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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.
BMJ Case Rep ; 13(9)2020 Sep 02.
Artículo en Inglés | MEDLINE | ID: covidwho-744831

RESUMEN

On 31 December 2019, the first case of COVID-19, was reported in Wuhan. A public health emergency of international concern was declared on 30 January 2020 and the first case in Scotland, on 2 March. The effect of COVID-19 appears to be less in the paediatric population and there are fewer cases reported in the literature in comparison to the adult population. Here, we report a case of a previously well 5-week-old infant who presented with fever and increased sleepiness. There was no known contact with any unwell individuals. COVID-19 was identified through a septic screen work up. The infant's course was uneventful and she has made a full recovery. This case highlights the need to have a low index of suspicion in the diagnosis of COVID-19 and the need to be vigilant in use of personal protective equipment, even in paediatric patients with subtle symptoms.


Asunto(s)
Infecciones por Coronavirus/diagnóstico , Infecciones por Coronavirus/terapia , Neumonía Viral/diagnóstico , Neumonía Viral/terapia , Betacoronavirus , Infecciones por Coronavirus/complicaciones , Trastornos de Somnolencia Excesiva/etiología , Fiebre/etiología , Humanos , Recién Nacido , Masculino , Pandemias , Neumonía Viral/complicaciones , Resultado del Tratamiento
3.
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.
Biomed Res Int ; 2020: 3149020, 2020.
Artículo en Inglés | MEDLINE | ID: covidwho-733121

RESUMEN

An outbreak of pneumonia, caused by a novel coronavirus (SARS-CoV-2), was identified in China in December 2019. This virus expanded worldwide, causing global concern. Although clinical, laboratory, and imaging features of COVID-19 are characterized in some observational studies, we undertook a systematic review and meta-analysis to assess the frequency of these features. We did a systematic review and meta-analysis using three databases to identify clinical, laboratory, and computerized tomography (CT) scanning features of rRT-PCR confirmed cases of COVID-19. Data for 3420 patients from 30 observational studies were included. Overall, the results showed that fever (84.2%, 95% CI 82.6-85.7), cough (62%, 95% CI 60-64), and fatigue (39.4%, 95% CI 37.2-41.6%) are the most prevalent symptoms in COVID-19 patients. Increased CRP level, decreased lymphocyte count, and increased D-dimer level were the most common laboratory findings. Among COVID-19 patients, 92% had a positive CT finding, most prevalently ground-glass opacification (GGO) (60%, 95% CI 58-62) and peripheral distribution opacification (64%, 95% CI 60-69). These results demonstrate the clinical, paraclinical, and imaging features of COVID-19.


Asunto(s)
Infecciones por Coronavirus , Pandemias , Neumonía Viral , Adolescente , Adulto , Anciano , Anciano de 80 o más Años , Betacoronavirus , Niño , Preescolar , Comorbilidad , Infecciones por Coronavirus/complicaciones , Infecciones por Coronavirus/diagnóstico , Infecciones por Coronavirus/epidemiología , Infecciones por Coronavirus/patología , Tos/etiología , Femenino , Fiebre/etiología , Humanos , Lactante , Recién Nacido , Pulmón/diagnóstico por imagen , Pulmón/patología , Masculino , Persona de Mediana Edad , Neumonía Viral/complicaciones , Neumonía Viral/diagnóstico , Neumonía Viral/epidemiología , Neumonía Viral/patología , Tomografía Computarizada por Rayos X , Adulto Joven
5.
Euro Surveill ; 25(33)2020 08.
Artículo en Inglés | MEDLINE | ID: covidwho-727369

RESUMEN

We report three clusters related with potential pre-symptomatic transmission of coronavirus disease (COVID-19) between January and February 2020 in Shanghai, China. Investigators interviewed suspected COVID-19 cases to collect epidemiological information, including demographic characteristics, illness onset, hospital visits, close contacts, activities' trajectories between 14 days before illness onset and isolation, and exposure histories. Respiratory specimens of suspected cases were collected and tested for SARS-CoV-2 by real-time reverse-transcriptase polymerase chain reaction (rRT-PCR) assay. The interval between the onset of illness in the primary case and the last contact of the secondary case with the primary case in our report was 1 to 7 days. In Cluster 1 (five cases), illness onset in the five secondary cases was 2 to 5 days after the last contact with the primary case. In Cluster 2 (five cases) and Cluster 3 (four cases), the illness onset in secondary cases occurred prior to or on the same day as the onset in the primary cases. The study provides empirical evidence for transmission of COVID-19 during the incubation period and indicates that pre-symptomatic person-to-person transmission can occur following sufficient exposure to confirmed COVID-19 cases. The potential pre-symptomatic person-to-person transmission puts forward higher requirements for prevention and control measures.


