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1.
Monaldi Arch Chest Dis ; 90(4)2020 Dec 23.
Artículo en Inglés | MEDLINE | ID: covidwho-1042105

RESUMEN

We report the case of a man affected by cystic fibrosis who developed a severe SARS-CoV-2 related pneumonia in March 2020. In addition to lopinavir/ritonavir and hydroxychloroquine, he was treated with two doses of tocilizumab, displaying a significant clinical improvement. This is the first case described in the literature of an adult patient affected by cystic fibrosis who received tocilizumab for COVID-19, with documented total recovery, also assessed by a spirometry.


Asunto(s)
Anticuerpos Monoclonales Humanizados/administración & dosificación , Fibrosis Quística , Hidroxicloroquina/administración & dosificación , Lopinavir/administración & dosificación , Neumonía Viral , Infecciones del Sistema Respiratorio/microbiología , Ritonavir/administración & dosificación , /aislamiento & purificación , Adulto , Antivirales/administración & dosificación , /diagnóstico , /fisiopatología , Fibrosis Quística/complicaciones , Fibrosis Quística/inmunología , Fibrosis Quística/fisiopatología , Combinación de Medicamentos , Humanos , Pulmón/diagnóstico por imagen , Pulmón/fisiopatología , Masculino , Terapia por Inhalación de Oxígeno/métodos , Neumonía Viral/diagnóstico , Neumonía Viral/tratamiento farmacológico , Neumonía Viral/etiología , Receptores de Interleucina-6/antagonistas & inhibidores , Pruebas de Función Respiratoria/métodos , Infecciones del Sistema Respiratorio/tratamiento farmacológico , Infecciones del Sistema Respiratorio/etiología , Tomografía Computarizada por Rayos X/métodos , Resultado del Tratamiento
2.
Emerg Med J ; 37(9): 565-566, 2020 Sep.
Artículo en Inglés | MEDLINE | ID: covidwho-1024248

RESUMEN

We report the experience of prone ventilation in selected patients treated with helmet non-invasive ventilation (NIV) continuous positive airway pressure (CPAP) for acute respiratory failure in COVID-19 pneumonia. Preliminary results showed an improvement in the PaO2 value and PaO2/FiO2 ratio after 1 hour of prone ventilation. No variation of the lung ultrasound pattern before and after prone ventilation has been detected. At the time of writing, we attempted proning with helmet NIV CPAP in 10 patients. In 4 out of 10 patients, the attempt failed due to lack of compliance of the patient, scarce pain control even with ongoing treatment and refusal by the patient to prone positioning.


Asunto(s)
Presión de las Vías Aéreas Positiva Contínua/métodos , Infecciones por Coronavirus , Ventilación no Invasiva/métodos , Pandemias , Neumonía Viral , Posición Prona , Insuficiencia Respiratoria , Anciano , Betacoronavirus/aislamiento & purificación , Infecciones por Coronavirus/complicaciones , Infecciones por Coronavirus/epidemiología , Infecciones por Coronavirus/fisiopatología , Infecciones por Coronavirus/terapia , Servicio de Urgencia en Hospital/estadística & datos numéricos , Femenino , Humanos , Italia/epidemiología , Masculino , Consumo de Oxígeno , Terapia por Inhalación de Oxígeno/métodos , Posicionamiento del Paciente , Neumonía Viral/complicaciones , Neumonía Viral/epidemiología , Neumonía Viral/etiología , Neumonía Viral/fisiopatología , Neumonía Viral/terapia , Insuficiencia Respiratoria/etiología , Insuficiencia Respiratoria/fisiopatología , Insuficiencia Respiratoria/terapia , Resultado del Tratamiento
6.
Monaldi Arch Chest Dis ; 90(4)2020 Dec 23.
Artículo en Inglés | MEDLINE | ID: covidwho-1000398

RESUMEN

COVID-19 pneumonia has a significant case fatality rate and no effective antiviral drugs are available even after 9 months of the pandemic. The spectrum of COVID-19 disease ranges from asymptomatic cases to severe ARDS with myriad manifestations. Here we report a case of a male patient with severe COVID-19 ARDS who improved after receiving standard therapy but again 'deteriorated' after being stepped down to ward. He complained of worsening shortness of breath and hypoxemia which was found to be mainly positional. After ruling out other causes, he was labeled as a case of platypnea-orthodeoxia syndrome due to underlying lung involvement.  It is important to be aware of this condition in the context of COVID-19 which can be easily diagnosed bedside with pulse oximetry.


