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2.
BMJ Open ; 10(7): e039771, 2020 07 13.
Artículo en Inglés | MEDLINE | ID: covidwho-647148

RESUMEN

INTRODUCTION: The recent viral pneumonia caused by the COVID-19 has gained the attention of the people all over the world. We aim to investigate the effects of respiratory rehabilitation therapy on patients infected with the novel coronavirus by conducting a systematic review and meta-analysis. METHODS AND ANALYSIS: This systematic review and meta-analysis have been registered in the International Prospective Register of Systematic Reviews (PROSPERO). The PubMed, Embase, Web of Science, the Cochrane Central Register of Controlled Trials, Chinese Biomedical Literature Database, China National Knowledge Infrastructure, Wanfang Data and Viper information databases will be searched from inception time to date without restricting research types to find relevant studies. We will also look into reference lists of relevant trials and reviews, and manually search grey literature, such as trial registries. Two reviewers will independently extract data and perform quality assessment of included studies. Review Manager V.5.3 (Cochrane Collaboration) and Stata V.16.0 software will be used to conduct this meta-analysis. The mean difference or standardised mean difference with 95% CIs is used in the computation of continuous variables to synthesise data. ETHICS AND DISSEMINATION: Ethical approval is not required due to the nature of this meta-analysis, which is based on published papers. The results of this systematic review and meta-analysis will be published in a peer-reviewed journal once we finish this study. PROSPERO REGISTRATION NUMBER: CRD42020180214.


Asunto(s)
Betacoronavirus , Infecciones por Coronavirus/complicaciones , Infecciones por Coronavirus/rehabilitación , Neumonía Viral/etiología , Neumonía Viral/rehabilitación , Humanos , Pandemias , Neumonía Viral/complicaciones
3.
BMC Infect Dis ; 20(1): 500, 2020 Jul 11.
Artículo en Inglés | MEDLINE | ID: covidwho-640102

RESUMEN

BACKGROUND: The rapid spread of coronavirus disease 2019 (COVID-19) was declared as an emerging public health threat by the World Health Organization. As various measures have been taken successfully to combat the epidemic caused by SARS-CoV-2, a growing number of fully recovered patients have been discharged from hospitals. However, some of them have relapsed. Little is known about the causes that triggered the relapse. CASE PRESENTATION: We report a case of a 40 years old man who suffered from recurrent pulmonary infection with progression of lesions on chest computed tomography (CT), elevated levels of ferritin and IL2R, reduced lymphocyte count and positive oropharyngeal swab test for SARS-CoV-2 again after 5 days discharge from hospital. The anti-SARS-CoV-2 antibody level of this patient was very low at the time of relapse, suggesting a weak humoral immune response to the virus. Total exon sequencing revealed mutations in TRNT1 gene, which may be responsible for B cell immunodeficiency. Therefore, uncleared SARS-CoV-2 at his first discharge was likely to lead to his recurrence. However, viral superinfection and non-infectious organizing pneumonia could not be completely excluded. CONCLUSION: COVID-19 relapse may occur in a part of discharged patients with low titers of anti-SARS-CoV-2 antibodies. These patients should be maintained in isolation for longer time even after discharge. A more sensitive method to detect SARS-CoV-2 needs to be established and serological testing for specific antibodies may be used as a reference to determine the duration of isolation.


