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2.
BMC Pregnancy Childbirth ; 21(1): 326, 2021 Apr 26.
Artículo en Inglés | MEDLINE | ID: covidwho-1204051

RESUMEN

BACKGROUND: Knowledge about SARS-CoV-2 infection in pregnancy and newborns is scarce. The objective of this study is to analyse clinical and epidemiological characteristics of a cohort of women infected with SARS-CoV-2 during pregnancy and their newborns exposed to SARS-CoV-2 during gestation. METHODS: Multicentric observational study of Spanish hospitals from the GESNEO-COVD cohort, participants in RECLIP (Spanish Network of Paediatric Clinical Assays). Women with confirmed SARS-CoV-2 infection by PCR and/or serology during pregnancy, diagnosed and delivering during the period 15/03/2020-31/07/2020 were included. Epidemiological, clinical, and analytical data was collected. RESULTS: A total of 105 pregnant women with a median of 34.1 years old (IQR: 28.8-37.1) and 107 newborns were included. Globally, almost 65% of pregnant women had some COVID-19 symptoms and more than 43% were treated for SARS-COV-2. Overall, 30.8% of pregnant women had pneumonia and 5 (4.8%) women were admitted to the intensive care unit needing invasive mechanical ventilation. There was a rate of 36.2% of caesarean sections, which was associated with pneumonia during pregnancy (OR: 4.203, CI 95%: 1.473-11.995) and lower gestational age at delivery (OR: 0.724, CI 95%: 0.578-0.906). The prevalence of preterm birth was 20.6% and prematurity was associated with pneumonia during gestation (OR: 6.970, CI95%: 2.340-22.750) and having a positive SARS-CoV-2 PCR at delivery (OR: 6.520, CI95%: 1.840-31.790). All nasopharyngeal PCR in newborns were negative at birth and one positivized at 15 days of life. Two newborns died, one due to causes related to prematurity and another of unexpected sudden death during early skin-to-skin contact after delivery. CONCLUSIONS: Although vertical transmission has not been reported in this cohort, the prognosis of newborns could be worsened by SARS-CoV-2 infection during pregnancy as COVID-19 pneumonia increased the risk of caesarean section deliveries and preterm births.


Asunto(s)
/epidemiología , Portador Sano/epidemiología , Complicaciones Infecciosas del Embarazo/epidemiología , Nacimiento Prematuro/epidemiología , Adulto , Antibacterianos/uso terapéutico , Antivirales/uso terapéutico , /fisiopatología , Cesárea/estadística & datos numéricos , Estudios de Cohortes , Comorbilidad , Tos/fisiopatología , Diabetes Gestacional/epidemiología , Disnea/fisiopatología , Femenino , Fiebre/fisiopatología , Edad Gestacional , Humanos , Hipertensión/epidemiología , Hipotiroidismo/epidemiología , Factores Inmunológicos/uso terapéutico , Recién Nacido , Transmisión Vertical de Enfermedad Infecciosa , Unidades de Cuidados Intensivos/estadística & datos numéricos , Pulmón/diagnóstico por imagen , Masculino , Obesidad Materna/epidemiología , Neumonía Viral/diagnóstico por imagen , Neumonía Viral/fisiopatología , Neumonía Viral/terapia , Embarazo , Complicaciones del Embarazo/epidemiología , Complicaciones Infecciosas del Embarazo/fisiopatología , Complicaciones Infecciosas del Embarazo/terapia , Segundo Trimestre del Embarazo , Tercer Trimestre del Embarazo , Radiografía Torácica , Respiración Artificial , Factores de Riesgo , Índice de Severidad de la Enfermedad , España/epidemiología
3.
Gac Med Mex ; 156(6): 527-531, 2020.
Artículo en Inglés | MEDLINE | ID: covidwho-1194846

