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

RESUMEN

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


Asunto(s)
/epidemiología , Tos/epidemiología , Fiebre/epidemiología , Cefalea/epidemiología , Adolescente , Infecciones Asintomáticas/epidemiología , Niño , Preescolar , Tos/virología , Femenino , Fiebre/virología , Cefalea/virología , Hospitalización , Humanos , Lactante , Recién Nacido , Masculino , México , Reacción en Cadena de la Polimerasa , Índice de Severidad de la Enfermedad
2.
JAMA Netw Open ; 4(3): e211085, 2021 03 01.
Artículo en Inglés | MEDLINE | ID: mdl-33688964

RESUMEN

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


Asunto(s)
/fisiopatología , Portador Sano/epidemiología , Tos/epidemiología , Disnea/epidemiología , Fiebre/epidemiología , Adolescente , Adulto , Factores de Edad , Anciano , Anciano de 80 o más Años , /epidemiología , Dolor en el Pecho/epidemiología , Dolor en el Pecho/fisiopatología , Niño , Preescolar , Trazado de Contacto , Tos/fisiopatología , Enfermedad Crítica , Progresión de la Enfermedad , Disnea/fisiopatología , Femenino , Fiebre/fisiopatología , Humanos , Lactante , Recién Nacido , Italia/epidemiología , Masculino , Persona de Mediana Edad , Faringitis/epidemiología , Faringitis/fisiopatología , Cuarentena , Factores de Riesgo , Índice de Severidad de la Enfermedad , Taquipnea/epidemiología , Taquipnea/fisiopatología , Adulto Joven
3.
Medicine (Baltimore) ; 100(11): e24771, 2021 Mar 19.
Artículo en Inglés | MEDLINE | ID: mdl-33725944

RESUMEN

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


Asunto(s)
/epidemiología , /terapia , Adulto , Anciano , China/epidemiología , Tos/epidemiología , Tos/virología , Femenino , Fiebre/epidemiología , Fiebre/virología , Hospitalización , Humanos , Masculino , Persona de Mediana Edad , Terapia por Inhalación de Oxígeno/métodos , Respiración Artificial/métodos , Estudios Retrospectivos , Índice de Severidad de la Enfermedad , Tomografía Computarizada por Rayos X , Viaje , Resultado del Tratamiento
4.
Chron Respir Dis ; 18: 14799731211002240, 2021.
Artículo en Inglés | MEDLINE | ID: mdl-33729021

RESUMEN

Knowledge on the sequelae of Coronavirus Disease 2019 (COVID-19) remains limited due to the relatively recent onset of this pathology. However, the literature on other types of coronavirus infections prior to COVID-19 reports that patients may experience persistent symptoms after discharge. To determine the prevalence of respiratory symptoms in survivors of hospital admission after COVID-19 infection. A living systematic review of five databases was performed in order to identify studies which reported the persistence of respiratory symptoms in COVID-19 patients after discharge. Two independent researchers reviewed and analysed the available literature, and then extracted and assessed the quality of those articles. Of the 1,154 reports returned by the initial search nine articles were found, in which 1,816 patients were included in the data synthesis. In the pooled analysis, we found a prevalence of 0.52 (CI 0.38-0.66, p < 0.01, I 2 = 97%), 0.37 (CI 0.28-0.48, p < 0.01, I 2 = 93%), 0.16 (CI 0.10-0.23, p < 0.01, I 2 = 90%) and 0.14 (CI 0.06-0.24, p < 0.01, I 2 = 96%) for fatigue, dyspnoea, chest pain, and cough, respectively. Fatigue, dyspnoea, chest pain, and cough were the most prevalent respiratory symptoms found in 52%, 37%, 16% and 14% of patients between 3 weeks and 3 months, after discharge in survivors of hospital admission by COVID-19, respectively.


