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Artigo em Inglês | MEDLINE | ID: mdl-32730915


In December 2019, the first case of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2, COVID-19) infection was reported. In only few weeks it has caused a global pandemic, with mortality reaching 3.4%, mostly due to a severe pneumonia. However, the impact of SARS-CoV-2 virus on the central nervous system (CNS) and mental health outcomes remains unclear. Previous studies have demonstrated the presence of other types of coronaviruses in the brain, especially in the brainstem. There is evidence that the novel coronavirus can penetrate CNS through the olfactory or circulatory route as well as it can have an indirect impact on the brain by causing cytokine storm. There are also first reports of neurological signs in patients infected by the SARS-Cov-2. They show that COVID-19 patients have neurologic manifestations like acute cerebrovascular disease, conscious disturbance, taste and olfactory disturbances. In addition, there are studies showing that certain psychopathological symptoms might appear in infected patients, including those related to mood and psychotic disorders as well as post-traumatic stress disorder. Accumulating evidence also indicates that the pandemic might have a great impact on mental health from the global perspective, with medical workers being particularly vulnerable. In this article, we provide a review of studies investigating the impact of the SARS-CoV-2 on the CNS and mental health outcomes. We describe neurobiology of the virus, highlighting the relevance to mental disorders. Furthermore, this article summarizes the impact of the SARS-CoV-2 from the public health perspective. Finally, we present a critical appraisal of evidence and indicate future directions for studies in this field.

Infecções por Coronavirus/psicologia , Transtornos Mentais/psicologia , Saúde Mental , Pneumonia Viral/psicologia , Betacoronavirus , Encéfalo/virologia , Infecções por Coronavirus/complicações , Humanos , Transtornos Mentais/complicações , Transtornos Mentais/etiologia , Doenças do Sistema Nervoso/etiologia , Pandemias , Pneumonia Viral/complicações , Resultado do Tratamento
Am Heart J ; 231: 93-95, 2021 01.
Artigo em Inglês | MEDLINE | ID: mdl-33181067


We evaluated the incidence of thrombosis in patients hospitalized with non-COVID-19 acute viral respiratory illnesses nationwide from 2012 to 2014 and compared this to the incidence among patients hospitalized with COVID-19 at a large health system in New York. Non-COVID-19 viral respiratory illness was complicated by acute MI in 2.8% of hospitalizations, VTE in 1.6%, ischemic stroke in 0.7%, and other systemic embolism in 0.1%. The proportion of hospitalizations complicated by thrombosis was lower in patients with viral respiratory illness in 2002-2014 than in COVID-19 (5% vs 16%; P< .001). BACKGROUND: Thrombosis is a prominent feature of the novel Coronavirus disease 2019 (COVID-19). The incidence of thrombosis during hospitalization for non-COVID-19 viral respiratory infections is uncertain. We evaluated the incidence of thrombosis in patients hospitalized with non-COVID-19 acute viral respiratory illnesses compared to COVID-19. METHODS: Adults age >18 years hospitalized with a non-COVID-19 viral respiratory illness between 2002 and 2014 were identified. The primary study outcome was a composite of venous and arterial thrombotic events, including myocardial infarction (MI), acute ischemic stroke, and venous thromboembolism (VTE), as defined by ICD-9 codes. The incidence of thrombosis in non-COVID-19 viral respiratory illnesses was compared to the recently published incidence of thrombosis in COVID-19 from 3,334 patients hospitalized in New York in 2020. RESULTS: Among 954,521 hospitalizations with viral pneumonia from 2002 to 2014 (mean age 62.3 years, 57.1% female), the combined incidence of arterial and venous thrombosis was 5.0%. Acute MI occurred in 2.8% of hospitalizations, VTE in 1.6%, ischemic stroke in 0.7%, and other systemic embolism in 0.1%. Patients with thrombosis had higher in-hospital mortality (14.9% vs 3.3%, P< .001) than those without thrombosis. The proportion of hospitalizations complicated by thrombosis was lower in patients with viral respiratory illness in 2002-2014 than in COVID-19 (median age 64; 39.6% female) in 2020 (5% vs 16%; P< .001) CONCLUSION: In a nationwide analysis of hospitalizations for viral pneumonias, thrombosis risk was lower than that observed in patients with COVID-19. Investigations into mechanisms of thrombosis and risk reduction strategies in COVID-19 and other viral respiratory infections are necessary.

Infarto do Miocárdio , Pneumonia Viral , Infecções Respiratórias , Trombose , Tromboembolia Venosa , /diagnóstico , Feminino , Hospitalização/estatística & dados numéricos , Humanos , /epidemiologia , Masculino , Pessoa de Meia-Idade , Infarto do Miocárdio/diagnóstico , Infarto do Miocárdio/epidemiologia , Infarto do Miocárdio/etiologia , Pneumonia Viral/complicações , Pneumonia Viral/diagnóstico , Infecções Respiratórias/complicações , Infecções Respiratórias/diagnóstico , Infecções Respiratórias/virologia , Medição de Risco , Trombose/epidemiologia , Trombose/virologia , Estados Unidos/epidemiologia , Tromboembolia Venosa/diagnóstico , Tromboembolia Venosa/epidemiologia , Tromboembolia Venosa/etiologia
J Infect Chemother ; 27(1): 110-112, 2021 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-33039267


