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1.
Medicine (Baltimore) ; 100(29): e26533, 2021 Jul 23.
Artículo en Inglés | MEDLINE | ID: mdl-34398008

RESUMEN

ABSTRACT: The coronavirus disease 2019 (COVID-19) pandemic, caused by severe acute respiratory syndrome coronavirus 2, keeps spreading globally. Evidence suggests that a subgroup of patients with severe symptomatology might have cytokine storms, which increases mortality. The use of interleukin-6 (IL-6) inhibitors may help in controlling the pathological immune response to the virus. Tocilizumab, a monoclonal antibody against IL-6, stands as an optional treatment for COVID-19 patients presenting this inflammatory hyper-response.We conducted a retrospective, observational, cohort study including 50 patients affected by COVID-19 with severe pneumonia and poor prognosis criteria, who have also undergone standard treatment; 36 of these patients additionally received tocilizumab in an early stage. The need for intensive care unit (ICU) admission, mortality, recovery of respiratory function, and improvement of biochemical and hematological parameters were compared between cohorts.Most patients were men, non-smokers and the most frequently reported comorbidities were hypertension and diabetes. Recurrent symptoms were fever, cough, and dyspnoea. 54.8% of patients from the tocilizumab group needed intubation, while in the control group 85.7% needed it. Treatment with tocilizumab significatively increased IL-6 levels, (554.45; CI 95% 186.69, 1032.93; P < .05) while C-reactive protein mean levels were reduced (-108.19; CI 95% -140.15, -75.33; P < .05), but no significant difference was found between cohorts. In comparison with the controls, tocilizumab reduced mortality (25.0% vs 42.9%, P = .021) and the number of ICU admissions (63.9% vs 100.0%, P = .021). 44.1% of patients treated with tocilizumab showed favorable radiological evolution, when compared with 15.4% of patients from the control group.Tocilizumab may improve clinical symptoms and mitigate deterioration observed in severe COVID-19 patients, and could be considered as an effective therapeutic option in subjects experiencing a significant inflammatory response to the disease.


Asunto(s)
Anticuerpos Monoclonales Humanizados/uso terapéutico , COVID-19/tratamiento farmacológico , Unidades de Cuidados Intensivos/estadística & datos numéricos , Interleucina-6/antagonistas & inhibidores , Neumonía Viral/tratamiento farmacológico , Adulto , Anciano , Anciano de 80 o más Años , COVID-19/complicaciones , COVID-19/diagnóstico , COVID-19/mortalidad , Femenino , Humanos , Masculino , Persona de Mediana Edad , Neumonía Viral/diagnóstico , Neumonía Viral/etiología , Neumonía Viral/mortalidad , Pronóstico , Estudios Retrospectivos
2.
Crit Rev Biomed Eng ; 49(1): 21-33, 2021.
Artículo en Inglés | MEDLINE | ID: mdl-34347985

RESUMEN

The outbreak of coronavirus disease 2019 (COVID-19) has resulted in a world-wide crisis. To contain the virus, it is important to find infected individuals and isolate them to stop transmission. Various diagnostic techniques are used to check for infection. With the havoc that severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) has created, it is imperative to work on alternative diagnostic techniques that can be used at both point of care with little or no expertise and at mass testing (i.e., when screening). Despite extensive research, to this date no specific effective treatment or cure is available to neutralize this viral infection. Globally, researchers are working to develop effective treatments, and several vaccines have been approved for public use. We found the studies that we explored for this review using appropriate key words for indexing in PubMed and Google Scholar from 2019 to 2020. We compile various techniques that have been used worldwide to diagnose and treat SARS-CoV-2 and discuss novel methods that may be modified for use in diagnosis and treatment. It is crucial to develop a more specific serological test for diagnosis that can rule out the possibility of COVID-19 and be used for mass testing. An affordable, safe, targeted, effective treatment must be developed to cure this disease, which has created a public health emergency of international concern.


