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3.
Theranostics ; 10(14): 6113-6121, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-32483442

RESUMEN

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.


Asunto(s)
Betacoronavirus , Infecciones por Coronavirus/diagnóstico por imagen , Neumonía Viral/diagnóstico por imagen , Adulto , Factores de Edad , Anciano , China/epidemiología , Infecciones por Coronavirus/sangre , Infecciones por Coronavirus/mortalidad , Progresión de la Enfermedad , Femenino , Humanos , Recuento de Leucocitos , Recuento de Linfocitos , Masculino , Persona de Mediana Edad , Neutrófilos , Pandemias , Neumonía Viral/sangre , Neumonía Viral/mortalidad , Pronóstico , Estudios Retrospectivos , Factores de Riesgo , Nanomedicina Teranóstica , Tórax/diagnóstico por imagen , Tomografía Computarizada por Rayos X
4.
Indian J Public Health ; 64(Supplement): S90, 2020 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-32496231

RESUMEN

The COVID-19 pandemic behaves like many other viruses spread through respiratory routes. This is generally a mild disease for those aged less than 50 years. A complete and prolonged lockdown will reduce COVID-19 mortality but simultaneously lead to a graver public health, social, and economic disaster. The focus has to be based on the reality that exists in an area.


Asunto(s)
Infecciones por Coronavirus/epidemiología , Neumonía Viral/epidemiología , Betacoronavirus , Infecciones por Coronavirus/mortalidad , Infecciones por Coronavirus/transmisión , Humanos , India/epidemiología , Pandemias , Neumonía Viral/mortalidad , Neumonía Viral/transmisión , Salud Pública
5.
Indian J Public Health ; 64(Supplement): S183-S187, 2020 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-32496252

RESUMEN

Background: India has reported more than 70,000 cases and 2000 deaths. Pune is the second city in the Maharashtra state after Mumbai to breach the 1000 cases. Total deaths reported from Pune were 158 with a mortality of 5.7%. To plan health services, it is important to learn lessons from early stage of the outbreak on course of the disease in a hospital setting. Objectives: To describe the epidemiological characteristics of the outbreak of COVID-19 in India from a tertiary care hospital. Methods: This was a hospital-based cross-sectional study which included all admitted laboratory confirmed COVID19 cases from March 31, to April 24, 2020. The information was collected in a predesigned pro forma which included sociodemographic data, duration of stay, family background, outcome, etc., by trained staff after ethics approval. Epi Info7 was used for data analysis. Results: Out of the total 197 cases, majority cases were between the ages of 31-60 years with slight male preponderance. Majority of these cases were from the slums. Breathlessness was the main presenting symptom followed by fever and cough. More than 1/5th of patients were asymptomatic from exposure to admission. The case fatality rate among the admitted cases was 29.4%. Comorbidity was one of the significant risk factors for the progression of disease and death (odds ratio [OR] = 16.8, 95% confidence interval [CI] = 7.0 - 40.1, P < 0.0001). Conclusion: Mortality was higher than the national average of 3.2%; comorbidity was associated with bad prognosis.


Asunto(s)
Infecciones por Coronavirus/epidemiología , Neumonía Viral/epidemiología , Centros de Atención Terciaria/estadística & datos numéricos , Adolescente , Adulto , Anciano , Betacoronavirus , Comorbilidad , Infecciones por Coronavirus/mortalidad , Infecciones por Coronavirus/fisiopatología , Estudios Transversales , Femenino , Hospitalización , Humanos , India/epidemiología , Tiempo de Internación , Masculino , Persona de Mediana Edad , Pandemias , Neumonía Viral/mortalidad , Neumonía Viral/fisiopatología , Factores de Riesgo , Factores Socioeconómicos , Análisis Espacial , Adulto Joven
6.
Indian J Public Health ; 64(Supplement): S221-S224, 2020 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-32496259

