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1.
BMC Pregnancy Childbirth ; 20(1): 580, 2020 Oct 02.
Artigo em Inglês | MEDLINE | ID: mdl-33008308

RESUMO

BACKGROUND: During the ongoing global outbreak of COVID-19, pregnant women who are susceptible to COVID-19 should be highly concerned. The issue of vertical transmission and the possibility of neonatal infection is a major concern. CASE PRESENTATION: Case 1: A 35-year-old pregnant woman with a gestational age of 37 weeks and 6 days was admitted to our hospital at the point of giving birth. Except for the abnormalities in her chest CT image, she was asymptomatic. She had an uncomplicated spontaneous vaginal delivery, and her infant was discharged home for isolation. Because of the positive result of the maternal swabs for SARS-CoV-2 obtained on the 2nd day after sampling, we transferred the mother to the designated hospital and followed up with her by telephone interviews. Luckily, it was confirmed on February 23 that the newborn did not develop any COVID-19 symptoms after observation for 14 days after birth. Case 2: Another pregnant woman, with a gestational age of 38 weeks and 2 days, was also admitted to our hospital because of spontaneous labor with cervical dilation of 5 cm. Since she had the typical manifestations of COVID-19, including cough, lymphopenia, and abnormal chest CT images, she was highly suspected of having COVID-19. Based on the experience from case 1, we helped the mother deliver a healthy baby by vaginal delivery. On the 2nd day after delivery, the maternal nasopharyngeal swab result was positive, while the infant's result was negative. CONCLUSION: There is still insufficient evidence supporting maternal-fetal vertical transmission for COVID-19-infected mothers in late pregnancy, and vaginal delivery may not increase the possibility of neonatal infection.


Assuntos
Infecções Assintomáticas , Infecções por Coronavirus/diagnóstico , Parto Obstétrico/métodos , Pulmão/diagnóstico por imagem , Pneumonia Viral/diagnóstico , Complicações Infecciosas na Gravidez/diagnóstico , Adulto , Antibacterianos/uso terapêutico , Antivirais/uso terapêutico , Betacoronavirus , Aleitamento Materno , Técnicas de Laboratório Clínico , Infecções por Coronavirus/terapia , Tosse , Medicamentos de Ervas Chinesas/uso terapêutico , Feminino , Idade Gestacional , Humanos , Linfopenia , Máscaras , Oxigenoterapia , Pandemias , Isolamento de Pacientes , Equipamento de Proteção Individual , Pneumonia Viral/terapia , Reação em Cadeia da Polimerase , Gravidez , Complicações Infecciosas na Gravidez/terapia , Testes Sorológicos , Tomografia Computadorizada por Raios X
2.
J Breath Res ; 14(4): 041003, 2020 10 02.
Artigo em Inglês | MEDLINE | ID: mdl-33006317

RESUMO

We hypothesized that most patients with severe pulmonary COVID-19 were exposed to cough aerosols. Among patients that were almost 100% certain which person infected them, only 14 out of 38 overall, and 9 out of 25 hospitalized patients requiring supplemental oxygen, were infected by someone who coughed, which did not support our hypothesis. Talking, especially with a loud voice, could be an alternative source generating SARS-CoV-2 aerosols. Further research is needed to determine how SARS-CoV-2 spreads. Avoiding to talk when you are not wearing your mask and not talking with a loud voice, 'voice etiquette', could be other public health interventions worthwhile exploring.


Assuntos
Aerossóis , Infecções por Coronavirus/diagnóstico , Infecções por Coronavirus/etiologia , Tosse/complicações , Pneumonia Viral/diagnóstico , Pneumonia Viral/etiologia , Betacoronavirus , Humanos , Pandemias
3.
Artigo em Chinês | MEDLINE | ID: mdl-33040502

RESUMO

Objective:To observe the secondary prevention efficacy of subcutaneous immunotherapy in children with allergic rhinitis(AR) and cough variant asthma(CVA) and to analyze its effect on the levels of serum sIgG4, IL-27 and IL-33. Method:The clinical data of 112 children aged 5-12 years with AR and CVA were retrospectively analyzed and divided into control group(52 cases) and SCIT group(60 cases). The patients were followed up for 3 years. The control group was received symptomatic treatment only, and the SCIT group was received SCIT on the basis of the control group. The numbers of cases of the two groups of children who produced new allergens and developed CA were analyze during the 3-year treatment. Changes in serum sIgG4, IL-27, IL-33 levels, TNSS, DCSS, NCSS, TRMS, TCMS, VAS score, and FEV1% before and after treatment were analyzed. Result:During the treatment, 4 patients(6.67%) in the SCIT group produced the new allergen, and 20 patients(38.46%) in the control group(χ²=16.73, P<0.05). There were only 3 cases(5.00%) in the SCIT group, which developed into CA, while 15 cases(28.85%) in the control group. The difference between the groups was statistically significant(χ²=11.74, P<0.05). Compared with baseline, serum levels of sIgG4 and IL-27 in both groups were significantly increased after 3 years of treatment(P<0.05), while serum levels of IL-33 were significantly decreased(P<0.05). After 3 years of treatment, serum levels of sIgG4 and IL-27 in the SCIT group were significantly higher than those in the control group, and serum levels of IL-33 were significantly lower than those in the control group(P<0.05). Compared with baseline, TNSS, DCSS, NCSS, TRMS, TCMS, VAS, and FEV1% in both groups were significantly improved at 1, 2, and 3 years of treatment(P<0.05). There was no significant difference in TNSS, DCSS, NCSS, TRMS, TCMS, VAS and FEV1% between the two groups at baseline(P>0.05), while after 1, 2 and 3 years of treatment the above indicators in the SCIT group were significantly better than those in the control group(P<0.05). Conclusion:SCIT treatment can prevent AR with CVA patients from producing new allergens and developing into CA, and improve serum sIgG4 and IL-27 and IL-33 levels.


