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1.
Ann Lab Med ; 41(2): 129-138, 2021 Mar 01.
Artículo en Inglés | MEDLINE | ID: mdl-33063674

RESUMEN

Since its first report in December 2019, coronavirus disease 2019 (COVID-19), caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), has rapidly emerged as a pandemic affecting nearly all countries worldwide. As the COVID-19 pandemic progresses, the need to identify genetic risk factors for susceptibility to this serious illness has emerged. Host genetic factors, along with other risk factors may help determine susceptibility to respiratory tract infections. It is hypothesized that the ACE2 gene, encoding angiotensin-converting enzyme 2 (ACE2), is a genetic risk factor for SARS-CoV-2 infection and is required by the virus to enter cells. Together with ACE2, transmembrane protease serine 2 (TMPRSS2) and dipeptidyl peptidase-4 (DPP4) also play an important role in disease severity. Evaluating the role of genetic variants in determining the direction of respiratory infections will help identify potential drug target candidates for further study in COVID-19 patients. We have summarized the latest reports demonstrating that ACE2 variants, their expression, and epigenetic factors may influence an individual's susceptibility to SARS-CoV-2 infection and disease outcome.


Asunto(s)
Betacoronavirus/genética , Infecciones por Coronavirus/patología , Variación Genética , Neumonía Viral/patología , Betacoronavirus/aislamiento & purificación , Infecciones por Coronavirus/virología , Dipeptidil Peptidasa 4/genética , Dipeptidil Peptidasa 4/metabolismo , Susceptibilidad a Enfermedades , Expresión Génica , Humanos , Pandemias , Peptidil-Dipeptidasa A/química , Peptidil-Dipeptidasa A/genética , Peptidil-Dipeptidasa A/metabolismo , Neumonía Viral/virología , Serina Endopeptidasas/genética , Serina Endopeptidasas/metabolismo , Índice de Severidad de la Enfermedad
2.
Ann Lab Med ; 41(2): 225-229, 2021 Mar 01.
Artículo en Inglés | MEDLINE | ID: mdl-33063685

RESUMEN

In response to the ongoing coronavirus disease 2019 (COVID-19) pandemic, an online laboratory surveillance system was established to monitor severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) real-time reverse transcription-PCR (rRT-PCR) testing capacities and results. SARS-CoV-2 rRT-PCR testing data were collected from 97 clinical laboratories, including 84 medical institutions and 13 independent clinical laboratories in Korea. We assessed the testing capacities to utilize SARS-CoV-2 rRT-PCR based on surveillance data obtained from February 7th to June 4th, 2020 and evaluated positive result characteristics according to the reagents used and sample types. A total of 1,890,319 SARS-CoV-2 rRT-PCR testing were performed, 2.3% of which were positive. Strong correlations were observed between the envelope (E) gene and RNA-dependent RNA polymerase (RdRp)/nucleocapsid (N) genes threshold cycle (Ct) values for each reagent. No statistically significant differences in gene Ct values were observed between the paired upper and lower respiratory tract samples, except in the N gene for nasopharyngeal swab and sputum samples. Our study showed that clinical laboratories in Korea have rapidly expanded their testing capacities in response to the COVID-19 outbreak, with a peak daily capacity of 34,193 tests. Rapid expansion in testing capacity is a critical component of the national response to the ongoing pandemic.


Asunto(s)
Betacoronavirus/genética , Servicios de Laboratorio Clínico/estadística & datos numéricos , Infecciones por Coronavirus/diagnóstico , Neumonía Viral/diagnóstico , Betacoronavirus/aislamiento & purificación , Infecciones por Coronavirus/virología , Humanos , Laboratorios de Hospital , Pandemias , Neumonía Viral/virología , ARN Replicasa/genética , ARN Viral/genética , ARN Viral/metabolismo , Reacción en Cadena en Tiempo Real de la Polimerasa , República de Corea , Proteínas del Envoltorio Viral/genética , Proteínas Virales/genética
3.
Radiographics ; 40(6): 1574-1599, 2020 10.
Artículo en Inglés | MEDLINE | ID: mdl-33001783

RESUMEN

Infection with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) results in coronavirus disease 2019 (COVID-19), which was declared an official pandemic by the World Health Organization on March 11, 2020. The infection has been reported in most countries around the world. As of August 2020, there have been over 21 million cases of COVID-19 reported worldwide, with over 800 000 COVID-19-associated deaths. It has become apparent that although COVID-19 predominantly affects the respiratory system, many other organ systems can also be involved. Imaging plays an essential role in the diagnosis of all manifestations of the disease, as well as its related complications, and proper utilization and interpretation of imaging examinations is crucial. With the growing global COVID-19 outbreak, a comprehensive understanding of the diagnostic imaging hallmarks, imaging features, multisystemic involvement, and evolution of imaging findings is essential for effective patient management and treatment. To date, only a few articles have been published that comprehensively describe the multisystemic imaging manifestations of COVID-19. The authors provide an inclusive system-by-system image-based review of this life-threatening and rapidly spreading infection. In part 1 of this article, the authors discuss general aspects of the disease, with an emphasis on virology, the pathophysiology of the virus, and clinical presentation of the disease. The key imaging features of the varied pathologic manifestations of this infection that involve the pulmonary and peripheral and central vascular systems are also described. Part 2 will focus on key imaging features of COVID-19 that involve the cardiac, neurologic, abdominal, dermatologic and ocular, and musculoskeletal systems, as well as pediatric and pregnancy-related manifestations of the virus. Vascular complications pertinent to each system will be also be discussed in part 2. Online supplemental material is available for this article. ©RSNA, 2020.


