Your browser doesn't support javascript.
Mostrar: 20 | 50 | 100
Resultados 1 - 20 de 566
Filtrar
Añadir filtros

Intervalo de año
2.
Int J Mol Sci ; 21(14)2020 Jul 14.
Artículo en Inglés | MEDLINE | ID: covidwho-649852

RESUMEN

Effective treatment of retinal diseases with adeno-associated virus (AAV)-mediated gene therapy is highly dependent on the proportion of successfully transduced cells. However, due to inflammatory reactions at high vector doses, adjunctive treatment may be necessary to enhance the therapeutic outcome. Hydroxychloroquine and chloroquine are anti-malarial drugs that have been successfully used in the treatment of autoimmune diseases. Evidence suggests that at high concentrations, hydroxychloroquine and chloroquine can impact viral infection and replication by increasing endosomal and lysosomal pH. This effect has led to investigations into the potential benefits of these drugs in the treatment of viral infections, including human immunodeficiency virus and severe acute respiratory syndrome coronavirus-2. However, at lower concentrations, hydroxychloroquine and chloroquine appear to exert immunomodulatory effects by inhibiting nucleic acid sensors, including toll-like receptor 9 and cyclic GMP-AMP synthase. This dose-dependent effect on their mechanism of action supports observations of increased viral infections associated with lower drug doses. In this review, we explore the immunomodulatory activity of hydroxychloroquine and chloroquine, their impact on viral infections, and their potential to improve the efficacy and safety of retinal gene therapy by reducing AAV-induced immune responses. The safety and practicalities of delivering hydroxychloroquine into the retina will also be discussed.


Asunto(s)
Cloroquina/uso terapéutico , Terapia Genética , Hidroxicloroquina/uso terapéutico , Enfermedades de la Retina/terapia , Virosis/tratamiento farmacológico , Animales , Betacoronavirus/efectos de los fármacos , Cloroquina/farmacología , Dependovirus/genética , Humanos , Hidroxicloroquina/farmacología , Inmunomodulación/efectos de los fármacos , Enfermedades de la Retina/patología
4.
Postgrad Med J ; 96(1139): 550-555, 2020 Sep.
Artículo en Inglés | MEDLINE | ID: covidwho-751468

RESUMEN

Hydroxychloroquine and chloroquine are medications that have been used for a long time. Their most common use is for the treatment and prophylaxis of malaria. However, these antimalarial drugs are known to also have anti-inflammatory and antiviral effects and are used for several chronic diseases such as systemic lupus erythematosus with low adverse effects. The antiviral action of hydroxychloroquine and chloroquine has been a point of interest to different researchers due to its mechanism of action. Several in vitro studies have proven their effectiveness on severe acute respiratory syndrome virus and currently both in vitro and in vivo studies have been conducted on 2019 novel coronavirus (covid-19). The purpose of this article is to review the history and mechanism of actions of these drugs and the potential use they can have on the current covid-19 pandemic.


Asunto(s)
Antimaláricos/farmacología , Betacoronavirus , Infecciones por Coronavirus/tratamiento farmacológico , Hidroxicloroquina/farmacología , Neumonía Viral/tratamiento farmacológico , Humanos , Pandemias
5.
Rev Peru Med Exp Salud Publica ; 37(2): 302-311, 2020.
Artículo en Español | MEDLINE | ID: covidwho-749299

RESUMEN

During the first weeks of 2020, cases of SARS-CoV-2 began to be reported outside of China, with a rapid increase in cases and deaths worldwide. SARS-CoV-2 is a positive single-stranded RNA virus, encased in a lipid bilayer derived from the host cell membrane and consists of four structural proteins (S, M, E and N), plus a haemagglutinin-sterase. The binding of the S protein to the ECA2 receptor allows the entry of the virus into the host cell and is a potential therapeutic target. 81% of patients develop mild symptoms, 14% have severe symptoms and 5% require intensive care management. Fever is the most frequent symptom, followed by cough and dyspnea. Most patients do not present leukocytosis, but they do present lymphopenia with sputum cultures that do not show other pathogens. In lung biopsies of severe patients, the most noticeable finding is diffuse alveolar damage. Radiologically, ground glass and alveolar patterns are observed; the lesions being predominantly basal, subpleural, and posterior, with a multifocal peripheral distribution, more affecting the right lower lobe. There is a marked inflammatory response, up to the cytokine storm, in which anti-inflammatory treatment with pulse therapy with methylprednisolone would be indicated. Although there are no large-scale studies regarding the use of chloroquine / hydroxychloroquine, due to the global situation, its use has been authorized for its anti-SARS-CoV-2 and anti-inflammatory effect, which can be potentiated with the use of azithromycin.