Asunto(s)
Técnicas de Laboratorio Clínico/métodos , Trazado de Contacto , Infecciones por Coronavirus/diagnóstico , Coronavirus/aislamiento & purificación , Pandemias/prevención & control , Adulto , Anciano , Anciano de 80 o más Años , Betacoronavirus , China/epidemiología , Coronavirus/genética , Infecciones por Coronavirus/epidemiología , Femenino , Fiebre/etiología , Humanos , Masculino , Persona de Mediana Edad , Neumonía Viral/diagnóstico , Neumonía Viral/epidemiología , Reacción en Cadena en Tiempo Real de la Polimerasa , Reacción en Cadena de la Polimerasa de Transcriptasa Inversa
6.
BMJ Case Rep ; 13(8)2020 Aug 11.
Artículo en Inglés | MEDLINE | ID: covidwho-714107

RESUMEN

Beyond the typical respiratory symptoms and fever associated with severe acute respiratory syndrome, we may still have much to learn about other manifestations of the novel SARS-CoV-2 infection. A patient presented with Guillain-Barré syndrome in China with a concurrent SARS-CoV-2 infection. The following case report looks at a patient presenting with the rare Miller Fisher syndrome, a variant of Guillain-Barré while also testing positive for COVID-19.


Asunto(s)
Betacoronavirus/aislamiento & purificación , Infecciones por Coronavirus/complicaciones , Síndrome de Miller Fisher/complicaciones , Neumonía Viral/complicaciones , China , Infecciones por Coronavirus/diagnóstico , Diagnóstico Diferencial , Fiebre/etiología , Humanos , Masculino , Persona de Mediana Edad , Síndrome de Miller Fisher/diagnóstico , Pandemias , Neumonía Viral/diagnóstico
7.
JAMA Netw Open ; 3(8): e2017703, 2020 08 03.
Artículo en Inglés | MEDLINE | ID: covidwho-713159

RESUMEN

Importance: International Statistical Classification of Diseases and Related Health Problems, Tenth Revision (ICD-10) codes are used to characterize coronavirus disease 2019 (COVID-19)-related symptoms. Their accuracy is unknown, which could affect downstream analyses. Objective: To compare the performance of fever-, cough-, and dyspnea-specific ICD-10 codes with medical record review among patients tested for COVID-19. Design, Setting, and Participants: This cohort study included patients who underwent quantitative reverse transcriptase-polymerase chain reaction testing for severe acute respiratory syndrome coronavirus 2 at University of Utah Health from March 10 to April 6, 2020. Data analysis was performed in April 2020. Main Outcomes and Measures: The sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) of ICD-10 codes for fever (R50*), cough (R05*), and dyspnea (R06.0*) were compared with manual medical record review. Performance was calculated overall and stratified by COVID-19 test result, sex, age group (<50, 50-64, and >64 years), and inpatient status. Bootstrapping was used to generate 95% CIs, and Pearson χ2 tests were used to compare different subgroups. Results: Among 2201 patients tested for COVD-19, the mean (SD) age was 42 (17) years; 1201 (55%) were female, 1569 (71%) were White, and 282 (13%) were Hispanic or Latino. The prevalence of fever was 66% (1444 patients), that of cough was 88% (1930 patients), and that of dyspnea was 64% (1399 patients). For fever, the sensitivity of ICD-10 codes was 0.26 (95% CI, 0.24-0.29), specificity was 0.98 (95% CI, 0.96-0.99), PPV was 0.96 (95% CI, 0.93-0.97), and NPV was 0.41 (95% CI, 0.39-0.43). For cough, the sensitivity of ICD-10 codes was 0.44 (95% CI, 0.42-0.46), specificity was 0.88 (95% CI, 0.84-0.92), PPV was 0.96 (95% CI, 0.95-0.97), and NPV was 0.18 (95% CI, 0.16-0.20). For dyspnea, the sensitivity of ICD-10 codes was 0.24 (95% CI, 0.22-0.26), specificity was 0.97 (95% CI, 0.96-0.98), PPV was 0.93 (95% CI, 0.90-0.96), and NPV was 0.42 (95% CI, 0.40-0.44). ICD-10 code performance was better for inpatients than for outpatients for fever (χ2 = 41.30; P < .001) and dyspnea (χ2 = 14.25; P = .003) but not for cough (χ2 = 5.13; P = .16). Conclusions and Relevance: These findings suggest that ICD-10 codes lack sensitivity and have poor NPV for symptoms associated with COVID-19. This inaccuracy has implications for any downstream data model, scientific discovery, or surveillance that relies on these codes.


