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1.
Int J Med Sci ; 18(2): 520-527, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-33390821

RESUMO

Background: Multiple societies including the Fleischner Society do not recommend that CT is routinely used in asymptomatic SARS-CoV-2 infections; however, this advice is based on the limited evidence. In this study, we aim to confirm whether it is necessary to do CT scans in SARS-CoV-2 asymptomatic infections by summarizing the longitudinal chest CT and clinical features of asymptomatic SARS-CoV-2 infections. Methods: A total of 33 individuals (14 men and 19 women) with asymptomatic SARS-CoV-2 infections were retrospectively enrolled. Clinical data of CT positive and negative groups were compared. Longitudinal chest CT scans were reviewed for CT features and analyzed for temporal change. Results: Thirty-two (97%) individuals had positive results for first RT-PCR testing. For clinical data, only monocyte count showed a significant difference between CT positive and negative groups. For first chest CT, only eighteen (54.5%) individuals had abnormal manifestations, common CT features were GGO (88.9%) and consolidation (33.3%), the median number of segments involved was 3.0 (1.0-7.5). No case in CT negative group was abnormal on the follow-up CT. Three patterns of evolution throughout series of CT were observed in CT positive group, including gradual improvement (12, 66.7%), mismatch to improvement (3, 16.7%) and mild progression to improvement (3, 16.7%). On last CT scans, most cases had radiographic improvement but residual abnormalities. Significant differences were exhibited in density, long diameter, number of lung segments involved, and percentage of consolidation between the first and last CT scans. All cases had stable conditions and finally confirmed negative for SARS-CoV-2 RT-PCR tests without developing into severe pneumonia. Conclusion: Considering poor performance of CT in screening, stable conditions during followup, and good outcomes in asymptomatic SARS-CoV-2 infections, we confirm that it is unnecessary to do CT scans in asymptomatic SARS-CoV-2 infections.


Assuntos
Infecções Assintomáticas , Radiografia Torácica , Tomografia Computadorizada por Raios X , Adulto , Feminino , Humanos , Estudos Longitudinais , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Procedimentos Desnecessários
2.
Parasit Vectors ; 14(1): 22, 2021 Jan 06.
Artigo em Inglês | MEDLINE | ID: mdl-33407778

RESUMO

BACKGROUND: Due to an increase in mosquito habitats and the lack facilities to carry out basic mosquito control, construction sites in China are more likely to experience secondary dengue fever infection after importation of an initial infection, which may then increase the number of infections in the neighboring communities and the chance of community transmission. The aim of this study was to investigate how to effectively reduce the transmission of dengue fever at construction sites and the neighboring communities. METHODS: The Susceptible-Exposed-Infectious/Asymptomatic-Recovered (SEIAR) model of human and SEI model of mosquitoes were developed to estimate the transmission of dengue virus between humans and mosquitoes within the construction site and within a neighboring community, as well between each of these. With the calibrated model, we further estimated the effectiveness of different intervention scenarios targeting at reducing the transmissibility at different locations (i.e. construction sites and community) with the total attack rate (TAR) and the duration of the outbreak (DO). RESULTS: A total of 102 construction site-related and 131 community-related cases of dengue fever were reported in our area of study. Without intervention, the number of cases related to the construction site and the community rose to 156 (TAR: 31.25%) and 10,796 (TAR: 21.59%), respectively. When the transmission route from mosquitoes to humans in the community was cut off, the number of community cases decreased to a minimum of 33 compared with other simulated scenarios (TAR: 0.068%, DO: 60 days). If the transmission route from infectious mosquitoes in the community and that from the construction site to susceptible people on the site were cut off at the same time, the number of cases on the construction site dropped to a minimum of 74 (TAR: 14.88%, DO: 66 days). CONCLUSIONS: To control the outbreak of dengue fever effectively on both the construction site and in the community, interventions needed to be made both within the community and from the community to the construction site. If interventions only took place within the construction site, the number of cases on the construction site would not be reduced. Also, interventions implemented only within the construction site or between the construction site and the community would not lead to a reduction in the number of cases in the community.