Asunto(s)
Infecciones por Coronavirus/epidemiología , Inflamación/virología , Neumonía Viral/epidemiología , Antiinflamatorios/administración & dosificación , Antivirales/administración & dosificación , Cloroquina/administración & dosificación , Infecciones por Coronavirus/tratamiento farmacológico , Infecciones por Coronavirus/fisiopatología , Humanos , Hidroxicloroquina/administración & dosificación , Inflamación/tratamiento farmacológico , Pandemias , Neumonía Viral/tratamiento farmacológico , Neumonía Viral/fisiopatología
6.
Vestn Oftalmol ; 136(4. Vyp. 2): 265-271, 2020.
Artículo en Ruso | MEDLINE | ID: covidwho-745625

RESUMEN

Coronavirus infection is currently en extremely relevant scientific topic due to the emergence of a new serotype that causes a condition identified as Severe Acute Respiratory Syndrome (SARS)-COV-2. Chloroquine and hydroxychloroquine have a long history of use against other infectious diseases, they are available and inexpensive, so the possibility of using them in vivo and in vitro to suppress the infectious agent was examined. Despite the noted therapeutic potential of these drugs, it was necessary to take into account the toxicological aspects that dictate the importance of rational use of 4-aminoquinoline derivatives. This review analyzes literature on the development patterns of hydroxychloroquine retinopathy, basic principles of diagnosis and differentiation of this condition from other types of retinal pathology.


Asunto(s)
Antivirales/uso terapéutico , Betacoronavirus , Neumonía Viral/diagnóstico , Neumonía Viral/tratamiento farmacológico , Diagnóstico Diferencial , Humanos , Hidroxicloroquina/uso terapéutico , Pandemias
7.
MMWR Morb Mortal Wkly Rep ; 69(35): 1210-1215, 2020 Sep 04.
Artículo en Inglés | MEDLINE | ID: covidwho-745358

RESUMEN

Hydroxychloroquine and chloroquine, primarily used to treat autoimmune diseases and to prevent and treat malaria, received national attention in early March 2020, as potential treatment and prophylaxis for coronavirus disease 2019 (COVID-19) (1). On March 20, the Food and Drug Administration (FDA) issued an emergency use authorization (EUA) for chloroquine phosphate and hydroxychloroquine sulfate in the Strategic National Stockpile to be used by licensed health care providers to treat patients hospitalized with COVID-19 when the providers determine the potential benefit outweighs the potential risk to the patient.* Following reports of cardiac and other adverse events in patients receiving hydroxychloroquine for COVID-19 (2), on April 24, 2020, FDA issued a caution against its use† and on June 15, rescinded its EUA for hydroxychloroquine from the Strategic National Stockpile.§ Following the FDA's issuance of caution and EUA rescindment, on May 12 and June 16, the federal COVID-19 Treatment Guidelines Panel issued recommendations against the use of hydroxychloroquine or chloroquine to treat COVID-19; the panel also noted that at that time no medication could be recommended for COVID-19 pre- or postexposure prophylaxis outside the setting of a clinical trial (3). However, public discussion concerning the effectiveness of these drugs on outcomes of COVID-19 (4,5), and clinical trials of hydroxychloroquine for prophylaxis of COVID-19 continue.¶ In response to recent reports of notable increases in prescriptions for hydroxychloroquine or chloroquine (6), CDC analyzed outpatient retail pharmacy transaction data to identify potential differences in prescriptions dispensed by provider type during January-June 2020 compared with the same period in 2019. Before 2020, primary care providers and specialists who routinely prescribed hydroxychloroquine, such as rheumatologists and dermatologists, accounted for approximately 97% of new prescriptions. New prescriptions by specialists who did not typically prescribe these medications (defined as specialties accounting for ≤2% of new prescriptions before 2020) increased from 1,143 prescriptions in February 2020 to 75,569 in March 2020, an 80-fold increase from March 2019. Although dispensing trends are returning to prepandemic levels, continued adherence to current clinical guidelines for the indicated use of these medications will ensure their availability and benefit to patients for whom their use is indicated (3,4), because current data on treatment and pre- or postexposure prophylaxis for COVID-19 indicate that the potential benefits of these drugs do not appear to outweigh their risks.