Asunto(s)
Prueba de COVID-19/tendencias , COVID-19/diagnóstico , COVID-19/terapia , Salud Global , Neumonía Viral/diagnóstico , Neumonía Viral/terapia , Vacunas contra la COVID-19 , Humanos , Pandemias , SARS-CoV-2
3.
Dan Med J ; 68(8)2021 Jul 12.
Artículo en Inglés | MEDLINE | ID: mdl-34356014

RESUMEN

INTRODUCTION: Viral pneumonia is a common cause of hospital admission among Danish children. However, it remains unknown how many admissions among Danish children may be ascribed to viral pneumonia overall. METHODS: Based on data drawn from the National Patient Register and the Danish Microbiology Database, hospital admissions for viral pneumonia and asthma-like disease were investigated among Danish children and adolescents less than 18 years. Testing of admitted patients for respiratory syncytial virus (RSV) and influenza virus was also considered. RESULTS: A total of 5,218 admissions with a diagnosis of viral pneumonia were identified among Danish children and adolescents less than 18 years from 2012 to 2016. During the same period, 63,731 tests were conducted during hospital admission for RSV or influenza virus, which produced 9,933 positive tests for RSV and 3,287 for influenza. In addition, 43,213 admissions were due to asthma-like disease. CONCLUSIONS: The present study documented overlapping age and seasonal epidemiological patterns of different measures of viral pneumonia among Danish children and presented how the collection of data from different sources (diagnoses and diagnostic tests) yielded a more complete picture of the burden of hospital contacts among Danish children and adolescents caused by viral pneumonia. Viral pneumonia is a very common cause of hospital admission among Danish children and adolescents. FUNDING: No specific funding was available for the present project. TRIAL REGISTRATION: not relevant.


Asunto(s)
Asma , Neumonía Viral , Virus Sincitial Respiratorio Humano , Adolescente , Niño , Dinamarca/epidemiología , Hospitalización , Humanos , Lactante , Neumonía Viral/diagnóstico , Neumonía Viral/epidemiología
4.
Comput Math Methods Med ; 2021: 5528144, 2021.
Artículo en Inglés | MEDLINE | ID: mdl-34194535

RESUMEN

Pneumonia is an infamous life-threatening lung bacterial or viral infection. The latest viral infection endangering the lives of many people worldwide is the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), which causes COVID-19. This paper is aimed at detecting and differentiating viral pneumonia and COVID-19 disease using digital X-ray images. The current practices include tedious conventional processes that solely rely on the radiologist or medical consultant's technical expertise that are limited, time-consuming, inefficient, and outdated. The implementation is easily prone to human errors of being misdiagnosed. The development of deep learning and technology improvement allows medical scientists and researchers to venture into various neural networks and algorithms to develop applications, tools, and instruments that can further support medical radiologists. This paper presents an overview of deep learning techniques made in the chest radiography on COVID-19 and pneumonia cases.


Asunto(s)
Prueba de COVID-19/métodos , COVID-19/diagnóstico por imagen , Aprendizaje Profundo , SARS-CoV-2 , Algoritmos , COVID-19/diagnóstico , Prueba de COVID-19/estadística & datos numéricos , Biología Computacional , Diagnóstico Diferencial , Humanos , Conceptos Matemáticos , Redes Neurales de la Computación , Neumonía Viral/diagnóstico , Neumonía Viral/diagnóstico por imagen , Radiografía Torácica/estadística & datos numéricos , Tomografía Computarizada por Rayos X/estadística & datos numéricos
5.
J Coll Physicians Surg Pak ; 31(7): S117-S119, 2021 07.
Artículo en Inglés | MEDLINE | ID: mdl-34271808

RESUMEN

Pneumonia is one of the major manifestations of infection by the novel coronavirus (COVID-19) virus. CT scans are used as first line investigation in suspected cases. Biopsies are almost never done. The gross and microscopic pathology has been studied mostly on autopsy specimens in fatal cases. We present a case of a mildly symptomatic adult male, who was a chronic liver disease patient awaiting liver transplant. His lung biopsy was done for diagnosis of a lesion, suspected to be a fungal infection. He was tested for COVID-19 and was PCR-negative at the time. His biopsy showed patchy changes of viral pneumonia. One week later, he tested positive for COVID-19 on PCR. He became asymptomatic soon and the ground glass lung opacities cleared up within another week without any treatment in spite of having a serious comorbid condition.   Key Words: Viral pneumonia, COVID-19, Lung biopsy.