Asunto(s)
Betacoronavirus/fisiología , Infecciones por Coronavirus/diagnóstico por imagen , Pulmón/diagnóstico por imagen , Pandemias , Neumonía Viral/diagnóstico por imagen , Tromboembolia/diagnóstico por imagen , Trombosis/diagnóstico por imagen , Angiografía/métodos , Infecciones por Coronavirus/complicaciones , Infecciones por Coronavirus/epidemiología , Infecciones por Coronavirus/virología , Síndrome de Liberación de Citoquinas/etiología , Síndrome de Liberación de Citoquinas/fisiopatología , Progresión de la Enfermedad , Productos de Degradación de Fibrina-Fibrinógeno/análisis , Humanos , Inflamación , Peptidil-Dipeptidasa A/fisiología , Neumonía Viral/complicaciones , Neumonía Viral/epidemiología , Neumonía Viral/virología , Arteria Pulmonar/diagnóstico por imagen , Receptores Virales/fisiología , Síndrome de Dificultad Respiratoria del Adulto/diagnóstico por imagen , Síndrome de Dificultad Respiratoria del Adulto/etiología , Evaluación de Síntomas , Tromboembolia/sangre , Tromboembolia/etiología , Trombosis/sangre , Trombosis/etiología , Microangiopatías Trombóticas/diagnóstico por imagen , Microangiopatías Trombóticas/etiología , Tomografía Computarizada por Rayos X/métodos , Ultrasonografía/métodos
4.
Cancer Cytopathol ; 128(10): 679-680, 2020 10.
Artículo en Inglés | MEDLINE | ID: mdl-33006815
5.
Biomed Res Int ; 2020: 5324560, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-33029513

RESUMEN

The ongoing global pandemic caused by the human coronavirus, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), has infected millions of people and claimed hundreds of thousands of lives. The absence of approved therapeutics to combat this disease threatens the health of all persons on earth and could cause catastrophic damage to society. New drugs are therefore urgently required to bring relief to people everywhere. In addition to repurposing existing drugs, natural products provide an interesting alternative due to their widespread use in all cultures of the world. In this study, alkaloids from Cryptolepis sanguinolenta have been investigated for their ability to inhibit two of the main proteins in SARS-CoV-2, the main protease and the RNA-dependent RNA polymerase, using in silico methods. Molecular docking was used to assess binding potential of the alkaloids to the viral proteins whereas molecular dynamics was used to evaluate stability of the binding event. The results of the study indicate that all 13 alkaloids bind strongly to the main protease and RNA-dependent RNA polymerase with binding energies ranging from -6.7 to -10.6 kcal/mol. In particular, cryptomisrine, cryptospirolepine, cryptoquindoline, and biscryptolepine exhibited very strong inhibitory potential towards both proteins. Results from the molecular dynamics study revealed that a stable protein-ligand complex is formed upon binding. Alkaloids from Cryptolepis sanguinolenta therefore represent a promising class of compounds that could serve as lead compounds in the search for a cure for the corona virus disease.


Asunto(s)
Alcaloides/farmacología , Betacoronavirus/efectos de los fármacos , Infecciones por Coronavirus/tratamiento farmacológico , Cryptolepis/química , Neumonía Viral/tratamiento farmacológico , Proteínas Virales/antagonistas & inhibidores , Alcaloides/química , Antivirales/química , Antivirales/farmacología , Betacoronavirus/enzimología , Simulación por Computador , Infecciones por Coronavirus/virología , Cisteína Endopeptidasas , Evaluación Preclínica de Medicamentos , Humanos , Alcaloides Indólicos/química , Alcaloides Indólicos/farmacología , Simulación del Acoplamiento Molecular , Simulación de Dinámica Molecular , Pandemias , Neumonía Viral/virología , Relación Estructura-Actividad Cuantitativa , Quinolinas/química , Quinolinas/farmacología , ARN Replicasa/antagonistas & inhibidores , Proteínas no Estructurales Virales/antagonistas & inhibidores
6.
Biomed Res Int ; 2020: 7610678, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-33029522

RESUMEN

Background: There is a shortage of chemical reagents for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) diagnosis and a surge of SARS-CoV-2 cases, especially in limited-resource settings. Therefore, the combination of an optimal assay kit is necessary. Methods: We compared the ability to screen SARS-CoV-2 among three primer-probe sets in two different master mixes, Invitrogen™ SuperScript™ III One-Step RT-PCR and LightCycler Multiplex RNA Virus Master. Results: The assay with TIB-Molbiol, IDT, and Phu Sa sets for LightCycler Multiplex RNA Virus Master or Invitrogen™ SuperScript™ III One-Step RT-PCR showed positive results from a single reaction of triplicate in the three days of 4.8 copies per reaction. R squared and amplification efficiency were 0.97 and ranged from 107 to 108%, respectively. Conclusions: Our findings indicated that TIB-Molbiol, IDT, and Phu Sa primer-probe sets could be beneficial for the laboratory screening of SARS-CoV-2 by RT-qPCR assay of E gene. There is a need to consider the combination of these reagent sets as a new strategy to increase the testing capacity of screening programs for COVID-19.