Asunto(s)
Cloroquina/uso terapéutico , Hidroxicloroquina/uso terapéutico , Pautas de la Práctica en Medicina/estadística & datos numéricos , Especialización/estadística & datos numéricos , Infecciones por Coronavirus/tratamiento farmacológico , Femenino , Humanos , Masculino , Resultado del Tratamiento , Estados Unidos
8.
J Cardiovasc Med (Hagerstown) ; 21(10): 765-771, 2020 10.
Artículo en Inglés | MEDLINE | ID: covidwho-745112

RESUMEN

AIMS: The aim of this study was to evaluate the clinical course of COVID-19 in patients who had recently undergone a cardiac procedure and were inpatients in a cardiac rehabilitation department. METHODS: All patients hospitalized from 1 February to 15 March 2020 were included in the study (n = 35; 16 men; mean age 78 years). The overall population was divided into two groups: group 1 included 10 patients who presented with a clinical picture of COVID-19 infection and were isolated, and group 2 included 25 patients who were COVID-19-negative. In group 1, nine patients were on chronic oral anticoagulant therapy and one patient was on acetylsalicylic acid (ASA) and clopidogrel. A chest computed tomography scan revealed interstitial pneumonia in all 10 patients. RESULTS: During hospitalization, COVID-19 patients received azithromycin and hydroxychloroquine in addition to their ongoing therapy. Only the patient on ASA with clopidogrel therapy was transferred to the ICU for mechanical ventilation because of worsening respiratory failure, and subsequently died from cardiorespiratory arrest. All other patients on chronic anticoagulant therapy recovered and were discharged. CONCLUSION: Our study suggests that COVID-19 patients on chronic anticoagulant therapy may have a more favorable and less complicated clinical course. Further prospective studies are warranted to confirm this preliminary observation.


Asunto(s)
Anticoagulantes/uso terapéutico , Azitromicina/administración & dosificación , Procedimientos Quirúrgicos Cardíacos , Infecciones por Coronavirus , Hidroxicloroquina/administración & dosificación , Pandemias , Inhibidores de Agregación Plaquetaria/uso terapéutico , Neumonía Viral , Complicaciones Posoperatorias , Anciano , Antiinfecciosos/administración & dosificación , Procedimientos Quirúrgicos Cardíacos/efectos adversos , Procedimientos Quirúrgicos Cardíacos/métodos , Terapia Combinada/métodos , Infecciones por Coronavirus/sangre , Infecciones por Coronavirus/diagnóstico , Infecciones por Coronavirus/mortalidad , Infecciones por Coronavirus/fisiopatología , Femenino , Humanos , Masculino , Evaluación de Procesos y Resultados en Atención de Salud , Neumonía Viral/sangre , Neumonía Viral/diagnóstico , Neumonía Viral/etiología , Neumonía Viral/mortalidad , Neumonía Viral/fisiopatología , Complicaciones Posoperatorias/sangre , Complicaciones Posoperatorias/prevención & control , Complicaciones Posoperatorias/virología , Tomografía Computarizada por Rayos X/métodos
10.
Trials ; 21(1): 754, 2020 Aug 31.
Artículo en Inglés | MEDLINE | ID: covidwho-742452

