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1.
Emerg Microbes Infect ; 11(1): 168-171, 2022 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-34907853

RESUMO

HCoV-OC43 is one of the mildly pathogenic coronaviruses with high infection rates in common population. Here, 43 HCoV-OC43 related cases with pneumonia were reported, corresponding genomes of HCoV-OC43 were obtained. Phylogenetic analyses based on complete genome, orf1ab and spike genes revealed that two novel genotypes of HCoV-OC43 have emerged in China. Obvious recombinant events also can be detected in the analysis of the evolutionary dynamics of novel HCoV-OC43 genotypes. Estimated divergence time analysis indicated that the two novel genotypes had apparently independent evolutionary routes. Efforts should be conducted for further investigation of genomic diversity and evolution analysis of mildly pathogenic coronaviruses.


Assuntos
Resfriado Comum/epidemiologia , Infecções por Coronavirus/epidemiologia , Coronavirus Humano OC43/genética , Genoma Viral , Genótipo , Pneumonia Viral/epidemiologia , Sequência de Bases , Teorema de Bayes , Criança , Criança Hospitalizada , Pré-Escolar , China/epidemiologia , Resfriado Comum/patologia , Resfriado Comum/transmissão , Resfriado Comum/virologia , Infecções por Coronavirus/patologia , Infecções por Coronavirus/transmissão , Infecções por Coronavirus/virologia , Coronavirus Humano OC43/classificação , Coronavirus Humano OC43/patogenicidade , Monitoramento Epidemiológico , Feminino , Humanos , Lactente , Masculino , Método de Monte Carlo , Mutação , Filogenia , Pneumonia Viral/patologia , Pneumonia Viral/transmissão , Pneumonia Viral/virologia , Recombinação Genética
2.
Am J Otolaryngol ; 43(1): 103230, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-34537504

RESUMO

PURPOSE: Tracheostomy is an aerosol-generating procedure, thus performing it during the COVID-19 pandemic arises considerations such as the most appropriate timing and the patients to whom it is suitable. Medical teams lack sufficient data to assist determining whether or not to conduct tracheostomy, its short- and long-term implications are not fully understood. This study aims to shed light on the critically ill COVID-19 patients that require tracheostomy, and to investigate its value. METHODS: A retrospective multicentral case-control study of 157 hospitalized critically ill COVID-19 patients, among whom 30 patients went through tracheostomy and consisted of our study group. RESULTS: The mean age was similar between study and control groups (68.9 ± 12.7 years vs 70.5 ± 15.8 years, p = 0.57), as well as comorbidity prevalence (56.7% vs 67.7%, p = 0.25). Patients in the study group were hospitalized for longer duration until defined critically ill (5 ± 4.3 vs 3 ± 3.9 days; p = 0.01), until admitted to the intensive care unit (6 ± 6.6 vs 2.5 ± 3.7 days respectively; p = 0.005), and until discharged (24 ± 9.7 vs 10.7 ± 9.1 days, p < 0.001). Mortality rate was lower in the study group (30% vs 59.8%, p = 0.003). Kaplan Meier survival analysis revealed a statistically significant difference in survival time between groups (Log rank chi-sq = 20.91, p < 0.001) with mean survival time of 41 ± 3.1 days vs 21 ± 2.2 days. Survival was significantly longer in the study group (OR = 0.37, p = 0.004). CONCLUSION: Tracheostomy allows for more prolonged survival for gradually deteriorating critically ill COVID-19 patients. This should be integrated into the medical teams' considerations when debating whether or not to conduct tracheostomy.


Assuntos
COVID-19/terapia , Estado Terminal/terapia , Pneumonia Viral/terapia , Traqueostomia , Idoso , COVID-19/mortalidade , Estado Terminal/mortalidade , Feminino , Humanos , Tempo de Internação/estatística & dados numéricos , Masculino , Pandemias , Pneumonia Viral/mortalidade , Pneumonia Viral/virologia , SARS-CoV-2 , Taxa de Sobrevida
3.
Am J Otolaryngol ; 43(1): 103199, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-34560597

RESUMO

BACKGROUND: COVID-19 is a severe acute respiratory syndrome caused by SARS-CoV-2. OBJECTIVE: To study the demographic and clinical presentations of COVID-19 with their types including MIS-C and Kawasaki among children who were admitted to Doctor Jamal Ahmad Rashid Pediatric Teaching Hospital (DJARPTH) at Sulaimaniyah city, Iraq. PATIENTS AND METHODS: A prospective cohort study was conducted from June to December 2020 in which 50 cases suspected of COVID-19 were enrolled in the study that was admitted at the first visit to the emergency department of DJARPTH and their age ranged between 3 months to 14 years. Then, the collected data were divided into 3 groups: COVID-19, Kawasaki disease (KD), and MIS-C. RESULTS: The fever was the most common presented symptom in all cases with COVID-19 regardless of the severity. COVID-19 may be presented as KD as well as MIS-C. There is an increase in the number of Kawasaki cases since 2019 by 6.7 fold due to the increased number of COVID-19 cases in children. Death was more related to MIS-C and primary COVID-19 diseases. Most COVID-19 cases presented with pericardial effusion; although coronary involvement and LV dysfunction mostly seen with MIS-C cases. CONCLUSION: COVID-19 is not uncommon in pediatric patients and it presents as either primary, MIS-C, and KD. Most of the deaths and ICU outcomes were related to MIS-C presentations.