Asunto(s)
Infecciones por Coronavirus/complicaciones , Neumonía Viral/etiología , Neumonía Viral/terapia , Adulto , Formación de Anticuerpos , Antivirales/uso terapéutico , Linfocitos B/inmunología , Betacoronavirus/inmunología , Betacoronavirus/patogenicidad , Infecciones por Coronavirus/tratamiento farmacológico , Infecciones por Coronavirus/patología , Hospitales , Humanos , Inmunidad Humoral , Indoles/uso terapéutico , Masculino , Nucleotidiltransferasas/genética , Pandemias , Alta del Paciente , Neumonía Viral/complicaciones , Neumonía Viral/tratamiento farmacológico , Neumonía Viral/patología , Recurrencia , Ventiladores Mecánicos
4.
J Intensive Care Med ; 35(8): 818-824, 2020 Aug.
Artículo en Inglés | MEDLINE | ID: covidwho-634271

RESUMEN

It has been well known for decades that prone positioning (PP) improves oxygenation. However, it has gained widespread acceptance only in the last few years since studies have shown significant survival benefit. Many centers have established prone ventilation in their treatment algorithm for mechanically ventilated patients with severe acute respiratory distress syndrome (ARDS). Physiologically, PP should also benefit awake, non-intubated patients with acute hypoxemic respiratory failure. However, proning in non-intubated (PINI) patients did not gain any momentum until a few months ago when the Coronavirus disease 2019 (COVID-19) pandemic surged. A large number of sick patients overwhelmed the health care system, and many centers faced a dearth of ventilators. In addition, outcomes of patients placed on mechanical ventilation because of COVID-19 infection have been highly variable and often dismal. Hence, increased focus has shifted to using various strategies to prevent intubation, such as PINI. There is accumulating evidence that PINI is a low-risk intervention that can be performed even outside intensive care unit with minimal assistance and may prevent intubation in certain patients with ARDS. It can also be performed safely at smaller centers and, therefore, may reduce the patient transfer to larger institutions that are overwhelmed in the current crisis. We present a case series of 2 patients with acute hypoxemic respiratory failure who experienced significant improvements in oxygenation with PP. In addition, the physiology of PP is described, and concerns such as proning in obese and patient's anxiety are addressed; an educational pamphlet that may be useful for both patients and health care providers is provided.


Asunto(s)
Ansiedad , Infecciones por Coronavirus , Obesidad , Pandemias , Posicionamiento del Paciente/métodos , Neumonía Viral , Posición Prona/fisiología , Insuficiencia Respiratoria , Adulto , Ansiedad/fisiopatología , Ansiedad/prevención & control , Betacoronavirus/aislamiento & purificación , Infecciones por Coronavirus/epidemiología , Infecciones por Coronavirus/metabolismo , Infecciones por Coronavirus/fisiopatología , Infecciones por Coronavirus/terapia , Humanos , Hipoxia/etiología , Hipoxia/terapia , Masculino , Obesidad/epidemiología , Obesidad/fisiopatología , Consumo de Oxígeno , Terapia por Inhalación de Oxígeno/métodos , Neumonía Viral/diagnóstico por imagen , Neumonía Viral/epidemiología , Neumonía Viral/etiología , Neumonía Viral/metabolismo , Neumonía Viral/fisiopatología , Neumonía Viral/psicología , Neumonía Viral/terapia , Respiración Artificial/métodos , Insuficiencia Respiratoria/etiología , Insuficiencia Respiratoria/fisiopatología , Insuficiencia Respiratoria/psicología , Insuficiencia Respiratoria/terapia , Resultado del Tratamiento
6.
Br J Haematol ; 189(6): 1054-1056, 2020 06.
Artículo en Inglés | MEDLINE | ID: covidwho-629645
7.
Acta Obstet Gynecol Scand ; 99(7): 839-847, 2020 07.
Artículo en Inglés | MEDLINE | ID: covidwho-622517