Assuntos
Dengue/prevenção & controle , Dengue/transmissão , Infecções Assintomáticas/epidemiologia , China/epidemiologia , Controle de Doenças Transmissíveis , Indústria da Construção , Dengue/epidemiologia , Dengue/virologia , Vírus da Dengue/fisiologia , Surtos de Doenças/prevenção & controle , Suscetibilidade a Doenças/epidemiologia , Suscetibilidade a Doenças/virologia , Humanos , Incidência , Modelos Teóricos , Controle de Mosquitos , Mosquitos Vetores/crescimento & desenvolvimento , Mosquitos Vetores/virologia , Características de Residência , Local de Trabalho
4.
BMJ Case Rep ; 14(1)2021 Jan 12.
Artigo em Inglês | MEDLINE | ID: mdl-33436362

RESUMO

SARS-CoV-2 is primarily a respiratory disease; however, there have been multiple reports of associated myocarditis. In our 463 bedded, district general hospital, we noted an influx of young patients with myocarditis shortly after the peak of the outbreak. We report two cases presenting with myocarditis, both of whom tested negative for the virus despite clinical and biochemical evidence of recent infection. Diagnosis was made based on positive transthoracic echocardiogram (TTE) findings and a raised troponin, not in the context of suspected acute coronary syndrome. We recommend that patients with negative coronavirus tests should still be considered at risk of potential sequelae from the disease. There should be a low threshold for performing basic cardiac investigations: ECG, troponin and TTE as well as seeking a cardiology opinion. Colchicine is a recognised treatment for viral pericarditis and should be considered as adjunctive treatment; however, further research is required specific to SARS-CoV-2.


Assuntos
Miocardite , Adulto , Infecções Assintomáticas , /diagnóstico , Diagnóstico Diferencial , Humanos , Masculino , Miocardite/diagnóstico , Miocardite/etiologia , Miocardite/terapia
6.
J Korean Med Sci ; 36(1): e12, 2021 Jan 04.
Artigo em Inglês | MEDLINE | ID: mdl-33398946

RESUMO

BACKGROUND: A coronavirus disease 2019 (COVID-19) outbreak started in February 2020 and was controlled at the end of March 2020 in Daegu, the epicenter of the coronavirus outbreak in Korea. The aim of this study was to describe the clinical course and outcomes of patients with COVID-19 in Daegu. METHODS: In collaboration with Daegu Metropolitan City and Korean Center for Diseases Control, we conducted a retrospective, multicenter cohort study. Demographic, clinical, treatment, and laboratory data, including viral RNA detection, were obtained from the electronic medical records and cohort database and compared between survivors and non-survivors. We used univariate and multi-variable logistic regression methods and Cox regression model and performed Kaplan-Meier analysis to determine the risk factors associated with the 28-day mortality and release from isolation among the patients. RESULTS: In this study, 7,057 laboratory-confirmed patients with COVID-19 (total cohort) who had been diagnosed from February 18 to July 10, 2020 were included. Of the total cohort, 5,467 were asymptomatic to mild patients (77.4%) (asymptomatic 30.6% and mild 46.8%), 985 moderate (14.0%), 380 severe (5.4%), and 225 critical (3.2%). The mortality of the patients was 2.5% (179/7,057). The Cox regression hazard model for the patients with available clinical information (core cohort) (n = 2,254) showed the risk factors for 28-day mortality: age > 70 (hazard ratio [HR], 4.219, P = 0.002), need for O2 supply at admission (HR, 2.995; P = 0.001), fever (> 37.5°C) (HR, 2.808; P = 0.001), diabetes (HR, 2.119; P = 0.008), cancer (HR, 3.043; P = 0.011), dementia (HR, 5.252; P = 0.008), neurological disease (HR, 2.084; P = 0.039), heart failure (HR, 3.234; P = 0.012), and hypertension (HR, 2.160; P = 0.017). The median duration for release from isolation was 33 days (interquartile range, 24.0-46.0) in survivors. The Cox proportional hazard model for the long duration of isolation included severity, age > 70, and dementia. CONCLUSION: Overall, asymptomatic to mild patients were approximately 77% of the total cohort (asymptomatic, 30.6%). The case fatality rate was 2.5%. Risk factors, including older age, need for O2 supply, dementia, and neurological disorder at admission, could help clinicians to identify COVID-19 patients with poor prognosis at an early stage.


