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1.
Bol Med Hosp Infant Mex ; 78(1): 18-23, 2021.
Artículo en Inglés | MEDLINE | ID: mdl-33661874

RESUMEN

Background: The SARS-CoV-2 virus may affect both adults and children. Although COVID-19 has a lower prevalence in infancy and has been described as mild, the clinical characteristics may vary, and there is a possibility of complications. The objectives of this study were to describe the clinical and epidemiological aspects of confirmed COVID-19 pediatric cases in the state of Sinaloa, Mexico, during the first 3 months of the pandemic, and children admitted with COVID-19 to a secondary hospital. Methods: This case series includes all patients with SARS-CoV-2 infection confirmed by PCR (polymerase chain reaction) test, identified in the state epidemiological surveillance system (SISVER) between March 1 and May 31, 2020. Confirmed patients admitted to the Sinaloa Pediatric Hospital (HPS) in the same period are also described. Results: Fifty-one children with SARS-CoV-2 were included, of which ten were admitted to the HPS. The median age was 10 years. The more frequent symptoms were fever (78%), cough (67%), and headache (57%). Most cases were mild or asymptomatic. Three patients with comorbidities died. Only four of ten patients identified in HPS were admitted with the diagnosis of possible COVID-19. Conclusions: SARS-CoV-2 infection in children was mostly mild or asymptomatic, and the clinical presentation varied. There is a possibility of complications, especially in children with comorbidities.


Asunto(s)
/epidemiología , Tos/epidemiología , Fiebre/epidemiología , Cefalea/epidemiología , Adolescente , Infecciones Asintomáticas/epidemiología , Niño , Preescolar , Tos/virología , Femenino , Fiebre/virología , Cefalea/virología , Hospitalización , Humanos , Lactante , Recién Nacido , Masculino , México , Reacción en Cadena de la Polimerasa , Índice de Severidad de la Enfermedad
2.
Medicine (Baltimore) ; 100(11): e24771, 2021 Mar 19.
Artículo en Inglés | MEDLINE | ID: mdl-33725944

RESUMEN

ABSTRACT: As an international tourist center, Hainan province includes both imported and local COVID-19 cases. This study aimed to investigate the clinical characteristics and outcomes of COVID-19 patients in Hainan, China.COVID-19 patients hospitalized in Hainan affiliated Hospital of Hainan Medical University in January to March 2020 were retrospectively assessed. Routine blood tests, blood gas analyses, and computed tomography imaging were performed within 24 hours. Virus nucleic acid was detected every other day. The patients were divided into local resident and traveler groups, and differences in clinical data as well as leukocyte, lymphocyte, and neutrophil levels were analyzed.A total of 70 patients aged 51.23 ±â€Š13.54 years were assessed, including 16 local residents and 54 travelers. Of these, 55 cases (78.6%) had fever, 47 (67.1%) had cough and sputum, and 9 (12.9%) had chest dyspnea; 60 and 10 cases were mild/common and severe/critical, respectively. Sex, basic diseases, smoking history and drinking history, Charlson Comorbidity Index, symptoms, time of onset to admission, clinical severity, white blood cell count, lymphocyte count, neutrophil count, oxygen inhalation, mechanical ventilation, glucocorticoid therapy, treatment, admission to ICU, hospital stay, and mortality were similar between the 2 groups.The warm and humid climate of Hainan does not seem to significantly affect patient features and outcomes from COVID-19. Unnecessary travel to tourist areas should be avoided.


Asunto(s)
/epidemiología , /terapia , Adulto , Anciano , China/epidemiología , Tos/epidemiología , Tos/virología , Femenino , Fiebre/epidemiología , Fiebre/virología , Hospitalización , Humanos , Masculino , Persona de Mediana Edad , Terapia por Inhalación de Oxígeno/métodos , Respiración Artificial/métodos , Estudios Retrospectivos , Índice de Severidad de la Enfermedad , Tomografía Computarizada por Rayos X , Viaje , Resultado del Tratamiento
3.
JAMA Netw Open ; 4(3): e211085, 2021 03 01.
Artículo en Inglés | MEDLINE | ID: mdl-33688964

RESUMEN

Importance: Solid estimates of the risk of developing symptoms and of progressing to critical disease in individuals infected with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) are key to interpreting coronavirus disease 2019 (COVID-19) dynamics, identifying the settings and the segments of the population where transmission is more likely to remain undetected, and defining effective control strategies. Objective: To estimate the association of age with the likelihood of developing symptoms and the association of age with the likelihood of progressing to critical illness after SARS-CoV-2 infection. Design, Setting, and Participants: This cohort study analyzed quarantined case contacts, identified between February 20 and April 16, 2020, in the Lombardy region of Italy. Contacts were monitored daily for symptoms and tested for SARS-CoV-2 infection, by either real-time reverse transcriptase-polymerase chain reaction using nasopharyngeal swabs or retrospectively via IgG serological assays. Close contacts of individuals with laboratory-confirmed COVID-19 were selected as those belonging to clusters (ie, groups of contacts associated with an index case) where all individuals were followed up for symptoms and tested for SARS-CoV-2 infection. Data were analyzed from February to June 2020. Exposure: Close contact with individuals with confirmed COVID-19 cases as identified by contact tracing operations. Main Outcomes and Measures: Age-specific estimates of the risk of developing respiratory symptoms or fever greater than or equal to 37.5 °C and of experiencing critical disease (defined as requiring intensive care or resulting in death) in SARS-CoV-2-infected case contacts. Results: In total, 5484 case contacts (median [interquartile range] age, 50 [30-61] years; 3086 female contacts [56.3%]) were analyzed, 2824 of whom (51.5%) tested positive for SARS-CoV-2 (median [interquartile range] age, 53 [34-64] years; 1604 female contacts [56.8%]). The proportion of infected persons who developed symptoms ranged from 18.1% (95% CI, 13.9%-22.9%) among participants younger than 20 years to 64.6% (95% CI, 56.6%-72.0%) for those aged 80 years or older. Most infected contacts (1948 of 2824 individuals [69.0%]) did not develop respiratory symptoms or fever greater than or equal to 37.5 °C. Only 26.1% (95% CI, 24.1%-28.2%) of infected individuals younger than 60 years developed respiratory symptoms or fever greater than or equal to 37.5 °C; among infected participants older than 60 years, 6.6% (95% CI, 5.1%-8.3%) developed critical disease. Female patients were 52.7% (95% CI, 24.4%-70.7%) less likely than male patients to develop critical disease after SARS-CoV-2 infection. Conclusions and Relevance: In this Italian cohort study of close contacts of patients with confirmed SARS-CoV-2 infection, more than one-half of individuals tested positive for the virus. However, most infected individuals did not develop respiratory symptoms or fever. The low proportion of children and young adults who developed symptoms highlights the possible challenges in readily identifying SARS-CoV-2 infections.