RESUMEN

The information on the clinical course of coronavirus disease 2019 (COVID-19) and its correlates which are essential to assess the hospital care needs of the population are currently limited. We investigated the factors associated with hospital stay and death for COVID-19 patients for the entire state of Karnataka, India. A retrospective-cohort analysis was conducted on 445 COVID-19 patients that were reported in the publicly available media-bulletin from March 9, 2020, to April 23, 2020, for the Karnataka state. This fixed cohort was followed till 14 days (May 8, 2020) for definitive outcomes (death/discharge). The median length of hospital stay was 17 days (interquartile range: 15-20) for COVID-19 patients. Having severe disease at the time of admission (adjusted-hazard-ratio: 9.3 (3.2-27.3);P < 0.001) and being aged ≥ 60 years (adjusted-hazard-ratio: 11.9 (3.5-40.6);P < 0.001) were the significant predictors of COVID-19 mortality. By moving beyond descriptive (which provide only crude information) to survival analyses, information on the local hospital-related characteristics will be crucial to model bed-occupancy demands for contingency planning during COVID-19 pandemic.


Asunto(s)
Infecciones por Coronavirus/epidemiología , Infecciones por Coronavirus/fisiopatología , Hospitalización/estadística & datos numéricos , Neumonía Viral/epidemiología , Neumonía Viral/fisiopatología , Adulto , Factores de Edad , Anciano , Betacoronavirus , Comorbilidad , Infecciones por Coronavirus/mortalidad , Femenino , Humanos , India/epidemiología , Tiempo de Internación/estadística & datos numéricos , Masculino , Persona de Mediana Edad , Pandemias , Neumonía Viral/mortalidad , Características de la Residencia , Estudios Retrospectivos , Factores de Riesgo , Índice de Severidad de la Enfermedad , Factores Sexuales , Factores Socioeconómicos , Análisis de Supervivencia
7.
JCO Glob Oncol ; 6: 799-808, 2020 06.
Artículo en Inglés | MEDLINE | ID: mdl-32511066

RESUMEN

PURPOSE: Whether cancer is associated with worse prognosis among patients with COVID-19 is unknown. We aimed to quantify the effect (if any) of the presence as opposed to absence of cancer on important clinical outcomes of patients with COVID-19 by carrying out a systematic review and meta-analysis. METHODS: We systematically searched PubMed, medRxiv, COVID-19 Open Research Dataset (CORD-19), and references of relevant articles up to April 27, 2020, to identify observational studies comparing patients with versus without cancer infected with COVID-19 and to report on mortality and/or need for admission to the intensive care unit (ICU). We calculated pooled risk ratios (RR) and 95% CIs with a random-effects model. The meta-analysis was registered with PROSPERO (CRD42020181531). RESULTS: A total of 32 studies involving 46,499 patients (1,776 patients with cancer) with COVID-19 from Asia, Europe, and the United States were included. All-cause mortality was higher in patients with versus those without cancer (2,034 deaths; RR, 1.66; 95% CI, 1.33 to 2.07; P < .0001; 8 studies with 37,807 patients). The need for ICU admission was also more likely in patients with versus without cancer (3,220 events; RR, 1.56; 95% CI, 1.31 to 1.87; P < .0001; 26 studies with 15,375 patients). However, in a prespecified subgroup analysis of patients > 65 years of age, all-cause mortality was comparable between those with versus without cancer (915 deaths; RR, 1.06; 95% CI, 0.79 to 1.41; P = .71; 8 studies with 5,438 patients). CONCLUSION: The synthesized evidence suggests that cancer is associated with worse clinical outcomes among patients with COVID-19. However, elderly patients with cancer may not be at increased risk of death when infected with COVID-19. These findings may inform discussions of clinicians with patients about prognosis and may guide health policies.


Asunto(s)
Betacoronavirus/patogenicidad , Infecciones por Coronavirus/terapia , Cuidados Críticos , Neoplasias/terapia , Neumonía Viral/terapia , Anciano , Causas de Muerte , Infecciones por Coronavirus/diagnóstico , Infecciones por Coronavirus/mortalidad , Infecciones por Coronavirus/virología , Femenino , Mortalidad Hospitalaria , Interacciones Huésped-Patógeno , Humanos , Unidades de Cuidados Intensivos , Masculino , Persona de Mediana Edad , Neoplasias/diagnóstico , Neoplasias/mortalidad , Estudios Observacionales como Asunto , Pandemias , Admisión del Paciente , Neumonía Viral/diagnóstico , Neumonía Viral/mortalidad , Neumonía Viral/virología , Medición de Riesgo , Factores de Riesgo , Resultado del Tratamiento
8.
Int J Equity Health ; 19(1): 91, 2020 06 08.
Artículo en Inglés | MEDLINE | ID: mdl-32513261