RESUMEN

OBJECTIVES: To evaluate the effect of the combination of hydroxychloroquine (HCQ) and standard personal protective equipment (PPE) compared to the use of standard personal protective equipment alone on the proportion of laboratory confirmed COVID-19 infections among frontline healthcare workers(HCWs) in India TRIAL DESIGN: HOPE is an investigator initiated multi-centre open-label parallel group randomized controlled trial. PARTICIPANTS: All HCWs currently working in an environment with direct exposure to patients with confirmed COVID-19 infection are eligible to participate in the trial. The trial aims to be conducted across 20-30 centres (public and private hospitals) in India. HCWs who decline consent, who have a confirmed COVID-19 infection, those who are already on chloroquine/HCQ for any indication, or if pregnant or breast-feeding, or have known QT prolongation or are on medications that when taken with HCQ can prolong the QTc will be excluded. INTERVENTION AND COMPARATOR: The interventions to be compared in this trial are standard practice (use of recommended PPE) and HCQ plus standard practice. In the standard practice arm, HCWs will use recommended PPE as per institutional guidelines and based on their roles. They will be discouraged from taking HCQ to prevent contamination and contacted every week for the duration of the study to ascertain if they have taken any HCQ. Any such use will be reported as a protocol violation. In the intervention arm, HCWs will be administered 800mg of HCQ as a loading dose on the day of randomization (as two 400mg doses 12hrs apart) and subsequently continued on 400mg once a week for 12 weeks. This will be in addition to the use of recommended PPE as per institutional guidelines and based on their roles. HCWs will collect the drug once every week from designated research and pharmacy staff at site. A weekly phone reminder will be provided to participants in this arm to ensure compliance. An ECG will be performed between 4-6 weeks in this arm and if the QTc is prolonged (greater than 450milliseconds), the drug will be stopped. Follow-up will however continue. Participants in both arms will receive a weekly phone call for evaluation of the primary outcome, to monitor protocol compliance and development of any adverse events (in the HCQ group). MAIN OUTCOMES: Participants will be followed on a weekly basis. The primary outcome is the proportion of HCWs developing laboratory confirmed COVID-19 infection within 6 months of randomization. We will also evaluate a number of secondary outcomes, including hospitalization related to suspected/confirmed COVID-19 infection, intensive care unit or high-dependency unit admission due to suspected/confirmed COVID-19 infection, all-cause mortality, need for organ support ( non-invasive or invasive ventilation, vasopressors and renal replacement therapy), ICU and hospital length of stay, readmission, days off work and treatment-related adverse events. RANDOMISATION: Randomisation will be conducted through a password-protected, secure website using a central, computer-based randomisation program. Randomisation will be stratified by participating institutions and by the role of HCW - nursing, medical and other. Participants will be randomised 1:1 to either standard practice only or HCQ plus standard practice. Allocation concealment is maintained by central web-based randomisation BLINDING (MASKING): This is an unblinded study: study assigned treatment will be known to the research team and participant. Bias will be mitigated through an objective end point (laboratory confirmed COVID-19 infection). NUMBERS TO BE RANDOMISED (SAMPLE SIZE): A total of 6,950 HCWs will be enrolled (3475 to the intervention) and (3475 to the standard practice group) to detect a 25% relative reduction, or 2.5% absolute reduction, in the infection rate from an estimated baseline infection rate of 10%, with 80% statistical power using a two-sided test at 5% level of significance. Available data from China and Italy indicate that the rate of infection among frontline healthcare workers varies between 4% to 12%. We therefore assumed a baseline infection rate of 10% among HCWs. This sample size allows for a potential loss to follow-up rate of 10% and a potential non-compliance rate of 10% in both the treatment and control arms. TRIAL STATUS: HOPE protocol version 3.0 dated June 3rd 2020. Recruitment started on 29th June 2020 and currently 56 participants have been enrolled. Planned completion of enrolment is January 31st 2021. TRIAL REGISTRATION: Clinical Trials Registry of India: CTRI/2020/05/025067 (prospectively registered) Date of registration: 6th May 2020 FULL PROTOCOL: The full protocol is attached as an additional file, accessible from the Trials website (Additional file 1). In the interest of expedited dissemination of this material, the familiar formatting has been eliminated; this Letter serves as a summary of the key elements of the full protocol. The study protocol has been reported in accordance with the Standard Protocol Items: Recommendations for Clinical Interventional Trials (SPIRIT) guidelines (Additional file 2).


