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1.
Medicine (Baltimore) ; 99(29): e21334, 2020 Jul 17.
Artigo em Inglês | MEDLINE | ID: mdl-32702930

RESUMO

RATIONALE: The outbreak of coronavirus disease 2019 (COVID-19) in 2019 has become a global pandemic. It is not known whether the disease is associated with a higher risk of infection in pregnant women or whether intrauterine vertical transmission can occur. We report 2 cases of pregnant women diagnosed with COVID-19. PATIENT CONCERNS: In all of Yichang city from January 20, 2020, to April 9, 2020, only 2 pregnant women, who were in the late stage of pregnancy, were diagnosed with COVID-19; one patient was admitted for fever with limb asthenia, and the other patient was admitted for abnormal chest computed tomography results. DIAGNOSES: Both pregnant women were diagnosed with COVID-19. INTERVENTIONS: After the medical staff prepared for isolation and protection, the 2 pregnant women quickly underwent cesarean sections. A series of tests, such as laboratory, imaging, and SARS-CoV-2 nucleic acid examinations, were performed on the 2 women with COVID-19 and their newborns. OUTCOMES: One of the 2 infected pregnant women had severe COVID-19, and the other had mild disease. Both babies were delivered by cesarean section. Both of the women with COVID-19 worsened 3 to 6 days after delivery. Chest computed tomography suggested that the lesions due to SARS-CoV-2 infection increased. These women began to exhibit fever or reduced blood oxygen saturation again. One of the 2 newborns was born prematurely, and the other was born at full term. Neither infant was infected with COVID-19, but both had increased prothrombin time and fibrinogen, lactate dehydrogenase, phosphocreatine kinase, and creatine kinase isoenzyme contents. LESSONS: SARS-CoV-2 infection was not found in the newborns born to the 2 pregnant women with COVID-19, but transient coagulation dysfunction and myocardial damage occurred in the 2 newborns. Effective management strategies for pregnant women with COVID-19 will help to control the outbreak of COVID-19 among pregnant women.


Assuntos
Betacoronavirus/genética , Infecções por Coronavirus/diagnóstico , Infecções por Coronavirus/virologia , Pneumonia Viral/diagnóstico , Pneumonia Viral/virologia , Adulto , Astenia/etiologia , Betacoronavirus/isolamento & purificação , Cesárea/métodos , China/epidemiologia , Infecções por Coronavirus/tratamento farmacológico , Surtos de Doenças/prevenção & controle , Feminino , Febre/etiologia , Humanos , Recém-Nascido/sangue , Recém-Nascido/metabolismo , Transmissão Vertical de Doença Infecciosa/prevenção & controle , Pandemias , Pneumonia Viral/tratamento farmacológico , Gravidez , Complicações Infecciosas na Gravidez/epidemiologia , Complicações Infecciosas na Gravidez/virologia , Resultado da Gravidez/epidemiologia , Nascimento Prematuro/epidemiologia , Tórax/diagnóstico por imagem , Tomografia Computadorizada por Raios X/métodos
2.
Eur J Radiol ; 129: 109147, 2020 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-32623113

RESUMO

PURPOSE: To report the spectrum of chest computed tomographic (CT) imaging findings in coronavirus disease-19 (COVID-19) infected Indian patients. METHODS: This was a prospective descriptive study comprising 147 consecutive reverse transcriptase polymerase chain reaction (RT-PCR) positive patients who underwent CT chest. Prevalence, distribution, extent and type of abnormal lung findings were recorded. RESULTS: Among the total study cohort of 147 patients, 104 (70.7 %) were males and 43 (29.3 %) were females with mean age of 40.9 ±â€¯17.2 years (range 24-71 years). We observed lung parenchymal abnormalities in 51 (34.7 %) cases whereas 96 (65.3 %) RT-PCR positive cases had a normal chest CT. Only 12.2 % of the patients were dyspneic, 6.1 % had desaturation, 7.4 % had increased respiratory rate and 10.9 % had comorbidities. Among the patients with abnormal CT findings bilateral 39/51 (76.5 %), multilobar (88.2 %) lung involvement with a predominant peripheral and posterior distribution was commonly observed. With regards to the type of opacity, ground glass opacity (GGO) was the dominant abnormality found in all 51 (100 %) cases. Pure GGO was observed in 15 (29.4 %), GGO with crazy paving pattern was seen in 15 (29.4 %) and GGO mixed with consolidation was noted in 21(41.2 %). Peri-lesional or intralesional segmental or subsegmental pulmonary vessel enlargement was observed in 36 (70.6 %) cases. CONCLUSION: In this study population predominantly with mild symptoms and few comorbidities, two-thirds of RT-PCR positive patients had a normal chest CT; whereas the remaining patients showed typical findings of predominant GGOs with a bilateral distribution and peripheral predominance.


