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3.
Glob Heart ; 16(1): 18, 2021 03 15.
Artículo en Inglés | MEDLINE | ID: covidwho-1175699

RESUMEN

The current pandemic of SARS-COV 2 infection (Covid-19) is challenging health systems and communities worldwide. At the individual level, the main biological system involved in Covid-19 is the respiratory system. Respiratory complications range from mild flu-like illness symptoms to a fatal respiratory distress syndrome or a severe and fulminant pneumonia. Critically, the presence of a pre-existing cardiovascular disease or its risk factors, such as hypertension or type II diabetes mellitus, increases the chance of having severe complications (including death) if infected by the virus. In addition, the infection can worsen an existing cardiovascular disease or precipitate new ones. This paper presents a contemporary review of cardiovascular complications of Covid-19. It also specifically examines the impact of the disease on those already vulnerable and on the poorly resourced health systems of Africa as well as the potential broader consequences on the socio-economic health of this region.


Asunto(s)
/fisiopatología , Enfermedades Cardiovasculares/fisiopatología , Síndrome Coronario Agudo/economía , Síndrome Coronario Agudo/etiología , Síndrome Coronario Agudo/fisiopatología , África , Antimaláricos/efectos adversos , Arritmias Cardíacas/economía , Arritmias Cardíacas/etiología , Arritmias Cardíacas/fisiopatología , /economía , Enfermedades Cardiovasculares/economía , Enfermedades Cardiovasculares/etiología , Cloroquina/efectos adversos , Infecciones por Coronavirus/complicaciones , Infecciones por Coronavirus/fisiopatología , Prestación de Atención de Salud/economía , Recesión Económica , Producto Interno Bruto , Recursos en Salud/economía , Recursos en Salud/provisión & distribución , Insuficiencia Cardíaca/economía , Insuficiencia Cardíaca/etiología , Insuficiencia Cardíaca/fisiopatología , Humanos , Hidroxicloroquina/efectos adversos , Inflamación , Isquemia Miocárdica/economía , Isquemia Miocárdica/etiología , Isquemia Miocárdica/fisiopatología , Miocarditis/economía , Miocarditis/etiología , Miocarditis/fisiopatología , Síndrome Respiratorio Agudo Grave/complicaciones , Síndrome Respiratorio Agudo Grave/fisiopatología , Factores Socioeconómicos , Cardiomiopatía de Takotsubo/economía , Cardiomiopatía de Takotsubo/etiología , Cardiomiopatía de Takotsubo/fisiopatología
5.
Virulence ; 11(1): 1006-1014, 2020 12.
Artículo en Inglés | MEDLINE | ID: covidwho-684746

RESUMEN

Novel coronavirus disease 2019 (COVID-19), caused by novel coronavirus SARS-CoV-2, has spread globally since the end of 2019. Asymptomatic carriers are of great concern as they can undermine the interventions to stop the pandemic. However, there is limited information about the characteristics and outcomes of the asymptomatic patients. Therefore, we conducted this retrospective study and retrieved data of 79 asymptomatic COVID-19 patients at admission from three designated hospitals in Wuhan, China. The asymptomatic patients could happen at any age, ranged from 9 to 96 years. These patients also had lower levels of alanine aminotransferase and C-reactive protein. Patchy shadowing was the most common manifestation in computed tomography scan. Some asymptomatic carriers developed mild or moderate symptoms during hospitalization. Age and comorbidities, especially hypertension, may be predictive factors for symptom development in the initially asymptomatic carriers at admission. Early detection and treatment for these presymptomatic patients before symptom onset can shorten the communicable period for the coronavirus and reduce the occurrence of severe cases.


Asunto(s)
Infecciones Asintomáticas/epidemiología , Betacoronavirus , Infecciones por Coronavirus/epidemiología , Infecciones por Coronavirus/patología , Neumonía Viral/epidemiología , Neumonía Viral/patología , Adolescente , Adulto , Anciano , Anciano de 80 o más Años , Niño , China/epidemiología , Infecciones por Coronavirus/fisiopatología , Infecciones por Coronavirus/virología , Progresión de la Enfermedad , Femenino , Humanos , Masculino , Persona de Mediana Edad , Pandemias , Neumonía Viral/fisiopatología , Neumonía Viral/virología , Estudios Retrospectivos , Factores de Riesgo , Esparcimiento de Virus , Adulto Joven
7.
Rev Peru Med Exp Salud Publica ; 37(2): 356-360, 2020.
Artículo en Español | MEDLINE | ID: covidwho-1128207