Coronavirus disease (COVID-19) is often characterized by abnormal olfactory and gustatory symptoms in adults; however, detailed studies on pediatric patients with COVID-19 are extremely limited. A 13-year-old Japanese girl presented with fever and cough, and after 2 days, her olfactory and taste sensations suddenly disappeared. A real-time reverse transcriptase-polymerase chain reaction (RT-PCR) test for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) was performed using a nasopharyngeal swab. Because a positive result was seen, she was admitted on the 7th day of illness. On admission, the visual analogue scale (VAS) score for smell and taste was 0 of 100%. An intravenous olfaction test using prosultiamine (Alinamin test) was performed on the 15th day of illness to evaluate olfaction, and an increase in latency (33 seconds) and a decrease in duration (55 seconds) were observed. In the odor identification test using 12 different odor cards, only 7 odors were correctly identified. On the 18th day of illness, SARS-CoV-2 tested negative in the RT-PCR test; simultaneously, the VAS score for smell and taste fully improved to 100 of 100%. On the 77th day of illness, full recovery was confirmed in the Alinamin test (latency, 7 seconds; duration, 82 seconds). In this present case, an improvement in olfactory and gustatory dysfunctions was observed with negative results in RT-PCR test for SARS-CoV-2.

Infecções por Coronavirus/diagnóstico , Transtornos do Olfato/etiologia , Pneumonia Viral/diagnóstico , Distúrbios do Paladar/etiologia , Adolescente , Betacoronavirus/isolamento & purificação , Infecções por Coronavirus/complicações , Feminino , Humanos , Japão , Transtornos do Olfato/diagnóstico , Pandemias , Pneumonia Viral/complicações , Reação em Cadeia da Polimerase Via Transcriptase Reversa , Olfato , Paladar , Distúrbios do Paladar/diagnóstico
Acta Pharm ; 71(2): 175-184, 2021 Jun 01.
Artigo em Inglês | MEDLINE | ID: mdl-33151168


Recently, an outbreak of a fatal coronavirus, SARS-CoV-2, has emerged from China and is rapidly spreading worldwide. Possible interaction of SARS-CoV-2 with DPP4 peptidase may partly contribute to the viral pathogenesis. An integrative bioinformatics approach starting with mining the biomedical literature for high confidence DPP4-protein/gene associations followed by functional analysis using network analysis and pathway enrichment was adopted. The results indicate that the identified DPP4 networks are highly enriched in viral processes required for viral entry and infection, and as a result, we propose DPP4 as an important putative target for the treatment of COVID-19. Additionally, our protein-chemical interaction networks identified important interactions between DPP4 and sitagliptin. We conclude that sitagliptin may be beneficial for the treatment of COVID-19 disease, either as monotherapy or in combination with other therapies, especially for diabetic patients and patients with pre-existing cardiovascular conditions who are already at higher risk of COVID-19 mortality.

Infecções por Coronavirus/tratamento farmacológico , Dipeptidil Peptidase 4/efeitos dos fármacos , Inibidores da Dipeptidil Peptidase IV/farmacologia , Inibidores da Dipeptidil Peptidase IV/uso terapêutico , Pneumonia Viral/tratamento farmacológico , Fosfato de Sitagliptina/farmacologia , Fosfato de Sitagliptina/uso terapêutico , Doenças Cardiovasculares/complicações , Doenças Cardiovasculares/tratamento farmacológico , Biologia Computacional , Infecções por Coronavirus/complicações , Cristalografia por Raios X , Mineração de Dados , Complicações do Diabetes/tratamento farmacológico , Sistemas de Liberação de Medicamentos , Reposicionamento de Medicamentos , Redes Reguladoras de Genes , Humanos , Estrutura Molecular , Pandemias , Pneumonia Viral/complicações
Crit Care Clin ; 37(1): 175-190, 2021 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-33190768


Older adults are particularly vulnerable during the Coronavirus disease 2019 (COVID-19) pandemic, because higher age increases risk for both delirium and COVID-19-related death. Despite the health care system limitations and the clinical challenges of the pandemic, delirium screening and management remains an evidence-based cornerstone of critical care. This article discusses practical recommendations for delirium screening in the COVID-19 pandemic era, tips for training health care workers in delirium screening, validated tools for detecting delirium in critically ill older adults, and approaches to special populations of older adults (eg, sensory impairment, dementia, acute neurologic injury).

Infecções por Coronavirus/complicações , Delírio/complicações , Delírio/diagnóstico , Demência/complicações , Pneumonia Viral/complicações , Idoso , Idoso de 80 Anos ou mais , Betacoronavirus , Delírio/prevenção & controle , Perda Auditiva/complicações , Humanos , Unidades de Terapia Intensiva , Pandemias , Equipe de Assistência ao Paciente , Transtornos da Visão/complicações
Ann Med ; 53(1): 103-116, 2021 12.
Artigo em Inglês | MEDLINE | ID: mdl-33063540


