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1.
Zhonghua Jie He He Hu Xi Za Zhi ; 44(2): 88-95, 2021 Feb 12.
Artículo en Chino | MEDLINE | ID: mdl-33535322

RESUMEN

Objective: To study the clinical and etiological characteristics of viral pneumonia in patients with chronic obstructive pulmonary disease(VP-COPD), and to identify the risk factors associated with poor prognosis. Methods: From August 1, 2017 to August 1, 2019, totally 235 patients in a general hospital in Beijing were prospectively enrolled in this research, and all patients were diagnosed with viral pneumonia by imaging and etiology. The patients were divided into VP-COPD group(n=60) and VP-nCOPD(viral pneumonia in non-COPD patients) group(n=175). Pathogen detection and clinical characteristics were compared between the two groups.Finally, the binomial logistic regression was used to explore the risk factors associated with severe VP-COPD. Results: Compared with the VP-nCOPD group, the VP-COPD group was older(76.5 vs 66.0 years, P=0.001), and the CURB-65 score(2 vs 1, P= 0.001) and the PSI score(111 vs 85, P<0.001) were higher at admission. Pseudomonas aeruginosa(χ²= 10.308, P= 0.001) and Staphylococcus aureus(χ²= 5.953, P=0.028) were the most common co-infection bacteria. In the VP-COPD group type Ⅱ respiratory failure was more common(23.3% vs 6.8%, P<0.001), the number of severely ill patients was larger(48.3% vs 30.3%, P=0.011), the length of hospital stay was longer(13 vs 8, P<0.001), and the mortality rate during hospitalization was higher(18.3% vs 7.4%, P=0.016) in the VP-nCOPD group. Multivariate analysis showed that the level of blood glucose(OR: 1.73, 95%CI: 1.22-2.44, P= 0.002) and pleural effusion(OR: 133.12, 95%CI: 7.57-2 340.36, P=0.001) were risk factors for severe VP-COPD patients. Conclusion: Viral pneumonia in patients with COPD tended to develop into severe cases and had a poor prognosis.


Asunto(s)
Neumonía Viral/etiología , Enfermedad Pulmonar Obstructiva Crónica/complicaciones , Anciano , China/epidemiología , Coinfección , Femenino , Humanos , Tiempo de Internación/estadística & datos numéricos , Masculino , Persona de Mediana Edad , Neumonía Viral/diagnóstico , Neumonía Viral/epidemiología , Neumonía Viral/terapia , Pronóstico , Infecciones por Pseudomonas/epidemiología , Pseudomonas aeruginosa/aislamiento & purificación , Enfermedad Pulmonar Obstructiva Crónica/epidemiología , Enfermedad Pulmonar Obstructiva Crónica/terapia , Respiración Artificial/estadística & datos numéricos , Insuficiencia Respiratoria , Estudios Retrospectivos , Factores de Riesgo , Infecciones Estafilocócicas/epidemiología , Staphylococcus aureus/aislamiento & purificación
3.
Monaldi Arch Chest Dis ; 90(4)2020 Dec 23.
Artículo en Inglés | MEDLINE | ID: mdl-33372742

RESUMEN

COVID-19 pneumonia has a significant case fatality rate and no effective antiviral drugs are available even after 9 months of the pandemic. The spectrum of COVID-19 disease ranges from asymptomatic cases to severe ARDS with myriad manifestations. Here we report a case of a male patient with severe COVID-19 ARDS who improved after receiving standard therapy but again 'deteriorated' after being stepped down to ward. He complained of worsening shortness of breath and hypoxemia which was found to be mainly positional. After ruling out other causes, he was labeled as a case of platypnea-orthodeoxia syndrome due to underlying lung involvement.  It is important to be aware of this condition in the context of COVID-19 which can be easily diagnosed bedside with pulse oximetry.


Asunto(s)
Disnea , Hipoxia , Pulmón , Posicionamiento del Paciente/métodos , Neumonía Viral , Anciano , /fisiopatología , Deterioro Clínico , Diagnóstico Diferencial , Disnea/diagnóstico , Disnea/etiología , Humanos , Hipoxia/diagnóstico , Hipoxia/etiología , Pulmón/diagnóstico por imagen , Pulmón/fisiopatología , Masculino , Oximetría/métodos , Terapia por Inhalación de Oxígeno/métodos , Manejo de Atención al Paciente , Neumonía Viral/diagnóstico , Neumonía Viral/etiología , Neumonía Viral/fisiopatología , Neumonía Viral/terapia , Pruebas de Función Respiratoria/métodos , Síndrome , Tomografía Computarizada por Rayos X/métodos
4.
Monaldi Arch Chest Dis ; 90(4)2020 Dec 23.
Artículo en Inglés | MEDLINE | ID: mdl-33372741

RESUMEN

We report the case of a man affected by cystic fibrosis who developed a severe SARS-CoV-2 related pneumonia in March 2020. In addition to lopinavir/ritonavir and hydroxychloroquine, he was treated with two doses of tocilizumab, displaying a significant clinical improvement. This is the first case described in the literature of an adult patient affected by cystic fibrosis who received tocilizumab for COVID-19, with documented total recovery, also assessed by a spirometry.


