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1.
Pediatric Dermatology ; 40(Supplement 1):24, 2023.
Artigo em Inglês | EMBASE | ID: covidwho-20245450

RESUMO

Background: Lichen planus (LP) is an inflammatory disorder believed to result from CD8+ cytotoxic T-cell (CTL) mediated autoimmune reactions against basal keratinocytes. We present a review of LP following COVID-19 infection and vaccination. Method(s): Literature searches were conducted on PubMed and Google Scholar from 2019 to 7/2022. 35 articles were selected based on subject relevance, and references within articles were also screened. Result(s): 39 cases of post-vaccination LP and 6 cases of post-infection LP were found among case reports and case series. 150 cases of postvaccination LP and 12 cases of post-infection LP were found in retrospective and prospective studies. Conclusion(s): LP is a rare complication of COVID-19 infection and vaccination that may be mediated by overstimulation of T-cell responses and proinflammatory cytokine production. However, it does not represent a limitation against COVID-19 vaccination, and the benefits of vaccination considerably outweigh the risks.

2.
Cell Reports Physical Science ; 4(1), 2023.
Artigo em Inglês | Scopus | ID: covidwho-2268911

RESUMO

Monitoring respiration is vital for personal diagnosis of chronic diseases. However, the existing respiratory sensors have severe limitations, such as single function, finite detection parameters, and lack of smart signal analysis. Here, we present an integrated wearable and low-cost smart respiratory monitoring sensor (RMS) system with artificial intelligence (AI)-assisted diagnosis of respiratory abnormality by detecting multi-parameters of human respiration. Coupling with intelligent analysis and data mining algorithms embedded in a phone app, the lighter system of 7.3 g can acquire real-time self-calibrated parameters, including breathing frequency, apnea hypopnea index (AHI), vital capacity (VC), peak expiratory flow (PEF), and other respiratory indexes with an accuracy >95.21%. The data can be wirelessly transferred to the user's data cloud terminal. The RMS system enables comprehensive multi-physiological parameters analysis for auxiliary diagnosing and classifying diseases, including sleep apnea, rhinitis, and chronic lung diseases, as well as rehabilitation of COVID-19, and exhibits advantages of portable healthcare. © 2022 The Authors

3.
Infectious Medicine ; 2023.
Artigo em Inglês | Scopus | ID: covidwho-2246699

RESUMO

Background: Global evidence on the transmission of asymptomatic SARS-CoV-2 infection needs to be synthesized. Methods: A search of 4 electronic databases (PubMed, EMBASE, Cochrane Library, and Web of Science databases) as of January 24, 2021 was performed. Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines were followed. Studies which reported the transmission rate among close contacts with asymptomatic SARS-CoV-2 cases were included, and transmission activities occurred were considered. The transmission rates were pooled by zero-inflated beta distribution. The risk ratios (RRs) were calculated using random-effects models. Results: Of 4923 records retrieved and reviewed, 15 studies including 3917 close contacts with asymptomatic indexes were eligible. The pooled transmission rates were 1.79 per 100 person-days (or 1.79%, 95% confidence interval [CI] 0.41%–3.16%) by asymptomatic index, which is significantly lower than by presymptomatic (5.02%, 95% CI 2.37%–7.66%;p<0.001), and by symptomatic (5.27%, 95% CI 2.40%–8.15%;p<0.001). Subgroup analyses showed that the household transmission rate of asymptomatic index was (4.22%, 95% CI 0.91%–7.52%), four times significantly higher than non-household transmission (1.03%, 95% CI 0.73%–1.33%;p=0.03), and the asymptomatic transmission rate in China (1.82%, 95% CI 0.11%–3.53%) was lower than in other countries (2.22%, 95% CI 0.67%–3.77%;p=0.01). Conclusions: People with asymptomatic SARS-CoV-2 infection are at risk of transmitting the virus to their close contacts, particularly in household settings. The transmission potential of asymptomatic infection is lower than symptomatic and presymptomatic infections. This meta-analysis provides evidence for predicting the epidemic trend and promulgating vaccination and other control measures. Registered with PROSPERO International Prospective Register of Systematic Reviews, CRD42021269446;https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=269446. © 2022 The Author(s)