BACKGROUND: Hyperglycaemia has emerged as an important risk factor for death in coronavirus disease 2019 (COVID-19). The aim of this study was to evaluate the association between blood glucose (BG) levels and in-hospital mortality in non-critically patients hospitalized with COVID-19. METHODS: This is a retrospective multi-centre study involving patients hospitalized in Spain. Patients were categorized into three groups according to admission BG levels: <140 mg/dL, 140-180 mg/dL and >180 mg/dL. The primary endpoint was all-cause in-hospital mortality. RESULTS: Of the 11,312 patients, only 2128 (18.9%) had diabetes and 2289 (20.4%) died during hospitalization. The in-hospital mortality rates were 15.7% (<140 mg/dL), 33.7% (140-180 mg) and 41.1% (>180 mg/dL), p<.001. The cumulative probability of mortality was significantly higher in patients with hyperglycaemia compared to patients with normoglycaemia (log rank, p<.001), independently of pre-existing diabetes. Hyperglycaemia (after adjusting for age, diabetes, hypertension and other confounding factors) was an independent risk factor of mortality (BG >180 mg/dL: HR 1.50; 95% confidence interval (CI): 1.31-1.73) (BG 140-180 mg/dL; HR 1.48; 95%CI: 1.29-1.70). Hyperglycaemia was also associated with requirement for mechanical ventilation, intensive care unit (ICU) admission and mortality. CONCLUSIONS: Admission hyperglycaemia is a strong predictor of all-cause mortality in non-critically hospitalized COVID-19 patients regardless of prior history of diabetes. KEY MESSAGE Admission hyperglycaemia is a stronger and independent risk factor for mortality in COVID-19. Screening for hyperglycaemia, in patients without diabetes, and early treatment of hyperglycaemia should be mandatory in the management of patients hospitalized with COVID-19. Admission hyperglycaemia should not be overlooked in all patients regardless prior history of diabetes.

Infecções por Coronavirus/mortalidade , Hiperglicemia/complicações , Pneumonia Viral/mortalidade , Sistema de Registros , Idoso , Idoso de 80 Anos ou mais , Glicemia , Infecções por Coronavirus/sangue , Infecções por Coronavirus/complicações , Cuidados Críticos/estatística & dados numéricos , Feminino , Humanos , Hiperglicemia/mortalidade , Tempo de Internação , Masculino , Pessoa de Meia-Idade , Pandemias , Pneumonia Viral/sangue , Pneumonia Viral/complicações , Respiração Artificial/estatística & dados numéricos , Espanha/epidemiologia
J Infect Chemother ; 27(1): 99-102, 2021 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-33023821


We present three patients affected by pulmonary squamous cell carcinoma, metastatic esophageal cancer and advanced non-Hodgkin lymphoma, who incurred in coronavirus 2019 (COVID-19) infection during the early phase of epidemic wave in Italy. All patients presented with fever. Social contact with subject positive for COVID-19 was declared in only one of the three cases. In all cases, laboratory findings showed lymphopenia and elevated C-reactive protein (CRP). Chest x-ray and computed tomography showed bilateral ground-glass opacities, shadowing, interstitial abnormalities, and "crazy paving" pattern which evolved with superimposition of consolidations in one patient. All patients received antiviral therapy based on ritonavir and lopinavir, associated with hydroxychloroquine. Despite treatment, two patients with advanced cancers died after 39 and 17 days of hospitalization, while the patient with lung cancer was dismissed at home, in good conditions.

Infecções por Coronavirus/tratamento farmacológico , Hidroxicloroquina/uso terapêutico , Lopinavir/uso terapêutico , Neoplasias/complicações , Pneumonia Viral/tratamento farmacológico , Ritonavir/uso terapêutico , Idoso , Antibacterianos/uso terapêutico , Antivirais/uso terapêutico , Betacoronavirus , Carcinoma de Células Escamosas/complicações , Carcinoma de Células Escamosas/diagnóstico , Carcinoma de Células Escamosas/tratamento farmacológico , Infecções por Coronavirus/complicações , Infecções por Coronavirus/diagnóstico , Surtos de Doenças , Quimioterapia Combinada , Neoplasias Esofágicas/complicações , Neoplasias Esofágicas/diagnóstico , Neoplasias Esofágicas/tratamento farmacológico , Evolução Fatal , Humanos , Itália , Neoplasias Pulmonares/complicações , Neoplasias Pulmonares/diagnóstico , Neoplasias Pulmonares/tratamento farmacológico , Linfoma não Hodgkin/complicações , Linfoma não Hodgkin/diagnóstico , Linfoma não Hodgkin/tratamento farmacológico , Masculino , Pessoa de Meia-Idade , Neoplasias/diagnóstico , Neoplasias/tratamento farmacológico , Pandemias , Pneumonia Viral/complicações , Pneumonia Viral/diagnóstico , Tomografia Computadorizada por Raios X , Resultado do Tratamento
Am J Hum Genet ; 108(1): 194-201, 2021 01 07.
Artigo em Inglês | MEDLINE | ID: mdl-33357513