Asunto(s)
Anticuerpos Monoclonales Humanizados/administración & dosificación , Fibrosis Quística , Hidroxicloroquina/administración & dosificación , Lopinavir/administración & dosificación , Neumonía Viral , Infecciones del Sistema Respiratorio/microbiología , Ritonavir/administración & dosificación , /aislamiento & purificación , Adulto , Antivirales/administración & dosificación , /diagnóstico , /fisiopatología , Fibrosis Quística/complicaciones , Fibrosis Quística/inmunología , Fibrosis Quística/fisiopatología , Combinación de Medicamentos , Humanos , Pulmón/diagnóstico por imagen , Pulmón/fisiopatología , Masculino , Terapia por Inhalación de Oxígeno/métodos , Neumonía Viral/diagnóstico , Neumonía Viral/tratamiento farmacológico , Neumonía Viral/etiología , Receptores de Interleucina-6/antagonistas & inhibidores , Pruebas de Función Respiratoria/métodos , Infecciones del Sistema Respiratorio/tratamiento farmacológico , Infecciones del Sistema Respiratorio/etiología , Tomografía Computarizada por Rayos X/métodos , Resultado del Tratamiento
5.
Ned Tijdschr Geneeskd ; 1642020 09 24.
Artículo en Holandés | MEDLINE | ID: mdl-33331722

RESUMEN

COVID-19 patients admitted to the Intensive Care Unit may develop painful range of motion restrictions of the large joints due to heterotopic ossifications. Here we describe two patients who developed restricted and painful passive and active mobility of the hips, shoulders and elbows after mechanical ventilation because of respiratory failure due to COVID-19 pneumonia. Conventional radiography showed extensive heterotopic ossifications. Retrospectively, alkaline phosphatase levels were elevated. It is likely that local and systemic factors contribute to the development of heterotopic ossifications. Early diagnosis is important to provide complementary non-pharmacological interventions (gentle passive mobilization) and medication (non-steroidal anti-inflammatory drugs, such as indomethacin). If pain and limited joint mobility remain present, surgical removal of ectopic bone could be considered. Future trials are needed to systematically map the prevalence of heterotopic ossifications in COVID-19 patients who were admitted to the Intensive Care Unit, andto evaluate whether prophylactic treatment with non-steroidal anti-inflammatory drug is of relevance.


Asunto(s)
Articulaciones , Osificación Heterotópica , Neumonía Viral , Respiración Artificial/efectos adversos , Insuficiencia Respiratoria , Antiinflamatorios no Esteroideos/uso terapéutico , /terapia , Femenino , Humanos , Articulaciones/diagnóstico por imagen , Articulaciones/patología , Articulaciones/fisiopatología , Masculino , Persona de Mediana Edad , Terapia Pasiva Continua de Movimiento/métodos , Osificación Heterotópica/etiología , Osificación Heterotópica/fisiopatología , Osificación Heterotópica/terapia , Neumonía Viral/etiología , Neumonía Viral/fisiopatología , Radiografía/métodos , Rango del Movimiento Articular , Respiración Artificial/métodos , Insuficiencia Respiratoria/terapia , Insuficiencia Respiratoria/virología , /aislamiento & purificación
6.
Circ Cardiovasc Interv ; 13(11): e010027, 2020 11.
Artículo en Inglés | MEDLINE | ID: mdl-33167699

RESUMEN

BACKGROUND: The optimal treatment strategy for treating ST-segment-elevation myocardial infarction (STEMI) in context of the coronavirus disease 2019 (COVID-19) pandemic is unclear given the potential risk of occupational exposure during primary percutaneous coronary intervention (PPCI). We quantified the impact of different STEMI treatment strategies on patient outcomes and provider risk in context of the COVID-19 pandemic. METHODS: Using a decision-analytic framework, we evaluated the effect of PPCI versus the pharmaco-invasive strategy for managing STEMI on 30-day patient mortality and individual provider infection risk based on presence of cardiogenic shock, suspected coronary territory, and presence of known or presumptive COVID-19 infection. RESULTS: For patients with low suspicion for COVID-19, PPCI had mortality benefit over the pharmaco-invasive strategy, and the risk of cardiac catheterization laboratory provider infection remained very low (<0.25%) across all subgroups. For patients with presumptive COVID-19 with cardiogenic shock, PPCI offered substantial mortality benefit to patients relative to the pharmaco-invasive strategy (7.9% absolute decrease in 30-day mortality), but also greater risk of provider infection (2.3% absolute increase in risk of provider infection). For patients with presumptive COVID-19 with nonanterior STEMI without cardiogenic shock, PPCI offered a 0.4% absolute mortality benefit over the pharmaco-invasive strategy with a 0.2% greater absolute risk of provider infection, and the tradeoff between patient and provider risk with PPCI became more apparent in sensitivity analysis with more severe COVID-19 infections. CONCLUSIONS: Usual care with PPCI remains the appropriate treatment strategy in the majority of cases presenting with STEMI in the setting of the COVID-19 pandemic. However, utilization of a pharmaco-invasive strategy in selected patients with STEMI with presumptive COVID-19 and low likelihood of mortality from STEMI and use of preventive strategies such as preprocedural intubation in high risk patients when PPCI is the preferred strategy may be reasonable to reduce provider risk of COVID-19 infection.


