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1.
BMC Infect Dis ; 20(1): 646, 2020 Sep 01.
Artigo em Inglês | MEDLINE | ID: mdl-32873235

RESUMO

BACKGROUND: COVID-19 is known as a new viral infection. Viral-bacterial co-infections are one of the biggest medical concerns, resulting in increased mortality rates. To date, few studies have investigated bacterial superinfections in COVID-19 patients. Hence, we designed the current study on COVID-19 patients admitted to ICUs. METHODS: Nineteen patients admitted to our ICUs were enrolled in this study. To detect COVID-19, reverse transcription real-time polymerase chain reaction was performed. Endotracheal aspirate samples were also collected and cultured on different media to support the growth of the bacteria. After incubation, formed colonies on the media were identified using Gram staining and other biochemical tests. Antimicrobial susceptibility testing was carried out based on the CLSI recommendations. RESULTS: Of nineteen COVID-19 patients, 11 (58%) patients were male and 8 (42%) were female, with a mean age of ~ 67 years old. The average ICU length of stay was ~ 15 days and at the end of the study, 18 cases (95%) expired and only was 1 case (5%) discharged. In total, all patients were found positive for bacterial infections, including seventeen Acinetobacter baumannii (90%) and two Staphylococcus aureus (10%) strains. There was no difference in the bacteria species detected in any of the sampling points. Seventeen of 17 strains of Acinetobacter baumannii were resistant to the evaluated antibiotics. No metallo-beta-lactamases -producing Acinetobacter baumannii strain was found. One of the Staphylococcus aureus isolates was detected as methicillin-resistant Staphylococcus aureus and isolated from the patient who died, while another Staphylococcus aureus strain was susceptible to tested drugs and identified as methicillin-sensitive Staphylococcus aureus. CONCLUSIONS: Our findings emphasize the concern of superinfection in COVID-19 patients due to Acinetobacter baumannii and Staphylococcus aureus. Consequently, it is important to pay attention to bacterial co-infections in critical patients positive for COVID-19.


Assuntos
Infecções por Acinetobacter/complicações , Acinetobacter baumannii/isolamento & purificação , Betacoronavirus/fisiologia , Coinfecção/epidemiologia , Infecções por Coronavirus/complicações , Pneumonia Viral/complicações , Infecções Estafilocócicas/complicações , Staphylococcus aureus/isolamento & purificação , Infecções por Acinetobacter/epidemiologia , Infecções por Acinetobacter/microbiologia , Acinetobacter baumannii/efeitos dos fármacos , Adulto , Idoso , Idoso de 80 Anos ou mais , Antibacterianos/farmacologia , Infecções por Coronavirus/epidemiologia , Infecções por Coronavirus/virologia , Complicações do Diabetes/epidemiologia , Feminino , Cardiopatias/complicações , Humanos , Hipertensão/complicações , Unidades de Terapia Intensiva , Masculino , Staphylococcus aureus Resistente à Meticilina/efeitos dos fármacos , Staphylococcus aureus Resistente à Meticilina/isolamento & purificação , Pessoa de Meia-Idade , Pandemias , Pneumonia Viral/epidemiologia , Pneumonia Viral/virologia , Sistema Respiratório/microbiologia , Infecções Estafilocócicas/epidemiologia , Infecções Estafilocócicas/microbiologia , Staphylococcus aureus/efeitos dos fármacos
2.
Pan Afr Med J ; 36: 158, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32874422

RESUMO

Diabetes mellitus is a non-infectious disease and has affected about 425 million adults globally and nearly 15.9 million of them reside in Africa. Moreover, the prevalence of undiagnosed diabetes mellitus is very high in Africa and approximates to around 62%. Nearly 75% of the total deaths due to diabetes are in individuals lesser than 60 years of age. The multifaceted disease of diabetes mellitus produces chronic complications such as, neuropathy, nephropathy, retinopathy, microangiopathy etc. These patients of diabetes mellitus are more susceptible to infections due to compromised immune system. Hence these patients of diabetes mellitus and undiagnosed diabetes mellitus are at greater risk of contracting COVID-19 infections. The dual impact of pathophysiology of COVID-19 infections in diabetes mellitus may increase morbidity and mortality in these patients. Hence there is need of health awareness in diabetics as well in the high-risk group for diabetes such as persons with hypertension and obesity. The scarcity of health resources, shortage of trained medical personnel and disease burden of infectious and non-infectious diseases has laid a heavy impact on the economy in Africa and this has been further strained due to the COVID-19 pandemic. The practice of preventive measures by the risk group of Undiagnosed Diabetes Mellitus patients will prevent them from getting infected by COVID-19 and at the same time decrease mortality rates and hence the undiscovered group that is the patients of undiagnosed diabetes mellitus needs to be vigilant regarding safe preventive practices.