Asunto(s)
Betacoronavirus/genética , Técnicas de Laboratorio Clínico/métodos , Infecciones por Coronavirus/diagnóstico , Cartilla de ADN/genética , Neumonía Viral/diagnóstico , Sondas ARN/genética , Betacoronavirus/aislamiento & purificación , Técnicas de Laboratorio Clínico/estadística & datos numéricos , Infecciones por Coronavirus/epidemiología , Infecciones por Coronavirus/virología , Humanos , Reacción en Cadena de la Polimerasa Multiplex/métodos , Reacción en Cadena de la Polimerasa Multiplex/estadística & datos numéricos , Pandemias , Neumonía Viral/epidemiología , Neumonía Viral/virología , ARN Viral/genética , Reacción en Cadena en Tiempo Real de la Polimerasa/métodos , Reacción en Cadena en Tiempo Real de la Polimerasa/estadística & datos numéricos , Reacción en Cadena de la Polimerasa de Transcriptasa Inversa/métodos , Reacción en Cadena de la Polimerasa de Transcriptasa Inversa/estadística & datos numéricos , Sensibilidad y Especificidad
7.
Anatol J Cardiol ; 24(4): 224-234, 2020 10.
Artículo en Inglés | MEDLINE | ID: mdl-33001051

RESUMEN

Coronavirus disease 2019 (COVID-19) caused by 'Severe Acute Respiratory Syndrome Coronavirus-2' (SARS-CoV-2) infection emerged in Wuhan, a city of China, and spread to the entire planet in early 2020. The virus enters the respiratory tract cells and other tissues via ACE2 receptors. Approximately 20% of infected subjects develop severe or critical disease. A cytokine storm leads to over inflammation and thrombotic events. The most common clinical presentation in COVID-19 is pneumonia, typically characterized by bilateral, peripheral, and patchy infiltrations in the lungs. However multi-systemic involvement including peripheral thromboembolic skin lesions, central nervous, gastrointestinal, circulatory, and urinary systems are reported. The disease has a higher mortality compared to other viral agents causing pneumonia and unfortunately, no approved specific therapy, nor vaccine has yet been discovered. Several clinical trials are ongoing with hydroxychloroquine, remdesivir, favipiravir, and low molecular weight heparins. This comprehensive review aimed to summarize coagulation abnormalities reported in COVID-19, discuss the thrombosis, and inflammation-driven background of the disease, emphasize the impact of thrombotic and inflammatory processes on the progression and prognosis of COVID-19, and to provide evidence-based therapeutic guidance, especially from antithrombotic and anti-inflammatory perspectives.


Asunto(s)
Betacoronavirus/patogenicidad , Infecciones por Coronavirus/complicaciones , Inflamación/virología , Neumonía Viral/complicaciones , Trombosis/virología , Trastornos de la Coagulación Sanguínea/terapia , Trastornos de la Coagulación Sanguínea/virología , Infecciones por Coronavirus/mortalidad , Infecciones por Coronavirus/terapia , Infecciones por Coronavirus/virología , Citocinas/metabolismo , Trastornos Hemostáticos/virología , Humanos , Inmunomodulación/fisiología , Inflamación/terapia , Pandemias , Neumonía Viral/mortalidad , Neumonía Viral/terapia , Neumonía Viral/virología , Pronóstico , Trombosis/terapia
8.
Euro Surveill ; 25(39)2020 10.
Artículo en Inglés | MEDLINE | ID: mdl-33006300

RESUMEN

We found that a single nucleotide polymorphism (SNP) in the nucleoprotein gene of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) from a patient interfered with detection in a widely used commercial assay. Some 0.2% of the isolates in the EpiCoV database contain this SNP. Although SARS-CoV-2 was still detected by the other probe in the assay, this underlines the necessity of targeting two independent essential regions of a pathogen for reliable detection.