Asunto(s)
Betacoronavirus , Infecciones por Coronavirus/etiología , Personal de Salud , Exposición Profesional/efectos adversos , Intervención Coronaria Percutánea/efectos adversos , Neumonía Viral/etiología , Infarto del Miocardio con Elevación del ST/terapia , Anciano , Infecciones por Coronavirus/prevención & control , Técnicas de Apoyo para la Decisión , Humanos , Persona de Mediana Edad , Pandemias/prevención & control , Neumonía Viral/prevención & control , Riesgo , Infarto del Miocardio con Elevación del ST/mortalidad
7.
J Prim Care Community Health ; 11: 2150132720969483, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-33213266

RESUMEN

BACKGROUND: Healthcare workers (HCWs) are faced with an elevated risk of exposure to SARS-COV-2 due to the clinical procedures they perform on COVID-19 patients. However, data for frontline HCWs level of exposure and risk of COVID-19 virus infection are limited. OBJECTIVE: We investigated the level of exposure and risk of COVID-19 virus infection among HCWs in COVID-19 treatment centers in Ghana. METHODS: A cross-sectional study was utilized in this study and HCWs were invited by convenience to participate in the study, 408 HCWs in 4 COVID-19 treatment centers participated in the study. Adherence to infection prevention and control (IPC) measures were used to categorized HCWs as low or high risk of COVID-19 virus infection. The WHO COVID-19 risk assessment tool was used to collect quantitative data from the study participants. RESULTS: There was a high (N = 328, 80.4%) level of occupational exposure to the COVID-19 virus. However, only 14.0% of the exposed HCWs were at high risk of COVID-19 virus infection. Healthcare workers who performed or were present during any aerosol-generating procedures (AGP) were 23.8 times more likely to be exposed compared to HCWs who did not perform or were absent during any AGP (AOR 23.83; 95% CI: 18.45, 39.20). High risk of COVID-19 virus infection was less likely among registered nurses (AOR = 0.09; 95% CI: 0.02, 0.60), HCWs who performed or were present during any AGP (AOR = 0.05; 95% CI: 0.01, 0.50) and HCWs with a master's degree qualification (AOR 0.06; 95% CI: 0.01, 0.63). CONCLUSION: Despite the high level of exposure to the COVID-19 virus among HCWs in the treatment centers, only 14.0% were at high risk of COVID-19 virus infection. To protect this group of HCWs, treatment centers and HCWs should continue to adhere to WHO and national IPC protocols in managing of COVID-19 cases.


Asunto(s)
Infecciones por Coronavirus/etiología , Personal de Salud/estadística & datos numéricos , Neumonía Viral/etiología , Medición de Riesgo , Adulto , Infecciones por Coronavirus/prevención & control , Infecciones por Coronavirus/transmisión , Estudios Transversales , Femenino , Ghana/epidemiología , Humanos , Transmisión de Enfermedad Infecciosa de Paciente a Profesional/estadística & datos numéricos , Masculino , Persona de Mediana Edad , Enfermeras y Enfermeros/estadística & datos numéricos , Exposición Profesional/prevención & control , Exposición Profesional/estadística & datos numéricos , Pandemias/prevención & control , Neumonía Viral/prevención & control , Neumonía Viral/transmisión , Embarazo , Medición de Riesgo/métodos , Factores de Riesgo , Encuestas y Cuestionarios , Adulto Joven
8.
Environ Health ; 19(1): 106, 2020 10 13.
Artículo en Inglés | MEDLINE | ID: mdl-33050915

RESUMEN

BACKGROUND: Environmental factors play a central role in seasonal epidemics. SARS-CoV-2 infection in Spain has shown a heterogeneous geographical pattern This study aimed to assess the influence of several climatic factors on the infectivity of SARS-CoV-2 and the severity of COVID-19 among the Spanish Autonomous Communities (AA.CC.). METHODS: Data on coronavirus infectivity and severity of COVID-19 disease, as well as the climatic variables were obtained from official sources (Ministry of Health and Spanish Meteorological Agency, respectively). To assess the possible influence of climate on the development of the disease, data on ultraviolet radiation (UVR) were collected during the months before the start of the pandemic. To analyze its influence on the infectivity of SARS-CoV-2, data on UVR, temperature, and humidity were obtained from the months of highest contagiousness to the peak of the pandemic. RESULTS: From October 2019 to January 2020, mean UVR was significantly related not only to SARS-CoV-2 infection (cumulative incidence -previous 14 days- × 105 habitants, rho = - 0.0,666; p = 0.009), but also with COVID-19 severity, assessed as hospital admissions (rho = - 0.626; p = 0.017) and ICU admissions (rho = - 0.565; p = 0.035). Besides, temperature (February: rho = - 0.832; p < 0.001 and March: rho = - 0.904; p < 0.001), was the main climatic factor responsible for the infectivity of the coronavirus and directly contributed to a different spread of SARS-CoV-2 across the Spanish regions. CONCLUSIONS: Climatic factors may partially explain the differences in COVID-19 incidence and severity across the different Spanish regions. The knowledge of these factors could help to develop preventive and public health actions against upcoming outbreaks of the disease.