RESUMEN

The COVID-19 pandemic has caused high mortality rates among older people, and in order to avoid a healthcare system crisis, almost all countries worldwide have adopted social isolation measures to prevent the spread of the disease. However, in Brazil, a country demarcated by economic inequalities, in which approximately 25% of the population live below the poverty line, these measures will cost severe economic losses and accentuated starvation. For this reason, the underprivileged population should be immediately prioritized and well informed through good practice to avoid the virus. Since, government discrepancies in dealing with the COVID-19 outbreak leaves the population without congruent guidelines on how to react or what to believe, allowing the spread of fake news and political crises. Here, we discuss who will pay the price of the Brazilian government denying the impact of COVID-19 pandemic and suggest some measures to ensure that clear information and protection reach this population.


Asunto(s)
Infecciones por Coronavirus/mortalidad , Disparidades en el Estado de Salud , Pandemias , Neumonía Viral/mortalidad , Brasil/epidemiología , Infecciones por Coronavirus/prevención & control , Gobierno , Humanos , Pandemias/prevención & control , Neumonía Viral/prevención & control , Pobreza , Factores Socioeconómicos
9.
Cien Saude Colet ; 25(suppl 1): 2403-2410, 2020 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-32520285

RESUMEN

Mortality statistics due to COVID-19 worldwide are compared, by adjusting for the size of the population and the stage of the pandemic. Data from the European Centre for Disease Control and Prevention, and Our World in Data websites were used. Analyses are based on number of deaths per one million inhabitants. In order to account for the stage of the pandemic, the baseline date was defined as the day in which the 10th death was reported. The analyses included 78 countries and territories which reported 10 or more deaths by April 9. On day 10, India had 0.06 deaths per million, Belgium had 30.46 and San Marino 618.78. On day 20, India had 0.27 deaths per million, China had 0.71 and Spain 139.62. On day 30, four Asian countries had the lowest mortality figures, whereas eight European countries had the highest ones. In Italy and Spain, mortality on day 40 was greater than 250 per million, whereas in China and South Korea, mortality was below 4 per million. Mortality on day 10 was moderately correlated with life expectancy, but not with population density. Asian countries presented much lower mortality figures as compared to European ones. Life expectancy was found to be correlated with mortality.


Asunto(s)
Betacoronavirus , Infecciones por Coronavirus/mortalidad , Salud Global/estadística & datos numéricos , Esperanza de Vida , Pandemias/estadística & datos numéricos , Neumonía Viral/mortalidad , Humanos
10.
Trials ; 21(1): 513, 2020 Jun 10.
Artículo en Inglés | MEDLINE | ID: mdl-32522282