Given the coronavirus disease 2019 (COVID-19) pandemic, investigations into host susceptibility to infectious diseases and downstream sequelae have never been more relevant. Pneumonia is a lung disease that can cause respiratory failure and hypoxia and is a common complication of infectious diseases, including COVID-19. Few genome-wide association studies (GWASs) of host susceptibility and severity of pneumonia have been conducted. We performed GWASs of pneumonia susceptibility and severity in the Vanderbilt University biobank (BioVU) with linked electronic health records (EHRs), including Illumina Expanded Multi-Ethnic Global Array (MEGAEX)-genotyped European ancestry (EA, n= 69,819) and African ancestry (AA, n = 15,603) individuals. Two regions of large effect were identified: the CFTR locus in EA (rs113827944; OR = 1.84, p value = 1.2 × 10-36) and HBB in AA (rs334 [p.Glu7Val]; OR = 1.63, p value = 3.5 × 10-13). Mutations in these genes cause cystic fibrosis (CF) and sickle cell disease (SCD), respectively. After removing individuals diagnosed with CF and SCD, we assessed heterozygosity effects at our lead variants. Further GWASs after removing individuals with CF uncovered an additional association in R3HCC1L (rs10786398; OR = 1.22, p value = 3.5 × 10-8), which was replicated in two independent datasets: UK Biobank (n = 459,741) and 7,985 non-overlapping BioVU subjects, who are genotyped on arrays other than MEGAEX. This variant was also validated in GWASs of COVID-19 hospitalization and lung function. Our results highlight the importance of the host genome in infectious disease susceptibility and severity and offer crucial insight into genetic effects that could potentially influence severity of COVID-19 sequelae.

/complicações , Interações Hospedeiro-Patógeno/genética , Pneumonia Viral/complicações , Pneumonia Viral/genética , Bronquite/genética , /fisiopatologia , Regulador de Condutância Transmembrana em Fibrose Cística/genética , Bases de Dados Genéticas , Registros Eletrônicos de Saúde , Feminino , Estudo de Associação Genômica Ampla , Genótipo , Hemoglobinas/genética , Humanos , Pacientes Internados , Desequilíbrio de Ligação , Masculino , Pacientes Ambulatoriais , Pneumonia Viral/patologia , Pneumonia Viral/fisiopatologia , Polimorfismo de Nucleotídeo Único/genética , Análise de Componente Principal , Doença Pulmonar Obstrutiva Crônica/genética , Reprodutibilidade dos Testes , Reino Unido
Arch Phys Med Rehabil ; 102(1): 155-158, 2021 01.
Artigo em Inglês | MEDLINE | ID: mdl-32991870


OBJECTIVES: To report the cognitive features of patients with severe coronavirus disease 2019 (COVID-19) entering the postacute phase, to understand whether COVID-19 acute respiratory distress syndrome itself could result in long-term cognitive deficits, and to determine whether neuropsychological treatment after the acute stage might represent a specific rehabilitation need. DESIGN: Case series. SETTING: Rehabilitation hospital. PARTICIPANTS: We assessed the general cognitive functioning through tablet-supported video calls in 9 of 12 consecutive patients (N=9) admitted to the hospital at least 30 days earlier for acute respiratory distress syndrome due to COVID-19. Three patients were excluded based on the exclusion criteria. None of the patients presented cognitive symptoms before hospitalization. MAIN OUTCOME MEASURE: General cognitive functioning, measured using the Mini-Mental State Examination (MMSE) test. RESULTS: A general cognitive decay was observed in 3 patients (33.3%) who had a pathologic score on the MMSE, with a specific decline in attention, memory, language, and praxis abilities. The cognitive malfunctioning appears to be linearly associated with the length of stay (in d) in the intensive care unit (ICU). The longer the amount of time spent in the ICU, the lower the MMSE score, indicating a lower global cognitive functioning. CONCLUSIONS: Our results indicate that some patients with COVID-19 might also benefit from neuropsychological rehabilitation, given their possible global cognitive decay. The link between neuropsychological functioning and the length of stay in the ICU suggests that neurocognitive rehabilitative treatments should be directed explicitly toward patients who treated in the ICU, rather than toward every patient who experienced acute respiratory distress syndrome owing to COVID-19. However, given the limitation of a case series study, those hypotheses should be tested with future studies with larger samples and a longer follow-up period.

/complicações , Transtornos Cognitivos/etiologia , Transtornos Cognitivos/reabilitação , Pneumonia Viral/complicações , Cuidados Semi-Intensivos/métodos , Adulto , Idoso , Feminino , Hospitalização , Humanos , Unidades de Terapia Intensiva , Tempo de Internação/estatística & dados numéricos , Masculino , Testes de Estado Mental e Demência , Pessoa de Meia-Idade , Fatores de Risco
Rev. Hosp. Ital. B. Aires (2004) ; 40(4): 227-232, dic. 2020. ilus, tab
Artigo em Espanhol | LILACS | ID: biblio-1145596


La enfermedad producida por el nuevo coronavirus SARS-CoV-2 se identificó por primera vez en diciembre de 2019 en la ciudad de Wuhan, en la República Popular China, y en pocos meses se convirtió en una pandemia. Desde el comienzo ha sido un desafío mundial, que amenazó la salud pública y obligó a tomar medidas estrictas de aislamiento social. Como consecuencia de la emergencia sanitaria se ha producido una reducción importante de la actividad asistencial, que puso en riesgo el acceso y la continuidad de los métodos anticonceptivos, exponiendo a mujeres a embarazos no intencionales. Los derechos sexuales y reproductivos resultan esenciales y deben garantizarse siempre. (AU)