Asunto(s)
Betacoronavirus , Clima , Infecciones por Coronavirus/epidemiología , Neumonía Viral/epidemiología , Tiempo (Meteorología) , Infecciones por Coronavirus/diagnóstico , Infecciones por Coronavirus/etiología , Humanos , Incidencia , Modelos Lineales , Pandemias , Neumonía Viral/diagnóstico , Neumonía Viral/etiología , Factores de Riesgo , Índice de Severidad de la Enfermedad , España/epidemiología , Rayos Ultravioleta
9.
Epidemiol Infect ; 148: e255, 2020 10 14.
Artículo en Inglés | MEDLINE | ID: mdl-33050972

RESUMEN

To determine what exacerbate severity of the COVID-19 among patients without comorbidities and advanced age and investigate potential clinical indicators for early surveillance, we adopted a nested case-control study, design in which severe cases (case group, n = 67) and moderate cases (control group, n = 67) of patients diagnosed with COVID-19 without comorbidities, with ages ranging from 18 to 50 years who admitted to Wuhan Tongji Hospital were matched based on age, sex and BMI. Demographic and clinical characteristics, and risk factors associated with severe symptoms were analysed. Percutaneous oxygen saturation (SpO2), lymphocyte counts, C-reactive protein (CRP) and IL-10 were found closely associated with severe COVID-19. The adjusted multivariable logistic regression analyses revealed that the independent risk factors associated with severe COVID-19 were CRP (OR 2.037, 95% CI 1.078-3.847, P = 0.028), SpO2 (OR 1.639, 95% CI 0.943-2.850, P = 0.080) and lymphocyte (OR 1.530, 95% CI 0.850-2.723, P = 0.148), whereas the changes exhibited by indicators influenced incidence of disease severity. Males exhibited higher levels of indicators associated with inflammation, myocardial injury and kidney injury than the females. This study reveals that increased CRP levels and decreased SpO2 and lymphocyte counts could serve as potential indicators of severe COVID-19, independent of comorbidities, advanced age and sex. Males could at higher risk of developing severe symptoms of COVID-19 than females.


Asunto(s)
Betacoronavirus , Infecciones por Coronavirus/epidemiología , Infecciones por Coronavirus/etiología , Neumonía Viral/epidemiología , Neumonía Viral/etiología , Adolescente , Adulto , Factores de Edad , Área Bajo la Curva , Proteína C-Reactiva/análisis , Estudios de Casos y Controles , China/epidemiología , Infecciones por Coronavirus/complicaciones , Femenino , Humanos , Incidencia , Inflamación/etiología , Tiempo de Internación , Modelos Logísticos , Recuento de Linfocitos , Masculino , Persona de Mediana Edad , Oxígeno/metabolismo , Pandemias , Neumonía Viral/complicaciones , Curva ROC , Estudios Retrospectivos , Factores de Riesgo , Índice de Severidad de la Enfermedad , Factores Sexuales , Adulto Joven
10.
Immun Inflamm Dis ; 8(4): 753-762, 2020 12.
Artículo en Inglés | MEDLINE | ID: mdl-33124193

RESUMEN

BACKGROUND: Severe acute respiratory syndrome coronavirus clade 2 (SARS-CoV-2) is a single-stranded RNA virus responsible for the global pandemic of the coronavirus disease-2019 (COVID-19). To date, there are still no effective approaches for the prevention and treatment of COVID-19. OBJECTIVE: The present study aims to explore the possible mechanisms of SARS-CoV-2 infection in human lung cells. METHODS: Data interpretation was conducted by recruiting bioinformatics analysis, including Gene Ontology and Kyoto Encyclopedia of Genes and Genomes pathways analysis using downloaded data from the NCBI Gene Expression Omnibus database. RESULTS: The present study demonstrated that SARS-CoV-2 infection induces the upregulation of 14 interferon-stimulated genes, indicative of immune, and interferon responses to the virus. Notably, genes for pyrimidine metabolism and steroid hormone biosynthesis are selectively enriched in human lung cells after SARS-CoV-2 infection, suggesting that altered pyrimidine metabolism and steroid biosynthesis are remarkable, and perhaps druggable features after SARS-CoV-2 infection. Besides, there is a strong positive correlation between viral ORF1ab, ORF6, and angiotensin-converting enzyme 2 (ACE2) expression in human lung cells, implying that ACE2 facilitates SARS-CoV-2 infection and replication in host cells probably through the induction of ORF1ab and ORF6.