Asunto(s)
Disnea , Hipoxia , Pulmón , Posicionamiento del Paciente/métodos , Neumonía Viral , Anciano , /fisiopatología , Deterioro Clínico , Diagnóstico Diferencial , Disnea/diagnóstico , Disnea/etiología , Humanos , Hipoxia/diagnóstico , Hipoxia/etiología , Pulmón/diagnóstico por imagen , Pulmón/fisiopatología , Masculino , Oximetría/métodos , Terapia por Inhalación de Oxígeno/métodos , Manejo de Atención al Paciente , Neumonía Viral/diagnóstico , Neumonía Viral/etiología , Neumonía Viral/fisiopatología , Neumonía Viral/terapia , Pruebas de Función Respiratoria/métodos , Síndrome , Tomografía Computarizada por Rayos X/métodos
7.
J Med Internet Res ; 22(10): e21743, 2020 10 30.
Artículo en Inglés | MEDLINE | ID: covidwho-982837

RESUMEN

BACKGROUND: The COVID-19 outbreak was designated a global pandemic on March 11, 2020. The relationship between vaping and contracting COVID-19 is unclear, and information on the internet is conflicting. There is some scientific evidence that vaping cannabidiol (CBD), an active ingredient in cannabis that is obtained from the hemp plant, or other substances is associated with more severe manifestations of COVID-19. However, there is also inaccurate information that vaping can aid COVID-19 treatment, as well as expert opinion that CBD, possibly administered through vaping, can mitigate COVID-19 symptoms. Thus, it is necessary to study the spread of inaccurate information to better understand how to promote scientific knowledge and curb inaccurate information, which is critical to the health of vapers. Inaccurate information about vaping and COVID-19 may affect COVID-19 treatment outcomes. OBJECTIVE: Using structural topic modeling, we aimed to map temporal trends in the web-based vaping narrative (a large data set comprising web-based vaping chatter from several sources) to indicate how the narrative changed from before to during the COVID-19 pandemic. METHODS: We obtained data using a textual query that scanned a data pool of approximately 200,000 different domains (4,027,172 documents and 361,100,284 words) such as public internet forums, blogs, and social media, from August 1, 2019, to April 21, 2020. We then used structural topic modeling to understand changes in word prevalence and semantic structures within topics around vaping before and after December 31, 2019, when COVID-19 was reported to the World Health Organization. RESULTS: Broadly, the web-based vaping narrative can be organized into the following groups or archetypes: harms from vaping; Vaping Regulation; Vaping as Harm Reduction or Treatment; and Vaping Lifestyle. Three archetypes were observed prior to the emergence of COVID-19; however, four archetypes were identified post-COVID-19 (Vaping as Harm Reduction or Treatment was the additional archetype). A topic related to CBD product preference emerged after COVID-19 was first reported, which may be related to the use of CBD by vapers as a COVID-19 treatment. CONCLUSIONS: Our main finding is the emergence of a vape-administered CBD treatment narrative around COVID-19 when comparing the web-based vaping narratives before and during the COVID-19 pandemic. These results are key to understanding how vapers respond to inaccurate information about COVID-19, optimizing treatment of vapers who contract COVID-19, and possibly minimizing instances of inaccurate information. The findings have implications for the management of COVID-19 among vapers and the monitoring of web-based content pertinent to tobacco to develop targeted interventions to manage COVID-19 among vapers.


Asunto(s)
Cannabidiol/administración & dosificación , Infecciones por Coronavirus/epidemiología , Infecciones por Coronavirus/etiología , Internet/estadística & datos numéricos , Neumonía Viral/epidemiología , Neumonía Viral/etiología , Vapeo/efectos adversos , Vapeo/epidemiología , Cannabidiol/efectos adversos , Cannabidiol/farmacología , Cannabidiol/uso terapéutico , Infecciones por Coronavirus/tratamiento farmacológico , Infecciones por Coronavirus/terapia , Humanos , Pandemias , Neumonía Viral/terapia , Fumadores/psicología , Fumadores/estadística & datos numéricos , Medios de Comunicación Sociales , Productos de Tabaco
8.
J Prim Care Community Health ; 11: 2150132720969483, 2020.
Artículo en Inglés | MEDLINE | ID: covidwho-937036