Assuntos
COVID-19/complicações , COVID-19/epidemiologia , Síndrome de Linfonodos Mucocutâneos/epidemiologia , Pneumonia Viral/epidemiologia , Síndrome de Resposta Inflamatória Sistêmica/epidemiologia , Adolescente , Criança , Pré-Escolar , Feminino , Humanos , Lactente , Iraque/epidemiologia , Masculino , Pandemias , Pneumonia Viral/virologia , Estudos Prospectivos , SARS-CoV-2
4.
Epilepsy Behav ; 126: 108470, 2022 01.
Artigo em Inglês | MEDLINE | ID: mdl-34902662

RESUMO

Several studies reported acute symptomatic seizures as a possible neurological complication of COVID-19 pneumonia. Apart from metabolic imbalances, hypoxia, and fever, other ictogenic mechanisms are likely related to an immune-mediated damage. The same mechanisms are shared by other respiratory viruses. Since neurotropic properties of SARS-CoV-2 have been questioned, we investigated whether SARS-CoV-2 has a similar ictogenic potential to other respiratory non-neurotropic viruses. We conducted a retrospective study identifying 1141 patients with SARS-CoV-2 pneumonia and 146 patients with H1N1/H3N2 pneumonia. We found a similar prevalence of seizures in the two viral pneumonia (1.05% with SARS-CoV-2 vs 2.05% with influenza; p = 0.26). We detailed clinical, electroencephalographic, and neuroradiological features of each patient, together with the hypothesized pathogenesis of seizures. Previous epilepsy or pre-existing predisposing conditions (i.e., Alzheimer's disease, stroke, cerebral neoplasia) were found in one-third of patients that experienced seizures, while two-thirds of patients had seizures without known risk factors other than pneumonia in both groups. The prevalence of pre-existing predisposing conditions and disease severity indexes was similar in SARS-CoV-2 and H1N1/H3N2 pneumonia, thus excluding they could act as potential confounders. Considering all the patients with viral pneumonia together, previous epilepsy (p < 0.001) and the need for ventilatory support (p < 0.001), but not the presence of pre-existing predisposing conditions (p = 0.290), were associated with seizure risk. Our study showed that SARS-CoV-2 and influenza viruses share a similar ictogenic potential. In both these infections, seizures are rare but serious events, and can manifest without pre-existing predisposing conditions, in particular when pneumonia is severe, thus suggesting an interplay between disease severity and host response as a major mechanism of ictogenesis, rather than a virus-specific mechanism.


Assuntos
COVID-19 , Vírus da Influenza A Subtipo H1N1 , Pneumonia Viral , Humanos , Vírus da Influenza A Subtipo H3N2 , Estudos Retrospectivos , SARS-CoV-2 , Convulsões
5.
Khirurgiia (Mosk) ; (12): 15-19, 2021.
Artigo em Russo | MEDLINE | ID: mdl-34941204

RESUMO

OBJECTIVE: To evaluate the features of preoperative preparation and postoperative outcomes in patients with lung cancer and previous COVID-19 pneumonia. MATERIAL AND METHODS: There were 7 patients with non-small cell lung cancer and previous bilateral viral pneumonia between June 2020 and January 2021. In 3 cases, lung cancer was detected in a hospital for COVID-19 patients. Four patients had persistent structural changes in X-ray images. After appropriate preparation, all patients underwent total resection. RESULTS: At admission, all patients had severe physical and functional exhaustion associated with prolonged hypoxia and adynamia that required preoperative rehabilitation. Considering high risk of thromboembolic complications, we administered anticoagulation throughout the entire perioperative period and after discharge. Surgical treatment included anatomical resection (extended lobectomy). Postoperative complications occurred in 2 cases and were associated with prolonged air discharge through the pleural drainage tube. CONCLUSION: As we study the consequences of the new coronavirus infection COVID-19, it becomes obvious that a new category of patients requiring specific diagnosis and treatment has emerged.


Assuntos
COVID-19 , Carcinoma Pulmonar de Células não Pequenas , Neoplasias Pulmonares , Pneumonia Viral , Humanos , Pulmão , Neoplasias Pulmonares/complicações , Neoplasias Pulmonares/diagnóstico , Neoplasias Pulmonares/cirurgia , SARS-CoV-2
6.
S Afr Med J ; 111(9): 849-851, 2021 07 27.
Artigo em Inglês | MEDLINE | ID: mdl-34949248

RESUMO

During the second wave of the COVID-19 pandemic in South Africa, a recurrent pattern of prolonged recovery after acute COVID-19 pneumonia, characterised by low oxygen saturation levels for >2 weeks, was observed in an intermediate-care facility in Cape Town. A case study together with a series of 12 patients is presented to illustrate this phenomenon, and two types of 'sats gap' are described, which were used by physiotherapists and doctors to monitor daily progress. We attempt to explain this prolonged recovery in terms of the possible pathophysiology, and suggest a number of learning points to guide further research.