RESUMEN

INTRODUCTION: There are hematological parameters that correlate severity and predict mortality mainly in septic and inflammatory states. OBJECTIVE: To correlate the neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR) and systemic immune-inflammation index (SIII) with COVID-19 severity. METHOD: Descriptive, analytical, retrospective study of patients with COVID-19 pneumonia, in whom NLR, PLR and SIII were analyzed. RESULTS: One-hundred patients were included, 54 men and 46 women, with a mean age of 49.4 ± 19.3 years. NLR, PLR and SIII means were 10.7 ± 10.9, 290.1 ± 229.2, and 2.6 ± 3.4 x 109, respectively. In 54 %, pneumonia was mild, and in 46 %, severe. Regarding hospital outcomes, 75 % were discharged due to improvement and 25 % died. NLR, PLR and SIII means of the patients who died versus the patients who improved were 20.4 ± 16.9 versus 7.5 ± 4.9 (p = 0.001), 417.1 ± 379.7 versus 247.7 ± 127.4 (p = 0.038) and 4.8 ± 6.1 versus 1.9 ± 1.2 × 109 (p = 0.030), respectively. CONCLUSION: Hematological parameters can be used in patients with COVID-19-associated pneumonia as predictors of severity and prognosis. INTRODUCCIÓN: Existen índices hematológicos que correlacionan la severidad y predicen la mortalidad, principalmente en ­estados sépticos y de inflamación. OBJETIVO: Correlacionar los índices neutrófilo/linfocito (INL), plaqueta/linfocito (IPL) e inmunidad/inflamación sistémica (IIIS) con la severidad de COVID-19. MÉTODO: Estudio descriptivo, analítico y retrospectivo de pacientes con neumonía por COVID-19, en quienes se analizaron INL, IPL e IIIS. RESULTADOS: Se incluyeron 100 pacientes, 54 hombres y 46 mujeres, con una media de 49.4 ± 19.3 años. Las medias de INL, IPL e IIIS fueron 10.7 ± 10.9, 290.1 ± 229.2 y 2.6 ± 3.4 × 109, respectivamente. En 54 %, la neumonía fue leve y en 46 %, grave. En cuanto a los desenlaces hospitalarios, 75 % egresó por mejoría y 25 % falleció. Las medias de INL, IPL e IIIS de los pacientes que fallecieron versus las de los pacientes que mejoraron fueron 20.4 ± 16.9 versus 7.5 ± 4.9 (p = 0.001), 417.1 ± 379.7 versus 247.7 ± 127.4 (p = 0.038) y 4.8 ± 6.1 versus 1.9 ± 1.2 × 109 (p = 0.030), respectivamente. CONCLUSIÓN: Los índices hematológicos en pacientes con neumonía por COVID-19 pueden ser empleados como predictores de severidad y pronóstico.


Asunto(s)
/complicaciones , Inflamación/virología , Linfocitos/metabolismo , Neumonía Viral/virología , Adulto , Anciano , Plaquetas/metabolismo , Femenino , Humanos , Inflamación/patología , Recuento de Linfocitos , Masculino , Persona de Mediana Edad , Neutrófilos/metabolismo , Neumonía Viral/fisiopatología , Pronóstico , Estudios Retrospectivos , Índice de Severidad de la Enfermedad
4.
BMC Pulm Med ; 21(1): 126, 2021 Apr 19.
Artículo en Inglés | MEDLINE | ID: covidwho-1191325

RESUMEN

BACKGROUND: Platypnea-orthodeoxia syndrome (POS) is a rare condition characterized by dyspnoea (platypnea) and arterial desaturation in the upright position resolved in the supine position (orthodeoxia). Intracardiac shunt, pulmonary ventilation-perfusion mismatch and others intrapulmonary abnormalities are involved. CASE PRESENTATION: We report a case of POS associated with two pathophysiological issues: one, cardiac POS caused by a patent foramen ovale (PFO) and second, pulmonary POS due to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) interstitial pneumonia. POS has resolved after recovery of coronavirus disease 2019 (COVID-19) pneumonia. CONCLUSIONS: Right-to-left interatrial shunt and intrapulmonary shunt caused by SARS-CoV-2 pneumonia contributed to refractory hypoxemia and POS. Therefore, in case of COVID-19 patient with unexplained POS, the existence of PFO must be investigated.