Assuntos
Infecções por Coronavirus/epidemiologia , Complicações do Diabetes/epidemiologia , Diabetes Mellitus/epidemiologia , Pneumonia Viral/epidemiologia , Adulto , África/epidemiologia , Infecções por Coronavirus/mortalidade , Infecções por Coronavirus/fisiopatologia , Complicações do Diabetes/diagnóstico , Complicações do Diabetes/fisiopatologia , Diabetes Mellitus/diagnóstico , Diabetes Mellitus/fisiopatologia , Humanos , Pandemias , Pneumonia Viral/mortalidade , Pneumonia Viral/fisiopatologia , Prevalência , Fatores de Risco
3.
Medicine (Baltimore) ; 99(33): e20805, 2020 Aug 14.
Artigo em Inglês | MEDLINE | ID: mdl-32871971

RESUMO

Patients with acute coronary syndrome (ACS) have an increased serum level of calprotectin. The purpose of present study was to analyze the prognostic significance of serum calprotectin levels in elderly diabetic patients underwent percutaneous coronary intervention (PCI) due to ACS.A total of 273 consecutive elderly diabetic patients underwent PCI for primary ACS were enrolled. Serum calprotectin levels were measured before PCI, and baseline clinical characteristics of all patients were collected. All patients were followed up at regular interval for major adverse cardiovascular events (MACEs) during 1 year after PCI. MACEs include cardiovascular death, nonfatal myocardial infarction, and target vessel revascularization (TVR). The predicting value of serum calprotectin for MACEs was analyzed by using univariate and multivariate analysis and receiver-operating characteristic curve (ROC).At the endpoint of this study, 47 patients of all 273 patients had MACEs. According to optimal cutoff value of calprotectin for predicting MACEs by ROC analysis, all patients were stratified into a high calprotectin group and a low calprotectin group. The incidence rate of MACEs and TVR in high calprotectin group was prominently higher than that in low calprotectin group (21.9% vs 11.5%, P = .02). In multivariable COX regression analysis adjusting for potential confounders, serum calprotectin level remains as an independent risk predictor of MACE (hazard ratio, 1.56; 95% confidence interval [CI]: 1.08-4.62; P = .01).In diabetic patients with a comorbidity of ACS, a high serum level of calprotectin is associated to a higher MACE rate after PCI.


Assuntos
Síndrome Coronariana Aguda/sangue , Síndrome Coronariana Aguda/cirurgia , Complicações do Diabetes/sangue , Complexo Antígeno L1 Leucocitário/sangue , Intervenção Coronária Percutânea , Síndrome Coronariana Aguda/epidemiologia , Idoso , Biomarcadores/sangue , Estudos de Coortes , Comorbidade , Complicações do Diabetes/epidemiologia , Complicações do Diabetes/cirurgia , Feminino , Humanos , Incidência , Masculino , Pessoa de Meia-Idade , Complicações Pós-Operatórias/sangue , Prognóstico
4.
J Diabetes Res ; 2020: 1652403, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32851093

RESUMO

Background: Since December 2019, novel coronavirus- (SARS-CoV-2) infected pneumonia (COVID-19) has rapidly spread throughout China. This study is aimed at describing the characteristics of COVID-19 patients in Wuhan. Methods: 199 COVID-19 patients were admitted to Wuhan Red Cross Hospital in China from January 24th to March 15th. The cases were divided into diabetic and nondiabetic groups according to the history of taking antidiabetic drugs or by plasma fasting blood glucose level at admission, and the difference between groups were compared. Results: Among 199 COVID-19 patients, 76 were diabetic and 123 were nondiabetic. Compared with nondiabetics, patients with diabetes had an older age, high levels of fasting plasma glucose (FPG), D-dimer, white blood cell, blood urea nitrogen (BUN) and total bilirubin (TBIL), lower levels of lymphocyte, albumin and oxygen saturation (SaO2), and higher mortality (P < 0.05). The two groups showed no difference in clinical symptoms. Diabetes, higher level of D-dimer at admission, and lymphocyte count less than 0.6 × 109/L at admission were associated with increasing odds of death. Antidiabetic drugs were associated with decreasing odds of death. Treatment with low molecular weight heparin was not related to odds of death. Conclusion: The mortality rate of COVID-19 patients with diabetes was significantly higher than those without diabetes. Diabetes, higher level of D-dimer, and lymphocyte count less than 0.6 × 109/L at admission were the risk factors associated with in-hospital death.