Assuntos
COVID-19/complicações , Pneumonia Viral/fisiopatologia , Idoso , Feminino , Humanos , Pneumonia Viral/virologia , Recuperação de Função Fisiológica , África do Sul
7.
Recurso na Internet em Português | LIS - Localizador de Informação em Saúde | ID: lis-48531

RESUMO

Página com as principais dúvidas sobre o coronavírus, tais como: o que é coronavírus?; como o Coronavírus é transmitido?; quais são os sintomas?; como é o tratamento?; quando se deve procurar o serviço de saúde?; quando devo usar a máscara de proteção?.


Assuntos
Infecções por Coronavirus/epidemiologia , Pneumonia Viral/epidemiologia , Brasil/epidemiologia , Betacoronavirus
8.
Recurso na Internet em Português | LIS - Localizador de Informação em Saúde | ID: lis-48529

RESUMO

Boletins Coronavírus de óbitos e casos confirmados no RJ


Assuntos
Infecções por Coronavirus/epidemiologia , Pneumonia Viral/epidemiologia , Brasil/epidemiologia , Betacoronavirus
9.
Comput Math Methods Med ; 2021: 6919483, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34721659

RESUMO

In March 2020, the World Health Organization announced the COVID-19 pandemic, its dangers, and its rapid spread throughout the world. In March 2021, the second wave of the pandemic began with a new strain of COVID-19, which was more dangerous for some countries, including India, recording 400,000 new cases daily and more than 4,000 deaths per day. This pandemic has overloaded the medical sector, especially radiology. Deep-learning techniques have been used to reduce the burden on hospitals and assist physicians for accurate diagnoses. In our study, two models of deep learning, ResNet-50 and AlexNet, were introduced to diagnose X-ray datasets collected from many sources. Each network diagnosed a multiclass (four classes) and a two-class dataset. The images were processed to remove noise, and a data augmentation technique was applied to the minority classes to create a balance between the classes. The features extracted by convolutional neural network (CNN) models were combined with traditional Gray-level Cooccurrence Matrix (GLCM) and Local Binary Pattern (LBP) algorithms in a 1-D vector of each image, which produced more representative features for each disease. Network parameters were tuned for optimum performance. The ResNet-50 network reached accuracy, sensitivity, specificity, and Area Under the Curve (AUC) of 95%, 94.5%, 98%, and 97.10%, respectively, with the multiclasses (COVID-19, viral pneumonia, lung opacity, and normal), while it reached accuracy, sensitivity, specificity, and AUC of 99%, 98%, 98%, and 97.51%, respectively, with the binary classes (COVID-19 and normal).


Assuntos
COVID-19/diagnóstico por imagem , Aprendizado Profundo , SARS-CoV-2 , Tomografia Computadorizada por Raios X/métodos , Algoritmos , Biologia Computacional , Bases de Dados Factuais/estatística & dados numéricos , Diagnóstico por Computador/métodos , Diagnóstico por Computador/estatística & dados numéricos , Diagnóstico Precoce , Humanos , Pulmão/diagnóstico por imagem , Redes Neurais de Computação , Pandemias , Pneumonia Viral/diagnóstico por imagem , Tomografia Computadorizada por Raios X/estatística & dados numéricos
10.
J Healthc Eng ; 2021: 9437538, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34777739

RESUMO

COVID-19 is an infectious disease-causing flu-like respiratory problem with various symptoms such as cough or fever, which in severe cases can cause pneumonia. The aim of this paper is to develop a rapid and accurate medical diagnosis support system to detect COVID-19 in chest X-ray images using a stacking approach combining transfer learning techniques and KNN algorithm for selection of the best model. In deep learning, we have multiple approaches for building a classification system for analyzing radiographic images. In this work, we used the transfer learning technique. This approach makes it possible to store and use the knowledge acquired from a pretrained convolutional neural network to solve a new problem. To ensure the robustness of the proposed system for diagnosing patients with COVID-19 using X-ray images, we used a machine learning method called the stacking approach to combine the performances of the many transfer learning-based models. The generated model was trained on a dataset containing four classes, namely, COVID-19, tuberculosis, viral pneumonia, and normal cases. The dataset used was collected from a six-source dataset of X-ray images. To evaluate the performance of the proposed system, we used different common evaluation measures. Our proposed system achieves an extremely good accuracy of 99.23% exceeding many previous related studies.


