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1.
Psychiatr Danub ; 32(2): 266-272, 2020.
Artículo en Inglés | MEDLINE | ID: covidwho-2100757

RESUMEN

BACKGROUND: Occurrence of symptoms of fear and depression among general population during the outbreak of COVID-19 seems to present an emerging problem worldwide. The aim of this study was to examine levels of fear and depressive symptoms in association with COVID-19 outbreak and to assess other contributing factors in the population of Bosnia and Herzegovina. SUBJECTS AND METHODS: Link to an anonymous questionnaire, mainly based on The Fear of COVID-19 Scale (Ahorsu et al. 2020) and two-item and nine-item Patient Health Questionnaires (PHQs) (Maurer et al. 2018) (background information, fear assessment and information regarding depression) was distributed online to general population of Bosnia and Herzegovina. RESULTS: Out of 1201 respondents, 217 (18.0%) reported experiencing fear and 341 (28.4%) reported having symptoms of depression during COVID-19 outbreak. The mean age of the subjects was 30.57±11.26. Being older (OR=1.044; 95% CI 1.031-1.057; p<0.001) and having moderate to severe depressive symptoms (OR=1.093; 95% CI 1.067-1.120; p<0.001) were independent significant predictors for developing fear; living in rural environment (OR=0.551; 95% Cl 0.325-0.935; p=0.0027) significantly decreased the risk of developing fear; being female (OR=1.750; 95% CI 1.242-2.466; p=0.001), unemployed (OR=1.557; 95% CI 1.040-2.330; p=0.032) or student (OR=1.943; 95% CI 1.450-2.604; p<0.001) were independent significant predictors for developing moderate to severe depressive symptoms in association with COVID-19. Mann Whitney U-test showed that being older was statistically associated with fear (p<0.001) and being younger was statistically associated with depressive symptoms (p<0.001). CONCLUSIONS: In conclusion, based on our findings, fear and depressive symptoms in general population of Bosnia and Herzegovina during the outbreak of COVID-19 were present in 18.06% (fear) and 28.39% (depression) of subjects and it was statistically associated with age, gender, occupation, living environment and may present a secondary uprising problem connected to outbreak of COVID-19.


Asunto(s)
Ansiedad/epidemiología , Infecciones por Coronavirus/epidemiología , Infecciones por Coronavirus/psicología , Depresión/epidemiología , Miedo , Encuestas Epidemiológicas , Internet , Neumonía Viral/epidemiología , Neumonía Viral/psicología , Bosnia y Herzegovina/epidemiología , COVID-19 , Humanos , Pandemias
2.
Infect Control Hosp Epidemiol ; 41(9): 1011-1015, 2020 Sep.
Artículo en Inglés | MEDLINE | ID: covidwho-2096316

RESUMEN

OBJECTIVE: To determine whether ambient air pollutants and meteorological variables are associated with daily COVID-19 incidence. DESIGN: A retrospective cohort from January 25 to February 29, 2020. SETTING: Cities of Wuhan, Xiaogan, and Huanggang, China. PATIENTS: The COVID-19 cases detected each day. METHODS: We collected daily data of COVID-19 incidence, 8 ambient air pollutants (particulate matter of ≤2.5 µm [PM2.5], particulate matter ≤10 µm [PM10], sulfur dioxide [SO2], carbon monoxide [CO], nitrogen dioxide [NO2], and maximum 8-h moving average concentrations for ozone [O3-8h]) and 3 meteorological variables (temperature, relative humidity, and wind) in China's 3 worst COVID-19-stricken cities during the study period. The multivariate Poisson regression was performed to understand their correlation. RESULTS: Daily COVID-19 incidence was positively associated with PM2.5 and humidity in all cities. Specifically, the relative risk (RR) of PM2.5 for daily COVID-19 incidences were 1.036 (95% confidence interval [CI], 1.032-1.039) in Wuhan, 1.059 (95% CI, 1.046-1.072) in Xiaogan, and 1.144 (95% CI, 1.12-1.169) in Huanggang. The RR of humidity for daily COVID-19 incidence was consistently lower than that of PM2.5, and this difference ranged from 0.027 to 0.111. Moreover, PM10 and temperature also exhibited a notable correlation with daily COVID-19 incidence, but in a negative pattern The RR of PM10 for daily COVID-19 incidence ranged from 0.915 (95% CI, 0.896-0.934) to 0.961 (95% CI, 0.95-0.972, while that of temperature ranged from 0.738 (95% CI, 0.717-0.759) to 0.969 (95% CI, 0.966-0.973). CONCLUSIONS: Our data show that PM2.5 and humidity are substantially associated with an increased risk of COVID-19 and that PM10 and temperature are substantially associated with a decreased risk of COVID-19.