Asunto(s)
/complicaciones , Dolor en el Pecho/epidemiología , Tos/epidemiología , Disnea/epidemiología , Fatiga/epidemiología , /epidemiología , Dolor en el Pecho/fisiopatología , Tos/fisiopatología , Disnea/fisiopatología , Fatiga/fisiopatología , Humanos , Prevalencia , Sobrevivientes
5.
PLoS Negl Trop Dis ; 15(3): e0009248, 2021 03.
Artículo en Inglés | MEDLINE | ID: mdl-33690662

RESUMEN

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


Asunto(s)
Enfermedades Asintomáticas/epidemiología , /epidemiología , Adolescente , Adulto , Anciano , Niño , China/epidemiología , Tos/diagnóstico , Tos/epidemiología , Tos/virología , Femenino , Fiebre/diagnóstico , Fiebre/epidemiología , Fiebre/virología , Humanos , Masculino , Persona de Mediana Edad , Estudios Retrospectivos , /aislamiento & purificación , Adulto Joven
6.
PLoS One ; 16(2): e0246190, 2021.
Artículo en Inglés | MEDLINE | ID: mdl-33592019

RESUMEN

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


Asunto(s)
/epidemiología , Enfermedades Cardiovasculares/epidemiología , Tos/epidemiología , Diabetes Mellitus/epidemiología , Diarrea/epidemiología , Fiebre/epidemiología , Insuficiencia Renal Crónica/epidemiología , Adulto , Anciano , Comorbilidad , Femenino , Humanos , Masculino , Persona de Mediana Edad , Mortalidad/tendencias
7.
PLoS One ; 16(2): e0246793, 2021.
Artículo en Inglés | MEDLINE | ID: mdl-33571300

RESUMEN

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


Asunto(s)
/epidemiología , /fisiopatología , Adulto , Argentina/epidemiología , Asma/epidemiología , Asma/fisiopatología , Comorbilidad , Tos/epidemiología , Tos/fisiopatología , Diabetes Mellitus/epidemiología , Diabetes Mellitus/fisiopatología , Femenino , Fiebre/epidemiología , Fiebre/fisiopatología , Cefalea/epidemiología , Cefalea/fisiopatología , Humanos , Hipertensión/epidemiología , Hipertensión/fisiopatología , Unidades de Cuidados Intensivos , Masculino , Persona de Mediana Edad , Factores de Riesgo , Índice de Severidad de la Enfermedad , Adulto Joven
8.
Emerg Infect Dis ; 27(2): 385-395, 2021 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-33496225

RESUMEN

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


Asunto(s)
/complicaciones , Pacientes Internos/estadística & datos numéricos , Pacientes Ambulatorios/estadística & datos numéricos , Adolescente , Adulto , Anciano , Anciano de 80 o más Años , Niño , Preescolar , Colorado/epidemiología , Tos/epidemiología , Tos/virología , Progresión de la Enfermedad , Disnea/epidemiología , Disnea/virología , Fatiga/epidemiología , Fatiga/virología , Femenino , Fiebre/epidemiología , Fiebre/virología , Humanos , Lactante , Masculino , Persona de Mediana Edad , Mialgia/epidemiología , Mialgia/virología , Evaluación de Síntomas , Adulto Joven
9.
West Afr J Med ; 38(1): 54-58, 2021 01.
Artículo en Inglés | MEDLINE | ID: mdl-33463708

RESUMEN

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


Asunto(s)
/epidemiología , Pandemias , Adolescente , Tos/epidemiología , Tos/etiología , Fatiga/epidemiología , Fatiga/etiología , Fiebre/epidemiología , Fiebre/etiología , Cefalea/epidemiología , Cefalea/etiología , Humanos , Masculino , Nigeria/epidemiología , Faringitis/epidemiología , Faringitis/etiología , Prevalencia , Estudios Retrospectivos
10.
Isr Med Assoc J ; 22(12): 775-780, 2020 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-33381951