Assuntos
Asma , Interleucina-27 , Rinite Alérgica , Asma/terapia , Criança , Pré-Escolar , Tosse , Humanos , Imunoterapia , Injeções Subcutâneas , Interleucina-33 , Estudos Retrospectivos , Rinite Alérgica/terapia , Prevenção Secundária
4.
J Breath Res ; 14(4): 042003, 2020 10 06.
Artigo em Inglês | MEDLINE | ID: mdl-33021206

RESUMO

Diagnosis of SARS-COV-2 infection (COVID-19) is currently based on detection of the viral RNA in nasopharyngeal swab samples by reverse transcription polymerase chain reaction (RT-PCR). However, sampling via nasopharyngeal swabs frequently provokes sneezing or coughing, which results in increased risk of the viral dissemination and environmental contamination. Furthermore, the sensitivity associated with the PCR tests s limited to 60%-70%, which is mainly attributable to technical deficiency in sampling. Given that the disease is transmitted via exhaled aerosol and droplets, and that the exhaled breath condensate (EBC) is the established modality for sampling exhaled aerosol, detection of the viral RNA in EBC is a promising approach for safe and efficient diagnosis of the disease. Subjects are those patients who are diagnosed with COVID-19 by positive nasopharyngeal swab PCR test and admitted to Saitama Medical Center, Japan. EBC samples will be collected using an R-tube® or R-tubeVent® device. Collected EBC samples will be introduced into a nucleic acid purifier. The purified nucleic acids will undergo amplification through RT-PCR for detection and quantification of SARS-COV-2 RNA. To date we have collected eight samples from seven subjects. Among them, two samples from two subjects tested positive for SARS-COV-2 RNA by the RT-PCR. Reflecting the second wave of COVID-19 prevalence in Japan, new admissions of COVID-19 patients to the Saitama Medical Center are increasing, and we are expecting to collect at least 50 EBC samples from 25 patients before the end of this year.


Assuntos
Testes Respiratórios/instrumentação , Infecções por Coronavirus/diagnóstico , Pneumonia Viral/diagnóstico , Reação em Cadeia da Polimerase Via Transcriptase Reversa/métodos , Aerossóis/análise , Betacoronavirus , Técnicas de Laboratório Clínico , Tosse , Expiração , Humanos , Japão , Pandemias , RNA Viral/análise , Projetos de Pesquisa , Manejo de Espécimes , Carga Viral
6.
Pan Afr Med J ; 36: 167, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32952811

RESUMO

Coronavirus disease 2019 (COVID-19) has been reported as the possible cause of acute myocarditis. Myocarditis is an inflammatory heart disease mostly caused by viral infections. Cytomegalovirus (CMV) primary infection is often not suspected as a cause of myocarditis in immune-competent adults. We report the case of a 37-year-old male admitted with fever, cough and dyspnea. Chest CT showed typical ground-glass changes indicative of viral pneumonia. He was tested negative for COVID-19 but had biological markers that made us still suspect it. He had elevated troponin I level (up to 111.5 ng/mL) and diffuse myocardial dyskinesia along with a decreased left ventricular ejection fraction (LVEF). He was diagnosed with CMV myocarditis with cardiac insufficiency and totally recovered without antiviral therapy. During the COVID-19 pandemic patients may develop myocarditis, still every myocarditis is not a COVID infection. Myocarditis linked to CMV infection may be rare, but life-threatening.


Assuntos
Infecções por Coronavirus/diagnóstico , Infecções por Citomegalovirus/diagnóstico , Miocardite/diagnóstico , Pneumonia Viral/diagnóstico , Técnicas de Laboratório Clínico , Infecções por Coronavirus/epidemiologia , Tosse/etiologia , Infecções por Citomegalovirus/virologia , Diagnóstico Diferencial , Dispneia/etiologia , Febre/etiologia , Humanos , Masculino , Pessoa de Meia-Idade , Miocardite/diagnóstico por imagem , Miocardite/virologia , Pandemias , Pneumonia Viral/epidemiologia , Tomografia Computadorizada por Raios X
7.
BMC Infect Dis ; 20(1): 688, 2020 Sep 21.
Artigo em Inglês | MEDLINE | ID: mdl-32957928