Asunto(s)
COVID-19 , Neumonía Viral , Adulto , Biopsia , Humanos , Pulmón/diagnóstico por imagen , Masculino , Neumonía Viral/diagnóstico , SARS-CoV-2
6.
WMJ ; 120(2): 100-105, 2021 Jul.
Artículo en Inglés | MEDLINE | ID: mdl-34255948

RESUMEN

INTRODUCTION: Testing and mitigation strategies for severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) infection often focus on high-prevalence, urban communities, leaving low-prevalence rural areas without specific strategies to maintain the health and safety of their populations. We evaluated a cost-effective strategy for SARS-CoV-2 testing to determine point prevalence in a rural community with a generally low prevalence of infection. METHODS: We voluntarily tested asymptomatic clinic employees and conducted 2 community SARS-CoV-2 testing events in Cashton, Wisconsin, that included testing for asymptomatic persons. We also partnered with local clinics and public health departments to conduct weekly drive-up clinics for asymptomatic, high-risk persons identified through enhanced contact tracing. This was possible as testing capacity in Wisconsin never reached its maximum, and we continued symptomatic testing through our clinic. RESULTS: We tested 61 employees, 268 individuals at 2 community events, 36 high-risk asymptomatic people at drive-up clinic events, and 128 symptomatic people within our clinic. We observed 1 positive result in asymptomatic people and 5 positive results in symptomatic patients, confirming the low prevalence in our area. CONCLUSIONS: Our testing events confirmed a low prevalence of SARS-CoV-2 infection, providing prevalence information to local businesses and schools. We reinforced our partnership with local public health departments to facilitate enhanced contact tracing and test asymptomatic persons, and we provided a service to asymptomatic persons requiring testing for travel, school, or work. Local businesses and community members appreciated the services and expressed relief for point-in-time testing results during a period of stress and uncertainty.


Asunto(s)
Prueba de COVID-19 , COVID-19/diagnóstico , COVID-19/epidemiología , Neumonía Viral/diagnóstico , Neumonía Viral/epidemiología , Adulto , Anciano , Documentación , Femenino , Humanos , Masculino , Persona de Mediana Edad , Pandemias , Neumonía Viral/virología , Prevalencia , Población Rural , SARS-CoV-2 , Wisconsin/epidemiología
7.
Ann Palliat Med ; 10(7): 7194-7204, 2021 Jul.
Artículo en Inglés | MEDLINE | ID: mdl-34263632

RESUMEN

BACKGROUND: Severe adenovirus pneumonia (SAP) of children is prone to multi-system complications, has the high mortality rate and high incidence of sequelae. Severity prediction can facilitate an adequate individualized treatment plan. Our study try to develop and evaluate a predictive nomogram for children with SAP. METHODS: An observational study was designed and performed retrospectively. The data were categorized as training and validation datasets using the method of credible random split-sample (split ratio =0.7:0.3). The predictors were selected using Lasso (least absolute shrinkage and selection operator) logistic regression and the nomogram was developed. Nomogram discrimination was assessed using the receiver operating characteristic (ROC) curve, and the prediction accuracy was evaluated using a calibration curve. The nomogram was also evaluated for clinical effectiveness by the decision curve analysis (DCA). A P value of <0.05 was deemed statistically significant. RESULTS: The identified predictors were fever duration, and interleukin-6 and CD4+ T cells and were assembled into the nomogram. The nomogram exhibited good discrimination with area under ROC curve in training dataset (0.79, 95% CI: 0.60-0.92) and test dataset (0.76, 95% CI: 0.63-0.87). The nomogram seems to be useful clinically as per DCA. CONCLUSIONS: A nomogram with a potentially effective application was developed to facilitate individualized prediction for SAP in children.


