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1.
Ars pharm ; 61(2): 63-79, abr.-jun. 2020. tab, ilus, graf
Artigo em Espanhol | IBECS | ID: ibc-188101

RESUMO

INTRODUCCIÓN: En diciembre de 2019, se detectaron los primeros casos de enfermedad respiratoria causada por un coronavirus emergente, al que se denominó SARS-CoV-2, que en los primeros meses de 2020 se ha extendido por todo el mundo con características de pandemia. MÉTODO: Se examinaron las publicaciones más relevantes en relación con los objetivos de la revisión. RESULTADOS: La enfermedad, conocida como COVID-19, cursa con tos, fiebre y dificultad respiratoria. Las formas más graves, que afectan principalmente a personas de edad avanzada y con determinadas comorbilidades, se manifiestan por afectación de la función respiratoria, que requiere ventilación mecánica, y síndrome de respuesta inflamatoria sistémica, que puede conducir a un choque séptico con fallo multiorgánico, y altas tasas de mortalidad. En esta revisión se examina el estado actual de conocimientos sobre las características y origen del SARS-CoV-2, su replicación, y la patogénesis, clínica, diagnóstico, tratamiento y prevención de COVID-19. CONCLUSIONES: Las características del SARS-CoV-2 y la clínica de COVID-19 son bien conocidas. La PCR es la técnica de referencia para el diagnóstico de laboratorio; se dispone de ensayos para detección de antígenos y de anticuerpos, con margen de optimización. Los protocolos de tratamiento incluyen la corrección de la respuesta inflamatoria sistémica y administración de agentes antivirales. Existen vacunas en desarrollo


INTRODUCTION: In December 2019, the first cases of respiratory disease caused by an emerging coronavirus were detected. The causative agento f the outbreak was called SARS-CoV-2, and in the first months of 2020 it spread throughout the world as a pandemic. METHOD: The most relevant publications concerned with the aims of the review were examined. RESULTS: The disease, known as COVID-19. Patients show cough, fever, and respiratory distress. The most severe forms, mainly affecting the elderly and associated with various comorbidities, are manifested by impaired respiratory function, requiring mechanical ventilation, and systemic inflammatory response syndrome, which can lead to septic shock with multi-organ failure and high mortality rates. This review examines the current state of knowledge about the characteristics and origin of SARS-CoV-2, its replication, and the pathogenesis, clinical, diagnosis, treatment, and prevention of COVID-19. CONCLUSIONS: The characteristics of SARS-CoV-2 and the clinical manifestations of COVID-19 are well known. PCR is the reference technique for laboratory diagnosis; assays for the detection of antigens and antibodies are available, with optimization possibilities. Treatment protocols include attenuation of the systemic inflammatory response and administration of antiviral agents. There are vaccines in development


Assuntos
Humanos , Infecções por Coronavirus , Pneumonia Viral , Betacoronavirus/patogenicidade , Pandemias , Infecções por Coronavirus/diagnóstico , Infecções por Coronavirus/prevenção & controle , Infecções por Coronavirus/terapia , Pneumonia Viral/diagnóstico , Pneumonia Viral/prevenção & controle , Pneumonia Viral/terapia
2.
Recurso na Internet em Português | LIS - Localizador de Informação em Saúde | ID: lis-LISBR1.1-47374

RESUMO

Este mapa apresenta uma visão geral da evidência sobre a aplicação das MTCI com base na caracterização de 125 estudos de revisão e estudos clínicos controlados, distribuídos em uma matriz com 57 intervenções sobre uma série de desfechos clínicos agrupados em 3 categorias: Melhora da imunidade/efeito antiviral para vírus respiratórios; Manejo complementar dos sintomas de infecções respiratórias; e Contribuições à Saúde Mental/Emocional em situações de trauma. As intervenções representam especialmente medicamentos fitoterápicos, medicina e terapias tradicionais chinesas, terapias mente-corpo como meditação e yoga, probióticos e outros suplementos nutricionais além de formulações dinamizadas da homeopatia.