Asunto(s)
/fisiopatología , Portador Sano/epidemiología , Tos/epidemiología , Disnea/epidemiología , Fiebre/epidemiología , Adolescente , Adulto , Factores de Edad , Anciano , Anciano de 80 o más Años , /epidemiología , Dolor en el Pecho/epidemiología , Dolor en el Pecho/fisiopatología , Niño , Preescolar , Trazado de Contacto , Tos/fisiopatología , Enfermedad Crítica , Progresión de la Enfermedad , Disnea/fisiopatología , Femenino , Fiebre/fisiopatología , Humanos , Lactante , Recién Nacido , Italia/epidemiología , Masculino , Persona de Mediana Edad , Faringitis/epidemiología , Faringitis/fisiopatología , Cuarentena , Factores de Riesgo , Índice de Severidad de la Enfermedad , Taquipnea/epidemiología , Taquipnea/fisiopatología , Adulto Joven
4.
BMJ Open Respir Res ; 8(1)2021 03.
Artículo en Inglés | MEDLINE | ID: mdl-33664125

RESUMEN

BACKGROUND: Air pollution may affect the risk of respiratory infection, though research has focused on uncommon infections or infections in children. Whether ambient air pollutants increase the risk of common acute respiratory infections among adults is uncertain, yet this may help understand whether pollutants influence spread of pandemic respiratory infections like COVID-19. OBJECTIVE: To estimate the association between ambient air pollutant exposures and respiratory infections in adults. METHODS: During five study examinations over 12 years, 6536 participants in the multiethnic study of atherosclerosis (MESA) reported upper respiratory tract infections, bronchitis, pneumonia or febrile illness in the preceding 2 weeks. Using a validated spatiotemporal model, we estimated residential concentrations of ambient PM2.5, NOx and NO2 for the 2-6 weeks (short-term) and year (long-term) prior to each examination. RESULTS: In this population aged 44-84 years at baseline, 10%-32% of participants reported a recent respiratory infection, depending on month of examination and study region. PM2.5, NOx and NO2 concentrations over the prior 2-6 weeks were associated with increased reporting of recent respiratory infection, with risk ratios (95% CIs) of 1.04 (1.00 to 1.09), 1.15 (1.10 to 1.20) and 1.21 (1.10 to 1.33), respectively, per increase from 25th to 75th percentile in residential pollutant concentration. CONCLUSION: Higher short-term exposure to PM2.5 and traffic-related pollutants are associated with increased risk of symptomatic acute respiratory infections among adults. These findings may provide an insight into the epidemiology of COVID-19.


Asunto(s)
Contaminación del Aire/efectos adversos , Contaminación del Aire/estadística & datos numéricos , Aterosclerosis/etnología , Aterosclerosis/epidemiología , /epidemiología , Comparación Transcultural , Grupos Étnicos/estadística & datos numéricos , Infecciones del Sistema Respiratorio/etnología , Infecciones del Sistema Respiratorio/epidemiología , Enfermedad Aguda , Adulto , Anciano , Anciano de 80 o más Años , Bronquitis/epidemiología , Bronquitis/etnología , Correlación de Datos , Estudios Transversales , Femenino , Fiebre/epidemiología , Fiebre/etnología , Humanos , Masculino , Persona de Mediana Edad , Oportunidad Relativa , Neumonía/epidemiología , Neumonía/etnología , Riesgo , Análisis Espacio-Temporal , Estados Unidos
5.
PLoS Negl Trop Dis ; 15(3): e0009248, 2021 03.
Artículo en Inglés | MEDLINE | ID: mdl-33690662

RESUMEN

OBJECTIVES: In December 2019, coronavirus disease 2019 (COVID-19) emerged in Wuhan City and rapidly spread across the world. The clinical characteristics of affected patients in different regions and populations may differ. Thus, this study aimed to identify the characteristics of the disease to provide an insight about the prevention and treatment of COVID-19. METHODS: Data on the demographic characteristics and clinical findings of the patients admitted at the First Hospital of Changsha from January 1, 2020 to February 10, 2020 were assessed. RESULTS: In this study, there were 8 (3.8%) asymptomatic, 21 (10.0%) mild upper respiratory tract infection (URTI), and 180 (86.1%) pneumonia cases. In total, 47 (22.5%) patients resided in Wuhan, and 45 (21.5%) had recently traveled to Wuhan before disease onset. Moreover, 19 (9.1%) had contact with people from Wuhan, and 69 (33.0%) were family cluster cases. The median incubation period was approximately 6.3 (range: 1.0-20.0) days. Fever and cough were the most common initial symptoms: 99 (49.3%) patients presented with fever, without cough; 59 (29.4%) with cough, without fever; and 33 (16.4%) with both fever and cough. CONCLUSION: The symptoms of patients with COVID-19 were relatively mild outside Wuhan, and family cluster was a remarkable epidemic characteristic. Special attention should be paid to asymptomatic patients.