RESUMEN

BACKGROUND: Healthcare workers (HCWs) are faced with an elevated risk of exposure to SARS-COV-2 due to the clinical procedures they perform on COVID-19 patients. However, data for frontline HCWs level of exposure and risk of COVID-19 virus infection are limited. OBJECTIVE: We investigated the level of exposure and risk of COVID-19 virus infection among HCWs in COVID-19 treatment centers in Ghana. METHODS: A cross-sectional study was utilized in this study and HCWs were invited by convenience to participate in the study, 408 HCWs in 4 COVID-19 treatment centers participated in the study. Adherence to infection prevention and control (IPC) measures were used to categorized HCWs as low or high risk of COVID-19 virus infection. The WHO COVID-19 risk assessment tool was used to collect quantitative data from the study participants. RESULTS: There was a high (N = 328, 80.4%) level of occupational exposure to the COVID-19 virus. However, only 14.0% of the exposed HCWs were at high risk of COVID-19 virus infection. Healthcare workers who performed or were present during any aerosol-generating procedures (AGP) were 23.8 times more likely to be exposed compared to HCWs who did not perform or were absent during any AGP (AOR 23.83; 95% CI: 18.45, 39.20). High risk of COVID-19 virus infection was less likely among registered nurses (AOR = 0.09; 95% CI: 0.02, 0.60), HCWs who performed or were present during any AGP (AOR = 0.05; 95% CI: 0.01, 0.50) and HCWs with a master's degree qualification (AOR 0.06; 95% CI: 0.01, 0.63). CONCLUSION: Despite the high level of exposure to the COVID-19 virus among HCWs in the treatment centers, only 14.0% were at high risk of COVID-19 virus infection. To protect this group of HCWs, treatment centers and HCWs should continue to adhere to WHO and national IPC protocols in managing of COVID-19 cases.


Asunto(s)
Infecciones por Coronavirus/etiología , Personal de Salud/estadística & datos numéricos , Neumonía Viral/etiología , Medición de Riesgo , Adulto , Infecciones por Coronavirus/prevención & control , Infecciones por Coronavirus/transmisión , Estudios Transversales , Femenino , Ghana/epidemiología , Humanos , Transmisión de Enfermedad Infecciosa de Paciente a Profesional/estadística & datos numéricos , Masculino , Persona de Mediana Edad , Enfermeras y Enfermeros/estadística & datos numéricos , Exposición Profesional/prevención & control , Exposición Profesional/estadística & datos numéricos , Pandemias/prevención & control , Neumonía Viral/prevención & control , Neumonía Viral/transmisión , Embarazo , Medición de Riesgo/métodos , Factores de Riesgo , Encuestas y Cuestionarios , Adulto Joven
9.
Medicine (Baltimore) ; 99(43): e22591, 2020 Oct 23.
Artículo en Inglés | MEDLINE | ID: covidwho-933920

RESUMEN

INTRODUCTION: COVID-19 is now a global pandemic. Although there are very few studies describing the characteristics of SARS-CoV-2 infections in patients with prostate cancer, these patients are likely to be more susceptible to COVID-19 than healthy people because of their immunosuppressed state. However, there is no evidence that prostate cancer is a risk factor for COVID-19. METHODS: We searched the Wanfang database, the China Science Journal Citation Report (VIP database), the China National Knowledge Infrastructure (CNKI), Web of Science, EMBASE, PubMed, and the Cochrane Library for studies related to the topic. We designed a standardized data extraction sheet and used Epidata software 3.1 for data extraction. In accordance with the Cochrane 5.1.0 standard, both a quality assessment and a risk assessment were carried out for the research meeting the inclusion criteria. The data were analyzed using Revman 5.3 and Stata 13.0 software. RESULTS: The study integrated existing research findings and a meta-analysis of the data to investigate the prevalence of prostate cancer in males infected with SARS-CoV-2 and the adverse clinical outcomes in male patients with or without COVID-19. CONCLUSION: The results of this research may provide a basis for judging if prostate cancer is a risk factor for males infected with SARS-CoV-2, and the findings can effectively help to prevent COVID-19 in patients with prostate cancer. ETHICS AND DISSEMINATION: Ethics approval is not required for this systematic review as it will involve the collection and analysis of secondary data. The results of the review will be reported in international peer-reviewed journals PRORPERO REGISTRATION NUMBER:: CRD42020194071.


Asunto(s)
Betacoronavirus , Infecciones por Coronavirus/etiología , Neumonía Viral/etiología , Neoplasias de la Próstata/complicaciones , Protocolos Clínicos , Infecciones por Coronavirus/diagnóstico , Salud Global , Humanos , Masculino , Pandemias , Neumonía Viral/diagnóstico , Prevalencia , Pronóstico , Neoplasias de la Próstata/epidemiología , Medición de Riesgo , Factores de Riesgo
10.
Circ Cardiovasc Interv ; 13(11): e010027, 2020 11.
Artículo en Inglés | MEDLINE | ID: covidwho-917835