Asunto(s)
Contaminantes Atmosféricos/toxicidad , Contaminación del Aire/efectos adversos , Betacoronavirus , Infecciones por Coronavirus/epidemiología , Neumonía Viral/epidemiología , Tiempo (Meteorología) , Contaminantes Atmosféricos/análisis , Contaminación del Aire/análisis , Contaminación del Aire/estadística & datos numéricos , COVID-19 , China/epidemiología , Infecciones por Coronavirus/etiología , Humanos , Incidencia , Pandemias , Neumonía Viral/etiología , Distribución de Poisson , Estudios Retrospectivos , Factores de Riesgo , SARS-CoV-2
3.
J Am Heart Assoc ; 9(22): e017364, 2020 11 17.
Artículo en Inglés | MEDLINE | ID: covidwho-2064368

RESUMEN

Background Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) utilizes the angiotensin-converting enzyme-2 (ACE-2) receptor to enter human cells. Angiotensin-converting enzyme inhibitors (ACEI) and angiotensin II receptor antagonists (ARB) are associated with ACE-2 upregulation. We hypothesized that antecedent use of ACEI/ARB may be associated with mortality in coronavirus disease 2019 (COVID-19). Methods and Results We used the Coracle registry, which contains data of patients hospitalized with COVID-19 in 4 regions of Italy, and restricted analyses to those ≥50 years of age. The primary outcome was in-hospital mortality. Among these 781 patients, 133 (17.0%) used an ARB and 171 (21.9%) used an ACEI. While neither sex nor smoking status differed by user groups, patients on ACEI/ARB were older and more likely to have hypertension, diabetes mellitus, and congestive heart failure. The overall mortality rate was 15.1% (118/781) and increased with age (PTrend<0.0001). The crude odds ratios (ORs) for death for ACEI users and ARB users were 0.98, 95% CI, 0.60-1.60, P=0.9333, and 1.13, 95% CI, 0.67-1.91, P=0.6385, respectively. After adjusting for age, hypertension, diabetes mellitus, and congestive heart failure, antecedent ACEI administration was associated with reduced mortality (OR, 0.55; 95% CI, 0.31-0.98, P=0.0436); a similar, but weaker trend was observed for ARB administration (OR, 0.58; 95% CI, 0.32-1.07, P=0.0796). Conclusions In those aged ≥50 years hospitalized with COVID-19, antecedent use of ACEI was independently associated with reduced risk of inpatient death. Our findings suggest a protective role of renin-angiotensin-aldosterone system inhibition in patients with high cardiovascular risk affected by COVID-19.


Asunto(s)
Antagonistas de Receptores de Angiotensina/uso terapéutico , Inhibidores de la Enzima Convertidora de Angiotensina/uso terapéutico , COVID-19/terapia , Hospitalización , Factores de Edad , Anciano , Anciano de 80 o más Años , COVID-19/diagnóstico , COVID-19/mortalidad , Femenino , Mortalidad Hospitalaria , Humanos , Italia , Masculino , Persona de Mediana Edad , Factores Protectores , Sistema de Registros , Estudios Retrospectivos , Medición de Riesgo , Factores de Riesgo , Factores de Tiempo , Resultado del Tratamiento
4.
5.
Curr Psychol ; : 1-10, 2021 May 19.
Artículo en Inglés | MEDLINE | ID: covidwho-2035354

RESUMEN

The main goal of this study was to examine the psychometric properties of the COVID Stress Scales (CSS) in the Palestinian context and the factorial structure of the instrument. The CSS, a newly emerging internationally standardized measure of stress related to being exposed to or contracting COVID-19, was translated and validated for a Palestinian context to ensure that it can be used to measure COVID-19 stress. The sample of the study consisted of 860 Palestinian adults living in the West Bank of Palestine. Participants' age ranged from 20 to 48 years old (M = 34.7, SD =13.46). They were all recruited from online advertisements, e-mail campaigns, blogs, social media, and SMS campaigns. The CSS was found to be valid in the Arabic language within a Palestinian context. The confirmatory factor analysis yielded six factors: (1) Fears about the dangerousness of COVID-19, (2) fears about the personal social, and economic consequences of COVID-19, fears of disruption in the supply chain, fears of looting or rioting, (3) COVID-19-xenophobia, fears that foreigners are sources of COVID-19, (4) fears about sources of COVID-19-related contamination,(5) traumatic stress symptoms related to COVID-19, and (6) COVID-19-related checking which is consisting with the ordinal structure the scale. The CSS demonstrated a high level of validity and reliability in a Palestinian context and therefore can be considered for future studies as the COVID-19 pandemic persists. Further investigations using the Arabic Language of CSS may have far-reaching implications for measuring and combating the stress of COVID-19 at a personal and societal level for uniquely at-risk populations such as in the occupied territories of Palestine.