RESUMO

BACKGROUND: The outbreak of coronavirus disease 2019 (COVID-19) caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is currently the peak season of common respiratory viral infections. However, the clinical symptoms of most SARS-CoV-2 infected patients are not significantly different from those of common respiratory viral infections. Therefore, knowing the epidemiological patterns of common respiratory viruses may be valuable to improve the diagnostic and therapeutic efficacy of patients with suspected COVID-19, especially in Southwest China (a mild epidemic area). METHODS: A total of 2188 patients with clinically suspected of COVID-19 in Southwest China were recruited from January 21 to February 29, 2020. Nasopharyngeal swabs, throat swabs and sputum specimens were collected to detect SARS-CoV-2 by using real-time reverse transcription-polymerase chain reaction (RT-PCR) and other 12 viruses via PCR fragment analysis combined with capillary electrophoresis. Clinical characteristics and laboratory test findings were acquired from electronic medical records. All data were analyzed to unravel the epidemiological patterns. RESULTS: Only 1.1% (24/2188) patients with suspected COVID-19 were eventually confirmed to have SARS-CoV-2 infection, and the most frequently observed symptoms were fever (75.0%, 18/24) and cough (20.8%, 5/24). The overall detection rate of other respiratory pathogens was 10.3% (226/2188). Among them, human rhinovirus (3.2%, 71/2188), human parainfluenza viruses (1.6%, 35/2188), influenza B virus (1.2%, 26/2188) and mycoplasma pneumonia (1.2%, 26/2188) were the predominantly detected pathogens in this study. Moreover, the co-infection was observed in 22 specimens. Notably, one COVID-19 case had a coexisting infection with human parainfluenza virus (4.2%, 1/24) and bocavirus was the most common virus tending to occur in co-infection with other respiratory pathogens. CONCLUSIONS: This study reveals the epidemiological features of common respiratory viruses and their clinical impact during the ongoing outbreak of COVID-19 in a mild epidemic area. The findings highlight the importance of understanding the transmission patterns of the common respiratory virus in COVID-19 regions, which can provide information support for the development of appropriate treatment plans and health policies, while eliminating unnecessary fear and tension.


Assuntos
Betacoronavirus/isolamento & purificação , Infecções por Coronavirus/epidemiologia , Infecções por Coronavirus/virologia , Pneumonia Viral/epidemiologia , Pneumonia Viral/virologia , Sistema Respiratório/virologia , Infecções Respiratórias/virologia , Adulto , China/epidemiologia , Coinfecção/epidemiologia , Tosse/virologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Pandemias , Reação em Cadeia da Polimerase em Tempo Real , Estudos Retrospectivos , Adulto Jovem
8.
BMC Infect Dis ; 20(1): 640, 2020 Aug 31.
Artigo em Inglês | MEDLINE | ID: mdl-32867706

RESUMO

BACKGROUND: The COVID-19 pandemic has affected the world deeply, with more than 14,000,000 people infected and nearly 600,000 deaths. This review aimed to summarize the epidemiologic traits, clinical spectrum, CT results and laboratory findings of the COVID-19 pandemic. METHODS: We scoped for relevant literatures published during 1st December 2019 to 16th July 2020 based on three databases using English and Chinese languages. We reviewed and analyzed the relevant outcomes. RESULTS: The COVID-19 pandemic was found to have a higher transmission rate compared to SARS and MERS and involved 4 stages of evolution. The basic reproduction number (R0) is 3.32 (95% CI:3.24-3.39), the incubation period was 5.24 days (95% CI:3.97-6.50, 5 studies) on average, and the average time for symptoms onset varied by countries. Common clinical spectrums identified included fever (38.1-39.0 °C), cough and fatigue, with Acute Respiratory Distress Syndrome (ARDS) being the most common complication reported. Body temperatures above 39.0 °C, dyspnea, and anorexia were more common symptoms in severe patients. Aged over 65 years old, having co-morbidities, and developing complications were the commonest high-risk factors associated with severe conditions. Leucopenia and lymphopenia were the most common signs of infection while liver and kidney damage were rare but may cause bad outcomes for patients. The bilateral, multifocal Ground-Glass Opacification (GGO) on peripheral, and the consolidative pulmonary opacity were the most frequent CT results and the tendency of mortality rates differed by region. CONCLUSIONS: We provided a bird's-eye view of the COVID-19 during the current pandemic, which will help better understanding the key traits of the disease. The findings could be used for disease's future research, control and prevention.