RESUMEN

BACKGROUND: The optimal treatment strategy for treating ST-segment-elevation myocardial infarction (STEMI) in context of the coronavirus disease 2019 (COVID-19) pandemic is unclear given the potential risk of occupational exposure during primary percutaneous coronary intervention (PPCI). We quantified the impact of different STEMI treatment strategies on patient outcomes and provider risk in context of the COVID-19 pandemic. METHODS: Using a decision-analytic framework, we evaluated the effect of PPCI versus the pharmaco-invasive strategy for managing STEMI on 30-day patient mortality and individual provider infection risk based on presence of cardiogenic shock, suspected coronary territory, and presence of known or presumptive COVID-19 infection. RESULTS: For patients with low suspicion for COVID-19, PPCI had mortality benefit over the pharmaco-invasive strategy, and the risk of cardiac catheterization laboratory provider infection remained very low (<0.25%) across all subgroups. For patients with presumptive COVID-19 with cardiogenic shock, PPCI offered substantial mortality benefit to patients relative to the pharmaco-invasive strategy (7.9% absolute decrease in 30-day mortality), but also greater risk of provider infection (2.3% absolute increase in risk of provider infection). For patients with presumptive COVID-19 with nonanterior STEMI without cardiogenic shock, PPCI offered a 0.4% absolute mortality benefit over the pharmaco-invasive strategy with a 0.2% greater absolute risk of provider infection, and the tradeoff between patient and provider risk with PPCI became more apparent in sensitivity analysis with more severe COVID-19 infections. CONCLUSIONS: Usual care with PPCI remains the appropriate treatment strategy in the majority of cases presenting with STEMI in the setting of the COVID-19 pandemic. However, utilization of a pharmaco-invasive strategy in selected patients with STEMI with presumptive COVID-19 and low likelihood of mortality from STEMI and use of preventive strategies such as preprocedural intubation in high risk patients when PPCI is the preferred strategy may be reasonable to reduce provider risk of COVID-19 infection.


Asunto(s)
Betacoronavirus , Infecciones por Coronavirus/etiología , Personal de Salud , Exposición Profesional/efectos adversos , Intervención Coronaria Percutánea/efectos adversos , Neumonía Viral/etiología , Infarto del Miocardio con Elevación del ST/terapia , Anciano , Infecciones por Coronavirus/prevención & control , Técnicas de Apoyo para la Decisión , Humanos , Persona de Mediana Edad , Pandemias/prevención & control , Neumonía Viral/prevención & control , Riesgo , Infarto del Miocardio con Elevación del ST/mortalidad
11.
Medicine (Baltimore) ; 99(43): e22591, 2020 Oct 23.
Artículo en Inglés | MEDLINE | ID: covidwho-894687

RESUMEN

INTRODUCTION: COVID-19 is now a global pandemic. Although there are very few studies describing the characteristics of SARS-CoV-2 infections in patients with prostate cancer, these patients are likely to be more susceptible to COVID-19 than healthy people because of their immunosuppressed state. However, there is no evidence that prostate cancer is a risk factor for COVID-19. METHODS: We searched the Wanfang database, the China Science Journal Citation Report (VIP database), the China National Knowledge Infrastructure (CNKI), Web of Science, EMBASE, PubMed, and the Cochrane Library for studies related to the topic. We designed a standardized data extraction sheet and used Epidata software 3.1 for data extraction. In accordance with the Cochrane 5.1.0 standard, both a quality assessment and a risk assessment were carried out for the research meeting the inclusion criteria. The data were analyzed using Revman 5.3 and Stata 13.0 software. RESULTS: The study integrated existing research findings and a meta-analysis of the data to investigate the prevalence of prostate cancer in males infected with SARS-CoV-2 and the adverse clinical outcomes in male patients with or without COVID-19. CONCLUSION: The results of this research may provide a basis for judging if prostate cancer is a risk factor for males infected with SARS-CoV-2, and the findings can effectively help to prevent COVID-19 in patients with prostate cancer. ETHICS AND DISSEMINATION: Ethics approval is not required for this systematic review as it will involve the collection and analysis of secondary data. The results of the review will be reported in international peer-reviewed journals PRORPERO REGISTRATION NUMBER:: CRD42020194071.


Asunto(s)
Betacoronavirus , Infecciones por Coronavirus/etiología , Neumonía Viral/etiología , Neoplasias de la Próstata/complicaciones , Protocolos Clínicos , Infecciones por Coronavirus/diagnóstico , Salud Global , Humanos , Masculino , Pandemias , Neumonía Viral/diagnóstico , Prevalencia , Pronóstico , Neoplasias de la Próstata/epidemiología , Medición de Riesgo , Factores de Riesgo
12.
Immun Inflamm Dis ; 8(4): 753-762, 2020 12.
Artículo en Inglés | MEDLINE | ID: covidwho-893223