Assuntos
Betacoronavirus , Técnicas de Laboratório Clínico/métodos , Infecções por Coronavirus/diagnóstico por imagem , Pneumonia Viral/diagnóstico por imagem , Adulto , Idoso , Infecções por Coronavirus/diagnóstico , Dispneia/diagnóstico por imagem , Dispneia/virologia , Feminino , Humanos , Hipertrofia/diagnóstico por imagem , Hipertrofia/virologia , Índia , Pulmão/diagnóstico por imagem , Masculino , Pessoa de Meia-Idade , Pandemias , Estudos Prospectivos , Taquipneia/diagnóstico por imagem , Taquipneia/virologia , Tórax/diagnóstico por imagem , Tomografia Computadorizada por Raios X/métodos , Adulto Jovem
3.
Medicine (Baltimore) ; 99(27): e21129, 2020 Jul 02.
Artigo em Inglês | MEDLINE | ID: mdl-32629747

RESUMO

RATIONALE: The left internal jugular vein has a higher possibility of anatomical variation than the right side. Therefore, the complication risk during cannulation is expected to be higher. PATIENT CONCERNS: A 74-year-old woman was scheduled for elective surgery for left upper lobe wedge resection. We observed an anatomical abnormality at the location of the common carotid artery (CCA) and left internal jugular vein (IJV). DIAGNOSIS: During the ultrasound, the left IJV was detected at the medial side of the CCA, and this anatomical variation was confirmed by color Doppler ultrasonography. Enhanced chest computed tomography showed that the left CCA ran across the left IJV from medial to lateral at the level of the clavicle. INTERVENTION: A triple-lumen central venous catheter was inserted at the right IJV to avoid complications caused by the anatomical variation. OUTCOMES: There were no intraoperative or postoperative complications. LESSONS: Anesthesiologists should consider anatomical variation during central venous cannulation, especially with the left IJV approach. Because of anatomical variation, ultrasound-guided intervention is highly recommended to prevent procedure-related complications.


Assuntos
Cateterismo Venoso Central/métodos , Veias Jugulares/diagnóstico por imagem , Aspergilose Pulmonar/cirurgia , Ultrassonografia de Intervenção/métodos , Idoso , Variação Anatômica , Artéria Carótida Primitiva/diagnóstico por imagem , Feminino , Humanos , Veias Jugulares/anatomia & histologia , Aspergilose Pulmonar/diagnóstico por imagem , Aspergilose Pulmonar/patologia , Tórax/diagnóstico por imagem , Tomografia Computadorizada por Raios X/métodos , Resultado do Tratamento , Ultrassonografia Doppler em Cores/métodos
4.
Theranostics ; 10(14): 6372-6383, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32483458

RESUMO

Background: The risk factors for adverse events of Coronavirus Disease-19 (COVID-19) have not been well described. We aimed to explore the predictive value of clinical, laboratory and CT imaging characteristics on admission for short-term outcomes of COVID-19 patients. Methods: This multicenter, retrospective, observation study enrolled 703 laboratory-confirmed COVID-19 patients admitted to 16 tertiary hospitals from 8 provinces in China between January 10, 2020 and March 13, 2020. Demographic, clinical, laboratory data, CT imaging findings on admission and clinical outcomes were collected and compared. The primary endpoint was in-hospital death, the secondary endpoints were composite clinical adverse outcomes including in-hospital death, admission to intensive care unit (ICU) and requiring invasive mechanical ventilation support (IMV). Multivariable Cox regression, Kaplan-Meier plots and log-rank test were used to explore risk factors related to in-hospital death and in-hospital adverse outcomes. Results: Of 703 patients, 55 (8%) developed adverse outcomes (including 33 deceased), 648 (92%) discharged without any adverse outcome. Multivariable regression analysis showed risk factors associated with in-hospital death included ≥ 2 comorbidities (hazard ratio [HR], 6.734; 95% CI; 3.239-14.003, p < 0.001), leukocytosis (HR, 9.639; 95% CI, 4.572-20.321, p < 0.001), lymphopenia (HR, 4.579; 95% CI, 1.334-15.715, p = 0.016) and CT severity score > 14 (HR, 2.915; 95% CI, 1.376-6.177, p = 0.005) on admission, while older age (HR, 2.231; 95% CI, 1.124-4.427, p = 0.022), ≥ 2 comorbidities (HR, 4.778; 95% CI; 2.451-9.315, p < 0.001), leukocytosis (HR, 6.349; 95% CI; 3.330-12.108, p < 0.001), lymphopenia (HR, 3.014; 95% CI; 1.356-6.697, p = 0.007) and CT severity score > 14 (HR, 1.946; 95% CI; 1.095-3.459, p = 0.023) were associated with increased odds of composite adverse outcomes. Conclusion: The risk factors of older age, multiple comorbidities, leukocytosis, lymphopenia and higher CT severity score could help clinicians identify patients with potential adverse events.