7.
MMWR Morb Mortal Wkly Rep ; 70(14): 519-522, 2021 04 09.
Artículo en Inglés | MEDLINE | ID: covidwho-1384037

RESUMEN

CDC's National Vital Statistics System (NVSS) collects and reports annual mortality statistics using data from U.S. death certificates. Because of the time needed to investigate certain causes of death and to process and review data, final annual mortality data for a given year are typically released 11 months after the end of the calendar year. Daily totals reported by CDC COVID-19 case surveillance are timely but can underestimate numbers of deaths because of incomplete or delayed reporting. As a result of improvements in timeliness and the pressing need for updated, quality data during the global COVID-19 pandemic, NVSS expanded provisional data releases to produce near real-time U.S. mortality data.* This report presents an overview of provisional U.S. mortality data for 2020, including the first ranking of leading causes of death. In 2020, approximately 3,358,814 deaths† occurred in the United States. From 2019 to 2020, the estimated age-adjusted death rate increased by 15.9%, from 715.2 to 828.7 deaths per 100,000 population. COVID-19 was reported as the underlying cause of death or a contributing cause of death for an estimated 377,883 (11.3%) of those deaths (91.5 deaths per 100,000). The highest age-adjusted death rates by age, race/ethnicity, and sex occurred among adults aged ≥85 years, non-Hispanic Black or African American (Black) and non-Hispanic American Indian or Alaska Native (AI/AN) persons, and males. COVID-19 death rates were highest among adults aged ≥85 years, AI/AN and Hispanic persons, and males. COVID-19 was the third leading cause of death in 2020, after heart disease and cancer. Provisional death estimates provide an early indication of shifts in mortality trends and can guide public health policies and interventions aimed at reducing numbers of deaths that are directly or indirectly associated with the COVID-19 pandemic.


Asunto(s)
COVID-19/mortalidad , Mortalidad/tendencias , Adolescente , Adulto , Anciano , Anciano de 80 o más Años , COVID-19/etnología , Causas de Muerte/tendencias , Niño , Preescolar , Femenino , Disparidades en el Estado de Salud , Humanos , Lactante , Masculino , Persona de Mediana Edad , Mortalidad/etnología , Estados Unidos/epidemiología , Estadísticas Vitales , Adulto Joven
8.
Clin Exp Rheumatol ; 39(3): 676-687, 2021.
Artículo en Inglés | MEDLINE | ID: covidwho-1970080

RESUMEN

Systemic autoimmune diseases (SAD) are a heterogeneous group of diseases with a common aetiopathogenic basis affecting all ages characterised by a systemic phenotypic expression with a wide range of severity and outcomes that often require immunosuppressive therapies, leaving patients at high risk of infection. Knowledge of the impact of COVID-19 in patients with SAD is limited because most are included in studies carried out in patients with autoimmune and rheumatic diseases (mainly inflammatory arthritis). Most studies supported an increased risk of SARS-Cov-2 infection in patients with AD and SAD. Although case-control studies reported no significant differences in the rate of poor outcomes between patients with and without AD, large population-based studies analysing baseline risk factors reported a 2-3 times higher rate of poor outcomes in patients with AD, especially in those with SAD. Individual risk factors associated with poor outcomes included gender male, older age, and underlying comorbidities and therapies (glucocorticoids, sulfasalazine, immunosuppressants and rituximab). Patients with SAD had less favourable COVID-19 outcomes than those with inflammatory arthritis, possibly due to a differentiated underlying therapeutic approach (glucocorticoids, immunosuppressants and B-cell depleting agents for most SAD, anti-cytokine therapies and JAK inhibitors for inflammatory arthritis). Despite the limited evidence, most studies suggest that patients with SAD have an increased risk of a worse evolution of SARS-CoV-2 infection, including a greater risk of hospitalisation/ICU admission and worse survival rates and, therefore, should be considered a high-risk group for COVID-19.