Assuntos
/epidemiologia , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Infecções Assintomáticas/epidemiologia , Criança , Pré-Escolar , Surtos de Doenças , Feminino , Humanos , Lactente , Recém-Nascido , Masculino , Pessoa de Meia-Idade , Modelos de Riscos Proporcionais , República da Coreia/epidemiologia , Estudos Retrospectivos , Adulto Jovem
8.
Curr Oncol ; 28(1): 278-282, 2021 01 06.
Artigo em Inglês | MEDLINE | ID: mdl-33419159

RESUMO

Patients with cancer are more vulnerable to severe COVID-19. As a result, routine SARS-CoV-2 testing of asymptomatic patients with cancer is recommended prior to treatment. However, there is limited evidence of its clinical usefulness. The objective of this study is to evaluate the value of routine testing of asymptomatic patients with cancer. Asymptomatic patients with cancer attending Odette Cancer Centre (Toronto, ON, Canada) were tested for SARS-CoV-2 prior to and during treatment cycles. Results were compared to positivity rates of SARS-CoV-2 locally and provincially. All 890 asymptomatic patients tested negative. Positivity rates in the province were 1.5%, in hospital were 1.0%, and among OCC's symptomatic cancer patients were 0% over the study period. Given our findings and the low SARS-CoV-2 community positivity rates, we recommend a dynamic testing model of asymptomatic patients that triggers testing during increasing community positivity rates of SARS-CoV-2.


Assuntos
Infecções Assintomáticas , Neoplasias/virologia , Adulto , Idoso , Idoso de 80 Anos ou mais , Institutos de Câncer , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Neoplasias/tratamento farmacológico , Ontário
9.
Artigo em Inglês | MEDLINE | ID: mdl-33431724

RESUMO

Search and find methods*) such as cluster tracing1)-6) or large-scale PCR testing**) of those who exhibit no symptoms or only mild symptoms of COVID-19 is shown by data analysis to be a powerful means to suppress the spread of COVID-19 instead of, or in addition to, lockdown of the entire population. Here we investigate this issue by analyzing the data from some cities and countries and we establish that search and find method is as powerful as lockdown of a city or a country. Moreover, in contrast to lockdown, it neither causes inconvenience to citizens nor does it disrupt the economy. Generally speaking, it is advisable that both social distancing and increased test numbers be employed to suppress spread of the virus. The product of the total test number with the rate of positive cases is the crucial index.


Assuntos
/prevenção & controle , Controle de Doenças Transmissíveis/métodos , África/epidemiologia , Infecções Assintomáticas/epidemiologia , Brasil/epidemiologia , /transmissão , China/epidemiologia , Controle de Doenças Transmissíveis/estatística & dados numéricos , Política de Saúde , Humanos , Imunidade Coletiva , Japão/epidemiologia , Los Angeles/epidemiologia , Modelos Biológicos , Modelos Estatísticos , New York/epidemiologia , Pandemias/prevenção & controle , Pandemias/estatística & dados numéricos , Quarentena , Sensibilidade e Especificidade , Suécia/epidemiologia , Tóquio/epidemiologia , Estados Unidos/epidemiologia
10.
Curr Opin Allergy Clin Immunol ; 21(1): 38-45, 2021 02 01.
Artigo em Inglês | MEDLINE | ID: mdl-33369568

RESUMO

PURPOSE OF REVIEW: The WHO announced the coronavirus disease 2019 (COVID-19) outbreak as a pandemic in February 2020 with over 15 million confirmed cases of COVID-19 globally to date. Otolaryngologists are at a high risk of contracting COVID-19 during this pandemic if there is inadequate and improper personal protective equipment provision, as we are dealing with diseases of the upper-aerodigestive tract and routinely engaged in aerosol-generating procedures. RECENT FINDINGS: This article discusses the background and transmission route for severe acute respiratory syndrome coronavirus 2, its viral load and temporal profile as well as precaution guidelines in outpatient and operative setting in otorhinolaryngology. SUMMARY: As it is evident that COVID-19 can be transmitted at presymptomatic or asymptomatic period of infections, it is essential to practice ear, nose, and throat surgery with high vigilance in a safe and up-to-standard protection level during the pandemic. This article provides a summary for guidelines and recommendations in otorhinolaryngology.