Assuntos
COVID-19 , Aprendizado Profundo , Pneumonia Viral , Teste para COVID-19 , Humanos , SARS-CoV-2 , Raios X
11.
Aging (Albany NY) ; 13(21): 23895-23912, 2021 11 01.
Artigo em Inglês | MEDLINE | ID: mdl-34725309

RESUMO

The coronavirus disease 2019 (COVID-19) is presently the most pressing public health concern worldwide. Cytokine storm is an important factor leading to death of patients with COVID-19. This study aims to characterize serum cytokines of patients with severe or critical COVID-19. Clinical records were obtained from 149 patients who were tested at the Sino-French New City Branch of Tongji Hospital from 30 January to 30 March 2020. Data regarding the clinical features of the patients was collected and analyzed. Among the 149, 45 (30.2%) of them had severe conditions and 104 (69.8%) of that presented critical symptoms. In the meantime, 80 (53.7%) of that 149 died during hospitalization. Of all, male patients accounted for 94 (69.1%). Compared with patients in severe COVID-19, those who in critical COVID-19 had significantly higher levels of tumor necrosis factor-α (TNF-α), interleukin-6 (IL-6), IL-8, and IL-10. Moreover, the passed-away patients had considerably higher levels of TNF-α, IL-6, IL-8, and IL-10 than those survived from it. Regression analysis revealed that serum TNF-α level was an independent risk factor for the death of patient with severe conditions. Among the proinflammatory cytokines (IL-1ß, TNF-α, IL-8, and IL-6) analyzed herein, TNF-α was seen as a risk factor for the death of patients with severe or critical COVID-19. This study suggests that anti-TNF-α treatment allows patients with severe or critical COVID-19 pneumonia to recover.


Assuntos
COVID-19 , Estado Terminal , Interleucinas/sangue , Pneumonia Viral , Fator de Necrose Tumoral alfa/sangue , COVID-19/diagnóstico , COVID-19/imunologia , COVID-19/mortalidade , COVID-19/terapia , China/epidemiologia , Estado Terminal/mortalidade , Estado Terminal/terapia , Feminino , Mortalidade Hospitalar , Humanos , Testes Imunológicos/métodos , Masculino , Pessoa de Meia-Idade , Mortalidade , Pneumonia Viral/diagnóstico por imagem , Pneumonia Viral/etiologia , Valor Preditivo dos Testes , Fatores de Risco , SARS-CoV-2 , Índice de Gravidade de Doença , Tomografia Computadorizada por Raios X/métodos , Inibidores do Fator de Necrose Tumoral/uso terapêutico
12.
Artigo em Russo | MEDLINE | ID: mdl-34719905

RESUMO

The number of patients who have had pneumonia caused by COVID-19 is increasing every month. However, despite the ongoing treatment, the consequences of this disease are possible, which may appear in the short term or after a while. Pneumonia associated by the new coronavirus infection COVID-19 is characterized by the presence of such complications as cough, shortness of breath, fatigue, sleep disturbances, appetite disorders, etc. Often, pneumonia leads to dysfunctions of the respiratory system, higher mental functions, functions of the cardiovascular system and, unfortunately, possible disability. The search and implementation of new methods of physical rehabilitation is an urgent task of modern medicine. Low-frequency magnetotherapy is one of the safest and most commonly recommended treatments for pneumonia. The development of new methods of medical rehabilitation for patients with pneumonia associated with COVID-19, using physical factors such as low-frequency magnetotherapy, laser therapy is one of the leading fields. Magnetotherapy is included in the recommendations of the Ministry of Health of the Russian Federation for the purpose of anti-inflammatory, decongestant, reparative-regenerative action; improvement of microcirculation, acceleration of the resorption of infiltrative changes (Temporary methodological recommendations «Medical rehabilitation for a new coronavirus infection (COVID-19)¼, version 2 of 31.07.2020). International rehabilitation practice of using the International Classification of Functioning, Disability and Health (ICF) advises to use it as a tool that allows you to objectively determine the state of health of patients, determine the prognosis of impaired functions and evaluate the effectiveness of ongoing rehabilitation measures. OBJECTIVE: To assess the effectiveness of the use of low-frequency magnetotherapy in the complex medical rehabilitation of patients who have had pneumonia in the phase of convalescence according to the International Classification of Functioning, Disability and Health. MATERIAL AND METHODS: The study included 200 patients who had suffered from pneumonia associating by COVID-19 and whose average age was 54.3±5.8 years. 1st (main) group (n=100), against the background of standard therapy on the 16th day after discharge from the hospital, received low-frequency magnetotherapy on the ALMAG-02 apparatus («Elamed¼, Russia) daily for 10-20 minutes, a course of 15 procedures. The 2nd group(control) included 100 patients who underwent low-frequency placebo-magnetotherapy on the ALMAG-02 apparatus («Elamed¼, Russia). In order to assess the dynamics of clinical and laboratory data and the effectiveness of treatment, control methods were used in this study in accordance with the Temporary Clinical Recommendations of the Ministry of Health of the Russian Federation. Each patient was evaluated for the severity of the initial manifestations of respiratory failure using the mMRC scale (Degree of Shortness of breath) and the Borg scale, and the quality of life of patients was assessed on the EQ-5D scale. Also, at the time of inclusion in the study and during the control examination after the completion of prospective follow-up, the Individual profile of patients was determined in accordance with the international classification of functioning (ICF) with the data of the «Individual Registration Card of the clinical trial participant¼. RESULTS AND DISCUSSION: In 43% (43 people) of patients of the 1th group, an improvement in respiration functions was noted with lung auscultation and with spirometry, an increase in the vital capacity of the lungs by 28.2% (p=0.0021), an increase in chest excursion by 53.1% (p=0.0019) a decrease in the level of shortness of breath by 50% and Borg by 33.3% (p=0.0016). According to the data of the quality of life questionnaire (EQ-5D), the patients of the main group showed an improvement in the quality of life by 23% (p=0.0019). In the 1st group of patients, there was a decrease in moderate disorders in the domains «b152 - emotion functions¼ in 45% of patients; «b440 - respiratory functions¼ in 87% of patients; «b455 - exercise tolerance functions¼ in 74% of patients; «b134 - sleep functions¼ in 30% of patients; «d450 - walking¼ in 100% of patients. In the general blood analysis of patients of the 1st (main) group, there was a relief of leukocytosis, normalization of the erythrocyte sedimentation rate (ESR). In the 1st group a decrease in the duration of being on the sick list was observed for 3.4±0.2 days. CONCLUSION: The inclusion of low-frequency magnetic therapy in the complex rehabilitation of patients who have suffered pneumonia associated by COVID-19 contributes to improving the function of external respiration of patients, regression of residual infiltrative changes in the lungs after pneumonia, relief of residual manifestations of the inflammatory process, reducing the duration of the rehabilitation period and the duration of disability, improving the general well-being of patients, increasing tolerance to physical exertion, normalization of the psycho-emotional state and, as a result,, restoring activity in everyday life and improving the quality of life of patients. The researchers did not register any side effects and side effects of magnetic therapy from ALMAG-02 apparatus (Elamed, Russia).