RESUMEN

BACKGROUND: Severe acute respiratory syndrome coronavirus clade 2 (SARS-CoV-2) is a single-stranded RNA virus responsible for the global pandemic of the coronavirus disease-2019 (COVID-19). To date, there are still no effective approaches for the prevention and treatment of COVID-19. OBJECTIVE: The present study aims to explore the possible mechanisms of SARS-CoV-2 infection in human lung cells. METHODS: Data interpretation was conducted by recruiting bioinformatics analysis, including Gene Ontology and Kyoto Encyclopedia of Genes and Genomes pathways analysis using downloaded data from the NCBI Gene Expression Omnibus database. RESULTS: The present study demonstrated that SARS-CoV-2 infection induces the upregulation of 14 interferon-stimulated genes, indicative of immune, and interferon responses to the virus. Notably, genes for pyrimidine metabolism and steroid hormone biosynthesis are selectively enriched in human lung cells after SARS-CoV-2 infection, suggesting that altered pyrimidine metabolism and steroid biosynthesis are remarkable, and perhaps druggable features after SARS-CoV-2 infection. Besides, there is a strong positive correlation between viral ORF1ab, ORF6, and angiotensin-converting enzyme 2 (ACE2) expression in human lung cells, implying that ACE2 facilitates SARS-CoV-2 infection and replication in host cells probably through the induction of ORF1ab and ORF6.


Asunto(s)
Betacoronavirus/patogenicidad , Infecciones por Coronavirus/etiología , Interferones/metabolismo , Pulmón/patología , Peptidil-Dipeptidasa A/metabolismo , Neumonía Viral/etiología , Betacoronavirus/metabolismo , Biología Computacional , Infecciones por Coronavirus/patología , Células Epiteliales/inmunología , Células Epiteliales/metabolismo , Células Epiteliales/virología , Perfilación de la Expresión Génica , Humanos , Pulmón/citología , Pulmón/inmunología , Pulmón/virología , Pandemias , Neumonía Viral/patología , Poliproteínas , Pirimidinas/metabolismo , Mucosa Respiratoria/citología , Mucosa Respiratoria/inmunología , Mucosa Respiratoria/metabolismo , Mucosa Respiratoria/virología , Transducción de Señal/inmunología , Esteroides/biosíntesis , Regulación hacia Arriba/inmunología , Proteínas Virales/metabolismo
13.
JAMA Netw Open ; 3(10): e2026373, 2020 10 01.
Artículo en Inglés | MEDLINE | ID: covidwho-893184

RESUMEN

Importance: Policy makers have relaxed restrictions for certain nonessential industries, including construction, jeopardizing the effectiveness of social distancing measures and putting already at-risk populations at greater risk of coronavirus disease 2019 (COVID-19) infection. In Texas, Latinx populations are overly represented among construction workers, and thus have elevated rates of exposure that are compounded by prevalent high-risk comorbidities and lack of access to health care. Objective: To assess the association between construction work during the COVID-19 pandemic and hospitalization rates for construction workers and the surrounding community. Design, Setting, and Participants: This decision analytical model used a mathematical model of COVID-19 transmission, stratified by age and risk group, with construction workers modeled explicitly. The model was based on residents of the Austin-Round Rock metropolitan statistical area, with a population of 2.17 million. Based on 500 stochastic simulations for each of 15 scenarios that varied the size of the construction workforce and level of worksite transmission risk, the association between continued construction work and hospitalizations was estimated and then compared with anonymized line-list hospitalization data from central Texas through August 20, 2020. Exposures: Social distancing interventions, size of construction workforce, and level of disease transmission at construction worksites. Main Outcomes and Measures: For each scenario, the total number of COVID-19 hospitalizations and the relative risk of hospitalization among construction workers was projected and then compared with relative risks estimated from reported hospitalization data. Results: Allowing unrestricted construction work was associated with an increase of COVID-19 hospitalization rates through mid-August 2020 from 0.38 per 1000 residents to 1.5 per 1000 residents and from 0.22 per 1000 construction workers to 9.3 per 1000 construction workers. This increased risk was estimated to be offset by safety measures (such as thorough cleaning of equipment between uses, wearing of protective equipment, limits on the number of workers at a worksite, and increased health surveillance) that were associated with a 50% decrease in transmission. The observed relative risk of hospitalization among construction workers compared with other occupational categories among adults aged 18 to 64 years was 4.9 (95% CI, 3.8-6.2). Conclusions and Relevance: The findings of this study suggest that unrestricted work in high-contact industries, such as construction, is associated with a higher level of community transmission, increased risks to at-risk workers, and larger health disparities among members of racial and ethnic minority groups.