Assuntos
/prevenção & controle , Otolaringologia/métodos , Pandemias , Aerossóis , Instituições de Assistência Ambulatorial , Infecções Assintomáticas , /transmissão , Humanos , Transmissão de Doença Infecciosa do Paciente para o Profissional/prevenção & controle , Transmissão de Doença Infecciosa do Profissional para o Paciente/prevenção & controle , Nasofaringe/virologia , Orofaringe/virologia , Procedimentos Cirúrgicos Otorrinolaringológicos/métodos , Equipamento de Proteção Individual , Exame Físico , Carga Viral
11.
J Infect Chemother ; 27(1): 70-75, 2021 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-32950393

RESUMO

OBJECTIVES: The symptoms of Coronavirus disease 2019 (COVID-19) vary among patients. The aim of this study was to investigate the clinical manifestation and disease duration in young versus elderly patients. METHODS: We retrospectively analyzed 187 patients (87 elderly and 100 young patients) with confirmed COVID-19. The clinical characteristics and chest computed tomography (CT) extent as defined by a score were compared between the two groups. RESULTS: The numbers of asymptomatic cases and severe cases were significantly higher in the elderly group (elderly group vs. young group; asymptomatic cases, 31 [35.6%] vs. 10 [10%], p < 0.0001; severe cases, 25 [28.7%] vs. 8 [8.0%], p = 0.0002). The proportion of asymptomatic patients and severe patients increased across the 10-year age groups. There was no significant difference in the total CT score and number of abnormal cases. A significant positive correlation between the disease duration and patient age was observed in asymptomatic patients (ρ = 0.4570, 95% CI 0.1198-0.6491, p = 0.0034). CONCLUSIONS: Although the extent of lung involvement did not have a significant difference between the young and elderly patients, elderly patients were more likely to have severe clinical manifestations. Elderly patients were also more likely to be asymptomatic and a source of COVID-19 viral shedding.


Assuntos
Infecções Assintomáticas/epidemiologia , Infecções por Coronavirus/epidemiologia , Pneumonia Viral/epidemiologia , Eliminação de Partículas Virais , Adulto , Fatores Etários , Idoso , Betacoronavirus , Infecções por Coronavirus/diagnóstico por imagem , Infecções por Coronavirus/patologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Pandemias , Pneumonia Viral/diagnóstico por imagem , Pneumonia Viral/patologia , Estudos Retrospectivos , Índice de Gravidade de Doença , Tomografia Computadorizada por Raios X
12.
Br J Radiol ; 94(1117): 20200994, 2021 Jan 01.
Artigo em Inglês | MEDLINE | ID: mdl-33242245

RESUMO

OBJECTIVES: In accordance with initial guidance from the Royal College of Surgeons and Royal College of Radiologists, we evaluated the utility of CT of the chest in the exclusion of asymptomatic COVID-19 infection prior to elective cancer surgery on self-isolating patients during the pandemic. METHODS: All surgical referrals without symptoms of COVID-19 infection in April and May 2020 were included. Patient records were retrospectively reviewed. Screening included CT chest for major thoracic and abdominal surgery. CTs were reported according to British Society of Thoracic Imaging guidelines and correlated with reverse transcriptase polymerase chain reaction (RT-PCR) and surgical outcomes. RESULTS: The prevalence of RT-PCR confirmed COVID-19 infection in our screened population was 0.7% (5/681). 240 pre-operative CTs were performed. 3.8% (9/240) of CTs were reported as abnormal, only one of which was RT-PCR positive. 2% (5/240) of cases had surgery postponed based on CT results. All nine patients with CTs reported as abnormal have had surgery, all without complication. CONCLUSION: The prevalence of asymptomatic COVID-19 infection in our screened population was low. The pre-test probability of CT chest in asymptomatic, self-isolating patients is consequently low. CT can produce false positives in this setting, introducing unnecessary delay in surgery for a small proportion of cases. ADVANCES IN KNOWLEDGE: Self-isolation, clinical assessment and RT-PCR are effective at minimising COVID-19 related surgical risk. The addition of CT chest is unhelpful. Our data have particular relevance during the second wave of infection and in the recovery phase.