RESUMEN

COVID-19 represents a global crisis. Rapidly conducting a clinical trial with the rigor necessary to obtain reliable results requires the collaboration of various participants involved in the development, evaluation and authorization of clinical trials (CT) such as the trial sponsor, researchers, regulatory authority and the ethics committee (EC). Carrying out these studies is not only scientifically appropriate, but an ethical and moral obligation to guarantee our patients effective treatment. SOLIDARITY is a mega clinical trial that recruited thousands of subjects with moderate to severe disease, who were randomly assigned to one of the treatment groups under evaluation, including hydroxychloroquine, lopinavir/ritonavir associated or not with interferon; or remdesivir compared to standard therapy. Peru has joined the list of countries where the trial will be reproduced, through which it will be possible to quickly identify if any of these drugs offers a real benefit to patients.


Asunto(s)
Antivirales/administración & dosificación , Infecciones por Coronavirus/tratamiento farmacológico , Neumonía Viral/tratamiento farmacológico , Infecciones por Coronavirus/fisiopatología , Quimioterapia Combinada , Humanos , Cooperación Internacional , Pandemias , Perú , Neumonía Viral/fisiopatología , Índice de Severidad de la Enfermedad , Resultado del Tratamiento
8.
Rev Peru Med Exp Salud Publica ; 37(2): 335-340, 2020.
Artículo en Español | MEDLINE | ID: covidwho-1128201

RESUMEN

COVID-19 is rarely reported in children and they are mildly affected in most cases. The most common clinical presentation of COVID-19 is cough, fever and sore throat; severe cases show tachypnea. The course of the disease is from one to two weeks. Laboratory findings are nonspecific; lymphopenia, elevation of C-reactive protein and procalcitonin have been described. Early chest X-ray is usually normal, and the most common tomographic findings are consolidations with halo, ground-glass opacities and tiny nodules which mainly affects subpleural areas. Management of the disease is supportive; in severe cases, it should be focused on respiratory support. It is recommended to limit the handling of respiratory secretions and to follow the same preventive measures provided to adults.


Asunto(s)
Infecciones por Coronavirus/epidemiología , Tos/epidemiología , Fiebre/epidemiología , Neumonía Viral/epidemiología , Factores de Edad , Niño , Infecciones por Coronavirus/fisiopatología , Tos/virología , Fiebre/virología , Humanos , Pandemias , Faringitis/epidemiología , Faringitis/virología , Neumonía Viral/fisiopatología , Índice de Severidad de la Enfermedad , Tomografía Computarizada por Rayos X
9.
Rev Peru Med Exp Salud Publica ; 37(2): 253-258, 2020.
Artículo en Español, Inglés | MEDLINE | ID: covidwho-1128200

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
11.
J Cardiovasc Med (Hagerstown) ; 21(10): 725-732, 2020 10.
Artículo en Inglés | MEDLINE | ID: covidwho-1105978

RESUMEN

: The coronavirus disease 2019 (COVID-19) has important implications for the cardiovascular care of patients. COVID-19 interacts with the cardiovascular system on multiple levels, increasing morbidity in patients with underlying cardiovascular conditions and favoring acute myocardial injury and dysfunction. COVID-19 infection may also have long-term implications for overall cardiovascular health. Many issues regarding the involvement of the cardiovascular system remain controversial. Despite angiotensin-converting enzyme 2 serving as the site of entry of the virus into the cells, the role of angiotensin-converting enzyme inhibitors or AT1 blockers requires further investigation. Therapies under investigation for COVID-19 may have cardiovascular side effects. Treatment of COVID-19, especially the use of antivirals, must be closely monitored. This article is a review of the most updated literature.