Asunto(s)
Enfermedades Autoinmunes , COVID-19 , Enfermedades Reumáticas , Anciano , Enfermedades Autoinmunes/diagnóstico , Enfermedades Autoinmunes/tratamiento farmacológico , Enfermedades Autoinmunes/epidemiología , Glucocorticoides/uso terapéutico , Humanos , Masculino , SARS-CoV-2
9.
Clin Exp Rheumatol ; 39(3): 639-647, 2021.
Artículo en Inglés | MEDLINE | ID: covidwho-1970074

RESUMEN

OBJECTIVES: Rheumatoid arthritis (RA) and spondyloarthritis (SpA) are the most common inflammatory rheumatic diseases (IRD). The aim of this study was to elucidate differences in the outcome of SARS-CoV-2 infection in RA- and SpA-patients. METHODS: Data from the German COVID-19 registry for IRD patients from 30th March to 16th November 2020 were analysed. 208 RA and SpA patients were included in the study, matched for gender and age. RESULTS: 104 SpA patients (40% patients with ankylosing spondylitis, 54% with psoriatic arthritis and 6% with enteropathic arthritis) were compared to 104 RA patients. For both groups, median age was 56 years. TNF-i treatment was reported in 45% of the SpA and in 19% of RA patients (p=0.001). Glucocorticoids were used in 13% of the SpA and in 40% of the RA patients (p=0.001). In both groups, the majority of the patients (97% SpA, 95% RA) recovered from COVID-19. Hospitalisation was needed in 16% of the SpA and in 30% of the RA patients (p=0.05), and oxygen treatment in 10% and 18% respectively (p=ns). Three versus six (p=ns) fatal courses were reported in the SpA versus the RA group. CONCLUSIONS: The study revealed that the hospitalisation rate during COVID-19 infection, but not the mortality, was significantly higher in RA as compared to SpA patients. This could be explained either by different treatment strategies or by different susceptibilities of the two diseases.


Asunto(s)
Artritis Psoriásica , Artritis Reumatoide , COVID-19 , Espondiloartritis , Artritis Reumatoide/diagnóstico , Artritis Reumatoide/tratamiento farmacológico , Artritis Reumatoide/epidemiología , Humanos , Persona de Mediana Edad , SARS-CoV-2 , Espondiloartritis/tratamiento farmacológico , Espondiloartritis/epidemiología
10.
Curr Opin Anaesthesiol ; 34(2): 187-198, 2021 Apr 01.
Artículo en Inglés | MEDLINE | ID: covidwho-1956585

RESUMEN

PURPOSE OF REVIEW: Hospitalizations for COVID-19 dramatically increase with age. This is likely because of increases in fragility across biological repair systems and a weakened immune system, including loss of the cardiorenal protective arm of the renin--angiotensin system (RAS), composed of angiotensin-converting enzyme-2 (ACE2)/angiotensin-(1--7) [Ang-(1--7)] and its actions through the Mas receptor. The purpose of this review is to explore how cardiac ACE2 changes with age, cardiac diseases, comorbid conditions and pharmaceutical regimens in order to shed light on a potential hormonal unbalance facilitating SARs-CoV-2 vulnerabilities in older adults. RECENT FINDINGS: Increased ACE2 gene expression has been reported in human hearts with myocardial infarction, cardiac remodeling and heart failure. We also found ACE2 mRNA in atrial appendage tissue from cardiac surgical patients to be positively associated with age, elevated by certain comorbid conditions (e.g. COPD and previous stroke) and increased in conjunction with patients' chronic use of antithrombotic agents and thiazide diuretics but not drugs that block the renin--angiotensin system. SUMMARY: Cardiac ACE2 may have bifunctional roles in COVID-19 as ACE2 not only mediates cellular susceptibility to SARS-CoV-2 infection but also protects the heart via the ACE2/Ang-(1--7) pathway. Linking tissue ACE2 from cardiac surgery patients to their comorbid conditions and medical regimens provides a unique latform to address the influence that altered expression of the ACE2/Ang-(1-7)/Mas receptor axis might have on SARs-CoV-2 vulnerability in older adults.