Asunto(s)
Nomogramas , Neumonía Viral , Adenoviridae , Niño , Humanos , Neumonía Viral/diagnóstico , Curva ROC , Estudios Retrospectivos
8.
Sci Rep ; 11(1): 14471, 2021 07 14.
Artículo en Inglés | MEDLINE | ID: mdl-34262116

RESUMEN

Early detection of severe forms of COVID-19 is absolutely essential for timely triage of patients. We longitudinally followed-up two well-characterized patient groups, hospitalized moderate to severe (n = 26), and ambulatory mild COVID-19 patients (n = 16) at home quarantine. Human D-dimer, C-reactive protein (CRP), ferritin, cardiac troponin I, interleukin-6 (IL-6) levels were measured on day 1, day 7, day 14 and day 28. All hospitalized patients were SARS-CoV-2 positive on admission, while all ambulatory patients were SARS-CoV-2 positive at recruitment. Hospitalized patients had higher D-dimer, CRP and ferritin, cardiac troponin I and IL-6 levels than ambulatory patients (p < 0.001, p < 0.001, p = 0.016, p = 0.035, p = 0.002 respectively). Hospitalized patients experienced significant decreases in CRP, ferritin and IL-6 levels from admission to recovery (p < 0.001, p = 0.025, and p = 0.001 respectively). Cardiac troponin I levels were high during the acute phase in both hospitalized and ambulatory patients, indicating a potential myocardial injury. In summary, D-dimer, CRP, ferritin, cardiac troponin I, IL-6 are predictive laboratory markers and can largely determine the clinical course of COVID-19, in particular the prognosis of critically ill COVID-19 patients.


Asunto(s)
COVID-19/sangre , COVID-19/diagnóstico , Atención Ambulatoria , Biomarcadores/sangre , Proteína C-Reactiva/análisis , Diagnóstico Precoz , Ferritinas/sangre , Productos de Degradación de Fibrina-Fibrinógeno/análisis , Estudios de Seguimiento , Hospitalización , Humanos , Interleucina-6/sangre , Estudios Longitudinales , Neumonía Viral/sangre , Neumonía Viral/diagnóstico , Medicina de Precisión , Pronóstico , Cuarentena , SARS-CoV-2 , Índice de Severidad de la Enfermedad , Troponina I/sangre
9.
Rev Bras Ter Intensiva ; 33(2): 325, 2021.
Artículo en Portugués, Inglés | MEDLINE | ID: mdl-34231815

RESUMEN

COVID-19 was declared a pandemic by the World Health Organization on March 11, 2020. The clinical presentation is predominantly respiratory symptoms; however, in the current literature, several neurological manifestations associated with SARS-CoV-2 infection have been described. The authors present the clinical case of a 45-year-old man hospitalized for pneumonia with a positive test result for SARS-CoV-2, without a neurological history, who, on the sixteenth day of hospitalization, presented a sudden change in his state of consciousness accompanied by conjugated right gaze deviation and myoclonus of the face and thoracic region to the left, followed by generalized tonic-clonic seizures associated with persistent left hemiparesis. The present study highlights a positive RT-PCR test for SARS-CoV-2 in cerebrospinal fluid. The patient progressed with gradual improvement, and the outcome was favorable.


Asunto(s)
COVID-19/complicaciones , Enfermedades del Sistema Nervioso/virología , SARS-CoV-2/aislamiento & purificación , Hospitalización , Humanos , Masculino , Persona de Mediana Edad , Enfermedades del Sistema Nervioso/fisiopatología , Neumonía Viral/diagnóstico , Convulsiones/virología
10.
BMC Pulm Med ; 21(1): 233, 2021 Jul 13.
Artículo en Inglés | MEDLINE | ID: mdl-34256743