RESUMEN

OBJECTIVES: The aim of this randomised GCP-controlled trial is to clarify whether combination therapy with the antibiotic azithromycin and hydroxychloroquine via anti-inflammation/immune modulation, antiviral efficacy and pre-emptive treatment of supra-infections can shorten hospitalisation duration for patients with COVID-19 (measured as "days alive and out of hospital" as the primary outcome), reduce the risk of non- invasive ventilation, treatment in the intensive care unit and death. TRIAL DESIGN: This is a multi-centre, randomised, Placebo-controlled, 2-arm ratio 1:1, parallel group double-blind study. PARTICIPANTS: 226 participants are recruited at the trial sites/hospitals, where the study will take place in Denmark: Aalborg, Bispebjerg, Gentofte, Herlev, Hillerød, Hvidovre, Odense and Slagelse hospitals. INCLUSION CRITERIA: • Patient admitted to Danish emergency departments, respiratory medicine departments or internal medicine departments • Age≥ 18 years • Hospitalized ≤48 hours • Positive COVID-19 test / diagnosis during the hospitalization (confirmed). • Men or non-fertile women. Fertile women* must not be pregnant, i.e. negative pregnancy test must be available at inclusion • Informed consent signed by the patient *Defined as after menarche and until postmenopausal (no menstruation for 12 months) Exclusion criteria: • At the time of recruitment, the patient uses >5 LO2/min (equivalent to 40% FiO2 if measured) • Known intolerance/allergy to azithromycin or hydroxychloroquine or hypersensitivity to quinine or 4-aminoquinoline derivatives • Neurogenic hearing loss • Psoriasis • Retinopathy • Maculopathy • Visual field changes • Breastfeeding • Severe liver diseases other than amoebiasis (INR> 1.5 spontaneously) • Severe gastrointestinal, neurological and hematological disorders (investigator-assessed) • eGFR <45 ml/min/1.73 m2 • Clinically significant cardiac conduction disorders/arrhythmias or prolonged QTc interval (QTc (f) of> 480/470 ms). • Myasthenia gravis • Treatment with digoxin* • Glucose-6-phosphate dehydrogenase deficiency • Porphyria • Hypoglycaemia (Blood glucose at any time since hospitalization of <3.0 mmol/L) • Severe mental illness which significantly impedes cooperation • Severe linguistic problems that significantly hinder cooperation • Treatment with ergot alkaloids *The patient must not be treated with digoxin for the duration of the intervention. For atrial fibrillation/flutter, select according to the Cardiovascular National Treatment Guide (NBV): Calcium antagonist, Beta blocker, direct current (DC) conversion or amiodarone. In case of urgent need for digoxin treatment (contraindication for the aforementioned equal alternatives), the test drug should be paused, and ECG should be taken daily. INTERVENTION AND COMPARATOR: Control group: The control group will receive the standard treatment + placebo for both types of intervention medication at all times. If part or all the intervention therapy being investigated becomes standard treatment during the study, this may also be offered to the control group. Intervention group: The patients in the intervention group will also receive standard care. Immediately after randomisation to the intervention group, the patient will begin treatment with: Azithromycin: Day 1-3: 500 mg x 1 Day 4-15: 250 mg x 1 If the patient is unable to take the medication orally by themselves, the medication will, if possible, be administered by either stomach-feeding tube, or alternatively, temporary be changed to clarithromycin 500 mg x 2 (this only in agreement with either study coordinator Pradeesh Sivapalan or principal investigator Jens-Ulrik Stæhr Jensen). This will also be done in the control group if necessary. The patient will switch back to azithromycin when possible. Hydroxychloroquine: Furthermore, the patient will be treated with hydroxychloroquine as follows: Day 1-15: 200 mg x 2 MAIN OUTCOMES: • Number of days alive and discharged from hospital within 14 days (summarises both whether the patient is alive and discharged from hospital) ("Days alive and out of hospital") RANDOMISATION: The sponsor (Chronic Obstructive Pulmonary Disease Trial Network, COP:TRIN) generates a randomisation sequence. Randomisation will be in blocks of unknown size and the final allocation will be via an encrypted website (REDCap). There will be stratification for age (>70 years vs. <=70 years), site of recruitment and whether the patient has any of the following chronic lung diseases: COPD, asthma, bronchiectasis, interstitial lung disease (Yes vs. No). BLINDING (MASKING): Participants and study personnel will both be blinded, i.e. neither will know which group the participant is allocated to. NUMBERS TO BE RANDOMISED (SAMPLE SIZE): This study requires 226 patients randomised 1:1 with 113 in each group. TRIAL STATUS: Protocol version 1.8, from April 16, 2020. Recruitment is ongoing (first patient recruited April 6, 2020; final patient expected to be recruited October 31, 2020). TRIAL REGISTRATION: ClinicalTrials.gov Identifier: NCT04322396 (registered March 26, 2020) FULL PROTOCOL: The full protocol is attached as an additional file, accessible from the Trials website (Additional file 1). In the interest in expediting dissemination of this material, the familiar formatting has been eliminated; this Letter serves as a summary of the key elements of the full protocol. The study protocol has been reported in accordance with the Standard Protocol Items: Recommendations for Clinical Interventional Trials (SPIRIT) guidelines (Additional file 2).