Asunto(s)
Disnea , Foramen Oval Permeable , Hipoxia , Pulmón/diagnóstico por imagen , Neumonía Viral , /diagnóstico , Disnea/diagnóstico , Disnea/etiología , Disnea/fisiopatología , Ecocardiografía/métodos , Foramen Oval Permeable/complicaciones , Foramen Oval Permeable/diagnóstico , Foramen Oval Permeable/fisiopatología , Hemodinámica , Humanos , Hipoxia/diagnóstico , Hipoxia/etiología , Hipoxia/fisiopatología , Enfermedades Pulmonares Intersticiales/complicaciones , Enfermedades Pulmonares Intersticiales/fisiopatología , Enfermedades Pulmonares Intersticiales/virología , Masculino , Persona de Mediana Edad , Oxígeno/análisis , Neumonía Viral/complicaciones , Neumonía Viral/diagnóstico , Neumonía Viral/fisiopatología , Postura/fisiología , Síndrome , Resultado del Tratamiento
8.
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
10.
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
11.
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
12.
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
13.
Technol Health Care ; 29(S1): 153-164, 2021.
Artículo en Inglés | MEDLINE | ID: covidwho-1121834

RESUMEN

BACKGROUND: The SARS-CoV-2 pneumonia infection is associated with high rates of hospitalization and mortality and this has placed healthcare systems under strain. Our study provides a novel method for the progress prediction, clinical treatment and prognosis of NCP, and has important clinical value for timely treatment of severe NCP patients. OBJECTIVE: To summarize the clinical features and severe illness risk factors of the patients with novel coronavirus pneumonia (NCP), in order to provide support for the progression prediction, clinical treatment and prognosis of NCP patients. MATERIALS AND METHODS: A total of 196 NCP patients treated in our hospital from January 25, 2020 to June 21, 2020 were divided into the severe group and the mild group. The clinical features of the two groups were analyzed and compared. The risk factors were explored by using multivariate logistic regression, and the receiver operating characteristic (ROC) curve was obtained. The correlations of the risk factors with the prognosis of NCP were investigated combined with the lung function test. RESULTS: The primary clinical symptoms of 196 cases of NCP included fever in 167 cases (85.2%) and cough in 121 cases (61.73%). The chest computed tomography (CT) scans of the 178 cases (90.81%) showed a typical ground-glass opacification. In 149 cases, the lymphocyte count was decreased, while the levels of creatine kinase (CK), lactate dehydrogenase (LDH), c-reactive protein (CRP), erythrocyte sedimentation rate (ESR) and D-dimer (D-D) increased. 44 cases (22.45%) were found to be severely ill. The multivariate logistic regression analysis demonstrated that age, underlying disease, length of hospital stay, body mass index (BMI), LDH, chest CT visual score, absolute lymphocyte count (ALC) and CRP were risk factors for severe.


Asunto(s)
/diagnóstico por imagen , Neumonía Viral/diagnóstico por imagen , Neumonía Viral/fisiopatología , Adulto , Anciano , Índice de Masa Corporal , China , Comorbilidad , Progresión de la Enfermedad , Femenino , Pruebas Hematológicas , Humanos , Tiempo de Internación , Modelos Logísticos , Pulmón/diagnóstico por imagen , Masculino , Persona de Mediana Edad , Neumonía Viral/mortalidad , Pronóstico , Curva ROC , Estudios Retrospectivos , Factores de Riesgo , Índice de Severidad de la Enfermedad , Tomografía Computarizada por Rayos X
14.
Medicine (Baltimore) ; 100(9): e25072, 2021 Mar 05.
Artículo en Inglés | MEDLINE | ID: covidwho-1114904

