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MeSH Disease

Human Phenotype

Transmission

Seroprevalence
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    Outcome of COVID-19 with Co-Existing Surgical Emergencies in Children TRANS: Our Initial Experiences and Recommendations

    Authors: Samiul Hasan; Md Ayub Ali; Umama Huq

    doi:10.21203/rs.3.rs-71589/v1 Date: 2020-09-03 Source: ResearchSquare

    Background: COVID-19 has changed the practice of surgery vividly all over the world. This has already lead to a huge burden of rescheduled pediatric surgical cases worldwide. Though children TRANS are less likely to be infected MESHD and suffer less when infected, there is a growing fear among health care workers of being self-infected, which is limiting the surgical care of children TRANS globally. This study aims to share our experiences with the outcome of COVID-19 in children TRANS who had a co-existing surgical emergency, which might help the pediatric surgeons globally to mitigate the effect of COVID 19 on pediatric surgery.Methods: This is a retrospective observational study. We reviewed the epidemiological, clinical, and laboratory data of all patients admitted in our surgery department through the emergency department and later diagnosed to have COVID-19 by RT-PCR. During April 2020 – June 2020. A nasopharyngeal swab was taken from all patients irrespective of symptoms to detect SARS CoV 2 by RT-PCR to identify and isolate asymptomatic TRANS patients and patients with atypical symptoms. We divided the test positive patients into 4 age groups TRANS for the convenience of data analysis. Data were retrieved from hospital records and analyzed using SPSS (version 25) software. Ethical permission was taken from the hospital ethical review board.Results: Total patients were 32. Seven (21.9%) of them were neonates. Twenty-four (75%) patients were male TRANS. The predominant diagnosis was acute abdomen followed by infantile hypertrophic pyloric stenosis MESHD pyloric stenosis HP (IHPS), myelomeningocele HP, and intussusception HP. Only two patients had mild respiratory symptoms MESHD ( dry cough MESHD cough HP). Fever HP Fever MESHD was present in 13 (40.6%) patients. Fourteen (43.8%) patients required surgical treatment. The mean duration of hospital stay was 5.5 days. One neonate with ARM died in the post-operative ward due to cardiac arrest HP cardiac arrest MESHD. No patient had hypoxemia HP hypoxemia MESHD or organ failure. Seven health care workers (5.51%) including doctors & nurses got infected with SARS Co V2 during this period.Conclusion: Our study has revealed a milder course of COVID-19 in children TRANS with minimal infectivity even when present in association with emergency surgical conditions. This might encourage a gradual restart to mitigate the impact of COVID-19 on children’s surgery.

    Possible silent hypoxemia HP hypoxemia MESHD in a COVID-19 patient: a case report

    Authors: Siswanto; Munawar Gani; Aditya Rifqi Fauzi; Bagus Nugroho; Denny Agustiningsih; Gunadi