RESUMEN

INTRODUCTION: The aim of this study is to report our clinical experience in the management of pregnant women infected with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) during the first 30 days of the coronavirus disease (COVID-19) pandemic. MATERIAL AND METHODS: We reviewed clinical data from the first 60 pregnant women with COVID-19 whose care was managed at Puerta de Hierro University Hospital, Madrid, Spain from 14 March to 14 April 2020. Demographic data, clinical findings, laboratory test results, imaging findings, treatment received, and outcomes were collected. An analysis of variance (Kruskal-Wallis test) was performed to compare the medians of laboratory parameters. Fisher's exact test was used to evaluate categorical variables. A correspondence analysis was used to explore associations between variables. RESULTS: A total of 60 pregnant women were diagnosed with COVID-19. The most common symptoms were fever and cough (75.5% each) followed by dyspnea (37.8%). Forty-one women (68.6%) required hospital admission (18 because of disease worsening and 23 for delivery) of whom 21 women (35%) underwent pharmacological treatment, including hydroxychloroquine, antivirals, antibiotics, and tocilizumab. No renal or cardiac failures or maternal deaths were reported. Lymphopenia (50%), thrombocytopenia (25%), and elevated C-reactive protein (CRP) (59%) were observed in the early stages of the disease. Median CRP, D-dimer, and the neutrophil/lymphocyte ratio were elevated. High CRP and D-dimer levels were the parameters most frequently associated with severe pneumonia. The neutrophil/lymphocyte ratio was found to be the most sensitive marker for disease improvement (relative risk 6.65; 95% CI 4.1-5.9). During the study period, 18 of the women (78%) delivered vaginally. All newborns tested negative for SARS-CoV-2 and none of them were infected during breastfeeding. No SARS-CoV-2 was detected in placental tissue. CONCLUSIONS: Most of the pregnant women with COVID-19 had a favorable clinical course. However, one-third of them developed pneumonia, of whom 5% presented a critical clinical status. CRP and D-dimer levels positively correlated with severe pneumonia and the neutrophil/lymphocyte ratio decreased as the patients improved clinically. Seventy-eight percent of the women had a vaginal delivery. No vertical or horizontal transmissions were diagnosed in the neonates during labor or breastfeeding.


Asunto(s)
Infecciones por Coronavirus , Parto Obstétrico , Pandemias , Neumonía Viral , Complicaciones Infecciosas del Embarazo , Adulto , Betacoronavirus/aislamiento & purificación , Lactancia Materna/estadística & datos numéricos , Proteína C-Reactiva/análisis , Infecciones por Coronavirus/diagnóstico , Infecciones por Coronavirus/tratamiento farmacológico , Infecciones por Coronavirus/epidemiología , Infecciones por Coronavirus/fisiopatología , Parto Obstétrico/métodos , Parto Obstétrico/estadística & datos numéricos , Femenino , Productos de Degradación de Fibrina-Fibrinógeno/análisis , Humanos , Recién Nacido , Pandemias/estadística & datos numéricos , Neumonía Viral/sangre , Neumonía Viral/diagnóstico , Neumonía Viral/tratamiento farmacológico , Neumonía Viral/epidemiología , Neumonía Viral/etiología , Neumonía Viral/fisiopatología , Embarazo , Complicaciones Infecciosas del Embarazo/tratamiento farmacológico , Complicaciones Infecciosas del Embarazo/epidemiología , Complicaciones Infecciosas del Embarazo/fisiopatología , Complicaciones Infecciosas del Embarazo/virología , Resultado del Embarazo , España/epidemiología , Evaluación de Síntomas/métodos , Evaluación de Síntomas/estadística & datos numéricos
13.
J Exp Med ; 217(8)2020 08 03.
Artículo en Inglés | MEDLINE | ID: covidwho-607919

RESUMEN

The renin-angiotensin system (RAS) has long been appreciated as a major regulator of blood pressure, but has more recently been recognized as a mechanism for modulating inflammation as well. While there has been concern in COVID-19 patients over the use of drugs that target this system, the RAS has not been explored fully as a druggable target. The abbreviated description of the RAS suggests that its dysregulation may be at the center of COVID-19.