Assuntos
COVID-19 , Terapia de Campo Magnético , Pneumonia Viral , Humanos , Pessoa de Meia-Idade , Estudos Prospectivos , Qualidade de Vida , SARS-CoV-2 , Resultado do Tratamento
13.
Pan Afr Med J ; 39: 230, 2021.
Artigo em Francês | MEDLINE | ID: mdl-34630842

RESUMO

Introduction: the main purpose of this study is to describe chest computed tomography (CT) findings in 26 patients hospitalized with COVID-19 pneumonia during the first wave of the SARS-CoV-2 pandemic at the University Clinics in Kinshasa (UCK). Methods: we conducted a descriptive study of chest CT findings in 26 patients hospitalized with coronavirus pneumonia at the UCK over a 9-month period, from March 17 to November 17, 2020. Hitachi - CT-scanner 16 slice was used in all our patients. After analyzing lesions, these were divided into lesions suggestive and non-suggestive of SARS-CoV-2 infection. Results: the average age of patients was 53.02 years. Male sex was the most affected (76.9%). Respiratory distress was the most common clinical symptom (61.5%). Arterial hypertension and renal failure were the most common comorbidities (3O% and 6%). Bilateral ground-glass opacities, with a predominantly peripheral distribution, accounted for 69.2% of cases, followed by condensations (57.7%) and crazy paving (19.2%). Severe COVID-19 was most frequently found (34.61%). Distal and proximal pulmonary embolism was the most common complication (11.5%). Among the associated diseases, pleurisy and pulmonary PAH were most frequently found (30.8%). The majority of our patients had parenchymal lung lesions, corresponding to early-stage disease on CT (50%). Conclusion: at the UCK, during the first wave of SARS-CoV-2 pandemic, lesions on CT suggestive of COVID-19 were dominated by plaque-like ground-glass opacities, followed by nonsystematized parenchymatous condensations and crazy paving. The less observed atypical lesions consisted of unilateral, peribronchovascular pseudo-nodular condensations and infection in the remodeled lung. Severe COVID-19 was the most common CT finding. Proximal and distal pulmonary embolism was the most common complication. This study highlights that these findings are consistent with those reported in the literature.


Assuntos
COVID-19/complicações , Hospitalização , Pneumonia Viral/diagnóstico por imagem , Tomografia Computadorizada por Raios X/métodos , Adolescente , Adulto , Idoso , COVID-19/diagnóstico por imagem , Criança , Pré-Escolar , República Democrática do Congo , Feminino , Humanos , Lactente , Masculino , Pessoa de Meia-Idade , Pneumonia Viral/virologia , Índice de Gravidade de Doença , Distribuição por Sexo , Adulto Jovem
14.
Wien Klin Wochenschr ; 133(21-22): 1208-1214, 2021 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-34605974

RESUMO

BACKGROUND: Antimicrobial stewardship is crucial to avoid antimicrobial resistance in microbes and adverse drug effects in patients. In respiratory infections, however, viral pneumonia is difficult to distinguish from bacterial pneumonia, which explains the overuse of antibiotic therapy in this indication. CASES: Five cases of lung consolidation are presented. Lung ultrasound, in conjunction with procalcitonin levels, were used to exclude or corroborate bacterial pneumonia. CONCLUSION: Lung ultrasound is easy to learn and perform and is helpful in guiding diagnosis in unclear cases of pneumonia and may also offer new insights into the spectrum of certain virus diseases. The use of lung ultrasound can raise awareness in clinicians of the need for antimicrobial stewardship and may help to avoid the unnecessary use of antibiotics.