    doi:10.21203/rs.3.rs-58296/v1 Date: 2020-08-12 Source: ResearchSquare

    Background: It has been hypothesized that silent hypoxemia HP hypoxemia MESHD is the cause of the rapid progressive respiratory failure HP respiratory failure MESHD with severe hypoxia MESHD that occurs in some patients with COVID-19 without warning. Here, we reported one COVID-19 case with the possibility of silent hypoxemia HP hypoxemia MESHD. Case presentation: A 60-year-old male TRANS presented with complaints of cough HP that he felt starting two weeks before admission without any breathing difficulty. Complaints were accompanied by fever HP fever MESHD, runny nose and sore throat. Vital signs examination showed blood SERO pressure 130/75 mmHg, pulse 84 times per minute, normal respiratory rate (RR) of 21 times per minute, body temperature 36.5 C, and 99% oxygen saturation with oxygen via nasal cannula 3 liters per minute were recorded. On physical examination, an increase in vesicular sounds and crackles HP in both lungs were identified. Chest x-ray showed bilateral pneumonia HP pneumonia MESHD. Nasopharyngeal and oropharyngeal swab real-time polymerase chain reaction tests for COVID-19 were positive. On the third day of treatment, the patient complained of worsening of shortness of breath MESHD, but his RR was still normal with 22 times per minute. On the fifth day of treatment, the patient experienced severe shortness of breath MESHD with a RR of 38 times per minute. The patient was then intubated and his blood SERO gas analysis showed respiratory alkalosis HP respiratory alkalosis MESHD (pH 7.54, PaO2 58.9 mmHg, PaCO2 31.1 mmHg, HCO3 26.9 mEq/L, SaO2 94.7%). On the eighth day of treatment, his condition deteriorated starting in the morning, with blood SERO pressure 80/40 mmHg with norepinephrine support, pulse 109 times per minute, and 72% SpO2 with ventilator. In the afternoon, the patient experienced cardiac arrest HP cardiac arrest MESHD and underwent basic life support, then resumed strained breathing with return of spontaneous circulation. Blood SERO gas analysis showed severe respiratory acidosis HP respiratory acidosis MESHD (pH 7.07, PaO2 58.1 mmHg, PaCO2 108.9 mmHg, HCO3 32.1 mEq /L, SaO2 78.7%). Three hours later, he suffered cardiac arrest HP cardiac arrest MESHD again, but was unable to be resuscitated. The patient eventually died.Conclusions: Silent hypoxemia HP hypoxemia MESHD might be considered as an early clinical sign of deterioration of patients with COVID-19, thus, the physician may be able to intervene early and decrease its morbidity and mortality.

    Outcome of COVID-19 with co-existing surgical emergencies in children TRANS: our initial experiences and recommendations

    Authors: Md Samiul Hasan; Md Ayub Ali; Umama Huq

    doi:10.1101/2020.08.01.20166371 Date: 2020-08-04 Source: medRxiv

    Background: COVID 19 has changed the practice of surgery vividly all over the world. Pediatric surgery is not an exception. Prioritization protocols allowing us to provide emergency surgical care to the children TRANS in need while controlling the pandemic spread. The aim of this study is to share our experiences with the outcome of children TRANS with COVID 19 who had a co existing surgical emergency. Methods: This is a retrospective observational study. We reviewed the epidemiological, clinical, and laboratory data of all patients admitted in our surgery department through the emergency department and later diagnosed to have COVID 19 by RT PCR. The study duration was 3 months (April 2020 to June 2020). A nasopharyngeal swab was taken from all patients irrespective of symptoms to detect SARS CoV 2 by RT PCR with the purpose of detecting asymptomatic TRANS patients and patients with atypical symptoms. Emergency surgical services were provided immediately without delay and patients with positive test results were isolated according to the hospital protocol. We divided the test positive patients into 4 age groups TRANS for the convenience of data analysis. Data were retrieved from hospital records and analyzed using SPSS (version 25) software. Ethical permission was taken from the hospital ethical review board. Results: Total patients were 32. Seven (21.9%) of them were neonates. Twenty four (75%) patients were male TRANS. The predominant diagnosis was acute abdomen followed by infantile hypertrophic pyloric stenosis MESHD pyloric stenosis HP (IHPS), myelomeningocele HP, and intussusception HP. Only two patients had mild respiratory symptoms MESHD ( dry cough MESHD cough HP). Fever HP Fever MESHD was present in 13 (40.6%) patients. Fourteen (43.8%) patients required surgical treatment. The mean duration of hospital stay was 5.5 days. One neonate with ARM died in the postoperative ward due to cardiac arrest HP cardiac arrest MESHD. No patient had hypoxemia HP hypoxemia MESHD or organ failure. Seven health care workers (5.51%) including doctors & nurses got infected with SARS Co V2 during this period. Conclusion: Our study has revealed a milder course of COVID 19 in children TRANS with minimal infectivity even when present in association with emergency surgical conditions. This might encourage a gradual restart to mitigate the impact of COVID 19 on children TRANS surgery. Keywords: COVID 19, COVID 19 in children TRANS, Children TRANS Surgery, Surgical emergency, Surgery in COVID 19 positive patients.

