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2.
Bioanalysis ; 12(13): 919-935, 2020 Jul.
Artículo en Inglés | MEDLINE | ID: covidwho-656243

RESUMEN

Aim: Evaluation of a novel microsampling device for its use in clinical sample collection and biomarker analysis. Methodology: Matching samples were collected from 16 healthy donors (ten females, six males; age 42 ± 20) via K2EDTA touch activated phlebotomy (TAP) device and phlebotomy. The protein profile differences between sampling groups was evaluated using aptamer-based proteomic assay SomaScan and selected ELISA. Conclusion: Somascan signal concordance between phlebotomy- and TAP-generated samples was studied and comparability of protein abundances between these blood sample collection methods was demonstrated. Statistically significant correlation in selected ELISA assays also confirmed the TAP device applicability to the quantitative analysis of protein biomarkers in clinical trials.


Asunto(s)
Proteínas Sanguíneas/análisis , Flebotomía/instrumentación , Adulto , Biomarcadores/sangre , Ensayos Clínicos como Asunto , Infecciones por Coronavirus/sangre , Ensayo de Inmunoadsorción Enzimática , Femenino , Hemólisis , Humanos , Masculino , Persona de Mediana Edad , Pandemias , Neumonía Viral/sangre , Proteómica/instrumentación , Adulto Joven
4.
Euro Surveill ; 25(28)2020 Jul.
Artículo en Inglés | MEDLINE | ID: covidwho-647502

RESUMEN

Serological reactivity was analysed in plasma from 436 individuals with a history of disease compatible with COVID-19, including 256 who had been laboratory-confirmed with SARS-CoV-2 infection. Over 99% of laboratory-confirmed cases developed a measurable antibody response (254/256) and 88% harboured neutralising antibodies (226/256). Antibody levels declined over 3 months following diagnosis, emphasising the importance of the timing of convalescent plasma collections. Binding antibody measurements can inform selection of convalescent plasma donors with high neutralising antibody levels.


Asunto(s)
Anticuerpos Neutralizantes/sangre , Betacoronavirus/inmunología , Infecciones por Coronavirus/sangre , Infecciones por Coronavirus/terapia , Neumonía Viral/sangre , Neumonía Viral/terapia , Adolescente , Adulto , Anciano , Anticuerpos Neutralizantes/uso terapéutico , Especificidad de Anticuerpos , Donantes de Sangre/estadística & datos numéricos , Infecciones por Coronavirus/diagnóstico , Infecciones por Coronavirus/inmunología , Inglaterra , Humanos , Inmunización Pasiva/estadística & datos numéricos , Persona de Mediana Edad , Pandemias , Neumonía Viral/diagnóstico , Neumonía Viral/inmunología , Estadísticas no Paramétricas , Factores de Tiempo , Adulto Joven
5.
Euro Surveill ; 25(28)2020 07.
Artículo en Inglés | MEDLINE | ID: covidwho-647501

RESUMEN

Most cases of coronavirus disease 2019 are mild or asymptomatic. Therefore, many cases remain unrecorded. We determined seroprevalence of IgG antibodies against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in 3,186 regular blood donors in three German federal states between 9 March and 3 June 2020. The IgG seroprevalence was 0.91% (95% confidence interval (CI): 0.58-1.24) overall, ranging from 0.66% (95% CI: 0.13-1.19) in Hesse to 1.22% (95% CI: 0.33-2.10) in Lower-Saxony.


Asunto(s)
Betacoronavirus/inmunología , Donantes de Sangre/estadística & datos numéricos , Infecciones por Coronavirus/inmunología , Inmunoglobulina G/sangre , Neumonía Viral/inmunología , Infecciones por Coronavirus/sangre , Infecciones por Coronavirus/diagnóstico , Infecciones por Coronavirus/epidemiología , Ensayo de Inmunoadsorción Enzimática , Femenino , Alemania/epidemiología , Humanos , Masculino , Pandemias , Neumonía Viral/sangre , Neumonía Viral/diagnóstico , Neumonía Viral/epidemiología , Estudios Seroepidemiológicos , Glicoproteína de la Espiga del Coronavirus/inmunología , Factores de Tiempo
8.
Trials ; 21(1): 769, 2020 Sep 07.
Artículo en Inglés | MEDLINE | ID: covidwho-748922