Assuntos
Betacoronavirus/fisiologia , Infecções por Coronavirus/epidemiologia , Linfopenia/epidemiologia , Pandemias , Pneumonia Viral/epidemiologia , Síndrome do Desconforto Respiratório do Adulto/epidemiologia , Fatores Etários , Idoso , Comorbidade , Infecções por Coronavirus/mortalidade , Infecções por Coronavirus/patologia , Infecções por Coronavirus/transmissão , Tosse/epidemiologia , Demografia , Progressão da Doença , Dispneia/epidemiologia , Fadiga/epidemiologia , Feminino , Febre/epidemiologia , Humanos , Laboratórios , Masculino , Pneumonia Viral/mortalidade , Pneumonia Viral/patologia , Pneumonia Viral/transmissão , Fatores de Risco , Fatores Sexuais , Tomografia Computadorizada por Raios X
9.
Zhong Nan Da Xue Xue Bao Yi Xue Ban ; 45(7): 790-796, 2020 Jul 28.
Artigo em Inglês, Chinês | MEDLINE | ID: mdl-32879082

RESUMO

OBJECTIVES: To analyze the clinical characteristics of 71 patients with coronavirus disease 2019 (COVID-19). METHODS: The general data, epidemiological data, laboratory tests, imaging examinations, and treatment of 71 patients with COVID-19 admitted to the Sixth People's Hospital of Zhengzhou from January 19, 2020 to March 3, 2020 were retrospectively analyzed. RESULTS: Of the 71 COVID-19 patients, the ages were 4-84 (41.29±15.21) years, 38 (53.5%) patients were male, 33 (46.5%) were female, and 52 (73.2%) were in 22 clusters. The main clinical manifestations were fever (78.9%), cough (64.8%), and sputum (38.0%). The fever was mainly low and moderate, with 49 patients (69.0%) at 37.3-39.0 ℃. Most of the leukocytes, neutrophils, and lymphocytes were normal, accounting for 47 (66.2%), 51 (71.8%), and 51 (71.8%) patients, respectively; a few of them were decreased, accounting for 21 (29.6%), 16 (22.5%), and 20 (28.2%) patients, respectively. There were 38 (53.5%) and 31 (43.7%) patients with the decreased CD4+ and CD8+ T cell counts, respectively. There were 41 (57.7%), 38 (53.5%), 32 (45.1%), 26(36.6%), 22 (31.0%), 20 (28.2%), 14 (19.7%), 14 (19.7%), and 9 (12.7%) patients with the increased levels of C-reactive protein, erythrocyte sedimentation rate, procalcitonin, fibrinogen,interleukin 6, lactate dehydrogenase,D-dimer,alanine aminotransferase, and aspartate aminotransferase, respectively. Of the 71 patients, the lung was involved in 60 (84.5%) patients, the double lung was involved in 47 (66.2%) patients, and the single lung was involved in 13 (18.3%) patients. The course of the disease was long, and the time from symptom onset to the second severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) nucleic acid negative transformation was (17.22±6.34) days.There were no significant differences in the incubation period (t=-0.453, P>0.05), the complicates (χ2=0.042, P>0.05), and the time from symptom onset to diagnosis (t=-1.330, P>0.05) in patients between the non-severe group and the severe group. The onset age, gender, SARS-CoV-2 nucleic acid negative time, lymphocyte count, D-dimer, C-reactive protein, total bilirubin, direct bilirubin, lactate dehydrogenase, calcium ion, CD4+ T cell count, CD8+ T cell count, calcitonin, procalcitonin, and troponin were significantly different between the severe group and the non-severe group (all P<0.05). Among the 71 patients, 4 (5.6%) patients were mild, 59 (83.1%) were normal, and 8 (11.3%) were severe or critical. CONCLUSIONS: The aggregation phenomenon of COVID-19 is obvious. Fever and cough are the main clinical manifestations. White blood cells, neutrophils, and lymphocytes in the most patients in the early onset are normal. Most COVID-19 patients are light and ordinary type, with good prognosis.


Assuntos
Infecções por Coronavirus/diagnóstico , Infecções por Coronavirus/fisiopatologia , Pneumonia Viral/diagnóstico , Pneumonia Viral/fisiopatologia , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Betacoronavirus , Criança , Pré-Escolar , China , Tosse/virologia , Feminino , Febre/virologia , Humanos , Contagem de Leucócitos , Masculino , Pessoa de Meia-Idade , Pandemias , Estudos Retrospectivos , Adulto Jovem
11.
BMC Infect Dis ; 20(1): 662, 2020 Sep 09.
Artigo em Inglês | MEDLINE | ID: mdl-32907540

RESUMO

BACKGROUND: The outbreak of the novel coronavirus (COVID-19) that was firstly reported in Wuhan, China, with cases now confirmed in more than 100 countries. However, COVID-19 pneumonia with spontaneous pneumothorax is unknown. CASE PRESENTATION: We reported a case of 66-year-old man infected with COVID-19, presenting with fever, cough and myalgia; The patient received supportive and empirical treatment including antiviral treatment, anti-inflammatory treatment, oxygen supply and inhalation therapy; The symptoms, CT images, laboratory results got improved after the treatments, and a throat swab was negative for COVID-19 PCR test; However, on the hospital day 30, the patient presented with a sudden chest pain and dyspnea. CT showed a 30-40% left-sided pneumothorax. Immediate thoracic closed drainage was performed and his dyspnea was rapidly improved. With five more times negative PCR tests for SARS-CoV-2 virus, the patient was discharged and home quarantine. CONCLUSION: This case highlights the importance for clinicians to pay attention to the appearance of spontaneous pneumothorax, especially patients with severe pulmonary damage for a long course, as well as the need for early image diagnose CT and effective treatment once pneumothorax occurs.


