , Neumonía Viral/patología , Adulto , Anciano , Betacoronavirus/aislamiento & purificación , China/epidemiología , Infecciones por Coronavirus/diagnóstico por imagen , Infecciones por Coronavirus/virología , Tos/etiología , Diarrea/etiología , Fatiga/etiología , Femenino , Fiebre/etiología , Cefalea/etiología , Humanos , Recuento de Leucocitos , Masculino , Persona de Mediana Edad , Pandemias , Faringitis/etiología , Neumonía Viral/diagnóstico por imagen , Neumonía Viral/virología , Estudios Retrospectivos , Tomografía Computarizada por Rayos X , Adulto Joven
16.
Gastroenterol Hepatol ; 43(7): 408-413, 2020.
Artículo en Inglés, Español | MEDLINE | ID: covidwho-304432

RESUMEN

COVID-19 is a disease caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), which was described in China in late 2019. There are currently more than three million diagnosed cases, constituting a pandemic which has caused a worldwide crisis. The devastating effects of this infection are due to its highly contagious nature and although mild forms predominate, in absolute values, the rates for severe forms and mortality are very high. The information on the characteristics of the infection in inflammatory bowel disease is of special interest, as these patients have higher attendance at health centres, which may increase their risk of infection. Furthermore, the treatments used to control the inflammatory activity may modify the disease course of COVID-19. The Spanish Working Group on Crohn's Disease and Ulcerative Colitis and the Spanish Nurses Working Group on Inflammatory Bowel Disease have prepared this document as a practical response to some common questions about the treatment of these patients.


Asunto(s)
Betacoronavirus , Infecciones por Coronavirus/epidemiología , Enfermedades Inflamatorias del Intestino/epidemiología , Pandemias , Neumonía Viral/epidemiología , Ansiedad/etiología , Productos Biológicos/efectos adversos , Productos Biológicos/uso terapéutico , Técnicas de Laboratorio Clínico , Comorbilidad , Contraindicaciones de los Medicamentos , Infecciones por Coronavirus/diagnóstico , Infecciones por Coronavirus/tratamiento farmacológico , Infecciones por Coronavirus/prevención & control , Infecciones por Coronavirus/transmisión , Diarrea/etiología , Susceptibilidad a Enfermedades , Interacciones Farmacológicas , Endoscopía Gastrointestinal/efectos adversos , Composición Familiar , Miedo , Humanos , Huésped Inmunocomprometido , Inmunosupresores/efectos adversos , Inmunosupresores/uso terapéutico , Enfermedades Inflamatorias del Intestino/complicaciones , Enfermedades Inflamatorias del Intestino/tratamiento farmacológico , Enfermedades Profesionales/prevención & control , Pandemias/prevención & control , Neumonía Viral/diagnóstico , Neumonía Viral/prevención & control , Neumonía Viral/transmisión , Cuarentena , Riesgo , España/epidemiología , Vitamina B 12/administración & dosificación , Deficiencia de Vitamina B 12/tratamiento farmacológico , Deficiencia de Vitamina B 12/etiología , Lugar de Trabajo
17.
Gastroenterol Hepatol ; 43(7): 408-413, 2020.
Artículo en Inglés, Español | MEDLINE | ID: covidwho-276425

RESUMEN

COVID-19 is a disease caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), which was described in China in late 2019. There are currently more than three million diagnosed cases, constituting a pandemic which has caused a worldwide crisis. The devastating effects of this infection are due to its highly contagious nature and although mild forms predominate, in absolute values, the rates for severe forms and mortality are very high. The information on the characteristics of the infection in inflammatory bowel disease is of special interest, as these patients have higher attendance at health centres, which may increase their risk of infection. Furthermore, the treatments used to control the inflammatory activity may modify the disease course of COVID-19. The Spanish Working Group on Crohn's Disease and Ulcerative Colitis and the Spanish Nurses Working Group on Inflammatory Bowel Disease have prepared this document as a practical response to some common questions about the treatment of these patients.