RESUMEN

OBJECTIVES: To assess the effect of anticoagulation with bivalirudin administered intravenously on gas-exchange in patients with COVID-19 and respiratory failure using invasive mechanical ventilation. TRIAL DESIGN: This is a single centre parallel group, superiority, randomized (1:1 allocation ratio) controlled trial. PARTICIPANTS: All patients admitted to the Hamad Medical Corporation -ICU in Qatar for COVID-19 associated respiratory distress and in need of mechanical ventilation are screened for eligibility. INCLUSION CRITERIA: all adult patients admitted to the ICU who test positive for COVID-19 by PCR-test and in need for mechanical ventilation are eligible for inclusion. Upon crossing the limit of D-dimers (1.2 mg/L) these patients are routinely treated with an increased dose of anticoagulant according to our local protocol. This will be the start of randomization. EXCLUSION CRITERIA: pregnancy, allergic to the drug, inherited coagulation abnormalities, no informed consent. INTERVENTION AND COMPARATOR: The intervention group will receive the anticoagulant bivalirudin intravenously with a target aPTT of 45-70 sec for three days while the control group will stay on the standard treatment with low-molecular-weight heparins /unfractionated heparin subcutaneously (see scheme in Additional file 1). All other treatment will be unchanged and left to the attending physicians. MAIN OUTCOMES: As a surrogate parameter for clinical improvement and primary outcome we will use the PaO2/FiO2 (P/F) ratio. RANDOMISATION: After inclusion, the patients will be randomized using a closed envelope method into the conventional treatment group, which uses the standard strategy and the experimental group which receives anticoagulation treatment with bivalirudin using an allocation ratio of 1:1. BLINDING (MASKING): Due to logistical and safety reasons (assessment of aPTT to titrate the study drug) only the data-analyst will be blinded to the groups. NUMBERS TO BE RANDOMISED (SAMPLE SIZE): We performed a sample size calculation and assumed the data for P/F ratio (according to literature) is normally distributed and used the mean which would be: 160 and SD is 80. We expect the treatment will improve this by 30%. In order to reach a power of 80% we would need 44 patients per group (in total 88 patients). Taking approximately 10% of dropout into account we will include 100 patients (50 in each group). TRIAL STATUS: The local registration number is MRC-05-082 with the protocol version number 2. The date of approval is 18th June 2020. Recruitment started on 28th June and is expected to end in November 2020. TRIAL REGISTRATION: The protocol is registered before starting subject recruitment under the title: "Anticoagulation in patients suffering from COVID-19 disease. The ANTI-CO Trial" in ClinicalTrials.org with the registration number: NCT04445935 . Registered on 24 June 2020. FULL PROTOCOL: The full protocol is attached as an additional file, accessible from the Trials website (Additional file 2). In the interest in expediting dissemination of this material, the familiar formatting has been eliminated; this Letter serves as a summary of the key elements of the full protocol.


Asunto(s)
Antitrombinas/uso terapéutico , Infecciones por Coronavirus/tratamiento farmacológico , Fragmentos de Péptidos/uso terapéutico , Neumonía Viral/tratamiento farmacológico , Respiración Artificial , Síndrome de Dificultad Respiratoria del Adulto/terapia , Anticoagulantes/uso terapéutico , Betacoronavirus , Infecciones por Coronavirus/sangre , Enfermedad Crítica , Productos de Degradación de Fibrina-Fibrinógeno/metabolismo , Heparina/uso terapéutico , Heparina de Bajo-Peso-Molecular/uso terapéutico , Hirudinas , Humanos , Pandemias , Tiempo de Tromboplastina Parcial , Neumonía Viral/sangre , Qatar , Proteínas Recombinantes/uso terapéutico
9.
Lipids Health Dis ; 19(1): 204, 2020 Sep 07.
Artículo en Inglés | MEDLINE | ID: covidwho-745682

RESUMEN

BACKGROUND: The purpose of the study is to describe the blood lipid levels of patients diagnosed with coronavirus disease 2019 (COVID-19) and to analyze the correlation between blood lipid levels and the prognosis of COVID-19 patients. METHODS: In the clinical retrospective analysis, a total of 228 adults infected with COVID-19 were enrolled between January 17, 2020 and March 14, 2020, in Changsha, China. One thousand one hundred and forty healthy participants with matched age and gender were used as control. Median with interquartile range and Mann-Whitney test were adopted to describe and analyze clinical data. The Kaplan-Meier (KM) curve and Cox regression analysis were used to analyze the correlation between high-density lipoprotein cholesterol (HDL-C) and the severity of COVID-19. RESULTS: Compared with control, COVID-19 patients showed significantly lower levels of total cholesterol (TC) [median, 3.76 vs 4.65 mmol/L, P = 0.031], triglyceride [median, 1.08 vs 1.21 mmol/L, P <  0.001], low-density lipoprotein cholesterol (LDL-C) [median, 2.63 vs 2.83 mmol/L, P <  0.001], and HDL-C [median, 0.78 vs 1.37 mmol/L, P <  0.001], while compared with non-severe patients, severe COVID-19 patients only presented lower levels of HDL-C [median, 0.69 vs 0.79 mmol/L, P = 0.032]. In comparison with patients with high HDL-C, patients with low HDL-C showed a higher proportion of male (69.57% vs 45.60%, P = 0.004), higher levels of C-reactive protein (CRP) (median, 27.83 vs 12.56 mg/L, P <  0.001) and higher proportion of severe events (36.96% vs 14.84%, P = 0.001). Moreover, patients with low HDL-C at admission showed a higher risk of developing severe events compared with those with high HDL-C (Log Rank P = 0.009). After adjusting for age, gender and underlying diseases, they still had elevated possibility of developing severe cases than those with high HDL-C (HR 2.827, 95% CI 1.190-6.714, P = 0.019). CONCLUSIONS: HDL-C level was lower in COVID-19 adult patients, and low HDL-C in COVID-19 patients was correlated with a higher risk of developing severe events.