Assuntos
Betacoronavirus , Pneumonia Viral/prevenção & controle , Pneumonia Viral/epidemiologia , Pneumonia Viral/terapia , Infecções por Coronavirus/epidemiologia , Infecções por Coronavirus/terapia , Infecções por Coronavirus/prevenção & controle , Pandemias/prevenção & controle , Resultado do Tratamento , Medicina Baseada em Evidências/métodos , Medicina Tradicional Chinesa/métodos
3.
Recurso na Internet em Espanhol | LIS - Localizador de Informação em Saúde | ID: lis-LISBR1.1-47375

RESUMO

Este mapa presenta una visión general sobre posibles contribuciones de las MTCI a varias dimensiones de la pandemia por COVID-19. Dichas contribuciones se organizaron en tres categorías: Mejora de la inmunidad y efecto antiviral ante diferentes virus respiratorios; tratamiento complementario de los síntomas de las infecciones respiratorias; y salud mental en situaciones de crisis. Para el mapa se caracterizaron 125 estudios de revisión y estudios clínicos controlados, distribuidos en una matriz con 57 intervenciones para las tres categorías mencionadas. Las intervenciones representan especialmente medicinas herbales/ fitoterapia, medicina tradicional china, terapias de cuerpo-mente como la meditación y el yoga, probióticos y otros suplementos nutricionales además de formulaciones de homeopatía.


Assuntos
Betacoronavirus , Pneumonia Viral/prevenção & controle , Pneumonia Viral/epidemiologia , Pneumonia Viral/terapia , Infecções por Coronavirus/epidemiologia , Infecções por Coronavirus/terapia , Infecções por Coronavirus/prevenção & controle , Pandemias/prevenção & controle , Resultado do Tratamento , Medicina Baseada em Evidências/métodos , Medicina Tradicional Chinesa/métodos
4.
Recurso na Internet em Inglês | LIS - Localizador de Informação em Saúde | ID: lis-LISBR1.1-47376

RESUMO

This map presents an overview of the evidence on the application of TCIM based on the characterization of 125 review studies and controlled clinical studies distributed in a matrix with 57 interventions on a series of clinical outcomes grouped into 3 major categories: Improved immunity/antiviral effect for respiratory viruses; Complementary management of symptoms of respiratory infections; and Mental health. The interventions represent especially herbal medicines, traditional Chinese medicine and therapies, mind-body therapies like meditation and yoga, probiotics and other nutritional supplements besides homeopathy formulations.


Assuntos
Betacoronavirus , Pneumonia Viral/prevenção & controle , Pneumonia Viral/epidemiologia , Pneumonia Viral/terapia , Infecções por Coronavirus/epidemiologia , Infecções por Coronavirus/terapia , Infecções por Coronavirus/prevenção & controle , Pandemias/prevenção & controle , Resultado do Tratamento , Medicina Baseada em Evidências/métodos , Medicina Tradicional Chinesa/métodos
6.
J Korean Med Sci ; 35(18): e176, 2020 May 11.
Artigo em Inglês | MEDLINE | ID: mdl-32383371

RESUMO

The global fight against coronavirus disease 2019 (COVID-19) is largely based on strategies to boost immune responses to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and prevent its severe course and complications. The human defence may include antibodies which interact with SARS-CoV-2 and neutralize its aggressive actions on multiple organ systems. Protective cross-reactivity of antibodies against measles and other known viral infections has been postulated, primarily as a result of the initial observations of asymptomatic and mild COVID-19 in children. Uncontrolled case series have demonstrated virus-neutralizing effect of convalescent plasma, supporting its efficiency at early stages of contracting SARS-CoV-2. Given the variability of the virus structure, the utility of convalescent plasma is limited to the geographic area of its preparation, and for a short period of time. Intravenous immunoglobulin may also be protective in view of its nonspecific antiviral and immunomodulatory effects. Finally, human monoclonal antibodies may interact with some SARS-CoV-2 proteins, inhibiting the virus-receptor interaction and prevent tissue injury. The improved understanding of the host antiviral responses may help develop safe and effective immunotherapeutic strategies against COVID-19 in the foreseeable future.