Asunto(s)
Antivirales/administración & dosificación , Azitromicina/administración & dosificación , Betacoronavirus/efectos de los fármacos , Infecciones por Coronavirus/tratamiento farmacológico , Hidroxicloroquina/administración & dosificación , Pacientes Internos , Admisión del Paciente , Neumonía Viral/tratamiento farmacológico , Antivirales/efectos adversos , Azitromicina/efectos adversos , Betacoronavirus/patogenicidad , Infecciones por Coronavirus/diagnóstico , Infecciones por Coronavirus/mortalidad , Infecciones por Coronavirus/virología , Cuidados Críticos , Dinamarca , Método Doble Ciego , Esquema de Medicación , Mortalidad Hospitalaria , Interacciones Huésped-Patógeno , Humanos , Hidroxicloroquina/efectos adversos , Tiempo de Internación , Estudios Multicéntricos como Asunto , Ventilación no Invasiva , Pandemias , Neumonía Viral/diagnóstico , Neumonía Viral/mortalidad , Neumonía Viral/virología , Ensayos Clínicos Controlados Aleatorios como Asunto , Índice de Severidad de la Enfermedad , Factores de Tiempo , Resultado del Tratamiento
11.
Pan Afr Med J ; 35(Suppl 2): 1, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-32528612

RESUMEN

The epidemic of Coronavirus disease 2019 (COVID-19) in China caused by the Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) has become a global concern and subsequently labeled a pandemic by the World Health Organization on March 11th. As the world mobilizes to contain the COVID-19, scientists and public health experts are increasingly alarmed about the potentially catastrophic effects of an outbreak in Africa. The establishment of Africa Centres for Disease Control and Prevention by the Africa Union in 2017 was an unprecedented move toward strengthening national responses, so far enabling all fifty member states with confirmed cases of COVID-19 to adequately respond, break chains of transmission and effectively contain the spread of SARS-CoV-2. We enter an uncertain and challenging period that may severely test the preparedness, organizational resource and resilience of African states and the fabric of their societies. However, we speculate that the fear associated with COVID-19 may also lead to some of the long-standing messages about simple measures to reduce the spread, such as hand washing, finally becoming absorbed and more universally adopted by health workers and the public. Is it possible that regardless of the terrible threat posed by SARS-CoV-2, the increased adoption of these health protection measures may result in a reduction in the spread of other infectious diseases?


Asunto(s)
Betacoronavirus , Infecciones por Coronavirus/epidemiología , Infecciones por Coronavirus/prevención & control , Pandemias/prevención & control , Neumonía Viral/epidemiología , Neumonía Viral/prevención & control , África/epidemiología , Infecciones por Coronavirus/economía , Infecciones por Coronavirus/mortalidad , Desinfección de las Manos , Fiebre Hemorrágica Ebola/epidemiología , Fiebre Hemorrágica Ebola/mortalidad , Humanos , Cooperación Internacional , Pandemias/economía , Neumonía Viral/economía , Neumonía Viral/mortalidad , Precauciones Universales
12.
Pan Afr Med J ; 35(Suppl 2): 11, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-32528622

RESUMEN

COVID-19 pandemic is an emergent cardiovascular risk factor and a major cause of mortality worldwide. Thromboembolism is highly suspected as a leading cause of death in these patients through vascular inflammation caused by SARS COV2. Until now there is no real treatment of COVID-19 and many proposed drugs are under clinical trials. Considering the high incidence of thromboembolic events in critically ill patients with COVID-19, prevention of this disorder should be essential in order to reduce mortality in these patients.


Asunto(s)
Betacoronavirus , Enfermedades Cardiovasculares/diagnóstico , Infecciones por Coronavirus/mortalidad , Países en Desarrollo , Pandemias , Neumonía Viral/mortalidad , Enfermedades Cardiovasculares/mortalidad , Infecciones por Coronavirus/epidemiología , Humanos , Neumonía Viral/epidemiología , Factores de Riesgo , Evaluación de Síntomas
13.
Beijing Da Xue Xue Bao Yi Xue Ban ; 52(3): 420-424, 2020 Jun 18.
Artículo en Chino | MEDLINE | ID: mdl-32541972