RESUMEN

BACKGROUND: Our 1600-bed teaching hospital opened the first physician-led specialist pleural service in Israel in November 2016. Thoracentesis is one of the frequently performed procedures in clinic. OBJECTIVES: To review the incidence of thoracentesis-related symptoms, complications, and risk factors in a specialist pleural clinic. METHODS: Prospective analysis was conducted of 658 ultrasound-assisted thoracenteses between November 2016 and November 2019. Data were collected on patient demographics, clinical characteristics, procedural aspects, symptoms, complications, and additional interventions required. RESULTS: Of the procedures, 24% were accompanied by a reported symptom of any intensity or duration. Cough and chest discomfort were noted in 56.4% and 52% of these cases, respectively. Large-volume drainage was associated with symptoms (P = 0.002). Ultrasound-estimated effusion volume before drainage predicted pain (P = 0.001) and pneumothorax (P = 0.021). Of 8 cases of pneumothorax, 6 were due to non-expandable lung. Two patients were hospitalized (0.3%), and one required a chest drain. CONCLUSIONS: Symptoms are a common feature of thoracentesis even when performed by experienced operators in ideal settings. Complications, however, are rare when the procedure is performed with bedside ultrasound and attention is paid to patient-reported symptoms and volume drained. Specialist pleural clinics provide a good model for a standardized approach to safe performance of this common procedure.


Asunto(s)
Toracocentesis/efectos adversos , Ultrasonografía Intervencional/efectos adversos , Anciano , Dolor en el Pecho/epidemiología , Dolor en el Pecho/etiología , Tos/epidemiología , Tos/etiología , Disnea/epidemiología , Disnea/etiología , Femenino , Humanos , Incidencia , Israel/epidemiología , Masculino , Estudios Prospectivos , Factores de Riesgo , Toracocentesis/métodos , Ultrasonografía Intervencional/métodos
11.
Medicine (Baltimore) ; 99(47): e23407, 2020 Nov 20.
Artículo en Inglés | MEDLINE | ID: mdl-33217886

RESUMEN

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


Asunto(s)
Betacoronavirus , Infecciones por Coronavirus/epidemiología , Hospitalización/estadística & datos numéricos , Neumonía Viral/epidemiología , Índice de Severidad de la Enfermedad , Adolescente , Adulto , Anciano , Anciano de 80 o más Años , Niño , China/epidemiología , Infecciones por Coronavirus/complicaciones , Infecciones por Coronavirus/virología , Tos/epidemiología , Tos/virología , Fatiga/epidemiología , Fatiga/virología , Femenino , Fiebre/epidemiología , Fiebre/virología , Humanos , Pulmón/diagnóstico por imagen , Pulmón/virología , Linfopenia/epidemiología , Linfopenia/virología , Masculino , Persona de Mediana Edad , Pandemias , Neumonía Viral/complicaciones , Neumonía Viral/virología , Estudios Retrospectivos , Tomografía Computarizada por Rayos X/estadística & datos numéricos , Adulto Joven
12.
PLoS One ; 15(11): e0241470, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-33152043

RESUMEN

This study described the epidemiology of 487 confirmed coronavirus disease 2019 (COVID-19) cases in Sichuan province of China, and aimed to provide epidemiological evidence to support public health decision making. Epidemiological information of 487 COVID-19 cases were collected from the official websites of 21 districts (including 18 cities, 3 autonomous prefecture) health commissions within Sichuan between 21st of January 2020 to 17th of April 2020. We focus on the single-day diagnosis, demographics (gender and age), regional distribution, incubation period and symptoms. The number of single-day confirmed COVID-19 cases reach a peak on January 29 (33 cases), and then decreased. Chengdu (121 cases), Dazhou (39 cases) Nanchong (37 cases) and Ganzi Tibetan Autonomous Prefecture (78 cases) contributed 275 cases (56.5% of the total cases) of Sichuan province. The median age of patients was 44.0 years old and 52.6% were male. The history of living in or visiting Hubei, close contact, imported and unknown were 170 cases (34.9%), 136 cases (27.9%), 21 cases (4.3%) and 160 cases (32.9%) respectively. The interval from the onset of initial symptoms to laboratory diagnosis was 4.0 days in local cases, while that of imported cases was 4.5 days. The most common symptoms of illness onset were fever (71.9%) and cough (35.9%). The growth rate of COVID-19 in Sichuan has significantly decreased. New infected cases have shifted from the living in or visiting Wuhan and close contact to imported. It is necessary to closely monitor the physical condition of imported cases.


