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1.
J Headache Pain ; 21(1): 121, 2020 Oct 13.
Artigo em Inglês | MEDLINE | ID: mdl-33050880

RESUMO

BACKGROUND: Headache is the most common COVID-19-related neurological symptom. We aimed to reveal diagnostic clues of headache for COVID-19 infection and to investigate the course of primary headaches during the pandemic. METHODS: We developed a detailed web-based questionnaire screening the characteristics and course of headaches besides clinical COVID-19 features. The participants were grouped according to being diagnosed with COVID-19 infection or not, and having previous or new-onset headaches. The COVID-19 related headache features and their associations with other clinical features were investigated. A binary logistic regression model was performed to differentiate the characteristics of headache related to COVID-19. FINDINGS: A total of 3458 participants (2341 females;67.7%, 1495 healthcare workers;43.2%) with a mean age of 43.21 ± 11.2 years contributed to the survey. Among them, 262 participants had COVID-19 diagnosis and 126 (48.1%) were male. The rate of males in the group without COVID-19 was 31% (991 out of 3196 participants) showing significant gender difference between groups (p < 0.000). COVID-19 related headaches were more closely associated with anosmia/ageusia and gastrointestinal complaints (p < 0.000 and p < 0.000), and showed different characteristics like pulsating, pressing, and even stabbing quality. Logistic regression analyses showed that bilateral headache, duration over 72 h, analgesic resistance and having male gender were significant variables to differentiate COVID-19 positive patients from those without COVID-19 (p = 0.04 for long duration and p < 0.000 for others). A worsening of previous primary headaches due to the pandemic-related problems was not reported in the majority of patients. INTERPRETATION: Bilateral, long-lasting headaches, resistance to analgesics and having male gender were more frequent in people with COVID-19 in conjunction with anosmia/ageusia and gastrointestinal complaints. These features may be helpful for diagnosing the headache related to COVID-19 during the pandemic.


Assuntos
Ageusia/fisiopatologia , Infecções por Coronavirus/fisiopatologia , Diarreia/fisiopatologia , Cefaleia/fisiopatologia , Transtornos do Olfato/fisiopatologia , Pneumonia Viral/fisiopatologia , Adulto , Analgésicos/uso terapêutico , Betacoronavirus , Feminino , Cefaleia/tratamento farmacológico , Pessoal de Saúde , Humanos , Modelos Logísticos , Masculino , Pessoa de Meia-Idade , Pandemias , Fatores Sexuais , Inquéritos e Questionários
3.
J Med Internet Res ; 22(10): e20509, 2020 10 02.
Artigo em Inglês | MEDLINE | ID: mdl-32936770

RESUMO

BACKGROUND: In December 2019, the COVID-19 outbreak started in China and rapidly spread around the world. Lack of a vaccine or optimized intervention raised the importance of characterizing risk factors and symptoms for the early identification and successful treatment of patients with COVID-19. OBJECTIVE: This study aims to investigate and analyze biomedical literature and public social media data to understand the association of risk factors and symptoms with the various outcomes observed in patients with COVID-19. METHODS: Through semantic analysis, we collected 45 retrospective cohort studies, which evaluated 303 clinical and demographic variables across 13 different outcomes of patients with COVID-19, and 84,140 Twitter posts from 1036 COVID-19-positive users. Machine learning tools to extract biomedical information were introduced to identify mentions of uncommon or novel symptoms in tweets. We then examined and compared two data sets to expand our landscape of risk factors and symptoms related to COVID-19. RESULTS: From the biomedical literature, approximately 90% of clinical and demographic variables showed inconsistent associations with COVID-19 outcomes. Consensus analysis identified 72 risk factors that were specifically associated with individual outcomes. From the social media data, 51 symptoms were characterized and analyzed. By comparing social media data with biomedical literature, we identified 25 novel symptoms that were specifically mentioned in tweets but have been not previously well characterized. Furthermore, there were certain combinations of symptoms that were frequently mentioned together in social media. CONCLUSIONS: Identified outcome-specific risk factors, symptoms, and combinations of symptoms may serve as surrogate indicators to identify patients with COVID-19 and predict their clinical outcomes in order to provide appropriate treatments.