Asunto(s)
Apéndice Atrial , COVID-19 , Procedimientos Quirúrgicos Cardíacos , Anciano , Envejecimiento , Enzima Convertidora de Angiotensina 2 , Angiotensinas , Apéndice Atrial/cirugía , Humanos , SARS-CoV-2
11.
Lancet Respir Med ; 9(5): 533-544, 2021 05.
Artículo en Inglés | MEDLINE | ID: covidwho-1931217

RESUMEN

Cough is one of the most common presenting symptoms of COVID-19, along with fever and loss of taste and smell. Cough can persist for weeks or months after SARS-CoV-2 infection, often accompanied by chronic fatigue, cognitive impairment, dyspnoea, or pain-a collection of long-term effects referred to as the post-COVID syndrome or long COVID. We hypothesise that the pathways of neurotropism, neuroinflammation, and neuroimmunomodulation through the vagal sensory nerves, which are implicated in SARS-CoV-2 infection, lead to a cough hypersensitivity state. The post-COVID syndrome might also result from neuroinflammatory events in the brain. We highlight gaps in understanding of the mechanisms of acute and chronic COVID-19-associated cough and post-COVID syndrome, consider potential ways to reduce the effect of COVID-19 by controlling cough, and suggest future directions for research and clinical practice. Although neuromodulators such as gabapentin or opioids might be considered for acute and chronic COVID-19 cough, we discuss the possible mechanisms of COVID-19-associated cough and the promise of new anti-inflammatories or neuromodulators that might successfully target both the cough of COVID-19 and the post-COVID syndrome.


Asunto(s)
COVID-19/complicaciones , COVID-19/fisiopatología , Tos/etiología , Inflamación/etiología , Enfermedades del Sistema Nervioso/etiología , Neuroinmunomodulación , Tos/fisiopatología , Humanos , Inflamación/fisiopatología , Enfermedades del Sistema Nervioso/fisiopatología , SARS-CoV-2 , Síndrome
12.
JGH Open ; 4(6): 1102-1107, 2020 Dec.
Artículo en Inglés | MEDLINE | ID: covidwho-1898843

RESUMEN

Background and Aim: Hepatic steatosis (HS) is associated with diabetes, hypertension, and obesity, comorbidities recently related to COVID-19 severity. Here, we assessed if tomographic HS is also a risk factor for severe COVID-19 pneumonia. Methods: We included 213 patients with a positive real time polymerase chain reaction (RT-PCR) test and chest computed tomography (CT) from an out-hospital facility and a hospital. We obtained information on demographics; weight; height; smoking history; diabetes; hypertension; and cardiovascular, lung, and renal disease. Two radiologists scored the CO-RADs system (COVID-19 Reporting and Data System) (1 = normal, 2 = inconsistent, 3-4 = indeterminate, and 5 = typical findings) and the chest CT severity index (≥20 of 40 was considered severe disease). They evaluated the liver-to-spleen ratio (CTL/S) and defined tomographic steatosis as a CTL/S index ≤0.9. We used descriptive statistics, χ2 and t student tests, logistic regression, and reported odds ratio (OR) with 95% confidence interval (CI). Results: Of the patients, 61% were men, with a mean age of 51.2 years, 48.3% were CO-RADs 1 and 51.7% CO-RADs 2-5. Severe tomographic disease was present in 103 patients (48.4%), all CO-RADs 5. This group was older; mostly men; and with a higher prevalence of obesity, hypertension, diabetes, and HS (69.9 vs 29%). On multivariate analysis, age (OR 1.058, 95% CI 1.03-1.086, P < 0.0001), male gender (OR 1.9, 95% CI 1.03-3.8, P = 0.04), and HS (OR 4.9, 95% CI 2.4-9.7, P < 0.0001) remained associated. Conclusion: HS was independently associated with severe COVID pneumonia. The physiopathological explanation of this finding remains to be elucidated. CTL/S should be routinely measured in thoracic CT scans in patients with COVID-19 pneumonia.

13.
J Am Coll Emerg Physicians Open ; 1(6): 1354-1356, 2020 Dec.
Artículo en Inglés | MEDLINE | ID: covidwho-1898685

RESUMEN

SARS-CoV-2 is a novel strain of coronavirus that was first identified in Wuhan, China; it has since spread rapidly throughout the world. Most of the patients with COVID-19 present with respiratory symptoms, including cough, nasal symptoms, fever, and shortness of breath. However, several groups have reported that SARS-CoV-2 can infect the central nervous system via the olfactory bulb followed by spread throughout the brain and peripheral nervous system. This brief report illustrated a 78-year-old man who presented to the emergency department (ED) on March 22, 2020, with chief complaints of dizziness and unsteadiness while walking. He had no symptoms suggestive of COVID-19 on arrival. SARS-CoV-2 nasopharyngeal swab test performed at that time due to his atypical presentation and lymphocytopenia was positive for virus nucleic acids. The neurological symptoms associated with COVID-19 are frequently non-specific and may emerge several days before the respiratory symptoms; as such, identification of patients presenting with these subtle and seemingly unremarkable COVID-19 symptoms will be quite difficult. Added to this, numerous countries still limit testing for SARS-COV-2 to patients presenting with fever or respiratory symptoms. Frontline physicians should be aware of early, non-specific symptoms associated with SARS-CoV-2 infection.