Asunto(s)
Industria de la Construcción , Infecciones por Coronavirus/etiología , Hospitalización , Exposición Profesional/efectos adversos , Pandemias , Neumonía Viral/etiología , Adolescente , Adulto , Betacoronavirus , Comorbilidad , Grupos de Población Continentales , Infecciones por Coronavirus/epidemiología , Infecciones por Coronavirus/etnología , Infecciones por Coronavirus/virología , Grupos Étnicos , Femenino , Hispanoamericanos , Humanos , Masculino , Persona de Mediana Edad , Grupos Minoritarios , Neumonía Viral/epidemiología , Neumonía Viral/etnología , Neumonía Viral/virología , Características de la Residencia , Factores de Riesgo , Seguridad , Texas/epidemiología , Lugar de Trabajo , Adulto Joven
14.
Int J Tuberc Lung Dis ; 24(10): 1032-1037, 2020 10 01.
Artículo en Inglés | MEDLINE | ID: covidwho-895585

RESUMEN

OBJECTIVE: To evaluate the clinical features of disease progression among patients with COVID-19 to help early identification of patients at high risk.DESIGN: This was a retrospective, multi-centre cohort study. From 10 January to 29 February 2020, all cases diagnosed with COVID-19 at 24 hospitals (with complete medical records) in Jiangsu Province, China were recruited. The primary outcome was deterioration in condition, i.e., the dramatic progression from asymptomatic or mild or moderate status into severe or critically ill status during 14 days´ follow-up.RESULTS: Of the 625 patients in Jiangsu, none died; 597 patients were asymptomatic or had mild or moderate disease on admission, of whom 36 (6%) experienced disease deterioration to become severe or critically ill.CONCLUSION: Disease deterioration to severe or critically ill status was associated with age, pulmonary opacity score, lymphocyte count on admission and exposure to the pandemic centre in Wuhan.


Asunto(s)
Betacoronavirus , Infecciones por Coronavirus/epidemiología , Neumonía Viral/epidemiología , Adulto , Factores de Edad , China/epidemiología , Estudios de Cohortes , Infecciones por Coronavirus/etiología , Infecciones por Coronavirus/patología , Progresión de la Enfermedad , Femenino , Humanos , Masculino , Persona de Mediana Edad , Pandemias , Neumonía Viral/etiología , Neumonía Viral/patología , Estudios Retrospectivos , Factores de Riesgo
15.
World J Gastroenterol ; 26(37): 5534-5542, 2020 Oct 07.
Artículo en Inglés | MEDLINE | ID: covidwho-886833

RESUMEN

The first cases of a novel corona virus infection were reported in Wuhan China in December of 2019, followed by the declaration of an international pandemic by the World Health Organization in March 2020. Early reports of the virus, now known as severe acute respiratory syndrome coronavirus 2, and its clinical disease coronavirus disease 2019 (COVID-19), has shown higher rates of morbidity and mortality in the elderly and those with pre-existing medical conditions. Of particular concern is the safety of those with compromised immune systems. Inflammatory Bowel disease (IBD) is itself caused by a disordered immune response, with the most effective medical therapies being immune suppressing or modifying. As such, the risk of COVID-19, virus related outcomes, and appropriate management of IBD patients during the global pandemic is of immediate concern to gastroenterologists worldwide. There has been a rapid accumulation of clinical data and expert opinion on the topic. This review will highlight the latest source information on clinical observation/outcomes of the IBD population and provide a concise summary of the most up to date perspectives on IBD management in the age of COVID-19.


Asunto(s)
Betacoronavirus , Infecciones por Coronavirus/prevención & control , Enfermedades Inflamatorias del Intestino/complicaciones , Enfermedades Inflamatorias del Intestino/terapia , Pandemias/prevención & control , Neumonía Viral/prevención & control , Infecciones por Coronavirus/diagnóstico , Infecciones por Coronavirus/etiología , Infecciones por Coronavirus/terapia , Salud Global , Humanos , Enfermedades Inflamatorias del Intestino/inmunología , Neumonía Viral/diagnóstico , Neumonía Viral/etiología , Neumonía Viral/terapia , Medición de Riesgo , Factores de Riesgo
16.
Medicine (Baltimore) ; 99(42): e22688, 2020 Oct 16.
Artículo en Inglés | MEDLINE | ID: covidwho-883210