4.
Australas J Dermatol ; 2022.
Artigo em Inglês | Web of Science | ID: covidwho-2161505

RESUMO

Stevens-Johnson Syndrome (SJS) is a rare but severe skin reaction characterized by blistering and peeling of the skin and ulcerations of mucous membranes;toxic epidermal necrolysis (TEN) is a subset of SJS characterized by the involvement of >30% of the skin. Though previously associated with drugs and infections, discussions on the association between TEN/SJS and COVID-19 have been limited. We present a review of TEN/SJS after COVID-19 infection and vaccination. Literature searches were conducted on PubMed and Google Scholar from 2019 to 8/2022. Thirty-eight articles were selected based on subject relevance, and references within selected articles were also screened for relevance. As of 8/2022, there have been 34 published cases of TEN, SJS, and SJS-TEN overlap after COVID-19 infection and vaccination, including 12 cases after vaccination and 22 cases after infection. Multiple authors hypothesize that virotopes or excipients in COVID-19 vaccines can activate T-cells or cytokines to induce TEN/SJS. Meanwhile, some hypothesize that COVID-19 infection induces immune activation that can trigger TEN/SJS or increase susceptibility to drug-induced TEN/SJS. Treatments for post-infection and post-vaccination TEN/SJS vary significantly. We recommend remaining vigilant for this rare and severe potential complication.

5.
Emergency and Critical Care Medicine ; 1(1):29-36, 2021.
Artigo em Inglês | Scopus | ID: covidwho-2097480

RESUMO

Background: This study aimed to investigate the clinical characteristics of 21 deaths and evaluate potential factors affecting disease severity and mortality risk in patients with coronavirus disease (COVID-19). Methods: This retrospective analysis assessed clinical data of 21 patients who died owing to COVID-19. Disease severity and mortality risk were assessed using Acute Physiology and Chronic Health Evaluation II (APACHE II);Sepsis-related Organ Failure Assessment (SOFA);multilobular infiltration, hypo-lymphocytosis, bacterial coinfection, smoking history, hypertension and age (MuLBSTA);and pneumonia severity index (PSI) scores. Results: The mean age of the patients was 66 ± 14 years and 15 (71.4%) patients were men. Sixteen (76.2%) patients had chronic medical illnesses. Twelve (57.1%) patients were overweight. Decreased lymphocyte proportions were observed in 17 (81.0%) patients on admission. Elevated D-dimer levels were observed in 11 (52.4%) patients, and the levels significantly increased when pneumonia deteriorated. The initial APACHE II and SOFA scores demonstrated that 18 (85.7%) and 13 (61.9%) patients, respectively, were in the middle-risk level. MuLBSTA and PSI scores after admission were associated with higher risks of mortality in 13 (61.9%) patients. Most patients developed organ failure and subsequently died. Conclusions: Older, overweight, male patients with a history of chronic illnesses and continuously decreased lymphocyte proportions and increased D-dimer levels might have higher risks of death owing to COVID-19. The combination of general scoring (SOFA) and pneumonia-specific scoring (MuLBSTA and PSI) systems after admission might be sensitive in assessing the mortality risk of patients with COVID-19 who are in critical condition. Copyright © 2021 Shandong University, published by Wolters Kluwer, Inc.