14.
J Am Coll Emerg Physicians Open ; 1(4): 569-577, 2020 Aug.
Artículo en Inglés | MEDLINE | ID: covidwho-1898677

RESUMEN

Background: The SARS-CoV-2 (COVID-19) virus has wide community spread. The aim of this study was to describe patient characteristics and to identify factors associated with COVID-19 among emergency department (ED) patients under investigation for COVID-19 who were admitted to the hospital. Methods: This was a retrospective observational study from 8 EDs within a 9-hospital health system. Patients with COVID-19 testing around the time of hospital admission were included. The primary outcome measure was COVID-19 test result. Patient characteristics were described and a multivariable logistic regression model was used to identify factors associated with a positive COVID-19 test. Results: During the study period from March 1, 2020 to April 8, 2020, 2182 admitted patients had a test resulted for COVID-19. Of these patients, 786 (36%) had a positive test result. For COVID-19-positive patients, 63 (8.1%) died during hospitalization. COVID-19-positive patients had lower pulse oximetry (0.91 [95% confidence interval, CI], [0.88-0.94]), higher temperatures (1.36 [1.26-1.47]), and lower leukocyte counts than negative patients (0.78 [0.75-0.82]). Chronic lung disease (odds ratio [OR] 0.68, [0.52-0.90]) and histories of alcohol (0.64 [0.42-0.99]) or substance abuse (0.39 [0.25-0.62]) were less likely to be associated with a positive COVID-19 result. Conclusion: We observed a high percentage of positive results among an admitted ED cohort under investigation for COVID-19. Patient factors may be useful in early differentiation of patients with COVID-19 from similarly presenting respiratory illnesses although no single factor will serve this purpose.

16.
Clin Infect Dis ; 74(10): 1713-1721, 2022 05 30.
Artículo en Inglés | MEDLINE | ID: covidwho-1873862

RESUMEN

BACKGROUND: Patients hospitalized for coronavirus disease 2019 (COVID-19) may experience complications following hospitalization and require readmission. In this analysis, we estimated the rate and risk factors associated with COVID-19-related readmission and inpatient mortality. METHODS: In this retrospective cohort study, we used deidentified chargemaster data from 297 hospitals across 40 US states on patients hospitalized with COVID-19 from 15 February 2020 through 9 June 2020. Demographics, comorbidities, acute conditions, and clinical characteristics of first hospitalization are summarized. Multivariable logistic regression was used to measure risk factor associations with 30-day readmission and in-hospital mortality. RESULTS: Among 29 659 patients, 1070 (3.6%) were readmitted. Readmitted patients were more likely to have diabetes, hypertension, cardiovascular disease (CVD), or chronic kidney disease (CKD) vs those not readmitted (P < .0001) and to present on first admission with acute kidney injury (15.6% vs 9.2%), congestive heart failure (6.4% vs 2.4%), or cardiomyopathy (2.1% vs 0.8%) (P < .0001). Higher odds of readmission were observed in patients aged >60 vs 18-40 years (odds ratio [OR], 1.92; 95% confidence interval [CI], 1.48-2.50) and those admitted in the Northeast vs West (OR, 1.43; 95% CI, 1.14-1.79) or South (OR, 1.28; 95% CI, 1.11-1.49). Comorbidities including diabetes (OR, 1.34; 95% CI, 1.12-1.60), CVD (OR, 1.46; 95% CI, 1.23-1.72), CKD stage 1-5 (OR, 1.51; 95% CI, 1.25-1.81), and CKD stage 5 (OR, 2.27; 95% CI, 1.81-2.86) were associated with higher odds of readmission; 12.3% of readmitted patients died during second hospitalization. CONCLUSIONS: Among this large US population of patients hospitalized with COVID-19, readmission was associated with certain comorbidities and acute conditions during first hospitalization. These findings may inform strategies to mitigate risks of readmission due to COVID-19 complications.