Assuntos
Infecções por Coronavirus/fisiopatologia , Aprendizado de Máquina , Pneumonia Viral/fisiopatologia , Mídias Sociais , Antivirais/uso terapêutico , Betacoronavirus , Infecções por Coronavirus/epidemiologia , Infecções por Coronavirus/terapia , Tosse/fisiopatologia , Coleta de Dados , Diarreia/fisiopatologia , Surtos de Doenças , Dispneia/fisiopatologia , Fadiga/fisiopatologia , Febre/fisiopatologia , Cefaleia/fisiopatologia , Humanos , Mialgia/fisiopatologia , Oxigenoterapia , Pandemias , Pneumonia Viral/epidemiologia , Pneumonia Viral/terapia , Publicações , Estudos Retrospectivos , Fatores de Risco
5.
Clin Neurol Neurosurg ; 197: 106173, 2020 10.
Artigo em Inglês | MEDLINE | ID: mdl-32877769

RESUMO

People with Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) infection, COVID-19, can have neurological problems including headache, anosmia, dysgeusia, altered mental status (AMS), ischemic stroke with or without large vessel occlusion, and Guillen-Barre Syndrome. Louisiana was one of the states hit hardest by the pandemic with just over 57,000 laboratory-confirmed cases of COVID-19 by the end of June 2020. We reviewed the electronic medical records (EMR) of patients hospitalized during the peak of the pandemic, March 1st through March 31st, to document the type and frequency of neurological problems seen in patients with COVID-19 at presentation to the emergency room. Secondary aims were to determine: 1) the frequency of neurological complaints during the hospital stay; 2) whether the presence of any neurological complaint at presentation or any of the individual types of neurological complaints at admission predicted three separate outcomes: death, length of hospital stay, or the need for intubation; and 3) if the presence of any neurological complaint or any of the individual types of neurological complaints developed during hospital stay predicted the previous three outcomes. A large proportion of our sample (80 %) was African American and had hypertension (79 %). Out of 250 patients, 56 (22 %) patients died, and 72 (29 %) patients required intubation. Thirty-four (14 %) had a neurological chief complaint at presentation; the most common neurological chief complaints in the entire sample were altered mental status (AMS) (8 %), headache (2 %), and syncope (2 %). We used a competing risk model to determine whether neurological symptoms at presentation or during hospital stay were predictors of prolonged hospital stay and death. To establish whether neurological symptoms were associated with higher odds of intubation, we used logistic regression. Age was the only significant demographic predictor of death and hospital stay. The HR (95 %CI) for remaining in the hospital for a ten-year increase in age was 1.2, (1.1, 1.3, p < 0.0001), and for death was 1.3, (1.1, 1.5, p < 0.01). There were no demographic characteristics, including age or comorbidities predictive of intubation. Adjusting for age, patients who at presentation had neurological issues as their chief complaint were at significantly increased risk for remaining in the hospital, HR = 1.7, (1.1,2.5, p = 0.0001), and dying, HR = 2.1(1.1,3.8, p = 0.02), compared to patients without any neurological complaint. Of the individual admission complaints, AMS was associated with a significantly prolonged hospital stay, HR = 1.8, (1.0-3.3, p = 0.05). Patients that required dialysis or intubation or had AMS during hospitalization had more extended hospital stays. After adjusting for age, dialysis, and intubation, patients with AMS during hospital stay had a HR of 1.6, (1.1, 2.5, p = 0.01) for remaining in the hospital. Patients who had statistically significant higher odds of requiring intubation were those who presented with any neurological chief complaint, OR = 2.8 (1.3,5.8, p = 0.01), or with headaches OR = 13.3 (2.1,257.0, p = 0.008). Patients with AMS during the hospital stay, as well as those who had seizures, were more likely to need intubation. In the multivariate model, dialysis, OR = 4.9 (2.6,9.4, p < 0.0001), and AMS, OR = 8.8 (3.9,21.2, p < 0.0001), were the only independent predictors of intubation. Neurological complaints at presentation and during the hospital stay are associated with a higher risk of death, prolonged hospital stay, and intubation. More work is needed to determine whether the cause of the neurological complaints was direct CNS involvement by the virus or the other systemic complications of the virus.