6.
Facets ; 7:1199-1213, 2022.
Artigo em Inglês | Web of Science | ID: covidwho-2042873

RESUMO

Atypical disease presentations are common in older adults with COVID-19. The objective of this study was to determine the prevalence of atypical and typical symptoms in older adults with COVID-19 through progressive pandemic waves and the association of these symptoms with in -hospital mortality. This retrospective cohort study included consecutive adults aged over 65 years with confirmed COVID-19 infection who were admitted to seven hospitals in Toronto, Canada, from 1 March 2020 to 30 June 2021. The median age for the 1786 patients was 78.0 years and 847 (47.5%) were female. Atypical symptoms (as defined by geriatric syndromes) occurred in 1187 patients (66.5%), but rarely occurred in the absence of other symptoms (n = 106;6.2%). The most common atypical symptoms were anorexia (n = 598;33.5%), weakness (n = 519;2 3.9%), and delirium (n = 449;25.1%). Dyspnea (adjusted odds ratio [aOR] 2.05;95% confidence interval [CI] 1.62-2.62), tachycardia (aOR 1.87;95% CI 1.14-3.04), and delirium (aOR 1.52;95% CI 1.18-1.96) were inde-pendently associated with in-hospital mortality. In a cohort of older adults hospitalized with COVID-19 infection, atypical presentations frequently overlapped with typical symptoms. Further research should be directed at understanding the cause and clinical significance of atypical presenta-tions in older adults.

7.
Social Responsibility Journal ; 2022.
Artigo em Inglês | Scopus | ID: covidwho-1992561

RESUMO

Purpose: This study aims to examine the corporate donations in response to the intensive outbreak of the COVID-19 pandemic in China in 2020 and proposes that the local spread of COVID-19 is negatively associated with corporate donations due to the non-trivial costs, but meanwhile, strong institutional pressures based on institutional theory are put on firms to donate, which thus creates a dilemma for firms. This study further argues that the dilemma is heterogeneous across different institutional fields. Design/methodology/approach: Using a sample of Chinese listed companies during the intensive outbreak of this pandemic, a two-stage Heckman selection model is conducted to address the potential sample selection bias. Findings: This study reveals a negative relationship between the local spread of COVID-19 and corporate donations, confirms the driving effect of various types of institutional pressure and finds that the intensity of the COVID-19 pandemic strengthens the effect of coercive pressure and mimetic pressure on philanthropic giving but weakens the effect of normative pressure. Originality/value: This study extends the knowledge on firms’ philanthropic response to natural crises, as the COVID-19 pandemic has not only led to a public health crisis but also to a global economic crisis, and how the effects of institutional pressures are affected by a situational crisis. This work enriches the literature on corporate philanthropy and crisis management and has some implications for both policymakers and business practitioners. © 2022, Emerald Publishing Limited.

8.
Journal of the International Aids Society ; 25:21-21, 2022.
Artigo em Inglês | Web of Science | ID: covidwho-1981300
9.
Topics in Antiviral Medicine ; 30(1 SUPPL):381, 2022.
Artigo em Inglês | EMBASE | ID: covidwho-1881032