Asunto(s)
Betacoronavirus , HDL-Colesterol/sangre , LDL-Colesterol/sangre , Infecciones por Coronavirus/fisiopatología , Neumonía Viral/fisiopatología , Adulto , Proteína C-Reactiva/análisis , China , Colesterol/sangre , Infecciones por Coronavirus/sangre , Femenino , Humanos , Masculino , Persona de Mediana Edad , Pandemias , Neumonía Viral/sangre , Estudios Retrospectivos , Factores de Riesgo , Índice de Severidad de la Enfermedad , Factores Sexuales , Triglicéridos/sangre
10.
Zhong Nan Da Xue Xue Bao Yi Xue Ban ; 45(5): 530-535, 2020 May 28.
Artículo en Inglés, Chino | MEDLINE | ID: covidwho-745312

RESUMEN

OBJECTIVES: To describe the clinical characteristics and outcomes of severely ill patients with coronavirus disease 2019, and to investigate the relationship between plasma glucose level and the prognosis of severely ill patients with coronavirus disease 2019. METHODS: We enrolled 52 severely ill patients with coronavirus disease 2019. Among them, 12 cases progressed to critical illness. The clinical and biochemical characteristics of severely and critically ill patients were compared. RESULTS: Compared with the severely ill patients, critically ill patients had higher white blood cell and neutrophil counts, as well as higher levels of D-dimer, IL-6 and C-reactive protein (all P<0.05). Before treatment, the fasting plasma glucose (FPG) levels were significantly higher in the critically ill patient's group [(10.23±3.71) mmol/L] compared to those in the severely ill patients [(7.12±3.35) mmol/L, P<0.05]. After adjusting for age, gender, and course of the disease, fasting blood glucose at admission (OR=1.308, 95% CI 1.066 to 1.606, P=0.01) and hyperglycemia at admission (OR=29.198, 95% CI 2.903 to 293.639, P=0.004) were closely related to whether severely ill patients progressed to critical patients with coronavirus disease 2019. In our study, 15 (34.8%) of the severely ill and 10 (83.3%) critically ill patients received the steroid treatment. Compared with the severely ill patients, the FPG levels in critically ill patients were higher (P<0.05). CONCLUSIONS: Fasting hyperglycemia at admission is a significant predictor for the prognosis of severely ill patients with coronavirus disease 2019. Closely monitoring and the optimal management of hyperglycemia may improve the prognosis of patients with coronavirus disease 2019.


Asunto(s)
Glucemia , Infecciones por Coronavirus/sangre , Hiperglucemia/complicaciones , Neumonía Viral/sangre , Betacoronavirus , Infecciones por Coronavirus/diagnóstico , Enfermedad Crítica , Humanos , Recuento de Leucocitos , Pandemias , Neumonía Viral/diagnóstico , Pronóstico
11.
BMC Pregnancy Childbirth ; 20(1): 511, 2020 Sep 04.
Artículo en Inglés | MEDLINE | ID: covidwho-744979

RESUMEN

BACKGROUND: It has been proposed that pregnant women and their fetuses may be particularly at risk for poor outcomes due to the coronavirus (COVID-19) pandemic. From the few case series that are available in the literature, women with high risk pregnancies have been associated with higher morbidity. It has been suggested that pregnancy induced immune responses and cardio-vascular changes can exaggerate the course of the COVID-19 infection. CASE PRESENTATION: A 26-year old Somalian woman (G2P1) presented with a nine-day history of shortness of breath, dry cough, myalgia, nausea, abdominal pain and fever. A nasopharyngeal swab returned positive for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. Her condition rapidly worsened leading to severe liver and coagulation impairment. An emergency Caesarean section was performed at gestational week 32 + 6 after which the patient made a rapid recovery. Severe COVID-19 promptly improved by the termination of the pregnancy or atypical HELLP (Hemolysis, Elevated Liver Enzymes and Low Platelet Count) exacerbated by concomitant COVID-19 infection could not be ruled out. There was no evidence of vertical transmission. CONCLUSIONS: This case adds to the growing body of evidence which raises concerns about the possible negative maternal outcomes of COVID-19 infection during pregnancy and advocates for pregnant women to be recognized as a vulnerable group during the current pandemic.