Assuntos
Infecções por Coronavirus/complicações , Infecções por Coronavirus/mortalidade , Complicações do Diabetes/mortalidade , Diabetes Mellitus/mortalidade , Pneumonia Viral/complicações , Pneumonia Viral/mortalidade , Idoso , Betacoronavirus/genética , Betacoronavirus/isolamento & purificação , Estudos de Casos e Controles , China/epidemiologia , Técnicas de Laboratório Clínico/métodos , Comorbidade , Infecções por Coronavirus/sangue , Infecções por Coronavirus/diagnóstico , Complicações do Diabetes/sangue , Complicações do Diabetes/tratamento farmacológico , Complicações do Diabetes/epidemiologia , Diabetes Mellitus/sangue , Diabetes Mellitus/tratamento farmacológico , Diabetes Mellitus/epidemiologia , Feminino , Mortalidade Hospitalar , Humanos , Hipoglicemiantes/uso terapêutico , Tempo de Internação/estatística & dados numéricos , Masculino , Pessoa de Meia-Idade , Pandemias , Admissão do Paciente/estatística & dados numéricos , Pneumonia Viral/sangue , Pneumonia Viral/diagnóstico , RNA Viral/análise , Estudos Retrospectivos , Fatores de Risco
5.
Artigo em Inglês | MEDLINE | ID: mdl-32754119

RESUMO

Background: Diabetes correlates with poor prognosis in patients with COVID-19, but very few studies have evaluated whether impaired fasting glucose (IFG) is also a risk factor for the poor outcomes of patients with COVID-19. Here we aimed to examine the associations between IFG and diabetes at admission with risks of complications and mortality among patients with COVID-19. Methods: In this multicenter retrospective cohort study, we enrolled 312 hospitalized patients with COVID-19 from 5 hospitals in Wuhan from Jan 1 to Mar 17, 2020. Clinical information, laboratory findings, complications, treatment regimens, and mortality status were collected. The associations between hyperglycemia and diabetes status at admission with primary composite end-point events (including mechanical ventilation, admission to intensive care unit, or death) were analyzed by Cox proportional hazards regression models. Results: The median age of the patients was 57 years (interquartile range 38-66), and 172 (55%) were women. At the time of hospital admission, 84 (27%) had diabetes (and 36 were new-diagnosed), 62 (20%) had IFG, and 166 (53%) had normal fasting glucose (NFG) levels. Compared to patients with NFG, patients with IFG and diabetes developed more primary composite end-point events (9 [5%], 11 [18%], 26 [31%]), including receiving mechanical ventilation (5 [3%], 6 [10%], 21 [25%]), and death (4 [2%], 9 [15%], 20 [24%]). Multivariable Cox regression analyses showed diabetes was associated increased risks of primary composite end-point events (hazard ratio 3.53; 95% confidence interval 1.48-8.40) and mortality (6.25; 1.91-20.45), and IFG was associated with an increased risk of mortality (4.11; 1.15-14.74), after adjusting for age, sex, hospitals and comorbidities. Conclusion: IFG and diabetes at admission were associated with higher risks of adverse outcomes among patients with COVID-19.


Assuntos
Glicemia/metabolismo , Infecções por Coronavirus/mortalidade , Complicações do Diabetes/mortalidade , Diabetes Mellitus/fisiopatologia , Intolerância à Glucose/complicações , Hiperglicemia/complicações , Pneumonia Viral/mortalidade , Adulto , Idoso , Betacoronavirus/isolamento & purificação , China/epidemiologia , Infecções por Coronavirus/complicações , Infecções por Coronavirus/epidemiologia , Infecções por Coronavirus/virologia , Complicações do Diabetes/epidemiologia , Complicações do Diabetes/virologia , Diabetes Mellitus/virologia , Jejum , Feminino , Seguimentos , Intolerância à Glucose/virologia , Mortalidade Hospitalar , Hospitalização , Humanos , Hiperglicemia/virologia , Masculino , Pessoa de Meia-Idade , Pandemias , Pneumonia Viral/complicações , Pneumonia Viral/epidemiologia , Pneumonia Viral/virologia , Prognóstico , Estudos Retrospectivos , Fatores de Risco , Índice de Gravidade de Doença , Taxa de Sobrevida
7.
Am J Physiol Heart Circ Physiol ; 319(3): H604-H609, 2020 09 01.
Artigo em Inglês | MEDLINE | ID: mdl-32762561