RESUMO

Background: China implemented strict lockdowns to contain COVID-19 at the early stage. We aimed to evaluate the impact of COVID-19 on HIV care continuum in China. Methods: Anonymized programmatic data on HIV care continuum between 1 January 2017 and 31 December 2020 were collected from seven provincial and municipal centers for disease control and prevention and eight major infectious disease hospitals specialized in HIV care in various regions in China. We performed interrupted time series analysis to characterize temporal trend in monthly numbers of HIV tests, HIV diagnosis, HIV antiretroviral therapy (ART) initiations, ART collections, and HIV post-exposure prophylaxis (PEP) prescriptions before, during and after the national lockdown period (23 January to 7 April 2020). We used Poisson segmented regression models to estimate the immediate impact of the lockdown on these outcomes, as well as post-lockdown trends. Results: During the study period, we recorded 1,101,686 HIV tests, 69,659 HIV diagnoses, 63,458 ART initiations, 1,593,490 ART collections, and 16,780 PEP prescriptions. A median of 789 (IQR 367-975), 409 (278-626), and 1045 (524-1262) HIV tests per day were recorded before, during and after lockdown. Lockdown was associated with 32.8% decrease in HIV testing in January 2020, the first month after lockdown (incidence rate ratio [IRR] 0.672;95% confidence interval [CI] 0.585-0.772). Daily HIV diagnoses decreased from a median of 50 (7-76) before lockdown, to 23 (6-46) during lockdown, and back to 48 (12-74) after lockdown, with an estimated 27.1% decrease in January 2020 (0.729, 0.599-0.887). There was no marked change in the number of ART initiation and ART collection during the lockdown, but the number of ART collection was lower than the expected level by the end of December 2020 (0.761, 0.659-0.879). The number of monthly PEP prescriptions decreased significantly during the lockdown (0.362, 0.220-0.595) and still had not recovered to the expected level by the end of December 2020 (0.456, 0.362-0.574). With the ease of restrictions, HIV testing (slope change 1.067/month, 1.048-1.086) and PEP prescriptions (1.077/month, 1.016-1.142) showed a significant increasing trend. Conclusion: ART initiation and ART collection generally remained stable during the lockdown, but HIV testing, HIV diagnosis and PEP prescription were affected. ART collection and PEP prescriptions have not recovered to expected levels in the eighth month after the suspension of lockdown.

10.
Topics in Antiviral Medicine ; 30(1 SUPPL):378, 2022.
Artigo em Inglês | EMBASE | ID: covidwho-1880919

RESUMO

Background: Travel restrictions during the COVID-19 epidemic in China have impacted on the daily life and antiretroviral therapy (ART) of people living with HIV, including men who have sex with men (MSM). As China enters a state of routine COVID-19 prevention and control, it is necessary to understand the conditions of ART interruption (ATI) among HIV-infected MSM during and after the lockdown period (23 January to 7 April 2020) to summarize experience on HIV treatment. Methods: A nationwide cross-sectional online survey was conducted among HIV-infected MSM in China in February 2021, using convenience sampling on the WeChat platform called Li Hui Shi Kong. We collected information during and around lockdown period, including socio-demographics, health behaviors such as physical exercise and alcohol drinking, ART maintenance, CD4 and viral load testing. Pearson's Chi-squared test was performed to compare those characteristics between participants who experienced ATI during the lockdown period and did not. Logistic regression analysis was conducted to assess the correlates of ATI. Results: A total of 1296 participants were included in the analysis. The median age was 29.3 years (interquartile range [IQR] 25.2-34.0). 40.9% (n=530) of them did not exercise regularly in the second half of 2019 and 62.3% (n=808) had alcohol drinking. During the lockdown period, 6.8% (n=88) reported ATI experience, and 49.5% (n=629) performed CD4 cell test. Among the participants who took the last CD4 test after the lockdown, more people had not experienced ATI (66.8%) compared to those had experienced ATI (38.6%). HIV-infected MSM using other ART regimen as temporary substitution were more unlikely to experience ATI, including free ART (adjusted odds ratio [aOR] 0.05, 95% confidence interval [CI] 0.02-0.11) and out-of-pocket ART (aOR 0.11, 95% CI 0.01-0.89), which is different from their previous prescription. Conclusion: COVID-restrictions did not result in significantly negative effects on ART maintenance among HIV-infected MSM in China. In order to reduce the negative impact on HIV-infected MSM, attention should be paid to conducting health behavior education, maintaining ART service and encouraging CD4 and viral load testing during and after public emergencies.