Asunto(s)
Enfermedades Asintomáticas/epidemiología , /epidemiología , Adolescente , Adulto , Anciano , Niño , China/epidemiología , Tos/diagnóstico , Tos/epidemiología , Tos/virología , Femenino , Fiebre/diagnóstico , Fiebre/epidemiología , Fiebre/virología , Humanos , Masculino , Persona de Mediana Edad , Estudios Retrospectivos , /aislamiento & purificación , Adulto Joven
6.
BMC Infect Dis ; 21(1): 186, 2021 Feb 18.
Artículo en Inglés | MEDLINE | ID: mdl-33602147

RESUMEN

BACKGROUND: Chikungunya fever (CHIKF) was first described in Tanzania in 1952. Several epidemics including East Africa have occurred, but there are no descriptions of longitudinal surveillance of endemic disease. Here, we estimate the incidence of CHIKF in coastal Kenya and describe the associated viral phylogeny. METHODS: We monitored acute febrile illnesses among 3500 children visiting two primary healthcare facilities in coastal Kenya over a 5-year period (2014-2018). Episodes were linked to a demographic surveillance system and blood samples obtained. Cross-sectional sampling in a community survey of a different group of 435 asymptomatic children in the same study location was done in 2016. Reverse-transcriptase PCR was used for chikungunya virus (CHIKV) screening, and viral genomes sequenced for phylogenetic analyses. RESULTS: We found CHIKF to be endemic in this setting, associated with 12.7% (95% CI 11.60, 13.80) of all febrile presentations to primary healthcare. The prevalence of CHIKV infections among asymptomatic children in the community survey was 0.7% (95% CI 0.22, 2.12). CHIKF incidence among children < 1 year of age was 1190 cases/100,000-person years and 63 cases/100,000-person years among children aged ≥10 years. Recurrent CHIKF episodes, associated with fever and viraemia, were observed among 19 of 170 children with multiple febrile episodes during the study period. All sequenced viral genomes mapped to the ECSA genotype albeit distinct from CHIKV strains associated with the 2004 East African epidemic. CONCLUSIONS: CHIKF may be a substantial public health burden in primary healthcare on the East African coast outside epidemic years, and recurrent infections are common.


Asunto(s)
Fiebre Chikungunya/epidemiología , Fiebre Chikungunya/virología , Adolescente , Fiebre Chikungunya/diagnóstico , Virus Chikungunya/clasificación , Virus Chikungunya/genética , Virus Chikungunya/aislamiento & purificación , Niño , Preescolar , Estudios Transversales , Femenino , Fiebre/diagnóstico , Fiebre/epidemiología , Fiebre/virología , Genotipo , Humanos , Incidencia , Lactante , Kenia/epidemiología , Masculino , Filogenia , Prevalencia , Estudios Prospectivos , Recurrencia
7.
PLoS One ; 16(2): e0246190, 2021.
Artículo en Inglés | MEDLINE | ID: mdl-33592019

RESUMEN

BACKGROUND AND OBJECTIVES: With the increase in the number of COVID-19 infections, the global health apparatus is facing insufficient resources. The main objective of the current study is to provide additional data regarding the clinical characteristics of the patients diagnosed with COVID-19, and in particular to analyze the factors associated with disease severity, lack of improvement, and mortality. METHODS: 102 studies were included in the present meta-analysis, all of which were published before September 24, 2020. The studies were found by searching a number of databases, including Scopus, MEDLINE, Web of Science, and Embase. We performed a thorough search from early February until September 24. The selected papers were evaluated and analyzed using Stata software application version 14. RESULTS: Ultimately, 102 papers were selected for this meta- analysis, covering 121,437 infected patients. The mean age of the patients was 58.42 years. The results indicate a prevalence of 79.26% for fever (95% CI: 74.98-83.26; I2 = 97.35%), 60.70% for cough (95% CI: 56.91-64.43; I2 = 94.98%), 33.21% for fatigue or myalgia (95% CI: 28.86-37.70; I2 = 96.12%), 31.30% for dyspnea (95% CI: 26.14-36.69; I2 = 97.67%), and 10.65% for diarrhea (95% CI: 8.26-13.27; I2 = 94.20%). The prevalence for the most common comorbidities was 28.30% for hypertension (95% CI: 23.66-33.18; I2 = 99.58%), 14.29% for diabetes (95% CI: 11.88-16.87; I2 = 99.10%), 12.30% for cardiovascular diseases (95% CI: 9.59-15.27; I2 = 99.33%), and 5.19% for chronic kidney disease (95% CI: 3.95-6.58; I2 = 96.42%). CONCLUSIONS: We evaluated the prevalence of some of the most important comorbidities in COVID-19 patients, indicating that some underlying disorders, including hypertension, diabetes, cardiovascular diseases, and chronic kidney disease, can be considered as risk factors for patients with COVID-19 infection. Furthermore, the results show that an elderly male with underlying diseases is more likely to have severe COVID-19.