Assuntos
Infecções Assintomáticas , Procedimentos Cirúrgicos Eletivos , Neoplasias/cirurgia , Tomografia Computadorizada por Raios X , Adulto , Idoso , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Isolamento de Pacientes , Período Pré-Operatório , Estudos Retrospectivos , Tórax , Reino Unido
13.
J Epidemiol Community Health ; 75(1): 84-87, 2021 01.
Artigo em Inglês | MEDLINE | ID: mdl-32855261

RESUMO

BACKGROUND: The presymptomatic transmission of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has been documented in limited clusters, and it is predicted through modelling. However, there is a lack of evidence from observations with a large sample size. METHODS: We used data from meticulous contact tracing of people exposed to cases of SARS-CoV-2 to estimate the proportion of cases that result from the presymptomatic transmission of the virus in Beijing during January 2020 and February 2020. RESULTS: The results showed that presymptomatic transmission occurred in at least 15% of 100 secondary COVID-19 cases. The earliest presymptomatic contact event occurred 5 days prior to the index case's onset of symptoms, and this occurred in two clusters. CONCLUSIONS: The finding suggested that the contact tracing period should be earlier and highlighted the importance of preventing transmission opportunities well before the onset of symptoms.


Assuntos
Infecções Assintomáticas/epidemiologia , Portador Sadio/virologia , Surtos de Doenças , /isolamento & purificação , Adulto , Doenças Assintomáticas , /epidemiologia , Portador Sadio/epidemiologia , China/epidemiologia , Busca de Comunicante , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , /genética
14.
Pediatr Infect Dis J ; 40(1): e7-e11, 2021 01.
Artigo em Inglês | MEDLINE | ID: mdl-33093428

RESUMO

OBJECTIVE: The COVID pandemic has affected Colombia with a high number of cases and deceases; however, no studies have been published regarding pediatric population. An epidemiologic analysis of the nationwide COVID register, therefore, is necessary to outline and describe the impact in such population. METHODS: A retrospective analysis was made of the characteristics of a cohort of 5062 patients <18 years of age, until June 16, 2020, reported at the National Institute of Health-INS (https://www.ins.gov.co/News./Pages/Coronavirus.aspx), through the national public access database, with all subjects confirmed with COVID-19 or severe acute respiratory syndrome-CoV-2. RESULTS: Reviewed on June 16, 2020, a total of 54,971 confirmed cases were reported nationwide for COVID-19, of which 5062 (9.2%) are cases in patients under 18 years of age. There was a statistically significant difference between groups; age was statistically significantly higher in the asymptomatic, compared with: deceased, severe and moderate cases; moreover, age was statistically significantly higher in the mild, compared with: deceased, severe and moderate. Statistically significant difference determined with one-way ANOVA was found between groups (F = 16.08, P < 0.001). Post hoc analysis reveals significant differences between groups, the age of patients at home (9.39 years) and those recovered (9.3 years) being significantly higher than those in intensive care unit (4.9 years), in hospital (6.1 years), or than the deceased (2.9 years). CONCLUSION: The results of this study show that, at the nationwide level, patients in more severe states (deceased, severe and moderate), are significantly younger than those in the milder state (asymptomatic and mild).