Assuntos
Betacoronavirus , Infecções por Coronavirus/diagnóstico , Pneumonia Viral/diagnóstico , Adolescente , Adulto , Fatores Etários , Idoso , Idoso de 80 Anos ou mais , Criança , Pré-Escolar , China/epidemiologia , Comorbidade , Infecções por Coronavirus/epidemiologia , Infecções por Coronavirus/mortalidade , Feminino , Mortalidade Hospitalar , Humanos , Lactente , Estimativa de Kaplan-Meier , Masculino , Pessoa de Meia-Idade , Pandemias , Pneumonia Viral/epidemiologia , Pneumonia Viral/mortalidade , Prognóstico , Modelos de Riscos Proporcionais , Estudos Retrospectivos , Fatores de Risco , Nanomedicina Teranóstica , Tórax/diagnóstico por imagem , Tomografia Computadorizada por Raios X , Adulto Jovem
5.
Einstein (Sao Paulo) ; 18: eRW5741, 2020.
Artigo em Inglês, Português | MEDLINE | ID: mdl-32578687

RESUMO

The disease caused by the new coronavirus, or COVID-19, has been recently described and became a health issue worldwide. Its diagnosis of certainty is given by polymerase chain reaction. High-resolution computed tomography, however, is useful in the current context of pandemic, especially for the most severe cases, in assessing disease extent, possible differential diagnoses and searching complications. In patients with suspected clinical symptoms and typical imaging findings, in which there is still no laboratory test result, or polymerase chain reaction is not available, the role of this test is still discussed. In addition, it is important to note that part of the patients present false-negative laboratory tests, especially in initial cases, which can delay isolation, favoring the spread of the disease. Thus, knowledge about the COVID-19 and its imaging manifestations is extremely relevant for all physicians involved in the patient care, clinicians or radiologists.


Assuntos
Infecções por Coronavirus/diagnóstico por imagem , Pulmão/diagnóstico por imagem , Pneumonia Viral/diagnóstico por imagem , Tórax/diagnóstico por imagem , Tomografia Computadorizada por Raios X , Betacoronavirus , Diagnóstico Diferencial , Humanos , Linfadenopatia/diagnóstico por imagem , Pandemias , Derrame Pleural/diagnóstico por imagem
6.
Kyobu Geka ; 73(6): 437-440, 2020 Jun.
Artigo em Japonês | MEDLINE | ID: mdl-32475968

RESUMO

We report a case of right ventricular rupture caused by sternal bone fracture following chest compression at cardiopulmonary resuscitation (CPR). A 68-year-old man presented with syncope and was referred to our hospital in an ambulance. Ventricular fibrillation was confirmed by electrocardiography(ECG), and CPR was performed with chest compression. He was resuscitated and his ECG showed ST elevation. He immediately underwent percutaneous coronary intervention to the right coronary #1 which was subtotally occluded. Thereafter, massive cardiac tamponade was noted by echocardiography, and coronary injury or left ventricle( LV) rupture was suspected. Emergency exploratory surgery was performed through median sternotomy. Laceration of the right ventricle corresponding to the sternal bone fracture was found intraoperatively. We repaired the injury and he was discharged without complication. The possibility of iatrogenic cardiac tamponade should be considered when a resuscitated patient by chest compression develops hypotension.