RESUMEN

OBJECTIVE: The pathogenesis of myocardial injury upon corona virus disease 2019 (COVID-19) infection remain unknown,evidence of impact on outcome is insufficient, therefore, we aim to investigate the risk factors for death among COVID-19 patients combined with hypertension, coronary heart disease or diabetes in this study. METHODS: This was a single-centered, retrospective, observational study. Patients of Sino-French Eco-City section of Tongji Hospital, Wuhan, China attended by Peking University Supporting Medical Team and admitted from Jan. 29, 2020 to Mar. 20, 2020 were included. The positive nucleic acid of COVID-19 virus and combination with hypertension, coronary heart disease or diabetes were in the standard. We collected the clinical data and laboratory examination results of the eligible patients to evaluate the related factors of death. RESULTS: In the study, 94 COVID-19 patients enrolled were divided into the group of death (13 cases) and the group of survivors (81 cases), the average age was 66.7 years. Compared with the survival group, the death group had faster basal heart rate(103.2 beats/min vs. 88.4 beats /min, P=0.004), shortness of breath(29.0 beats /min vs. 20.0 beats /min, P<0.001), higher neutrophil count(9.2×109/L vs. 3.8×109/L, P<0.001), lower lymphocyte count(0.5×109/L vs. 1.1×109/L, P<0.001), creatine kinase MB(CK-MB, 3.2 µg/L vs. 0.8 µg/L, P<0.001), high sensitivity cardiac troponin Ⅰ(hs-cTnⅠ, 217.2 ng/L vs. 4.9 ng/L, P<0.001), N-terminal pro brain natriuretic peptide(NT-proBNP; 945.0 µg/L vs. 154.0 µg/L, P<0.001), inflammatory factor ferritin(770.2 µg/L vs. 622.8 µg/L , P=0.050), interleukin-2 recepter(IL-2R, 1 586.0 U/mL vs. 694.0 U/mL, P<0.001), interleukin-6(IL-6, 82.3 ng/L vs. 13.0 ng/L, P<0.001), interleukin-10(IL-10, 9.8 ng/L vs. 5.0 ng/L, P<0.001)were higher than those in the survival group. Univariate logistic regression analysis showed that the risk factors for death were old age, low non oxygen saturation, low lymphocyte count, myocardial injury, abnormal increase of IL 2R, IL-6, and IL-10. Multivariate regression showed that old age (OR=1.11, 95%CI=1.03-1.19, P=0.026), low non oxygen saturation(OR=0.85, 95%CI=0.72-0.99, P=0.041), and abnormal increase of IL-10(>9.1 ng/L, OR=101.93, 95%CI=4.74-2190.71, P=0.003)were independent risk factors for COVID-19 patients combined with hypertension, coronary heart disease or diabetes. CONCLUSION: In COVID-19 patients combined with hypertension, coronary heart disease or diabetes, the risk factors for death were old age, low non oxygen saturation, low lymphocyte count, myocardial injury, and abnormal increase of IL-2R, IL-6, and IL-10. Old age, low non oxygen saturation and abnormal increase of IL-10 were independent risk factors.


Asunto(s)
Enfermedad Coronaria , Infecciones por Coronavirus , Diabetes Mellitus , Hipertensión , Pandemias , Neumonía Viral , Anciano , Betacoronavirus , China/epidemiología , Enfermedad Coronaria/complicaciones , Infecciones por Coronavirus/complicaciones , Infecciones por Coronavirus/epidemiología , Infecciones por Coronavirus/mortalidad , Humanos , Hipertensión/complicaciones , Neumonía Viral/complicaciones , Neumonía Viral/epidemiología , Neumonía Viral/mortalidad , Estudios Retrospectivos , Factores de Riesgo
15.
Sci Total Environ ; 736: 138763, 2020 Sep 20.
Artículo en Inglés | MEDLINE | ID: mdl-32492610

RESUMEN

Transient local over-dry environment might be a contributor and an explanation for the observed asynchronous local rises in Covid-19 mortality. We propose that a habitat's air humidity negatively correlate with Covid-19 morbidity and mortality, and support this hypothesis on the example of publicly available data from German federal states.


Asunto(s)
Infecciones por Coronavirus/mortalidad , Humedad , Neumonía Viral/mortalidad , Betacoronavirus , Alemania/epidemiología , Humanos , Pandemias
16.
J Chin Med Assoc ; 83(6): 527-533, 2020 06.
Artículo en Inglés | MEDLINE | ID: mdl-32502117

RESUMEN

Coronavirus disease 2019 (COVID-19), caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), emerged from China in December 2019. The outbreak further exploded in Europe and America in mid-March 2020 to become a global health emergency. We reviewed recent published articles and on-line open messages on SARS-CoV-2-positive infants and children younger than 20 years of age. Symptoms are usually less severe in children than in adults. Twelve critically or mortally ill children were found in the published or news reports before April 6, 2020. Vertical transmission from the mother to her fetus or neonate has not been proven definitively. However, six early-onset (<7 days) and 3 late-onset neonatal SARS-CoV-2 infections were found in the literature. We also summarized the presentations and contact information of 24 SARS-CoV-2-positive children announced by the Taiwan Centers for Disease Control. Early identification and isolation, adequate management, prevention, and vaccine development are the keys to controlling the disease spread. Clinical physicians should be alert to asymptomatic children with COVID-19. Multidirectional investigations are crucial in the global fight against COVID-19.