Asunto(s)
Betacoronavirus , Infecciones por Coronavirus/epidemiología , Enfermedades Inflamatorias del Intestino/epidemiología , Pandemias , Neumonía Viral/epidemiología , Ansiedad/etiología , Productos Biológicos/efectos adversos , Productos Biológicos/uso terapéutico , Técnicas de Laboratorio Clínico , Comorbilidad , Contraindicaciones de los Medicamentos , Infecciones por Coronavirus/diagnóstico , Infecciones por Coronavirus/tratamiento farmacológico , Infecciones por Coronavirus/prevención & control , Infecciones por Coronavirus/transmisión , Diarrea/etiología , Susceptibilidad a Enfermedades , Interacciones Farmacológicas , Endoscopía Gastrointestinal/efectos adversos , Composición Familiar , Miedo , Humanos , Huésped Inmunocomprometido , Inmunosupresores/efectos adversos , Inmunosupresores/uso terapéutico , Enfermedades Inflamatorias del Intestino/complicaciones , Enfermedades Inflamatorias del Intestino/tratamiento farmacológico , Enfermedades Profesionales/prevención & control , Pandemias/prevención & control , Neumonía Viral/diagnóstico , Neumonía Viral/prevención & control , Neumonía Viral/transmisión , Cuarentena , Riesgo , España/epidemiología , Vitamina B 12/administración & dosificación , Deficiencia de Vitamina B 12/tratamiento farmacológico , Deficiencia de Vitamina B 12/etiología , Lugar de Trabajo
19.
Acad Emerg Med ; 27(6): 469-474, 2020 06.
Artículo en Inglés | MEDLINE | ID: covidwho-245669

RESUMEN

BACKGROUND: Symptom criteria for COVID-19 testing of heath care workers (HCWs) limitations on testing availability have been challenging during the COVID-19 pandemic. An evidence-based symptom criteria for identifying HCWs for testing, based on the probability of positive COVID-19 test results, would allow for a more appropriate use of testing resources. METHODS: This was an observational study of outpatient COVID-19 testing of HCWs. Prior to testing, HCWs were asked about the presence of 10 symptoms. Their responses were then compared to their subsequent pharyngeal swab COVID-19 polymerase chain reaction test results. These data were used to derive and evaluate a symptom-based testing criteria. RESULTS: A total of 961 HCWs were included in the analysis, of whom 225 (23%) had positive test results. Loss of taste or smell was the symptom with the largest positive likelihood ratio (3.33). Dry cough, regardless of the presence or absence of other symptoms, was the most sensitive (74%) and the least specific (32%) symptom. The existing testing criteria consisting of any combination of one or more of three symptoms (fever, shortness of breath, dry cough) was 93% sensitive and 9% specific (area unce the curve [AUC] = 0.63, 95% confidence interval [CI] = 0.59 to 0.67). The derived testing criteria consisting of any combination of one or more of two symptoms (fever, loss of taste or smell) was 89% sensitive and 48% specific (AUC = 0.75, 95% CI = 0.71 to 0.78). The hybrid testing criteria consisting of any combination of one or more of four symptoms (fever, shortness of breath, dry cough, loss of taste or smell) was 98% sensitive and 8% specific (AUC = 0.77, 95% CI = 0.73 to 0.80). CONCLUSION: An evidence-based approach to COVID-19 testing that at least includes fever and loss of taste or smell should be utilized when determining which HCWs should be tested.


Asunto(s)
Técnicas de Laboratorio Clínico , Infecciones por Coronavirus/diagnóstico , Personal de Salud , Neumonía Viral/diagnóstico , Ageusia/etiología , Anorexia/etiología , Betacoronavirus , Infecciones por Coronavirus/complicaciones , Infecciones por Coronavirus/fisiopatología , Tos/etiología , Diarrea/etiología , Disnea/etiología , Fatiga/etiología , Fiebre/etiología , Humanos , Mialgia/etiología , Trastornos del Olfato/etiología , Pandemias , Faringitis/etiología , Neumonía Viral/complicaciones , Neumonía Viral/fisiopatología , Reacción en Cadena de la Polimerasa
SELECCIÓN DE REFERENCIAS
DETALLE DE LA BÚSQUEDA