Assuntos
Betacoronavirus , Infecções por Coronavirus/complicações , Pneumonia Viral/complicações , Pneumotórax/complicações , Idoso , Betacoronavirus/patogenicidade , Dor no Peito/complicações , Infecções por Coronavirus/terapia , Infecções por Coronavirus/virologia , Tosse/complicações , Drenagem , Dispneia/complicações , Febre/complicações , Humanos , Masculino , Pandemias , Alta do Paciente , Pneumonia Viral/terapia , Pneumonia Viral/virologia , Pneumotórax/terapia
12.
BMJ Open ; 10(9): e041079, 2020 09 16.
Artigo em Inglês | MEDLINE | ID: mdl-32938604

RESUMO

OBJECTIVES: Our research question was: what are the most frequent baseline clinical characteristics in adult patients with COVID-19? Our major aim was to identify common baseline clinical features that could help recognise adult patients at high risk of having COVID-19. DESIGN: We conducted a scoping review of all the evidence available at LitCovid, until 23 March 2020. SETTING: Studies conducted in any setting and any country were included. PARTICIPANTS: Studies had to report the prevalence of sociodemographic characteristics, symptoms and comorbidities specifically in adults with a diagnosis of infection by SARS-CoV-2. RESULTS: In total, 1572 publications were published on LitCovid. We have included 56 articles in our analysis, with 89% conducted in China and 75% containing inpatients. Three studies were conducted in North America and one in Europe. Participants' age ranged from 28 to 70 years, with balanced gender distribution. The proportion of asymptomatic cases were from 2% to 79%. The most common reported symptoms were fever (4%-99%), cough (4%-92%), dyspnoea/shortness of breath (1%-90%), fatigue (4%-89%), myalgia (3%-65%) and pharyngalgia (2%-61%), while regarding comorbidities, we found cardiovascular disease (1%-40%), hypertension (0%-40%) and cerebrovascular disease (1%-40%). Such heterogeneity impaired the conduction of meta-analysis. CONCLUSIONS: The infection by COVID-19 seems to affect people in a very diverse manner and with different characteristics. With the available data, it is not possible to clearly identify those at higher risk of being infected with this condition. Furthermore, the evidence from countries other than China is, at the moment, too scarce.


Assuntos
Infecções Assintomáticas/epidemiologia , Infecções por Coronavirus/fisiopatologia , Tosse/fisiopatologia , Dispneia/fisiopatologia , Fadiga/fisiopatologia , Febre/fisiopatologia , Pneumonia Viral/fisiopatologia , Betacoronavirus , Doenças Cardiovasculares/epidemiologia , Transtornos Cerebrovasculares/epidemiologia , Comorbidade , Infecções por Coronavirus/epidemiologia , Humanos , Hipertensão/epidemiologia , Mialgia/fisiopatologia , Pandemias , Faringite/fisiopatologia , Pneumonia Viral/epidemiologia
13.
Epidemiol Infect ; 148: e218, 2020 09 21.
Artigo em Inglês | MEDLINE | ID: mdl-32951624

RESUMO

'Recurrence' of coronavirus disease 2019 (COVID-19) has triggered numerous discussions of scholars at home and abroad. A total of 44 recurrent cases of COVID-19 and 32 control cases admitted from 11 February to 29 March 2020 to Guanggu Campus of Tongji Hospital affiliated to Tongji Medical College Huazhong University of Science and Technology were enrolled in this study. All the 44 recurrent cases were classified as mild to moderate when the patients were admitted for the second time. The gender and mean age in both cases (recurrent and control) were similar. At least one concomitant disease was observed in 52.27% recurrent cases and 34.38% control cases. The most prevalent comorbidity among them was hypertension. Fever and cough being the most prevalent clinical symptoms in both cases. On comparing both the cases, recurrent cases had markedly elevated concentrations of alanine aminotransferase (ALT) (P = 0.020) and aspartate aminotransferase (AST) (P = 0.007). Moreover, subgroup analysis showed mild to moderate abnormal concentrations of ALT and AST in recurrent cases. The elevated concentrations of ALT and AST may be recognised as predictive markers for the risk of 'recurrence' of COVID-19, which may provide insights into the prevention and control of COVID-19 in the future.