Assuntos
Infecções por Coronavirus/terapia , Coronavirus , Imunoglobulinas Intravenosas/uso terapêutico , Pneumonia Viral/terapia , Anticorpos Antivirais/sangue , Betacoronavirus , Infecções por Coronavirus/tratamento farmacológico , Infecções por Coronavirus/epidemiologia , Humanos , Imunização Passiva , Pandemias , Pneumonia Viral/epidemiologia
7.
Basic Res Cardiol ; 115(4): 36, 2020 05 12.
Artigo em Inglês | MEDLINE | ID: mdl-32399655

RESUMO

There are no definitive therapies for patients with severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) infection. Therefore, new therapeutic strategies are needed to improve clinical outcomes, particularly in patients with severe disease. This case series explores the safety and effectiveness of intravenous allogeneic cardiosphere-derived cells (CDCs), formulated as CAP-1002, in critically ill patients with confirmed coronavirus disease 2019 (COVID-19). Adverse reactions to CAP-1002, clinical status on the World Health Organization (WHO) ordinal scale, and changes in pro-inflammatory biomarkers and leukocyte counts were analyzed. All patients (n = 6; age range 19-75 years, 1 female) required ventilatory support (invasive mechanical ventilation, n = 5) with PaO2/FiO2 ranging from 69 to 198. No adverse events related to CAP-1002 administration were observed. Four patients (67%) were weaned from respiratory support and discharged from the hospital. One patient remains mechanically ventilated as of April 28th, 2020; all survive. A contemporaneous control group of critically ill COVID-19 patients (n = 34) at our institution showed 18% overall mortality at a similar stage of hospitalization. Ferritin was elevated in all patients at baseline (range of all patients 605.43-2991.52 ng/ml) and decreased in 5/6 patients (range of all patients 252.89-1029.90 ng/ml). Absolute lymphocyte counts were low in 5/6 patients at baseline (range 0.26-0.82 × 103/µl) but had increased in three of these five patients at last follow-up (range 0.23-1.02 × 103/µl). In this series of six critically ill COVID-19 patients, intravenous infusion of CAP-1002 was well tolerated and associated with resolution of critical illness in 4 patients. This series demonstrates the apparent safety of CAP-1002 in COVID-19. While this initial experience is promising, efficacy will need to be further assessed in a randomized controlled trial.


Assuntos
Terapia Baseada em Transplante de Células e Tecidos , Ensaios de Uso Compassivo , Infecções por Coronavirus/terapia , Miocárdio/citologia , Pneumonia Viral/terapia , Células-Tronco/citologia , Idoso , Betacoronavirus , Biomarcadores/sangue , Estado Terminal/terapia , Feminino , Ferritinas/sangue , Humanos , Infusões Intravenosas , Los Angeles , Contagem de Linfócitos , Masculino , Pessoa de Meia-Idade , Pandemias , Adulto Jovem
8.
Euro Surveill ; 25(18)2020 05.
Artigo em Inglês | MEDLINE | ID: mdl-32400362

RESUMO

Data on features of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in children and adolescents are scarce. We report preliminary results of an Italian multicentre study comprising 168 laboratory-confirmed paediatric cases (median: 2.3 years, range: 1 day-17.7 years, 55.9% males), of which 67.9% were hospitalised and 19.6% had comorbidities. Fever was the most common symptom, gastrointestinal manifestations were frequent; two children required intensive care, five had seizures, 49 received experimental treatments and all recovered.