Asunto(s)
Betacoronavirus/genética , Técnicas de Laboratorio Clínico , Infecciones por Coronavirus/diagnóstico , Nucleoproteínas/genética , Pandemias , Neumonía Viral/diagnóstico , Mutación Puntual , Polimorfismo de Nucleótido Simple , ARN Viral/genética , Reacción en Cadena en Tiempo Real de la Polimerasa , Proteínas Virales/genética , Secuencia de Bases , Betacoronavirus/aislamiento & purificación , Técnicas de Laboratorio Clínico/métodos , Trazado de Contacto , Infecciones por Coronavirus/virología , Cartilla de ADN , Errores Diagnósticos , Reacciones Falso Negativas , Femenino , Genes Virales , Humanos , Persona de Mediana Edad , Nasofaringe/virología , Nucleoproteínas/análisis , Filogenia , Neumonía Viral/virología , Reacción en Cadena en Tiempo Real de la Polimerasa/métodos , Rumanía , Enfermedad Relacionada con los Viajes , Proteínas Virales/análisis
9.
Medicine (Baltimore) ; 99(40): e22439, 2020 Oct 02.
Artículo en Inglés | MEDLINE | ID: mdl-33019426

RESUMEN

BACKGROUND: The mortality rate associated with Covid-19 varies considerably among studies and determinants of this variability are not well characterized. METHODS: A systematic review of peer-reviewed literature published through March 31, 2020 was performed to estimate the mortality rate among hospitalized patients in China with a confirmed diagnosis of Covid-19. Hospital mortality rates were estimated using an inverse variance-weighted random-effects meta-analysis model. Funnel plot symmetry was evaluated for small-study effects, a one-study removed sensitivity analysis assessed the influence of individual studies on the pooled mortality rate, and metaregression assessed the association of potential confounding variables with mortality rates. RESULTS: The review included 16 observational studies involving 1832 hospitalized patients with a diagnosis of Covid-19. The surveillance period among studies ranged from December 16, 2019 to February 23, 2020. The median patient age was 53 years and 53% were males. A total of 38.5% of patients presented with at least 1 comorbidity, most commonly hypertension (24.0%), cardiac disease (15.1%), and diabetes mellitus (14.4%). Fever and cough, reported in 84.8% and 61.7% of patients respectively, were the most common patient symptoms. The pooled mortality rate was 9.9% (95% confidence interval 6.1% to 14.5%). Funnel plot asymmetry was not observed and the meta-analysis results were not substantially influenced by any single study since the pooled mortality rate ranged from 8.9% to 11.1% following iterative removal of one study at a time. Substantial heterogeneity in the mortality rate was identified among studies (I = 87%; P < .001). In a metaregression that included demographics, patient risk factors, and presenting symptoms, only a higher prevalence of diabetes mellitus was associated with a higher mortality rate (P = .03). CONCLUSIONS: In a meta-analysis of hospitalized patients in China with a diagnosis of Covid-19, the mortality rate was 9.9% and a higher diabetes mellitus prevalence was independently associated with a worse prognosis. The independent influence of diabetes mellitus with Covid-19 mortality should be viewed as hypothesis-generating and warrants further study.


Asunto(s)
Betacoronavirus , Infecciones por Coronavirus/mortalidad , Complicaciones de la Diabetes/mortalidad , Diabetes Mellitus/mortalidad , Mortalidad Hospitalaria , Neumonía Viral/mortalidad , Adulto , Anciano , Infecciones por Coronavirus/complicaciones , Infecciones por Coronavirus/virología , Complicaciones de la Diabetes/virología , Diabetes Mellitus/virología , Femenino , Humanos , Masculino , Persona de Mediana Edad , Pandemias , Neumonía Viral/complicaciones , Neumonía Viral/virología , Prevalencia , Factores de Riesgo
10.
Nutrients ; 12(10)2020 Oct 10.
Artículo en Inglés | MEDLINE | ID: mdl-33050404

RESUMEN

Unexpected isolation, which has not yet been seen on a global scale, has created the conditions for evaluating nutrition in a situation of reduced spatial activity. The study aimed to assess the influence of lockdown on selected eating habits of Polish adults. An anonymous questionnaire was conducted, including questions about eating habits and self-reported anthropometric measurements, referring to "before" and "during" lockdown. We reported the findings of 312 adults (aged 41.12 ± 13.05 years). Overall, 64.1% of the participants were women, 77.7% urban inhabitants and 78.6% employed. The average length of social isolation was 50.79 ± 10.53 days. The majority (51.6%) of the respondents did not eat outside the house during lockdown (p < 0.0001). The number of meals eaten during the day during lockdown increased significantly, 11.2% of the respondents ate 5 and more meals (p < 0.0001). The percentage of people snacking between meals increased by 5.1% during lockdown (p = 0.0001). Eggs, potatoes, sweets, canned meat and alcohol were consumed considerably more commonly during lockdown, while fast-food products, instant soups and energy drinks were eaten or drunk significantly less frequently. A marked decrease in the number of daily servings of the following products was observed: bakery products, red meat, fast food, instant soups, sweet beverages and energy drinks. Conversely, the number of daily servings of sweets and canned meat significantly increased. Two thirds of the respondents reported body weight changes, with 45.86% of the participants being overweight during lockdown. Significant changes in the diet of Polish adults were found during lockdown due to COVID-19.