RESUMO

Coronavirus disease 2019 (COVID-19) and diabetes outcomes (CORONADO) trial revealed that 10.6% of patients with diabetes mellitus hospitalized for COVID-19 (COVID-19) die within 7 days. Several studies from New York, Italy, and China confirm that patients with diabetes are at a much higher risk for mortality due to COVID-19. Besides respiratory illness, COVID-19 increases cardiac injury and diabetic ketoacidosis. In the absence of specific guidelines for the prevention and treatment of COVID-19 for patients with diabetes, they remain at higher risk and are more susceptible to COVID-19. Furthermore, there is a scarcity of basic knowledge on how diabetes affects pathogenesis of severe acute respiratory coronavirus (SARS-CoV-2) infection. In patients with diabetes, impaired glucose use alters metabolic and consequently biological processes instigating pathological remodeling, which has detrimental effects on cardiovascular systems. A majority of biological processes are regulated by noncoding microRNAs (miRNAs), which have emerged as a promising therapeutic candidate for several diseases. In consideration of the higher risk of mortality in patients with diabetes and COVID-19, novel diagnostic test and treatment strategy are urgently warranted in post-COVID-19 era. Here, we describe potential roles of miRNA as a biomarker and therapeutic candidate, especially for heart failure, in patients with diabetes and COVID-19.


Assuntos
Infecções por Coronavirus/metabolismo , Complicações do Diabetes/epidemiologia , MicroRNAs/genética , Pneumonia Viral/metabolismo , Animais , Biomarcadores/metabolismo , Infecções por Coronavirus/epidemiologia , Infecções por Coronavirus/patologia , Humanos , MicroRNAs/metabolismo , Pandemias , Peptidil Dipeptidase A/genética , Peptidil Dipeptidase A/metabolismo , Pneumonia Viral/epidemiologia , Pneumonia Viral/patologia
8.
Environ Microbiol ; 22(8): 3588-3592, 2020 08.
Artigo em Inglês | MEDLINE | ID: mdl-32632947

RESUMO

We reported 20 cases of discharged COVID-19 patients whose RT-PCR test results showed 're-positive'. After finding 're-positive', these patients were admitted to hospital for the second time and were followed up until the end of May 2020. We recorded detailed treatment and follow-up process, and collected relevant data. The possible causes and potential clinical significance of this phenomenon are discussed.


Assuntos
Betacoronavirus/isolamento & purificação , Infecções por Coronavirus/terapia , Pneumonia Viral/terapia , Adolescente , Adulto , Idoso de 80 Anos ou mais , Betacoronavirus/genética , Criança , Pré-Escolar , China , Comorbidade , Infecções por Coronavirus/diagnóstico , Infecções por Coronavirus/etiologia , Complicações do Diabetes/epidemiologia , Feminino , Seguimentos , Humanos , Hipertensão/complicações , Hipertensão/epidemiologia , Masculino , Pessoa de Meia-Idade , Orofaringe/virologia , Pandemias , Alta do Paciente/normas , Readmissão do Paciente , Pneumonia Viral/diagnóstico , Pneumonia Viral/etiologia , RNA Viral/análise , RNA Viral/isolamento & purificação , Kit de Reagentes para Diagnóstico , Reação em Cadeia da Polimerase em Tempo Real , Recidiva , Reação em Cadeia da Polimerase Via Transcriptase Reversa , Adulto Jovem
9.
Stroke ; 51(9): e219-e222, 2020 09.
Artigo em Inglês | MEDLINE | ID: mdl-32684145

RESUMO

BACKGROUND AND PURPOSE: Initial reports suggest a significant risk of thrombotic events, including stroke, in patients hospitalized with coronavirus disease 2019 (COVID-19). However, there is little systematic data on stroke incidence and mechanisms, particularly in racially diverse populations in the United States. METHODS: We performed a retrospective, observational study of stroke incidence and mechanisms in all patients with COVID-19 hospitalized from March 15 to May 3, 2020, at 3 Philadelphia hospitals. RESULTS: We identified 844 hospitalized patients with COVID-19 (mean age 59 years, 52% female, 68% Black); 20 (2.4%) had confirmed ischemic stroke; and 8 (0.9%) had intracranial hemorrhage. Of the ischemic stroke patients, mean age was 64 years, with only one patient (5%) under age 50, and 80% were Black. Conventional vascular risk factors were common, with 95% of patients having a history of hypertension and 60% a history of diabetes mellitus. Median time from onset of COVID symptoms to stroke diagnosis was 21 days. Stroke mechanism was cardioembolism in 40%, small vessel disease in 5%, other determined mechanism in 20%, and cryptogenic in 35%. Of the 11 patients with complete vascular imaging, 3 (27%) had large vessel occlusion. Newly positive antiphospholipid antibodies were present in >75% of tested patients. Of the patients with intracranial hemorrhage, 5/8 (63%) were lobar intraparenchymal hemorrhages, and 3/8 (38%) were subarachnoid hemorrhage; 4/8 (50%) were on extracorporeal membrane oxygenation. CONCLUSIONS: We found a low risk of acute cerebrovascular events in patients hospitalized with COVID-19. Most patients with ischemic stroke had conventional vascular risk factors, and traditional stroke mechanisms were common.