RESUMEN

BACKGROUND: To explore the long-term trajectories considering pneumonia volumes and lymphocyte counts with individual data in COVID-19. METHODS: A cohort of 257 convalescent COVID-19 patients (131 male and 126 females) were included. Group-based multi-trajectory modelling was applied to identify different trajectories in terms of pneumonia lesion percentage and lymphocyte counts covering the time from onset to post-discharge follow-ups. We studied the basic characteristics and disease severity associated with the trajectories. RESULTS: We characterised four distinct trajectory subgroups. (1) Group 1 (13.9%), pneumonia increased until a peak lesion percentage of 1.9% (IQR 0.7-4.4) before absorption. The slightly decreased lymphocyte rapidly recovered to the top half of the normal range. (2) Group 2 (44.7%), the peak lesion percentage was 7.2% (IQR 3.2-12.7). The abnormal lymphocyte count restored to normal soon. (3) Group 3 (26.0%), the peak lesion percentage reached 14.2% (IQR 8.5-19.8). The lymphocytes continuously dropped to 0.75 × 109/L after one day post-onset before slowly recovering. (4) Group 4 (15.4%), the peak lesion percentage reached 41.4% (IQR 34.8-47.9), much higher than other groups. Lymphopenia was aggravated until the lymphocytes declined to 0.80 × 109/L on the fourth day and slowly recovered later. Patients in the higher order groups were older and more likely to have hypertension and diabetes (all P values < 0.05), and have more severe disease. CONCLUSIONS: Our findings provide new insights to understand the heterogeneous natural courses of COVID-19 patients and the associations of distinct trajectories with disease severity, which is essential to improve the early risk assessment, patient monitoring, and follow-up schedule.


Asunto(s)
COVID-19 , Convalecencia , Neumonía Viral/sangre , Neumonía Viral/diagnóstico , Adulto , Femenino , Humanos , Recuento de Linfocitos , Masculino , Persona de Mediana Edad , Estudios Retrospectivos , Índice de Severidad de la Enfermedad
11.
Medicine (Baltimore) ; 100(25): e26446, 2021 Jun 25.
Artículo en Inglés | MEDLINE | ID: mdl-34160438

RESUMEN

RATIONALE: Viruses are the most common pathogens that can cause infection-related non-recurrent death after transplantation, occurring mostly from the early stages of hematopoietic stem cell transplantation (HSCT) to within 1 year after transplantation. Human coronavirus (HCoV)-NL63 is a coronavirus that could cause mortality among patients with underlying disease complications. Serological tests are of limited diagnostic value in immunocompromised hosts and cases of latent infection reactivation. In contrast, macro-genomic high-throughput (DNA and RNA) sequencing allows for rapid and accurate diagnosis of infecting pathogens for targeted treatment. PATIENT CONCERNS: In this report, we describe a patient who exhibited acute B-lymphocytic leukemia and developed complicated pulmonary HCoV-NL63 infection after a second allogeneic HSCT (allo-HSCT). Six months after the second allo-HSCT, he developed sudden-onset hyperthermia and cough with decreased oxygen saturation. Chest computed tomography (CT) suggested bilateral multiple rounded ground-glass opacities with the pulmonary lobules as units. DIAGNOSES: HCoV-NL63 was detected by metagenomic next-generation sequencing (NGS), and HCoV-NL63 viral pneumonia was diagnosed. INTERVENTIONS: The treatment was mainly based on the use of antiviral therapy, hormone administration, and gamma-globulin. OUTCOMES: After the therapy, the body temperature returned to normal, the chest CT findings had improved on review, and the viral copy number eventually became negative. LESSONS: The latest NGS is an effective method for early infection diagnosis. The HCoV-NL63 virus can cause inflammatory factor storm and alter the neutrophil-to-lymphocyte ratio (NLR). This case suggests that the patient's NLR and cytokine levels could be monitored during the clinical treatment to assess the disease and its treatment outcome in a timely manner.


Asunto(s)
Infecciones por Coronavirus/diagnóstico , Coronavirus Humano NL63/aislamiento & purificación , Trasplante de Células Madre Hematopoyéticas/efectos adversos , Leucemia de Células B/terapia , Neumonía Viral/diagnóstico , Antivirales/administración & dosificación , Infecciones por Coronavirus/tratamiento farmacológico , Infecciones por Coronavirus/inmunología , Infecciones por Coronavirus/virología , Coronavirus Humano NL63/genética , Coronavirus Humano NL63/inmunología , Quimioterapia Combinada/métodos , Secuenciación de Nucleótidos de Alto Rendimiento , Humanos , Huésped Inmunocomprometido , Leucemia de Células B/inmunología , Pulmón/diagnóstico por imagen , Masculino , Metagenómica , Neumonía Viral/tratamiento farmacológico , Neumonía Viral/inmunología , Neumonía Viral/virología , Tomografía Computarizada por Rayos X , Trasplante Homólogo/efectos adversos , Adulto Joven , gammaglobulinas/administración & dosificación
13.
BMC Infect Dis ; 21(1): 524, 2021 Jun 04.
Artículo en Inglés | MEDLINE | ID: mdl-34088268