Asunto(s)
Enfermedades Cardiovasculares , Infecciones por Coronavirus , Pandemias , Neumonía Viral , Antivirales/efectos adversos , Antivirales/farmacología , Betacoronavirus/patogenicidad , Betacoronavirus/fisiología , Enfermedades Cardiovasculares/epidemiología , Enfermedades Cardiovasculares/prevención & control , Enfermedades Cardiovasculares/terapia , Enfermedades Cardiovasculares/virología , Comorbilidad , Infecciones por Coronavirus/complicaciones , Infecciones por Coronavirus/epidemiología , Infecciones por Coronavirus/fisiopatología , Infecciones por Coronavirus/terapia , Interacciones Microbiota-Huesped , Humanos , Neumonía Viral/complicaciones , Neumonía Viral/epidemiología , Neumonía Viral/fisiopatología , Neumonía Viral/terapia
12.
Med Clin (Barc) ; 155(5): 191-196, 2020 09 11.
Artículo en Inglés, Español | MEDLINE | ID: covidwho-526756

RESUMEN

OBJECTIVE: The purpose of our study was to assess organ function in 102 patients with severe COVID-19 infections, using retrospective clinical analysis. MATERIAL AND METHODS: A retrospective analysis was conducted on 102 patients with severe COVID-19 infections. The patients were divided into a survival group (n=73) and a non-survival group (n=29) according to their prognosis. The age, sex, underlying diseases, clinical laboratory data within 48h (routine blood tests, ALT, AST, TBIL, ALB, BUN, CR, D-Dimer, PT, APTT, FIB, F VIII:C, CK-MB, CK, and LDH), and ventilation status were collected. The organ functions of these severe COVID-19 patients were assessed by comparing the differences between the two groups. RESULTS: AST, BUN, CR, CK-MB, LDH, and CK in the non-survival group were higher than those in the survival group, and the differences were statistically significant (P<0.05). D-Dimer, PT, FIB, and F VIII:C in the non-survival group were higher than the values observed in the survival group, and the differences were statistically significant (P<0.05). PLT, AST, BUN, CR, D-Dimer, PT, FIB, F VIII:C, CK-MB, CK, and LDH predicted the area under the ROC curve (AUC) of the COVID19 endpoint events and were 0.721, 0.854, 0.867, 0.757, 0.699, 0.679, 0.715, 0.811, 0.935, and 0.802, respectively. CONCLUSION: The results showed that there were different degrees of damage to the liver, kidneys, blood coagulation, and heart function in the non-survival group. In addition, PLT, AST, BUN, CR, D-Dimer, PT, FIB, F VIII:C, CK-MB, CK, and LDH had value in evaluating disease prognosis.


Asunto(s)
Betacoronavirus , Infecciones por Coronavirus/fisiopatología , Insuficiencia Multiorgánica/virología , Neumonía Viral/fisiopatología , Índice de Severidad de la Enfermedad , Adulto , Anciano , Anciano de 80 o más Años , Biomarcadores/sangre , Estudios de Casos y Controles , China/epidemiología , Técnicas de Laboratorio Clínico , Infecciones por Coronavirus/sangre , Infecciones por Coronavirus/diagnóstico , Infecciones por Coronavirus/mortalidad , Femenino , Humanos , Masculino , Persona de Mediana Edad , Insuficiencia Multiorgánica/sangre , Insuficiencia Multiorgánica/diagnóstico , Insuficiencia Multiorgánica/mortalidad , Puntuaciones en la Disfunción de Órganos , Pandemias , Neumonía Viral/sangre , Neumonía Viral/diagnóstico , Neumonía Viral/mortalidad , Pronóstico , Curva ROC , Estudios Retrospectivos
13.
Cardiol Young ; 30(9): 1346-1349, 2020 Sep.
Artículo en Inglés | MEDLINE | ID: covidwho-1083646

RESUMEN

We present our recent experience with a 6-month-old infant with a personal history of short bowel syndrome that presented with fever, cyanosis, and cardiogenic shock secondary to severe pulmonary hypertension and right ventricular failure without pulmonary thromboembolism. He did not present signs of toxin-mediated disease or Kawasaki disease. He was finally diagnosed with SARS-CoV-2 infection. If this presentation is confirmed in future research, the severe cardiovascular impairment in children with COVID-19 could be also attributable to the primary pulmonary infection, not only to a multisystem inflammatory syndrome but also in children without heart disease.