Asunto(s)
/epidemiología , Enfermedades Cardiovasculares/epidemiología , Tos/epidemiología , Diabetes Mellitus/epidemiología , Diarrea/epidemiología , Fiebre/epidemiología , Insuficiencia Renal Crónica/epidemiología , Adulto , Anciano , Comorbilidad , Femenino , Humanos , Masculino , Persona de Mediana Edad , Mortalidad/tendencias
8.
Epidemiol Infect ; 149: e61, 2021 02 24.
Artículo en Inglés | MEDLINE | ID: mdl-33622421

RESUMEN

A fever clinic within a hospital plays a vital role in pandemic control because it serves as an outpost for pandemic discovery, monitoring and handling. As the outbreak of coronavirus disease 2019 (COVID-19) in Wuhan was gradually brought under control, the fever clinic in the West Campus of Wuhan Union Hospital introduced a new model for construction and management of temporary mobile isolation wards. A traditional battlefield hospital model was combined with pandemic control regulations, to build a complex of mobile isolation wards that used adaptive design and construction for medical operational, medical waste management and water drainage systems. The mobile isolation wards allowed for the sharing of medical resources with the fever clinic. This increased the capacity and efficiency of receiving, screening, triaging and isolation and observation of patients with fever. The innovative mobile isolation wards also controlled new sudden outbreaks of COVID-19. We document the adaptive design and construction model of the novel complex of mobile isolation wards and explain its characteristics, functions and use.


Asunto(s)
Fiebre/terapia , Modelos Organizacionales , Aislamiento de Pacientes/métodos , /complicaciones , China/epidemiología , Fiebre/epidemiología , Humanos , Control de Infecciones/instrumentación , Control de Infecciones/métodos , Aislamiento de Pacientes/tendencias
9.
PLoS One ; 16(2): e0246793, 2021.
Artículo en Inglés | MEDLINE | ID: mdl-33571300

RESUMEN

BACKGROUND: There is limited evidence on the clinical characteristics of SARS-CoV-2 infection in Latin America. We present findings from a nationwide study in Argentina. RESEARCH QUESTION: What is disease severity measures and risk factors are associated with admission to an intensive care unit and mortality? STUDY DESIGN AND METHODS: Data were extracted from the COVID-19 database of the Integrated Argentina Health Information System, encompassing the period of March 3rd to October 2nd, 2020, using a standardized case report form that included information on contact history, clinical signs and symptoms, and clinical diagnosis. Information was collected at the initial site of care and follow-up conducted through calls by the regional healthcare authorities. A confirmed case of COVID-19 was defined as having a positive result through sequencing or real-time reverse-transcriptase polymerase chain reaction (RT-PCR) assay of nasal and pharyngeal swab specimens. RESULTS: RT-PCR testing was positive in 738,776 cases. Complete datasets were available for analysis in 207,079 cases. Mean age was 42.9±18.8 years, 50.0% were males. Frequent co-existing conditions included hypertension (19.2%), diabetes (9.7%), asthma (6.1%) and obesity (5.2%). Most common symptoms included fever (58.5%), cough (58.0%), headache (45.4%), and sore throat (42.1%). Death or ICU admission were independently associated with older age, male, coma, dyspnea or tachypnea, and seizures, with underlying co-morbidities such as immunodeficiency, chronic renal failure, and liver disease showing the strongest effects. INTERPRETATION: Most cases of COVID-19 diagnosed in Argentina were mild and had a favorable outcome, but fatality rates were relatively elevated. Risk factors for adverse outcome included older age, male sex, coma and seizures, and the concurrent presence of several morbidities. These data may be useful for healthcare providers and healthcare policy makers of low-middle income and Latin American countries to guide decisions toward optimized care during the pandemic.


Asunto(s)
/epidemiología , /fisiopatología , Adulto , Argentina/epidemiología , Asma/epidemiología , Asma/fisiopatología , Comorbilidad , Tos/epidemiología , Tos/fisiopatología , Diabetes Mellitus/epidemiología , Diabetes Mellitus/fisiopatología , Femenino , Fiebre/epidemiología , Fiebre/fisiopatología , Cefalea/epidemiología , Cefalea/fisiopatología , Humanos , Hipertensión/epidemiología , Hipertensión/fisiopatología , Unidades de Cuidados Intensivos , Masculino , Persona de Mediana Edad , Factores de Riesgo , Índice de Severidad de la Enfermedad , Adulto Joven
10.
Public Health ; 192: 12-14, 2021 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-33607515

RESUMEN

OBJECTIVES: On March 28, the Japanese government decided on the "Basic Policies for Novel Coronavirus Disease Control" and called on the public to thoroughly implement social distancing measures (i.e., behavioral restrictions to limit the frequency and intensity of human contact), especially telework. METHODS: We used population-level questionnaire data from a social networking service (SNS), with 275,560 respondents from March 5 to April 6, to evaluate the relationship between telework implementation and the presence of a fever (body temperature higher than 37.5 °C) within 1 month as a surrogate indicator of COVID-19 infection, by occupation type and age-group. RESULTS: Among company employees, statistical significance was identified in the 15- to 29-year and 30- to 59-year age-groups, showing higher fever rates in the non-teleworker group (for the 15- to 29-year age-group, non-teleworkers: 7.64%; teleworkers: 6.45%; P = 0.02; for the 30- to 59-year age-group, non-teleworkers: 3.46%; teleworkers: 3.14%; P = 0.02). CONCLUSIONS: Telework remains a controversial topic in Japan as the government called for emergency measures. Although caution is warranted in interpreting our findings because our data are limited to the voluntary SNS users, they will be essential to push forward with more measures to promote social distancing measures in the midst of Japan's current tense political climate.