Assuntos
Doença Crônica/epidemiologia , Coinfecção/epidemiologia , Infecções por Coronavirus/diagnóstico , Coronavirus/isolamento & purificação , Pandemias/prevenção & controle , Pneumonia Viral/diagnóstico , Adolescente , Antivirais/uso terapêutico , Betacoronavirus , Criança , Pré-Escolar , Técnicas de Laboratório Clínico , Coinfecção/virologia , Comorbidade , Infecções por Coronavirus/epidemiologia , Infecções por Coronavirus/terapia , Diarreia/etiologia , Surtos de Doenças , Fezes/virologia , Feminino , Febre/etiologia , Hospitais Pediátricos , Humanos , Hospedeiro Imunocomprometido , Lactente , Recém-Nascido , Itália/epidemiologia , Masculino , Ventilação não Invasiva/métodos , Pneumonia Viral/epidemiologia , Pneumonia Viral/terapia , Inibidores de Proteases/uso terapêutico , Estudos Retrospectivos , Síndrome Respiratória Aguda Grave/diagnóstico , Síndrome Respiratória Aguda Grave/epidemiologia , Síndrome Respiratória Aguda Grave/terapia , Resultado do Tratamento
9.
Scand J Trauma Resusc Emerg Med ; 28(1): 37, 2020 May 13.
Artigo em Inglês | MEDLINE | ID: mdl-32404141

RESUMO

The COVID-19 crisis is an unprecedented event. It is therefore essential for dispatch centres to share their experiences while the crisis is underway, similar to hospitals, so that we will all benefit from feedback.This letter to the editor describes the Lausanne dispatch centre response to COVID-19 and the lessons learned so far.


Assuntos
Infecções por Coronavirus/terapia , Despacho de Emergência Médica , Pneumonia Viral/terapia , Infecções por Coronavirus/epidemiologia , Humanos , Pandemias , Pneumonia Viral/epidemiologia
10.
Eur J Med Res ; 25(1): 16, 2020 May 13.
Artigo em Inglês | MEDLINE | ID: mdl-32404189

RESUMO

The rapid spread of the corona virus pandemic is an existential problem for many people in numerous countries. So far, there is no effective vaccine protection or proven therapy available against the SARS-CoV-2 virus. In this review, we describe the role of passive immunization in times of the corona virus. Passive immunization could be a bridging technology to improve the immune defense of critically ill patients until better approaches with effective medications are available.


Assuntos
Betacoronavirus/imunologia , Infecções por Coronavirus/imunologia , Infecções por Coronavirus/terapia , Imunização Passiva , Pneumonia Viral/imunologia , Pneumonia Viral/terapia , Humanos , Imunização Passiva/tendências , Pandemias
11.
Can Fam Physician ; 66(5): 332-334, 2020 05.
Artigo em Inglês | MEDLINE | ID: mdl-32404451

RESUMO

Question Coronavirus disease 2019 (COVID-19) is affecting millions of people worldwide. It seems that it affects mostly adults older than 40 years of age, and the death rate is highest for older individuals in the population. What should I tell parents worried about their children contracting the coronavirus (SARS-CoV-2) causing COVID-19, and what symptoms should I look for to determine if there is a need to test for the virus?Answer The COVID-19 global pandemic affects all ages. Severe respiratory manifestations have been the mainstay of illness in adults, with what seems to be rapid deterioration necessitating mechanical ventilation. Only 5% of those tested and found to have COVID-19 have been younger than 19 years, possibly owing to limited testing, as the symptoms in children are usually mild. Symptoms in children include fever, dry cough, rhinorrhea, sore throat, and fatigue, and in 10% diarrhea or vomiting. Rarely dyspnea or hypoxemia were also described. Blood tests and imaging have been shown to be of little value in children and should only be ordered for those in whom you would normally order these investigations for viral-like illness. No specific therapy is available and supportive care with rest, fluids, and antipyretics for children is the recommended approach. Ibuprofen or acetaminophen for fever and pain can be given. Antiviral and immunomodulatory treatment is not recommended at this time for otherwise healthy children, and corticosteroids should also not be used. Children with immunocompromised states should be isolated and avoid contact with others.