Assuntos
/epidemiologia , /patologia , Adolescente , Fatores Etários , Infecções Assintomáticas , Criança , Pré-Escolar , Colômbia/epidemiologia , Feminino , Hospitalização/estatística & dados numéricos , Humanos , Lactente , Recém-Nascido , Masculino , Estudos Retrospectivos , Índice de Gravidade de Doença
15.
Rev. esp. quimioter ; 33(6): 415-421, dic. 2020. tab
Artigo em Inglês | IBECS | ID: ibc-195992

RESUMO

INTRODUCTION: The aim of this study is to assess the value of systematic screening in asymptomatic women admitted for spontaneous delivery with a combination of reverse transcription polymerase chain reaction (RT-PCR) and cycle threshold (Ct) and serum antibodies. MATERIAL AND METHODS: Since May 6 all women admitted for spontaneous delivery underwent RT-PCR in nasopharyngeal swabs and specific antibodies IgG of Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) in serum that were performed as part of routine clinical care in our institution. Ct of the PCR was recorded. We analyzed the first 100 women consecutively admitted for spontaneous delivery at our institution. RESULTS: Nine women were positive for SARS-CoV-2 in nasopharyngeal samples (9%) and 13 (13%) presented positive specific antibodies of the coronavirus. Overall, SARS-CoV-2 prior exposure was 15%. The Ct determination (RT-PCR test) of our 9 positive patients ranged from 36 to 41 cycles with a median of 40. Vaginal delivery occurred in 94% of the cases and only 6% underwent a cesarean section, always for obstetric reasons. No fetal transmission was observed and maternal and neonatal prognosis was excellent. CONCLUSIONS: During epidemic episodes in asymptomatic women in labor, universal testing with RT-PCR (considering Ct determination), and the detection of antibodies, permits a better interpretation of the results and avoid unnecessary isolation procedures


OBJETIVO: El objetivo de este estudio es evaluar, en mujeres asintomáticas que acuden a urgencias en trabajo de parto, el valor de la detección sistemática con una combinación de reacción en cadena de la polimerasa con transcriptasa inversa (RT-PCR) y umbral del ciclo (Ct) y anticuerpos séricos. MATERIAL Y MÉTODOS: Desde el 6 de mayo, todas las mujeres ingresadas para parto espontáneo se sometieron a RT-PCR en hisopos nasofaríngeos y anticuerpos específicos IgG del síndrome respiratorio agudo severo por coronavirus 2 (SARS-CoV-2) en suero que se realizaron como parte de la atención clínica de rutina en nuestra institución. Se registró el Ct de la PCR. Analizamos las primeras 100 mujeres admitidas consecutivamente para parto espontáneo en nuestra institución. RESULTADOS: Nueve mujeres fueron positivas para SARS-CoV-2 en muestras nasofaríngeas (9%) y 13 (13%) presentaron anticuerpos específicos positivos del coronavirus. En general, la exposición previa a SARS-CoV-2 fue del 15%. La determinación de Ct (prueba de RT-PCR) de nuestros 9 pacientes positivos varió de 36 a 41 ciclos con una mediana de 40. El parto vaginal se produjo en el 94% de los casos y solo el 6% se sometió a una cesárea, siempre por razones obstétricas. No se observó transmisión fetal y el pronóstico materno y neonatal fue excelente. CONCLUSIONES: Durante los episodios epidémicos en mujeres asintomáticas en trabajo de parto, las pruebas universales con RT-PCR (considerando la determinación de Ct) y la detección de anticuerpos, permiten una mejor interpretación de los resultados y evitan procedimientos de aislamiento innecesarios


Assuntos
Humanos , Feminino , Gravidez , Adolescente , Adulto Jovem , Adulto , Infecções por Coronavirus/diagnóstico , Betacoronavirus/imunologia , Pneumonia Viral/diagnóstico , Infecções Assintomáticas , Pandemias , Complicações Infecciosas na Gravidez/diagnóstico , Reação em Cadeia da Polimerase Via Transcriptase Reversa , Anticorpos Antivirais/sangue , Imunoglobulina G/sangue , Nasofaringe/virologia , Programas de Rastreamento , Parto
16.
Medicine (Baltimore) ; 99(51): e23547, 2020 Dec 18.
Artigo em Inglês | MEDLINE | ID: mdl-33371079