Asunto(s)
Codificación Clínica/normas , Infecciones por Coronavirus/diagnóstico , Tos/diagnóstico , Disnea/diagnóstico , Registros Electrónicos de Salud , Fiebre/diagnóstico , Clasificación Internacional de Enfermedades , Neumonía Viral/diagnóstico , Adulto , Anciano , Betacoronavirus , Codificación Clínica/métodos , Estudios de Cohortes , Infecciones por Coronavirus/complicaciones , Infecciones por Coronavirus/epidemiología , Infecciones por Coronavirus/virología , Tos/etiología , Disnea/etiología , Femenino , Fiebre/etiología , Humanos , Masculino , Persona de Mediana Edad , Pandemias , Neumonía Viral/complicaciones , Neumonía Viral/epidemiología , Neumonía Viral/virología , Reacción en Cadena de la Polimerasa , Reproducibilidad de los Resultados , Sensibilidad y Especificidad , Utah/epidemiología
8.
Rev Peru Med Exp Salud Publica ; 37(2): 253-258, 2020.
Artículo en Español, Inglés | MEDLINE | ID: covidwho-699402

RESUMEN

In order to describe manifestations from patients with coronavirus disease 2019 (COVID-19), sociodemographic variables such as, previous medical history, clinical and radiological manifestations, treatments and evolution of patients were evaluated. This took place from March 6th to 25th, 2020, in the "Edgardo Rebagliati Martins" National Hospital in Lima. Seventeen patients were registered: 76% were male, with an average age of 53.5 years (range 25-94); 23.5% had returned from abroad; 41.2% were referred from other health facilities; 41.2% were admitted to mechanical ventilation; 29.4% (5 patients) died. The risk factors detected were: advanced age, arterial hypertension and obesity. The main symptoms detected were: cough, fever and dyspnea. Frequent laboratory findings were: elevated C-reactive protein and lymphopenia. The predominant radiological presentation was bilateral interstitial lung infiltrate. A first experience in the management of patients diagnosed with severe COVID-19 in Peru is reported.


Asunto(s)
Infecciones por Coronavirus/fisiopatología , Hospitalización , Neumonía Viral/fisiopatología , Respiración Artificial , Adulto , Anciano , Anciano de 80 o más Años , Infecciones por Coronavirus/mortalidad , Infecciones por Coronavirus/terapia , Tos/epidemiología , Tos/etiología , Disnea/epidemiología , Disnea/etiología , Femenino , Fiebre/epidemiología , Fiebre/etiología , Humanos , Masculino , Persona de Mediana Edad , Pandemias , Perú , Neumonía Viral/mortalidad , Neumonía Viral/terapia , Estudios Retrospectivos , Factores de Riesgo , Índice de Severidad de la Enfermedad
9.
Epidemiol Infect ; 148: e174, 2020 08 07.
Artículo en Inglés | MEDLINE | ID: covidwho-695910

RESUMEN

Coronavirus disease 2019 (COVID-19) is a global health threat. A hospital in Zhuhai adopted several measures in Fever Clinic Management (FCM) to respond to the outbreak of COVID-19. FCM has been proved to be effective in preventing nosocomial cross infection. Faced with the emergency, the hospital undertook creative operational steps in relation to the control and spread of COVID-19, with special focuses on physical and administrative layout of buildings, staff training and preventative procedures. The first operational step was to set up triaging stations at all entrances and then complete a standard and qualified fever clinic, which was isolated from the other buildings within our hospital complex. Secondly, the hospital established its human resource reservation for emergency response and the allocation of human resources to ensure strict and standardised training methods through the hospital for all medical staff and ancillary employees. Thirdly, the hospital divided the fever clinic into partitioned areas and adapted a three-level triaging system. The experiences shared in this paper would be of practical help for the facilities that are encountering or will encounter the challenges of COVID-19, i.e. to prevent nosocomial cross infection among patients and physicians.