Asunto(s)
COVID-19 , Enfermedades Cardiovasculares , Fallo Renal Crónico , COVID-19/epidemiología , COVID-19/terapia , Enfermedades Cardiovasculares/epidemiología , Hospitalización , Humanos , Readmisión del Paciente , Estudios Retrospectivos , Factores de Riesgo , Estados Unidos/epidemiología
17.
J Ayurveda Integr Med ; 13(1): 100413, 2022.
Artículo en Inglés | MEDLINE | ID: covidwho-1838953

RESUMEN

BACKGROUND: Outbreak of Corona Virus Disease in late 2019 (COVID-19) has become a pandemic global Public health emergency. Since there is no approved anti-viral drug or vaccine declared for the disease and investigating existing drugs against the COVID-19. OBJECTIVE: AYUSH-64 is an Ayurvedic formulation, developed and patented by Central Council of Research in Ayurvedic Sciences, India, has been in clinical use as anti-malarial, anti-inflammatory, anti-pyretic drug for few decades. Thus, the present study was undertaken to evaluate AYUSH-64 compounds available in this drug against Severe Acute Respiratory Syndrome-Corona Virus (SARS-CoV-2) Main Protease (Mpro; PDB ID: 6LU7) via in silico techniques. MATERIALS AND METHODS: Different molecular docking software's of Discovery studio and Auto Dock Vina were used for drugs from selected AYUSH-64 compounds against SARS-CoV-2. We also conducted 100 ns period of molecular dynamics simulations with Desmond and further MM/GBSA for the best complex of AYUSH-64 with Mpro of SARS-CoV-2. RESULTS: Among 36 compounds of four ingredients of AYUSH-64 screened, 35 observed to exhibits good binding energies than the published positive co-crystal compound of N3 pepetide. The best affinity and interactions of Akuammicine N-Oxide (from Alstonia scholaris) towards the Mpro with binding energy (AutoDock Vina) of -8.4 kcal/mol and Discovery studio of Libdock score of 147.92 kcal/mol. Further, molecular dynamics simulations with MM-GBSA were also performed for Mpro- Akuammicine N-Oxide docked complex to identify the stability, specific interaction between the enzyme and the ligand. Akuammicine N-Oxide is strongly formed h-bonds with crucial Mpro residues, Cys145, and His164. CONCLUSION: The results provide lead that, the presence of Mpro- Akuammicine N-Oxide with highest Mpro binding energy along with other 34 chemical compounds having similar activity as part of AYUSH-64 make it a suitable candidate for repurposing to management of COVID-19 by further validating through experimental, clinical studies.

18.
J Ayurveda Integr Med ; 13(1): 100380, 2022.
Artículo en Inglés | MEDLINE | ID: covidwho-1838951

RESUMEN

The world is facing a global crisis and health emergency of COVID-19. Understanding of COVID-19 pathophysiology in ayurvedic host centric framework is prerequisite for apt use of Ayurveda. This paper reviews COVID-19 pathophysiology, clinical presentations and prognosis in ayurvedic perspective. Concept of exogenous pathogenic diseases can be traced in fever, microbes, toxins, epidemics and seasonal regimens chapters of Ayurveda. Such exogenous diseases later manifest multi-system presentation according to involvement of different 'Dosha' and derangement of 'Agni'. The pathology of COVID-19 is primarily that of Sannipata Jwara (fever) with involvement of respiratory system. Secondary manifestations include coagulopathies, cardiovascular, neural, and renal complications. Gastrointestinal system is closely associated with respiratory mechanism in ayurvedic pathophysiological conceptualization of Srotas. Abnormal immune responses in COVID-19 are result of abnormalities of Tridosha, Rakta (blood) and Ojus (Vital nectar). The initial phase is Vata-Kapha dominant whereas later stage of aggravated immune response is Vata-Pitta dominant. Alveolar damage, coagulopathies indicate Rakta dhatu vitiation. With this integrative understanding of COVID-19, we propose novel strategies for therapeutics and prophylaxis. Measures for 'Conservation of Agni-bala', 'Attainment of Rakta- Pitta-Prana homeostasis and 'Protection of Tri-Marma i.e. vital organs' can be important Host based strategies for reduction in the mortality in COVID-19 and for better clinical outcomes. This host centric approach can make paradigm shift in management of this epidemic.