Assuntos
Tamponamento Cardíaco , Reanimação Cardiopulmonar , Idoso , Traumatismos Cardíacos , Humanos , Masculino , Esterno , Tórax
7.
Biomed Res Int ; 2020: 6928368, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32596354

RESUMO

Objective: The COVID-19 pandemic and annual influenza epidemic are responsible for thousands of deaths globally. With a similarity in clinical as well as laboratory findings, there is a need to differentiate these two conditions on chest CT scan. This paper attempts to use existing literature to draw out differences in chest CT findings in COVID-19 and influenza. Methods: A search was conducted using PubMed. 17 original studies on chest CT findings in COVID-19 and influenza were identified for full-text review and data analysis. Findings. COVID-19 and influenza share similar chest CT findings. The differences found show that COVID-19 ground-glass opacities are usually peripherally located with the lower lobes being commonly involved, while influenza has a central, peripheral, or random distribution usually affecting the five lobes. Vascular engorgement, pleural thickening, and subpleural lines were reported in COVID-19 patients. In contrast, pneumomediastinum and pneumothorax were reported only in studies on influenza. Conclusion and Relevance. COVID-19 and influenza have overlapping chest CT features with few differences which can assist in telling apart the two pathologies. Additional studies are needed to further define the differences and degree between COVID-19 and influenza.


Assuntos
Betacoronavirus , Infecções por Coronavirus/diagnóstico por imagem , Influenza Humana/diagnóstico por imagem , Pneumonia Viral/diagnóstico por imagem , Tórax/diagnóstico por imagem , Adulto , Infecções por Coronavirus/epidemiologia , Diagnóstico Diferencial , Feminino , Humanos , Influenza Humana/epidemiologia , Pulmão/diagnóstico por imagem , Masculino , Pessoa de Meia-Idade , Pandemias , Pneumonia Viral/epidemiologia , Tomografia Computadorizada por Raios X
8.
Medicine (Baltimore) ; 99(23): e20599, 2020 Jun 05.
Artigo em Inglês | MEDLINE | ID: mdl-32502033

RESUMO

Pediatricians are unfamiliar with chronic granulomatous disease (CGD) because of its rarity and paucity of available data, potentially leading to misdiagnosis, late treatments, and mortality. The main purpose of this study was to summarize the clinical manifestations and auxiliary examination findings of four children with CGD confirmed by genetic testing.This was a case series study of children hospitalized at the Pediatric Respiratory Department of Shandong Provincial Hospital. The clinical, laboratory, treatment, and prognosis data were analyzed.All 4 children were boys. Two were brothers. The children's age was from 34 days to 3 years and 2 months at disease onset. The manifestations were repeated pulmonary infection, lymphadenitis, skin infection, and granuloma formation. Pulmonary infections were common. Abnormal responses were common after BCG vaccination. Thoracic computed tomography (CT) mainly showed nodules and masses, while the consolidation area in CT images reduced slowly. No abnormalities in cellular immune functions and immunoglobulin were found. The disease in all four children was confirmed by genetic testing. Long-term antibiotics and anti-fungal drugs were needed to prevent bacterial and fungal infections.CGD should be considered in children with repeated severe bacterial and fungal infections. Abnormal responses after BCG vaccination and nodular or mass-shaped consolidation in thoracic CT images should hint toward CGD. Gene sequencing could provide molecular evidence for diagnosis. The treatments of CGD include the prevention and treatment of infections and complications. Immunologic reconstitution treatment is currently the only curative treatment for CGD.


Assuntos
Testes Genéticos/métodos , Doença Granulomatosa Crônica/fisiopatologia , Pré-Escolar , Progressão da Doença , Doença Granulomatosa Crônica/diagnóstico , Doença Granulomatosa Crônica/genética , Humanos , Lactente , Masculino , Tórax/diagnóstico por imagem , Tórax/patologia , Tomografia Computadorizada por Raios X
9.
PLoS One ; 15(6): e0235187, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32589673

RESUMO

COVID-19 is a worldwide epidemic, as announced by the World Health Organization (WHO) in March 2020. Machine learning (ML) methods can play vital roles in identifying COVID-19 patients by visually analyzing their chest x-ray images. In this paper, a new ML-method proposed to classify the chest x-ray images into two classes, COVID-19 patient or non-COVID-19 person. The features extracted from the chest x-ray images using new Fractional Multichannel Exponent Moments (FrMEMs). A parallel multi-core computational framework utilized to accelerate the computational process. Then, a modified Manta-Ray Foraging Optimization based on differential evolution used to select the most significant features. The proposed method evaluated using two COVID-19 x-ray datasets. The proposed method achieved accuracy rates of 96.09% and 98.09% for the first and second datasets, respectively.