RESUMEN

BACKGROUND: Unknown origin pneumonia has been furiously spreading since the late of December 2019, subsequently spread to approximately all provinces and areas in China and many countries, which was announced as a Public Health Emergency of International Concern by World Health Organization (WHO). The studies on 2019 Corona Virus Disease-19 (COVID-19) conducted from various fields around the world. Herein, the objective of the present study is to summarize the etiology, epidemiology, clinical manifestations, image findings, traceability analysis, and drug development of COVID-19. METHODS: The following electronic databases were searched: Cochrane Central Register of Controlled Trials (CENTRAL), PubMed, EMBASE, Cochrane Library, China National Knowledge Infrastructure (CNKI), Chinese Biomedical Literature Database, VIP Chinese Science and Technology Periodical Database, and Wanfang Data. Other relevant literature will be manually searched as a compliment. We have reviewed etiology, epidemiology, clinical manifestations, image findings, and medication from case reports and retrospective clinical studies relating to COVID-19 published since the outbreak. RESULTS: The coronavirus is closely related to bat coronavirus and pangolin coronavirus. Besides, the infection pathway is confirmed to be the respiratory and digestive systems. The virus indicates person-to-person transmission and some patients present asymptomatic. The elderly have a higher mortality rate. Rapid and sensitive nucleic acid testing is usually used as a basis for diagnosis. Currently, there is no specific vaccine and antiviral drug. Intervention actions such as travel bans and quarantine adopted have effectively reduced the spread of the epidemic. CONCLUSION: This systemic review will provide high-quality evidence to summarize etiology, epidemiology, clinical manifestations, image findings, traceability analysis, drug development in patients with COVID-19.


Asunto(s)
Infecciones por Coronavirus/epidemiología , Infecciones por Coronavirus/fisiopatología , Neumonía Viral/epidemiología , Neumonía Viral/fisiopatología , Corticoesteroides/uso terapéutico , Factores de Edad , Antivirales/uso terapéutico , Betacoronavirus , China , Comorbilidad , Infecciones por Coronavirus/etiología , Infecciones por Coronavirus/terapia , Citocinas/metabolismo , Humanos , Inmunoglobulinas/uso terapéutico , Pulmón/diagnóstico por imagen , Pulmón/patología , Pandemias , Peptidil-Dipeptidasa A/metabolismo , Neumonía Viral/etiología , Neumonía Viral/terapia , Pronóstico , Reacción en Cadena de la Polimerasa de Transcriptasa Inversa , Factores Sexuales
17.
Eur J Cardiothorac Surg ; 58(5): 991-996, 2020 Nov 01.
Artículo en Inglés | MEDLINE | ID: covidwho-883098

RESUMEN

OBJECTIVES: We reviewed the incidence of coronavirus disease 2019 cases and the postoperative outcomes of patients who had thoracic surgery during the beginning and at the highest point of transmission in our community. METHODS: We retrospectively reviewed patients who had undergone elective thoracic surgery from 12 February 2020 to 30 April 2020 and were symptomatic or tested positive for severe acute respiratory syndrome coronavirus 2 infection within 14 days after surgery, with a focus on their complications and potential deaths. RESULTS: Out of 101 surgical procedures, including 57 primary oncological resections, 6 lung transplants and 18 emergency procedures, only 5 cases of coronavirus disease 2019 were identified, 3 in the immediate postoperative period and 2 as outpatients. All 5 patients had cancer; the median age was 64 years. The main virus-related symptom was fever (80%), and the median onset of coronavirus disease 2019 was 3 days. Although 80% of the patients who had positive test results for severe acute respiratory syndrome coronavirus 2 required in-hospital care, none of them were considered severe or critical and none died. CONCLUSIONS: These results indicate that, in properly selected cases, with short preoperative in-hospital stays, strict isolation and infection control protocols, managed by a dedicated multidisciplinary team, a surgical procedure could be performed with a relatively low risk for the patient.


Asunto(s)
Betacoronavirus , Carcinoma de Células Escamosas/cirugía , Infecciones por Coronavirus/etiología , Procedimientos Quirúrgicos Electivos , Neoplasias Pulmonares/cirugía , Neumonía Viral/etiología , Complicaciones Posoperatorias , Procedimientos Quirúrgicos Torácicos , Adulto , Anciano , Betacoronavirus/aislamiento & purificación , Técnicas de Laboratorio Clínico , Infecciones por Coronavirus/diagnóstico , Infecciones por Coronavirus/epidemiología , Infecciones por Coronavirus/terapia , Femenino , Estudios de Seguimiento , Humanos , Incidencia , Masculino , Evaluación de Resultado en la Atención de Salud , Pandemias , Neumonía Viral/diagnóstico , Neumonía Viral/epidemiología , Neumonía Viral/terapia , Complicaciones Posoperatorias/diagnóstico , Complicaciones Posoperatorias/epidemiología , Complicaciones Posoperatorias/terapia , Estudios Retrospectivos , España , Resultado del Tratamiento
18.
Eur J Cardiothorac Surg ; 58(5): 899-906, 2020 11 01.
Artículo en Inglés | MEDLINE | ID: covidwho-883097