Asunto(s)
Betacoronavirus/patogenicidad , Infecciones por Coronavirus/etiología , Interferones/metabolismo , Pulmón/patología , Peptidil-Dipeptidasa A/metabolismo , Neumonía Viral/etiología , Betacoronavirus/metabolismo , Biología Computacional , Infecciones por Coronavirus/patología , Células Epiteliales/inmunología , Células Epiteliales/metabolismo , Células Epiteliales/virología , Perfilación de la Expresión Génica , Humanos , Pulmón/citología , Pulmón/inmunología , Pulmón/virología , Pandemias , Neumonía Viral/patología , Poliproteínas , Pirimidinas/metabolismo , Mucosa Respiratoria/citología , Mucosa Respiratoria/inmunología , Mucosa Respiratoria/metabolismo , Mucosa Respiratoria/virología , Transducción de Señal/inmunología , Esteroides/biosíntesis , Regulación hacia Arriba/inmunología , Proteínas Virales/metabolismo
11.
Int J Tuberc Lung Dis ; 24(10): 1032-1037, 2020 10 01.
Artículo en Inglés | MEDLINE | ID: mdl-33126935

RESUMEN

OBJECTIVE: To evaluate the clinical features of disease progression among patients with COVID-19 to help early identification of patients at high risk.DESIGN: This was a retrospective, multi-centre cohort study. From 10 January to 29 February 2020, all cases diagnosed with COVID-19 at 24 hospitals (with complete medical records) in Jiangsu Province, China were recruited. The primary outcome was deterioration in condition, i.e., the dramatic progression from asymptomatic or mild or moderate status into severe or critically ill status during 14 days´ follow-up.RESULTS: Of the 625 patients in Jiangsu, none died; 597 patients were asymptomatic or had mild or moderate disease on admission, of whom 36 (6%) experienced disease deterioration to become severe or critically ill.CONCLUSION: Disease deterioration to severe or critically ill status was associated with age, pulmonary opacity score, lymphocyte count on admission and exposure to the pandemic centre in Wuhan.


Asunto(s)
Betacoronavirus , Infecciones por Coronavirus/epidemiología , Neumonía Viral/epidemiología , Adulto , Factores de Edad , China/epidemiología , Estudios de Cohortes , Infecciones por Coronavirus/etiología , Infecciones por Coronavirus/patología , Progresión de la Enfermedad , Femenino , Humanos , Masculino , Persona de Mediana Edad , Pandemias , Neumonía Viral/etiología , Neumonía Viral/patología , Estudios Retrospectivos , Factores de Riesgo
12.
World J Gastroenterol ; 26(37): 5534-5542, 2020 Oct 07.
Artículo en Inglés | MEDLINE | ID: mdl-33088153

RESUMEN

The first cases of a novel corona virus infection were reported in Wuhan China in December of 2019, followed by the declaration of an international pandemic by the World Health Organization in March 2020. Early reports of the virus, now known as severe acute respiratory syndrome coronavirus 2, and its clinical disease coronavirus disease 2019 (COVID-19), has shown higher rates of morbidity and mortality in the elderly and those with pre-existing medical conditions. Of particular concern is the safety of those with compromised immune systems. Inflammatory Bowel disease (IBD) is itself caused by a disordered immune response, with the most effective medical therapies being immune suppressing or modifying. As such, the risk of COVID-19, virus related outcomes, and appropriate management of IBD patients during the global pandemic is of immediate concern to gastroenterologists worldwide. There has been a rapid accumulation of clinical data and expert opinion on the topic. This review will highlight the latest source information on clinical observation/outcomes of the IBD population and provide a concise summary of the most up to date perspectives on IBD management in the age of COVID-19.


Asunto(s)
Betacoronavirus , Infecciones por Coronavirus/prevención & control , Enfermedades Inflamatorias del Intestino/complicaciones , Enfermedades Inflamatorias del Intestino/terapia , Pandemias/prevención & control , Neumonía Viral/prevención & control , Infecciones por Coronavirus/diagnóstico , Infecciones por Coronavirus/etiología , Infecciones por Coronavirus/terapia , Salud Global , Humanos , Enfermedades Inflamatorias del Intestino/inmunología , Neumonía Viral/diagnóstico , Neumonía Viral/etiología , Neumonía Viral/terapia , Medición de Riesgo , Factores de Riesgo
13.
JAMA Netw Open ; 3(10): e2026373, 2020 10 01.
Artículo en Inglés | MEDLINE | ID: mdl-33119111

