Your browser doesn't support javascript.
loading
Mostrar: 20 | 50 | 100
Resultados 1 - 20 de 5.680
Filtrar
1.
Acta Biomed ; 91(11-S): e2020003, 2020 09 15.
Artigo em Inglês | MEDLINE | ID: mdl-33004773

RESUMO

n December 2019, in Wuhan (Hubei, China), the first COVID-19 cases due to SARS-COV-2 had been reported. On July 1st 2020, more than 10.268.839 million people had developed the disease, with at least 506.064 deaths. At present, Italy is the third country considering the number of cases (n=240.760), after Spain, and the second for the cumulative number of deaths (n=249.271), after the United States. As regard pediatric COVID-19 cases, more than 4000 cases (have been reported; however, these figures are likely to be underestimated since they are influenced by the number of diagnostic tests carried out. Three pediatric deaths have been reported in Italy to date. We aimed to review the peculiar aspects of SARS-COV-2 infection in the pediatric population.


Assuntos
Betacoronavirus , Infecções por Coronavirus/epidemiologia , Estado Terminal/epidemiologia , Pandemias , Pneumonia Viral/epidemiologia , Medição de Risco/métodos , Criança , Saúde Global , Humanos , Morbidade/tendências
2.
PLoS One ; 15(9): e0239175, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32941485

RESUMO

The COVID-19 outbreak has forced most of the global population to lock-down and has put in check the health services all over the world. Current predictive models are complex, region-dependent, and might not be generalized to other countries. However, a 150-year old epidemics law promulgated by William Farr might be useful as a simple arithmetical model (percent increase [R1] and acceleration [R2] of new cases and deaths) to provide a first sight of the epidemic behavior and to detect regions with high predicted dynamics. Thus, this study tested Farr's Law assumptions by modeling COVID-19 data of new cases and deaths. COVID-19 data until April 10, 2020, was extracted from available countries, including income, urban index, and population characteristics. Farr's law first (R1) and second ratio (R2) were calculated. We constructed epidemic curves and predictive models for the available countries and performed ecological correlation analysis between R1 and R2 with demographic data. We extracted data from 210 countries, and it was possible to estimate the ratios of 170 of them. Around 42·94% of the countries were in an initial acceleration phase, while 23·5% already crossed the peak. We predicted a reduction close to zero with wide confidence intervals for 56 countries until June 10 (high-income countries from Asia and Oceania, with strict political actions). There was a significant association between high R1 of deaths and high urban index. Farr's law seems to be a useful model to give an overview of COVID-19 pandemic dynamics. The countries with high dynamics are from Africa and Latin America. Thus, this is a call to urgently prioritize actions in those countries to intensify surveillance, to re-allocate resources, and to build healthcare capacities based on multi-nation collaboration to limit onward transmission and to reduce the future impact on these regions in an eventual second wave.


Assuntos
Betacoronavirus , Infecções por Coronavirus/prevenção & controle , Modelos Biológicos , Pandemias/legislação & jurisprudência , Pneumonia Viral/prevenção & controle , África/epidemiologia , Ásia/epidemiologia , Infecções por Coronavirus/epidemiologia , Previsões , Geografia Médica , Humanos , Incidência , América Latina/epidemiologia , Morbidade/tendências , Mortalidade/tendências , Pandemias/prevenção & controle , Pneumonia Viral/epidemiologia , Dinâmica Populacional , Saúde da População Urbana
3.
PLoS One ; 15(9): e0238214, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32946442

RESUMO

Brazil detected community transmission of COVID-19 on March 13, 2020. In this study we identified which areas in the country were the most vulnerable for COVID-19, both in terms of the risk of arrival of cases, the risk of sustained transmission and their social vulnerability. Probabilistic models were used to calculate the probability of COVID-19 spread from São Paulo and Rio de Janeiro, the initial hotspots, using mobility data from the pre-epidemic period, while multivariate cluster analysis of socio-economic indices was done to identify areas with similar social vulnerability. The results consist of a series of maps of effective distance, outbreak probability, hospital capacity and social vulnerability. They show areas in the North and Northeast with high risk of COVID-19 outbreak that are also highly socially vulnerable. Later, these areas would be found the most severely affected. The maps produced were sent to health authorities to aid in their efforts to prioritize actions such as resource allocation to mitigate the effects of the pandemic. In the discussion, we address how predictions compared to the observed dynamics of the disease.