RESUMO

ABSTRACT: This study aims to investigate the clinical characteristics and viral shedding kinetics of asymptomatic patients with coronavirus disease 2019 (COVID-19).The data of 38 asymptomatic patients positive for SARS-CoV-2 nucleic acid were collected from February to March 2020 in Tuanfeng County, Huanggang, Hubei, China. The epidemiology, laboratory examination, chest imaging, viral nucleic acid test results, clinical characteristics, and viral shedding time were summarized in this retrospective study.The study included 20 family members of patients with COVID-19, 10 medical personnel participating in COVID-19 treatment or working in a fever clinic, 6 personnel from quarantine places, 1 individual with a close contact history with confirmed patients, and 1 local epidemic prevention personnel. All were positive for SARS-CoV-2 nucleic acid. The white blood cell (WBC) count, the absolute value of lymphocytes, C-reactive protein (CRP), and D-dimer were normal. Pneumonia manifestations were not found in the chest computed tomography (CT) scan of 36 patients; the remaining 2 cases included a 1-year-old child and a pregnant woman, and they did not undergo chest CT. The viral shedding time was 6 days.All asymptomatic patients with COVID-19 had a history of close contact or exposure. Laboratory tests were normal. Chest imaging did not show any pneumonia manifestation. The viral shedding time was <10 days, which is shorter than that of patients with COVID-19. A timely discovery of such asymptomatic infections is crucial for blocking the spread of the virus and strengthening the prevention and control measures.


Assuntos
Infecções Assintomáticas/epidemiologia , Eliminação de Partículas Virais , Adolescente , Adulto , Infecções Assintomáticas/terapia , /diagnóstico por imagem , Criança , China/epidemiologia , Feminino , Humanos , Indóis/uso terapêutico , Lactente , Masculino , Medicina Tradicional Chinesa , Pessoa de Meia-Idade , Radiografia Torácica , Estudos Retrospectivos , Adulto Jovem
17.
Medicine (Baltimore) ; 99(51): e23797, 2020 Dec 18.
Artigo em Inglês | MEDLINE | ID: mdl-33371153

RESUMO

ABSTRACT: The coronavirus disease 2019 (COVID-19) caused by SARS-CoV-2 had resulted in a global pandemic. A comprehensive analysis of pediatric COVID-19 cases is essential to decipher the natural features of children under the risk of this disease.In the epidemic period, all the children infected with SARS-CoV-2 in Wuxi, a city with a stable medical system during the COVID-19 outbreak in China, were enrolled for comprehensive data documenting their clinical, prognosis, follow-up, treatment and various tests results. Combing their family cluster characteristics, the epidemiological, hospitalization, and transmission features of children with SARS-CoV-2 were analyzed and discussed.A total of 7 children were enrolled, including 4 mild cases, 1 moderate case, and 2 asymptomatic cases. The common symptoms were fever and dry cough. The length of viral nucleic acid duration in nasopharynx varied and was irrelevant to the severity of the symptom, whether symptomatic or asymptomatic. Two cases showed viral nucleic acid positive recurrence after discharge from the hospital. A child with type 1 diabetes was also focused, for the elevated blood sugar during hospitalization. All these children had close contacts with their family members, some of those were confirmed COVID-19 cases.We provided a holistic and detailed portrayal of the pediatric COVID-19 cases in a typical city of timely response to the epidemic. While the family cluster exhibits the major transmission mode, attention should be paid for the potential risk since the expanded social space of children in future.