RESUMEN

Importance: Policy makers have relaxed restrictions for certain nonessential industries, including construction, jeopardizing the effectiveness of social distancing measures and putting already at-risk populations at greater risk of coronavirus disease 2019 (COVID-19) infection. In Texas, Latinx populations are overly represented among construction workers, and thus have elevated rates of exposure that are compounded by prevalent high-risk comorbidities and lack of access to health care. Objective: To assess the association between construction work during the COVID-19 pandemic and hospitalization rates for construction workers and the surrounding community. Design, Setting, and Participants: This decision analytical model used a mathematical model of COVID-19 transmission, stratified by age and risk group, with construction workers modeled explicitly. The model was based on residents of the Austin-Round Rock metropolitan statistical area, with a population of 2.17 million. Based on 500 stochastic simulations for each of 15 scenarios that varied the size of the construction workforce and level of worksite transmission risk, the association between continued construction work and hospitalizations was estimated and then compared with anonymized line-list hospitalization data from central Texas through August 20, 2020. Exposures: Social distancing interventions, size of construction workforce, and level of disease transmission at construction worksites. Main Outcomes and Measures: For each scenario, the total number of COVID-19 hospitalizations and the relative risk of hospitalization among construction workers was projected and then compared with relative risks estimated from reported hospitalization data. Results: Allowing unrestricted construction work was associated with an increase of COVID-19 hospitalization rates through mid-August 2020 from 0.38 per 1000 residents to 1.5 per 1000 residents and from 0.22 per 1000 construction workers to 9.3 per 1000 construction workers. This increased risk was estimated to be offset by safety measures (such as thorough cleaning of equipment between uses, wearing of protective equipment, limits on the number of workers at a worksite, and increased health surveillance) that were associated with a 50% decrease in transmission. The observed relative risk of hospitalization among construction workers compared with other occupational categories among adults aged 18 to 64 years was 4.9 (95% CI, 3.8-6.2). Conclusions and Relevance: The findings of this study suggest that unrestricted work in high-contact industries, such as construction, is associated with a higher level of community transmission, increased risks to at-risk workers, and larger health disparities among members of racial and ethnic minority groups.


Asunto(s)
Industria de la Construcción , Infecciones por Coronavirus/etiología , Hospitalización , Exposición Profesional/efectos adversos , Pandemias , Neumonía Viral/etiología , Adolescente , Adulto , Betacoronavirus , Comorbilidad , Grupos de Población Continentales , Infecciones por Coronavirus/epidemiología , Infecciones por Coronavirus/etnología , Infecciones por Coronavirus/virología , Grupos Étnicos , Femenino , Hispanoamericanos , Humanos , Masculino , Persona de Mediana Edad , Grupos Minoritarios , Neumonía Viral/epidemiología , Neumonía Viral/etnología , Neumonía Viral/virología , Características de la Residencia , Factores de Riesgo , Seguridad , Texas/epidemiología , Lugar de Trabajo , Adulto Joven
14.
Medicine (Baltimore) ; 99(43): e22591, 2020 Oct 23.
Artículo en Inglés | MEDLINE | ID: mdl-33120746

RESUMEN

INTRODUCTION: COVID-19 is now a global pandemic. Although there are very few studies describing the characteristics of SARS-CoV-2 infections in patients with prostate cancer, these patients are likely to be more susceptible to COVID-19 than healthy people because of their immunosuppressed state. However, there is no evidence that prostate cancer is a risk factor for COVID-19. METHODS: We searched the Wanfang database, the China Science Journal Citation Report (VIP database), the China National Knowledge Infrastructure (CNKI), Web of Science, EMBASE, PubMed, and the Cochrane Library for studies related to the topic. We designed a standardized data extraction sheet and used Epidata software 3.1 for data extraction. In accordance with the Cochrane 5.1.0 standard, both a quality assessment and a risk assessment were carried out for the research meeting the inclusion criteria. The data were analyzed using Revman 5.3 and Stata 13.0 software. RESULTS: The study integrated existing research findings and a meta-analysis of the data to investigate the prevalence of prostate cancer in males infected with SARS-CoV-2 and the adverse clinical outcomes in male patients with or without COVID-19. CONCLUSION: The results of this research may provide a basis for judging if prostate cancer is a risk factor for males infected with SARS-CoV-2, and the findings can effectively help to prevent COVID-19 in patients with prostate cancer. ETHICS AND DISSEMINATION: Ethics approval is not required for this systematic review as it will involve the collection and analysis of secondary data. The results of the review will be reported in international peer-reviewed journals PRORPERO REGISTRATION NUMBER:: CRD42020194071.