Assuntos
Gestão de Antimicrobianos , Pneumonia Viral , Infecções Respiratórias , Antibacterianos/uso terapêutico , Humanos , Pulmão/diagnóstico por imagem , Pneumonia Viral/diagnóstico por imagem , Pneumonia Viral/tratamento farmacológico , Pró-Calcitonina
15.
Acta Med Indones ; 53(3): 339-348, 2021 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-34611075

RESUMO

In this era, the novel Coronavirus, referred to as Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2), a life-threatening virus with a high mortality rate (4.2%) and with no absolute treatment as of yet, may ultimately result in acute respiratory distress syndrome (ARDS). ARDS is one of the fatal complications, highlighted by pulmonary infiltration and severe hypoxemia. This condition can be developed from primary lung inflammation caused by various viruses, particularly influenza viruses, some of the most common human pathogens. Due to this issue, many studies explored several approaches for ARDS treatment. Lung transplantation has been claimed as an efficient cure for severe ARDS and Influenza, which can also be offered for treating critical lung complications of SARS-CoV-2. Thereupon, to the best of our knowledge for the first time, we aimed to review all available data about capability of lung transplantation for the treatment of critically ill patients with ARDS, Influenza, and SARS-CoV-2.


Assuntos
COVID-19/cirurgia , Influenza Humana/cirurgia , Transplante de Pulmão , Pneumonia Viral , COVID-19/diagnóstico , Humanos , Influenza Humana/diagnóstico , Transplante de Pulmão/efeitos adversos , Transplante de Pulmão/métodos , Orthomyxoviridae/isolamento & purificação , Pneumonia Viral/etiologia , Pneumonia Viral/cirurgia , SARS-CoV-2/isolamento & purificação , Índice de Gravidade de Doença
16.
BMC Med Imaging ; 21(1): 143, 2021 10 04.
Artigo em Inglês | MEDLINE | ID: mdl-34602051

RESUMO

BACKGROUND: This study aimed to compare the performance and interobservers agreement of cases with findings on chest CT based on the British Society of Thoracic Imaging (BSTI) guideline statement of COVID-19 and the Radiological Society of North America (RSNA) expert consensus statement. METHODS: In this study, 903 patients who had admitted to the emergency department with a pre-diagnosis of COVID-19 between 1 and 18 July 2020 and had chest CT. Two radiologists classified the chest CT findings according to the RSNA and BSTI consensus statements. The performance, sensitivity and specificity values of the two classification systems were calculated and the agreement between the observers was compared by using kappa analysis. RESULTS: Considering RT-PCR test result as a gold standard, the sensitivity, specificity and positive predictive values were significantly higher for the two observers according to the BSTI guidance statement and the RSNA expert consensus statement (83.3%, 89.7%, 89.0%; % 81.2,% 89.7,% 88.7, respectively). There was a good agreement in the PCR positive group (κ: 0.707; p < 0.001 for BSTI and κ: 0.716; p < 0.001 for RSNA), a good agreement in the PCR negative group (κ: 0.645; p < 0.001 for BSTI and κ: 0.743; p < 0.001 for RSNA) according to the BSTI and RSNA classification between the two radiologists. CONCLUSION: As a result, RSNA and BSTI statement provided reasonable performance and interobservers agreement in reporting CT findings of COVID-19. However, the number of patients defined as false negative and indeterminate in both classification systems is at a level that cannot be neglected.


Assuntos
COVID-19/diagnóstico por imagem , Pneumonia Viral/diagnóstico por imagem , Tomografia Computadorizada por Raios X , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Consenso , Serviço Hospitalar de Emergência , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Pandemias , Pneumonia Viral/virologia , Valor Preditivo dos Testes , Estudos Retrospectivos , SARS-CoV-2 , Sensibilidade e Especificidade , Sociedades Médicas , Turquia
17.
Med Sci Monit ; 27: e930776, 2021 Oct 12.
Artigo em Inglês | MEDLINE | ID: mdl-34635632