Asunto(s)
Trastornos de la Coagulación Sanguínea/sangre , Cesárea , Infecciones por Coronavirus/sangre , Hepatopatías/sangre , Obesidad Materna , Neumonía Viral/sangre , Complicaciones Infecciosas del Embarazo/sangre , Adulto , Antitrombina III/metabolismo , Puntaje de Apgar , Betacoronavirus , Trastornos de la Coagulación Sanguínea/etiología , Infecciones por Coronavirus/complicaciones , Infecciones por Coronavirus/diagnóstico por imagen , Infecciones por Coronavirus/fisiopatología , Diagnóstico Diferencial , Femenino , Productos de Degradación de Fibrina-Fibrinógeno/metabolismo , Síndrome HELLP/diagnóstico , Humanos , Recién Nacido , Recien Nacido Prematuro , L-Lactato Deshidrogenasa/sangre , Hepatopatías/etiología , Pulmón/diagnóstico por imagen , Masculino , Pandemias , Tiempo de Tromboplastina Parcial , Recuento de Plaquetas , Neumonía Viral/complicaciones , Neumonía Viral/diagnóstico por imagen , Neumonía Viral/fisiopatología , Embarazo , Complicaciones Infecciosas del Embarazo/fisiopatología , Suecia , Tomografía Computarizada por Rayos X
12.
Eur Respir J ; 56(2)2020 08.
Artículo en Inglés | MEDLINE | ID: covidwho-744959

RESUMEN

BACKGROUND: Timely diagnosis of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection is a prerequisite for treatment and prevention. The serology characteristics and complement diagnosis value of the antibody test to RNA test need to be demonstrated. METHOD: Serial sera of 80 patients with PCR-confirmed coronavirus disease 2019 (COVID-19) were collected at the First Affiliated Hospital of Zhejiang University, Hangzhou, China. Total antibody (Ab), IgM and IgG antibodies against SARS-CoV-2 were detected, and the antibody dynamics during the infection were described. RESULTS: The seroconversion rates for Ab, IgM and IgG were 98.8%, 93.8% and 93.8%, respectively. The first detectible serology marker was Ab, followed by IgM and IgG, with a median seroconversion time of 15, 18 and 20 days post exposure (d.p.e.) or 9, 10 and 12 days post onset (d.p.o.), respectively. The antibody levels increased rapidly beginning at 6 d.p.o. and were accompanied by a decline in viral load. For patients in the early stage of illness (0-7 d.p.o), Ab showed the highest sensitivity (64.1%) compared with IgM and IgG (33.3% for both; p<0.001). The sensitivities of Ab, IgM and IgG increased to 100%, 96.7% and 93.3%, respectively, 2 weeks later. When the same antibody type was detected, no significant difference was observed between enzyme-linked immunosorbent assays and other forms of immunoassays. CONCLUSIONS: A typical acute antibody response is induced during SARS-CoV-2 infection. Serology testing provides an important complement to RNA testing in the later stages of illness for pathogenic-specific diagnosis and helpful information to evaluate the adapted immunity status of patients.


Asunto(s)
Betacoronavirus , Técnicas de Laboratorio Clínico , Infecciones por Coronavirus/sangre , Infecciones por Coronavirus/diagnóstico , Neumonía Viral/sangre , Neumonía Viral/diagnóstico , Adulto , Anciano , China , Infecciones por Coronavirus/complicaciones , Femenino , Hospitalización , Humanos , Periodo de Incubación de Enfermedades Infecciosas , Masculino , Persona de Mediana Edad , Pandemias , Neumonía Viral/complicaciones , Sensibilidad y Especificidad , Seroconversión , Evaluación de Síntomas , Factores de Tiempo , Carga Viral
13.
JAMA Netw Open ; 3(9): e2019722, 2020 09 01.
Artículo en Inglés | MEDLINE | ID: covidwho-743602

RESUMEN

Importance: Vitamin D treatment has been found to decrease the incidence of viral respiratory tract infection, especially in patients with vitamin D deficiency. Whether vitamin D is associated with coronavirus disease 2019 (COVID-19) incidence is unknown. Objective: To examine whether the last vitamin D status before COVID-19 testing is associated with COVID-19 test results. Design, Setting, and Participants: This retrospective cohort study at an urban academic medical center included patients with a 25-hydroxycholecalciferol or 1,25-dihydroxycholecalciferol level measured within 1 year before being tested for COVID-19 from March 3 to April 10, 2020. Exposures: Vitamin D deficiency was defined by the last measurement of 25-hydroxycholecalciferol less than 20 ng/mL or 1,25-dihydroxycholecalciferol less than 18 pg/mL before COVID-19 testing. Treatment changes were defined by changes in vitamin D type and dose between the date of the last vitamin D level measurement and the date of COVID-19 testing. Vitamin D deficiency and treatment changes were combined to categorize the most recent vitamin D status before COVID-19 testing as likely deficient (last level deficient and treatment not increased), likely sufficient (last level not deficient and treatment not decreased), and 2 groups with uncertain deficiency (last level deficient and treatment increased, and last level not deficient and treatment decreased). Main Outcomes and Measures: The outcome was a positive COVID-19 polymerase chain reaction test result. Multivariable analysis tested whether vitamin D status before COVID-19 testing was associated with testing positive for COVID-19, controlling for demographic and comorbidity indicators. Results: A total of 489 patients (mean [SD] age, 49.2 [18.4] years; 366 [75%] women; and 331 [68%] race other than White) had a vitamin D level measured in the year before COVID-19 testing. Vitamin D status before COVID-19 testing was categorized as likely deficient for 124 participants (25%), likely sufficient for 287 (59%), and uncertain for 78 (16%). Overall, 71 participants (15%) tested positive for COVID-19. In multivariate analysis, testing positive for COVID-19 was associated with increasing age up to age 50 years (relative risk, 1.06; 95% CI, 1.01-1.09; P = .02); non-White race (relative risk, 2.54; 95% CI, 1.26-5.12; P = .009), and likely deficient vitamin D status (relative risk, 1.77; 95% CI, 1.12-2.81; P = .02) compared with likely sufficient vitamin D status. Predicted COVID-19 rates in the deficient group were 21.6% (95% CI, 14.0%-29.2%) vs 12.2%(95% CI, 8.9%-15.4%) in the sufficient group. Conclusions and Relevance: In this single-center, retrospective cohort study, likely deficient vitamin D status was associated with increased COVID-19 risk, a finding that suggests that randomized trials may be needed to determine whether vitamin D affects COVID-19 risk.