RESUMEN

RATIONALE: Northern Italy has been particularly hit by the current Covid-19 pandemic. Italian deceased patients have a mean age of 78.5 years and only 1.2% have no comorbidities. These data started a public debate whether patients die "with" or "from" Covid-19. If on one hand the public opinion has been persuaded to believe that Covid-19 infection has poor outcomes just in elderly and/or fragile subjects, on the other hand, hospitals are admitting an increasing number of healthy young patients needing semi-intensive or intensive care units. PATIENT CONCERNS: At the end of March 2020, a 79-year-old patient (M.G.) was admitted to the emergency department of our hospital with a 5 days history of fever, dyspnea, and cough. He was known for hypertension and coronary artery disease with a previous coronary artery stenting. Both the comorbidities were carried out without complications and the patient was previously asymptomatic and in good health. At admission, he was febrile and showed signs of respiratory failure with hypoxia and hypocapnia at blood gas analysis. DIAGNOSIS: The day after, he was tested for SARS-CoV-2 with a real-time reverse transcriptase-polymerase chain reaction assay of nasopharyngeal swab, which turned positive and a chest CT-Scan was consistent with the diagnosis of interstitial pneumonia. INTERVENTIONS: He was treated with i.v. diuretics, paracetamol, prolonged noninvasive ventilation (CPAP), and empiric antibiotic therapy on top of his chronic treatment. OUTCOMES: A treatment with heparin and corticosteroids was started; however, he developed irreversible respiratory failure. Invasive ventilation was not considered appropriate due to his comorbidities, low chances of recovery, and intensive care unit overcrowding. The patient died 9 days after admission. LESSONS: Health conditions that are most reported as risk factors are common cardiovascular diseases that can be managed in modern clinical practice. Through a brief illustrative clinical case, we would like to underline how Covid-19 can be per se the cause of death in patients that would otherwise have had an acceptable life expectancy.


Asunto(s)
Enfermedad de la Arteria Coronaria , Hipertensión , Manejo de Atención al Paciente/métodos , Neumonía Viral , Anciano , Análisis de los Gases de la Sangre/métodos , /mortalidad , /métodos , Deterioro Clínico , Enfermedad de la Arteria Coronaria/epidemiología , Enfermedad de la Arteria Coronaria/fisiopatología , Enfermedad de la Arteria Coronaria/terapia , Resultado Fatal , Humanos , Hipertensión/epidemiología , Hipertensión/fisiopatología , Hipertensión/terapia , Masculino , Neumonía Viral/sangre , Neumonía Viral/diagnóstico por imagen , Neumonía Viral/fisiopatología , Neumonía Viral/terapia , Medición de Riesgo , Tomografía Computarizada por Rayos X/métodos
16.
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
17.
Int J Biol Sci ; 17(2): 539-548, 2021.
Artículo en Inglés | MEDLINE | ID: covidwho-1090199

RESUMEN

Rationale: Coronavirus disease 2019 (COVID-19) has caused a global pandemic. A classifier combining chest X-ray (CXR) with clinical features may serve as a rapid screening approach. Methods: The study included 512 patients with COVID-19 and 106 with influenza A/B pneumonia. A deep neural network (DNN) was applied, and deep features derived from CXR and clinical findings formed fused features for diagnosis prediction. Results: The clinical features of COVID-19 and influenza showed different patterns. Patients with COVID-19 experienced less fever, more diarrhea, and more salient hypercoagulability. Classifiers constructed using the clinical features or CXR had an area under the receiver operating curve (AUC) of 0.909 and 0.919, respectively. The diagnostic efficacy of the classifier combining the clinical features and CXR was dramatically improved and the AUC was 0.952 with 91.5% sensitivity and 81.2% specificity. Moreover, combined classifier was functional in both severe and non-serve COVID-19, with an AUC of 0.971 with 96.9% sensitivity in non-severe cases, which was on par with the computed tomography (CT)-based classifier, but had relatively inferior efficacy in severe cases compared to CT. In extension, we performed a reader study involving three experienced pulmonary physicians, artificial intelligence (AI) system demonstrated superiority in turn-around time and diagnostic accuracy compared with experienced pulmonary physicians. Conclusions: The classifier constructed using clinical and CXR features is efficient, economical, and radiation safe for distinguishing COVID-19 from influenza A/B pneumonia, serving as an ideal rapid screening tool during the COVID-19 pandemic.


Asunto(s)
/métodos , Gripe Humana/diagnóstico por imagen , Neumonía Viral/diagnóstico por imagen , Radiografía Torácica , Anciano , /fisiopatología , Aprendizaje Profundo , Diagnóstico Diferencial , Humanos , Virus de la Influenza A/aislamiento & purificación , Virus de la Influenza B/aislamiento & purificación , Gripe Humana/fisiopatología , Gripe Humana/virología , Masculino , Persona de Mediana Edad , Pandemias , Neumonía , Neumonía Viral/fisiopatología , Neumonía Viral/virología , Curva ROC , Estudios Retrospectivos , Sensibilidad y Especificidad
18.
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
19.
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
20.
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
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