Asunto(s)
Angiografía por Tomografía Computarizada , Infecciones por Coronavirus , Insuficiencia Cardíaca , Hipertensión Pulmonar , Pandemias , Neumonía Viral , Choque Cardiogénico , Síndrome de Respuesta Inflamatoria Sistémica , Betacoronavirus/aislamiento & purificación , Angiografía por Tomografía Computarizada/métodos , Infecciones por Coronavirus/complicaciones , Infecciones por Coronavirus/diagnóstico , Infecciones por Coronavirus/tratamiento farmacológico , Infecciones por Coronavirus/fisiopatología , Infecciones por Coronavirus/terapia , Cuidados Críticos/métodos , Ecocardiografía/métodos , Electrocardiografía/métodos , Insuficiencia Cardíaca/diagnóstico , Insuficiencia Cardíaca/etiología , Insuficiencia Cardíaca/fisiopatología , Insuficiencia Cardíaca/terapia , Humanos , Hipertensión Pulmonar/diagnóstico , Hipertensión Pulmonar/etiología , Lactante , Masculino , Neumonía Viral/complicaciones , Neumonía Viral/diagnóstico , Neumonía Viral/fisiopatología , Neumonía Viral/terapia , Radiografía Torácica , Respiración Artificial/métodos , Índice de Severidad de la Enfermedad , Choque Cardiogénico/diagnóstico , Choque Cardiogénico/etiología , Síndrome de Respuesta Inflamatoria Sistémica/diagnóstico , Síndrome de Respuesta Inflamatoria Sistémica/fisiopatología , Resultado del Tratamiento
14.
An Sist Sanit Navar ; 43(2): 245-249, 2020 Aug 31.
Artículo en Español | MEDLINE | ID: covidwho-1083299

RESUMEN

One of the most significant negative prognostic factors in patients suffering from the disease caused by SARS-CoV-2 (COVID-19) is the development of coagulopathy, associated with abnormal laboratory findings, such as increased D-dimer, and venous thromboembolic complications, requiring thromboprophylactic strategies. The main clinical characteristics of COVID-19 patients are revised here as compared to other coronavirus infections, such as Severe Acute Respiratory Syndrome (SARS) and Middle East Respiratory Syndrome (MERS), emphasizing clinical, diagnostic and therapeutic aspects.


Asunto(s)
Betacoronavirus , Trastornos de la Coagulación Sanguínea/virología , Infecciones por Coronavirus/diagnóstico , Coronavirus del Síndrome Respiratorio de Oriente Medio , Virus del SRAS , Trombosis/virología , Trastornos de la Coagulación Sanguínea/diagnóstico , Trastornos de la Coagulación Sanguínea/terapia , Infecciones por Coronavirus/complicaciones , Infecciones por Coronavirus/fisiopatología , Infecciones por Coronavirus/terapia , Fibrinolíticos/uso terapéutico , Humanos , Pandemias , Neumonía Viral/complicaciones , Neumonía Viral/diagnóstico , Neumonía Viral/fisiopatología , Neumonía Viral/terapia , Pronóstico , Síndrome Respiratorio Agudo Grave/complicaciones , Síndrome Respiratorio Agudo Grave/diagnóstico , Síndrome Respiratorio Agudo Grave/fisiopatología , Síndrome Respiratorio Agudo Grave/terapia , Trombosis/diagnóstico , Trombosis/terapia
15.
Cardiol Young ; 30(9): 1339-1342, 2020 Sep.
Artículo en Inglés | MEDLINE | ID: covidwho-1082976
16.
Encephale ; 46(3S): S66-S72, 2020 Jun.
Artículo en Francés | MEDLINE | ID: covidwho-1065052

RESUMEN

OBJECTIVE: The COVID-19 pandemic affected today more than 3,000,000 worldwide, and more than half of humanity has been placed in quarantine. The scientific community and the political authorities fear an epidemic of suicide secondary to this crisis. The aim of this review is to analyze the impact of the COVID-19 pandemic on the dimensions of the suicidal process and its interaction with the various risk factors. We also propose innovative strategies to manage suicidal behavior in the context of pandemic. METHODS: We carried out a narrative review of international publications dealing with major pandemics (COVID-19, SARS) and their influence on suicidal vulnerability. RESULTS: Many factors are likely to increase the emergence of suicidal ideation and suicide attempts during this crisis. Social distancing and quarantine could increase the feeling of disconnection and the perception of social pain in vulnerable individuals. Some populations at high suicidal risk could be further impacted by the current pandemic: the elderly, medical staff and individuals exposed to economic insecurity. Several innovative tools adapted to the constraints of social distancing and quarantine may prevent suicide risk: e-health, VigilanS, buddhist-derived practices and art engagement. CONCLUSIONS: This unprecedented crisis may interact with certain dimensions of the suicidal process. However, it is time to innovate. Several suicide prevention tools all have their place in new modes of care and should be tested on a large scale.