Assuntos
Infecções por Coronavirus/diagnóstico por imagem , Aprendizado de Máquina , Pneumonia Viral/diagnóstico por imagem , Adulto , Idoso , Idoso de 80 Anos ou mais , Algoritmos , Betacoronavirus , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Pandemias , Radiografia Torácica , Tórax/diagnóstico por imagem , Raios X
10.
J Infect Public Health ; 13(6): 883-886, 2020 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-32505462

RESUMO

Information on SARS-CoV-2 asymptomatic infection and infectivity in children is limited. In this study, we aimed to report the epidemiological and clinical characteristics of a familial cluster infection including children with SARS-CoV-2. On February 1, 2020, two children(case 1 and case 2), an 8-year-old girl and a 9-year-old boy, were admitted to the isolation ward in Xiangyang Central Hospital, Hubei province, China, with the diagnosis of COVID-19. Before admission, they had been staying at home with their father and never contacted with any confirmed patients except their mother (case 3) who returned from Wuhan on January 22. Both case 1 and case 2 got mild symptoms. Case 3 did not develop any symptoms until February 6, 2020, with an asymptomatic period of 15 days. She was transferred to ICU and administered multiple treatment according to the disease progression and chest CT manifestations. Her nucleic acid test turned positive until Feb 21, 2020, 15 days after symptoms onset, 30 days after her return from Wuhan. Our data showed that patients with SARS-CoV-2 may have the ability to transmit during their asymptomatic period even with the negative of viral nucleic acid in pharyngeal swabs.


Assuntos
Infecções Assintomáticas , Infecções por Coronavirus/transmissão , Família , Pneumonia Viral/transmissão , Betacoronavirus , Criança , China , Infecções por Coronavirus/diagnóstico , Feminino , Humanos , Masculino , Mães , Pandemias , Pneumonia Viral/diagnóstico , Tórax/diagnóstico por imagem , Tórax/virologia
11.
Acad Radiol ; 27(7): 910-921, 2020 07.
Artigo em Inglês | MEDLINE | ID: mdl-32505599

RESUMO

RATIONALE AND OBJECTIVES: We aimed to assess the prevalence of significant computed tomographic(CT) manifestations and describe some notable features based on chest CT images, as well as the main clinical features of patients with coronavirus disease 2019(COVID-19). MATERIALS AND METHODS: A systematic literature search of PubMed, EMBASE, the Cochrane Library, and Web of Science was performed to identify studies assessing CT features, clinical, and laboratory results of COVID-19 patients. A single-arm meta-analysis was conducted to obtain the pooled prevalence and 95% confidence interval (95% CI). RESULTS: A total of 14 articles (including 1115 patients) based on chest CT images were retrieved. In the lesion patterns on chest CTs, we found that pure ground-glass opacities (GGO) (69%, 95% CI 58-80%), consolidation (47%, 35-60%) and "air bronchogram sign" (46%, 25-66%) were more common than the atypical lesion of "crazy-paving pattern" (15%, 8-22%). With regard to disease extent and involvement, 70% (95% CI 46-95%) of cases showed a location preference for the right lower lobe, 65% (58-73%) of patients presented with ≥3 lobes involvement, and meanwhile, 42% (32-53%) of patients had involvement of all five lobes, while 67% (55-78%) of patients showed a predominant peripheral distribution. An understanding of some important CT features might be helpful for medical surveillance and management. In terms of clinical features, muscle soreness (21%, 95% CI 15-26%) and diarrhea (7%, 4-10%) were minor symptoms compared to fever (80%, 74-87%) and cough (53%, 33-72%). CONCLUSION: Chest CT manifestations in patients with COVID-19, as well as its main clinical characteristics, might be helpful in disease evolution and management.


Assuntos
Betacoronavirus , Infecções por Coronavirus/diagnóstico por imagem , Pulmão/diagnóstico por imagem , Pneumonia Viral/diagnóstico por imagem , Tomografia Computadorizada por Raios X/métodos , Adulto , Biomarcadores/metabolismo , Broncografia/métodos , Proteína C-Reativa/metabolismo , Técnicas de Laboratório Clínico/métodos , Infecções por Coronavirus/diagnóstico , Infecções por Coronavirus/patologia , Tosse/virologia , Diarreia/virologia , Feminino , Febre/virologia , Humanos , Leucopenia/virologia , Pulmão/patologia , Pulmão/virologia , Linfopenia/virologia , Masculino , Pessoa de Meia-Idade , Mialgia/virologia , Pandemias , Pneumonia Viral/patologia , Reação em Cadeia da Polimerase Via Transcriptase Reversa , Tórax
12.
Medicine (Baltimore) ; 99(22): e20100, 2020 May 29.
Artigo em Inglês | MEDLINE | ID: mdl-32481376