Assuntos
Betacoronavirus , Infecções por Coronavirus/transmissão , Modelos Teóricos , Morbidade/tendências , Pneumonia Viral/transmissão , Brasil/epidemiologia , Análise por Conglomerados , Infecções por Coronavirus/epidemiologia , Surtos de Doenças/estatística & dados numéricos , Previsões/métodos , Humanos , Pandemias , Pneumonia Viral/epidemiologia , Fatores Socioeconômicos
4.
Int J Equity Health ; 19(1): 153, 2020 09 09.
Artigo em Inglês | MEDLINE | ID: mdl-32907584

RESUMO

BACKGROUND: The first wave of the Covid-19 pandemic hit Israel in late February 2020. The present study examines patterns of the first wave of Covid-19 morbidity in Israel at the macro level, during the period of late February to early June 2020, when the first wave has faded out. The analysis focuses on the significance of four sociodemographic variables: socioeconomic status, population density, rate of elderly population and minority status (Jewish / Arab identity) of the population in cities with 5000 residents or more. Additionally, we take a closer look into the association between morbidity rates and one SES component - home Internet access. METHODS: The article is a cross sectional study of morbidity rates, investigated on a residential community basis. Following the descriptive statistics, we move on to present multivariate analysis to explore associations between these variables and Covid-19 morbidity in Israel. RESULTS: Both the descriptive statistics and regressions show morbidity rates to be positively associated with population density. Socioeconomic status as well as the size of elderly population were both significantly related to morbidity, but only in Jewish communities. Interestingly, the association was inverse in both cases. i.e., the higher the SES the lower the morbidity and the larger the elderly population, the lower the community's morbidity. Another interesting result is that overall, morbidity rates in Jewish cities were consistently higher than in Arab communities. CONCLUSIONS: We attribute the low morbidity rates in communities with relatively small elderly populations to the exceptionally high fertility rates in ultra-orthodox communities that sustained increased rates of morbidity; the lower morbidity in Arab communities is attributed to several factors, including the spatial Jewish-Arab segregation.


Assuntos
Árabes/estatística & dados numéricos , Infecções por Coronavirus/epidemiologia , Judeus/estatística & dados numéricos , Grupos Minoritários/estatística & dados numéricos , Pandemias , Pneumonia Viral/epidemiologia , Características de Residência/estatística & dados numéricos , Idoso , Estudos Transversais , Humanos , Israel/epidemiologia , Morbidade/tendências , Densidade Demográfica , Classe Social
6.
JACC Clin Electrophysiol ; 6(9): 1193-1204, 2020 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-32972561

RESUMO

Current understanding of the impact of coronavirus disease-2019 (COVID-19) on arrhythmias continues to evolve as new data emerge. Cardiac arrhythmias are more common in critically ill COVID-19 patients. The potential mechanisms that could result in arrhythmogenesis among COVID-19 patients include hypoxia caused by direct viral tissue involvement of lungs, myocarditis, abnormal host immune response, myocardial ischemia, myocardial strain, electrolyte derangements, intravascular volume imbalances, and drug sides effects. To manage these arrhythmias, it is imperative to increase the awareness of potential drug-drug interactions, to monitor QTc prolongation while receiving COVID therapy and provide special considerations for patients with inherited arrhythmia syndromes. It is also crucial to minimize exposure to COVID-19 infection by stratifying the need for intervention and using telemedicine. As COVID-19 infection continues to prevail with a potential for future surges, more data are required to better understand pathophysiology and to validate management strategies.