Assuntos
Infecções por Coronavirus/epidemiologia , Infecções por Coronavirus/terapia , Saúde Global , Pandemias , Pneumonia Viral/epidemiologia , Pneumonia Viral/terapia , Criança , Serviços de Saúde da Criança , Técnicas de Laboratório Clínico , Infecções por Coronavirus/diagnóstico , Infecções por Coronavirus/fisiopatologia , Humanos , Pais/psicologia , Pneumonia Viral/diagnóstico , Pneumonia Viral/fisiopatologia , Avaliação de Sintomas
12.
Front Med ; 14(2): 232-248, 2020 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-32405974

RESUMO

Coronavirus disease 2019 (COVID-19) is a highly contagious disease and a serious threat to human health. COVID-19 can cause multiple organ dysfunction, such as respiratory and circulatory failure, liver and kidney injury, disseminated intravascular coagulation, and thromboembolism, and even death. The World Health Organization reports that the mortality rate of severe-type COVID-19 is over 50%. Currently, the number of severe cases worldwide has increased rapidly, but the experience in the treatment of infected patients is still limited. Given the lack of specific antiviral drugs, multi-organ function support treatment is important for patients with COVID-19. To improve the cure rate and reduce the mortality of patients with severe- and critical-type COVID-19, this paper summarizes the experience of organ function support in patients with severe- and critical-type COVID-19 in Optical Valley Branch of Tongji Hospital, Wuhan, China. This paper systematically summarizes the procedures of functional support therapies for multiple organs and systems, including respiratory, circulatory, renal, hepatic, and hematological systems, among patients with severe- and critical-type COVID-19. This paper provides a clinical reference and a new strategy for the optimal treatment of COVID-19 worldwide.


Assuntos
Betacoronavirus , Infecções por Coronavirus/terapia , Pneumonia Viral/terapia , Antivirais/uso terapêutico , Infecções por Coronavirus/tratamento farmacológico , Humanos , Oxigenoterapia , Pandemias , Respiração
13.
MMWR Morb Mortal Wkly Rep ; 69(19): 606-610, 2020 May 15.
Artigo em Inglês | MEDLINE | ID: mdl-32407303

RESUMO

On March 17, 2020, a member of a Skagit County, Washington, choir informed Skagit County Public Health (SCPH) that several members of the 122-member choir had become ill. Three persons, two from Skagit County and one from another area, had test results positive for SARS-CoV-2, the virus that causes coronavirus disease 2019 (COVID-19). Another 25 persons had compatible symptoms. SCPH obtained the choir's member list and began an investigation on March 18. Among 61 persons who attended a March 10 choir practice at which one person was known to be symptomatic, 53 cases were identified, including 33 confirmed and 20 probable cases (secondary attack rates of 53.3% among confirmed cases and 86.7% among all cases). Three of the 53 persons who became ill were hospitalized (5.7%), and two died (3.7%). The 2.5-hour singing practice provided several opportunities for droplet and fomite transmission, including members sitting close to one another, sharing snacks, and stacking chairs at the end of the practice. The act of singing, itself, might have contributed to transmission through emission of aerosols, which is affected by loudness of vocalization (1). Certain persons, known as superemitters, who release more aerosol particles during speech than do their peers, might have contributed to this and previously reported COVID-19 superspreading events (2-5). These data demonstrate the high transmissibility of SARS-CoV-2 and the possibility of superemitters contributing to broad transmission in certain unique activities and circumstances. It is recommended that persons avoid face-to-face contact with others, not gather in groups, avoid crowded places, maintain physical distancing of at least 6 feet to reduce transmission, and wear cloth face coverings in public settings where other social distancing measures are difficult to maintain.