Asunto(s)
Infecciones por Coronavirus , Dieta , Conducta Alimentaria , Conductas Relacionadas con la Salud , Pandemias , Neumonía Viral , Aislamiento Social , Aumento de Peso , Adulto , Betacoronavirus , Índice de Masa Corporal , Infecciones por Coronavirus/epidemiología , Infecciones por Coronavirus/virología , Comida Rápida , Femenino , Preferencias Alimentarias , Humanos , Estilo de Vida , Masculino , Comidas , Persona de Mediana Edad , Obesidad/etiología , Sobrepeso/etiología , Neumonía Viral/epidemiología , Neumonía Viral/virología , Polonia/epidemiología , Bocadillos , Encuestas y Cuestionarios , Población Urbana
11.
Nutrients ; 12(10)2020 Oct 12.
Artículo en Inglés | MEDLINE | ID: mdl-33053656

RESUMEN

The severe acute respiratory syndrome coronavirus (SARS-CoV)-2 disease (COVID)-19 is having profound effects on the global economy and food trade. Limited data are available on how this pandemic is affecting our dietary and lifestyle-related behaviors at the global level. Google Trends was used to obtain worldwide relative search volumes (RSVs) covering a timeframe from before the COVID-19 pandemic 1 June 2019 to 27 April 2020. Spearman's rank-order correlation coefficients were used to measure relationships between daily confirmed cases and aforementioned RSVs between 31 December 2019 and 15 April 2020. RSV curves showed increased interest in multiple keywords related to dietary and lifestyle behaviors during the COVID-19 lockdown period in March and April 2020. Spearman's correlation analysis showed that the strongest variables in each keyword category were (1) food security (food shortage: r = 0.749, food bank: r = 0.660, and free food: r = 0.555; all p < 0.001), (2) dietary behaviors (delivery: r = 0.780, restaurant: r = -0.731, take-away: r = 0.731, and food-delivery: r = 0.693; all p < 0.001), (3) outdoor-related behaviors (resort: r = -0.922, hotel: r = -0.913, cinema: r = -0.844, park: r = -0.827, fitness: r = -0.817, gym: r = -0.811; plant: r = 0.749, sunbathing: r = 0.668, and online: r = 0.670; all p < 0.001), and (4) immune-related nutrients/herbs/foods (vitamin C: r = 0.802, vitamin A: r = 0.780, zinc: r = 0.781, immune: r = 0.739, vitamin E: r = 0.707, garlic: r = 0.667, omega-3 fatty acid: r = -0.633, vitamin D: r = 0.549, and turmeric: r = 0.545; all p < 0.001). Restricted movement has affected peoples' dietary and lifestyle behaviors as people tend to search for immune-boosting nutrients/herbs and have replaced outdoor activities with sedentary indoor behaviors.


Asunto(s)
Infecciones por Coronavirus , Dieta , Conducta Alimentaria , Abastecimiento de Alimentos , Estilo de Vida , Pandemias , Neumonía Viral , Aislamiento Social , Betacoronavirus , Coronavirus , Infecciones por Coronavirus/epidemiología , Infecciones por Coronavirus/inmunología , Infecciones por Coronavirus/virología , Curcuma , Ácidos Grasos Omega-3 , Ajo , Conductas Relacionadas con la Salud , Humanos , Conducta en la Búsqueda de Información , Nutrientes , Neumonía Viral/epidemiología , Neumonía Viral/inmunología , Neumonía Viral/virología , Restaurantes , Motor de Búsqueda , Conducta Sedentaria , Síndrome Respiratorio Agudo Grave , Oligoelementos , Vitaminas
12.
Arkh Patol ; 82(5): 5-15, 2020.
Artículo en Ruso | MEDLINE | ID: mdl-33054027

RESUMEN

To date, descriptive results of a clinical and morphological study of novel coronavirus COVID-19 infection, mainly of the lungs, have appeared. However, in other organs, primarily in the cardiovascular system, there are substantial structural changes that lead to multiple organ dysfunction and contribute to death. OBJECTIVE: To analyze the thanatogenetic significance of novel coronavirus COVID-19 infection in different age and gender groups and to describe the main morphopathological manifestations in various organs. MATERIAL AND METHODS: The investigators carried out a comprehensive analysis of 700 autopsies of people disease from the novel coronavirus COVID-19 infection, which included an examination of gross changes reflected in the autopsy protocols and forensic medical examination reports, as well as that of microscopic changes detected during histological examination of organs. Immunohistochemistry (IHC) using mouse or rabbit antibodies to CD34, CD68, EMA, Ki67, caspase-3, and VEGF was employed in some observations. RESULTS: The novel coronavirus COVID-19 infection was the primary cause of death. Acute respiratory and pulmonary heart failure and multiple organ dysfunction became the leading thanatogenetic mechanisms in COVID-19. Cardiovascular disease, diabetes mellitus, and obesity were the most common diseases in patients with COVID-19. The most pronounced lung changes in COVID-19 were determined with a predominance of multiple total bilateral lesions of the lower lobes of the lungs, which was manifested by virus-induced changes in the parenchyma and stroma, as well as by microcirculation disorders. Acute dyscirculatory and ischemic changes in the parenchymal organs dominated in tissue damage caused by the virus. CONCLUSION: The changes in different organs of those who have died from the new coronavirus COVID-19 infection are stereotyped and include the manifestations of virus-induced action and a systemic inflammatory response with mainly microvasculature alteration, which leads to the development of coagulopathies and, accordingly, to total hypoxia.