Assuntos
Arritmias Cardíacas/etiologia , Betacoronavirus , Infecções por Coronavirus/complicações , Pandemias , Pneumonia Viral/complicações , Arritmias Cardíacas/epidemiologia , Infecções por Coronavirus/epidemiologia , Saúde Global , Humanos , Morbidade/tendências , Pneumonia Viral/epidemiologia
7.
Math Biosci Eng ; 17(4): 2842-2852, 2020 03 25.
Artigo em Inglês | MEDLINE | ID: mdl-32987501

RESUMO

Since the first case of coronavirus disease (COVID-19) in Wuhan Hubei, China, was reported in December 2019, COVID-19 has spread rapidly across the country and overseas. The first case in Anhui, a province of China, was reported on January 10, 2020. In the field of infectious diseases, modeling, evaluating and predicting the rate of disease transmission is very important for epidemic prevention and control. Different intervention measures have been implemented starting from different time nodes in the country and Anhui, the epidemic may be divided into three stages for January 10 to February 11, 2020, namely. We adopted interrupted time series method and develop an SEI/QR model to analyse the data. Our results displayed that the lockdown of Wuhan implemented on January 23, 2020 reduced the contact rate of epidemic transmission in Anhui province by 48.37%, and centralized quarantine management policy for close contacts in Anhui reduced the contact rate by an additional 36.97%. At the same time, the estimated basic reproduction number gradually decreased from the initial 2.9764 to 0.8667 and then to 0.5725. We conclude that the Wuhan lockdown and the centralized quarantine management policy in Anhui played a crucial role in the timely and effective mitigation of the epidemic in Anhui. One merit of this work is the adoption of morbidity data which may reflect the epidemic more accurately and promptly. Our estimated parameters are largely in line with the World Health Organization estimates and previous studies.


Assuntos
Betacoronavirus , Infecções por Coronavirus/epidemiologia , Modelos Biológicos , Pandemias , Pneumonia Viral/epidemiologia , Número Básico de Reprodução/estatística & dados numéricos , China/epidemiologia , Simulação por Computador , Infecções por Coronavirus/prevenção & controle , Infecções por Coronavirus/transmissão , Humanos , Análise de Séries Temporais Interrompida/estatística & dados numéricos , Cadeias de Markov , Conceitos Matemáticos , Método de Monte Carlo , Morbidade/tendências , Pandemias/prevenção & controle , Pandemias/estatística & dados numéricos , Pneumonia Viral/prevenção & controle , Pneumonia Viral/transmissão , Quarentena/estatística & dados numéricos
11.
Dan Med J ; 67(9)2020 Aug 06.
Artigo em Inglês | MEDLINE | ID: mdl-32800066

RESUMO

INTRODUCTION: We explored transmission of the coronavirus disease 2019 (COVID-19) in severely ill patients and analysed the relationship between co-morbidity and mortality or the need for intensive care unit (ICU) care. METHODS: Clinical data, treatment and outcome were analysed in this retrospective study of 101 consecutive patients with COVID-19 admitted to a regional Danish hospital from 2 March 2020, based on data from electronic medical records. RESULTS: The mean age was 71.8 years, 33% were never smokers and 82% had one or more predefined chronic diseases. In-hospital mortality was 30%, and 20% of the patients were offered ICU care. In ICU patients, we found a male preponderance (88% versus 44%, p = 0.006), but death (50% versus 25%, p = 0.053) and other pre-defined co-morbidities did not differ significantly from non-ICU patients. The source of infection was unknown in 74% of patients, related to endemic travel in 10%, hospital acquired in 6% and related to close acquaintances in 11%. COVID-19-related symptoms were initially observed from February 21 (week 8 and week 9) in the first three patients who had no known source of infection. We found that 7% of cases had an increased risk of in-hospital transmission, based on a 7-16 days delay in coronavirus testing. CONCLUSIONS: The frequency of co-morbidity in hospital-admitted COVID-19 patients and the correlation to death and ICU attendance were analysed. In all, 74% of the infection cases were of unknown source during the first weeks of the epidemic, which points to considerable community transmission and possibly pre- or asymptomatic transmission, also several weeks before 21 February 2020. FUNDING: none. TRIAL REGISTRATION: not relevant after correspondence with the Ethics Committee of Region Zealand. Furthermore, permission was granted from The Danish Data Protection Agency, Region Zealand (REG-070-2020).