Assuntos
Infecções por Coronavirus/fisiopatologia , Intubação Intratraqueal/estatística & dados numéricos , Tempo de Internação/estatística & dados numéricos , Doenças do Sistema Nervoso/fisiopatologia , Pneumonia Viral/fisiopatologia , Adulto , Afro-Americanos/estatística & dados numéricos , Fatores Etários , Idoso , Idoso de 80 Anos ou mais , Betacoronavirus , Infecções por Coronavirus/complicações , Infecções por Coronavirus/mortalidade , Infecções por Coronavirus/terapia , Serviço Hospitalar de Emergência , Grupo com Ancestrais do Continente Europeu , Feminino , Cefaleia/etiologia , Cefaleia/fisiopatologia , Humanos , Masculino , Pessoa de Meia-Idade , Mortalidade , Doenças do Sistema Nervoso/etiologia , Nova Orleans , Pandemias , Pneumonia Viral/complicações , Pneumonia Viral/mortalidade , Pneumonia Viral/terapia , Prognóstico , Modelos de Riscos Proporcionais , Respiração Artificial , Convulsões/etiologia , Convulsões/fisiopatologia , Estado Epiléptico/etiologia , Estado Epiléptico/fisiopatologia , Acidente Vascular Cerebral/etiologia , Acidente Vascular Cerebral/fisiopatologia , Síncope/etiologia , Síncope/fisiopatologia
6.
Mol Cell Proteomics ; 19(11): 1749-1759, 2020 11.
Artigo em Inglês | MEDLINE | ID: mdl-32788344

RESUMO

Coronavirus disease 2019 (COVID-19) is a highly contagious infection and threating the human lives in the world. The elevation of cytokines in blood is crucial to induce cytokine storm and immunosuppression in the transition of severity in COVID-19 patients. However, the comprehensive changes of serum proteins in COVID-19 patients throughout the SARS-CoV-2 infection is unknown. In this work, we developed a high-density antibody microarray and performed an in-depth proteomics analysis of serum samples collected from early COVID-19 (n = 15) and influenza (n = 13) patients. We identified a large set of differentially expressed proteins (n = 132) that participate in a landscape of inflammation and immune signaling related to the SARS-CoV-2 infection. Furthermore, the significant correlations of neutrophil and lymphocyte with the CCL2 and CXCL10 mediated cytokine signaling pathways was identified. These information are valuable for the understanding of COVID-19 pathogenesis, identification of biomarkers and development of the optimal anti-inflammation therapy.


Assuntos
Proteínas Sanguíneas/imunologia , Infecções por Coronavirus/imunologia , Tosse/imunologia , Síndrome da Liberação de Citocina/imunologia , Febre/imunologia , Cefaleia/imunologia , Influenza Humana/imunologia , Mialgia/imunologia , Pneumonia Viral/imunologia , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Betacoronavirus/patogenicidade , Proteínas Sanguíneas/genética , Criança , Infecções por Coronavirus/genética , Infecções por Coronavirus/fisiopatologia , Infecções por Coronavirus/virologia , Tosse/genética , Tosse/fisiopatologia , Tosse/virologia , Síndrome da Liberação de Citocina/genética , Síndrome da Liberação de Citocina/fisiopatologia , Síndrome da Liberação de Citocina/virologia , Citocinas/genética , Citocinas/imunologia , Feminino , Febre/genética , Febre/fisiopatologia , Febre/virologia , Perfilação da Expressão Gênica , Regulação da Expressão Gênica , Cefaleia/genética , Cefaleia/fisiopatologia , Cefaleia/virologia , Humanos , Influenza Humana/genética , Influenza Humana/fisiopatologia , Influenza Humana/virologia , Masculino , Pessoa de Meia-Idade , Mialgia/genética , Mialgia/fisiopatologia , Mialgia/virologia , Orthomyxoviridae/patogenicidade , Pandemias , Pneumonia Viral/genética , Pneumonia Viral/fisiopatologia , Pneumonia Viral/virologia , Análise Serial de Proteínas , Proteoma/genética , Proteoma/imunologia , Receptores de Citocinas/genética , Receptores de Citocinas/imunologia , Transdução de Sinais/imunologia
8.
Rinsho Shinkeigaku ; 60(9): 589-596, 2020 Sep 29.
Artigo em Japonês | MEDLINE | ID: mdl-32779603