Asunto(s)
Betacoronavirus , Infecciones por Coronavirus/epidemiología , Neumonía Viral/epidemiología , Adolescente , Niño , Preescolar , China/epidemiología , Infecciones por Coronavirus/diagnóstico , Infecciones por Coronavirus/mortalidad , Humanos , Lactante , Recién Nacido , Pandemias , Neumonía Viral/diagnóstico , Neumonía Viral/mortalidad , República de Corea/epidemiología , Estados Unidos/epidemiología , Adulto Joven
17.
Emergencias (Sant Vicenç dels Horts) ; 32(3): 162-168, jun. 2020. tab, ilus
Artículo en Español | IBECS | ID: ibc-187774

RESUMEN

OBJETIVO: Conocer las características clínico/epidemiológicas de los pacientes fallecidos en los servicios de urgencias (SU) de Aragón (España) y su relación con el índice de comorbilidad de Charlson. MÉTODO: Estudio observacional descriptivo y transversal realizado con datos recogidos entre los años 2013-2017. Las variables se obtuvieron de la base de datos "Puesto clínico hospitalario" (PCH) y estas se relacionaron con el índice de comorbilidad de Charlson mediante el estadístico ji cuadrado (ajustado a un nivel de significación de p < 0,05). RESULTADOS: Se obtuvo un valor medio de 6,58 en el índice de Charlson, con un total de 1.177 pacientes con valores mayores o igual a 7 puntos. La edad media fue de 81,1 años (DE: 12,1), con un 52,1% de hombres. El tiempo medio de fallecimiento en el servicio fue de 639 (DE: 777) minutos. Se encontró una relación estadísticamente significativa entre la variable Índice de Charlson con la mayoría de variables de estudio, exceptuando el sexo y año de fallecimiento. CONCLUSIONES: Los pacientes fallecidos en los SU de Aragón poseen elevados índices de comorbilidad. Entre estos se observa un grupo importante de pacientes con una elevada edad, alta frecuencia de patología crónica avanzada y polifarmacia. Se resalta la necesidad de incorporar estrategias de atención crónica y paliativa en los SU para este gru¬po cada vez más numeroso de pacientes por el progresivo envejecimiento poblacional


OBJECTIVE: To describe the clinical and personal characteristics of patients who died in hospital emergency departments in Aragon, Spain, and explore associations with the Charlson Comorbidity Index (CCI). METHODS: Descriptive, observational, cross-sectional study of deaths between 2013 and 2017. Data was extracted from the clinical database for hospital emergencies (official name, Puesto Clínico Hospitalario). Associations between variables and the CCI were explored with the χ2 test (significance level P<.05). RESULTS: The mean CCI was 6.58. A total of 1177 patients had CCIs of 7 or higher. The mean age was 81.1 years, and 52.1% were men. The mean (SD) time until death in the emergency department was 639 (777) minutes. The CCI was significantly associated with most clinical and personal variables studied, with the exception of sex and year. CONCLUSIONS: Patients who die in Aragon's emergency departments have high levels of comorbidity. A large proportion of patients are of advanced age. Polypharmacy and advanced chronic conditions are common. We stress the need to implement emergency department approaches to ongoing and palliative care for this group, which is growing as the population ages


Asunto(s)
Humanos , Masculino , Femenino , Anciano de 80 o más Años , Infecciones por Coronavirus/epidemiología , Servicios Médicos de Urgencia/tendencias , Comorbilidad , Mortalidad Hospitalaria , Cuidados Paliativos/métodos , España/epidemiología , Infecciones por Coronavirus/mortalidad , Estudios Transversales , Epidemiología Descriptiva , Triaje/métodos , Causas de Muerte
18.
Washington; Organización Panamericana de la Salud; jun. 15, 2020. 26 p.
No convencional en Español | LILACS | ID: biblio-1099999