Asunto(s)
Betacoronavirus/patogenicidad , Infecciones por Coronavirus/patología , Neumonía Viral/patología , Autopsia , Causas de Muerte , Infecciones por Coronavirus/mortalidad , Infecciones por Coronavirus/virología , Humanos , Pandemias , Neumonía Viral/mortalidad , Neumonía Viral/virología
13.
Arkh Patol ; 82(5): 57-62, 2020.
Artículo en Ruso | MEDLINE | ID: mdl-33054033

RESUMEN

The paper describes 4 autopsy cases of myocarditis in elderly patients with confirmed coronavirus infection. It gives the data of a morphological study of heart specimens and a detailed characterization of a myocardial infiltrate. An immunohistochemical study with cellular infiltrate typing was performed. The fact that lymphocytic viral myocarditis can develop in COVID-19 was morphologically and immunohistochemically confirmed. The features of myocarditis in COVID-19 are the development of the former in the presence of coronaritis and the possibility of its concurrence with lymphocytic endo- and pericarditis.


Asunto(s)
Infecciones por Coronavirus/complicaciones , Linfocitos/patología , Miocarditis/complicaciones , Miocarditis/virología , Neumonía Viral/complicaciones , Anciano , Autopsia , Betacoronavirus/patogenicidad , Infecciones por Coronavirus/patología , Infecciones por Coronavirus/virología , Humanos , Inmunohistoquímica , Miocarditis/patología , Pandemias , Neumonía Viral/patología , Neumonía Viral/virología
14.
BMJ ; 371: m3513, 2020 09 30.
Artículo en Inglés | MEDLINE | ID: mdl-32998872

RESUMEN

OBJECTIVES: To estimate the incidence, risk factors, and outcomes associated with in-hospital cardiac arrest and cardiopulmonary resuscitation in critically ill adults with coronavirus disease 2019 (covid-19). DESIGN: Multicenter cohort study. SETTING: Intensive care units at 68 geographically diverse hospitals across the United States. PARTICIPANTS: Critically ill adults (age ≥18 years) with laboratory confirmed covid-19. MAIN OUTCOME MEASURES: In-hospital cardiac arrest within 14 days of admission to an intensive care unit and in-hospital mortality. RESULTS: Among 5019 critically ill patients with covid-19, 14.0% (701/5019) had in-hospital cardiac arrest, 57.1% (400/701) of whom received cardiopulmonary resuscitation. Patients who had in-hospital cardiac arrest were older (mean age 63 (standard deviation 14) v 60 (15) years), had more comorbidities, and were more likely to be admitted to a hospital with a smaller number of intensive care unit beds compared with those who did not have in-hospital cardiac arrest. Patients who received cardiopulmonary resuscitation were younger than those who did not (mean age 61 (standard deviation 14) v 67 (14) years). The most common rhythms at the time of cardiopulmonary resuscitation were pulseless electrical activity (49.8%, 199/400) and asystole (23.8%, 95/400). 48 of the 400 patients (12.0%) who received cardiopulmonary resuscitation survived to hospital discharge, and only 7.0% (28/400) survived to hospital discharge with normal or mildly impaired neurological status. Survival to hospital discharge differed by age, with 21.2% (11/52) of patients younger than 45 years surviving compared with 2.9% (1/34) of those aged 80 or older. CONCLUSIONS: Cardiac arrest is common in critically ill patients with covid-19 and is associated with poor survival, particularly among older patients.


Asunto(s)
Betacoronavirus , Infecciones por Coronavirus/mortalidad , Paro Cardíaco/mortalidad , Mortalidad Hospitalaria , Neumonía Viral/mortalidad , Adulto , Anciano , Anciano de 80 o más Años , Estudios de Cohortes , Infecciones por Coronavirus/complicaciones , Infecciones por Coronavirus/virología , Femenino , Paro Cardíaco/virología , Humanos , Unidades de Cuidados Intensivos/estadística & datos numéricos , Masculino , Persona de Mediana Edad , Pandemias , Neumonía Viral/complicaciones , Neumonía Viral/virología , Estados Unidos/epidemiología
15.
Nat Commun ; 11(1): 4938, 2020 10 02.
Artículo en Inglés | MEDLINE | ID: mdl-33009401

RESUMEN

Antiviral strategies to inhibit Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV2) and the pathogenic consequences of COVID-19 are urgently required. Here, we demonstrate that the NRF2 antioxidant gene expression pathway is suppressed in biopsies obtained from COVID-19 patients. Further, we uncover that NRF2 agonists 4-octyl-itaconate (4-OI) and the clinically approved dimethyl fumarate (DMF) induce a cellular antiviral program that potently inhibits replication of SARS-CoV2 across cell lines. The inhibitory effect of 4-OI and DMF extends to the replication of several other pathogenic viruses including Herpes Simplex Virus-1 and-2, Vaccinia virus, and Zika virus through a type I interferon (IFN)-independent mechanism. In addition, 4-OI and DMF limit host inflammatory responses to SARS-CoV2 infection associated with airway COVID-19 pathology. In conclusion, NRF2 agonists 4-OI and DMF induce a distinct IFN-independent antiviral program that is broadly effective in limiting virus replication and in suppressing the pro-inflammatory responses of human pathogenic viruses, including SARS-CoV2.