Asunto(s)
Infecciones por Coronavirus/fisiopatología , Enfermedades Pulmonares/fisiopatología , Pulmón/virología , Neumonía Viral/fisiopatología , Angiotensina I/metabolismo , Animales , Trastornos de la Coagulación Sanguínea/virología , Infecciones por Coronavirus/etiología , Infecciones por Coronavirus/metabolismo , Citocinas/metabolismo , Humanos , Hipertensión/fisiopatología , Pulmón/metabolismo , Pulmón/fisiopatología , Enfermedades Pulmonares/metabolismo , Enfermedades Pulmonares/virología , Obesidad/fisiopatología , Pandemias , Fragmentos de Péptidos/metabolismo , Peptidil-Dipeptidasa A/metabolismo , Neumonía Viral/etiología , Neumonía Viral/metabolismo , Receptor de Angiotensina Tipo 1/metabolismo , Índice de Severidad de la Enfermedad
14.
Exp Biol Med (Maywood) ; 245(12): 997-998, 2020 06.
Artículo en Inglés | MEDLINE | ID: covidwho-607763

RESUMEN

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has caused a global pandemic, in part due to the highly infectious nature of the disease. Because SARS-CoV-2 is new, much is unknown regarding mechanisms of transmission, and such information is urgently needed. Here, based on previous findings from related human betacoronaviruses, it is suggested that one possible route of transmission may be via infectious sweat. It is suggested that research be conducted in order to determine whether sweat in SARS-CoV-2 infected individuals harbors virus in quantities that can infect others. Findings could be used for formulations of mitigation strategies and empirically based public health messaging.


Asunto(s)
Infecciones por Coronavirus/transmisión , Neumonía Viral/transmisión , Sudor/virología , Betacoronavirus/patogenicidad , Infecciones por Coronavirus/etiología , Interacciones Huésped-Patógeno , Humanos , Membrana Mucosa/virología , Pandemias , Peptidil-Dipeptidasa A/metabolismo , Neumonía Viral/etiología , Síndrome Respiratorio Agudo Grave/transmisión , Sudoración/fisiología
15.
J Popul Ther Clin Pharmacol ; 27(S Pt 1): e5-e10, 2020 06 03.
Artículo en Inglés | MEDLINE | ID: covidwho-602504

RESUMEN

The COVID-19 virus has spread rapidly around the world and there are many patients in multiple countries. Great efforts have been made to find effective medications against the COVID-19. This study aims to compare the effectiveness of LINCOCIN® and AZITRO® in the treatment of COVID-19 associated pneumonia. A total of 24 hospitalized patients aged between 30-80 years who were admitted to the Tarsus Medical Park Hospital between February to March 2020 was included in the study. The patients were divided into LINCOCIN® and AZITRO® treatment groups. Bronchoalveolar-lavage PCR results were compared after treatment. The mean age was 58.4±15.4 years in the LINCOCIN® group and 59.1±16.6 years in the AZITRO® group. In the LINCOCIN® group, the rate of males was 66.7% and it was 58.3% in the AZITRO® group. There were no statistical differences in terms of age and gender between the groups. On the 6th day after starting treatment, negative bronchoalveolar PCR result was 83.3% in the LINCOCIN® group and 33.3% in the AZITRO® group. The negative bronchoalveolar PCR proportion was significantly higher in the LINCOCIN® group than in the AZITRO® group. LINCOCIN® usage may be more appropriate in the treatment of COVID-19 associated pneumonia. Further studies with a large sample size should clarify these results.


Asunto(s)
Antibacterianos/uso terapéutico , Azitromicina/uso terapéutico , Infecciones por Coronavirus/complicaciones , Lincomicina/uso terapéutico , Neumonía Viral/tratamiento farmacológico , Adulto , Anciano , Anciano de 80 o más Años , Antibacterianos/administración & dosificación , Antibacterianos/efectos adversos , Azitromicina/administración & dosificación , Azitromicina/efectos adversos , Betacoronavirus , Líquido del Lavado Bronquioalveolar/virología , Femenino , Humanos , Lincomicina/administración & dosificación , Lincomicina/efectos adversos , Masculino , Persona de Mediana Edad , Pandemias , Neumonía Viral/complicaciones , Neumonía Viral/etiología , Neumonía Viral/virología , Estudios Prospectivos , Factores de Riesgo
16.
J Popul Ther Clin Pharmacol ; 27(S Pt 1): e5-e10, 2020 06 03.
Artículo en Inglés | MEDLINE | ID: covidwho-601932