Asunto(s)
Infecciones por Coronavirus/terapia , Servicios Médicos de Urgencia/métodos , Arquitectura y Construcción de Hospitales/métodos , Neumonía Viral/terapia , China/epidemiología , Infecciones por Coronavirus/epidemiología , Infecciones por Coronavirus/prevención & control , Infección Hospitalaria/prevención & control , Brotes de Enfermedades , Servicios Médicos de Urgencia/organización & administración , Servicios Médicos de Urgencia/normas , Fiebre/diagnóstico , Fiebre/etiología , Fiebre/terapia , Arquitectura y Construcción de Hospitales/normas , Humanos , Pandemias/prevención & control , Equipo de Protección Personal , Neumonía Viral/epidemiología , Neumonía Viral/prevención & control , Enseñanza , Factores de Tiempo , Triaje/métodos , Ventilación/normas , Flujo de Trabajo , Recursos Humanos/organización & administración , Recursos Humanos/normas
10.
BMC Med ; 18(1): 250, 2020 08 06.
Artículo en Inglés | MEDLINE | ID: covidwho-695766

RESUMEN

BACKGROUND: COVID-19 is an extremely severe infectious disease. However, few studies have focused on the epidemiological and clinical characteristics of pediatric COVID-19. This study conducted a retrospective review of the epidemiological and clinical features of COVID-19 in children. METHODS: A retrospective study was conducted on children with a definite diagnosis of COVID-19 in mainland China using the web crawler technique to collect anonymous COVID-19 updates published by local health authorities. RESULTS: Three hundred forty-one children aged 4 days to 14 years with a median age of 7 years were included. Sixty-six percent of pediatric patients were infected via family members with COVID-19. The median incubation period was 9 days (interquartile range, 6 to 13). Asymptomatic cases accounted for 5.9%, of which 30% had abnormal chest radiologic findings. A majority of pediatric COVID-19 cases showed mild to moderate clinical features, and only a few developed severe or critical diseases (0.6% and 0.3%, respectively). Fever (77.9%) and cough (32.4%) were the predominant presenting symptoms of pediatric COVID-19. The pediatric patients had fewer underlying diseases and complications than adults. The treatment modalities for pediatric COVID-19 patients were not as complex as those of adult COVID-19 patients. The overall prognosis of pediatric COVID-19 was benign with a decent recovery. The median time from onset to cure was 16 days (interquartile range, 13 to 21). CONCLUSIONS: Compared to adults, COVID-19 in children has distinct features of epidemiology and clinical manifestations. The findings from this study might help to guide the development of measures to prevent and treat this ongoing global pandemic. TRIAL REGISTRATION: Chinese Clinical Trial Registry ( chictr.org.cn ) identifier: ChiCTR2000030464.


Asunto(s)
Betacoronavirus , Infecciones por Coronavirus/epidemiología , Neumonía Viral/epidemiología , Adolescente , Niño , Preescolar , China/epidemiología , Tos/etiología , Femenino , Fiebre/etiología , Humanos , Lactante , Recién Nacido , Masculino , Pandemias , Estudios Retrospectivos
11.
Euro Surveill ; 25(30)2020 07.
Artículo en Inglés | MEDLINE | ID: covidwho-690936

RESUMEN

We report a case of Legionella pneumonia in a dishwasher of a restaurant in Rome, Italy, just after the end of the lockdown that was in place to control the SARS-CoV-2 epidemic. The case highlights the importance of strict monitoring of water and air systems immediately before reopening business or public sector buildings, and the need to consider Legionella infections among the differential diagnosis of respiratory infections after lockdown due to the ongoing COVID-19 pandemic.


Asunto(s)
Antígenos Bacterianos/orina , Legionella pneumophila/aislamiento & purificación , Legionella/aislamiento & purificación , Enfermedad de los Legionarios/diagnóstico , Levofloxacino/uso terapéutico , Neumonía/diagnóstico , Administración Intravenosa , Adulto , Antiinfecciosos Urinarios/uso terapéutico , Tos/etiología , Fiebre/etiología , Cefalea/etiología , Humanos , Enfermedad de los Legionarios/tratamiento farmacológico , Enfermedad de los Legionarios/orina , Masculino , Neumonía/tratamiento farmacológico , Neumonía/orina , Resultado del Tratamiento
12.
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
13.
J Coll Physicians Surg Pak ; 30(6): 37-39, 2020 Jun.
Artículo en Inglés | MEDLINE | ID: covidwho-690665

RESUMEN

We present a case of a 45-year male with history of fever and cough, followed by shortness of breath, lethargy and confusion at home. He was a known hypertensive, smoker and naswaar addict. He had history of contact with a friend who had recently returned from China, and used to work there as a physician. On presentation, he was hypoxic with bilateral coarse crepitations; and chest radiograph showed left middle zone consolidation. Considering the current pandemic, provisional diagnosis of meningoencephilits, with bilateral pneumonia owing to COVID-19, was made. Throat swab was sent for COVID-19 polymerase chain reaction (PCR). He was managed in intensive care unit (ICU) with broad-spectrum antibiotics, hydroxychloroquine alongwith anticoagulants; but he remained hypoxic with rapidly worsening clinical course, requiring mechanical ventilation; and ultimately succumbed to the disease. Report of COVID-19 PCR came positive after 24 hours. Key words: Coronavirus disease 2019 (COVID-19), Meningoencephalitis, Pneumonia.