Asunto(s)
Antiinflamatorios/farmacología , Antivirales/farmacología , Betacoronavirus/efectos de los fármacos , Infecciones por Coronavirus/tratamiento farmacológico , Dimetilfumarato/agonistas , Factor 2 Relacionado con NF-E2/metabolismo , Neumonía Viral/tratamiento farmacológico , Succinatos/agonistas , Adulto , Antioxidantes/farmacología , Betacoronavirus/metabolismo , Infecciones por Coronavirus/virología , Dimetilfumarato/farmacología , Femenino , Expresión Génica , Técnicas de Silenciamiento del Gen , Humanos , Interferón Tipo I , Pulmón/patología , Masculino , Factor 2 Relacionado con NF-E2/genética , Pandemias , Neumonía Viral/virología , Transducción de Señal/efectos de los fármacos , Succinatos/farmacología , Replicación Viral/efectos de los fármacos
16.
Ned Tijdschr Geneeskd ; 1642020 09 08.
Artículo en Holandés | MEDLINE | ID: mdl-33030322

RESUMEN

Since there is no adequate treatment for COVID-19, prevention of the transmission of SARS-CoV2 is the best way to cope with the pandemic. National guidelines for non-pharmaceutical interventions focus mainly on the interference with viral transmission via droplets and surface by hygiene measures, limitation of human contact, and social distancing. There is growing evidence that a third route of transmission by aerosols - exhaled tiny particles with viable infectious virus that remain airborne for hours - may be relevant. This route may even be the predominant way of viral transmission in the case of so-called superspreading events. It implies the need for adequate ventilation at indoor spaces without recirculation of virus containing aerosols. Here, the use of face-masks might be of added value too. These measures appear to be especially pivotal during episodes of colder weather, when people spend significantly more time indoors.


Asunto(s)
Microbiología del Aire , Betacoronavirus , Infecciones por Coronavirus/transmisión , Neumonía Viral/transmisión , Aerosoles , Infecciones por Coronavirus/prevención & control , Infecciones por Coronavirus/virología , Humanos , Pandemias/prevención & control , Equipo de Protección Personal , Neumonía Viral/prevención & control , Neumonía Viral/virología , Ventilación
18.
PLoS One ; 15(10): e0239400, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-33035216

RESUMEN

BACKGROUND: After a COVID-19 diagnosis, vulnerable populations face considerable logistical and financial challenges to isolate and quarantine. We developed and evaluated a novel, community-based approach ('Test-to-Care' Model) designed to address these barriers for socioeconomically vulnerable Latinx individuals with newly diagnosed COVID-19 and their households. METHODS: This three-week demonstration project was nested within an epidemiologic surveillance study in a primarily Latinx neighborhood in the Mission district of San Francisco, California. The Test-to-Care model was developed with input from community members and public health leaders. Key components included: (1) provision of COVID-19-related education and information about available community resources, (2) home deliveries of material goods to facilitate safe isolation and quarantine (groceries, personal protective equipment and cleaning supplies), and (3) longitudinal clinical and social support. Newly SARS-CoV-2 PCR-positive participants were eligible to participate. Components of the model were delivered by the Test-to-Care team, which was comprised of healthcare providers and community health workers (CHWs) who provided longitudinal clinic- and community-based support for the duration of the isolation period to augment existing services from the Department of Public Health (DPH). We evaluated the Test-to-Care Model using the Reach, Effectiveness, Adoption, Implementation, Maintenance (RE-AIM) Framework and drew upon multiple data sources including: programmatic data, informal interviews with participants and providers/CHWs and structured surveys among providers/CHWs. RESULTS: Overall, 83 participants in the surveillance study were diagnosed with COVID-19, of whom 95% (79/83) were Latinx and 88% (65/74) had an annual household income <$50,000. Ninety-six percent (80/83) of participants were reached for results disclosure, needs assessment and DPH linkage for contact tracing. Among those who underwent an initial needs assessment, 45% (36/80) were uninsured and 55% (44/80) were not connected to primary care. Sixty-seven percent (56/83) of participants requested community-based CHW support to safely isolate at their current address and 65% (54/83) of all COVID-19 participants received ongoing community support via CHWs for the entire self-isolation period. Participants reported that the intervention was highly acceptable and that their trust increased over time-this resulted in 9 individuals who disclosed a larger number of household members than first reported, and 6 persons who requested temporary relocation to a hotel room for isolation despite initially declining this service; no unintended harms were identified. The Test-to-Care Model was found to be both acceptable and feasible to providers and CHWs. Challenges identified included a low proportion of participants linked to primary care despite support (approximately 10% after one month), and insufficient access to financial support for wage replacement. CONCLUSIONS: The Test-to-Care Model is a feasible and acceptable intervention for supporting self-isolation and quarantine among newly diagnosed COVID-19 patients and their households by directly addressing key barriers faced by socioeconomically vulnerable populations.