Assuntos
Transtornos Cerebrovasculares/complicações , Transtornos Cerebrovasculares/epidemiologia , Infecções por Coronavirus/complicações , Infecções por Coronavirus/epidemiologia , Pneumonia Viral/complicações , Pneumonia Viral/epidemiologia , Grupo com Ancestrais do Continente Africano , Idoso , Isquemia Encefálica/complicações , Isquemia Encefálica/epidemiologia , Complicações do Diabetes/epidemiologia , Feminino , Humanos , Hipertensão/complicações , Incidência , Pacientes Internados , Hemorragias Intracranianas/complicações , Hemorragias Intracranianas/epidemiologia , Masculino , Pessoa de Meia-Idade , Pandemias , Philadelphia/epidemiologia , Estudos Retrospectivos , Fatores de Risco , Acidente Vascular Cerebral/complicações , Acidente Vascular Cerebral/epidemiologia , Trombose/complicações , Trombose/epidemiologia
10.
Medicine (Baltimore) ; 99(29): e20678, 2020 Jul 17.
Artigo em Inglês | MEDLINE | ID: mdl-32702818

RESUMO

BACKGROUND: Diabetic nephropathy (DN) is among the common and serious complications of diabetes and is also a major cause of end-stage kidney disease. Early DN is also called diabetic microalbumin period, the main treatment is in the control of blood sugar on the basis of kidney protection and urine lowering protein. There are few effective methods of western medicine treatment, and most of them are accompanied by adverse reactions. But some studies have shown that traditional Chinese medicine has achieved the curative effect and has certain superiority. However, there are few systematic reviews on the treatment of traditional Chinese herbal medicine for early DN currently. Therefore, this study conducted a systematic review of clinical efficacy and safety of Chinese herbal medicine for the treatment of patients with early DN, aim to comprehensively analyze the role of traditional Chinese herbal medicine in the treatment of early DN. METHODS AND ANALYSIS: The protocol of this systematic review and meta-analysis was registered on the INPLASY website (https://inplasy.com/inplasy-2020-4-0139/) and INPLASY registration number is INPLASY202040139. A systematic literature search will be conducted in 3 English database and 4 Chinese databases with a language limitation of English and Chinese. Search for clinical research literature on Chinese herbal medicine treatment of DN published in domestic and foreign biomedical journals. The time is limited from January 2010 to February 2020. We will investigate heterogeneity across studies and publication bias. To assess the risk of bias and quality of the included studies, we will use the Cochrane Collaboration's ROB tool. According to the relevant standards in the Cochrane Intervention System Evaluation Manual, it will be divided into low risk, high risk, and unclear. We will also use the RevMan 5.3 software and Stata 13.0 software for meta-analysis of the effectiveness and symptom scores of DN proteinuria. ETHICS AND DISSEMINATION: The ethical considerations are not required because the systematic review is based on published studies. The systematic review and meta-analysis will be published in a peer-reviewed Journal.


Assuntos
Nefropatias Diabéticas/tratamento farmacológico , Medicamentos de Ervas Chinesas/uso terapêutico , Medicina Tradicional Chinesa/métodos , Complicações do Diabetes/epidemiologia , Nefropatias Diabéticas/classificação , Nefropatias Diabéticas/complicações , Feminino , Humanos , Falência Renal Crônica/etiologia , Masculino , Proteinúria/diagnóstico , Proteinúria/etiologia , Proteinúria/urina , Ensaios Clínicos Controlados Aleatórios como Assunto , Segurança , Sensibilidade e Especificidade , Resultado do Tratamento
11.
Clin Med (Lond) ; 20(4): e87-e90, 2020 07.
Artigo em Inglês | MEDLINE | ID: mdl-32628128

RESUMO

COVID-19 and diabetes are both pandemics with major impacts on global public health. While the response to COVID-19 has been rapid and progressive to reduce risk of harm, the response to the diabetes pandemic has been somewhat more muted. People with diabetes have been disproportionately affected by COVID-19, with growing evidence of higher mortality and morbidity. In this article, we discuss the impact of COVID-19 on our diabetes service in an urban area in the UK. We discuss the impact on our patients and ourselves, and the possible lessons we can carry into the future.