Assuntos
Betacoronavirus , Infecções por Coronavirus/transmissão , Hospitalização/tendências , Pneumonia Viral/transmissão , Idoso , Infecções por Coronavirus/epidemiologia , Dinamarca/epidemiologia , Feminino , Mortalidade Hospitalar/tendências , Humanos , Masculino , Morbidade/tendências , Pandemias , Pneumonia Viral/epidemiologia , Estudos Retrospectivos
12.
Artigo em Russo | MEDLINE | ID: mdl-32827361

RESUMO

The article presents the results of the analysis of indices of morbidity of children and adults in the Kostroma Oblast in 2000-2017. The main trends and changes during analyzed period are established. The high morbidity in such classes of diseases as respiratory diseases, injuries and poisoning, complications of pregnancy, childbirth and postpartum period are determined. The morbidity population in the Kostroma Oblast in the main classes of diseases increased by 14.3% in 2000-2017. The children morbidity in age group 0-14 years remains high.


Assuntos
Morbidade/tendências , Saúde da População , Adulto , Criança , Feminino , Humanos , Gravidez , Federação Russa
13.
Artigo em Russo | MEDLINE | ID: mdl-32827362

RESUMO

The purpose of the study is to analyze dynamic of primary and general morbidity of population older than able-bodied age in Moscow Oblast, including data comparing in the Central Federal Okrug and the Russian Federation. The data of statistical reports of City of Moscow, the Central Federal Okrug and the Russian Federation in 2013-2018 was included in analysis. The common analytical and mathematical statistical methods were applied. It was established that in Moscow Oblast in 2013-2018, against the background of stagnation of primary morbidity of population older than able-bodied age, indices of mental and behavioral disorders, neoplasms and diseases of circulatory system. At the same time, the level of primary morbidity of the region's population older than able-bodied age exceeds that one of the Russian Federation or the Central Federal Okrug in almost all classes of diseases. The structure of primary morbidity has not changed and respiratory diseases, injures and poisoning and diseases of circulatory system continue to rank first places. The level of general morbidity also remained unchanged. However, morbidity of neoplasms, diseases of endocrine system and mental and behavior disorders continues to increase. The structure of general morbidity of population of this age group differs the structure of primary morbidity and diseases of circulatory, respiratory and musculoskeletal systems ranked first places. Monitoring and analysis of primary and general morbidity of population older than able-bodied age is necessary for developing measures of its decreasing on the basis of development of medical social and geriatric care in the regions.


Assuntos
Nível de Saúde , Morbidade/tendências , Saúde da População , Idoso , Idoso de 80 Anos ou mais , Feminino , Humanos , Masculino , Moscou , Federação Russa
14.
Am Surg ; 86(9): 1113-1118, 2020 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-32830522

RESUMO

BACKGROUND: To study the relationship between race and outcomes of patients with firearm injuries hospitalized in the United States. METHODS: The 2016 National Inpatient Sample was used. Patients were included if they had a principal diagnosis of firearm injury. Exclusion criteria were age <16 years and elective admissions. The primary outcome was in-hospital mortality. Secondary outcomes were morbidity (traumatic shock, prolonged mechanical ventilation, acute respiratory distress syndrome [ADRS], and ventilator-associated pneumonia [VAP]), and resource utilization (length of stay and total hospitalization charges and costs). RESULTS: The sample included 31 335 patients; 52% were Black and 29% were Caucasian. The mean age was 32 years and 88% were male. Black patients had lower odds of mortality (adjusted odds ratio (aOR): 0.41 (95% CI: 0.32-0.53), P < .01). However, compared with Caucasians, Blacks had higher mean total hospitalization charges (adjusted mean difference (aMD) : $14 052 (CI: $1469-$26 635), P = .03) and costs (aMD: $3248 (CI: $654-$5842), P = .01) despite similar mean length of stay (aMD: 0.70 (CI: -0.05-1.45), P = .07). Both racial groups had similar rates of traumatic shock (aOR: 0.91 (0.72-1.15), P = .44), prolonged mechanical ventilation (aOR: 0.82 (0.63-1.09), P = .17), ARDS (aOR: 1.18 (0.45-3.07), P = .74) and VAP (aOR: 1.27 (0.47-3.41), P = .63). DISCUSSION: Black patients with firearm injuries had a lower adjusted odds of in-hospital mortality compared with other races. However, despite having a similar hospital length of stay and in-hospital morbidity, -Black patients had higher total hospitalization costs and charges.