Asunto(s)
Infecciones por Coronavirus/diagnóstico , Coronavirus/aislamiento & purificación , Disnea/etiología , Hipoxia/etiología , Neumonía Viral/diagnóstico , Antibacterianos/uso terapéutico , Anticoagulantes/administración & dosificación , Betacoronavirus , Técnicas de Laboratorio Clínico , Coronavirus/genética , Infecciones por Coronavirus/tratamiento farmacológico , Tos/etiología , Enoxaparina/administración & dosificación , Resultado Fatal , Fiebre/etiología , Humanos , Hidroxicloroquina/uso terapéutico , Unidades de Cuidados Intensivos , Masculino , Persona de Mediana Edad , Pandemias , Neumonía Viral/tratamiento farmacológico , Reacción en Cadena de la Polimerasa de Transcriptasa Inversa
14.
J Coll Physicians Surg Pak ; 30(6): 43-45, 2020 Jun.
Artículo en Inglés | MEDLINE | ID: covidwho-690541

RESUMEN

Coronavirus disease (COVID-19), first reported in December 2019 in Wuhan, China, has spread all over the world in a short time and was declared as a pandemic by the World Health Organization (WHO). During COVID-19 pandemic, chest computed tomography (CT) imaging has become an important tool with high sensitivity for diagnosis due to the low positive rate of the real-time reverse-transcriptase polymerase chain reaction (RT-PCR). Furthermore, the chest CT has played an important role in the diagnosis of underlying pulmonary lesions. In this case report, we present a patient who was admitted to the emergency department with fever, cough and left shoulder pain, and was subsequently diagnosed with both COVID-19 and pneumothorax following chest CT and RT-PCR test. Key Words: COVID-19, Coronavirus, Pneumothorax, Tomography.


Asunto(s)
Infecciones por Coronavirus/diagnóstico , Coronavirus/aislamiento & purificación , Pulmón/diagnóstico por imagen , Neumonía Viral/diagnóstico , Neumotórax/diagnóstico por imagen , Antibacterianos/uso terapéutico , Anticoagulantes/uso terapéutico , Antivirales/uso terapéutico , Azitromicina/uso terapéutico , Betacoronavirus , Coronavirus/genética , Infecciones por Coronavirus/complicaciones , Infecciones por Coronavirus/tratamiento farmacológico , Tos/etiología , Enoxaparina/uso terapéutico , Femenino , Fiebre/etiología , Humanos , Hidroxicloroquina/uso terapéutico , Masculino , Oseltamivir/uso terapéutico , Pandemias/prevención & control , Neumonía Viral/complicaciones , Neumonía Viral/tratamiento farmacológico , Neumotórax/etiología , Reacción en Cadena de la Polimerasa de Transcriptasa Inversa , Tomografía Computarizada por Rayos X , Resultado del Tratamiento , Adulto Joven
15.
Rev. Hosp. Ital. B. Aires (2004) ; 40(2): 53-55, jun. 2020. ilus
Artículo en Español | LILACS (Américas) | ID: covidwho-679083

RESUMEN

Una de las características de la afección pulmonar por enfermedad por coronavirus (COVID-19) es la disociación entre la gravedad de la hipoxemia y el mantenimiento de una mecánica respiratoria relativamente conservada. En este contexto se ha establecido una teoría en relación con dos fenotipos de pacientes con síndrome de distrés respiratorio del adulto (SDRA): un fenotipo Low, caracterizado por baja elastancia y baja reclutabilidad, y un fenotipo High, con características de alta elastancia y alta reclutabilidad. Presentamos el caso de un paciente que cursó internación en la Unidad de Terapia Intensiva de Adultos de nuestro hospital, con clínica, mecánica ventilatoria y patrón tomográfico compatible con el fenotipo Low de SDRA por COVID-19. (AU)