11.
Journal of American Ethnic History ; 41(3):84-114, 2022.
Artigo em Inglês | Scopus | ID: covidwho-1847573

RESUMO

The Brian Ho lawsuit in the 1990s, brought about by several school children of Chinese descent in the San Francisco United School District against the school district, state defendants, and the San Francisco NAACP, signified a shift in the understanding of education equality that spotlighted divergent views, motivations, and actions concerning race-conscious education policies among Chinese San Franciscans. This article examines the intra-community dynamics and conflicts in Chinese San Franciscans' pursuit of education rights and racial equality in the 1980s and 1990s by reconstructing their various claims to education equality. These divergent yet analogous struggles for equal educational opportunities reflected varied racial attitudes and conceptions of Chinese American racial identity. What these disparate racial perceptions and identity conceptions embodied fundamentally was a range of arguments for racial inclusion and equality. The contrast and contradictions between these distinct views persisted, reemerging in Chinese Americans' continued apprehension of their racial identity in the wake of the renewed debate about racebased education policies that was juxtaposed with the rising racial hatred toward Asian Americans during the COVID-19 pandemic. © 2022 University of Illinois Press. All rights reserved.

12.
Huanjing Kexue/Environmental Science ; 43(5):2557-2565, 2022.
Artigo em Chinês | Scopus | ID: covidwho-1835958

RESUMO

To reveal the spatiotemporal distribution and risks of plastic additives in Taihu Lake during the COVID-19 pandemic, the occurrences of typical bisphenols, phthalate esters, and benzotriazoles in the surface water of Taihu Lake were investigated. The plastic additives in 19 sites in Taihu Lake were monitored in four seasons, and their potential ecological risks were evaluated. Diethylphthalate (DEP), dimethoxyethyl phthalate (DMEP), benzyl butyl phthalate (BBP), bisphenol A (BPA), and 2-(2H-benzotriazol-2-yl)-4, 6-di-tert-pentylphenol (UV-328) were detected, with detection rates of 100%, 97%, 58%, 98%, and 7%, respectively. During the COVID-19 pandemic, the sharply increasing usage of plastic products did not result in a significant increase in the plastic additives pollution in Taihu Lake. Conversely, the pollution of plastic additives showed a decreasing trend due to reduced human activities. There were significant seasonal differences in the concentrations of plastic additives in Taihu Lake. The average concentrations of plastic additives in spring and summer were 104.7 and 100.3 ng•L-1, respectively, which were higher than those in autumn (30.7 ng•L-1) and winter (29.9 ng•L-1). The plastic additive pollution also showed some differences in spatial distribution. The concentrations of plastic additives near the southwest coast of Taihu Lake were higher than those in other monitoring sites. The presence of plastic additives in Taihu Lake showed low risks to algae with the proportion of 30%. The risks in autumn and winter were higher than those in spring and summer. BPA and UV-328 may have been the main risk factors, which should be of concern. © 2022, Science Press. All right reserved.

13.
3rd IEEE International Conference on Circuits and Systems, ICCS 2021 ; : 59-63, 2021.
Artigo em Inglês | Scopus | ID: covidwho-1774639

RESUMO

The analysis of dielectric properties in Novel Coronavirus (COVID-19) has become an important research branch since the outbreak of the epidemic in 2019. In order to detect the dielectric properties of microfluidics like virus with higher sensitivity, a radio frequency sensor model is proposed in this paper. First, based on the excellent characteristics of the microstrip meander-line such as more concentrated electric field distribution, the microstrip meander-line is introduced into the design of traditional cancellation sensor, which is called the meander sensor. Then, the relationship between transmission coefficients of the system and dielectric properties of microfluidics is given in this paper. The simulation results verify the ultra-sensitivity of the meander sensor. Even though the relative permittivity of microfluidics is changed in the order of magnitude 10-2, the measurement results of the meander sensor also change significantly. However, the straight sensor can only measure changes of relative permittivity in the order of magnitude 10-1. What's more, there is a more concentrated measurement range for the meander sensor. This will be more practical for measuring weak changes of dielectric properties caused by the microfluidics itself and its interactions. © 2021 IEEE.