RESUMEN

BACKGROUND: With pandemic of coronavirus disease 2019 (COVID-19), human coronaviruses (HCoVs) have recently attached worldwide attention as essential pathogens in respiratory infection. HCoV-229E has been described as a rare cause of lower respiratory infection in immunocompetent adults. CASE PRESENTATION: We reported a 72-year-old man infected by HCoV-229E with rapid progression to acute respiratory distress syndrome, in conjunction with new onset atrial fibrillation, intensive care unit acquired weakness, and recurrent hospital acquired pneumonia. Clinical and radiological data were continuously collected. The absolute number of peripheral T cells and the level of complement components diminished initially and recovered after 2 months. The patient was successfully treated under intensive support care and discharged from the hospital after 3 months and followed. CONCLUSION: HCoV-229E might an essential causative agent of pulmonary inflammation and extensive lung damage. Supportive treatment was essential to HCoVs infection on account of a long duration of immunological recovery in critical HCoV-229E infection.


Asunto(s)
Resfriado Común/diagnóstico , Coronavirus Humano 229E , Infecciones por Coronavirus/diagnóstico , Neumonía Viral/diagnóstico , Anciano , Antibacterianos/uso terapéutico , Líquido del Lavado Bronquioalveolar/virología , Resfriado Común/complicaciones , Resfriado Común/virología , Infecciones por Coronavirus/complicaciones , Diabetes Mellitus , Neumonía Asociada a la Atención Médica/complicaciones , Neumonía Asociada a la Atención Médica/tratamiento farmacológico , Secuenciación de Nucleótidos de Alto Rendimiento , Humanos , Masculino , Neumonía Viral/tratamiento farmacológico
14.
Clin Transl Gastroenterol ; 12(6): e00348, 2021 06 04.
Artículo en Inglés | MEDLINE | ID: mdl-34092777

RESUMEN

INTRODUCTION: Patients with community-acquired pneumonia display enhanced levels of lipopolysaccharides (LPS) compared with controls, suggesting that low-grade endotoxemia may be implicated in vascular disturbances. It is unknown whether this occurs in patients with coronavirus 2019 (COVID-19) and its impact on thrombotic complications. METHODS: We measured serum levels of zonulin, a marker of gut permeability, LPS, and D-dimer in 81 patients with COVID-19 and 81 healthy subjects; the occurrence of thrombotic events in COVID-19 during the intrahospital stay was registered. RESULTS: Serum LPS and zonulin were higher in patients with COVID-19 than in control subjects and, in COVID-19, significantly correlated (R = 0.513; P < 0.001). Among the 81 patients with COVID-19, 11 (14%) experienced thrombotic events in the arterial (n = 5) and venous circulation (n = 6) during a median follow-up of 18 days (interquartile range 11-27 days). A logistic regression analysis showed that LPS (P = 0.024) and D-dimer (P = 0.041) independently predicted thrombotic events. DISCUSSION: The study reports that low-grade endotoxemia is detectable in patients with COVID-19 and is associated with thrombotic events. The coexistence of low-grade endotoxemia with enhanced levels of zonulin may suggest enhanced gut permeability as an underlying mechanism.