Assuntos
Grupos de Populações Continentais , Hospitalização/estatística & dados numéricos , Pacientes Internados , Sistema de Registros , Ferimentos por Arma de Fogo/etnologia , Adulto , Recursos em Saúde/estatística & dados numéricos , Mortalidade Hospitalar/tendências , Humanos , Incidência , Morbidade/tendências , Estudos Retrospectivos , Fatores de Tempo , Estados Unidos/epidemiologia
16.
N Z Med J ; 133(1518): 54-63, 2020 07 17.
Artigo em Inglês | MEDLINE | ID: mdl-32683432

RESUMO

AIM: To describe patterns of community lipid testing and subsequent therapeutic alteration in a cohort of patients taking statins. METHOD: We conducted a population-based cohort study. Our cohort comprised all people enrolled with a general practice in the Pegasus Health primary care network in Canterbury, New Zealand between 1 January 2016 and 31 December 2017 who were dispensed a statin between 1 January 2016 and 30 June 2016. We defined two six-month study periods: a baseline period (1 January to 30 June 2016) and a follow-up period (1 July to 31 December 2017). We identified statin dispensings for all people in our cohort in both study periods, and identified instances of lipid testing in the 12 months following each person's most recent baseline period dispensing. We examined the effect of gender, ethnicity and socioeconomic deprivation on the likelihood of lipid testing; and compared frequency of alteration of statin dose or type among tested and non-tested people. RESULTS: Data were available for analysis for 32,943 individuals who were dispensed a statin in the baseline period. Lipid testing was performed in 16,199 (49.2%) of individuals. Women were less likely to have been tested than men (OR 0.87, 95% CI 0.83-0.91). Compared to those with European ethnicity, testing was more likely for Maori (OR 1.20, 95% CI 1.07-1.34), Pacific (OR 1.22, 95% CI 1.03-1.44) and Asian (OR 1.41, 95% CI 1.25-1.59) individuals. Socioeconomic deprivation was associated with reduced testing (OR 0.80, 95% CI 0.74-0.87). Dose or type of statin dispensed was altered between baseline and follow-up study periods in 3,762 (23.2%) of those who were tested, and in 3,122 (18.6%) of those who were not tested (OR 1.32, 95% CI 1.25-1.39). CONCLUSION: Almost half (49.1%) of patients had a lipid test within 12 months of baseline period statin dispensing. Lipid testing was more likely for Maori, Pacific and Asian patients than for European patients. Testing was less likely for women and for those with greater socioeconomic deprivation. Subsequent statin therapy alteration was slightly more likely for those who had been tested than for those who had not.


Assuntos
Doenças Cardiovasculares/sangue , Inibidores de Hidroximetilglutaril-CoA Redutases/uso terapêutico , Metabolismo dos Lipídeos/fisiologia , Monitorização Fisiológica/métodos , Atenção Primária à Saúde/estatística & dados numéricos , Fatores Etários , Idoso , Biomarcadores/sangue , Doenças Cardiovasculares/tratamento farmacológico , Doenças Cardiovasculares/epidemiologia , Feminino , Seguimentos , Humanos , Masculino , Morbidade/tendências , Nova Zelândia/epidemiologia , Estudos Retrospectivos , Taxa de Sobrevida/tendências
17.
Spine (Phila Pa 1976) ; 45(15): E959-E966, 2020 Aug 01.
Artigo em Inglês | MEDLINE | ID: mdl-32675612