Asunto(s)
Infecciones por Coronavirus/epidemiología , Neumonía Viral/epidemiología , Adolescente , Adulto , Anciano , Anciano de 80 o más Años , Betacoronavirus , Niño , Preescolar , China/epidemiología , Tos/epidemiología , Femenino , Fiebre/epidemiología , Humanos , Lactante , Recién Nacido , Masculino , Persona de Mediana Edad , Pandemias , Adulto Joven
13.
J Res Health Sci ; 20(3): e00488, 2020 Aug 17.
Artículo en Inglés | MEDLINE | ID: mdl-33169720

RESUMEN

BACKGROUND: COVID-19 is a new viral disease with a rapid outbreak. Pregnant women are at a higher risk of contracting viral infections including COVID-19. We aimed to evaluate the clinical course and risk factors of pregnant women diagnosed with COVID 19 in Hamadan Province, west of Iran. STUDY DESIGN: A retrospective cohort study. METHODS: The convenience sampling was performed using 50 papers and electronic files of pregnant women diagnosed with COVID-19 according to the WHO's temporary guidelines. They were hospitalized in health centers and clinics of Hamadan Province. The data-collecting tool employed was a researcher-made questionnaire. The data were analyzed via SPSS software version 19. RESULTS: The mean age of pregnant women with COVID 19 was estimated to be 29.20 ± 5.8 yr and their average gestational age estimated to be 28.8 ± 8.20 weeks. About 32% of them had an underlying disease, 32% a history of influenza, and 40% recently traveled to infected areas. The most common findings were CT scans and multiple mottling and ground-glass opacity chest radiology. The most common symptoms were fever, cough, and shortness of breath. About 8% of the women required ICU hospitalization and the average length of hospital stay was 4.04 ± 2.38 and 29% had premature births. Moreover, 28% of infected mothers had a normal delivery and 20% had a cesarean section. CONCLUSION: Early diagnosis of Covid-19 disease is essential in pregnant women. Because there is a possibility of worsening complications in the mother and fetus.


Asunto(s)
Infecciones por Coronavirus/complicaciones , Neumonía Viral/complicaciones , Complicaciones Infecciosas del Embarazo/virología , Adolescente , Adulto , Betacoronavirus , Comorbilidad , Infecciones por Coronavirus/epidemiología , Infecciones por Coronavirus/virología , Tos/epidemiología , Tos/etiología , Demografía , Disnea/epidemiología , Disnea/etiología , Femenino , Fiebre/epidemiología , Fiebre/etiología , Hospitalización , Humanos , Recién Nacido , Irán/epidemiología , Pandemias , Neumonía Viral/epidemiología , Neumonía Viral/virología , Embarazo , Complicaciones Infecciosas del Embarazo/epidemiología , Nacimiento Prematuro , Estudios Retrospectivos , Factores de Riesgo , Tomografía Computarizada por Rayos X , Viaje , Adulto Joven
14.
BMC Infect Dis ; 20(1): 787, 2020 Oct 22.
Artículo en Inglés | MEDLINE | ID: mdl-33092539