Dissociation between severity of hypoxemia and relative preserved respiratory mechanics is a characteristic observed in lung impairment due to coronavirus disease (COVID-19). Patients with COVID-19 that present adult respiratory distress syndrome (ARDS) are identified for one of two phenotypes according to a theory recently established. The Low phenotype is distinguished by low elastance and low recruitability; and the High phenotype, by high elastance and high recruitability. The case describes a patient admitted in the adult Intensive Care Unit of Hospital Italiano de Buenos Aires with observed symptoms, ventilatory mechanics and tomographic pattern that are compatible with Low phenotype of ARDS due to COVID-19. (AU)


Asunto(s)
Humanos , Masculino , Persona de Mediana Edad , Síndrome de Dificultad Respiratoria del Adulto/microbiología , Infecciones por Coronavirus/terapia , Fenotipo , Síndrome de Dificultad Respiratoria del Adulto/genética , Mecánica Respiratoria , Infecciones por Coronavirus/diagnóstico , Infecciones por Coronavirus/fisiopatología , Tos/etiología , Disnea/etiología , Fiebre/etiología , Hipertensión/complicaciones , Unidades de Cuidados Intensivos , Hipoxia/fisiopatología , Obesidad/complicaciones
16.
Mol Med Rep ; 22(3): 2583-2587, 2020 Sep.
Artículo en Inglés | MEDLINE | ID: covidwho-675981

RESUMEN

Since December 2019, an increasing number of cases associated with the 2019 novel coronavirus (2019­nCoV) have emerged in Wuhan, China, which has resulted in a rapid outbreak in China and worldwide. The present study aimed to describe the clinical, laboratory and radiological characteristics of 2019­nCoV pneumonia (NCP) in Zhejiang province, outside of Wuhan. A total of 74 patients with 2019­nCoV were continuously enrolled between January 22 and March 2, 2020 at Zhejiang Hospital. Diagnosis was confirmed at Zhejiang Hospital by reverse transcription­PCR (RT­PCR), which was approved by the Chinese government. Subsequently, the clinical features between positive­ and negative­NCP patients in Zhejiang were compared. Among the 74 hospitalized patients with suspected 2019­NCP, six patients (one male and five female patients) were confirmed to be infected with 2019­nCoV by RT­PCR. The average age of the confirmed patients was 40±13 years. There were three family clusters among the confirmed cases, one patient from each of these families had travel history or contact with patients from Wuhan within 2 weeks. Compared with non­NCP patients, the most common symptoms at onset for patients with NCP were fever (5/6; 83.3%) and cough (5/6; 83.3%), followed by dyspnea/pharyngalgia (2/6; 33.3%), whereas myalgia (1/6; 16.7%) and fatigue (1/6; 16.7%) were less common. All 74 patients with suspected NCP exhibited abnormal computerized tomography (CT) images. In total, 2/6 (33.3%) patients with confirmed NCP presented with bilateral pneumonia, and 21/68 (30.9%) non­NCP patients exhibited bilateral pneumonia, with bilateral distribution of patchy shadows or ground glass opacity. The present study revealed that epidemiological history was critical to the diagnosis of 2019­nCoV in low epidemic regions outside Hubei province. It was also identified that chest CT could not replace nucleic acid testing due to similar radiological manifestations.


Asunto(s)
Betacoronavirus , Infecciones por Coronavirus/complicaciones , Tos/etiología , Fatiga/etiología , Fiebre/etiología , Neumonía Viral/complicaciones , Adulto , China/epidemiología , Infecciones por Coronavirus/transmisión , Infecciones por Coronavirus/virología , Tos/patología , Fatiga/patología , Femenino , Fiebre/patología , Humanos , Incidencia , Masculino , Pandemias , Neumonía Viral/transmisión , Neumonía Viral/virología
17.
Medicine (Baltimore) ; 99(29): e21334, 2020 Jul 17.
Artículo en Inglés | MEDLINE | ID: covidwho-676910