Assuntos
/sangue , /isolamento & purificação , Adolescente , Antivirais/uso terapêutico , Infecções Assintomáticas , /tratamento farmacológico , Criança , Pré-Escolar , Feminino , Humanos , Masculino , Radiografia Torácica , Estudos Retrospectivos , Tomografia Computadorizada por Raios X
18.
Rev Fac Cien Med Univ Nac Cordoba ; 77(4): 363-366, 2020 12 01.
Artigo em Inglês | MEDLINE | ID: mdl-33351369

RESUMO

BACKGROUND: Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) outbreak originated in Wuhan (China) rapidly turned into a pandemic. Due to a national compulsive decree of quarantine, office visits for chronic disease control were delay. Hypopituitarism includes all clinical conditions that result in partial or complete failure of the pituitary gland's ability to secrete hormones. Pituitary insufficiency per se has been associated with an increase in both morbidity and mortality, particularly due to cardiovascular disease, which is an important risk factor for COVID-19 disease severity. OBJECTIVE: To report the first case of SARS-CoV-2 infection in a patient with hypopituitarism, discuss the implications of the treatments the patient was taking and grade up the value of telemedicine in the present scenario. METHODS: Report of the clinical record of a patient with hypopituitarism and infection with SARS-CoV-2. RESULTS: During the span of the infection, the patient remained on the same hormonal therapeutic scheme (thyroid, gonadal and adrenal axis). The dose of hydrocortisone was not changed during the course of the infection as she was asymptomatic. We use telemedicine to control and advise her on the treatment. CONCLUSION: Health care professionals should carefully follow up on the evolution of patients with hypopituitarism to provide them a safer outcome. The use of telemedicine as a methodology for selected patients acquires relevance in the present epidemiological context.


Assuntos
/complicações , Hipopituitarismo/tratamento farmacológico , Infecções Assintomáticas , Feminino , Humanos , Hidrocortisona/uso terapêutico , Hipopituitarismo/complicações
19.
J Korean Med Sci ; 35(48): e424, 2020 Dec 14.
Artigo em Inglês | MEDLINE | ID: mdl-33316860

RESUMO

BACKGROUND: On February 21, 2020, 2 coronavirus disease 2019 (COVID-19) cases in pilgrim travelers from Korea to Israel were identified. We investigated the source of infection, clinical features of COVID-19, and transmission potential of presymptomatic and asymptomatic cases. METHODS: All 39 pilgrim travelers were aggressively tested for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Their clinical features and possible source of infection were investigated by interview and review of their medical records. Ten confirmed cases without symptoms at the first sampling dates were selected for follow-up reverse transcription polymerase chain reaction tests. RESULTS: Of 39 pilgrim travelers, 30 (77%) were positive for SARS-CoV-2. Among the 30 positive COVID-19 cases, 4 (13%) were asymptomatic. Available follow-up cycle threshold values from 10 cases gradually increased over time and were lower during the presymptomatic period than during the postsymptomatic period. Out of 328 contacts related to the COVID-19 cases in the pilgrim travelers, 22 additional cases (7%) were confirmed with SARS-CoV-2 infections. Three tertiary cases were identified to be transmitted by presymptomatic secondary cases. CONCLUSION: To prevent transmission of COVID-19, we need to focus on presymptomatic and asymptomatic cases, and massive testing for SARS-CoV-2 is required. More research about the possibility of presymptomatic transmission over 2 days before symptom onset is required.


Assuntos
/epidemiologia , Viagem , Idoso , Infecções Assintomáticas/epidemiologia , Controle de Doenças Transmissíveis , Surtos de Doenças , Feminino , Humanos , Israel , Masculino , Pessoa de Meia-Idade , Reação em Cadeia da Polimerase , Reação em Cadeia da Polimerase em Tempo Real , República da Coreia
20.
Zhonghua Yu Fang Yi Xue Za Zhi ; 54(12): 1310-1314, 2020 Dec 06.
Artigo em Chinês | MEDLINE | ID: mdl-33333651

RESUMO

With many hard efforts, the epidemic prevention and control work in China has borne successful, accelerating the gradual restoration of production, living order and routine medical work. However, there is increasing evidence that many patients with COVID-19 are asymptomatic, but they are potential transmitter of the virus. There are difficulties in screening for asymptomatic infections, which makes it more difficult for national prevention and control of this epidemic. Therefore, it is urgent to develop better screening and laboratory testing for asymptomatic infections with COVID-19 with high speed, sensitivity and specificity. It is also important to improve our risk assessment, prevention and control strategies to further prevent the spread of the epidemic.


Assuntos
Infecções Assintomáticas , China , Humanos , Laboratórios
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