14.
IEEE/CVF International Conference on Computer Vision (ICCVW) ; : 1487-1491, 2021.
Artigo em Inglês | Web of Science | ID: covidwho-1705631

RESUMO

In order to effectively prevent the spread of COVID-19 virus, almost everyone wears a mask during coronavirus epidemic. This nearly makes conventional facial recognition technology ineffective in many scenarios, such as face authentication, security check, community visit check-in, etc. Therefore, it is very urgent to boost performance of existing face recognition systems on masked faces. Most current advanced face recognition approaches are based on deep learning, which heavily depends on a large number of training samples. However, there are presently no publicly available masked face recognition datasets. To this end, this work proposes three types of masked face datasets, including Masked Face Detection Dataset (MFDD), Real-world Masked Face Recognition Dataset (RMFRD) and Synthetic Masked Face Recognition Dataset (SMFRD). As far as we know, we are the first to publicly release large-scale masked face recognition datasets that can be downloaded for free at: https://github.com/X-zhangyany/Real-World-Masked-Face-Dataset.

15.
2nd International Symposium on Artificial Intelligence for Medicine Sciences, ISAIMS 2021 ; : 545-550, 2021.
Artigo em Inglês | Scopus | ID: covidwho-1613112

RESUMO

The outbreak of COVID-19 in 2020 has had a serious impact on society and drawn the attention of all sectors of society to major emergency public security incidents. So this study focused on the social distance which is one of the most effective methods to reduce the transmission rate of the epidemic to conduct research. In order to visually describe the effect of social distance obedience behavior, we use Anylogic to simulate the subway station with high pedestrian traffic in daily life and visualize the process and rate of transmission. Social distance was introduced as a primary variable, mask-wearing rate as a secondary variable, and the simulation set the movement trajectory of pedestrians and used the "controlled variable method"to analyze their effects on infection. The results show that both maintaining a social distance of more than 1.25 meters and wearing a mask rate of more than 70% can effectively inhibit the spread of the epidemic, and the combined effect of both is more effective in infection control. © 2021 ACM.

16.
Chinese Journal of Emergency Medicine ; 30(10):1220-1228, 2021.
Artigo em Chinês | Scopus | ID: covidwho-1576023

RESUMO

Objective To summarize the clinical characteristics of patients with coronavirus disease 2019 (COVID-19) infected with Delta variant, so as to provide further references for clinical diagnosis and treatment. Methods A real-world study was conducted to analyze the characteristics of 166 COVID-19 patients infected with Delta variant at Guangzhou Eighth People’s Hospital, Guangzhou Medical University. Results The study enrolled 5 asymptomatic cases, 123 non-severe cases (mild and moderate type), and 38 severe cases (severe and critical type). Among these patients, 69 (41.6%) were male and 97 (58.4%) were female, with a mean age of 47.0±23.5 years. Thirty-nine cases (23.5%) had received 1 or 2 doses of inactivated vaccine. The incidence of severe COVID-19 cases was 7.7% in 2-doses vaccinated patients, which was lower than that of 11.5% in 1-dose and 26.8% in unvaccinated patients. The proportion of severe cases in 2 dose-vaccinated patients was 7.7%, which was lower than that of 11.5% in 1-dose vaccinated patients and 26.8% in unvaccinated patients, but the difference was not significant (P>0.05). The most common clinical symptom was fever (134 cases, 83.2%), and 39.1% of cases presented with high-grade fever (≥ 39 °C);other symptoms were cough, sputum, fatigue, and xerostomia. The proportion of fever in severe cases was significantly higher than that of non-severe cases (97.4% vs. 76.4%, P<0.01). Similarly, the proportion of severe cases with high peak temperature (≥ 39 ℃) () was also higher than that of non-severe cases (65.8% vs. 30.9%, P<0.01). The median minimal Cycle threshold (Ct) values of viral nucleic acid N gene and ORFlab gene were 20.3 and 21.5, respectively, and the minimum Ct values were 11.9 and 13.5, respectively. Within 48 h of admission, 9.0% of cases presented with decreased white blood cell counts, and 52.4% with decreased lymphocyte counts. The proportions of increased C-reactive protein, serum amyloid A, interleukin 6, and interleukin 10 were 32.5%, 57.4%, 65.3%, and 35.7%, respectively. The proportions of elevated C-reactive protein, serum amyloid A and interleukin-6 in severe cases were significantly higher than those in non-severe cases (P<0.01). Logistic regression analysis showed that older age and higher peak temperature were associated with a higher likelihood of severe cases (OR>3, 95% CI: 2-7, P<0.01). In terms of treatment, traditional Chinese medicine (TCM) was used in 97.6% of non-severe cases and 100% in severe cases. Other treatments included respiratory and nutritional support, immunotherapy (such as neutralizing antibodies and plasma of recovered patients). The median times from admission to progression to severe cases, of fever clearance, and of nucleic acid conversion were 5 days, 6 days and 19 days, respectively. No deaths were reported within 28 days. Conclusions The symptoms of Delta variant infection in Guangzhou are characterized by a high proportion of fever, high peak temperature, long duration of fever, high viral load, a long time to nucleic acid conversion, and a high incidence of severe cases. The severe cases exhibit a higher percentage of elderly patients, a longer duration of fever and have a higher fever rate and a higher hyperthermia rate than non-severe cases. Age and hyperthermia are independent risk factors for progression to severe disease. The combination of TCM and Western medicine can control the progression of the disease effectively. © 2021 Chinese Medical Association. All rights reserved.