Asunto(s)
Infecciones por Coronavirus/prevención & control , Inhibidores Enzimáticos/uso terapéutico , Personal de Salud , Hidroxicloroquina/uso terapéutico , Transmisión de Enfermedad Infecciosa de Paciente a Profesional/prevención & control , Enfermedades Profesionales/prevención & control , Pandemias/prevención & control , Equipo de Protección Personal , Neumonía Viral/prevención & control , Betacoronavirus , Quimioprevención , Infecciones por Coronavirus/transmisión , Humanos , India , Neumonía Viral/transmisión
11.
Adv Biol Regul ; 77: 100745, 2020 08.
Artículo en Inglés | MEDLINE | ID: covidwho-741319

RESUMEN

Coronavirus disease 2019 caused by SARS-CoV-2 originated from China and spread across every corner of the world. The scientific interest on COVID-19 increased after WHO declared it a pandemic in the early February of 2020. In fact, this pandemic has had a worldwide impact on economy, health, and lifestyle like no other in the last 100 years. SARS-CoV-2 belongs to Coronaviridae family and causes the deadliest clinical manifestations when compared to other viruses in the family. COVID-19 is an emerging zoonotic disease that has resulted in over 383,000 deaths around the world. Scientists are scrambling for ideas to develop treatment and prevention strategies to thwart the disease condition. In this review, we have attempted to summarize the latest information on the virus, disease, prevention, and treatment strategies. The future looks promising.


Asunto(s)
Betacoronavirus/patogenicidad , Control de Enfermedades Transmisibles/organización & administración , Infecciones por Coronavirus/epidemiología , Pandemias , Neumonía Viral/epidemiología , Antivirales/uso terapéutico , Ataxia/diagnóstico , Ataxia/fisiopatología , Ataxia/virología , Control de Enfermedades Transmisibles/métodos , Infecciones por Coronavirus/prevención & control , Infecciones por Coronavirus/terapia , Infecciones por Coronavirus/transmisión , Humanos , Hidroxicloroquina/uso terapéutico , Náusea/diagnóstico , Náusea/fisiopatología , Náusea/virología , Pandemias/prevención & control , Equipo de Protección Personal/provisión & distribución , Neumonía Viral/prevención & control , Neumonía Viral/terapia , Neumonía Viral/transmisión , Cuarentena/métodos , Cuarentena/organización & administración , Factores de Riesgo , Índice de Severidad de la Enfermedad , Distancia Social , Vómitos/diagnóstico , Vómitos/fisiopatología , Vómitos/virología
13.
Medwave ; 20(7): e8008, 2020 Aug 28.
Artículo en Español | MEDLINE | ID: covidwho-740553

RESUMEN

In December 2019, a new strain of the SARS-CoV-2 coronavirus was reported in Wuhan, China, which produced severe lung involvement and progressed to respiratory distress. To date, more than seventeen million confirmed cases and more than half a million died worldwide from COVID-19. Patients with cardiovascular disease are more susceptible to contracting this disease and presenting more complications. We did a literature search on the association of cardiovascular disease and COVID-19 in databases such as Scopus, PubMed/MEDLINE, and the Cochrane Library. The purpose of this review is to provide updated information for health professionals who care for patients with COVID-19 and cardiovascular disease, given that they have a high risk of complications and mortality. Treatment with angiotensin-converting enzyme inhibitors and receptor blockers is controversial, and there is no evidence not to use these medications in patients with COVID-19. Regarding treatment with hydroxychloroquine associated or not with azithromycin, there is evidence of a higher risk with its use than clinical benefit and decreased mortality. Likewise, patients with heart failure are an important risk group due to their condition per se. Patients with heart failure and COVID-19 are a diagnostic dilemma because the signs of acute heart failure could be masked. On the other hand, in patients with acute coronary syndrome, the initial therapeutic approach could change in the context of the pandemic, although only based on expert opinions. Nonetheless, many controversial issues will be the subject of future research.


Asunto(s)
Betacoronavirus , Enfermedades Cardiovasculares/complicaciones , Infecciones por Coronavirus/complicaciones , Neumonía Viral/complicaciones , Síndrome Coronario Agudo/etiología , Síndrome Coronario Agudo/terapia , Algoritmos , Inhibidores de la Enzima Convertidora de Angiotensina/uso terapéutico , Antivirales/efectos adversos , Azitromicina/efectos adversos , Infecciones por Coronavirus/tratamiento farmacológico , Quimioterapia Combinada , Electrocardiografía/efectos de los fármacos , Insuficiencia Cardíaca/etiología , Insuficiencia Cardíaca/terapia , Humanos , Hidroxicloroquina/efectos adversos , Hipertensión/complicaciones , Hipertensión/tratamiento farmacológico , Pandemias , Peptidil-Dipeptidasa A/metabolismo , Neumonía Viral/tratamiento farmacológico , Pronóstico , Sistema Renina-Angiotensina/fisiología
15.
J Bras Nefrol ; 42(2 suppl 1): 49-50, 2020 Aug 26.
Artículo en Inglés, Portugués | MEDLINE | ID: covidwho-740468