Asunto(s)
COVID-19 , Endotoxemia , Haptoglobinas/metabolismo , Mucosa Intestinal , Precursores de Proteínas/metabolismo , SARS-CoV-2 , Trombosis , Biomarcadores/sangre , COVID-19/sangre , COVID-19/complicaciones , COVID-19/fisiopatología , Correlación de Datos , Endotoxemia/diagnóstico , Endotoxemia/metabolismo , Endotoxemia/virología , Femenino , Productos de Degradación de Fibrina-Fibrinógeno/análisis , Humanos , Mucosa Intestinal/metabolismo , Mucosa Intestinal/virología , Lipopolisacáridos/análisis , Masculino , Persona de Mediana Edad , Permeabilidad , Neumonía Viral/diagnóstico , Neumonía Viral/etiología , SARS-CoV-2/patogenicidad , SARS-CoV-2/fisiología , Trombosis/sangre , Trombosis/diagnóstico , Trombosis/etiología
18.
J Investig Med High Impact Case Rep ; 9: 23247096211016228, 2021.
Artículo en Inglés | MEDLINE | ID: mdl-33978499

RESUMEN

Spontaneous pneumomediastinum is reported in patients with coronavirus disease-2019 (COVID-19) and influenza infection independently, usually associated with noninvasive and mechanical ventilation. We report a case of spontaneous pneumomediastinum in a patient with COVID-19 and influenza coinfection. A 58-year-old male admitted with shortness of breath, diagnosed with COVID-19 and influenza infection. A computed tomography angiogram showed pneumomediastinum. He was treated conservatively with 15 L of oxygen, remdesivir, convalescent plasma, and oseltamivir. The case is being reported for its uniqueness since this is the first documented case of spontaneous pneumomediastinum in COVID-19 and influenza coinfection.


Asunto(s)
COVID-19/complicaciones , Gripe Humana/complicaciones , Enfisema Mediastínico/virología , Neumonía Viral/complicaciones , Antivirales/uso terapéutico , COVID-19/diagnóstico , COVID-19/terapia , Coinfección , Terapia Combinada , Quimioterapia Combinada , Humanos , Inmunización Pasiva , Gripe Humana/diagnóstico , Gripe Humana/terapia , Masculino , Enfisema Mediastínico/diagnóstico por imagen , Enfisema Mediastínico/terapia , Persona de Mediana Edad , Terapia por Inhalación de Oxígeno , Neumonía Viral/diagnóstico , Neumonía Viral/terapia , SARS-CoV-2
19.
J Ambul Care Manage ; 44(3): 197-206, 2021.
Artículo en Inglés | MEDLINE | ID: mdl-34016847

RESUMEN

In response to the coronavirus disease-2019 (COVID-19) pandemic, we developed and launched a student-led telemedicine program in Chelsea. From April to November 2020, over 200 student volunteers contacted over 1000 patients to assess COVID-19 symptoms, provide counseling, and triage patients. Through a retrospective cohort study, we determined that student triage decision was associated with patient outcomes, including hospitalization status, COVID-19 test administration, and COVID-19 test result. These results quantify the outcomes of a student-led telemedicine clinic to combat the ongoing pandemic and may serve as a model for implementation of similar clinics to alleviate mounting health care system burden.


Asunto(s)
COVID-19/diagnóstico , Neumonía Viral/diagnóstico , Clínica Administrada por Estudiantes , Telemedicina/organización & administración , COVID-19/epidemiología , Consejo , Inglaterra/epidemiología , Humanos , Pandemias , Neumonía Viral/epidemiología , Estudios Retrospectivos , SARS-CoV-2 , Triaje
20.
Ugeskr Laeger ; 183(18)2021 05 03.
Artículo en Danés | MEDLINE | ID: mdl-33998441

RESUMEN

In this review, we discuss viral pneumonias in an overall setting. Viruses are involved in about a quarter of all pneumonias, but despite literature in the past couple of decades emphasising this, the clinical effect remains elusive, and almost all hospitalised patients with pneumonia are treated with antibiotics. Thus, improved diagnostic methods and further research on the subject have the potential to benefit the overall treatment of patients with pneumonia, decrease antibiotic overconsumption and accelerate development of new antiviral therapeutics.


Asunto(s)
Neumonía Viral , Neumonía , Adulto , Antibacterianos/uso terapéutico , Antivirales/uso terapéutico , Humanos , Neumonía/tratamiento farmacológico , Neumonía Viral/diagnóstico , Neumonía Viral/tratamiento farmacológico
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