RESUMO

Over the course of the new coronavirus infectious disease (coronavirus disease 2019; COVID-19) pandemic, our social situation has been changing dramatically, in addition to the substantial efforts made for the early and appropriate management of COVID-19 and preventing this infection spreading. Recently, neurological symptoms associated with COVID-19 have been shown to be not uncommon, with headaches receiving attention as one of the main neurological symptoms. The frequency of headaches associated with COVID-19 ranged from 5.6% to 70.3%, based on 21 clinical studies and 8 meta-analyses. However, headaches were observed in 11.1% to 81.0% of non-COVID-19 individuals, including healthcare workers caring for COVID-19 patients. Although detailed descriptions of headaches were rarely provided in the literature obtained, in this article, I wil discuss the frequency and characteristics of headaches, and the pathophysiology of headaches as it relateds to COVID-19.


Assuntos
Infecções por Coronavirus/complicações , Cefaleia/epidemiologia , Cefaleia/etiologia , Pneumonia Viral/complicações , Infecções por Coronavirus/prevenção & controle , Cefaleia/fisiopatologia , Pessoal de Saúde/estatística & dados numéricos , Humanos , Metanálise como Assunto , Pandemias/prevenção & controle , Pneumonia Viral/prevenção & controle
10.
Neurology ; 95(13): e1868-e1882, 2020 09 29.
Artigo em Inglês | MEDLINE | ID: mdl-32680942

RESUMO

OBJECTIVE: To describe neuroimaging findings and to report the epidemiologic and clinical characteristics of patients with coronavirus disease 2019 (COVID-19) with neurologic manifestations. METHODS: In this retrospective multicenter study (11 hospitals), we included 64 patients with confirmed COVID-19 with neurologic manifestations who underwent a brain MRI. RESULTS: The cohort included 43 men (67%) and 21 women (33%); their median age was 66 (range 20-92) years. Thirty-six (56%) brain MRIs were considered abnormal, possibly related to severe acute respiratory syndrome coronavirus. Ischemic strokes (27%), leptomeningeal enhancement (17%), and encephalitis (13%) were the most frequent neuroimaging findings. Confusion (53%) was the most common neurologic manifestation, followed by impaired consciousness (39%), presence of clinical signs of corticospinal tract involvement (31%), agitation (31%), and headache (16%). The profile of patients experiencing ischemic stroke was different from that of other patients with abnormal brain imaging: the former less frequently had acute respiratory distress syndrome (p = 0.006) and more frequently had corticospinal tract signs (p = 0.02). Patients with encephalitis were younger (p = 0.007), whereas agitation was more frequent for patients with leptomeningeal enhancement (p = 0.009). CONCLUSIONS: Patients with COVID-19 may develop a wide range of neurologic symptoms, which can be associated with severe and fatal complications such as ischemic stroke or encephalitis. In terms of meningoencephalitis involvement, even if a direct effect of the virus cannot be excluded, the pathophysiology seems to involve an immune or inflammatory process given the presence of signs of inflammation in both CSF and neuroimaging but the lack of virus in CSF. CLINICALTRIALSGOV IDENTIFIER: NCT04368390.