RESUMEN

Chloroquine and hydroxychloroquine have shown promising preliminary results and have been discussed as therapeutic options for patients with Covid-19. Despite the lack of robust evidence demonstrating the benefits and justifying the use of one of these drugs, the final decision is the responsibility of the attending physician and should be individualized and shared, whenever possible. This position statement recommends dosage adjustment for these drugs in the context of renal impairment.


Asunto(s)
Antimaláricos/administración & dosificación , Cloroquina/administración & dosificación , Infecciones por Coronavirus/tratamiento farmacológico , Hidroxicloroquina/administración & dosificación , Neumonía Viral/tratamiento farmacológico , Insuficiencia Renal , Brasil , Humanos , Nefrología , Pandemias , Sociedades Médicas
16.
Medicine (Baltimore) ; 99(35): e21810, 2020 Aug 28.
Artículo en Inglés | MEDLINE | ID: covidwho-740205

RESUMEN

RATIONALE: The clinical manifestations of the SARS-CoV-2 infection are mainly respiratory but the virus can cause a variety of symptoms. Dermatological findings are less well-characterized. Data is scarce on their timing, type and correlation with the immune response. PATIENT CONCERNS: We present the case of SARS-CoV-2 infection in a previously healthy woman who presented with respiratory symptoms and developed anosmia, diarrhea, and an erythematous maculo-papular rash on day 15 from symptom onset. DIAGNOSIS: The nasopharyngeal swab tested by real time PCR for COVID-19 was positive. We interpreted this as a viral exanthema likely caused by an immune response to SARS-CoV-2 nucleotides. INTERVENTIONS: She was treated with Hydroxychloroquine, Azithromycin and Lopinavir/Ritonavir, and the rash with topical corticosteroids. OUTCOMES: All symptoms resolved except for anosmia which persisted for 6 weeks. At the 4- and 6-weeks follow-up the IgG titers for SARS-CoV-2 were high. LESSONS: We must consider that SARS-CoV-2 has a multi-organ tropism. In our case, the SARS-CoV-2 infection had lung, nasopharyngeal, neurological, digestive, and skin manifestations. Identifying the different manifestations is useful for understanding the extent of SARS-CoV-2 infection. We not only present a rare manifestation but also suggest that cutaneous manifestations may correlate with immunity.


Asunto(s)
Azitromicina/administración & dosificación , Betacoronavirus , Infecciones por Coronavirus , Exantema , Glucocorticoides/administración & dosificación , Hidroxicloroquina/administración & dosificación , Lopinavir/administración & dosificación , Pandemias , Neumonía Viral , Ritonavir/administración & dosificación , Administración Tópica , Adulto , Antivirales/administración & dosificación , Betacoronavirus/inmunología , Betacoronavirus/aislamiento & purificación , Técnicas de Laboratorio Clínico/métodos , Infecciones por Coronavirus/diagnóstico , Infecciones por Coronavirus/fisiopatología , Infecciones por Coronavirus/terapia , Combinación de Medicamentos , Exantema/diagnóstico , Exantema/tratamiento farmacológico , Exantema/etiología , Exantema/inmunología , Femenino , Humanos , Neumonía Viral/diagnóstico , Neumonía Viral/fisiopatología , Neumonía Viral/terapia , Evaluación de Síntomas/métodos , Resultado del Tratamiento
18.
Ann Ital Chir ; 91: 273-276, 2020.
Artículo en Inglés | MEDLINE | ID: covidwho-739593