The disease caused by the new coronavirus SARS-CoV-2 was identified for the first time in December 2019 in the city of Wuhan, in the People's Republic of China, and within a few months it became a pandemic. From the beginning, it has been a global challenge, threatening public health, having to take strict measures of social isolation. As a consequence of the health emergency, there has been a significant reduction in healthcare activity, putting access and continuity of contraceptive methods at risk, exposing women to unintended pregnancies. Sexual and reproductive rights are essential and must always be guaranteed. (AU)

Humanos , Feminino , Pneumonia Viral/complicações , Infecções por Coronavirus/complicações , Contracepção Hormonal/métodos , Pneumonia Viral/patologia , Gravidez não Desejada , Infecções por Coronavirus/patologia , Anticoncepcionais/administração & dosagem , Anticoncepcionais/classificação , Anticoncepcionais/provisão & distribução , Direitos Sexuais e Reprodutivos , Coagulação Intravascular Disseminada/etiologia , Tromboembolia Venosa/etiologia , Pandemias , Betacoronavirus , Acesso aos Serviços de Saúde
Braz. j. otorhinolaryngol. (Impr.) ; 86(6): 781-792, Nov.-Dec. 2020. tab, graf
Artigo em Inglês | LILACS | ID: biblio-1142605


Abstract Introduction: The SARS-CoV-2 virus causes COVID-19, and it is responsible for the largest pandemic since the 1918 H1N1 influenza outbreak. The classic symptoms of the disease have been well defined by the World Health Organization; however, olfactory/gustatory disorders have been reported in some studies, but there are still several missing points in the understanding and in the consensus about the clinical management of these cases. Objective: To identify evidence in the scientific literature about olfactory/gustatory disorders, their clinical presentation, prevalence and possible specific treatments associated with COVID-19. Methods: A systematic review of articles published up to April 25, 2020 was performed in Medline, Cochrane Clinical Trials, ScienceDirect, Lilacs, Scopus and Google Schoolar,, DissOnline, The New York Academy of Medicine and Reasearch Gate. Inclusion criteria: (1) Studies on patients with COVID-19; (2) Records of COVID-19 signs/symptoms, and olfactory/gustatory functions. Exclusion criteria: (1) Studies on non-human coronavirus; (2) Review articles; (3) Experimental studies (in animals or in vitro); (4) Olfactory/gustatory disorders initiated prior to SARS-CoV-2 infection. The risk assessment of bias of the selected studies was performed using the Newcastle-Ottawa scale. Results: Six articles from the 1788 records met the inclusion criteria and were analyzed. A total of 1457 patients of different ethnicities were assessed; of them, 885 (60.7%) and 822 (56.4%) had smell and taste disorders, respectively, with women being most often affected. There were olfactory/gustatory disorders even without nasal obstruction/rhinorrhea and beginning even before the signs/symptoms of COVID-19; the recovery of smell/taste, when it occurs, usually happened in the first two weeks after COVID-19 resolution. There is evidence that olfactory/gustatory disorders are strong predictors of infection by SARS-CoV-2, and it is possible to recommend patient isolation, as early as of the medical consultation, preventing the spread of the virus. No scientific evidence has been identified for effective treatments for any of the disorders. Conclusion: Olfactory/gustatory disorders may occur at varying intensities and prior to the general symptoms of COVID-19 and should be considered as part of the clinical features of COVID-19, even in mild cases. There is still no scientific evidence of specific treatments for such disorders in COVID-19 disease.

Resumo Introdução: O vírus SARS-CoV-2 causa a COVID-19 e é responsável pela maior pandemia desde o surto de influenza H1N1 de 1918. Os sintomas clássicos da doença já foram bem definidos pela Organização Mundial da Saúde; entretanto, distúrbios olfativo-gustativos têm sido relatados em alguns estudos, mas ainda com várias lacunas no entendimento e no consenso sobre a condução clínica desses casos. Objetivo: Identificar evidências na literatura científica sobre os distúrbios olfativo-gustativos acerca da apresentação clínica, prevalência e possíveis tratamentos específicos associados à COVID-19. Método: Revisão sistemática de artigos publicados até 25 de abril de 2020 nas bases de dados: Medline, Cochrane Clinical Trials, ScienceDirect, Lilacs, Scopus e Google Schoolar,, DissOnline, The New York Academy of Medicine e Research Gate. Foram critérios de inclusão: 1) Estudos com indivíduos com COVID-19; 2) Registro dos sinais/sintomas da COVID-19 e das funções olfativo-gustativa. Foram critérios de exclusão: 1) Estudos sobre coronavírus não humano; 2) Artigos de revisão; 3) Estudos experimentais (em animais ou in vitro); 4) Distúrbios olfativos-gustativos iniciados previamente à infecção pelo SARS-CoV-2. A avaliação de risco de viés dos estudos selecionados foi feita por meio da escala de Newcastle-Ottawa. Resultados: Seis artigos dos 1.788 registros foram selecionados. Um total de 1.457 pacientes de diversas etnias foi avaliado; desses, 885 (60,7%) apresentaram perda do olfato e 822 (56,4%) perda do paladar, sendo as mulheres as mais afetadas. Os distúrbios olfativo-gustativos estiveram presentes mesmo sem obstrução nasal/rinorreia e com início mesmo antes dos sinais/sintomas clínicos da COVID-19; a recuperação do olfato/paladar, quando ocorre, geralmente se dá nas duas primeiras semanas após a resolução da doença. Há evidências de que os distúrbios olfativo-gustativos sejam fortes preditores de infecção pelo SARS-CoV-2, podendo-se recomendar o isolamento do paciente, já a partir da consulta médica, para evitar a disseminação do vírus. Não foram identificadas evidências científicas para tratamentos eficazes para qualquer dos distúrbios. Conclusão: Podem ocorrer distúrbios olfativo-gustativos em intensidades variáveis e prévios aos sintomas gerais da COVID-19, devem ser considerados como parte dos sintomas da doença, mesmo em quadros leves. Não há ainda evidências científicas de tratamentos específicos para tais distúrbios na COVID-19.