Assuntos
Alanina Transaminase/sangue , Aspartato Aminotransferases/sangue , Infecções por Coronavirus/enzimologia , Pneumonia Viral/enzimologia , Estudos de Casos e Controles , Tosse , Feminino , Febre , Humanos , Masculino , Pessoa de Meia-Idade , Pandemias , Recidiva , Estudos Retrospectivos , Fatores de Risco
14.
J Korean Med Sci ; 35(37): e333, 2020 Sep 21.
Artigo em Inglês | MEDLINE | ID: mdl-32959547

RESUMO

BACKGROUND: There is limited information on the clinical characteristics of patients with coronavirus disease 2019 (COVID-19) who are asymptomatic or have mild symptoms. METHODS: We performed a retrospective case series of patients with COVID-19 enrolled from February 22 to March 26, 2020. Forty cases of COVID-19 were confirmed using real-time reverse-transcription polymerase chain reaction among patients who underwent screening tests and were consecutively hospitalized at Ulsan University Hospital, Ulsan, Korea. The final follow-up date was May 19, 2020. All COVID-19 cases in Ulsan were included. Demographic and epidemiological information, comorbidities, clinical signs and symptoms, laboratory and radiologic findings, medications, treatments, outcomes, and main durations of patients with COVID-19 were compared according to supplemental oxygen requirement. RESULTS: Forty patients were included (median age, 30 years; interquartile range [IQR], 25-57 years; 58% female). Six (15%) patients required supplemental oxygen. The prevalence of asymptomatic severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) infection was 5% and that of presymptomatic infection was 13%. Cough, fever, myalgia, rhinorrhea or nasal congestion, and diarrhea were the screening criteria for diagnosing symptomatic and presymptomatic SARS-CoV-2 infections. Sputum production, chest discomfort, a large number of symptoms, abnormal procalcitonin and C-reactive protein levels, and abnormal chest X-ray or chest computed tomography findings were more common in patients requiring supplemental oxygen than in those not requiring supplemental oxygen. Overall mortality rate was 3% (1/40). Four patients (10%) were readmitted after testing positive by reverse-transcription polymerase chain reaction again. Incubation period was 5 days (IQR, 4-6 days), and the duration of viral shedding was 21 days (IQR, 14-28 days; maximum, 51 days). CONCLUSION: The prevalence of asymptomatic SARS-CoV-2 infection was 5%, which is much lower than that previously reported. This finding suggests that careful interviews and follow-ups should be performed to identify SARS-CoV-2 infections. Cough, fever, myalgia, rhinorrhea or nasal congestion, and diarrhea are adequate screening criteria for covering all symptoms of SARS-CoV-2 infection. Further evaluation is required to create representative screening criteria for COVID-19.


Assuntos
Infecções Assintomáticas/epidemiologia , Infecções por Coronavirus/epidemiologia , Pneumonia Viral/epidemiologia , Adulto , Idoso , Betacoronavirus , Comorbidade , Tosse/epidemiologia , Diarreia/epidemiologia , Feminino , Febre/epidemiologia , Hospitalização , Humanos , Coreia (Geográfico)/epidemiologia , Masculino , Pessoa de Meia-Idade , Mialgia/epidemiologia , Pandemias , Prevalência , Reação em Cadeia da Polimerase em Tempo Real , Estudos Retrospectivos , Avaliação de Sintomas , Resultado do Tratamento
15.
BMJ Open ; 10(9): e039424, 2020 09 22.
Artigo em Inglês | MEDLINE | ID: mdl-32963071

RESUMO

OBJECTIVE: We examined the ability of fabrics which might be used to create home-made face masks to filter out ultrafine (0.02-0.1 µm) particles at the velocity of adult human coughing. METHODS: Twenty commonly available fabrics and materials were evaluated for their ability to reduce air concentrations of ultrafine particles at coughing face velocities. Further assessment was made on the filtration ability of selected fabrics while damp and of fabric combinations which might be used to construct home-made masks. RESULTS: Single fabric layers blocked a range of ultrafine particles. When fabrics were layered, a higher percentage of ultrafine particles were filtered. The average filtration efficiency of single layer fabrics and of layered combination was found to be 35% and 45%, respectively. Non-woven fusible interfacing, when combined with other fabrics, could add up to 11% additional filtration efficiency. However, fabric and fabric combinations were more difficult to breathe through than N95 masks. CONCLUSIONS: The current coronavirus pandemic has left many communities without access to N95 face masks. Our findings suggest that face masks made from layered common fabric can help filter ultrafine particles and provide some protection for the wearer when commercial face masks are unavailable.


Assuntos
Infecções por Coronavirus/transmissão , Tosse , Máscaras/provisão & distribução , Teste de Materiais , Material Particulado , Pneumonia Viral/transmissão , Têxteis , Filtros de Ar , Betacoronavirus , Celulose , Infecções por Coronavirus/prevenção & controle , Fibra de Algodão , Humanos , Nylons , Pandemias/prevenção & controle , Pneumonia Viral/prevenção & controle , Poliésteres , Poliuretanos , Dispositivos de Proteção Respiratória/provisão & distribução , Fibra de Lã
16.
Sci Rep ; 10(1): 15665, 2020 09 24.
Artigo em Inglês | MEDLINE | ID: mdl-32973285