RESUMEN

BACKGROUND: A cluster of acute respiratory illness, now known as Corona Virus Disease 2019 (COVID-19) caused by 2019 novel coronavirus (SARS-CoV-2), has become a global pandemic. Aged population with cardiovascular diseases are more likely be to infected with SARS-CoV-2 and result in more severe outcomes and elevated case-fatality rate. Meanwhile, cardiovascular diseases have a high prevalence in the middle-aged and elderly population. However, despite of several researches in COVID-19, cardiovascular implications related to it still remains largely unclear. Therefore, a specific analysis in regard to cardiovascular implications of COVID-19 patients is in great need. METHODS: In this single-centered, retrospective, observational study, 116 patients with laboratory-confirmed COVID-19 were enrolled, who admitted to the General Hospital of Central Theater Command (Wuhan, China) from January 20 to March 8, 2020. The demographic data, underlying comorbidities, clinical symptoms and signs, laboratory findings, chest computed tomography, treatment measures, and outcome data were collected from electronic medical records. Data were compared between non-severe and severe cases. RESULTS: Of 116 hospitalized patients with COVID-19, the median age was 58.5 years (IQR, 47.0-69.0), and 36 (31.0%) were female. Hypertension (45 [38.8%]), diabetes (19 [16.4%]), and coronary heart disease (17 [14.7%]) were the most common coexisting conditions. Common symptoms included fever [99 (85.3%)], dry cough (61 [52.6%]), fatigue (60 [51.7%]), dyspnea (52 [44.8%]), anorexia (50 [43.1%]), and chest discomfort (50 [43.1%]). Local and/or bilateral patchy shadowing were the typical radiological findings on chest computed tomography. Lymphopenia (lymphocyte count, 1.0 × 109/L [IQR, 0.7-1.3]) was observed in 66 patients (56.9%), and elevated lactate dehydrogenase (245.5 U/L [IQR, 194.3-319.8]) in 69 patients (59.5%). Hypokalemia occurred in 24 (20.7%) patients. Compared with non-severe cases, severe cases were older (64.0 years [IQR, 53.0-76.0] vs 56.0 years [IQR, 37.0-64.0]), more likely to have comorbidities (35 [63.6%] vs 24 [39.3%]), and more likely to develop acute cardiac injury (19 [34.5%] vs 4 [6.6%]), acute heart failure (18 [32.7%] vs 3 [4.9%]), and ARDS (20 [36.4%] vs 0 [0%]). During hospitalization, the prevalence of new onset hypertension was significantly higher in severe patients (55.2% vs 19.0%) than in non-severe ones. CONCLUSIONS: In this single-centered, retrospective, observational study, we found that the infection of SARS-CoV-2 was more likely to occur in middle and aged population with cardiovascular comorbidities. Cardiovascular complications, including new onset hypertension and heart injury were common in severe patients with COVID-19. More detailed researches in cardiovascular involvement in COVID-19 are urgently needed to further understand the disease.


Asunto(s)
Comorbilidad , Infecciones por Coronavirus/epidemiología , Infecciones por Coronavirus/fisiopatología , Hospitalización/estadística & datos numéricos , Neumonía Viral/epidemiología , Neumonía Viral/fisiopatología , Anciano , Betacoronavirus , China/epidemiología , Infecciones por Coronavirus/patología , Tos/epidemiología , Femenino , Fiebre/epidemiología , Humanos , Linfopenia/epidemiología , Linfopenia/patología , Masculino , Persona de Mediana Edad , Pandemias , Neumonía Viral/patología , Estudios Retrospectivos , Síndrome Respiratorio Agudo Grave/epidemiología
15.
J Int Med Res ; 48(10): 300060520961276, 2020 Oct.
Artículo en Inglés | MEDLINE | ID: mdl-33081538

RESUMEN

OBJECTIVE: To survey perceived general and ear-nose-throat (ENT) symptoms of COVID-19 in relation to psychological impact, mental health, perception of information and demographic characteristics in quarantined subjects during a lockdown period in Italy. METHODS: Participants were 1380 respondents who completed an online survey. A logistic regression model was used to evaluate the association between the independent variables and perceived symptoms. RESULTS: Participants reported different prevalences of perceived ENT and general symptoms. Coryza, cough, sore throat and tinnitus were the most common symptoms, and there was a low prevalence of anxiety, depression and stress compared with the psychological impact of the symptom. Comparison of the two symptom groups demonstrated a common need for updates, their relationship with the media and correct information about the route of transmission. CONCLUSIONS: The health information provided during a disease outbreak must be grounded in evidence. This would help to prevent adverse psychological reactions and somatization symptoms that can engulf healthcare systems, especially in clinical areas like ENT, which frequently treat airway problems.