Assuntos
Isquemia Encefálica/diagnóstico por imagem , Encéfalo/diagnóstico por imagem , Infecções por Coronavirus/diagnóstico por imagem , Meningoencefalite/diagnóstico por imagem , Pneumonia Viral/diagnóstico por imagem , Acidente Vascular Cerebral/diagnóstico por imagem , Adulto , Idoso , Idoso de 80 Anos ou mais , Betacoronavirus , Isquemia Encefálica/fisiopatologia , Confusão/fisiopatologia , Transtornos da Consciência/fisiopatologia , Infecções por Coronavirus/fisiopatologia , Encefalite/diagnóstico por imagem , Encefalite/fisiopatologia , Feminino , França , Cefaleia/fisiopatologia , Humanos , Imagem por Ressonância Magnética , Masculino , Meningite/diagnóstico por imagem , Meningite/fisiopatologia , Meningoencefalite/fisiopatologia , Pessoa de Meia-Idade , Pandemias , Pneumonia Viral/fisiopatologia , Agitação Psicomotora/fisiopatologia , Tratos Piramidais/diagnóstico por imagem , Tratos Piramidais/fisiopatologia , Síndrome do Desconforto Respiratório do Adulto/fisiopatologia , Estudos Retrospectivos , Acidente Vascular Cerebral/fisiopatologia , Adulto Jovem
11.
Diabetes Metab Syndr ; 14(5): 1053-1060, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32640417

RESUMO

BACKROUND AND AIMS: After the emergence of Severe Acute Respiratory Syndrome Coronavirus (SARS-CoV) and Middle East Respiratory Syndrome Coronavirus (MERS-CoV) in the last two decades, the world is facing its new challenge in SARS-CoV-2 pandemic with unfathomable global responses. The characteristic clinical symptoms for Coronavirus (COVID-19) affected patients are high fever, dry-cough, dyspnoea, lethal pneumonia whereas some patients also show additional neurological signs such as headache, nausea, vomiting etc. The accumulative evidences suggest that SARS-CoV-2 is not only confined within the respiratory tract but may also invade the central nervous system (CNS) and peripheral nervous system (PNS) inducing some fatal neurological diseases. Here, we analyze the phylogenetic perspective of SARS-CoV-2 with other strains of ß-Coronaviridae from a standpoint of neurological spectrum disorders. METHODOLOGY: A Pubmed/Medline, NIH Lit Covid, Cochrane library and some open data bases (BioRxiv, MedRxiv,preprint.org and others) search were carried out by using keywords relevant to our topic of discussion. The extracted literatures are scrutinized by the authors. RESULTS: 58 literatures including original articles, case reports and case series were selected by the authors to analyze the differential distribution of neurological impairments in COVID-19 positive patients along with angiotensin-converting enzyme-2 (ACE2) expression dynamics in neuronal and non-neuronal tissue in CNS and PNS with neuroinvasive potential of SARS-CoV2. CONCLUSION: We discuss the need for modulations in clinical approach from a neurological point of view, as a measure towards reducing disease transmission, morbidity and mortality in SARS-CoV2 positive patients.


Assuntos
Betacoronavirus/isolamento & purificação , Sistema Nervoso Central/virologia , Infecções por Coronavirus/epidemiologia , Cefaleia/virologia , Pneumonia Viral/epidemiologia , Sistema Nervoso Central/fisiopatologia , Infecções por Coronavirus/transmissão , Infecções por Coronavirus/virologia , Saúde Global , Cefaleia/fisiopatologia , Humanos , Incidência , Pandemias , Pneumonia Viral/transmissão , Pneumonia Viral/virologia
13.
Eur J Clin Invest ; 50(10): e13351, 2020 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-32681526

RESUMO

BACKGROUNDS: More paediatric-confirmed cases have been reported with the global pandemic of COVID-19. This study aims to summarize the key points and supply suggestions on screening paediatric COVID-19 patients more appropriately. MATERIALS AND METHODS: We retrospectively included paediatric patients who have accepted SARS-CoV-2 RT-PCR testing in Children's Hospital of Chongqing Medical University (30 January 2020 to 13 February 2020) and compared them with paediatric-confirmed COVID-19 cases. Besides, a review was carried out by analysing all current literature about laboratory-confirmed paediatric cases with COVID-19. RESULTS: There were 46 suspected cases included in the descriptive study. The results of SARS-CoV-2 RT-PCR testing were all negative. Compared with paediatric-confirmed cases, the incidence of epidemic history was lower in suspected cases (P < .001). The rate of fever (P < .001), cough (P < .001), headache or dizziness (P < .001), vomiting (P < .001) and abdominal discomfort or distention (P = .01) were more observed in the included suspected children. There were more children having decreased WBC count in the confirmed group. In the literature review, twenty-nine studies were obtained with 488 paediatric COVID-19 cases. 88.6% of them had epidemiological history. Cough and fever were the most common symptoms. Compared with older patients, the incidence of fever, respiratory symptoms, lethargy and headache or dizziness was lower, while gastrointestinal symptoms were reported more. CONCLUSIONS: Children with a history of close contact with confirmed cases, manifested as cough and fever should be paid more attention to after excluding infection of other common pathogens. Atypical symptoms should not be over-emphasized in screening paediatric COVID-19. More studies are needed for guiding efficient recognition in paediatric COVID-19.