RESUMO

STUDY DESIGN: Retrospective cohort study. OBJECTIVE: To develop a comprehensive understanding of the prognostic value of laboratory markers on morbidity and mortality following epidural abscess. SUMMARY OF BACKGROUND DATA: Spinal epidural abscess is a serious medical condition with high rates of morbidity. The value of laboratory data in forecasting morbidity and mortality after epidural abscess remains underexplored. METHODS: We obtained clinical data on patients treated for epidural abscess at two academic centers from 2005 to 2017. Our primary outcome was the development of one or more complications within 90-days of presentation, with mortality a secondary measure. Primary predictors included serum albumin, serum creatinine, platelet-lymphocyte ratio, and ambulatory status at presentation. We used multivariable logistic regression techniques to adjust for confounders. The most parsimonious set of variables influencing both complications and mortality were considered to be clinically significant. These were then examined individually and in combination to assess for synergy along with model-discrimination and calibration. We performed internal validation with a bootstrap procedure using sampling with replacement. RESULTS: We included 449 patients in this analysis. Complications were encountered in 164 cases (37%). Mortality within 1-year occurred in 39 patients (9%). Regression testing determined that serum albumin, serum creatinine, and ambulatory status at presentation were clinically important predictors of outcome, with albumin more than 3.5 g/dL, creatinine less than or equal to 1.2 mg/dL, and independent ambulatory function at presentation considered favorable characteristics. Patients with no favorable findings had increased likelihood of 90-day complications (odds ratio [OR] 5.43; 95% confidence intervals [CI] 1.98, 14.93) and 1-year mortality (OR 8.94; 95% CI 2.03, 39.37). Those with one favorable characteristic had greater odds of complications (OR 4.00; 95% CI 2.05, 7.81) and mortality (OR 5.71; 95% CI 1.60, 20.43). CONCLUSION: We developed a nomogram incorporating clinical and laboratory values to prognosticate outcomes after treatment for epidural abscess. The results can be used in shared-decision making and counseling. LEVEL OF EVIDENCE: 3.


Assuntos
Abscesso Epidural/sangue , Abscesso Epidural/mortalidade , Limitação da Mobilidade , Complicações Pós-Operatórias/sangue , Complicações Pós-Operatórias/mortalidade , Adulto , Idoso , Biomarcadores/sangue , Estudos de Coortes , Abscesso Epidural/terapia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Morbidade/tendências , Mortalidade/tendências , Prognóstico , Estudos Retrospectivos
18.
Perfusion ; 35(6): 465-473, 2020 09.
Artigo em Inglês | MEDLINE | ID: mdl-32666887

RESUMO

Coronavirus disease 2019 (COVID-19) is a serious health concern which affects all healthcare professionals worldwide. The pandemic puts health services, including cardiac surgery units, under escalating pressure. There are significant challenges caused by this novel virus and ensuing disease that leads to great uncertainty. While it has been advocated to delay elective surgeries, most cardiac surgical patients present in a more urgent manner which elevates the critical nature for intervention, which may make the surgical decision inevitable. To date, no definitive treatments to the pandemic have been promoted. Cardiac surgical centers may experience an increasing number of COVID-19 patients in clinical practice. Preparation for managing these patients will require a change in the current modalities for perioperative care. Therefore, the goal of this report is to share our own experiences, combined with a review of the emerging literature, by highlighting principles for the adult cardiac surgery community regarding treatment of patients scheduled for surgery. The following report will recommend perioperative guidance in patient management to include safety precautions for the heart team, the conduct of extracorporeal circulation and related equipment, and covering the early period in intensive care in the context of the current pandemic.