Assuntos
Betacoronavirus/isolamento & purificação , Infecções por Coronavirus/epidemiologia , Infecções por Coronavirus/transmissão , Surtos de Doenças , Pneumonia Viral/epidemiologia , Pneumonia Viral/transmissão , Canto , Adulto , Idoso , Idoso de 80 Anos ou mais , Infecções por Coronavirus/mortalidade , Infecções por Coronavirus/terapia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Pandemias , Pneumonia Viral/mortalidade , Pneumonia Viral/terapia , Fatores de Risco , Washington/epidemiologia
14.
J Exp Med ; 217(6)2020 06 01.
Artigo em Inglês | MEDLINE | ID: mdl-32353870

RESUMO

The novel 2019 strain of coronavirus is a source of profound morbidity and mortality worldwide. Compared with recent viral outbreaks, COVID-19 infection has a relatively high mortality rate, the reasons for which are not entirely clear. Furthermore, treatment options for COVID-19 infection are currently limited. In this Perspective, we explore the contributions of the innate and adaptive immune systems to both viral control as well as toxicity during COVID-19 infections and offer suggestions to both understand and therapeutically modulate anti-COVID immunity.


Assuntos
Betacoronavirus/imunologia , Infecções por Coronavirus/imunologia , Pneumonia Viral/imunologia , Imunidade Adaptativa/efeitos dos fármacos , Imunidade Adaptativa/imunologia , Betacoronavirus/efeitos dos fármacos , Betacoronavirus/patogenicidade , Infecções por Coronavirus/patologia , Infecções por Coronavirus/terapia , Síndrome da Liberação de Citocina/imunologia , Síndrome da Liberação de Citocina/patologia , Síndrome da Liberação de Citocina/terapia , Humanos , Hipóxia/patologia , Hipóxia/terapia , Imunidade Inata/efeitos dos fármacos , Imunidade Inata/imunologia , Inflamação/imunologia , Inflamação/patologia , Inflamação/terapia , Interleucina-6/antagonistas & inibidores , Interleucina-6/imunologia , Linfopenia/imunologia , Linfopenia/patologia , Linfopenia/terapia , Macrófagos/imunologia , Macrófagos/patologia , Coronavírus da Síndrome Respiratória do Oriente Médio/imunologia , Coronavírus da Síndrome Respiratória do Oriente Médio/patogenicidade , Pandemias , Pneumonia Viral/patologia , Pneumonia Viral/terapia , Respiração Artificial , Síndrome do Desconforto Respiratório do Adulto/patologia , Síndrome do Desconforto Respiratório do Adulto/terapia , Vírus da SARS/imunologia , Vírus da SARS/patogenicidade
16.
Enferm Intensiva ; 31(2): 82-89, 2020.
Artigo em Inglês, Espanhol | MEDLINE | ID: mdl-32360022

RESUMO

In January 2020, the Chinese authorities identified a new virus of the Coronaviridae family as the cause of several cases of pneumonia of unknown aetiology. The outbreak was initially confined to Wuhan City, but then spread outside Chinese borders. On 31 January 2020, the first case was declared in Spain. On 11 March 2020, The World Health Organization (WHO) declared the coronavirus outbreak a pandemic. On 16 March 2020, there were 139 countries affected. In this situation, the Scientific Societies SEMICYUC and SEEIUC, have decided to draw up this Contingency Plan to guide the response of the Intensive Care Services. The objectives of this plan are to estimate the magnitude of the problem and identify the necessary human and material resources. This is to provide the Spanish Intensive Medicine Services with a tool to programme optimal response strategies.