Asunto(s)
/prevención & control , Fiebre/epidemiología , /estadística & datos numéricos , Adolescente , Adulto , /psicología , Femenino , Fiebre/etiología , Gobierno , Humanos , Japón , Persona de Mediana Edad , Pandemias , Red Social , Servicio Social , Encuestas y Cuestionarios , Adulto Joven
11.
Emerg Infect Dis ; 27(2): 385-395, 2021 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-33496225

RESUMEN

To improve recognition of coronavirus disease (COVID-19) and inform clinical and public health guidance, we randomly selected 600 COVID-19 case-patients in Colorado. A telephone questionnaire captured symptoms experienced, when symptoms occurred, and how long each lasted. Among 128 hospitalized patients, commonly reported symptoms included fever (84%), fatigue (83%), cough (73%), and dyspnea (72%). Among 236 nonhospitalized patients, commonly reported symptoms included fatigue (90%), fever (83%), cough (83%), and myalgia (74%). The most commonly reported initial symptoms were cough (21%-25%) and fever (20%-25%). In multivariable analysis, vomiting, dyspnea, altered mental status, dehydration, and wheezing were significantly associated with hospitalization, whereas rhinorrhea, headache, sore throat, and anosmia or ageusia were significantly associated with nonhospitalization. General symptoms and upper respiratory symptoms occurred earlier in disease, and anosmia, ageusia, lower respiratory symptoms, and gastrointestinal symptoms occurred later. Symptoms should be considered alongside other epidemiologic factors in clinical and public health decisions regarding potential COVID-19 cases.


Asunto(s)
/complicaciones , Pacientes Internos/estadística & datos numéricos , Pacientes Ambulatorios/estadística & datos numéricos , Adolescente , Adulto , Anciano , Anciano de 80 o más Años , Niño , Preescolar , Colorado/epidemiología , Tos/epidemiología , Tos/virología , Progresión de la Enfermedad , Disnea/epidemiología , Disnea/virología , Fatiga/epidemiología , Fatiga/virología , Femenino , Fiebre/epidemiología , Fiebre/virología , Humanos , Lactante , Masculino , Persona de Mediana Edad , Mialgia/epidemiología , Mialgia/virología , Evaluación de Síntomas , Adulto Joven
12.
Cir Pediatr ; 34(1): 3-8, 2021 Jan 01.
Artículo en Inglés, Español | MEDLINE | ID: mdl-33507637

RESUMEN

OBJECTIVE: To describe our experience in the diagnostic and therapeutic management of patients with acute abdomen as the main manifestation of SARS-CoV-2 infection. MATERIAL AND METHODS: A descriptive study of patients with clinical signs of acute abdomen diagnosed with COVID-19 and admitted at out healthcare facility from April 1 to May 10, 2020 was carried out. Clinical records were reviewed for data collection purposes. RESULTS: A series of 14 patients (9 male and 5 female) with a median age of 9.5 years was analyzed. All patients had abdominal pain. There were 11 patients with fever, 9 patients with vomit or diarrhea, and 9 patients with clinically suspected surgical pathology (acute appendicitis or peritonitis). Increased acute phase reactants and coagulation disorders were a common characteristic at blood tests. An abdominal ultrasonography was carried out in all patients, and a CT-scan was performed in 4 patients, which demonstrated inflammatory signs in the terminal ileum, the ileocecal valve and the ascending colon, as well as gallbladder edema. Conservative management was decided upon in all patients except one, and eight patients required intensive care admission for support treatment. CONCLUSIONS: Gastrointestinal symptoms can be the primary manifestation of the new coronavirus infection, which simulates an acute abdomen with a potentially unfavorable evolution. For an accurate diagnosis to be achieved, a good clinical record and a comprehensive physical exploration, as well as complementary tests in search of characteristic findings of COVID-19, should be carried out.


Asunto(s)
Abdomen Agudo/diagnóstico , Dolor Abdominal/etiología , /diagnóstico , Abdomen Agudo/cirugía , Abdomen Agudo/virología , Dolor Abdominal/virología , Adolescente , Apendicitis/diagnóstico , Niño , Preescolar , Diarrea/epidemiología , Diarrea/etiología , Femenino , Fiebre/epidemiología , Fiebre/etiología , Humanos , Unidades de Cuidados Intensivos/estadística & datos numéricos , Masculino , Peritonitis/diagnóstico , Estudios Retrospectivos , Vómitos/epidemiología , Vómitos/etiología
13.
Drug Discov Ther ; 14(6): 282-286, 2021 Jan 23.
Artículo en Inglés | MEDLINE | ID: mdl-33390566

RESUMEN

Coronavirus disease 2019 (COVID-19) is a febrile respiratory illness that has spread rampantly across the globe and has emerged as one of the biggest pandemics of all time. Besides the direct effects of COVID-19 on mortality, collateral impacts on diagnosis and management of acute febrile illnesses (AFI) is a matter of great concern. The overlap in presentation, shunting of available resources and infection control precautions in patients with suspected COVID-19 result in a significant delay in diagnoses and management of AFI. This review highlights the challenges in the management of acute febrile illness during COVID pandemic and possible solutions for the same.


Asunto(s)
/diagnóstico , Fiebre/diagnóstico , Antiparasitarios/uso terapéutico , Antivirales/uso terapéutico , /epidemiología , Diagnóstico Diferencial , Fiebre/tratamiento farmacológico , Fiebre/epidemiología , Humanos , Valor Predictivo de las Pruebas , Pronóstico , Medición de Riesgo , Factores de Riesgo
14.
West Afr J Med ; 38(1): 54-58, 2021 01.
Artículo en Inglés | MEDLINE | ID: mdl-33463708

RESUMEN

BACKGROUND: The SARS-CoV-2 infection continues to ravage the global community since it was declared a pandemic. The socio-demographic and clinical characteristics defining the disease are mainly from Europe and Asia. The disease symptomatology is similar to the prevalent diseases in our environment, this could result in the delay in prompt identification and appropriate management of suspected cases toward combating community transmission. This study evaluates the prevalence, socio-demographic and clinical characteristics of positive cases of COVID -19. METHODS: This was a retrospective cohort study. Data on the socio-demographic, clinical characteristics and the results of the SARS-CoV-2 test of participants at the Nigerian Institute of Medical Research [NIMR] Modified Drive-through Centre for COVID-19 test sample collection over two months [24th February 2020- 27th April 2020] were retrieved from the electronic medical records (EMR). Data obtained were analyzed using SPSS version 22.0. RESULTS: A total number of 481 clients were evaluated in this review. The prevalence of SARS-CoV-2 infection in the population was 14.6%. The mean age of the positive cases was 42.2 [±15.9] years. The common symptoms reported by the positive cases were fever (40.0%), cough (32.9%), sore throat (17.1%) and running nose (15.7%). Fever depicted statistical significance with positive cases with the majority being of mild to moderate clinical severity. CONCLUSION: The prevalence of SARS-CoV-2 infection among this cohort was 14.6% with a male preponderance. Fever and sore throat were the variables that predicted SARS CoV-2 infection among our cohort.