RESUMEN

RATIONALE: The outbreak of coronavirus disease 2019 (COVID-19) in 2019 has become a global pandemic. It is not known whether the disease is associated with a higher risk of infection in pregnant women or whether intrauterine vertical transmission can occur. We report 2 cases of pregnant women diagnosed with COVID-19. PATIENT CONCERNS: In all of Yichang city from January 20, 2020, to April 9, 2020, only 2 pregnant women, who were in the late stage of pregnancy, were diagnosed with COVID-19; one patient was admitted for fever with limb asthenia, and the other patient was admitted for abnormal chest computed tomography results. DIAGNOSES: Both pregnant women were diagnosed with COVID-19. INTERVENTIONS: After the medical staff prepared for isolation and protection, the 2 pregnant women quickly underwent cesarean sections. A series of tests, such as laboratory, imaging, and SARS-CoV-2 nucleic acid examinations, were performed on the 2 women with COVID-19 and their newborns. OUTCOMES: One of the 2 infected pregnant women had severe COVID-19, and the other had mild disease. Both babies were delivered by cesarean section. Both of the women with COVID-19 worsened 3 to 6 days after delivery. Chest computed tomography suggested that the lesions due to SARS-CoV-2 infection increased. These women began to exhibit fever or reduced blood oxygen saturation again. One of the 2 newborns was born prematurely, and the other was born at full term. Neither infant was infected with COVID-19, but both had increased prothrombin time and fibrinogen, lactate dehydrogenase, phosphocreatine kinase, and creatine kinase isoenzyme contents. LESSONS: SARS-CoV-2 infection was not found in the newborns born to the 2 pregnant women with COVID-19, but transient coagulation dysfunction and myocardial damage occurred in the 2 newborns. Effective management strategies for pregnant women with COVID-19 will help to control the outbreak of COVID-19 among pregnant women.


Asunto(s)
Betacoronavirus/genética , Infecciones por Coronavirus/diagnóstico , Infecciones por Coronavirus/virología , Neumonía Viral/diagnóstico , Neumonía Viral/virología , Adulto , Astenia/etiología , Betacoronavirus/aislamiento & purificación , Cesárea/métodos , China/epidemiología , Infecciones por Coronavirus/tratamiento farmacológico , Brotes de Enfermedades/prevención & control , Femenino , Fiebre/etiología , Humanos , Recién Nacido/sangre , Recién Nacido/metabolismo , Transmisión Vertical de Enfermedad Infecciosa/prevención & control , Pandemias , Neumonía Viral/tratamiento farmacológico , Embarazo , Complicaciones Infecciosas del Embarazo/epidemiología , Complicaciones Infecciosas del Embarazo/virología , Resultado del Embarazo/epidemiología , Nacimiento Prematuro/epidemiología , Tórax/diagnóstico por imagen , Tomografía Computarizada por Rayos X/métodos
18.
Arch Gynecol Obstet ; 302(3): 545-551, 2020 09.
Artículo en Inglés | MEDLINE | ID: covidwho-658657

RESUMEN

OBJECTIVE: To investigate the maternal and infant outcomes of full-term pregnant patients in Wuhan, China, who were infected with 2019 severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) that is responsible for coronavirus disease 2019 (COVID-2019). DESIGN: Retrospective case series. SETTING: The Central Hospitals of Wuhan, Tongji Medical College, Huazhong University of Science and Technology in Wuhan, China. PARTICIPANTS: Twenty one full-term pregnant patients who were admitted to the Central Hospital of Wuhan, Tongji Medical College, Huazhong University of Science and Technology, confirmed SARS-CoV-2 infection and COVID-2019 with laboratorial and clinical methods, were reviewed by our medical team, and the data were collected from January 20, 2020 to February 29, 2020. MAIN CLINICAL DATA COLLECTION: Clinical data had been collecting using a standard case report form, such as epidemiological history, clinical manifestations, auxiliary examination of major laboratory and clinic, etc. All the information was collected and confirmed by our medical team. RESULTS: Twenty one full-term pregnant patients were reviewed (median age 29 years), and no patients were admitted to intensive care unit (ICU), and died during the treating progress. According to our review, all the cases were infected by human to human transmission, and the most common symptoms at onset of illness were cough in 17 (80.95%), fatigue in 10 (47.62%), fever in 7 (33.33%), expectoration in 1 (4.76%), and only one patient (4.76%) developed shortness of breath on admission. The median time from exposure to onset of illness was 10 days (interquartile range 7 -2 days), and from onset of symptoms to first hospital admission was 1 day (interquartile range 1-2 days). CONCLUSIONS: As of February 29, 2020, all the patients who were full-term pregnancy combined with COVID-2019 were cured and delivered successfully, and all the newborns were not infected with SARS-CoV-2, and there were no evidence of mother-to-child transmission.