RESUMEN

The COVID-19 virus has spread rapidly around the world and there are many patients in multiple countries. Great efforts have been made to find effective medications against the COVID-19. This study aims to compare the effectiveness of LINCOCIN® and AZITRO® in the treatment of COVID-19 associated pneumonia. A total of 24 hospitalized patients aged between 30-80 years who were admitted to the Tarsus Medical Park Hospital between February to March 2020 was included in the study. The patients were divided into LINCOCIN® and AZITRO® treatment groups. Bronchoalveolar-lavage PCR results were compared after treatment. The mean age was 58.4±15.4 years in the LINCOCIN® group and 59.1±16.6 years in the AZITRO® group. In the LINCOCIN® group, the rate of males was 66.7% and it was 58.3% in the AZITRO® group. There were no statistical differences in terms of age and gender between the groups. On the 6th day after starting treatment, negative bronchoalveolar PCR result was 83.3% in the LINCOCIN® group and 33.3% in the AZITRO® group. The negative bronchoalveolar PCR proportion was significantly higher in the LINCOCIN® group than in the AZITRO® group. LINCOCIN® usage may be more appropriate in the treatment of COVID-19 associated pneumonia. Further studies with a large sample size should clarify these results.


Asunto(s)
Antibacterianos/uso terapéutico , Azitromicina/uso terapéutico , Infecciones por Coronavirus/complicaciones , Lincomicina/uso terapéutico , Neumonía Viral/tratamiento farmacológico , Adulto , Anciano , Anciano de 80 o más Años , Antibacterianos/administración & dosificación , Antibacterianos/efectos adversos , Azitromicina/administración & dosificación , Azitromicina/efectos adversos , Betacoronavirus , Líquido del Lavado Bronquioalveolar/virología , Femenino , Humanos , Lincomicina/administración & dosificación , Lincomicina/efectos adversos , Masculino , Persona de Mediana Edad , Pandemias , Neumonía Viral/complicaciones , Neumonía Viral/etiología , Neumonía Viral/virología , Estudios Prospectivos , Factores de Riesgo
17.
BMJ Case Rep ; 13(6)2020 Jun 16.
Artículo en Inglés | MEDLINE | ID: covidwho-601611

RESUMEN

A 33-year-old man presented repeatedly with severe abdominal pain and diarrhoea. Renal colic was suspected, and he was admitted for pain management. Questioning elicited an additional history of sore throat and mild, dry cough. Inflammatory markers were mildly raised (C reactive protein (CRP) 40 mg/L). Initial nasopharyngeal swabs were negative for severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) by PCR. CT of the kidneys, ureters and bladder (CT KUB) was normal; however, CT of the thorax showed multifocal bilateral peripheral areas of consolidation consistent with COVID-19 infection. He developed respiratory compromise and was transferred to the intensive care unit (ICU). Sputum was positive for SARS-CoV-2 by PCR, and culture grew Yersinia enterocolitica He recovered following supportive management and treatment with piperacillin-tazobactam.