Asunto(s)
/epidemiología , Pandemias , Adolescente , Tos/epidemiología , Tos/etiología , Fatiga/epidemiología , Fatiga/etiología , Fiebre/epidemiología , Fiebre/etiología , Cefalea/epidemiología , Cefalea/etiología , Humanos , Masculino , Nigeria/epidemiología , Faringitis/epidemiología , Faringitis/etiología , Prevalencia , Estudios Retrospectivos
15.
World J Pediatr Congenit Heart Surg ; 12(1): 55-60, 2021 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-33407033

RESUMEN

BACKGROUND: Fever in the postoperative period in cardiac patients is common. The purpose of this study is to recognize the risk factors for prolonged postoperative fever in cardiac patients with pulmonary conduit insertion. METHODS: Patients were identified retrospectively by looking at the International Classification of Diseases, Ninth Revision, Clinical Modification procedure code for pulmonary conduit insertion between June 2009 and December 2015 at the American University of Beirut Medical Center. Data about preoperative, perioperative, and postoperative variables were collected. Data entry and analysis were performed using SPSS version 22. RESULTS: The study identified 59 patients. The most common type of pulmonary conduit used was the Contegra type (57.6%) (n = 34), followed by the Labcor type (20.3%; n = 12). Postoperative fever occurred in 61% of patients (n = 36). Fourteen patients (38.8%) had a prolonged fever that lasted for more than seven days. Prolonged postoperative fever was significantly associated with the Labcor pulmonary conduit (P value < .001) and a longer duration of pacing wires (P value: .039). Significantly prolonged fever that lasted for more than 21 days occurred in five patients who all had inserted the Labcor pulmonary conduit. CONCLUSIONS: The Labcor pulmonary conduit type is a risk factor for prolonged postoperative fever. The protracted use of pacing wires could be a consequence of the prolonged fever rather than a cause. In the absence of a demonstrable infectious etiology for prolonged postoperative fever in cardiac patients with pulmonary conduit insertion, the Labcor pulmonary conduit could be the underlying cause. Alternative management of such cases may lead to decreased antibiotic use and morbidity.


Asunto(s)
Fiebre/epidemiología , Cardiopatías Congénitas/cirugía , Prótesis e Implantes , Adolescente , Adulto , Preescolar , Femenino , Fiebre/etiología , Estudios de Seguimiento , Humanos , Incidencia , Lactante , Recién Nacido , Líbano/epidemiología , Masculino , Estudios Retrospectivos , Factores de Riesgo , Factores de Tiempo , Resultado del Tratamiento , Adulto Joven
16.
J Med Internet Res ; 23(1): e23897, 2021 01 06.
Artículo en Inglés | MEDLINE | ID: mdl-33320825

RESUMEN

BACKGROUND: Confirmed COVID-19 cases have been registered in more than 200 countries, and as of July 28, 2020, over 16 million cases have been reported to the World Health Organization. This study was conducted during the epidemic peak of COVID-19 in Italy. The early identification of individuals with suspected COVID-19 is critical in immediately quarantining such individuals. Although surveys are widely used for identifying COVID-19 cases, outcomes, and associated risks, no validated epidemiological tool exists for surveying SARS-CoV-2 infection in the general population. OBJECTIVE: We evaluated the capability of self-reported symptoms in discriminating COVID-19 to identify individuals who need to undergo instrumental measurements. We defined and validated a method for identifying a cutoff score. METHODS: Our study is phase II of the EPICOVID19 Italian national survey, which launched in April 2020 and included a convenience sample of 201,121 adults who completed the EPICOVID19 questionnaire. The Phase II questionnaire, which focused on the results of nasopharyngeal swab (NPS) and serological tests, was mailed to all subjects who previously underwent NPS tests. RESULTS: Of 2703 subjects who completed the Phase II questionnaire, 694 (25.7%) were NPS positive. Of the 472 subjects who underwent the immunoglobulin G (IgG) test and 421 who underwent the immunoglobulin M test, 22.9% (108/472) and 11.6% (49/421) tested positive, respectively. Compared to NPS-negative subjects, NPS-positive subjects had a higher incidence of fever (421/694, 60.7% vs 391/2009, 19.5%; P<.001), loss of taste and smell (365/694, 52.6% vs 239/2009, 11.9%; P<.001), and cough (352/694, 50.7% vs 580/2009, 28.9%; P<.001). With regard to subjects who underwent serological tests, IgG-positive subjects had a higher incidence of fever (65/108, 60.2% vs 43/364, 11.8%; P<.001) and pain in muscles/bones/joints (73/108, 67.6% vs 71/364, 19.5%; P<.001) than IgG-negative subjects. An analysis of self-reported COVID-19 symptom items revealed a 1-factor solution, the EPICOVID19 diagnostic scale. The following optimal scores were identified: 1.03 for respiratory problems, 1.07 for chest pain, 0.97 for loss of taste and smell 0.97, and 1.05 for tachycardia (ie, heart palpitations). These were the most important symptoms. For adults aged 18-84 years, the cutoff score was 2.56 (sensitivity: 76.56%; specificity: 68.24%) for NPS-positive subjects and 2.59 (sensitivity: 80.37%; specificity: 80.17%) for IgG-positive subjects. For subjects aged ≥60 years, the cutoff score was 1.28, and accuracy based on the presence of IgG antibodies improved (sensitivity: 88.00%; specificity: 89.58%). CONCLUSIONS: We developed a short diagnostic scale to detect subjects with symptoms that were potentially associated with COVID-19 from a wide population. Our results support the potential of self-reported symptoms in identifying individuals who require immediate clinical evaluations. Although these results come from the Italian pandemic period, this short diagnostic scale could be optimized and tested as a screening tool for future similar pandemics.