RESUMEN

OBJECTIVES: Few anecdotal cases have been reported in the literature regarding heart transplant recipients and infection with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). We report our experience with 6 patients hospitalized in Northern Italy during the outbreak. METHODS: Of the 396 living heart transplant recipients from 1985 to 2020 included in the study, 6 patients developed the novel 2019 coronavirus disease. Risk factors, last follow-up characteristics, onset presentation, in-hospital course of disease and blood examinations data were collected for these patients. RESULTS: All patients were symptomatic and had positive results from a nasopharyngeal swab test for SARS-CoV-2. Of the 6 patients, 5 were hospitalized and 1 remained self-quarantined at home. Two patients died and 3 were discharged home. Two patients were admittted to the intensive care unit . Immunosuppressive therapy was modified with a median reduction comprising doses that were 50% cyclosporine and 50% mycophenolate. All patients received a medium-dose of corticosteroids as a bolus medication in addition to their therapy. All hospitalized patients received hydroxychloroquine; 2 patients received ritonavir/lopinavir. Broad-spectrum antibiotics for prophylaxis were administered to all. One patient had an ischaemic stroke and died of sepsis. CONCLUSIONS: In the absence of any strong evidence regarding the treatment of heart transplant recipients infected with SARS-CoV-2, we faced a new challenge in managing viral infection in an immunosuppressed population. Because immunomodulation interaction with the infection seems to be crucial for developing severe forms of the disease, we managed to reduce immunosuppressive therapy by adding medium doses of corticosteroids. Despite the limited number of affected patients, this report suggests that special considerations should be given to treating coronavirus disease in the heart transplant recipient population.


Asunto(s)
Betacoronavirus , Infecciones por Coronavirus/etiología , Trasplante de Corazón , Neumonía Viral/etiología , Complicaciones Posoperatorias/etiología , Anciano , Anciano de 80 o más Años , Betacoronavirus/aislamiento & purificación , Técnicas de Laboratorio Clínico , Infecciones por Coronavirus/diagnóstico , Infecciones por Coronavirus/epidemiología , Infecciones por Coronavirus/terapia , Femenino , Estudios de Seguimiento , Humanos , Italia , Masculino , Persona de Mediana Edad , Pandemias , Neumonía Viral/diagnóstico , Neumonía Viral/epidemiología , Neumonía Viral/terapia , Complicaciones Posoperatorias/diagnóstico , Complicaciones Posoperatorias/epidemiología , Complicaciones Posoperatorias/terapia , Factores de Riesgo
20.
Environ Health ; 19(1): 106, 2020 10 13.
Artículo en Inglés | MEDLINE | ID: covidwho-868558

RESUMEN

BACKGROUND: Environmental factors play a central role in seasonal epidemics. SARS-CoV-2 infection in Spain has shown a heterogeneous geographical pattern This study aimed to assess the influence of several climatic factors on the infectivity of SARS-CoV-2 and the severity of COVID-19 among the Spanish Autonomous Communities (AA.CC.). METHODS: Data on coronavirus infectivity and severity of COVID-19 disease, as well as the climatic variables were obtained from official sources (Ministry of Health and Spanish Meteorological Agency, respectively). To assess the possible influence of climate on the development of the disease, data on ultraviolet radiation (UVR) were collected during the months before the start of the pandemic. To analyze its influence on the infectivity of SARS-CoV-2, data on UVR, temperature, and humidity were obtained from the months of highest contagiousness to the peak of the pandemic. RESULTS: From October 2019 to January 2020, mean UVR was significantly related not only to SARS-CoV-2 infection (cumulative incidence -previous 14 days- × 105 habitants, rho = - 0.0,666; p = 0.009), but also with COVID-19 severity, assessed as hospital admissions (rho = - 0.626; p = 0.017) and ICU admissions (rho = - 0.565; p = 0.035). Besides, temperature (February: rho = - 0.832; p < 0.001 and March: rho = - 0.904; p < 0.001), was the main climatic factor responsible for the infectivity of the coronavirus and directly contributed to a different spread of SARS-CoV-2 across the Spanish regions. CONCLUSIONS: Climatic factors may partially explain the differences in COVID-19 incidence and severity across the different Spanish regions. The knowledge of these factors could help to develop preventive and public health actions against upcoming outbreaks of the disease.


Asunto(s)
Betacoronavirus , Clima , Infecciones por Coronavirus/epidemiología , Neumonía Viral/epidemiología , Tiempo (Meteorología) , Infecciones por Coronavirus/diagnóstico , Infecciones por Coronavirus/etiología , Humanos , Incidencia , Modelos Lineales , Pandemias , Neumonía Viral/diagnóstico , Neumonía Viral/etiología , Factores de Riesgo , Índice de Severidad de la Enfermedad , España/epidemiología , Rayos Ultravioleta
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