RESUMO

To investigate the feasibility of single-port endoscopic mastectomy via the lateral chest approach in the treatment of Simon grade II gynecomastia.Data from 12 patients with grade II gynecomastia admitted from January 2017 to November 2018 were retrospectively analyzed, and related satisfaction surveys were conducted 6 months after the operation.All surgeries were successfully performed under single-port endoscopy, and no patients were converted to open surgery. There were no serious complications related to the surgery, and all the patients were satisfied with the postoperative appearance.The application of single-port endoscopy in the surgical treatment of grade II gynecomastia is safe and reliable.


Assuntos
Endoscopia/métodos , Ginecomastia/cirurgia , Mastectomia/métodos , Estudos de Viabilidade , Feminino , Humanos , Satisfação do Paciente , Estudos Retrospectivos , Tórax
13.
Theranostics ; 10(14): 6113-6121, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32483442

RESUMO

Rationale: To retrospectively analyze serial chest CT and clinical features in patients with coronavirus disease 2019 (COVID-19) for the assessment of temporal changes and to investigate how the changes differ in survivors and nonsurvivors. Methods: The consecutive records of 93 patients with confirmed COVID-19 who were admitted to Wuhan Union Hospital from January 10, 2020, to February 22, 2020, were retrospectively reviewed. A series of chest CT findings and clinical data were collected and analyzed. The serial chest CT scans were scored on a semiquantitative basis according to the extent of pulmonary abnormalities. Chest CT scores in different periods (0 - 5 days, 6 - 10 days, 11 - 15 days, 16 - 20 days, and > 20 days) since symptom onset were compared between survivors and nonsurvivors, and the temporal trend of the radiographic-clinical features was analyzed. Results: The final cohort consisted of 93 patients: 68 survivors and 25 nonsurvivors. Nonsurvivors were significantly older than survivors. For both survivors and nonsurvivors, the chest CT scores were not different in the first period (0 - 5 days) but diverged afterwards. The mortality rate of COVID-19 monotonously increased with chest CT scores, which positively correlated with the neutrophil-to-lymphocyte ratio, neutrophil percentage, D-dimer level, lactate dehydrogenase level and erythrocyte sedimentation rate, while negatively correlated with the lymphocyte percentage and lymphocyte count. Conclusions: Chest CT scores correlate well with risk factors for mortality over periods, thus they may be used as a prognostic indicator in COVID-19. While higher chest CT scores are associated with a higher mortality rate, CT images taken at least 6 days since symptom onset may contain more prognostic information than images taken at an earlier period.


Assuntos
Betacoronavirus , Infecções por Coronavirus/diagnóstico por imagem , Pneumonia Viral/diagnóstico por imagem , Adulto , Fatores Etários , Idoso , China/epidemiologia , Infecções por Coronavirus/sangue , Infecções por Coronavirus/mortalidade , Progressão da Doença , Feminino , Humanos , Contagem de Leucócitos , Contagem de Linfócitos , Masculino , Pessoa de Meia-Idade , Neutrófilos , Pandemias , Pneumonia Viral/sangue , Pneumonia Viral/mortalidade , Prognóstico , Estudos Retrospectivos , Fatores de Risco , Nanomedicina Teranóstica , Tórax/diagnóstico por imagem , Tomografia Computadorizada por Raios X
14.
Pediatr Infect Dis J ; 39(8): e195-e198, 2020 08.
Artigo em Inglês | MEDLINE | ID: mdl-32467457

RESUMO

We describe 5 children with severe SARS-CoV-2 infection, hemodynamic instability and suspected acute abdomen. This form of the disease has not been previously documented. Four of the cases were confirmed SARS-CoV-2 infection and 1 probable. All of them were previously healthy and needed a pediatric critical care unit admission. The respiratory symptoms were not dominant or were absent. Also, fever was observed. Laboratory testing revealed lymphopenia and high levels of C-reactive protein and procalcitonin with D-dimer, ferritin and interleukin-6 usually elevated. Respiratory support and inotropic support were almost always necessary. In all of them, deterioration occurred on the day of admission.