19.
Exp Physiol ; 107(7): 665-673, 2022 Jul.
Artículo en Inglés | MEDLINE | ID: covidwho-1807292

RESUMEN

NEW FINDINGS: What is the topic of this review? Lactate is considered an important substrate for mitochondria in the muscles, heart and brain during exercise and is the main gluconeogenetic precursor in the liver and kidneys. In this light, we review the (patho)physiology of lactate metabolism in sepsis and coronavirus disease 2019 (COVID-19). What advances does it highlight? Elevated blood lactate is strongly associated with mortality in septic patients. Lactate seems unrelated to tissue hypoxia but is likely to reflect mitochondrial dysfunction and high adrenergic stimulation. Patients with severe COVID-19 exhibit near-normal blood lactate, indicating preserved mitochondrial function, despite a systemic hyperinflammatory state similar to sepsis. ABSTRACT: In critically ill patients, elevated plasma lactate is often interpreted as a sign of organ hypoperfusion and/or tissue hypoxia. This view on lactate is likely to have been influenced by the pioneering exercise physiologists around 1920. August Krogh identified an oxygen deficit at the onset of exercise that was later related to an oxygen 'debt' and lactate accumulation by A. V. Hill. Lactate is considered to be the main gluconeogenetic precursor in the liver and kidneys during submaximal exercise, but hepatic elimination is attenuated by splanchnic vasoconstriction during high-intensity exercise, causing an exponential increase in blood lactate. With the development of stable isotope tracers, lactate has become established as an important energy source for muscle, brain and heart tissue, where it is used for mitochondrial respiration. Plasma lactate > 4 mM is strongly associated with mortality in septic shock, with no direct link between lactate release and tissue hypoxia. Herein, we provide evidence for mitochondrial dysfunction and adrenergic stimulation as explanations for the sepsis-induced hyperlactataemia. Despite profound hypoxaemia and intense work of breathing, patients with severe coronavirus disease 2019 (COVID-19) rarely exhibit hyperlactataemia (> 2.5 mM), while presenting a systemic hyperinflammatory state much like sepsis. However, lactate dehydrogenase, which controls the formation of lactate, is markedly elevated in plasma and strongly associated with mortality in severe COVID-19. We briefly review the potential mechanisms of the lactate dehydrogenase elevation in COVID-19 and its relationship to lactate metabolism based on mechanisms established in contracting skeletal muscle and the acute respiratory distress syndrome.


Asunto(s)
COVID-19 , Sepsis , Adrenérgicos/metabolismo , Humanos , Hipoxia , Lactato Deshidrogenasas/metabolismo , Ácido Láctico/metabolismo , Músculo Esquelético/metabolismo , Oxígeno/metabolismo , Sepsis/complicaciones , Sepsis/diagnóstico
20.
Psychol Res Behav Manag ; 13: 701-704, 2020.
Artículo en Inglés | MEDLINE | ID: covidwho-1793274

RESUMEN

BACKGROUND: Corona virus (COVID-19) is an outbreak of respiratory disease caused by a novel corona virus and declared to be a global health emergency and a pandemic by the World Health Organization (WHO) on March 11, 2020. Prevention strategies to control the transmission of the COVID-19 pandemic, such as closing of schools, refraining from gathering, and social distancing, have direct impacts on mental well-being. SARS-CoV-2 has a devastating psychological impact on the mental health status of the community and, particularly when associated with psychotic symptoms, it could affect the overall quality-of-life. The virus also has the potential to enter and infect the brain. As a result, psychosis symptoms could be an emerging phenomenon associated with the corona virus pandemic. The presence of psychotic symptoms may complicate the management options of patients with COVID-19. OBJECTIVE: The aim of this article review is to elaborate the relationships between COVID-19 and psychotic symptoms. METHODOLOGY: We independently searched different electronic databases, such as Google scholar, PubMed, Medline, CINAHL, EMBASE, PsychInfo, and other relevant sources published in English globally, by using the search terms "psychosis and COVID-19", "corona virus", "brief psychotic", "schizophrenia", "organic psychosis", "infectious disease", "mental illness", "pandemics", and "psychiatry" in various permutations and combinations. RESULTS: The results of the included studies revealed that patients with a novel corona virus had psychotic symptoms, including hallucination in different forms of modality, delusion, disorganized speech, and grossly disorganized or catatonic behaviors. The patients with COVID-19-related psychotic symptoms had responded with a short-term administration of the antipsychotic medication. CONCLUSION AND RECOMMENDATION: A corona virus-related psychosis has been identified in different nations, but it is difficult to conclude that a novel corona virus has been biologically related to psychosis or exacerbates psychotic symptoms. Therefore, to identify the causal relationships between COVID-19 and psychosis, the researchers should investigate the prospective study on the direct biological impacts of COVID-19 and psychosis, and the clinicians should pay attention for psychotic symptoms at the treatment center and isolation rooms in order to reduce the complication of a novel corona virus.

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