RESUMO

During the coronavirus disease 2019 (COVID-19) pandemic due to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection, patients presented with COVID-19 pneumonia of varying severity. The phenomenon of severe hypoxemia without signs of respiratory distress is also known as silent or hidden hypoxemia. Although silent hypoxemia is not unique to pneumonia due to SARS-CoV-2 infection, this phenomenon is now recognized to be associated with severe COVID-19 pneumonia. Proper management of critically ill patients is the key to reducing mortality. Herein, we summarize the possible and rare factors contributing to silent hypoxemia in patients with COVID-19. Microvascular thrombosis causes dead space ventilation in the lungs, and the flow of pulmonary capillaries is reduced, which leads to an imbalance in the V/Q ratio. The dissociation curve of oxyhemoglobin shifts to the left and limits the release of oxygen to the tissue. SARS-CoV-2 interferes with the synthesis of hemoglobin and reduces the ability to carry oxygen. The accumulation of endogenous carbon monoxide and carboxyhemoglobin will reduce the total oxygen carrying capacity and interfere with pulse oxygen saturation readings. There are also some non-specific factors that cause the difference between pulse oximetry and oxygen partial pressure. We propose some potentially more effective clinical alternatives and recommendations for optimizing the clinical management processes of patients with COVID-19. This review aims to describe the prevalence of silent hypoxemia in COVID-19 pneumonia, to provide an update on what is known of the pathophysiology, and to highlight the importance of diagnosing silent hypoxemia in patients with COVID-19 pneumonia.


Assuntos
COVID-19/metabolismo , Hipóxia/virologia , Pneumonia Viral/virologia , Doenças Assintomáticas/epidemiologia , COVID-19/epidemiologia , COVID-19/virologia , Humanos , Hipóxia/epidemiologia , Hipóxia/metabolismo , Pulmão/citologia , Pulmão/metabolismo , Pulmão/virologia , Microvasos/metabolismo , Oximetria , Oxigênio/metabolismo , Pneumonia Viral/metabolismo , Prevalência , SARS-CoV-2/isolamento & purificação , Trombose/metabolismo , Trombose/virologia
18.
Zhonghua Er Ke Za Zhi ; 59(9): 772-776, 2021 Sep 02.
Artigo em Chinês | MEDLINE | ID: mdl-34645218

RESUMO

Objective: To investigate the epidemiology and clinical characteristics of adenovirus (ADV)-caused acute respiratory tract infection among hospitalized children in Kunming, China. Methods: Clinical and laboratory data were collected from 467 children with adenovirus infection who were hospitalized from January 1, 2019 to December 31, 2019 in 6 grade A class Ⅲ hospitals in Kunming area. The basic characteristics, epidemiology, mixed infection and adenovirus genotypes of the patients were retrospectively analyzed. The patients diagnosed with adenovirus pneumonia (AP) were divided into two groups, severe AP (SAP) group and general AP(GAP) group according to the severity of illness. Mann-Whitney U test or χ2 test was used for comparison between groups, while multivariate regression was applied to analyze the risk factors of SAP. Results: Among 15 635 hospitalized children with respiratory tract infection, 467 cases were adenovirus positive, with a detection rate of 2.99%. Of the 467 patients with adenovirus infection, 284 were male and 183 female, the age was 2.4 (1.1,3.9) years, including 44 cases (9.4%) < 0.5 years, 59 cases (12.6%) of 0.5 to<1.0 years, 176 cases (37.7%) of 1.0 to <3.0 years, 150 cases (32.1%) of 3.0 to <7.0 years, and 38 cases (8.1%) of 7.0 to 14.0 years. Adenovirus infection was common in autumn and winter, and the high incidence months were October to December, which accounted for 51.6% (241/467) of the whole year cases. Co-infection was detected in 226 cases (48.4%) out of 467 patients, in which one pathogen co-infection was the most frequent form (172 cases, 76.1%). Of the 262 pathogen detected 108 (41.2%) were Mycoplasma pneumoniae. In 144 of ADV-positve cases (30.8%) were taken geno-typing was done by PCR amplification, the results showed that 74 cases (51.4%) were ADV 3, 7 subtypes and 65 cases (45.1%) of ADV 1, 2,6 subtypes. Of the 467 cases of ADV infection, 320 (68.5%) were diagnosed with pneumonia, 82 (17.6%) with upper respiratory tract infection and pharyngeal tonsillitis, and 65 (13.9%) with bronchitis, laryngeal bronchitis, and asthmatic bronchitis. Among the 320 patients with AP, 56 cases were severe and 264 cases were general. Two cases (3.6%) in severe group died. Compared with the GAP group, the age was young [17 (11,42) months vs. 24 (14,44) months, Z=2.222, P=0.026], the fever duration was long [8 (5,14) days vs. 6 (3,9) days, Z=3.380, P<0.01], and the proportions of preterm birth and having underlying diseases were high [respectively 19.6% (11/56) vs. 6.1% (16/264), 26.8% (15/56) vs. 10.2% (27/264), χ2=8.965,11.109, P<0.05] in SAP group. Referring to laboratory markers, white blood cell count, C-reactive protein, creatine kinase-MB and lactate dehydrogenase were significantly increased in SAP group as compared to GAP group(all P<0.05). Multivariate Logistic regression analysis showed that preterm birth (OR=3.284, 95%CI 1.079-9.993, P=0.036), underlying disease (OR=3.284, 95%CI 1.079-9.993, P=0.036), fever duration ≥10 d (OR=2.523,95%CI 1.195-5.328, P=0.015) and C-reactive protein ≥50 mg/L (OR=3.156, 95%CI 1.324-7.524, P=0.010) were positively correlated with the risk of SAP. Conclusions: The incidence of adenovirus infection among hospitalized children in Kunming was lower than the national level, and no outbreak occurred in 2019. Subtype 3 and 7 of ADV are the predominant strains for infection, which usually occurs in autumn and winter and mainly causes pneumonia. Premature birth, underlining diseases, long fever duration and markedly increased C-reactive protein are the risk factors for developing into severe pneumonia. This paper presents the prevalence and clinical characteristics of adenovirus infection in children at high altitude area.