RESUMEN

La finalidad de este documento es brindar orientación a los países de América Latina y el Caribe a fin de mejorar la vigilancia de la mortalidad por COVID-19. En este documento se amplían los métodos deanálisis de la mortalidad por todas las causas como uno de los enfoques propuestos para contribuir a la evaluación de la magnitud real de la carga de la epidemia de COVID-19 en los países de América Latina y el Caribe. Este documento está dirigido a las autoridades nacionales de salud, incluidos los equipos de vigilancia epidemiológica y de emergencia de salud pública que participan en la respuesta a la epidemia de COVID-19, así como a otros profesionales o instituciones a cargo de la vigilancia (como los departamentos de epidemiología) y de seguimiento de la mortalidad (como los institutos nacionales de estadística).


Asunto(s)
Humanos , Neumonía Viral/prevención & control , Infecciones por Coronavirus/mortalidad , Infecciones por Coronavirus/prevención & control , Infecciones por Coronavirus/epidemiología , Pandemias/prevención & control , Vigilancia en Salud Pública/métodos , Betacoronavirus/patogenicidad , Estadísticas Vitales , Región del Caribe/epidemiología , Servicios Médicos de Urgencia/organización & administración , Monitoreo Epidemiológico , América Latina/epidemiología
19.
Washington; Organización Panamericana de la Salud; jun. 3, 2020. 15 p.
No convencional en Español | LILACS | ID: biblio-1097690

RESUMEN

Este documento describe la certificación y clasificación (codificación) de muertes relacionadas con COVID-19. El objetivo principal es identificar todas las muertes debidas a COVID-19. La sección que se dirige específicamente a las personas que completan el certificado médico de causa de muerte debe distribuirse por separado de las instrucciones de codificación.


Asunto(s)
Neumonía Viral/prevención & control , Certificado de Defunción , Infecciones por Coronavirus/mortalidad , Infecciones por Coronavirus/prevención & control , Pandemias/prevención & control , Betacoronavirus
20.
Infez Med ; 28(2): 238-242, 2020 Jun 01.
Artículo en Inglés | MEDLINE | ID: mdl-32487789

RESUMEN

The present study is aimed to assess the risk factors for mortality in the first 107 rRT-PCR confirmed cases of SARS-CoV-2 infections in Bolivia. For this observational, retrospective and cross-sectional study, the epidemiological data records were collected from the Hospitals and the Ministry of Health of Bolivia, obtaining the clinical and epidemiological data of the COVID-19 cases that were laboratory-diagnosed during March 2-29, 2020. Samples were tested by rRT-PCR to SARS-CoV-2 at the Laboratory of the National Center of Tropical Diseases (CENETROP), following the protocol Charite, Berlin, Germany. The odds ratio (OR) with respective 95% confidence interval (95%CI) for mortality as dependent variable was calculated. When we comparatively analyzed survivors and non-survivors in this first group of 107 cases in Bolivia, we found that at bivariate analyses, age (±60 years old), hypertension, chronic heart failure, diabetes, and obesity, as well as the requirement of ICU, were significantly exposure variables associated with death. At the multivariate analysis (logistic regression), two variables remained significantly associated, age, ±60 years-old (OR=9.4, 95%CI 1.8-104.1) and hypertension (OR=3.3, 95%CI 1.3-6.3). As expected, age and comorbidities, particularly hypertension, were independent risk factors for mortality in Bolivia in the first 107 cases group. More further studies are required to better define risk factors and preventive measures related to COVID-19 in this and other Latin American countries.


Asunto(s)
Betacoronavirus , Infecciones por Coronavirus/mortalidad , Neumonía Viral/mortalidad , Adolescente , Adulto , Distribución por Edad , Factores de Edad , Anciano , Anciano de 80 o más Años , Bolivia/epidemiología , Niño , Intervalos de Confianza , Infecciones por Coronavirus/epidemiología , Estudios Transversales , Complicaciones de la Diabetes/mortalidad , Femenino , Insuficiencia Cardíaca/mortalidad , Humanos , Hipertensión/mortalidad , Masculino , Persona de Mediana Edad , Obesidad/mortalidad , Oportunidad Relativa , Pandemias , Neumonía Viral/epidemiología , Análisis de Regresión , Estudios Retrospectivos , Factores de Riesgo , Distribución por Sexo , Adulto Joven
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