Asunto(s)
Infecciones por Coronavirus , Pandemias , Neumonía Viral , Deficiencia de Vitamina D , Vitamina D/uso terapéutico , Betacoronavirus/aislamiento & purificación , Calcifediol/sangre , Calcitriol/sangre , Técnicas de Laboratorio Clínico/métodos , Infecciones por Coronavirus/sangre , Infecciones por Coronavirus/diagnóstico , Infecciones por Coronavirus/epidemiología , Femenino , Humanos , Masculino , Persona de Mediana Edad , Neumonía Viral/sangre , Neumonía Viral/diagnóstico , Neumonía Viral/epidemiología , Estudios Retrospectivos , Factores de Riesgo , Estados Unidos/epidemiología , Deficiencia de Vitamina D/sangre , Deficiencia de Vitamina D/epidemiología , Deficiencia de Vitamina D/terapia , Vitaminas/uso terapéutico
14.
Rev Paul Pediatr ; 38: e2020165, 2020.
Artículo en Portugués, Inglés | MEDLINE | ID: covidwho-740454

RESUMEN

OBJECTIVE: Recently, there have been reports of children with severe inflammatory syndrome and multiorgan dysfunction associated with elevated inflammatory markers. These cases are reported as presenting the Multisystem Inflammatory Syndrome in Children (MIS-C) associated with COVID-19. In this study, we describe with parental permission a case of MIS-C in an infant with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. CASE DESCRIPTION: A seven-month-old infant, with SARS-CoV-2 infection and a history of extreme preterm birth and very low weight at birth, with an initial course of mild respiratory symptoms and abrupt progression to vasoplegic shock, myocarditis and hyperinflammation syndrome, shown by high levels of troponin I, ferritin, CRP, D-dimer and hypoalbuminemia. Despite the intensive care provided, the child developed multiple organ dysfunction and died. COMMENTS: Patients with a history of extreme prematurity may present with MIS-C in the presence of COVID-19 and are a group of special concern.


Asunto(s)
Betacoronavirus/aislamiento & purificación , Infecciones por Coronavirus , Insuficiencia Multiorgánica , Pandemias , Neumonía Viral , Resucitación , Choque , Síndrome de Respuesta Inflamatoria Sistémica , Deterioro Clínico , Técnicas de Laboratorio Clínico/métodos , Infecciones por Coronavirus/sangre , Infecciones por Coronavirus/diagnóstico , Infecciones por Coronavirus/fisiopatología , Infecciones por Coronavirus/terapia , Resultado Fatal , Femenino , Humanos , Lactante , Recién Nacido de Bajo Peso , Recién Nacido , Enfermedades del Recién Nacido , Insuficiencia Multiorgánica/etiología , Insuficiencia Multiorgánica/terapia , Neumonía Viral/sangre , Neumonía Viral/fisiopatología , Neumonía Viral/terapia , Nacimiento Prematuro , Respiración Artificial/métodos , Resucitación/métodos , Factores de Riesgo , Choque/etiología , Choque/terapia , Síndrome de Respuesta Inflamatoria Sistémica/terapia , Síndrome de Respuesta Inflamatoria Sistémica/virología , Tomografía Computarizada por Rayos X/métodos
15.
Medicine (Baltimore) ; 99(33): e21709, 2020 Aug 14.
Artículo en Inglés | MEDLINE | ID: covidwho-740201

RESUMEN

BACKGROUND: The 2019 Coronavirus Disease (COVID-19) pandemic has threatened millions of people worldwide. Growing evidence suggests that the ABO blood type contributed to the susceptibility of COVID-19, but the results are controversial. The major objective of this systematic review and meta-analysis study is to investigate the impact of ABO blood group on COVID-19 pneumonia. METHODS: Two independent reviewers searches the databases of the China Biology Medicine disc, China National Knowledge Infrastructure, China Science and Technology Periodical Database, Wanfang Database, PubMed, Embase, and Web of Science from the date of conception to June 30, 2020. We will manually search for gray literature, such as meeting records and dissertations. Two independent reviewers will screen studies that meet the criteria, extract data, statistical data, and assess the risk of bias. The dichotomous variable will calculate the odds ratio and the corresponding 95% confidence interval. Heterogeneity between included studies will be assessed by heterogeneity χ tests and I index. The forest plots will be used to describe the pooled results. The Begg rank correlation test or Egger linear regression test will be performed to quantize the publication bias. DISCUSSION: This study will provide high-quality evidence to evaluate the contribution of the ABO blood group in COVID-19 pneumonia infection. PROSPERO REGISTRATION NUMBER: CRD42020195615.