Asunto(s)
Infecciones por Coronavirus/diagnóstico , Infecciones por Coronavirus/psicología , Neumonía Viral/diagnóstico , Neumonía Viral/psicología , Adolescente , Adulto , Anciano , Anciano de 80 o más Años , Ansiedad/epidemiología , Betacoronavirus , Tos/epidemiología , Estudios Transversales , Depresión/epidemiología , Femenino , Humanos , Italia/epidemiología , Masculino , Persona de Mediana Edad , Pandemias , Faringitis/epidemiología , Rinitis/epidemiología , Estrés Psicológico/epidemiología , Encuestas y Cuestionarios , Acúfeno/epidemiología , Adulto Joven
16.
BMC Infect Dis ; 20(1): 640, 2020 Aug 31.
Artículo en Inglés | MEDLINE | ID: mdl-32867706

RESUMEN

BACKGROUND: The COVID-19 pandemic has affected the world deeply, with more than 14,000,000 people infected and nearly 600,000 deaths. This review aimed to summarize the epidemiologic traits, clinical spectrum, CT results and laboratory findings of the COVID-19 pandemic. METHODS: We scoped for relevant literatures published during 1st December 2019 to 16th July 2020 based on three databases using English and Chinese languages. We reviewed and analyzed the relevant outcomes. RESULTS: The COVID-19 pandemic was found to have a higher transmission rate compared to SARS and MERS and involved 4 stages of evolution. The basic reproduction number (R0) is 3.32 (95% CI:3.24-3.39), the incubation period was 5.24 days (95% CI:3.97-6.50, 5 studies) on average, and the average time for symptoms onset varied by countries. Common clinical spectrums identified included fever (38.1-39.0 °C), cough and fatigue, with Acute Respiratory Distress Syndrome (ARDS) being the most common complication reported. Body temperatures above 39.0 °C, dyspnea, and anorexia were more common symptoms in severe patients. Aged over 65 years old, having co-morbidities, and developing complications were the commonest high-risk factors associated with severe conditions. Leucopenia and lymphopenia were the most common signs of infection while liver and kidney damage were rare but may cause bad outcomes for patients. The bilateral, multifocal Ground-Glass Opacification (GGO) on peripheral, and the consolidative pulmonary opacity were the most frequent CT results and the tendency of mortality rates differed by region. CONCLUSIONS: We provided a bird's-eye view of the COVID-19 during the current pandemic, which will help better understanding the key traits of the disease. The findings could be used for disease's future research, control and prevention.


Asunto(s)
Betacoronavirus/fisiología , Infecciones por Coronavirus/epidemiología , Linfopenia/epidemiología , Pandemias , Neumonía Viral/epidemiología , /epidemiología , Factores de Edad , Anciano , Comorbilidad , Infecciones por Coronavirus/mortalidad , Infecciones por Coronavirus/patología , Infecciones por Coronavirus/transmisión , Tos/epidemiología , Demografía , Progresión de la Enfermedad , Disnea/epidemiología , Fatiga/epidemiología , Femenino , Fiebre/epidemiología , Humanos , Laboratorios , Masculino , Neumonía Viral/mortalidad , Neumonía Viral/patología , Neumonía Viral/transmisión , Factores de Riesgo , Factores Sexuales , Tomografía Computarizada por Rayos X
17.
J Korean Med Sci ; 35(37): e333, 2020 Sep 21.
Artículo en Inglés | MEDLINE | ID: mdl-32959547