Assuntos
Betacoronavirus , Ponte Cardiopulmonar/métodos , Infecções por Coronavirus/complicações , Pandemias , Assistência Perioperatória/métodos , Pneumonia Viral/complicações , Doença da Artéria Coronariana , Infecções por Coronavirus/epidemiologia , Procedimentos Cirúrgicos Eletivos/métodos , Saúde Global , Humanos , Morbidade/tendências , Pneumonia Viral/epidemiologia
19.
J Card Surg ; 35(10): 2605-2610, 2020 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-32667069

RESUMO

BACKGROUND: Covid-19 was declared a pandemic by the World Health Organization (WHO) on 11 March 2020. Responses to this crisis integrated resource allocation for the increased amount of infected patients while maintaining an adequate response to other severe and life-threatening diseases. Though cardiothoracic patients are at high risk for Covid-19 severe illness, postponing surgeries would translate to increased mortality and morbidity. We reviewed our practice during the initial time of the pandemic, with emphasis on safety protocols. METHODS: From 11 March to 15 May 2020, 148 patients underwent surgery at the Department of Cardiothoracic Surgery of Centro Hospitalar Universitário de São João. The clinical characteristics of the patients were retrospectively registered, along with novel containment and infection prevention measures targeting the new coronavirus. RESULTS: The majority of adult cardiac patients were operated on an emergency basis. Hospital mortality was 1.9% (n = 2 patients). Most adult thoracic patients were admitted from home, with a diagnosis of neoplastic disease in 60% of patients. Hospital mortality was 3.3% (1 patient). Fifteen children underwent cardiothoracic surgery. There was no mortality. The infection prevention procedures applied, totally excluded the transmission of Covid-19 in the department. CONCLUSION: While guaranteeing a prompt response to emergent, urgent, and high priority cases, novel safety measures in individual protection, patients circuits, and preoperative diagnoses of symptomatic and asymptomatic infection were adopted. The surgical results corroborate that it was safe to undergo cardiothoracic surgery during the initial time of the Covid-19 pandemic. The new policies will be maintained while the virus stays in the community.


Assuntos
Betacoronavirus , Procedimentos Cirúrgicos Cardíacos/métodos , Infecções por Coronavirus/epidemiologia , Cardiopatias/cirurgia , Pandemias , Assistência Perioperatória/métodos , Pneumonia Viral/epidemiologia , Complicações Pós-Operatórias/epidemiologia , Adulto , Idoso , Idoso de 80 Anos ou mais , Comorbidade , Feminino , Cardiopatias/epidemiologia , Humanos , Masculino , Pessoa de Meia-Idade , Morbidade/tendências , Portugal/epidemiologia , Estudos Retrospectivos , Taxa de Sobrevida/tendências , Resultado do Tratamento , Adulto Jovem
20.
Expert Rev Gastroenterol Hepatol ; 14(10): 879-884, 2020 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-32649840

RESUMO

INTRODUCTION: The outbreak of COVID-19 is a serious health threat worldwide. Different degrees of liver injury or liver dysfunctions have been reported in patients with COVID-19 infection. However, currently, it remains unclear to what extent liver diseases should be considered as significant risk factors for the severity and mortality of COVID-19. Moreover, the mechanisms involved in liver injury in severe COVID-19 infection are not yet well understood. AREA COVERED: This review summarizes the current evidence on liver function abnormalities in COVID-19 patients and the effects of preexisting liver disease on the disease severity. This review also illustrates the possible underlying mechanisms linking COVID-19 to liver injury, as well as provides recommendations to prevent liver damage in COVID-19 infection. EXPERT OPINION: The elevated levels of ALT, AST, GGT and bilirubin are common in more severe patients than non-severe or mild COVID-19 patients. Patients with preexisting medical conditions including chronic hepatic diseases are at higher risk for severe illness from COVID-19 infection. The drug's effects, possible viral inclusion in liver cells, systemic inflammation and hypoxia are potential causes of liver injury in severe COVID-19. Nevertheless, further studies are needed focusing on the preexisting hepatic diseases on prevention, treatment and outcome of COVID-19.


Assuntos
Betacoronavirus , Infecções por Coronavirus/complicações , Hepatopatias/etiologia , Pandemias , Pneumonia Viral/complicações , Infecções por Coronavirus/epidemiologia , Saúde Global , Humanos , Hepatopatias/diagnóstico , Hepatopatias/epidemiologia , Testes de Função Hepática , Morbidade/tendências , Pneumonia Viral/epidemiologia , Fatores de Risco , Índice de Gravidade de Doença
SELEÇÃO DE REFERÊNCIAS
DETALHE DA PESQUISA