Asunto(s)
Infecciones por Coronavirus/diagnóstico , Coronavirus/aislamiento & purificación , Hospitalización/estadística & datos numéricos , Pandemias , Neumonía Viral/diagnóstico , Complicaciones del Embarazo/virología , Adulto , Betacoronavirus , China/epidemiología , Infecciones por Coronavirus/epidemiología , Infecciones por Coronavirus/terapia , Tos/etiología , Disnea/etiología , Fatiga/etiología , Femenino , Fiebre/etiología , Humanos , Recién Nacido , Neumonía Viral/epidemiología , Neumonía Viral/terapia , Embarazo , Complicaciones del Embarazo/terapia , Resultado del Embarazo , Estudios Retrospectivos
19.
BMC Infect Dis ; 20(1): 517, 2020 Jul 16.
Artículo en Inglés | MEDLINE | ID: covidwho-651422

RESUMEN

BACKGROUND: The outbreak of coronavirus disease 2019 (COVID-19) caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has become a public health emergency of major international concern. Real-time RT-PCR assays are recommended for diagnosis of COVID-19. Here we report a rare case of COVID-19 with multiple negative results for PCR assays outside Wuhan, China. CASE PRESENTATION: A 32-year old male was admitted to our hospital because of 6 days of unexplained fever on January 29, 2020. He had come from Wuhan city 10 days before admission. Five days before admission, no abnormality was noted in laboratory test, chest radiography, and nasopharyngeal swab test for the SARS-CoV-2 nucleic acid. The patient was treated with ibuprofen for alleviating fever. On admission, chest computed tomography showed multiple ground-glass opacities in right lower lung field. COVID-19 was suspected. Three times of nasopharyngeal swab specimens were collected after admission. However, none of the specimens were positive. The patient was confirmed with COVID-19 after fifth SARS-CoV-2 nucleic acid test. He was treated with lopinavir/ritonavir, recombinant human interferon alfa-2b inhalation, methylprednisolone. After 18 days of treatment, he was discharged with improved symptoms, lung lesions and negative results of nasopharyngeal swab. CONCLUSION: This case reminds clinician that a patient with high clinical suspicion of COVID-19 but multiple negative RT-PCR result should not be taken out of isolation. A combination of patient's exposure history, clinical manifestations, laboratory tests, and typical imaging findings plays a vital role in making preliminary diagnosis and guide early isolation and treatment. Repeat swab tests are helpful in diagnosis for this kind of patients.


Asunto(s)
Betacoronavirus/aislamiento & purificación , Infecciones por Coronavirus/diagnóstico , Infecciones por Coronavirus/virología , Resultados Negativos , Neumonía Viral/diagnóstico , Neumonía Viral/virología , Adulto , Betacoronavirus/genética , China/epidemiología , Infecciones por Coronavirus/diagnóstico por imagen , Infecciones por Coronavirus/fisiopatología , Fiebre/etiología , Fiebre/virología , Hospitalización , Humanos , Masculino , Pandemias , Neumonía Viral/diagnóstico por imagen , Neumonía Viral/fisiopatología , Cuarentena , Radiografía , Reacción en Cadena en Tiempo Real de la Polimerasa , Sensibilidad y Especificidad , Tomografía Computarizada por Rayos X , Incertidumbre
20.
Clin Pediatr (Phila) ; 59(12): 1069-1073, 2020 10.
Artículo en Inglés | MEDLINE | ID: covidwho-638784

RESUMEN

In order to accurately admit children with COVID-19 to an isolation ward, our study retrospectively analyzed the clinical characteristics of children in isolation wards during the COVID-19 epidemic. It was found that 55 cases (83.3%) had fever and 48 cases (72.7%) coughed in the isolated area, 31 cases (47%) had a history of exposure, 26 cases (39.4%) had a decrease in lymphocytes (LYM), more than half had an increase in lactate dehydrogenase and creatine kinase isoenzyme, 14 cases (21.2%) had positive SARS-CoV-2 nucleic acid, 58 cases (87.9%) had abnormal chest computed tomography (CT), and 11 cases (16.7%) had sinus arrhythmia. Therefore, for some suspected children with COVID-19, we can make a comprehensive judgment through clinical symptoms, epidemiological history, LYM number, myocardial enzyme spectrum, chest CT, and electrocardiogram; put these children in an isolation ward for treatment; and then transfer them to a general ward for treatment after excluding COVID-19.


Asunto(s)
Betacoronavirus , Infecciones por Coronavirus/diagnóstico , Infecciones por Coronavirus/epidemiología , Neumonía Viral/diagnóstico , Neumonía Viral/epidemiología , Índice de Severidad de la Enfermedad , Niño , Preescolar , Infecciones por Coronavirus/complicaciones , Tos/etiología , Femenino , Fiebre/etiología , Humanos , Recuento de Linfocitos , Masculino , Pandemias , Neumonía Viral/complicaciones , Estudios Retrospectivos
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