Asunto(s)
/diagnóstico , Encuestas Epidemiológicas , Tamizaje Masivo/normas , Psicometría , Autoinforme , Adolescente , Adulto , Anciano , Anciano de 80 o más Años , /fisiopatología , Femenino , Fiebre/epidemiología , Humanos , Inmunoglobulina G/análisis , Inmunoglobulina M/análisis , Italia/epidemiología , Masculino , Persona de Mediana Edad , Pandemias , Reproducibilidad de los Resultados , Adulto Joven
17.
Glob Health Res Policy ; 5(1): 54, 2020 12 21.
Artículo en Inglés | MEDLINE | ID: mdl-33349271

RESUMEN

OBJECTIVES: To analyze the epidemiological characteristics of COVID-19 related deaths in Wuhan, China and comprehend the changing trends of this epidemic along with analyzing the prevention and control measures in Wuhan. METHODS: Through the China's Infectious Disease Information System, we collected information about COVID-19 associated deaths from December 15, 2019 to February 24, 2020 in Wuhan. We analyzed the patient's demographic characteristics, drew epidemiological curve and made geographic distribution maps of the death toll in each district over time, etc. ArcGIS was used to plot the numbers of daily deaths on maps. Statistical analyses were performed using SPSS and @Risk software. RESULTS: As of February 24, 2020, a total of 1833 deaths were included. Among the deaths with COVID-19, mild type accounted for the most (37.2%), followed by severe type (30.1%). The median age was 70.0 (inter quartile range: 63.0-79.0) years. Most of the deaths were distributed in 50-89 age group, whereas no deaths occurred in 0-9 age group. Additionally, the male to female ratio was 1.95:1. A total of 65.7% of the deaths in Wuhan combined with underlying diseases, and was more pronounced among males. Most of the underlying diseases included hypertension, diabetes and cardiovascular diseases. The peak of daily deaths appeared on February 14 and then declined. The median interval from symptom onset to diagnosis was 10.0 (6.0-14.0) days; the interval from onset to diagnosis gradually shortened. The median intervals from diagnosis to death and symptom onset to deaths were 6.0 (2.0-11.0), 17.0 (12.0-22.0) days, respectively. Most of the disease was centralized in central urban area with highest death rate in Jianghan District. CONCLUSION: COVID-19 poses a greater threat to the elderly people and men with more devastating effects, particularly in the presence of underlying diseases. The geographical distributions show that the epidemic in the central area of Wuhan is more serious than that in the surrounding areas. Analysis of deaths as of February 24 indicates that a tremendous improvement of COVID-19 epidemic in Wuhan has achieved by effective control measures taken by Wuhan Government.


Asunto(s)
/mortalidad , Diabetes Mellitus/epidemiología , Hipertensión/epidemiología , Anciano , Anciano de 80 o más Años , China/epidemiología , Femenino , Fiebre/epidemiología , Humanos , Masculino , Persona de Mediana Edad
18.
PLoS One ; 15(12): e0243703, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-33351801

RESUMEN

BACKGROUND: Since the first cases reported in Wuhan, China, in December 2019, the Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) has spread worldwide. In Indonesia, the first case was reported in early March 2020, and the numbers of confirmed infections have been increasing until now. Efforts to contain the virus globally and in Indonesia are ongoing. This is the very first manuscript using a spatial-temporal model to describe the SARS-CoV-2 transmission in Indonesia, as well as providing a patient profile for all confirmed COVID-19 cases. METHOD: Data was collected from the official website of the Indonesia National Task Force for the Acceleration of COVID-19, from the period of 02 March 2020-02 August 2020. The data from RT-PCR confirmed, SARS-CoV-2 positive patients was categorized according to demographics, symptoms and comorbidities based on case categorization (confirmed, recovered, dead). The data collected provides granular and thorough information on time and geographical location for all 34 Provinces across Indonesia. RESULTS: A cumulative total of 111,450 confirmed cases of were reported in Indonesia during the study period. Of those confirmed cases 67.79% (75,551/111,450) were shown as recovered and 4.83% (5,382/111,450) of them as died. Patients were mostly male (50.52%; 56,300/111,450) and adults aged 31 to 45 years old (29.73%; 33,132/111,450). Overall patient presentation symptoms of cough and fever, as well as chronic disease comorbidities were in line with previously published data from elsewhere in South-East Asia. The data reported here, shows that from the detection of the first confirmed case and within a short time period of 40 days, all the provinces of Indonesia were affected by COVID-19. CONCLUSIONS: This study is the first to provide detailed characteristics of the confirmed SARS-CoV-2 patients in Indonesia, including their demographic profile and COVID-19 presentation history. It used a spatial-temporal analysis to present the epidemic spread from the very beginning of the outbreak throughout all provinces in the country. The increase of new confirmed cases has been consistent during this time period for all provinces, with some demonstrating a sharp increase, in part due to the surge in national diagnostic capacity. This information delivers a ready resource that can be used for prediction modelling, and is utilized continuously by the current Indonesian Task Force in order to advise on potential implementation or removal of public distancing measures, and on potential availability of healthcare capacity in their efforts to ultimately manage the outbreak.


