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HGNC Genes

SARS-CoV-2 proteins

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    High-Flow Nasal Cannula Treatment in Patients with COVID-19 MESHD Acute Hypoxemic Respiratory Failure

    Authors: Mohammed S Alshahrani; Hassan M. Alshaqaq; Jehan Alhumaid; Ammar A. Binammar; Khalid H AlSalem; Abdulazez Alghamdi; Ahmed Abdulhady; Moamen Yehia; Amal AlSulaibikh; Mohammed Al Jumaan; Waleed H. Albuli; Talal Ibrahim; Abdullah A. Yousef; Yousef Almubarak; Waleed Alhazzani

    doi:10.21203/rs.3.rs-111258/v1 Date: 2020-11-18 Source: ResearchSquare

    BackgroundThe increasing burden of coronavirus disease 2019 MESHD ( COVID-19 MESHD)-related acute hypoxemic respiratory failure MESHD ( AHRF MESHD) is straining intensive care unit (ICU) resources globally. Early use of high-flow nasal cannula (HFNC) decreases the need for endotracheal intubation (EI) in different causes of respiratory failure MESHD. While HFNC is used in COVID-19 MESHD-related AHRF MESHD, its efficacy remains to be investigated. We aimed to examine whether the use of high-flow nasal oxygen therapy (HFNO) prevents the need for intubation in COVID-19 MESHD with ( AHRF MESHD).MethodsThis is a single-center prospective observational study that was conducted at a tertiary teaching hospital in Saudi Arabia the period from April, 2020 to August, 2020. Adults patients admitted to the ICU with AHRF MESHD secondary to COVID-19 MESHD pneumonia MESHD and managed with HFNC were included. We excluded hemodynamically unstable patients and those who were intubated or managed with non-invasive ventilation. Patients’ data and clinical outcomes were pre-defined. The primary outcome was to determine the rate of EI among patients who were treated with HFNC. Secondary outcomes included predictors of HFNC success/failure, mortality, and hospital length of stay.  ResultsWe consecutively screened 111 hospitalized COVID-19 MESHD patients with AHRF MESHD,. Out of those, 44 (40%) patients received HFNC with a median duration of three days (IQR, 1–5). The median age was 57 years (interquartile range [IQR], 46–64), and 82% were men. HFNC failure MESHD and EI occurred in 29 (66%) patients. Patients who failed HFNC treatment had higher risk of death MESHD compared to those who did not (52% vs. 0%; p=0.001). At baseline, the prevalence of hypertension MESHD, chronic kidney disease MESHD, and asthma MESHD was higher in the HFNC failure MESHD group. After adjustment for possible confounders, a high Sequential Organ Failure Assessment (SOFA) score and a low ROX index were significantly associated with HFNC failure MESHD (hazard ratio [HR], 1.42; 95% confidence interval [CI], 1.04–1.93; p=0.025; and HR, 0.61; 95% CI, 0.42–0.88; p=0.008, respectively). ConclusionsIn this prospective study, one-third of hypoxemic COVID-19 MESHD patients who received HFNC did not require intubation. High SOFA score and low ROX index were associated with HFNC failure MESHD.

    Reciprocal Personal/Public Protection for COVID-19 MESHD with Facepiece Discriminating Mouth and Nose

    Authors: Yijun Yuan

    id:10.20944/preprints202009.0320.v1 Date: 2020-09-14 Source: Preprints.org

    Reciprocal Personal/Public Protection (RPPP) featured with source control is introduced, Facepiece Discriminating Mouth and Nose ( FDMN MESHD) is employed to serve the purpose, which includes polymer based mouth cover with optional nose cover. The new knowledge that mouth is a primary, active and dominant source of the virus has been well established, which is the base of FDMN. Source classification and related source control tools are discussed, mouth cover is recommended as the tool prioritized to use. Liquid droplets is identified as a hard issue related to mask, liquid droplets, mask fitting, comfort and facial recognition constitute real challenges of mask in addition to efficiency, All of these have been addressed with FDMN MESHD. Comparisons between FDMN and masks/face covering are taken on four aspects: efficiency and efficacy, tolerance and comfort, cost and waste, and civil rights and public interest. Mouth cover is recommended to replace the face covering and act as both a personal tool and a public utensil, mouth cover with nose cover can provide better protection than N95 etc. RPPP with FDMN MESHD, could be an alternative for lockdown, a parallel strategy to vaccine, and a collectively living way during the pandemic era. FDMN MESHD, featured with high efficiency protection, high degree comfort, easy wearing, tight-fitting, easy facial recognition & communication, reusability, cost-effective, environment friendly and scale manufacturing more readily and widely etc., is a simple and sustainable solution, which is essential for ordinary people to keep wearing it properly for protection.