Asunto(s)
Betacoronavirus , Infecciones por Coronavirus/etiología , Neumonía Viral/etiología , Neoplasias de la Próstata/complicaciones , Protocolos Clínicos , Infecciones por Coronavirus/diagnóstico , Salud Global , Humanos , Masculino , Pandemias , Neumonía Viral/diagnóstico , Prevalencia , Pronóstico , Neoplasias de la Próstata/epidemiología , Medición de Riesgo , Factores de Riesgo
15.
Medicine (Baltimore) ; 99(42): e22688, 2020 Oct 16.
Artículo en Inglés | MEDLINE | ID: mdl-33080715

RESUMEN

BACKGROUND: Unknown origin pneumonia has been furiously spreading since the late of December 2019, subsequently spread to approximately all provinces and areas in China and many countries, which was announced as a Public Health Emergency of International Concern by World Health Organization (WHO). The studies on 2019 Corona Virus Disease-19 (COVID-19) conducted from various fields around the world. Herein, the objective of the present study is to summarize the etiology, epidemiology, clinical manifestations, image findings, traceability analysis, and drug development of COVID-19. METHODS: The following electronic databases were searched: Cochrane Central Register of Controlled Trials (CENTRAL), PubMed, EMBASE, Cochrane Library, China National Knowledge Infrastructure (CNKI), Chinese Biomedical Literature Database, VIP Chinese Science and Technology Periodical Database, and Wanfang Data. Other relevant literature will be manually searched as a compliment. We have reviewed etiology, epidemiology, clinical manifestations, image findings, and medication from case reports and retrospective clinical studies relating to COVID-19 published since the outbreak. RESULTS: The coronavirus is closely related to bat coronavirus and pangolin coronavirus. Besides, the infection pathway is confirmed to be the respiratory and digestive systems. The virus indicates person-to-person transmission and some patients present asymptomatic. The elderly have a higher mortality rate. Rapid and sensitive nucleic acid testing is usually used as a basis for diagnosis. Currently, there is no specific vaccine and antiviral drug. Intervention actions such as travel bans and quarantine adopted have effectively reduced the spread of the epidemic. CONCLUSION: This systemic review will provide high-quality evidence to summarize etiology, epidemiology, clinical manifestations, image findings, traceability analysis, drug development in patients with COVID-19.


Asunto(s)
Infecciones por Coronavirus/epidemiología , Infecciones por Coronavirus/fisiopatología , Neumonía Viral/epidemiología , Neumonía Viral/fisiopatología , Corticoesteroides/uso terapéutico , Factores de Edad , Antivirales/uso terapéutico , Betacoronavirus , China , Comorbilidad , Infecciones por Coronavirus/etiología , Infecciones por Coronavirus/terapia , Citocinas/metabolismo , Humanos , Inmunoglobulinas/uso terapéutico , Pulmón/diagnóstico por imagen , Pulmón/patología , Pandemias , Peptidil-Dipeptidasa A/metabolismo , Neumonía Viral/etiología , Neumonía Viral/terapia , Pronóstico , Reacción en Cadena de la Polimerasa de Transcriptasa Inversa , Factores Sexuales
16.
Adv Genet ; 106: 119-122, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-33081921

RESUMEN

WHO's pronouncement of the 2019 novel coronavirus outbreak as a pandemic disease came months after we published a warning that the present deepest minimum of the sunspot cycle would be likely to facilitate the onset of a viral pandemic. During a deep sunspot minimum (deepest in 100 years) such as we are now witnessing, two space related phenomena could have an effect on the disposition of viral disease and potential pandemics. With the weakening of the magnetic field in the Earth's vicinity, there would be a high flux of mutagenic cosmic rays. These processes would be likely to herald the onset of new pandemics. Neutron counts from Moscow Neutron Monitor show that the flux of cosmic rays reaching Earth in 2019 was indeed at a maximum over a timespan of half a century since 1962. It is of interest to note that immediately prior to the first recorded cases of the novel Corona virus in China a peak of cosmic rays was measured as is indicated by the Huon neutron monitor data. Recent research revealed that estimates of the timing of the most recent common ancestor of COVID-19 made with current sequence data point to emergence of the virus in late November 2019 to early December 2019, compatible with the earliest retrospectively confirmed cases and the cosmic ray spike in late November 2019. In our view, this strong cosmic ray spike was in some way connected with the onset of the outbreak.


Asunto(s)
Evolución Biológica , Infecciones por Coronavirus/etiología , Radiación Cósmica , Neumonía Viral/etiología , Actividad Solar , Betacoronavirus/fisiología , Betacoronavirus/efectos de la radiación , Enfermedades Transmisibles Emergentes/epidemiología , Enfermedades Transmisibles Emergentes/etiología , Enfermedades Transmisibles Emergentes/virología , Infecciones por Coronavirus/epidemiología , Radiación Cósmica/efectos adversos , Planeta Tierra , Historia del Siglo XXI , Humanos , Neutrones , Pandemias , Neumonía Viral/epidemiología
17.
Adv Genet ; 106: 75-100, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-33081928

RESUMEN

The origins and global spread of two recent, yet quite different, pandemic diseases is discussed and reviewed in depth: Candida auris, a eukaryotic fungal disease, and COVID-19 (SARS-CoV-2), a positive strand RNA viral respiratory disease. Both these diseases display highly distinctive patterns of sudden emergence and global spread, which are not easy to understand by conventional epidemiological analysis based on simple infection-driven human- to-human spread of an infectious disease (assumed to jump suddenly and thus genetically, from an animal reservoir). Both these enigmatic diseases make sense however under a Panspermia in-fall model and the evidence consistent with such a model is critically reviewed.


