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Zhonghua Wei Zhong Bing Ji Jiu Yi Xue ; 32(7): 774-778, 2020 Jul.
Artículo en Chino | MEDLINE | ID: covidwho-714510


OBJECTIVE: To investigate the correlation between hyponatremia and the severity of coronavirus disease 2019 (COVID-19). METHODS: Clinical data of 12 patients with COVID-19 admitted to Shantou Central Hospital from January 23 to February 5 in 2020 were retrospectively analyzed, including gender, age, symptoms, lab test and clinical outcomes, to analyze the change trend of blood Na+ level in the patients with COVID-19. RESULTS: Among the 12 patients with COVID-19, there were 8 males and 4 females with the mean age of (38.0±16.3) years old, most of them were admitted to the hospital with cough and/or fever. All patients had a positive nucleic acid test for 2019 novel coronavirus (2019-nCoV), and were discharged after clinical treatment with oxygen therapy, antiviral, antibacterial, anti-inflammatory, and nutritional support. All patients were of ordinary type when they were admitted to the hospital. Among them, 1 patient turned into a severe case during the course of the disease, and 1 patient showed a tendency to become severe case. It was found that 10 patients without severe conversion had an average blood Na+ of (138.3±1.3) mmol/L at admission, and the lowest blood Na+ during the course of disease was (135.9±3.1) mmol/L. However, 2 patients who became severe and had a tendency to become severe disease (Na+ levels at admission were 140.0 mmol/L and 138.0 mmol/L, respectively) experienced hyponatremia during the course of the disease (the lowest blood Na+ levels were 129.0 mmol/L and 122.0 mmol/L). Further analysis showed that the lower serum Na+ level, the higher level of white blood cell count (WBC) and C-reactive protein (CRP), but serum Na+ level was consistent with the change trend of lymphocytes, suggesting that hyponatremia was closely correlated with severe inflammation reaction. CONCLUSIONS: Serum Na+ showed decreasing tendency during the development of COVID-19, and hyponatremia was closely related to the severity of COVID-19. It was necessary to pay great attention to the change trend of blood Na+ level. However, further research was needed to obtain more reliable conclusions and explorer the pathophysiological mechanisms.

Infecciones por Coronavirus/sangre , Infecciones por Coronavirus/complicaciones , Hiponatremia/epidemiología , Neumonía Viral/sangre , Neumonía Viral/complicaciones , Adulto , Infecciones por Coronavirus/terapia , Femenino , Humanos , Masculino , Persona de Mediana Edad , Pandemias , Neumonía Viral/terapia , Estudios Retrospectivos , Índice de Severidad de la Enfermedad , Adulto Joven
Am J Case Rep ; 21: e925779, 2020 Aug 13.
Artículo en Inglés | MEDLINE | ID: covidwho-713485


BACKGROUND Coronavirus disease 2019 (COVID-19) infection commonly presents as fever, cough, and shortness of breath in adults. Children are thought to have milder respiratory symptoms and to recover more quickly. We describe a new presentation of COVID-19 infection in children consisting of multisystem inflammation with decreased left ventricular function and evidence of lung disease. CASE REPORT Three children presented with fever, conjunctivitis, dry and cracked lips, rash, and/or cervical lymphadenopathy for at least 5 days. Two of these children required mechanical ventilation, and 1 of the 2 needed extracorporeal membrane oxygenation (ECMO) to support cardiorespiratory function. All of these children had moderate to severe hyponatremia and lymphopenia, which is usually seen in COVID-19. They were treated with intravenous immunoglobulin and high-dose aspirin. All of the children recovered. CONCLUSIONS Early recognition of children with multisystem inflammation is important because they are at increased risk for deterioration. Treatment with intravenous immunoglobulin and aspirin was used because this regimen has been shown to be beneficial in vasculitis of Kawasaki disease. The development of shock due to cardiac involvement may require ECMO.

Betacoronavirus , Infecciones por Coronavirus/diagnóstico , Neumonía Viral/diagnóstico , Síndrome de Respuesta Inflamatoria Sistémica/virología , Antipiréticos/uso terapéutico , Aspirina/uso terapéutico , Niño , Preescolar , Conjuntivitis/terapia , Conjuntivitis/virología , Infecciones por Coronavirus/terapia , Exantema/terapia , Exantema/virología , Oxigenación por Membrana Extracorpórea , Femenino , Fiebre/terapia , Fiebre/virología , Insuficiencia Cardíaca/terapia , Insuficiencia Cardíaca/virología , Humanos , Hiponatremia/terapia , Hiponatremia/virología , Inmunoglobulinas Intravenosas , Linfadenopatía/terapia , Linfadenopatía/virología , Linfopenia/terapia , Linfopenia/virología , Masculino , Pandemias , Neumonía Viral/terapia , Respiración Artificial , Síndrome de Respuesta Inflamatoria Sistémica/diagnóstico , Síndrome de Respuesta Inflamatoria Sistémica/terapia , Vasculitis/terapia , Vasculitis/virología
Int J Environ Res Public Health ; 17(15)2020 07 23.
Artículo en Inglés | MEDLINE | ID: covidwho-670811


Hyponatremia is one of the most common water-electrolyte imbalances in the human organism. A serum sodium concentration threshold of less than 135 mmol/L is diagnostic for hyponatremia. The disorder is usually secondary to various diseases, including infections. Our review aims to summarize the diagnostic value and impact of hyponatremia on the prognosis, length of the hospitalization, and mortality among patients with active infection. The scientific literature regarding hyponatremia was reviewed using PubMed, ClinicalKey, and Web of Science databases. Studies published between 2011 and 2020 were screened and eligible studies were selected according to the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) statement and specific inclusion criteria. The most common infections that were associated with hyponatremia were viral and bacterial infections, including COVID-19 (coronavirus disease 2019). The etiology varied according to the infection site, setting and patient cohort it concerned. In several studies, hyponatremia was associated with prolonged hospitalization, worse outcomes, and higher mortality rates. Hyponatremia can also play a diagnostic role in differentiating pathogens that cause a certain infection type, as it was observed in community-acquired pneumonia. Although many mechanisms leading to hyponatremia have already been described, it is impossible with any certainty to ascribe the etiology of hyponatremia to any of them.

Betacoronavirus/aislamiento & purificación , Infecciones por Coronavirus/complicaciones , Hiponatremia/complicaciones , Neumonía Viral/complicaciones , Estudios de Cohortes , Infecciones por Coronavirus/virología , Hospitalización , Humanos , Masculino , Pandemias , Neumonía Viral/virología , Sodio/sangre