17.
21st ACM Internet Measurement Conference, IMC 2021 ; : 54-61, 2021.
Artigo em Inglês | Scopus | ID: covidwho-1526551

RESUMO

Public cloud platforms are vital in supporting online applications for remote learning and telecommuting during the COVID-19 pandemic. The network performance between cloud regions and access networks directly impacts application performance and users' quality of experience (QoE). However, the location and network connectivity of vantage points often limits the visibility of edge-based measurement platforms (e.g., RIPE Atlas). We designed and implemented the CLoud-based Applications Speed Platform (CLASP) to measure performance to various networks from virtual machines in cloud regions with speed test servers that have been widely deployed on the Internet. In our five-month longitudinal measurements in Google Cloud Platform (GCP), we found that 30-70% of ISPs we measured showed severe throughput degradation from the peak throughput of the day. © 2021 ACM.

18.
Cardiovascular Innovations and Applications ; 5(3):183-192, 2021.
Artigo em Inglês | Web of Science | ID: covidwho-1154912

RESUMO

Objective: To explore the experience with and complications of extracorporeal membrane oxygenation (ECMO) combined with continuous renal replacement therapy (CRRT) for treatment of critically ill patients with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pneumonia. Methods: The data on critically ill COVID-19 patients who received ECMO/CRRT at Tongji Hospital, which is affiliated with Huazhong University of Science and Technology, in February and March 2020 were collected and analyzed. All three patients were male, and the mean age was 50.6 years (range 44-58 years). The indications for ECMO in critically ill SARS-CoV-2 pneumonia patients at our center were severe acute respiratory distress syndrome with Pao(2)/Fio(2) below 100 mmHg under an effective protective pulmonary ventilation strategy and inflammatory storm accompanied by acute kidney injury. One patient, with severe heart failure, was selected for venoarterial ECMO, and the other two patients were selected for venovenous ECMO. Results: In the three patients who received ECMO combined with bedside CRRT, the mean duration was 9.7 days (range 7-13 days). Four complications occurred during ECMO/CRRT, especially thrombocytopenia. Laboratory testing showed increased counts of leukocytes and lymphocytes and decreased levels of inflammatory factors. Lung CT was suggestive of significantly absorbed and reduced lesions and interstitial fibrosis. Conclusions: The survival rate of patients with cardiopulmonary failure treated with ECMO/CRRT in whom conventional treatment failed in this group was 100%, which indicates that combined treatment with ECMO and CRRT is an important treatment technique.

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