RESUMO

The COVID-19 pandemic triggered a surge in demand for facemasks to protect against disease transmission. In response to shortages, many public health authorities have recommended homemade masks as acceptable alternatives to surgical masks and N95 respirators. Although mask wearing is intended, in part, to protect others from exhaled, virus-containing particles, few studies have examined particle emission by mask-wearers into the surrounding air. Here, we measured outward emissions of micron-scale aerosol particles by healthy humans performing various expiratory activities while wearing different types of medical-grade or homemade masks. Both surgical masks and unvented KN95 respirators, even without fit-testing, reduce the outward particle emission rates by 90% and 74% on average during speaking and coughing, respectively, compared to wearing no mask, corroborating their effectiveness at reducing outward emission. These masks similarly decreased the outward particle emission of a coughing superemitter, who for unclear reasons emitted up to two orders of magnitude more expiratory particles via coughing than average. In contrast, shedding of non-expiratory micron-scale particulates from friable cellulosic fibers in homemade cotton-fabric masks confounded explicit determination of their efficacy at reducing expiratory particle emission. Audio analysis of the speech and coughing intensity confirmed that people speak more loudly, but do not cough more loudly, when wearing a mask. Further work is needed to establish the efficacy of cloth masks at blocking expiratory particles for speech and coughing at varied intensity and to assess whether virus-contaminated fabrics can generate aerosolized fomites, but the results strongly corroborate the efficacy of medical-grade masks and highlight the importance of regular washing of homemade masks.


Assuntos
Infecções por Coronavirus/prevenção & controle , Infecções por Coronavirus/transmissão , Máscaras , Pandemias/prevenção & controle , Pneumonia Viral/prevenção & controle , Pneumonia Viral/transmissão , Prevenção Primária/métodos , Dispositivos de Proteção Respiratória , Adolescente , Adulto , Aerossóis , Betacoronavirus , Tosse/virologia , Expiração , Feminino , Filtração/instrumentação , Humanos , Exposição por Inalação , Masculino , Pessoa de Meia-Idade , Prevenção Primária/instrumentação , Adulto Jovem
17.
Zhongguo Yi Xue Ke Xue Yuan Xue Bao ; 42(4): 566-569, 2020 Aug 30.
Artigo em Chinês | MEDLINE | ID: mdl-32895113

RESUMO

The ganglioneuroma is a benign tumor originating from sympathetic ganglion cells.It often locates in the posterior mediastinum,retroperitoneum,and adrenal medulla.The intraspinal ganglioneuromas is relatively rare in clinical practice,which mainly locates in the cervical and thoracolumbar segments.A patient with main symptom of cough was examined by magnetic resonance imaging before operation in our center.Intraspinal ganglioneuromas was confirmed in the left intervertebral cavity area.Total resection of the tumor via the posterior median approach was performed.HE staining showed the mature ganglion cells were scattered.The patient was followed up for three months and no tumor recurrence occured.


Assuntos
Tosse/etiologia , Ganglioneuroma , Ganglioneuroma/complicações , Humanos , Imagem por Ressonância Magnética , Neurônios , Coloração e Rotulagem
18.
Rev Peru Med Exp Salud Publica ; 37(2): 253-258, 2020.
Artigo em Espanhol, Inglês | MEDLINE | ID: mdl-32876213

RESUMO

In order to describe manifestations from patients with coronavirus disease 2019 (COVID-19), sociodemographic variables such as, previous medical history, clinical and radiological manifestations, treatments and evolution of patients were evaluated. This took place from March 6th to 25th, 2020, in the "Edgardo Rebagliati Martins" National Hospital in Lima. Seventeen patients were registered: 76% were male, with an average age of 53.5 years (range 25-94); 23.5% had returned from abroad; 41.2% were referred from other health facilities; 41.2% were admitted to mechanical ventilation; 29.4% (5 patients) died. The risk factors detected were: advanced age, arterial hypertension and obesity. The main symptoms detected were: cough, fever and dyspnea. Frequent laboratory findings were: elevated C-reactive protein and lymphopenia. The predominant radiological presentation was bilateral interstitial lung infiltrate. A first experience in the management of patients diagnosed with severe COVID-19 in Peru is reported.


Assuntos
Infecções por Coronavirus/fisiopatologia , Hospitalização , Pneumonia Viral/fisiopatologia , Respiração Artificial , Adulto , Idoso , Idoso de 80 Anos ou mais , Infecções por Coronavirus/mortalidade , Infecções por Coronavirus/terapia , Tosse/epidemiologia , Tosse/etiologia , Dispneia/epidemiologia , Dispneia/etiologia , Feminino , Febre/epidemiologia , Febre/etiologia , Humanos , Masculino , Pessoa de Meia-Idade , Pandemias , Peru , Pneumonia Viral/mortalidade , Pneumonia Viral/terapia , Estudos Retrospectivos , Fatores de Risco , Índice de Gravidade de Doença
19.
Med. clín (Ed. impr.) ; 155(5): 202-204, sept. 2020. tab
Artigo em Espanhol | IBECS | ID: ibc-188495