Assuntos
Assistência Ambulatorial/organização & administração , Infecções por Coronavirus/epidemiologia , Complicações do Diabetes/epidemiologia , Diabetes Mellitus/epidemiologia , Diabetes Mellitus/terapia , Pandemias , Pneumonia Viral/epidemiologia , Betacoronavirus , Comorbidade , Complicações do Diabetes/terapia , Hospitais Urbanos , Humanos , Hipoglicemia/epidemiologia , Hipoglicemia/terapia , Londres/epidemiologia , Telemedicina
12.
Diabetes Res Clin Pract ; 166: 108299, 2020 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-32623030

RESUMO

AIMS: To investigate the clinical characteristics, laboratory findings and high- resolution CT (HRCT) features and to explore the risk factors for in-hospital death and complications of coronavirus disease 2019 (COVID-19) patients with diabetes. METHODS: From Dec 31, 2019, to Apr 5, 2020, a total of 132 laboratory-confirmed COVID-19 patients with diabetes from two hospitals were retrospectively included in our study. Clinical, laboratory and chest CT data were analyzed and compared between the two groups with an admission glucose level of ≤11 mmol/L (group 1) and >11 mmol/L (group 2). Logistic regression analyses were used to identify the risk factors associated with in-hospital death and complications. RESULTS: Of 132 patients, 15 died in hospital and 113 were discharged. Patients in group 2 were more likely to require intensive care unit care (21.4% vs. 9.2%), to develop acute respiratory distress syndrome (ARDS) (23.2% vs. 9.2%) and acute cardiac injury (12.5% vs. 1.3%), and had a higher death rate (19.6% vs. 5.3%) than group 1. In the multivariable analysis, patients with admission glucose of >11 mmol/l had an increased risk of death (OR: 7.629, 95%CI: 1.391-37.984) and in-hospital complications (OR: 3.232, 95%CI: 1.393-7.498). Admission d-dimer of ≥1.5 µg/mL (OR: 6.645, 95%CI: 1.212-36.444) and HRCT score of ≥10 (OR: 7.792, 95%CI: 2.195-28.958) were associated with increased odds of in-hospital death and complications, respectively. CONCLUSIONS: In COVID-19 patients with diabetes, poorly-controlled blood glucose (>11 mmol/L) may be associated with poor outcomes. Admission hyperglycemia, elevated d-dimer and high HRCT score are potential risk factors for adverse outcomes and death.


Assuntos
Betacoronavirus/isolamento & purificação , Glicemia/metabolismo , Infecções por Coronavirus/mortalidade , Complicações do Diabetes/mortalidade , Diabetes Mellitus/fisiopatologia , Intolerância à Glucose/complicações , Hiperglicemia/complicações , Pneumonia Viral/mortalidade , Idoso , China/epidemiologia , Infecções por Coronavirus/complicações , Infecções por Coronavirus/transmissão , Infecções por Coronavirus/virologia , Complicações do Diabetes/epidemiologia , Complicações do Diabetes/virologia , Diabetes Mellitus/virologia , Feminino , Intolerância à Glucose/virologia , Hospitalização/estatística & dados numéricos , Humanos , Hiperglicemia/virologia , Unidades de Terapia Intensiva , Masculino , Pessoa de Meia-Idade , Pandemias , Alta do Paciente/estatística & dados numéricos , Pneumonia Viral/complicações , Pneumonia Viral/transmissão , Pneumonia Viral/virologia , Prognóstico , Estudos Retrospectivos , Fatores de Risco , Taxa de Sobrevida
13.
Rev Saude Publica ; 54: 54, 2020.
Artigo em Inglês | MEDLINE | ID: covidwho-537882

RESUMO

The coronavirus disease 2019 (covid-19) pandemic has caused a public health emergency worldwide. Risk, severity and mortality of the disease have been associated with non-communicable chronic diseases, such as diabetes mellitus. Accumulated evidence has caused great concern in countries with high prevalence of this morbidity, such as Brazil. This text shows the picture of diabetes in Brazil, followed by epidemiological data and explanatory hypothesis for the association between diabetes and covid-19. We emphasized how the burden of these two morbidities in a middle-income country has aggravated this pandemic scenario. The comprehension of this association and biological plausibility may help face this pandemic and future challenges.


Assuntos
Betacoronavirus , Infecções por Coronavirus/epidemiologia , Complicações do Diabetes/epidemiologia , Diabetes Mellitus/epidemiologia , Pneumonia Viral/epidemiologia , Adulto , Fatores Etários , Idoso , Idoso de 80 Anos ou mais , Brasil/epidemiologia , Doenças Cardiovasculares/complicações , Doenças Cardiovasculares/epidemiologia , Doenças Cardiovasculares/fisiopatologia , Comorbidade , Infecções por Coronavirus/fisiopatologia , Complicações do Diabetes/fisiopatologia , Diabetes Mellitus/fisiopatologia , Feminino , Humanos , Hipertensão/complicações , Hipertensão/epidemiologia , Hipertensão/fisiopatologia , Masculino , Pessoa de Meia-Idade , Obesidade/complicações , Obesidade/epidemiologia , Obesidade/fisiopatologia , Pandemias , Pneumonia Viral/fisiopatologia , Prevalência , Fatores de Risco , Índice de Gravidade de Doença
14.
J Infect Dis ; 222(4): 556-563, 2020 07 23.
Artigo em Inglês | MEDLINE | ID: mdl-32526012