RESUMEN

CASE REPORT: A 64-year-old woman presented to our emergency department during the outbreak of the covid-19 emergency in Italy with syncope, anosmia, mild dyspnoea and atypical chest and dorsal pain. A chest CT scan showed an acute type B aortic dissection (ATBAD) and bilateral lung involvement with ground-glass opacity, compatible with interstitial pneumonia. Nasopharyngeal swabs resulted positive for SARS-CoV-2. For the persistence of chest pain, despite the analgesic therapy, we decided to treat her with a TEVAR. Patient's chest and back pain resolved during the first few days after the procedure. No surgical or respiratory complications occurred and the patient was discharged 14 days after surgery. DISCUSSION: By performing the operation under local anesthesia, it was possible to limit both the staff inside the operatory room and droplet/aerosol release. Since we had to perform the operation in a hemodynamics room, thanks to the limited extension of the endoprosthesis and the good caliber of the right vertebral artery we were able to reduce the risk of spinal cord ischemia despite the lack of a revascularization of the left subclavian artery. CONCLUSIONS: A minimally invasive total endovascular approach allows, through local anesthesia and percutaneous access, to avoid surgical cut down and orotracheal intubation. This, combined with a defined management protocol for infected patients, seems to be a reasonable way to perform endovascular aortic procedures in urgent setting, even in a SARSCoV- 2 positive patient. KEY WORDS: COVID-19, Dissection, TEVAR.


Asunto(s)
Aneurisma Disecante/cirugía , Aneurisma de la Aorta Torácica/cirugía , Betacoronavirus/aislamiento & purificación , Implantación de Prótesis Vascular/métodos , Infecciones por Coronavirus/prevención & control , Procedimientos Endovasculares/métodos , Control de Infecciones/métodos , Transmisión de Enfermedad Infecciosa de Paciente a Profesional/prevención & control , Pandemias/prevención & control , Neumonía Viral/prevención & control , Anestesia Local , Aneurisma Disecante/complicaciones , Profilaxis Antibiótica , Anticoagulantes/uso terapéutico , Antivirales/uso terapéutico , Aneurisma de la Aorta Torácica/complicaciones , Contraindicaciones de los Procedimientos , Infecciones por Coronavirus/complicaciones , Infecciones por Coronavirus/tratamiento farmacológico , Infecciones por Coronavirus/transmisión , Darunavir/uso terapéutico , Diabetes Mellitus Tipo 2/complicaciones , Quimioterapia Combinada , Enoxaparina/uso terapéutico , Femenino , Humanos , Hidroxicloroquina/uso terapéutico , Complicaciones Intraoperatorias/prevención & control , Intubación Intratraqueal/efectos adversos , Persona de Mediana Edad , Nasofaringe/virología , Quirófanos , Aislamiento de Pacientes , Neumonía Viral/complicaciones , Neumonía Viral/tratamiento farmacológico , Neumonía Viral/transmisión , Ritonavir/uso terapéutico , Isquemia de la Médula Espinal/prevención & control , Arteria Vertebral/cirugía
20.
Emerg Microbes Infect ; 9(1): 1955-1957, 2020 Dec.
Artículo en Inglés | MEDLINE | ID: covidwho-738798

RESUMEN

The case refers to a 51-year-old symptomatic man with a new SARS-CoV-2 RNA positive nasopharyngeal swab after two negative ones and the lack of significant development of antibody response measured by different diagnostic serological test. Our case underlines that a discrepancy between clinical course of SARS-CoV-2 infection and results from diagnostic tests may exist. This concept is rapidly emerging and supports the need for a deep knowledge of available and "in development" tests for a correct interpretation of their findings.


Asunto(s)
Anticuerpos Antivirales/sangre , Betacoronavirus/inmunología , Betacoronavirus/aislamiento & purificación , Infecciones por Coronavirus/diagnóstico , Inmunoglobulina G/sangre , Neumonía Viral/diagnóstico , Infecciones por Coronavirus/tratamiento farmacológico , Ensayo de Inmunoadsorción Enzimática , Reacciones Falso Negativas , Humanos , Hidroxicloroquina/uso terapéutico , Masculino , Persona de Mediana Edad , Pandemias , Neumonía Viral/tratamiento farmacológico , Reacción en Cadena de la Polimerasa , Cuarentena , Recurrencia , Pruebas Serológicas , Carga Viral
SELECCIÓN DE REFERENCIAS
DETALLE DE LA BÚSQUEDA