Asunto(s)
Betacoronavirus , Infecciones por Coronavirus , Pandemias , Neumonía Viral , Suicidio/psicología , Intoxicación Alcohólica/psicología , Inteligencia Artificial , Betacoronavirus/fisiología , Infecciones por Coronavirus/complicaciones , Infecciones por Coronavirus/fisiopatología , Infecciones por Coronavirus/psicología , Costo de Enfermedad , Intervención en la Crisis (Psiquiatría)/instrumentación , Recesión Económica , Francia/epidemiología , Humanos , Inflamación , Soledad/psicología , Modelos Neurológicos , Neumonía Viral/complicaciones , Neumonía Viral/fisiopatología , Neumonía Viral/psicología , Psicoterapia/métodos , Trastornos Psicóticos/etiología , Trastornos Psicóticos/fisiopatología , Trastornos Psicóticos/virología , Cuarentena/psicología , Sistema Renina-Angiotensina/fisiología , Síndrome Respiratorio Agudo Grave/epidemiología , Síndrome Respiratorio Agudo Grave/psicología , Aislamiento Social/psicología , Estrés Psicológico/etiología , Estrés Psicológico/terapia , Ideación Suicida , Suicidio/prevención & control , Suicidio/estadística & datos numéricos , Intento de Suicidio/prevención & control , Intento de Suicidio/psicología , Telemedicina , Poblaciones Vulnerables
17.
Pediatr Pulmonol ; 55(12): 3252-3267, 2020 12.
Artículo en Inglés | MEDLINE | ID: covidwho-1064416

RESUMEN

BACKGROUND: The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) epidemic has been emerged as a cardinal public health problem. Children have their own specific clinical features; notably, they seem to be escaping the severe respiratory adverse effects. The international scientific community is rapidly carrying out studies, driving to the need to reassess knowledge of the disease and therapeutic strategies. AIM: To assess the characteristics of COVID-19 infected children worldwide of all ages, from neonates to children and adolescents, and how they differ from their adult counterparts. SEARCH STRATEGY: An electronic search in PubMed was conducted, using combinations of the following keywords: coronavirus, SARS-CoV-2, COVID-19, children. The search included all types of articles written in English between January 1, 2019 until August 15, 2020. RESULTS: The search identified 266 relevant articles. Children were mainly within family clusters of cases and have relatively milder clinical presentation compared with adults; children were reported to have better outcomes with a significantly lower mortality rate. Cough and fever were the most common symptoms while pneumonia was the cardinal respiratory manifestation of infected children. Laboratory results and thoracic imaging give varying results. CONCLUSIONS: Children were mainly family cluster cases and usually presented with a mild infection, although cases presented with the multisystem inflammatory syndrome are becoming more apparent. Studies determining why the manifestations of SARS-CoV-2 infection are so variable may help to gain a better understanding of the disease and accelerate the development of vaccines and therapies.


Asunto(s)
Infecciones por Coronavirus/fisiopatología , Neumonía Viral/fisiopatología , Síndrome de Respuesta Inflamatoria Sistémica/fisiopatología , Adolescente , Infecciones Asintomáticas , Betacoronavirus , Niño , Preescolar , Infecciones por Coronavirus/sangre , Infecciones por Coronavirus/diagnóstico por imagen , Infecciones por Coronavirus/mortalidad , Tos/fisiopatología , Diarrea/fisiopatología , Fiebre/fisiopatología , Humanos , Lactante , Recién Nacido , Pulmón/diagnóstico por imagen , Pandemias , Neumonía Viral/sangre , Neumonía Viral/diagnóstico por imagen , Neumonía Viral/mortalidad , Índice de Severidad de la Enfermedad , Síndrome de Respuesta Inflamatoria Sistémica/inmunología , Síndrome de Respuesta Inflamatoria Sistémica/mortalidad , Vómitos/fisiopatología
18.
Monaldi Arch Chest Dis ; 90(4)2020 Nov 09.
Artículo en Inglés | MEDLINE | ID: covidwho-1059803