    A severe coronavirus disease MESHD 2019 patient with high-risk predisposing factors died from massive gastrointestinal bleeding MESHD: a case report

    Authors: Taojiang Chen; Qin Yang; Hongyu Duan

    doi:10.21203/rs.3.rs-45116/v1 Date: 2020-07-17 Source: ResearchSquare

    Background: SARS-CoV-2 is highly infectious and has been a significant public health threat. Despite typical manifestations of illness are dominated by respiratory symptom, some patients have concurrent gastrointestinal manifestations, including   nausea MESHD, diarrhea HP diarrhea MESHD, and vomiting HP vomiting MESHD. Massive gastrointestinal bleeding MESHD, however, has rarely been reported. Case presentation: We herein describe a case of severe SARS-CoV-2 infected MESHD patient with several risk factors for poor prognosis, including male TRANS, hypertension HP hypertension MESHD, old age TRANS, mixed bacterial infection MESHD and multilobular infiltration on radiological imaging. After improvement of respiratory status, the onset of gastrointestinal bleeding MESHD occurred, probably resulting from direct viral invasion as evidenced by the positive findings for SARS-CoV-2 in the repeat stool specimens. Although aggressive resuscitation was administered, hematochezia HP hematochezia MESHD was uncontrolled. The patient rapidly deteriorated, suffered cardiac arrest HP cardiac arrest MESHD, and expired. Conclusions: Digestive symptoms could be severe in SARS-CoV-2 infected MESHD patients, especially for the high-risk individuals with predisposing conditions. A more thorough protocol for preventing cross-infection MESHD through faecal-oral transmission TRANS should be implemented in the process of patient care and infection MESHD control.

    Covid-19 infection MESHD without respiratory symptoms: case report of diagnosing a 14 year-old patient with acute abdomen 

    Authors: Ladan Goshayeshi; Nasrin Milani; Robert Bergqueist; Sayyed Majid Sadrzadeh; Farnood Rajabzadeh; Benyamin Hoseini

    doi:10.21203/rs.3.rs-27389/v1 Date: 2020-05-07 Source: ResearchSquare

    Background. C oronavirus Disease MESHD2019 (Covid-19) is expanding worldwide. Although it seems to be a purely r espiratory disease, MESHD occasional reports of lesions in other organs have been published. We report here an asymptomatic TRANS child TRANS Covid-19 patient with the main symptom of abdominal HP bdominal pain MESHD pain HP distension and without any respiratory symptoms.Case presentation. A 14 year-old male TRANS patient without respiratory involvement but with main complaints of fever HP ever, MESHD m alaise, MESHD anorexia HP norexia, MESHD and severe abdominal pain HP bdominal pain MESHDwas admitted to a hospital in Mashhad, Iran. Following general anaesthesia, laparotomy revealed distension of the small intestine and an adhesive ileo-caecal band that had produced ileum herniation without free fluid in the abdomen. The band was surgically severed and the patient referred to the recovery room.  Because of pulse rate of 36-40 per min and respiratory rate of 140 and a saturated O2 of 86%, the patient was referred to the intensive care unit. Chest X-ray and high-resolution computed tomography of the lungs showed bilateral, diffuse, peripheral dense areas of ground-glass appearance. A nasopharyngeal swab for Covid-19 diagnosis, ordered due to lymphopenia HP ymphopenia MESHDtogether with these diffuse lung infiltrations, showed a positive result. This led to drug treatment with lopinavir/ritonavir, hydroxychloroquine, ribavirin/oseltamivir and meropenem. The patient was febrile and developed tachycardia HP achycardia MESHDon the third day accompanied with a respiratory rate of 44/min. At this point, tracheal intubation was done but the patient died after 3 hours due to cardiac arrest HP ardiac arrest. MESHDConclusions. The case report brings forth the hypothesis that the gastrointestinal manifestation may be untypical symptoms of Covid-19 i nfection, MESHD and highlights the importance for the diagnosis to be based on combined laboratory-based data and scanning imagery.

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MeSH Disease
Human Phenotype
Transmission
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