Assuntos
Infecções por Coronavirus/epidemiologia , Infecções por Coronavirus/terapia , Cuidados Críticos/organização & administração , Pandemias , Pneumonia Viral/epidemiologia , Pneumonia Viral/terapia , Humanos , Espanha/epidemiologia
17.
J Investig Med High Impact Case Rep ; 8: 2324709620925571, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32370558

RESUMO

The coronavirus disease-2019 (COVID-19) is an infectious disease caused by severe acute respiratory syndrome-coronavirus-2 (SARS-CoV-2) that has significant potential cardiovascular implications for patients. These include myocarditis, acute coronary syndromes, cardiac arrhythmias, cardiomyopathies with heart failure and cardiogenic shock, and venous thromboembolic events. We describe a Caribbean-Black gentleman with COVID-19 infection presenting with atrial arrhythmias, namely, atrial flutter and atrial fibrillation, which resolved with rate and rhythm control strategies, and supportive care.


Assuntos
Fibrilação Atrial/diagnóstico , Infecções por Coronavirus/diagnóstico , Pneumonia Viral/diagnóstico , Fibrilação Atrial/diagnóstico por imagem , Fibrilação Atrial/etiologia , Fibrilação Atrial/terapia , Betacoronavirus , Infecções por Coronavirus/complicações , Infecções por Coronavirus/diagnóstico por imagem , Infecções por Coronavirus/terapia , Humanos , Masculino , Pessoa de Meia-Idade , Pandemias , Pneumonia Viral/complicações , Pneumonia Viral/diagnóstico por imagem , Pneumonia Viral/terapia , Tórax/diagnóstico por imagem
18.
Epidemiol Infect ; 148: e94, 2020 05 06.
Artigo em Inglês | MEDLINE | ID: mdl-32374248

RESUMO

Coronavirus disease 2019 (COVID-19) patients were classified into four clinical stages (uncomplicated illness, mild, severe and critical pneumonia) depending on disease severity. We aim to investigate the corresponding clinical, radiological and laboratory characteristics between different clinical stages. A retrospective, single-centre study of 101 confirmed patients with COVID-19 at Renmin Hospital of Wuhan University from 2 January to 28 January 2020 was enrolled; follow-up endpoint was on 8 February 2020. Clinical data were collected and compared during the course of illness. The median age of the 101 patients was 51.0 years and 33.6% were medical staff. Fever (68%), cough (50%) and fatigue (23%) are the most common symptoms. About 26% patients underwent the mechanical ventilation and 98% patients were treated with antibiotics. Thirty-seven per cent patients were cured and 11 died. On admission, the number of patients with uncomplicated illness, mild, severe and critical pneumonia were 2 [2%], 86 [85%], 11 [11%] and 2 [2%]. Forty-four of the 86 mild pneumonia progressed to severe illness within 4 days, with nine patients worsened due to critical pneumonia within 4 days. Two of the 11 severe patients improved to mild condition while three others deteriorated. Significant differences were observed among groups of different clinical stages in numbers of influenced pulmonary segments (6 vs. 12 vs. 17, P < 0.001). A significantly upward trend was witnessed in ground-glass opacities overlapped with striped shadows (33% vs. 42% vs. 55% vs. 80%, P < 0.001), while pure ground-glass opacities gradually decreased as disease progressed (45% vs. 35% vs. 24% vs. 13%, P < 0.001) within 12 days. Lymphocytes, prealbumin and albumin showed a downtrend as disease progressed from mild to severe or critical condition, an uptrend was found in white blood cells, C-reactive protein, neutrophils and lactate dehydrogenase. The proportions of serum amyloid A > 300 mg/l in mild, severe and critical conditions were 18%, 46% and 71%, respectively.


Assuntos
Infecções por Coronavirus/fisiopatologia , Infecções por Coronavirus/terapia , Pneumonia Viral/fisiopatologia , Pneumonia Viral/terapia , Adulto , China/epidemiologia , Infecções por Coronavirus/epidemiologia , Feminino , Indicadores Básicos de Saúde , Humanos , Masculino , Pessoa de Meia-Idade , Pandemias , Pneumonia Viral/epidemiologia , Prognóstico , Índice de Gravidade de Doença
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