Asunto(s)
Sistema del Grupo Sanguíneo ABO , Betacoronavirus , Infecciones por Coronavirus/sangre , Neumonía Viral/sangre , Infecciones por Coronavirus/virología , Susceptibilidad a Enfermedades/sangre , Susceptibilidad a Enfermedades/virología , Femenino , Humanos , Masculino , Metaanálisis como Asunto , Pandemias , Neumonía Viral/virología , Proyectos de Investigación , Factores de Riesgo , Revisiones Sistemáticas como Asunto
16.
Medicine (Baltimore) ; 99(35): e21700, 2020 Aug 28.
Artículo en Inglés | MEDLINE | ID: covidwho-740200

RESUMEN

The coronavirus disease 2019 (COVID-19) outbreak has become a global health threat and will likely be one of the greatest global challenges in the near future. The battle between clinicians and the COVID-19 outbreak may be a "protracted war."The objective of this study was to investigate the risk factors for in-hospital mortality in patients with COVID-19, so as to provide a reference for the early diagnosis and treatment.This study retrospectively enrolled 118 patients diagnosed with COVID-19, who were admitted to Eastern District of Renmin Hospital of Wuhan University from February 04, 2020 to March 04, 2020. The demographics and laboratory data were collected and compared between survivors and nonsurvivors. The risk factors of in-hospital mortality were explored by univariable and multivariable logistic regression to construct a clinical prediction model, the prediction efficiency of which was verified by receiver-operating characteristic (ROC) curve.A total of 118 patients (49 males and 69 females) were included in this study; the results revealed that the following factors associated with in-hospital mortality: older age (odds ratio [OR] 1.175, 95% confidence interval [CI] 1.073-1.287, P = .001), neutrophil count greater than 6.3 × 10 cells/L (OR 7.174, (95% CI 2.295-22.432, P = .001), lymphocytopenia (OR 0.069, 95% CI 0.007-0.722, P = .026), prothrombin time >13 seconds (OR 11.869, 95% CI 1.433-98.278, P = .022), D-dimer >1 mg/L (OR 22.811, 95% CI 2.224-233.910, P = .008) and procalcitonin (PCT) >0.1 ng/mL (OR 23.022, 95% CI 3.108-170.532, P = .002). The area under the ROC curve (AUC) of the above indicators for predicting in-hospital mortality were 0.808 (95% CI 0.715-0.901), 0.809 (95% CI 0.710-0.907), 0.811 (95% CI 0.724-0.898), 0.745 (95% CI 0.643-0.847), 0.872 (95% CI 0.804-0.940), 0.881 (95% CI 0.809-0.953), respectively. The AUC of combined diagnosis of these aforementioned factors were 0.992 (95% CI 0.981-1.000).In conclusion, older age, increased neutrophil count, prothrombin time, D-dimer, PCT, and decreased lymphocyte count at admission were risk factors associated with in-hospital mortality of COVID-19. The prediction model combined of these factors could improve the early identification of mortality risk in COVID-19 patients.


Asunto(s)
Infecciones por Coronavirus , Productos de Degradación de Fibrina-Fibrinógeno/análisis , Recuento de Leucocitos , Pandemias , Neumonía Viral , Polipéptido alfa Relacionado con Calcitonina/análisis , Tiempo de Protrombina , Adulto , Anciano , Betacoronavirus , China/epidemiología , Infecciones por Coronavirus/sangre , Infecciones por Coronavirus/inmunología , Infecciones por Coronavirus/mortalidad , Femenino , Mortalidad Hospitalaria , Hospitalización/estadística & datos numéricos , Humanos , Recuento de Leucocitos/métodos , Recuento de Leucocitos/estadística & datos numéricos , Masculino , Neumonía Viral/sangre , Neumonía Viral/inmunología , Neumonía Viral/mortalidad , Valor Predictivo de las Pruebas , Pronóstico , Tiempo de Protrombina/métodos , Tiempo de Protrombina/estadística & datos numéricos , Estudios Retrospectivos , Medición de Riesgo/métodos , Factores de Riesgo
17.
Ann Ital Chir ; 91: 235-238, 2020.
Artículo en Inglés | MEDLINE | ID: covidwho-739563

RESUMEN

The present pandemic caused by the SARS COV-2 coronavirus is still ongoing, although it is registered a slowdown in the spread for new cases. The main environmental route of transmission of SARS-CoV-2 is through droplets and fomites or surfaces, but there is a potential risk of virus spread also in smaller aerosols during various medical procedures causing airborne transmission. To date, no information is available on the risk of contagion from the peritoneal fluid with which surgeons can come into contact during the abdominal surgery on COVID-19 patients. We have investigated the presence of SARS-CoV-2 RNA in the peritoneal cavity of patients affected by COVID-19, intraoperatively and postoperatively. KEY WORDS: Covid-19, Laparotomy, Surgery.