RESUMO

ANTECEDENTES Y OBJETIVO: La pandemia por Covid-19 afecta especialmente a pacientes con cáncer con mayor incidencia y mortalidad según series publicadas de focos originales de pandemia. El estudio pretende conocer la mortalidad en nuestro centro por covid-19 en pacientes con cáncer durante las primeras3 semanas de epidemia. MATERIAL Y MÉTODOS: Se han revisado los pacientes con cáncer fallecidos por covid-19 durante el periodo de análisis describiendo las características oncológicas, de la infección por covid-19 y de los tratamientos instaurados. RESULTADOS: Casos confirmados covid-19: 1069 con 132 fallecimientos (12,3%). Con cáncer 36 pacientes (3.4%), 15 fallecidos (41,6%). De los fallecidos solo6 pacientes (40%) se encontraban en tratamiento activo. El tumor más frecuente asociado fue pulmón (8/15 pacientes, 53,3%), 11 con enfermedad metastásica (11/15, 73,3%). El 40% (6/15) no recibió tratamiento específico contra covid-19, el resto fue tratado con los protocolos activos. CONCLUSIÓN: La mortalidad por covid-19 en pacientes con cáncer casi cuadriplica la de la población general. Hasta disponer de tratamientos eficaces o una vacuna efectiva la única posibilidad de proteger a nuestros pacientes es impedir el contagio con las medidas adecuadas


BACKGROUND AND OBJECTIVE: The Covid-19 pandemic especially affects cancer patients with higher incidence and mortality according to published series of original pandemic foci. The study aims to determine the mortality in our center due to covid-19 in cancer patients during the first 3 weeks of the epidemic. MATERIAL AND METHODS: The cancer patients who died of covid-19 during the analysis period have been reviewed describing the oncological and the covid-19 infection characteristics and the treatments established. RESULTS: Confirmed cases covid-19: 1069 with 132 deaths (12.3%). With cancer 36 patients (3.4%), 15 deceased (41.6%). Of the deceased, only 6 patients (40%) were in active treatment. The most frequent associated tumor was lung (8/15 patients, 53.3%), 11 with metastatic disease (11/15, 73.3%). No specific treatment wasestablished in 40 % (6/15) of the patients. The rest of them received treatments with the active protocols. CONCLUSION: Covid-19 mortality in cancer patients is almost four times higher than that of the general population. Until we have effective treatments or an effective vaccine, the only possibility to protect our patients is to prevent the infection with the appropriate measures


Assuntos
Humanos , Masculino , Feminino , Adulto , Pessoa de Meia-Idade , Idoso , Idoso de 80 Anos ou mais , Infecções por Coronavirus/mortalidade , Neoplasias/epidemiologia , Comorbidade , Neoplasias/complicações , Febre/complicações , Tosse/complicações , Dispneia/complicações , Hidroxicloroquina/administração & dosagem , Lopinavir/administração & dosagem , Azitromicina/administração & dosagem , Antineoplásicos/administração & dosagem , Unidades de Terapia Intensiva/estatística & dados numéricos
20.
J Med Internet Res ; 22(10): e20509, 2020 10 02.
Artigo em Inglês | MEDLINE | ID: mdl-32936770

RESUMO

BACKGROUND: In December 2019, the COVID-19 outbreak started in China and rapidly spread around the world. Lack of a vaccine or optimized intervention raised the importance of characterizing risk factors and symptoms for the early identification and successful treatment of patients with COVID-19. OBJECTIVE: This study aims to investigate and analyze biomedical literature and public social media data to understand the association of risk factors and symptoms with the various outcomes observed in patients with COVID-19. METHODS: Through semantic analysis, we collected 45 retrospective cohort studies, which evaluated 303 clinical and demographic variables across 13 different outcomes of patients with COVID-19, and 84,140 Twitter posts from 1036 COVID-19-positive users. Machine learning tools to extract biomedical information were introduced to identify mentions of uncommon or novel symptoms in tweets. We then examined and compared two data sets to expand our landscape of risk factors and symptoms related to COVID-19. RESULTS: From the biomedical literature, approximately 90% of clinical and demographic variables showed inconsistent associations with COVID-19 outcomes. Consensus analysis identified 72 risk factors that were specifically associated with individual outcomes. From the social media data, 51 symptoms were characterized and analyzed. By comparing social media data with biomedical literature, we identified 25 novel symptoms that were specifically mentioned in tweets but have been not previously well characterized. Furthermore, there were certain combinations of symptoms that were frequently mentioned together in social media. CONCLUSIONS: Identified outcome-specific risk factors, symptoms, and combinations of symptoms may serve as surrogate indicators to identify patients with COVID-19 and predict their clinical outcomes in order to provide appropriate treatments.


Assuntos
Infecções por Coronavirus/fisiopatologia , Aprendizado de Máquina , Pneumonia Viral/fisiopatologia , Mídias Sociais , Antivirais/uso terapêutico , Betacoronavirus , Infecções por Coronavirus/epidemiologia , Infecções por Coronavirus/terapia , Tosse/fisiopatologia , Coleta de Dados , Diarreia/fisiopatologia , Surtos de Doenças , Dispneia/fisiopatologia , Fadiga/fisiopatologia , Febre/fisiopatologia , Cefaleia/fisiopatologia , Humanos , Mialgia/fisiopatologia , Oxigenoterapia , Pandemias , Pneumonia Viral/epidemiologia , Pneumonia Viral/terapia , Publicações , Estudos Retrospectivos , Fatores de Risco
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