RESUMEN

BACKGROUND: There is limited information on the clinical characteristics of patients with coronavirus disease 2019 (COVID-19) who are asymptomatic or have mild symptoms. METHODS: We performed a retrospective case series of patients with COVID-19 enrolled from February 22 to March 26, 2020. Forty cases of COVID-19 were confirmed using real-time reverse-transcription polymerase chain reaction among patients who underwent screening tests and were consecutively hospitalized at Ulsan University Hospital, Ulsan, Korea. The final follow-up date was May 19, 2020. All COVID-19 cases in Ulsan were included. Demographic and epidemiological information, comorbidities, clinical signs and symptoms, laboratory and radiologic findings, medications, treatments, outcomes, and main durations of patients with COVID-19 were compared according to supplemental oxygen requirement. RESULTS: Forty patients were included (median age, 30 years; interquartile range [IQR], 25-57 years; 58% female). Six (15%) patients required supplemental oxygen. The prevalence of asymptomatic severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) infection was 5% and that of presymptomatic infection was 13%. Cough, fever, myalgia, rhinorrhea or nasal congestion, and diarrhea were the screening criteria for diagnosing symptomatic and presymptomatic SARS-CoV-2 infections. Sputum production, chest discomfort, a large number of symptoms, abnormal procalcitonin and C-reactive protein levels, and abnormal chest X-ray or chest computed tomography findings were more common in patients requiring supplemental oxygen than in those not requiring supplemental oxygen. Overall mortality rate was 3% (1/40). Four patients (10%) were readmitted after testing positive by reverse-transcription polymerase chain reaction again. Incubation period was 5 days (IQR, 4-6 days), and the duration of viral shedding was 21 days (IQR, 14-28 days; maximum, 51 days). CONCLUSION: The prevalence of asymptomatic SARS-CoV-2 infection was 5%, which is much lower than that previously reported. This finding suggests that careful interviews and follow-ups should be performed to identify SARS-CoV-2 infections. Cough, fever, myalgia, rhinorrhea or nasal congestion, and diarrhea are adequate screening criteria for covering all symptoms of SARS-CoV-2 infection. Further evaluation is required to create representative screening criteria for COVID-19.


Asunto(s)
Infecciones Asintomáticas/epidemiología , Infecciones por Coronavirus/epidemiología , Neumonía Viral/epidemiología , Adulto , Anciano , Betacoronavirus , Comorbilidad , Tos/epidemiología , Diarrea/epidemiología , Femenino , Fiebre/epidemiología , Hospitalización , Humanos , Corea (Geográfico)/epidemiología , Masculino , Persona de Mediana Edad , Mialgia/epidemiología , Pandemias , Prevalencia , Reacción en Cadena en Tiempo Real de la Polimerasa , Estudios Retrospectivos , Evaluación de Síntomas , Resultado del Tratamiento
18.
Rev Peru Med Exp Salud Publica ; 37(2): 253-258, 2020.
Artículo en Español, Inglés | MEDLINE | ID: mdl-32876213

RESUMEN

In order to describe manifestations from patients with coronavirus disease 2019 (COVID-19), sociodemographic variables such as, previous medical history, clinical and radiological manifestations, treatments and evolution of patients were evaluated. This took place from March 6th to 25th, 2020, in the "Edgardo Rebagliati Martins" National Hospital in Lima. Seventeen patients were registered: 76% were male, with an average age of 53.5 years (range 25-94); 23.5% had returned from abroad; 41.2% were referred from other health facilities; 41.2% were admitted to mechanical ventilation; 29.4% (5 patients) died. The risk factors detected were: advanced age, arterial hypertension and obesity. The main symptoms detected were: cough, fever and dyspnea. Frequent laboratory findings were: elevated C-reactive protein and lymphopenia. The predominant radiological presentation was bilateral interstitial lung infiltrate. A first experience in the management of patients diagnosed with severe COVID-19 in Peru is reported.