Humanos , Masculino , Feminino , Pneumonia Viral/complicações , Infecções por Coronavirus/complicações , Vírus da Influenza A Subtipo H1N1 , Pandemias , Transtornos do Olfato/etiologia , Transtornos do Olfato/epidemiologia , Olfato , Distúrbios do Paladar/etiologia , Distúrbios do Paladar/epidemiologia , Inquéritos Nutricionais , Betacoronavirus
Med. clín (Ed. impr.) ; 155(12): 535-537, dic. 2020.
Artigo em Espanhol | IBECS | ID: ibc-191728


OBJETIVO: La preocupación por enfermar podría ayudar a prevenir enfermedades. El objetivo de este estudio fue analizar las propiedades psicométricas de una escala de preocupación por la COVID-19 (EPCov-19). MATERIALES Y MÉTODOS: El estudio es de tipo instrumental y se recogió información de 224 personas de nacionalidad peruana en el contexto de aislamiento social. Se realizó una adaptación de los ítems de la escala de preocupación por el cáncer. RESULTADOS: Se obtuvo una escala con propiedades psicométricas satisfactorias. Con una matriz de correlaciones policóricas se obtuvieron valores superiores al estándar en los 6 ítems (r > 0,3) y la confiabilidad fue aceptable (alfa = 0,866; IC del 95% = 0,83-0,89). El análisis paralelo sugirió la unidimensionalidad de la EPCov-19, la varianza explicada fue del 79,7% y las saturaciones fueron superiores a 0,4. Los índices de bondad de ajuste son satisfactorios (CFI = 0,995; GFI = 0,997; TLI = 0,991 y RMSEA = 0,059, IC del 95% = 0,012-0,077). CONCLUSIONES: Se presenta un instrumento válido y confiable para medir la preocupación por el contagio de COVID-19 y puede ser usados en futuros estudios

OBJECTIVE: Concern about getting sick could help prevent disease. The aim of this study was to analyze the psychometric properties of a COVID-19 concern scale (EPCov-19). MATERIALS AND METHODS: This is an instrument-based study and information was collected from 224 people of Peruvian nationality in the context of social isolation. The items of the Cancer Concern Scale were adapted for this study. RESULTS: A scale with satisfactory psychometric properties was obtained. With a matrix of polychoric correlations, values higher than the standard were obtained in all 6 items (r > 0.3) and the reliability was acceptable (alpha = 0.866; 95% CI = 0.83 - 0.89). Parallel analysis suggested unidimensionality of the EPCov-19, the variance explained was 79.7% and saturations were higher than 0.4. Goodness-of-fit índices were satisfactory (CFI = 0.995; GFI = 0.997; TLI = 0.991; and RMSEA = 0.059, 95% CI = 0.012 - 0.077). CONCLUSIONS: This is a valid and reliable instrument for measuring concern about the spread of COVID-19 and can be used in future studies

Humanos , Masculino , Feminino , Adolescente , Adulto Jovem , Adulto , Pessoa de Meia-Idade , Idoso , Ansiedade/diagnóstico , Infecções por Coronavirus/psicologia , Pneumonia Viral/psicologia , Estresse Psicológico , Psicometria/instrumentação , Betacoronavirus , Adaptação Psicológica , Infecções por Coronavirus/complicações , Pneumonia Viral/complicações , Inquéritos e Questionários , Análise Fatorial
Rev. esp. cardiol. Supl. (Ed. impresa) ; 20(supl.E): 9-13, dic. 2020. tab, graf
Artigo em Espanhol | IBECS | ID: ibc-195341


La infección por el SARS-CoV-2 de 2019 tiene una baja mortalidad en la mayoría de los casos, pero un 15-20% de los infectados sufre una enfermedad pulmonar con diferentes grados de afección sistémica, denominada enfermedad coronavírica de 2019 (COVID-19), que sí conlleva mayor mortalidad. Desde las primeras descripciones de series de pacientes, se identificó daño miocárdico en muchos pacientes con COVID-19 y su relación con mayor mortalidad. está revisión resume la evidencia sobre la afección cardiovascular y el pronóstico de los pacientes con COVID-19, que guardan mayor relación con las enfermedades cardiovasculares y son las más relevantes para el tratamiento de los pacientes ingresados