Assuntos
Infecções por Adenoviridae , Pneumonia Viral , Nascimento Prematuro , Infecções Respiratórias , Infecções por Adenoviridae/epidemiologia , Criança , Criança Hospitalizada , Pré-Escolar , China/epidemiologia , Feminino , Humanos , Lactente , Recém-Nascido , Masculino , Pneumonia Viral/epidemiologia , Gravidez , Infecções Respiratórias/epidemiologia , Estudos Retrospectivos
19.
BMC Infect Dis ; 21(1): 1051, 2021 Oct 09.
Artigo em Inglês | MEDLINE | ID: mdl-34627176

RESUMO

BACKGROUND: Atopy may be associated with disease severity and a poor prognosis of human adenovirus (HAdV) pneumonia in children. Our aim was to observe the clinical characteristics and pulmonary radiological changes in children with atopy and HAdV pneumonia in China. METHODS: Children hospitalised with HAdV pneumonia from June 2018 to December 2019 were analysed. All children were divided into atopic with HAdV, non-atopic with HAdV, and atopic without HAdV infection group. Each group was further divided into the mild and severe pneumonia groups according to disease severity. Standard treatment was initiated after admission, and regular follow-up evaluations were conducted at 1 month after discharge. Baseline and clinical characteristics and pulmonary radiological changes in children with and without atopy were evaluated. Risk factors associated with small airway lesions in patients with HAdV pneumonia were analysed. RESULTS: The eosinophil count in the atopic group was significantly higher than that in the non-atopic group (P < 0.05). Severe coughing, wheezing, and small airway lesions on chest high-resolution computed tomography (HRCT) upon admission, after discharge and 1 month after discharge were significantly higher in the atopic group (with or without HAdV infection) than in the non-atopic group (P < 0.05). There were significant differences in the number of patients with wheezing and small airway lesions during hospitalisation and after discharge among the three groups (P < 0.05). The risks of small airway lesions in children with a family or personal history of asthma, severe infection, atopy, and HAdV infection were 2.1-, 2.7-, 1.9-, 2.1-, and 1.4-times higher than those in children without these characteristics, respectively. CONCLUSIONS: Children with atopy and HAdV pneumonia may experience severe coughing in mild cases and wheezing in mild and severe cases. Children with atopy are more susceptible to the development of small airway lesions, recurrent wheezing after discharge and slower recovery of small airway lesions as observed on pulmonary imaging than non-atopic children after HAdV infection. A family or personal history of asthma, atopy, severe infection, and HAdV infection are independent risk factors associated with the development of small airway lesion as observed on chest HRCT.


Assuntos
Infecções por Adenoviridae , Infecções por Adenovirus Humanos , Adenovírus Humanos , Pneumonia Viral , Infecções por Adenovirus Humanos/complicações , Infecções por Adenovirus Humanos/epidemiologia , Criança , Humanos , Pneumonia Viral/diagnóstico por imagem , Pneumonia Viral/epidemiologia , Prognóstico
20.
Expert Rev Gastroenterol Hepatol ; 15(11): 1281-1294, 2021 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-34654347

RESUMO

INTRODUCTION: Human gut microbiota plays a crucial role in providing protective responses against pathogens, particularly by regulating immune system homeostasis. There is a reciprocal interaction between the gut and lung microbiota, called the gut-lung axis (GLA). Any alteration in the gut microbiota or their metabolites can cause immune dysregulation, which can impair the antiviral activity of the immune system against respiratory viruses such as severe acute respiratory syndrome coronavirus (SARS-CoV) and SARS-CoV-2. AREAS COVERED: This narrative review mainly outlines emerging data on the mechanisms underlying the interactions between the immune system and intestinal microbial dysbiosis, which is caused by an imbalance in the levels of essential metabolites. The authors will also discuss the role of probiotics in restoring the balance of the gut microbiota and modulation of cytokine storm. EXPERT OPINION: Microbiota-derived signals regulate the immune system and protect different tissues during severe viral respiratory infections. The GLA's equilibration could help manage the mortality and morbidity rates associated with SARS-CoV-2 infection.


Assuntos
COVID-19/imunologia , Disbiose/imunologia , Microbioma Gastrointestinal/imunologia , Sistema Imunitário/imunologia , Pneumonia Viral/imunologia , Humanos , SARS-CoV-2
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