Assuntos
Infecções por Coronavirus/diagnóstico , Pneumonia Viral/diagnóstico , Dor Abdominal/fisiopatologia , Betacoronavirus , Criança , Pré-Escolar , Técnicas de Laboratório Clínico , Infecções por Coronavirus/fisiopatologia , Tosse/fisiopatologia , Tontura/fisiopatologia , Feminino , Febre/fisiopatologia , Cefaleia/fisiopatologia , Humanos , Lactente , Pulmão/diagnóstico por imagem , Linfopenia/fisiopatologia , Masculino , Programas de Rastreamento , Pandemias , Pneumonia Viral/fisiopatologia , Estudos Retrospectivos , Reação em Cadeia da Polimerase Via Transcriptase Reversa , Medição de Risco , Vômito/fisiopatologia
14.
Neurol India ; 68(3): 560-572, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32643664

RESUMO

COVID-19, in most patients, presents with mild flu-like illness. Elderly patients with comorbidities, like hypertension, diabetes, or lung and cardiac disease, are more likely to have severe disease and deaths. Neurological complications are frequently reported in severely or critically ill patients with comorbidities. In COVID-19, both central and peripheral nervous systems can be affected. The SARS-CoV-2 virus causes the disease COVID-19 and has the potential to invade the brain. The SARS-CoV-2 virus enters the brain either via a hematogenous route or olfactory system. Angiotensin-converting enzyme two receptors, present on endothelial cells of cerebral vessels, are a possible viral entry point. The most severe neurological manifestations, altered sensorium (agitation, delirium, and coma), are because of hypoxic and metabolic abnormalities. Characteristic cytokine storm incites severe metabolic changes and multiple organ failure. Profound coagulopathies may manifest with ischemic or hemorrhagic stroke. Rarely, SARS-CoV-2 virus encephalitis or pictures like acute disseminated encephalomyelitis or acute necrotizing encephalopathy have been reported. Nonspecific headache is a commonly experienced neurological symptom. A new type of headache "personal protection equipment-related headache" has been described. Complete or partial anosmia and ageusia are common peripheral nervous system manifestations. Recently, many cases of Guillain-Barré syndrome in COVID-19 patients have been observed, and a postinfectious immune-mediated inflammatory process was held responsible for this. Guillain-Barré syndrome does respond to intravenous immunoglobulin. Myalgia/fatigue is also common, and elevated creatine kinase levels indicate muscle injury. Most of the reports about neurological complications are currently from China. COVID-19 pandemic is spreading to other parts of the world; the spectrum of neurological complications is likely to widen further.