Asunto(s)
Líquido Ascítico/virología , Betacoronavirus/aislamiento & purificación , Infecciones por Coronavirus/transmisión , Transmisión de Enfermedad Infecciosa de Paciente a Profesional/prevención & control , Perforación Intestinal/cirugía , Laparotomía , Pandemias , Neumonía Viral/transmisión , Enfermedades del Sigmoide/cirugía , Viremia/transmisión , Aerosoles , Anciano de 80 o más Años , Infecciones por Coronavirus/sangre , Infecciones por Coronavirus/complicaciones , Infecciones por Coronavirus/prevención & control , Estudios Transversales , Divertículo/complicaciones , Resultado Fatal , Femenino , Humanos , Perforación Intestinal/sangre , Perforación Intestinal/complicaciones , Perforación Intestinal/virología , Periodo Intraoperatorio , Nasofaringe/virología , Pandemias/prevención & control , Neumonía Viral/sangre , Neumonía Viral/complicaciones , Neumonía Viral/prevención & control , Periodo Posoperatorio , Estudios Prospectivos , ARN Viral/aislamiento & purificación , Riesgo , Suero/virología , Enfermedades del Sigmoide/sangre , Enfermedades del Sigmoide/complicaciones , Enfermedades del Sigmoide/virología , Viremia/virología
18.
BMJ Open ; 10(8): e040448, 2020 08 30.
Artículo en Inglés | MEDLINE | ID: covidwho-739117

RESUMEN

OBJECTIVE: To assess the impact of describing an antibody-positive test result using the terms Immunity and Passport or Certificate, alone or in combination, on perceived risk of becoming infected with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and protective behaviours. DESIGN: 2×3 experimental design. SETTING: Online. PARTICIPANTS: 1204 adults from a UK research panel. INTERVENTION: Participants were randomised to receive one of six descriptions of an antibody test and results showing SARS-CoV-2 antibodies, differing in the terms describing the type of test (Immunity vs Antibody) and the test result (Passport vs Certificate vs Test). MAIN OUTCOME MEASURES: Primary outcome: proportion of participants perceiving no risk of infection with SARS-CoV-2 given an antibody-positive test result. Other outcomes include: intended changes to frequency of hand washing and physical distancing. RESULTS: When using the term Immunity (vs Antibody), 19.1% of participants (95% CI 16.1% to 22.5%) (vs 9.8% (95% CI 7.5% to 12.4%)) perceived no risk of catching coronavirus given an antibody-positive test result (adjusted OR (AOR): 2.91 (95% CI 1.52 to 5.55)). Using the terms Passport or Certificate-as opposed to Test-had no significant effect (AOR: 1.24 (95% CI 0.62 to 2.48) and AOR: 0.96 (95% CI 0.47 to 1.99) respectively). There was no significant interaction between the effects of the test and result terminology. Across groups, perceiving no risk of infection was associated with an intention to wash hands less frequently (AOR: 2.32 (95% CI 1.25 to 4.28)); there was no significant association with intended avoidance of physical contact (AOR: 1.37 (95% CI 0.93 to 2.03)). CONCLUSIONS: Using the term Immunity (vs Antibody) to describe antibody tests for SARS-CoV-2 increases the proportion of people believing that an antibody-positive result means they have no risk of catching coronavirus in the future, a perception that may be associated with less frequent hand washing. TRIAL REGISTRATION NUMBER: Open Science Framework: https://osf.io/tjwz8/files/.


Asunto(s)
Anticuerpos Antivirales , Comunicación , Infecciones por Coronavirus , Conductas Relacionadas con la Salud , Conocimientos, Actitudes y Práctica en Salud , Inmunidad , Pandemias , Neumonía Viral , Adulto , Anticuerpos Antivirales/sangre , Betacoronavirus , Certificación , Infecciones por Coronavirus/sangre , Infecciones por Coronavirus/prevención & control , Infecciones por Coronavirus/virología , Revelación , Femenino , Humanos , Internet , Masculino , Oportunidad Relativa , Pandemias/prevención & control , Neumonía Viral/sangre , Neumonía Viral/prevención & control , Neumonía Viral/virología , Medición de Riesgo , Reino Unido
19.
J Diabetes Res ; 2020: 1652403, 2020.
Artículo en Inglés | MEDLINE | ID: covidwho-733124