Asunto(s)
Infecciones por Coronavirus/diagnóstico , Modelos Teóricos , Neumonía Viral/diagnóstico , Pobreza , Adolescente , Adulto , Anciano , Betacoronavirus/genética , Betacoronavirus/aislamiento & purificación , Niño , Preescolar , Agentes Comunitarios de Salud/educación , Agentes Comunitarios de Salud/psicología , Infecciones por Coronavirus/economía , Infecciones por Coronavirus/terapia , Infecciones por Coronavirus/virología , Femenino , Humanos , Entrevistas como Asunto , Masculino , Persona de Mediana Edad , Pandemias/economía , Neumonía Viral/economía , Neumonía Viral/terapia , Neumonía Viral/virología , Atención Primaria de Salud , Cuarentena , Apoyo Social , Encuestas y Cuestionarios , Adulto Joven
19.
PLoS One ; 15(10): e0239254, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-33035219

RESUMEN

In Bangladesh, an array of measures have been adopted to control the rapid spread of the COVID-19 epidemic. Such general population control measures could significantly influence perception, knowledge, attitudes, and practices (KAP) towards COVID-19. Here, we assessed KAP towards COVID-19 immediately after the lock-down measures were implemented and during the rapid rise period of the outbreak. Online-based cross-sectional study conducted from March 29 to April 19, 2020, involving Bangladeshi residents aged 12-64 years, recruited via social media. After consenting, participants completed an online survey assessing socio-demographic variables, perception, and KAP towards COVID-19. Of the 2017 survey participants, 59.8% were male, the majority were students (71.2%), aged 21-30 years (57.9%), having a bachelor's degree (61.0%), having family income >30,000 BDT (50.0%), and living in urban areas (69.8). The survey revealed that 48.3% of participants had more accurate knowledge, 62.3% had more positive attitudes, and 55.1% had more frequent practices regarding COVID-19 prevention. Majority (96.7%) of the participants agreed 'COVID-19 is a dangerous disease', almost all (98.7%) participants wore a face mask in crowded places, 98.8% agreed to report a suspected case to health authorities, and 93.8% implemented washing hands with soap and water. In multiple logistic regression analyses, COVID-19 more accurate knowledge was associated with age and residence. Sociodemographic factors such as being older, higher education, employment, monthly family income >30,000 BDT, and having more frequent prevention practices were the more positive attitude factors. More frequent prevention practice factors were associated with female sex, older age, higher education, family income > 30,000 BDT, urban area residence, and having more positive attitudes. To improve KAP of general populations is crucial during the rapid rise period of a pandemic outbreak such as COVID-19. Therefore, development of effective health education programs that incorporate considerations of KAP-modifying factors is needed.


Asunto(s)
Infecciones por Coronavirus/patología , Conocimientos, Actitudes y Práctica en Salud , Neumonía Viral/patología , Adolescente , Adulto , Bangladesh/epidemiología , Betacoronavirus/aislamiento & purificación , Niño , Infecciones por Coronavirus/epidemiología , Infecciones por Coronavirus/virología , Estudios Transversales , Femenino , Humanos , Internet , Masculino , Persona de Mediana Edad , Pandemias , Neumonía Viral/epidemiología , Neumonía Viral/virología , Factores de Riesgo , Autoinforme , Encuestas y Cuestionarios , Adulto Joven
20.
PLoS One ; 15(10): e0239490, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-33035228

RESUMEN

This study analyzes the effects of COVID-19 confinement on the autonomous learning performance of students in higher education. Using a field experiment with 458 students from three different subjects at Universidad Autónoma de Madrid (Spain), we study the differences in assessments by dividing students into two groups. The first group (control) corresponds to academic years 2017/2018 and 2018/2019. The second group (experimental) corresponds to students from 2019/2020, which is the group of students that had their face-to-face activities interrupted because of the confinement. The results show that there is a significant positive effect of the COVID-19 confinement on students' performance. This effect is also significant in activities that did not change their format when performed after the confinement. We find that this effect is significant both in subjects that increased the number of assessment activities and subjects that did not change the student workload. Additionally, an analysis of students' learning strategies before confinement shows that students did not study on a continuous basis. Based on these results, we conclude that COVID-19 confinement changed students' learning strategies to a more continuous habit, improving their efficiency. For these reasons, better scores in students' assessment are expected due to COVID-19 confinement that can be explained by an improvement in their learning performance.


Asunto(s)
Infecciones por Coronavirus/patología , Educación a Distancia , Evaluación Educacional/estadística & datos numéricos , Neumonía Viral/patología , Adulto , Betacoronavirus/aislamiento & purificación , Infecciones por Coronavirus/virología , Femenino , Humanos , Masculino , Modelos Teóricos , Pandemias , Neumonía Viral/virología , España , Estudiantes de Medicina/estadística & datos numéricos , Adulto Joven
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