RESUMO

Patients who died from COVID-19 often had comorbidities, such as hypertension, diabetes, and chronic obstructive lung disease. Although angiotensin-converting enzyme 2 (ACE2) is crucial for SARS-CoV-2 to bind and enter host cells, no study has systematically assessed the ACE2 expression in the lungs of patients with these diseases. Here, we analyzed over 700 lung transcriptome samples from patients with comorbidities associated with severe COVID-19 and found that ACE2 was highly expressed in these patients compared to control individuals. This finding suggests that patients with such comorbidities may have higher chances of developing severe COVID-19. Correlation and network analyses revealed many potential regulators of ACE2 in the human lung, including genes related to histone modifications, such as HAT1, HDAC2, and KDM5B. Our systems biology approach offers a possible explanation for increased COVID-19 severity in patients with certain comorbidities.


Assuntos
Infecções por Coronavirus/epidemiologia , Pulmão/enzimologia , Peptidil Dipeptidase A/metabolismo , Pneumonia Viral/epidemiologia , Estudos de Casos e Controles , Transtornos Cerebrovasculares/epidemiologia , Transtornos Cerebrovasculares/genética , Comorbidade , Doença das Coronárias/epidemiologia , Doença das Coronárias/genética , Infecções por Coronavirus/enzimologia , Infecções por Coronavirus/genética , Complicações do Diabetes/epidemiologia , Complicações do Diabetes/genética , Epigenômica , Feminino , Humanos , Hipertensão/epidemiologia , Hipertensão/genética , Masculino , Pandemias , Peptidil Dipeptidase A/genética , Pneumonia Viral/enzimologia , Pneumonia Viral/genética , Doença Pulmonar Obstrutiva Crônica/epidemiologia , Doença Pulmonar Obstrutiva Crônica/genética , Índice de Gravidade de Doença , Biologia de Sistemas , Transcriptoma
15.
Ann Agric Environ Med ; 27(2): 255-259, 2020 Jun 19.
Artigo em Inglês | MEDLINE | ID: mdl-32588602

RESUMO

INTRODUCTION: Diabetes is a civilisation disease creating a serious challenge for public health. In Poland, approximately 2 million people suffer from diabetes, of which about 25% are unaware of their illness. A considerable part of persons with diabetes experience complications related with the disease. OBJECTIVE: The aim of the study was to determine the relationship between elements of the state of health and socio-demographic characteristics of diabetic patients treated in the Diabetes Clinic at the Institute of Rural Health (IMW) in Lublin, eastern Poland, and the occurrence of depressive symptoms in these patients. MATERIAL AND METHODS: The study was conducted in 2017-2018 among patients treated in the Diabetes Clinic at the Institute of Rural Health in Lublin, by the method of a diagnostic survey using the Beck's Depression Inventory and an author-constructed questionnaire, as well as data from the patients' medical records. The study included 314 patients from the Diabetes Clinic who expressed their informed consent to participate in the research. RESULTS: The study showed that diabetes is a disease which predisposes for the occurrence of depression. The occurrence of depressive symptoms of various degrees of intensity was confirmed in more than a half of the examined patients. Among the factors which exerted a significant effect on the occurrence of depressive symptoms were: diabetic neuropathy, type 2 diabetes, high BMI value, lack of occupational activity, poor material standard, and the need to obtain assistance in daily functioning due to the fact of being ill with diabetes. CONCLUSIONS: It is necessary to implement routinely performed examinations into the diagnostic-therapeutic process to assess the state of psychological health of diabetic patients, which would allow sufficiently early application of appropriate psychological or psychiatric intervention.


Assuntos
Depressão/epidemiologia , Transtorno Depressivo/epidemiologia , Complicações do Diabetes/epidemiologia , Adulto , Idoso , Idoso de 80 Anos ou mais , Depressão/psicologia , Transtorno Depressivo/psicologia , Complicações do Diabetes/etiologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Polônia/epidemiologia , Adulto Jovem
16.
PLoS One ; 15(6): e0235161, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32574208

RESUMO

To determine the prevalence of vascular complications among inpatients with type 2 diabetes mellitus (T2DM) and factors independently associated with vascular complications in a tertiary care department in Ningbo, China, the authors conducted a cross-sectional study using an existing computerised medical records database. A total of 3370 adult patients with T2DM were admitted to this tertiary care department for the first time between 2012 and 2017. Patients were categorised as those (1) with at least one vascular complication, (2) with at least one microvascular complication, and (3) with at least one macrovascular complication. Over 5 years, the prevalence of vascular, microvascular, and macrovascular complications among inpatients with T2DM was 73.2%, 57.5%, and 51.4%, respectively. The odds of vascular, microvascular, and macrovascular complications increased with age and were higher in patients with hypertension. The odds of vascular and microvascular complications were higher in single, divorced, or widowed patients, patients with T2DM for a long time, and patients on advanced T2DM therapeutic regimen. The odds of vascular and macrovascular complications were lower in women. The odds of microvascular complications decreased with education. The odds of macrovascular complications were higher in smokers. In conclusion, in the tertiary care department, more than half of inpatients with T2DM had vascular complications, and factors independently associated with vascular complications were identified. The study findings could be used in future interventional studies to prevent and manage vascular complications among these patients.