Although the risk of death is generally low in patients with SARS-CoV-2 infection, 15-20% of those infected experience lung disease with a varying degree of systemic involvement, which is referred to as coronavirus disease 2019 (COVID-19) and is associated with higher mortality. From the first patient series reported, myocardial damage has been observed in many individuals with COVID-19 and has been linked to an increased risk of death. This review summarizes current knowledge about cardiovascular disease and prognosis in patients with COVID-19, with a particular emphasis on different cardiovascular conditions and on the treatment of hospitalized patients

Humanos , Masculino , Feminino , Pessoa de Meia-Idade , Idoso , Idoso de 80 Anos ou mais , Infecções por Coronavirus/complicações , Pneumonia Viral/complicações , Pandemias , Doenças Cardiovasculares/virologia , Doenças Cardiovasculares/mortalidade , Prognóstico
Rev. esp. cardiol. Supl. (Ed. impresa) ; 20(supl.E): 40-42, dic. 2020.
Artigo em Espanhol | IBECS | ID: ibc-195346


En diciembre de 2019, se detectaron en China los primeros casos de una neumonía cuyo agente causante se identificó como un nuevo coronavirus, el SARS-CoV-2. Dicho virus causa la enfermedad COVID-19, cuyas virulencia y capacidad de transmision, junto con la ausencia de vacuna o de un tratamiento especifico, han condicionado un impacto sin precedentes en los sistemas sanitarios. La COVID-19 puede producir una afección grave en el sistema cardiovascular. Los pacientes con factores de riesgo cardiovascular o con una enfermedad cardiovascular subyacente son poblaciones particularmente vulnerables, con un riesgo muy elevado de sufrir complicaciones y muerte. Sin embargo, se ha tenido que asistir a dichos pacientes con una evidencia científica inexistente o muy escasa. En este suplemento se analizan la Fisiopatología de la COVID-19, los mecanismos directos e indirectos de la afección cardiovascular y los diversos tipos de complicaciones cardiovasculares. Asimismo se resumen los documentos que la SEC elaboro para dar una respuesta practica a la compleja situación asistencial generada. También se describen las futuras formas de la reorganizacion ambulatoria, principalmente mediante telemedicina, para dar continuidad asistencial. Para terminar, se analizan los diferentes tipos de tratamientos farmacológicos utilizados y sus posibles interacciones. El presente suplemento, con una serie de artículos elaborados por autores de prestigio, resume el conocimiento actual sobre dicha enfermedad y aporta datos e Información de gran valor práctico

In December 2019, clinicians in China first observed cases of pneumonia whose cause was identified as a new coronavirus, SARS-CoV-2. This virus causes COVID-19 disease, which has a virulence and transmission rate that, coupled with the absence of a vaccine or specific treatment, has had an unprecedented impact on health systems. COVID-19 can cause serious cardiovascular disease. Patients with cardiovascular risk factors or with an underlying cardiovascular condition form a particularly vulnerable population with a very high risk of complications and death. However, these patients had to be treated on the basis of very limited or nonexistent scientific evidence. This supplement discusses the pathophysiology of COVID-19, the direct and indirect mechanisms of associated cardiovascular disease, and the different types of cardiovascular complications that can occur. It also summarizes Spanish Society of Cardiology publications that have been produced to provide a practical response to the resulting complex health-care situation. In addition, the supplement describes how outpatient care can be reorganized in the future to ensure continuity of care, principally through telemedicine. Finally, the different types of pharmacological treatment available are discussed, along with their potential interactions. This supplement, which contains a series of articles prepared by influential authors, summarizes current knowledge about this disease and provides data and Información of great practical value

Humanos , Doenças Cardiovasculares/fisiopatologia , Doenças Cardiovasculares/virologia , Infecções por Coronavirus/complicações , Pneumonia Viral/complicações , Pandemias , Inibidores da Enzima Conversora de Angiotensina/uso terapêutico , Infecções por Coronavirus/tratamento farmacológico , Assistência Ambulatorial/normas , Sociedades Médicas
Emergencias (Sant Vicenç dels Horts) ; 32(6): 386-394, dic. 2020. tab, graf
Artigo em Espanhol | IBECS | ID: ibc-195733


OBJETIVO: Analizar las revisitas y los factores asociados a la misma en pacientes con diagnóstico de posible COVID-19 dados de alta de un servicio de urgencias hospitalario (SUH). MÉTODO: Estudio observacional, retrospectivo que incluyó pacientes consecutivos que consultaron al SUH en un periodo de 2 meses y fueron diagnosticados de posible de COVID-19. Se analizaron variables clínico-epidemiológicas, tratamiento administrado en urgencias, destino final, revisita al SUH y motivo de esta. Se hizo un análisis comparativo entre ambos grupos (revisita sí/no) y se identificaron factores asociados a la revisita. RESULTADOS: Se incluyeron 2.378 pacientes (edad media 57 años; 49% mujeres). De los pacientes dados de alta (39% del total; n = 925), 170 (20,5%) reconsultaron al SUH, principalmente por persistencia o progresión de síntomas, y 66(38,8%) precisaron ingreso. Los factores relacionados con la revisita fueron: antecedentes de enfermedad reumatológica [OR: 2,97 (IC 95%: 1,10-7,99, p = 0,03)], síntomas digestivos [OR: 1,73 (IC 95%: 1,14-2,63, p = 0,01)], frecuencia respiratoria>=20 [OR: 1,03 (IC 95%: 1,0-1,06, p = 0,05)] y haber recibido tratamiento con esteroides en urgencias[OR: 7,78 (IC 95%: 1,77-14,21, p = 0,01)]. Los factores asociados al ingreso en la revisita fueron la edad>=48 años[OR: 2,57 (IC 95%: 1,42-4,67, p = 0,002)] y presentar fiebre [OR: 4,73 (IC 95%: 1,99-11,27, p = 0,001)]. CONCLUSIÓN: Los pacientes con posible COVID-19 menores de 48 años, sin comorbilidad y con signos vitales normales podrían ser dados de alta desde urgencias sin temor a sufrir complicaciones. Los antecedentes de enfermedad reumatológica, fiebre, sintomas digestivos, frecuencia respiratoria>=20/min o necesidad de tratamiento con esteroides fueron factores independientes de revisita, y la fiebre y edad>=48 años de necesidad de ingreso