Asunto(s)
Infecciones por Coronavirus/fisiopatología , Hospitalización , Neumonía Viral/fisiopatología , Respiración Artificial , Adulto , Anciano , Anciano de 80 o más Años , Infecciones por Coronavirus/mortalidad , Infecciones por Coronavirus/terapia , Tos/epidemiología , Tos/etiología , Disnea/epidemiología , Disnea/etiología , Femenino , Fiebre/epidemiología , Fiebre/etiología , Humanos , Masculino , Persona de Mediana Edad , Pandemias , Perú , Neumonía Viral/mortalidad , Neumonía Viral/terapia , Estudios Retrospectivos , Factores de Riesgo , Índice de Severidad de la Enfermedad
19.
Rev Peru Med Exp Salud Publica ; 37(2): 335-340, 2020.
Artículo en Español | MEDLINE | ID: mdl-32876226

RESUMEN

COVID-19 is rarely reported in children and they are mildly affected in most cases. The most common clinical presentation of COVID-19 is cough, fever and sore throat; severe cases show tachypnea. The course of the disease is from one to two weeks. Laboratory findings are nonspecific; lymphopenia, elevation of C-reactive protein and procalcitonin have been described. Early chest X-ray is usually normal, and the most common tomographic findings are consolidations with halo, ground-glass opacities and tiny nodules which mainly affects subpleural areas. Management of the disease is supportive; in severe cases, it should be focused on respiratory support. It is recommended to limit the handling of respiratory secretions and to follow the same preventive measures provided to adults.


Asunto(s)
Infecciones por Coronavirus/epidemiología , Tos/epidemiología , Fiebre/epidemiología , Neumonía Viral/epidemiología , Factores de Edad , Niño , Infecciones por Coronavirus/fisiopatología , Tos/virología , Fiebre/virología , Humanos , Pandemias , Faringitis/epidemiología , Faringitis/virología , Neumonía Viral/fisiopatología , Índice de Severidad de la Enfermedad , Tomografía Computarizada por Rayos X
20.
Medwave ; 20(7): e7994, 2020 Aug 13.
Artículo en Español | MEDLINE | ID: mdl-32804922

RESUMEN

Introduction: Health personnel, including physicians, are a fundamental part of the first line of defense against the SARS-CoV-2 pandemic. Objective: To characterize the clinical manifestations and course of the first cases of contagion by SARS-CoV-2 in doctors of Peru. Methodology: We present a series of six cases of doctors infected by SARS-CoV-2, with confirmed positivity for COVID-19, showing the daily evolution from the diagnosis of the disease, its main signs and symptoms, evolution, and until the outcome in each case. Results: Five were men. The median age was 28 years (interquartile range: 27 to 33). In three cases the physician worked more than 12 hours a day in emergency and hospitalization services and not wear a mask at all times. The most frequent symptoms were axillary temperature above 38°C, malaise, dry cough, and odynophagia (the latter in three of the cases). The diagnosis was made at a median of 3 days (interquartile range: 3 to 4 days). The symptoms that persisted the most were dry cough (present during ten days in four doctors). Dysgeusia was the only symptom with the most extended duration (15 days in only one doctor). In the six cases, the course was favorable. However, these doctors found it difficult to return to functions in their hospital centers adequately. Discussion: Despite a small number of cases, it is the first report detailing the evolution of symptoms day by day, which can help for occupational health and even for case surveillance and monitoring.


Asunto(s)
Técnicas de Laboratorio Clínico , Infecciones por Coronavirus/fisiopatología , Transmisión de Enfermedad Infecciosa de Paciente a Profesional , Médicos , Neumonía Viral/fisiopatología , Adulto , Infecciones por Coronavirus/diagnóstico , Infecciones por Coronavirus/transmisión , Tos/epidemiología , Tos/virología , Disgeusia/epidemiología , Disgeusia/virología , Femenino , Fiebre/epidemiología , Fiebre/virología , Humanos , Masculino , Máscaras/estadística & datos numéricos , Pandemias , Perú , Neumonía Viral/diagnóstico , Neumonía Viral/transmisión
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