Asunto(s)
Dolor Abdominal , Betacoronavirus/aislamiento & purificación , Infecciones por Coronavirus , Pulmón/diagnóstico por imagen , Pandemias , Combinación Piperacilina y Tazobactam/administración & dosificación , Neumonía Viral , Dolor Abdominal/diagnóstico , Dolor Abdominal/etiología , Adulto , Antibacterianos/administración & dosificación , Infecciones por Coronavirus/diagnóstico , Infecciones por Coronavirus/fisiopatología , Infecciones por Coronavirus/terapia , Cuidados Críticos/métodos , Diagnóstico Diferencial , Diarrea/diagnóstico , Diarrea/etiología , Humanos , Masculino , Neumonía Viral/diagnóstico , Neumonía Viral/etiología , Neumonía Viral/fisiopatología , Neumonía Viral/terapia , Esputo/microbiología , Tomografía Computarizada por Rayos X/métodos , Resultado del Tratamiento , Yersinia enterocolitica/aislamiento & purificación
18.
BMJ Case Rep ; 13(6)2020 Jun 14.
Artículo en Inglés | MEDLINE | ID: covidwho-599773

RESUMEN

A 57-year-old man presented with a progressive flaccid symmetrical motor and sensory neuropathy following a 1-week history of cough and malaise. He was diagnosed with Guillain-Barré syndrome secondary to COVID-19 and started on intravenous immunoglobulin. He proceeded to have worsening respiratory function and needed intubation and mechanical ventilation. This is the first reported case of this rare neurological complication of COVID-19 in the UK, but it adds to a small but growing body of international evidence to suggest a significant association between these two conditions. Increasing appreciation of this by clinicians will ensure earlier diagnosis, monitoring and treatment of patients presenting with this.


Asunto(s)
Betacoronavirus/aislamiento & purificación , Infecciones por Coronavirus , Síndrome de Guillain-Barré , Inmunoglobulinas Intravenosas/administración & dosificación , Pandemias , Neumonía Viral , Respiración Artificial/métodos , Infecciones por Coronavirus/complicaciones , Infecciones por Coronavirus/diagnóstico , Infecciones por Coronavirus/fisiopatología , Infecciones por Coronavirus/terapia , Diagnóstico Precoz , Síndrome de Guillain-Barré/diagnóstico , Síndrome de Guillain-Barré/etiología , Síndrome de Guillain-Barré/fisiopatología , Síndrome de Guillain-Barré/terapia , Humanos , Factores Inmunológicos/administración & dosificación , Pulmón/diagnóstico por imagen , Masculino , Persona de Mediana Edad , Examen Neurológico/métodos , Neumonía Viral/complicaciones , Neumonía Viral/diagnóstico , Neumonía Viral/etiología , Neumonía Viral/fisiopatología , Neumonía Viral/terapia , Tomografía Computarizada por Rayos X/métodos , Resultado del Tratamiento
19.
Cien Saude Colet ; 25(suppl 1): 2469-2477, 2020 Jun.
Artículo en Portugués, Inglés | MEDLINE | ID: covidwho-596435

RESUMEN

This paper aims to perform a theoretical reflection on the historical-social foundations of the COVID-19 pandemic. The "capital worldization", "capital-imperialism", "space-time compression", and "structural crisis of capital" categories are conjured from the historical materialistic-theoretical matrix, outlining a course that transcends the limits of Health Sciences to understand global health, of which the COVID-19 pandemic is an expression. We then return to the field of health, when the category of "social determination of health" allows elucidating the bases of the pandemic studied. We show that, other elements typical of the current phase of contemporary capitalism have become universal besides the SARS-CoV-2 characteristics or the dynamics of the rapid movement of people and objects around the world, unifying the health social determination process.


Asunto(s)
Betacoronavirus , Capitalismo , Infecciones por Coronavirus , Salud Global , Pandemias , Neumonía Viral , Determinantes Sociales de la Salud , Infecciones por Coronavirus/economía , Infecciones por Coronavirus/epidemiología , Infecciones por Coronavirus/etiología , Salud Global/economía , Salud Global/estadística & datos numéricos , Humanos , Pandemias/economía , Neumonía Viral/economía , Neumonía Viral/epidemiología , Neumonía Viral/etiología , Salud Pública , Determinantes Sociales de la Salud/economía , Factores de Tiempo
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