Assuntos
Ageusia/fisiopatologia , Infecções por Coronavirus/fisiopatologia , Síndrome da Liberação de Citocina/imunologia , Encefalite/fisiopatologia , Síndrome de Guillain-Barré/fisiopatologia , Cefaleia/fisiopatologia , Transtornos do Olfato/fisiopatologia , Pneumonia Viral/fisiopatologia , Acidente Vascular Cerebral/fisiopatologia , Ageusia/etiologia , Betacoronavirus , Transtornos da Coagulação Sanguínea/sangue , Transtornos da Coagulação Sanguínea/etiologia , Barreira Hematoencefálica , Isquemia Encefálica/sangue , Isquemia Encefálica/etiologia , Isquemia Encefálica/imunologia , Isquemia Encefálica/fisiopatologia , Coma/etiologia , Coma/fisiopatologia , Infecções por Coronavirus/sangue , Infecções por Coronavirus/complicações , Infecções por Coronavirus/imunologia , Delírio/etiologia , Delírio/fisiopatologia , Encefalite/etiologia , Encefalite/imunologia , Encefalomielite Aguda Disseminada/etiologia , Encefalomielite Aguda Disseminada/imunologia , Encefalomielite Aguda Disseminada/fisiopatologia , Fadiga/etiologia , Fadiga/fisiopatologia , Síndrome de Guillain-Barré/etiologia , Cefaleia/etiologia , Humanos , Hemorragias Intracranianas/sangue , Hemorragias Intracranianas/etiologia , Hemorragias Intracranianas/fisiopatologia , Leucoencefalite Hemorrágica Aguda/etiologia , Leucoencefalite Hemorrágica Aguda/imunologia , Leucoencefalite Hemorrágica Aguda/fisiopatologia , Mialgia/etiologia , Mialgia/fisiopatologia , Transtornos do Olfato/etiologia , Pandemias , Equipamento de Proteção Individual/efeitos adversos , Pneumonia Viral/sangue , Pneumonia Viral/complicações , Pneumonia Viral/imunologia , Acidente Vascular Cerebral/sangue , Acidente Vascular Cerebral/etiologia , Acidente Vascular Cerebral/imunologia
15.
Artigo em Inglês | MEDLINE | ID: covidwho-459560
16.
Microbes Infect ; 22(9): 481-488, 2020 10.
Artigo em Inglês | MEDLINE | ID: mdl-32561409

RESUMO

Clinical descriptions about influenza-like illnesses (ILI) in COVID-19 seem non-specific. We aimed to compare the clinical features of COVID-19 and influenza. We retrospectively investigated the clinical features and outcomes of confirmed cases of COVID-19 and influenza in Nord Franche-Comté Hospital between February 26th and March 14th 2020. We used SARS-CoV-2 RT-PCR and influenza virus A/B RT-PCR in respiratory samples to confirm the diagnosis. We included 124 patients. The mean age was 59 (±19 [19-98]) years with 69% female. 70 patients with COVID-19 and 54 patients with influenza A/B. Regarding age, sex and comorbidities, no differences were found between the two groups except a lower Charlson index in COVID-19 group (2 [±2.5] vs 3 [±2.4],p = 0.003). Anosmia (53% vs 17%,p < 0.001), dysgeusia (49% vs 20%,p = 0.001), diarrhea (40% vs 20%,p = 0.021), frontal headache (26% vs 9%,p = 0.021) and bilateral cracklings sounds (24% vs 9%,p = 0.034) were statistically more frequent in COVID-19. Sputum production (52% vs 29%,p = 0.010), dyspnea (59% vs 34%,p = 0.007), sore throat (44% vs 20%,p = 0.006), conjunctival hyperhemia (30% vs 4%,p < 0.001), tearing (24% vs 6%,p = 0.004), vomiting (22% vs 3%,p = 0.001) and rhonchi sounds (17% vs 1%,p = 0.002) were more frequent with influenza infection. We described several clinical differences which can help the clinicians during the co-circulation of influenza and SARS-CoV-2.


Assuntos
Betacoronavirus/patogenicidade , Infecções por Coronavirus/diagnóstico , Vírus da Influenza A/patogenicidade , Vírus da Influenza B/patogenicidade , Influenza Humana/diagnóstico , Pneumonia Viral/diagnóstico , Adulto , Idoso , Idoso de 80 Anos ou mais , Infecções por Coronavirus/fisiopatologia , Infecções por Coronavirus/virologia , Diagnóstico Diferencial , Diarreia/diagnóstico , Diarreia/fisiopatologia , Diarreia/virologia , Disgeusia/diagnóstico , Disgeusia/fisiopatologia , Disgeusia/virologia , Dispneia/diagnóstico , Dispneia/fisiopatologia , Dispneia/virologia , Feminino , França , Cefaleia/diagnóstico , Cefaleia/fisiopatologia , Cefaleia/virologia , Humanos , Influenza Humana/fisiopatologia , Influenza Humana/virologia , Masculino , Pessoa de Meia-Idade , Transtornos do Olfato/diagnóstico , Transtornos do Olfato/fisiopatologia , Transtornos do Olfato/virologia , Pandemias , Faringite/diagnóstico , Faringite/fisiopatologia , Faringite/virologia , Pneumonia Viral/fisiopatologia , Pneumonia Viral/virologia , Estudos Retrospectivos , Índice de Gravidade de Doença , Vômito/diagnóstico , Vômito/fisiopatologia , Vômito/virologia
17.
Am J Trop Med Hyg ; 103(2): 665-671, 2020 08.
Artigo em Inglês | MEDLINE | ID: mdl-32588803