Assuntos
Abdome Agudo/fisiopatologia , Infecções por Coronavirus/fisiopatologia , Pneumonia Viral/fisiopatologia , Centros de Atenção Terciária , Abdome Agudo/complicações , Abdome Agudo/diagnóstico por imagem , Abdome Agudo/terapia , Adolescente , Betacoronavirus , Criança , Infecções por Coronavirus/complicações , Infecções por Coronavirus/diagnóstico por imagem , Infecções por Coronavirus/terapia , Tosse , Febre , Hospitalização , Humanos , Pandemias , Pneumonia Viral/complicações , Pneumonia Viral/diagnóstico por imagem , Pneumonia Viral/terapia , Pele/patologia , Espanha , Tórax/diagnóstico por imagem
15.
J Clin Virol ; 128: 104393, 2020 07.
Artigo em Inglês | MEDLINE | ID: mdl-32387968

RESUMO

BACKGROUND: We evaluated the clinical performance of an immunochromatographic (IC) IgM/IgG antibody assay for severe acute respiratory syndrome coronavirus 2 (SARS-CoV2) and chest computed tomography (CT) for the diagnosis of Coronavirus disease 2019 (COVID-19). METHODS: We examined 139 serum specimens collected from 112 patients with COVID-19 and 48 serum specimens collected from 48 non-COVID-19 patients. The presence of IgM/IgG antibody for SARS-COV2 was determined using the One Step Novel Coronavirus (COVID-19) IgM/IgG Antibody Test. Chest CT was performed in COVID-19 patients on admission. FINDINGS: Of the139 COVID-19 serum specimens, IgM was detected in 27.8 %, 48.0 %, and 95.8 % of the specimens collected within 1 week, 1-2 weeks, and >2 weeks after symptom onset and IgG was detected in 3.3 %, 8.0 %, and 62.5 %, respectively. Among the 48 non-COVID-19 serum specimens, 1 generated a false-positive result for IgM. Thirty-eight of the 112 COVID-19 patients were asymptomatic, of whom 15 were positive for IgM, and 74 were symptomatic, of whom 22 were positive for IgM and 7 were positive for IgG. The diagnostic sensitivity of CT scan alone and in combination with the IC assay was 57.9 % (22/38) and 68.4 % (26/38) for the asymptomatic patients and 74.3 % (55/74) and 82.4 % (61/74) for the symptomatic patients, respectively. CONCLUSION: The IC assay had low sensitivity during the early phase of infection, and thus IC assay alone is not recommended for initial diagnostic testing for COVID-19. If RT-qPCR is not available, the combination of chest CT and IC assay may be useful for diagnosing COVID-19.


Assuntos
Anticorpos Antivirais/sangue , Betacoronavirus/imunologia , Técnicas de Laboratório Clínico/métodos , Infecções por Coronavirus/diagnóstico , Imunoglobulina G/sangue , Imunoglobulina M/sangue , Pneumonia Viral/diagnóstico , Adulto , Idoso , Infecções por Coronavirus/diagnóstico por imagem , Infecções por Coronavirus/virologia , Feminino , Humanos , Imunoensaio/métodos , Japão , Masculino , Pessoa de Meia-Idade , Pandemias , Pneumonia Viral/diagnóstico por imagem , Pneumonia Viral/virologia , Sensibilidade e Especificidade , Tórax/diagnóstico por imagem , Tomografia Computadorizada por Raios X/métodos
16.
J Clin Virol ; 128: 104396, 2020 07.
Artigo em Inglês | MEDLINE | ID: mdl-32438256

RESUMO

Since the outbreak of novel coronavirus disease 2019 (COVID-19), epidemic prevention strategies have been implemented worldwide. For the sake of controlling the infectious coronavirus pneumonia, early diagnosis and quarantine play an imperative role. Currently, the mainstream diagnostic methods are imaging and laboratory diagnosis, which differ in their efficacy of diagnosis. To compare the detection rate, we reviewed numerous literature on pneumonia caused by coronaviruses (SARS, MERS, and SARS-CoV-2) and analyzed two different ways of diagnosis. The results showed that the detection rate of computed tomography (CT) diagnosis was significantly higher than that of real-time quantitative polymerase chain reaction (qPCR) (P = 0.00697). Still, clinicians should combine radiology and laboratory methods to achieve a higher detection rate, so that instant isolation and treatment could be effectively conducted to curb the rampant spread of the epidemic.