RESUMEN

COVID-19 is a pandemic with over 5 million cases worldwide. The disease has imposed a huge burden on health resources. Evaluation of clinical and epidemiological profiles of such patients can help in understanding and managing the outbreak more efficiently. This study was a prospective observational analysis of 200 diagnosed COVID-19 patients admitted to a tertiary care center from 20th march to 8th May 2020. All these patients were positive for COVID-19 by an oro-nasopharyngeal swab-rtPCR based testing. Analyses of demographic factors, clinical characteristics, comorbidities, laboratory parameters, and the outcomes were performed. The mean age of the population was 40 years with a slight male predominance (116 patients out of 200, 58%). A majority of the patients (147, 73.5 %) were symptomatic, with fever being the most common symptom (109, 54.5%), followed by cough (91, 45.5%). An older age, presence of symptoms and their duration, leukocytosis, a high quick SOFA score, a high modified SOFA score, need for ventilator support, an AST level more than 3 times the upper limit of normal (ULN), and a serum creatinine level of 2 mg/dl or greater were at a significantly higher risk of ICU admission and mortality. Presence of diabetes mellitus, AST > three times ULN, serum creatinine 2 mg/dl or higher, and a qSOFA score of 1 or higher were all associated with significantly greater odds of critical care requirement. Triage and severity assessment helps in deciding the requirement for a hospital stay and ICU admission for COVID-19 which can easily be done using clinical and laboratory parameters. A mild, moderate and severe category approach with defined criteria and treatment guidelines will help in judicious utilization of health-care resources, especially for developing countries like India.   *Other members of the Safdarjung Hospital COVID-19 working group: Balvinder Singh (Microbiology), MK Sen (Pulmonary Medicine), Shibdas Chakrabarti (Pulmonary Medicine), NK Gupta (Pulmonary medicine), AJ Mahendran (Pulmonary Medicine), Ramesh Meena (Medicine), G Usha (Anaesthesiology), Santvana Kohli (Anaesthesiology), Sahil Diwan (Anaesthesiology), Rushika Saksena (Microbiology), Vikramjeet Dutta (Microbiology), Anupam Kr Anveshi (Microbiology).


Asunto(s)
Infecciones por Coronavirus/sangre , Infecciones por Coronavirus/fisiopatología , Neumonía Viral/sangre , Neumonía Viral/fisiopatología , Adolescente , Adulto , Anciano , Anciano de 80 o más Años , Alanina Transaminasa/sangre , Anemia/sangre , Aspartato Aminotransferasas/sangre , Betacoronavirus , Niño , Preescolar , Comorbilidad , Enfermedad de la Arteria Coronaria/epidemiología , Infecciones por Coronavirus/mortalidad , Infecciones por Coronavirus/terapia , Tos/fisiopatología , Creatinina/sangre , Diabetes Mellitus/epidemiología , Femenino , Fiebre/fisiopatología , Humanos , Hipertensión/epidemiología , Hipoxia/fisiopatología , India/epidemiología , Lactante , Recién Nacido , Unidades de Cuidados Intensivos , Tiempo de Internación , Recuento de Leucocitos , Leucocitosis/sangre , Linfopenia/sangre , Linfopenia/fisiopatología , Masculino , Persona de Mediana Edad , Mialgia/fisiopatología , Puntuaciones en la Disfunción de Órganos , Pandemias , Faringitis/fisiopatología , Recuento de Plaquetas , Neumonía Viral/mortalidad , Neumonía Viral/terapia , Estudios Prospectivos , Respiración Artificial , Taquipnea/fisiopatología , Centros de Atención Terciaria , Factores de Tiempo , Tuberculosis/epidemiología , Adulto Joven
19.
Obstet Gynecol ; 136(5): 1025-1029, 2020 11.
Artículo en Inglés | MEDLINE | ID: covidwho-1059683

RESUMEN

BACKGROUND: There are limited data regarding treatment options for pregnant women with severe coronavirus disease 2019 (COVID-19). CASE: A 35-year-old primigravid patient at 22 weeks of gestation presented with 7 days of fever, cough, anosmia, and dyspnea. Nasopharyngeal swab was positive for the novel coronavirus severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), and a chest X-ray demonstrated bilateral patchy infiltrates. Laboratory evaluation was notable for marked elevation of interleukin-6 and C-reactive protein concentrations. On hospital day 3, owing to increased dyspnea and oxygen requirement, the patient was treated with tocilizumab followed by 5 days of remdesivir. She responded well, recovered to room air, and was discharged home after a 9-day hospitalization. CONCLUSION: Tocilizumab and remdesivir may be effective for treatment of severe COVID-19 in pregnancy, but additional data are needed to guide risk-benefit considerations.