Asunto(s)
/epidemiología , Brotes de Enfermedades , ARN Viral/aislamiento & purificación , /patogenicidad , /diagnóstico , /virología , Femenino , Fiebre/diagnóstico , Fiebre/epidemiología , Fiebre/virología , Humanos , Indonesia/epidemiología , Masculino , Persona de Mediana Edad , ARN Viral/genética
19.
Medicine (Baltimore) ; 99(47): e23407, 2020 Nov 20.
Artículo en Inglés | MEDLINE | ID: mdl-33217886

RESUMEN

Coronavirus diseases 2019 (COVID-19) has become a global pandemic. To add to the scarce information on this disease, here, we investigated the epidemiological and clinical characteristics of 93 hospitalized patients with COVID-19 in Jilin, China from January 22 to March 15, 2020.We retrospectively investigated the demographic information, recent exposure history, clinical symptoms or signs, comorbidity, chest computed tomographic (CT) scan or X-ray results, laboratory test results, diagnostic classification, treatment, length of hospitalization, complications, and outcomes.Of the 93 patients, 54 were male and 39 female. More than half of these patients had a history of exposure to infected patients. The mean incubation period was 10.4 days in 87 patients, where the data was available. The 5 most common symptoms of illness onset were fever, cough, expectoration, fatigue, and dyspnea. One patient was asymptomatic. The imaging results were abnormal in majority of the patients. Almost one-third of the patients had lymphopenia. All patients received antiviral therapy, 84 patients were treated with antibiotics and 54 received different doses of the hormone for methylprednisolone. In addition, 72 patients used traditional Chinese medicine. Oxygen therapy, high nasal flow oxygen, non-invasive ventilator, invasive ventilator and extracorporeal membrane oxygenation (ECMO) were used symptomatically in different patients. Except 1 patient who died during treatment, all others were discharged.The average incubation time is prolonged in the present analysis, as compared to that in other reports. A few patients symptoms improved but CT exacerbated. Therefore, we suggest that close follow-up observation is still required after discharge.


Asunto(s)
Betacoronavirus , Infecciones por Coronavirus/epidemiología , Hospitalización/estadística & datos numéricos , Neumonía Viral/epidemiología , Índice de Severidad de la Enfermedad , Adolescente , Adulto , Anciano , Anciano de 80 o más Años , Niño , China/epidemiología , Infecciones por Coronavirus/complicaciones , Infecciones por Coronavirus/virología , Tos/epidemiología , Tos/virología , Fatiga/epidemiología , Fatiga/virología , Femenino , Fiebre/epidemiología , Fiebre/virología , Humanos , Pulmón/diagnóstico por imagen , Pulmón/virología , Linfopenia/epidemiología , Linfopenia/virología , Masculino , Persona de Mediana Edad , Pandemias , Neumonía Viral/complicaciones , Neumonía Viral/virología , Estudios Retrospectivos , Tomografía Computarizada por Rayos X/estadística & datos numéricos , Adulto Joven
20.
BMC Infect Dis ; 20(1): 838, 2020 Nov 12.
Artículo en Inglés | MEDLINE | ID: mdl-33183252

RESUMEN

BACKGROUND: A functioning Viral Haemorrhagic Fever (VHF) surveillance system in countries at risk for outbreaks can reduce early transmission in case of an outbreak. Surveillance performance depends on the application of suspect case definitions in daily clinical practice. Recommended suspect case criteria during outbreaks are designed for high sensitivity and include general symptoms, pyrexia, haemorrhage, epidemiological link and unexplained death in patients. Non-outbreak criteria are narrower, relying on the persistence of fever and the presence of haemorrhagic signs. METHODS: This study ascertains VHF suspect case prevalence based on outbreak and non-outbreak criteria in a Guinean regional hospital for a period of three months. The study further describes clinical trajectories of patients who meet non-outbreak VHF suspect case criteria in order to discuss challenges in their identification. We used cross-sectional data collection at triage and emergency room to record demographic and clinical data of all admitted patients during the study period. For the follow-up study with description of diagnostic trajectories of VHF suspect cases, we used retrospective chart review. RESULTS: The most common symptoms of all patients upon admission were fever, tiredness/weakness and abdominal pain. 686 patients met EVD outbreak criteria, ten adult patients and two paediatric patients met study-specific non-outbreak VHF suspect case criteria. None of the suspect cases was treated as VHF suspect case and none tested positive for malaria upon admission. Their most frequent discharge diagnosis was unspecific gastrointestinal infection. The most common diagnostic measures were haemoglobin level and glycaemia for both adults and for children; of the requested examinations for hospitalized suspect cases, 36% were not executed or obtained. Half of those patients self-discharged against medical advice. CONCLUSIONS: Our study shows that the number of VHF suspect cases may vary greatly depending on which suspect case criteria are applied. Identification of VHF suspect cases seems challenging in clinical practice. We suggest that this may be due to the low use of laboratory diagnostics to support certain diagnoses and the non-application of VHF suspect case definitions in clinical practice. Future VHF suspect case management should aim to tackle such challenges in comparable hospital settings.


Asunto(s)
Brotes de Enfermedades , Ebolavirus/genética , Servicio de Urgencia en Hospital , Fiebre Hemorrágica Ebola/diagnóstico , Fiebre Hemorrágica Ebola/epidemiología , Centros de Atención Terciaria , Triaje/métodos , Adolescente , Adulto , Niño , Preescolar , Estudios Transversales , Femenino , Fiebre/diagnóstico , Fiebre/epidemiología , Estudios de Seguimiento , Guinea/epidemiología , Fiebre Hemorrágica Ebola/virología , Humanos , Lactante , Masculino , Persona de Mediana Edad , Prevalencia , Estudios Retrospectivos , Reacción en Cadena de la Polimerasa de Transcriptasa Inversa , Adulto Joven
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