Assuntos
Betacoronavirus/isolamento & purificação , Técnicas de Laboratório Clínico/métodos , Infecções por Coronavirus/diagnóstico , Coronavirus/isolamento & purificação , Pandemias/prevenção & controle , Pneumonia Viral/diagnóstico , Betacoronavirus/genética , Betacoronavirus/imunologia , Coronavirus/genética , Coronavirus/imunologia , Infecções por Coronavirus/epidemiologia , Infecções por Coronavirus/virologia , Humanos , Pneumonia Viral/epidemiologia , Pneumonia Viral/virologia , Radiografia , Reação em Cadeia da Polimerase em Tempo Real , Tórax/diagnóstico por imagem , Tomografia Computadorizada por Raios X
18.
BMC Pediatr ; 20(1): 227, 2020 05 18.
Artigo em Inglês | MEDLINE | ID: mdl-32423435

RESUMO

BACKGROUND: Recently, the World Health Organization has declared the coronavirus disease 2019 (COVID-19) outbreak a public health emergency of international concern. So far, however, limited data are available for children. Therefore, we aimed to investigate the clinical and chest CT imaging characteristics of COVID-19 in preschool children. METHODS: From January 26, 2020 to February 20, 2020, the clinical and initial chest CT imaging data of eight preschool children with laboratory-confirmed COVID-19 from two hospitals were retrospectively collected. The chest CT imaging characteristics, including the distribution, shape, and density of lesions, and the pleural effusion, pleural changes, and enlarged lymph nodes were evaluated. RESULTS: Two cases (25%) were classified as mild type, and they showed no obvious abnormal CT findings or minimal pleural thickening on the right side. Five cases (62.5%) were classified as moderate type. Among these patients, one case showed consolidation located in the subpleural region of the right upper lobe, with thickening in the adjacent pleura; one case showed multiple consolidation and ground-glass opacities with blurry margins; one case displayed bronchial pneumonia-like changes in the left upper lobe; and two cases displayed asthmatic bronchitis-like changes. One case (12.5%) was classified as critical type and showed bronchial pneumonia-like changes in the bilateral lungs, presenting blurred and messy bilateral lung markings and multiple patchy shadows scattered along the lung markings with blurry margins. CONCLUSIONS: The chest CT findings of COVID-19 in preschool children are atypical and various. Accurate diagnosis requires a comprehensive evaluation of epidemiological, clinical, laboratory and CT imaging data.


Assuntos
Técnicas de Laboratório Clínico/métodos , Infecções por Coronavirus/diagnóstico por imagem , Coronavirus , Pulmão/diagnóstico por imagem , Tomografia Computadorizada Multidetectores/métodos , Pneumonia Viral/diagnóstico por imagem , Betacoronavirus , Criança , Pré-Escolar , Infecções por Coronavirus/diagnóstico , Infecções por Coronavirus/epidemiologia , Surtos de Doenças/prevenção & controle , Feminino , Humanos , Masculino , Pandemias , Derrame Pleural , Pneumonia Viral/epidemiologia , Estudos Retrospectivos , Tórax
20.
Pancreatology ; 20(4): 665-667, 2020 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-32387082

RESUMO

BACKGROUND/OBJECTIVES: Abdominal pain is one of the known symptoms associated with coronavirus disease 2019. Little is known about the development of acute pancreatitis as a complication of severe acute respiratory syndrome coronavirus 2 infection. This case report describes the presentation of acute pancreatitis in two of three family members with severe COVID-19 infection. METHODS: Data were collected from three family members admitted with COVID-19 to the intensive care unit in March 2020. This study was reviewed and approved by the local data and ethics committee (31-1521-253). RESULTS: Two of the three family members were diagnosed with acute pancreatitis associated with SARS-CoV-2. Other causes of acute pancreatitis were excluded for both patients (including alcohol, biliary obstruction/gall stones, drugs, trauma, hypertriglyceridemia, hypercalcemia, and hypotension). CONCLUSIONS: These cases highlight acute pancreatitis as a complication associated with COVID-19 and underlines the importance of measuring pancreas-specific plasma amylase in patients with COVID-19 and abdominal pain.


Assuntos
Infecções por Coronavirus/complicações , Pancreatite/etiologia , Pneumonia Viral/complicações , Dor Abdominal/etiologia , Doença Aguda , Idoso , Amilases/sangue , Infecções por Coronavirus/sangue , Infecções por Coronavirus/diagnóstico por imagem , Cuidados Críticos , Evolução Fatal , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Pancreatite/sangue , Pancreatite/diagnóstico por imagem , Pandemias , Pneumonia Viral/sangue , Pneumonia Viral/diagnóstico por imagem , Radiografia , Tórax/diagnóstico por imagem , Ultrassonografia
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