Asunto(s)
Adenosina Monofosfato/análogos & derivados , Alanina/análogos & derivados , Anticuerpos Monoclonales Humanizados/administración & dosificación , Infecciones por Coronavirus , Pulmón/diagnóstico por imagen , Pandemias , Neumonía Viral , Complicaciones Infecciosas del Embarazo , Adenosina Monofosfato/administración & dosificación , Adulto , Alanina/administración & dosificación , Antivirales/administración & dosificación , Betacoronavirus/aislamiento & purificación , Proteína C-Reactiva/análisis , Infecciones por Coronavirus/sangre , Infecciones por Coronavirus/diagnóstico , Infecciones por Coronavirus/tratamiento farmacológico , Infecciones por Coronavirus/fisiopatología , Femenino , Humanos , Interleucina-6/sangre , Oximetría/métodos , Neumonía Viral/sangre , Neumonía Viral/diagnóstico , Neumonía Viral/tratamiento farmacológico , Neumonía Viral/etiología , Neumonía Viral/fisiopatología , Embarazo , Complicaciones Infecciosas del Embarazo/sangre , Complicaciones Infecciosas del Embarazo/diagnóstico , Complicaciones Infecciosas del Embarazo/tratamiento farmacológico , Radiografía Torácica/métodos , Resultado del Tratamiento
20.
Obstet Gynecol ; 136(5): 1016-1020, 2020 11.
Artículo en Inglés | MEDLINE | ID: covidwho-1059680

RESUMEN

BACKGROUND: The risk of vertical transmission of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection remains unknown. Positive reverse-transcription polymerase chain reaction (RT-PCR) test results for SARS-CoV-2 infection in neonates and placental tissue have been reported, and immunoglobulin M antibodies have been detected in neonates born to mothers with infection. CASES: The first case is a woman at 22 3/7 weeks of gestation with coronavirus disease 2019 (COVID-19) who was admitted to the intensive care unit. In the second case, the patient remained at home with mild symptoms, starting at 20 weeks of gestation. In both cases, fetal skin edema was observed on ultrasound examination while maternal SARS-COV-2 RT-PCR test results were positive and resolved when maternal SARS-COV-2 RT-PCR test results became negative. The RT-PCR test result for SARS-CoV-2 in amniotic fluid was negative in both cases. The two pregnancies are ongoing and uneventful. CONCLUSION: Transient fetal skin edema noted in these two patients with COVID-19 in the second trimester may represent results of fetal infection or altered fetal physiology due to maternal disease or may be unrelated to the maternal illness.


Asunto(s)
Infecciones por Coronavirus , Monitoreo Fetal/métodos , Hidropesía Fetal/diagnóstico , Pandemias , Neumonía Viral , Complicaciones Infecciosas del Embarazo , Piel/diagnóstico por imagen , Adulto , Betacoronavirus/aislamiento & purificación , Técnicas de Laboratorio Clínico/métodos , Infecciones por Coronavirus/diagnóstico , Infecciones por Coronavirus/fisiopatología , Infecciones por Coronavirus/terapia , Femenino , Edad Gestacional , Humanos , Inmunoglobulina M/sangre , Recién Nacido , Transmisión Vertical de Enfermedad Infecciosa/prevención & control , Persona de Mediana Edad , Placenta/virología , Neumonía Viral/diagnóstico , Neumonía Viral/fisiopatología , Neumonía Viral/terapia , Embarazo , Complicaciones Infecciosas del Embarazo/diagnóstico , Complicaciones Infecciosas del Embarazo/fisiopatología , Complicaciones Infecciosas del Embarazo/terapia , Complicaciones Infecciosas del Embarazo/virología , Respiración Artificial/métodos , Resultado del Tratamiento , Ultrasonografía Prenatal/métodos
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