RESUMEN

Background: Since December 2019, novel coronavirus- (SARS-CoV-2) infected pneumonia (COVID-19) has rapidly spread throughout China. This study is aimed at describing the characteristics of COVID-19 patients in Wuhan. Methods: 199 COVID-19 patients were admitted to Wuhan Red Cross Hospital in China from January 24th to March 15th. The cases were divided into diabetic and nondiabetic groups according to the history of taking antidiabetic drugs or by plasma fasting blood glucose level at admission, and the difference between groups were compared. Results: Among 199 COVID-19 patients, 76 were diabetic and 123 were nondiabetic. Compared with nondiabetics, patients with diabetes had an older age, high levels of fasting plasma glucose (FPG), D-dimer, white blood cell, blood urea nitrogen (BUN) and total bilirubin (TBIL), lower levels of lymphocyte, albumin and oxygen saturation (SaO2), and higher mortality (P < 0.05). The two groups showed no difference in clinical symptoms. Diabetes, higher level of D-dimer at admission, and lymphocyte count less than 0.6 × 109/L at admission were associated with increasing odds of death. Antidiabetic drugs were associated with decreasing odds of death. Treatment with low molecular weight heparin was not related to odds of death. Conclusion: The mortality rate of COVID-19 patients with diabetes was significantly higher than those without diabetes. Diabetes, higher level of D-dimer, and lymphocyte count less than 0.6 × 109/L at admission were the risk factors associated with in-hospital death.


Asunto(s)
Infecciones por Coronavirus/complicaciones , Infecciones por Coronavirus/mortalidad , Complicaciones de la Diabetes/mortalidad , Diabetes Mellitus/mortalidad , Neumonía Viral/complicaciones , Neumonía Viral/mortalidad , Anciano , Betacoronavirus/genética , Betacoronavirus/aislamiento & purificación , Estudios de Casos y Controles , China/epidemiología , Técnicas de Laboratorio Clínico/métodos , Comorbilidad , Infecciones por Coronavirus/sangre , Infecciones por Coronavirus/diagnóstico , Complicaciones de la Diabetes/sangre , Complicaciones de la Diabetes/tratamiento farmacológico , Complicaciones de la Diabetes/epidemiología , Diabetes Mellitus/sangre , Diabetes Mellitus/tratamiento farmacológico , Diabetes Mellitus/epidemiología , Femenino , Mortalidad Hospitalaria , Humanos , Hipoglucemiantes/uso terapéutico , Tiempo de Internación/estadística & datos numéricos , Masculino , Persona de Mediana Edad , Pandemias , Admisión del Paciente/estadística & datos numéricos , Neumonía Viral/sangre , Neumonía Viral/diagnóstico , ARN Viral/análisis , Estudios Retrospectivos , Factores de Riesgo
20.
Crit Care ; 24(1): 525, 2020 08 27.
Artículo en Inglés | MEDLINE | ID: covidwho-733030

RESUMEN

BACKGROUND: Coronavirus disease 2019 (COVID-19) is a newly emerging infectious disease and rapidly escalating epidemic caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). The pathogenesis of COVID-19 remains to be elucidated. We aimed to clarify correlation of systemic inflammation with disease severity and outcomes in COVID-19 patients. METHODS: In this retrospective study, baseline characteristics, laboratory findings, and treatments were compared among 317 laboratory-confirmed COVID-19 patients with moderate, severe, or critically ill form of the disease. Moreover, the longitudinal changes of serum cytokines, lactate dehydrogenase (LDH), high-sensitivity C-reactive protein (hsCRP), and hsCRP to lymphocyte count ratio (hsCRP/L) as well as their associations with disease severity and outcomes were investigated in 68 COVID-19 patients. RESULTS: Within 24 h of admission, the critically ill patients showed higher concentrations of inflammatory markers including serum soluble interleukin (IL)-2 receptor, IL-6, IL-8, IL-10, tumor necrosis factor alpha (TNF-α), ferritin, procalcitonin, LDH, hsCRP, and hsCRP/L than patients with severe or moderate disease. The severe cases displayed the similar response patterns when compared with moderate cases. The longitudinal assays showed the levels of pro-inflammatory cytokines, LDH, hsCRP, and hsCRP/L gradually declined within 10 days post admission in moderate, severe cases or those who survived. However, there was no significant reduction in cytokines, LDH, hsCRP, and hsCRP/L levels in critically ill or deceased patients throughout the course of illness. Compared with female patients, male cases showed higher serum concentrations of soluble IL-2R, IL-6, ferritin, procalcitonin, LDH, and hsCRP. Multivariate logistic regression analysis revealed that IL-6 > 50 pg/mL and LDH > 400 U/L on admission were independently associated with disease severity in patients with COVID-19. CONCLUSION: Exuberant inflammatory responses within 24 h of admission in patients with COVID-19 may correlate with disease severity. SARS-CoV-2 infection appears to elicit a sex-based differential immune response. IL-6 and LDH were independent predictive parameters for assessing the severity of COVID-19. An early decline of these inflammation markers may be associated with better outcomes.


Asunto(s)
Infecciones por Coronavirus/sangre , Infecciones por Coronavirus/terapia , Citocinas/sangre , Inflamación/sangre , Neumonía Viral/sangre , Neumonía Viral/terapia , Anciano , China/epidemiología , Infecciones por Coronavirus/epidemiología , Femenino , Humanos , Estudios Longitudinales , Masculino , Persona de Mediana Edad , Pandemias , Neumonía Viral/epidemiología , Estudios Retrospectivos , Factores de Riesgo , Índice de Severidad de la Enfermedad , Resultado del Tratamiento
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