Asunto(s)
Evolución Biológica , Candidiasis/etiología , Enfermedades Transmisibles Emergentes/etiología , Infecciones por Coronavirus/etiología , Origen de la Vida , Neumonía Viral/etiología , Animales , Betacoronavirus/aislamiento & purificación , Betacoronavirus/fisiología , Candida/aislamiento & purificación , Candida/fisiología , Candidiasis/epidemiología , Enfermedades Transmisibles Emergentes/epidemiología , Coronavirus/aislamiento & purificación , Coronavirus/fisiología , Infecciones por Coronavirus/epidemiología , Planeta Tierra , Exobiología , Medio Ambiente Extraterrestre , Interacciones Huésped-Patógeno/fisiología , Humanos , Pandemias , Neumonía Viral/epidemiología
18.
Chest ; 158(4): e139-e142, 2020 10.
Artículo en Inglés | MEDLINE | ID: mdl-33036110

RESUMEN

Infection with the severe acute respiratory syndrome coronavirus 2 causes severe acute lung injury in approximately 5% of infected adults, but few reports have been made of severe pediatric disease. We present an adolescent patient who contracted severe acute respiratory syndrome coronavirus 2 one week after a paternal haplo-identical hematopoietic stem cell transplant, with development of severe hyperferritinemic acute lung injury and macrophage activation-like syndrome. We present her case and a comparison of her laboratory data with those of a cohort of pediatric patients with coronavirus disease 2019 without severe disease.


Asunto(s)
Betacoronavirus , Infecciones por Coronavirus/diagnóstico , Infecciones por Coronavirus/terapia , Trasplante de Células Madre Hematopoyéticas/efectos adversos , Síndromes Mielodisplásicos/terapia , Neumonía Viral/diagnóstico , Neumonía Viral/terapia , Adolescente , Infecciones por Coronavirus/etiología , Femenino , Humanos , Síndromes Mielodisplásicos/complicaciones , Pandemias , Neumonía Viral/etiología
19.
J Breath Res ; 14(4): 041003, 2020 10 02.
Artículo en Inglés | MEDLINE | ID: mdl-33006317

RESUMEN

We hypothesized that most patients with severe pulmonary COVID-19 were exposed to cough aerosols. Among patients that were almost 100% certain which person infected them, only 14 out of 38 overall, and 9 out of 25 hospitalized patients requiring supplemental oxygen, were infected by someone who coughed, which did not support our hypothesis. Talking, especially with a loud voice, could be an alternative source generating SARS-CoV-2 aerosols. Further research is needed to determine how SARS-CoV-2 spreads. Avoiding to talk when you are not wearing your mask and not talking with a loud voice, 'voice etiquette', could be other public health interventions worthwhile exploring.


Asunto(s)
Aerosoles , Infecciones por Coronavirus/diagnóstico , Infecciones por Coronavirus/etiología , Tos/complicaciones , Neumonía Viral/diagnóstico , Neumonía Viral/etiología , Betacoronavirus , Humanos , Pandemias
20.
J Infect Dev Ctries ; 14(9): 994-1000, 2020 09 30.
Artículo en Inglés | MEDLINE | ID: mdl-33031087

RESUMEN

Mozambique is located on the East Coast of Africa and was one of the last countries affected by COVID-19. The first case was reported on 22 March 2020 and since then the cases have increased gradually as they have in other countries worldwide. Environmental and population characteristics have been analyzed worldwide to understand their possible association with COVID-19. This article seeks to highlight the evolution and the possible contribution of risk factors for COVID-19 severity according to the available data in Mozambique. The available data highlight that COVID-19 severity can be magnified mainly by hypertension, obesity, cancer, asthma, HIV/SIDA and malnutrition conditions, and buffered by age (youthful population). Due to COVID-19 epidemic evolution, particularly in Cabo Delgado, there is the need to increase laboratory diagnosis capacity and monitor compliance of preventive measures. Particular attention should be given to Cabo Delgado, including its isolation from other provinces, to overcome local transmission and the spread of SARS-CoV-2.


Asunto(s)
Contaminación del Aire/efectos adversos , Betacoronavirus , Infecciones por Coronavirus/etiología , Neumonía Viral/etiología , Adolescente , Adulto , Anciano , Anciano de 80 o más Años , Niño , Preescolar , Infecciones por Coronavirus/diagnóstico , Infecciones por Coronavirus/epidemiología , Infecciones por Coronavirus/prevención & control , Femenino , Humanos , Lactante , Recién Nacido , Masculino , Persona de Mediana Edad , Mozambique/epidemiología , Pandemias/prevención & control , Neumonía Viral/diagnóstico , Neumonía Viral/epidemiología , Neumonía Viral/prevención & control , Pronóstico , Factores Protectores , Factores de Riesgo , Índice de Severidad de la Enfermedad , Adulto Joven
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