RESUMO

Blood cultures (BCs) detect an estimated 50% of typhoid fever cases. There is need for validated clinical criteria to define cases that are BC negative, both to help direct empiric antibiotic treatment and to better evaluate the magnitude of protection conferred by typhoid vaccines. To derive and validate a clinical rule for defining BC-negative typhoid fever, we assessed, in a cluster-randomized effectiveness trial of Vi-polysaccharide (ViPS) typhoid vaccine in Kolkata, India, 14,797 episodes of fever lasting at least 3 days during 4 years of comprehensive, BC-based surveillance of 70,865 persons. A recursive partitioning algorithm was used to develop a decision rule to predict BC-proven typhoid cases with a diagnostic specificity of 97-98%. To validate this rule as a definition for BC-negative typhoid fever, we assessed whether the rule defined culture-negative syndromes prevented by ViPS vaccine. In a training subset of individuals, we identified the following two rules: rule 1: patients aged < 15 years with prolonged fever accompanied by a measured body temperature ≥ 100°F, headache, and nausea; rule 2: patients aged ≥ 15 years with prolonged fever accompanied by nausea and palpable liver but without constipation. The adjusted protective efficacy of ViPS against clinical typhoid defined by these rules in persons aged ≥ 2 years in a separate validation subset was 33% (95% CI: 4-53%). We have defined and validated a clinical rule for predicting BC-negative typhoid fever using a novel vaccine probe approach. If validated in other settings, this rule may be useful to guide clinical care and to enhance typhoid vaccine evaluations.


Assuntos
Febre/fisiopatologia , Cefaleia/fisiopatologia , Fígado/patologia , Náusea/fisiopatologia , Febre Tifoide/diagnóstico , Adolescente , Adulto , Algoritmos , Hemocultura , Criança , Pré-Escolar , Regras de Decisão Clínica , Árvores de Decisões , Humanos , Índia , Aprendizado de Máquina , Palpação , Polissacarídeos Bacterianos/uso terapêutico , Ensaios Clínicos Controlados Aleatórios como Assunto , Sensibilidade e Especificidade , Fatores de Tempo , Febre Tifoide/fisiopatologia , Febre Tifoide/prevenção & controle , Vacinas Tíficas-Paratíficas/uso terapêutico , Adulto Jovem
18.
Artigo em Inglês | MEDLINE | ID: mdl-32482781
19.
J Headache Pain ; 21(1): 65, 2020 Jun 05.
Artigo em Inglês | MEDLINE | ID: mdl-32503421

RESUMO

The fifth cranial nerve is the common denominator for many headaches and facial pain pathologies currently known. Projecting from the trigeminal ganglion, in a bipolar manner, it connects to the brainstem and supplies various parts of the head and face with sensory innervation. In this review, we describe the neuroanatomical structures and pathways implicated in the sensation of the trigeminal system. Furthermore, we present the current understanding of several primary headaches, painful neuropathies and their pharmacological treatments. We hope that this overview can elucidate the complex field of headache pathologies, and their link to the trigeminal nerve, to a broader field of young scientists.


Assuntos
Dor Facial/patologia , Cefaleia/patologia , Gânglio Trigeminal/patologia , Nervo Trigêmeo/patologia , Animais , Tronco Encefálico/metabolismo , Tronco Encefálico/patologia , Tronco Encefálico/fisiopatologia , Dor Facial/metabolismo , Dor Facial/fisiopatologia , Cefaleia/metabolismo , Cefaleia/fisiopatologia , Humanos , Gânglio Trigeminal/metabolismo , Gânglio Trigeminal/fisiopatologia , Nervo Trigêmeo/metabolismo , Nervo Trigêmeo/fisiopatologia
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