OBJECTIVE: To analyze emergency department (ED) revisits from patients discharged with possible coronavirus disease2019 (COVID-19). METHODS: Retrospective observational study of consecutive patients who came to the ED over a period of 2 monthsand were diagnosed with possible COVID-19. We analyzed clinical and epidemiologic variables, treatments given inthe ED, discharge destination, need to revisit, and reasons for revisits. Patients who did or did not revisit werecompared, and factors associated with revisits were explored. RESULTS: The 2378 patients included had a mean age of 57 years; 49% were women. Of the 925 patients (39%) discharged, 170 (20.5%) revisited the ED, mainly for persistence or progression of symptoms. Sixty-six (38.8%) were hospitalized. Odds ratios (ORs) for the following factors showed an association with revisits: history of rheumatologic disease (OR, 2.97; 95% CI, 1.10-7.99;P= .03), digestive symptoms (OR, 1.73; 95% CI, 1.14-2.63;P= .01), respiratory rate over 20 breaths per minute (OR, 1.03; 95% CI, 1.0-1.06;P = .05), and corticosteroid therapy given in the ED (OR, 7.78; 95% CI, 1.77-14.21,P= .01). Factors associated with hospitalization after revisits were age over 48 years (OR, 2.57; 95% CI, 1 42-4.67;P= .002) and fever (OR, 4.73; 95% CI, 1.99-11.27;P= .001). CONCLUSIONS: Patients under the age of 48 years without comorbidity and with normal vitals can be discharged from the ED without fear of complications. A history of rheumatologic disease, fever, digestive symptoms, and a respiratory rate over 20 breaths per minute, or a need for corticosteroid therapy were independently associated with revisits. Fever and age over 48 years were associated with a need for hospitalization

Humanos , Masculino , Feminino , Adulto , Pessoa de Meia-Idade , Idoso , Infecções por Coronavirus/terapia , Pneumonia Viral/terapia , Serviço Hospitalar de Emergência , Alta do Paciente/normas , Readmissão do Paciente/estatística & dados numéricos , Infecções por Coronavirus/complicações , Infecções por Coronavirus/diagnóstico , Pneumonia Viral/complicações , Pneumonia Viral/diagnóstico , Razão de Chances , Estudos Retrospectivos , Fatores de Risco , Medição de Risco
Neurología (Barc., Ed. impr.) ; 35(9): 0-0, nov.-dic. 2020. tab
Artigo em Espanhol | IBECS | ID: ibc-194160


INTRODUCTION: The elderly population is the group most threatened by COVID-19, with the highest mortality rates. This study aims to analyse the case fatality of COVID-19 in a cohort of patients with degenerative dementia. METHODS: We conducted a descriptive case-control study of a sample of patients diagnosed with primary neurodegenerative dementia. RESULTS: Twenty-four of the 88 patients with COVID-19 included in the study died: 10/23 (43.4%) patients diagnosed with dementia and 14/65 (21.5%) controls; this difference was statistically significant. DISCUSSION: Our results suggest that case fatality of COVID-19 is significantly higher among patients with primary degenerative dementia than in other patients with similar mean ages and comorbidities

INTRODUCCIÓN: La población anciana es la más amenazada por COVID-19, con mayores tasas de mortalidad. El objetivo de este trabajo es analizar la letalidad en una cohorte de pacientes de COVID-19 con demencia degenerativa. MÉTODOS: Hicimos un estudio descriptivo de casos-control de una muestra de pacientes diagnosticados con demencias neurodegenerativas primarias. RESULTADOS: De los 88 pacientes incluidos en el estudio, 24 pacientes con COVID-19 fallecieron: 10/23 (43,4%) eran pacientes con diagnóstico de demencia y 14/65 (21,5%) pacientes del grupo control, una diferencia estadísticamente significativa. DISCUSIÓN: La letalidad entre los pacientes con demencia degenerativa primaria por COVID-19 es significativamente mayor en comparación con otros pacientes con edades medias y comorbilidades similares, según nuestro estudio

Humanos , Masculino , Feminino , Idoso , Idoso de 80 Anos ou mais , Doenças Neurodegenerativas/mortalidade , Doenças Neurodegenerativas/virologia , Infecções por Coronavirus/mortalidade , Pneumonia Viral/complicações , Pneumonia Viral/mortalidade , Pandemias , Demência/virologia , Estudos de Casos e Controles , Fatores de Risco