Assuntos
Doenças Cardiovasculares/epidemiologia , Complicações do Diabetes/epidemiologia , Diabetes Mellitus Tipo 2/complicações , Pacientes Internados/estatística & dados numéricos , Atenção Terciária à Saúde/estatística & dados numéricos , Adulto , Idoso , Doenças Cardiovasculares/etiologia , China/epidemiologia , Estudos Transversais , Bases de Dados Factuais/estatística & dados numéricos , Complicações do Diabetes/etiologia , Feminino , Humanos , Modelos Logísticos , Pessoa de Meia-Idade , Prevalência , Estudos Retrospectivos , Fatores de Risco , Adulto Jovem
17.
Rev Saude Publica ; 54: 54, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32491053

RESUMO

The coronavirus disease 2019 (covid-19) pandemic has caused a public health emergency worldwide. Risk, severity and mortality of the disease have been associated with non-communicable chronic diseases, such as diabetes mellitus. Accumulated evidence has caused great concern in countries with high prevalence of this morbidity, such as Brazil. This text shows the picture of diabetes in Brazil, followed by epidemiological data and explanatory hypothesis for the association between diabetes and covid-19. We emphasized how the burden of these two morbidities in a middle-income country has aggravated this pandemic scenario. The comprehension of this association and biological plausibility may help face this pandemic and future challenges.


Assuntos
Betacoronavirus , Infecções por Coronavirus/epidemiologia , Complicações do Diabetes/epidemiologia , Diabetes Mellitus/epidemiologia , Pneumonia Viral/epidemiologia , Adulto , Fatores Etários , Idoso , Idoso de 80 Anos ou mais , Brasil/epidemiologia , Doenças Cardiovasculares/complicações , Doenças Cardiovasculares/epidemiologia , Doenças Cardiovasculares/fisiopatologia , Comorbidade , Infecções por Coronavirus/fisiopatologia , Complicações do Diabetes/fisiopatologia , Diabetes Mellitus/fisiopatologia , Feminino , Humanos , Hipertensão/complicações , Hipertensão/epidemiologia , Hipertensão/fisiopatologia , Masculino , Pessoa de Meia-Idade , Obesidade/complicações , Obesidade/epidemiologia , Obesidade/fisiopatologia , Pandemias , Pneumonia Viral/fisiopatologia , Prevalência , Fatores de Risco , Índice de Gravidade de Doença
20.
Niger J Clin Pract ; 23(6): 870-878, 2020 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-32525125

RESUMO

Background: This study aimed to identify the unmet sexual health needs of the patients with diabetes seen in a tertiary healthcare facility in Nigeria. Methods: Case-control study design and random sampling method were utilized to recruit type 2 diabetic cases from the University of Calabar Teaching Hospital (UCTH), Calabar, Nigeria. Female Sexual Function Index (FSFI) and International Index for Erectile Function (IIEF) were used to assess sexual function. Result: There were 330 subjects with the mean age of 54.9 years. Among females, the FSFI score was lower among cases compared with controls (18.8 vs. 23.1, P < 0.05). Except for sexual interest, mean scores for all other domains of sexual function were also lower among cases (P < 0.05). Among males, there was no significant difference in overall mean IIEF score comparing cases and controls (40.0 vs. 41.7, P > 0.05). However, mean scores for desire and satisfaction was lower among cases compared with controls (P < 0.05). Older age, unmarried status, presence and duration of hypertension were associated with sexual dysfunction among females. The use of supplements was associated with sexual dysfunction among males (P < 0.05). Conclusion: Sexual dysfunction is common among diabetics with variation in affected domains in both genders in the study setting. These unmet sexual health needs focus to be addressed.


Assuntos
Complicações do Diabetes/epidemiologia , Diabetes Mellitus/fisiopatologia , Disfunção Erétil/fisiopatologia , Ereção Peniana/fisiologia , Disfunções Sexuais Fisiológicas , Disfunções Sexuais Psicogênicas/epidemiologia , Sexualidade/fisiologia , Adulto , Idoso , Estudos de Casos e Controles , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Nigéria/epidemiologia , Satisfação Pessoal , Comportamento Sexual , Disfunções Sexuais Psicogênicas/etiologia
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