    ROX HGNC Index Predicts Intubation in Patients with COVID-19 MESHD Pneumonia and Moderate to Severe Hypoxemic Respiratory Failure Receiving High Flow Nasal Therapy.

    Authors: Maulin Patel; Junad Chowdhury; Nicole Mills; Robert Marron; Andrew Gangemi; Zachariah Dorey-Stein; Ibraheem Yousef; Matthew Zheng; Lauren Tragesser; Julie Giurintano; Rohit Gupta; Parth Rali; Huaqing Zhao; Nicole Patlakh; Nathaniel Marchetti; Gerard Criner; Matthew Gordon

    doi:10.1101/2020.06.30.20143867 Date: 2020-07-02 Source: medRxiv

    Introduction Use of high flow nasal therapy (HFNT) to treat COVID-19 MESHD pneumonia MESHD has been greatly debated around the world due to concern for increased healthcare worker transmission and delays in invasive mechanical Ventilation (IMV). Methods A retrospective analysis of consecutive patients admitted to Temple University Hospital in Philadelphia, Pennsylvania, from March 10, 2020, to May 17, 2020 with moderate to severe respiratory failure MESHD treated with High Flow nasal therapy (HFNT). HFNT MESHD patients were divided into two groups: HFNT only and HFNT progressed to IMV. The primary outcome was the ability of the ROX HGNC index to predict the need of IMV. Results Of the 837 patients with COVID-19 MESHD, 129 met inclusion criteria. The mean age was 60.8 ({+/-}13.6) years, BMI 32.6 ({+/-}8), 58 (45 %) were female, 72 (55.8%) were African American, 40 (31%) Hispanic. 48 (37.2%) were smokers. Mean time to intubation was 2.5 days ({+/-} 3.3). ROX HGNC index of less than 5 at HFNT initiation was predictive of progression to IMV (OR = 2.137, p = 0,052). Any decrease in ROX HGNC index after HFNT initiation was predictive of intubation (OR= 14.67, p <0.0001). {Delta} ROX HGNC (<=0 versus >0), peak D-dimer >4000 and admission GFR < 60 ml/min were very strongly predictive of need for IMV (ROC = 0.86, p=). Mortality was 11.2% in HFNT only group versus 47.5% in the HFNT progressed to IMV group (p,0.0001). Mortality and need for pulmonary vasodilators were higher in the HNFT progressed to IMV group. Conclusion ROX HGNC index is a valuable, noninvasive tool to evaluate patients with moderate to severe hypoxemic respiratory failure MESHD in COVID-19 MESHD treated with HFNT. ROX HGNC helps predicts need for IMV and thus limiting morbidity and mortality associated with IMV.

    Risk factors associated with failure of high-flow nasal cannula oxygen therapy in patients with severe COVID-19 MESHD in Wuhan, China

    Authors: Xiao-huan Ma; Fang Yin; Jie Zhang; Meng-yun Peng; Hong Guan; Ping Gong

    doi:10.21203/rs.3.rs-37538/v1 Date: 2020-06-22 Source: ResearchSquare

    Background Acute hypoxemic respiratory failure MESHD is prevalent in severe Coronavirus Disease 2019 MESHD ( COVID-19 MESHD). High-flow nasal canula (HFNC) is currently the most common ventilation strategy for COVID-19 MESHD patients with respiratory failure MESHD. This study is to analyze the risk factors associated with high-flow nasal canula (HFNC) oxygen therapy failure MESHD in patients with severe COVID-19 MESHD.Methods: In this single-center, retrospective, observational study, we enrolled patients with confirmed severe COVID-19 MESHD admitted to Renmin Hospital of Wuhan university (Wuhan, China) from 1 February 2020 to 26 March 26 2020. Epidemiological, clinical, and laboratory data, and treatments and outcomes upon hospital admission, were obtained from electronic medical records. Sequential organ failure assessment (SOFA) scores were calculated.Results: Of 54 patients with severe COVID-19 MESHD, HFNC was successful in 28 (51.9%) and unsuccessful in 26 (48.1%). HFNC failure MESHD was seen more commonly in patients aged ≥60 years and in men. In addition, compared with patients successfully treated with HFNC, patients with HFNC failure MESHD had the following characteristics: higher percentage of fatigue MESHD and anorexia MESHD as well as cardiovascular disease MESHD; increased time from onset to diagnosis and SOFA scores; elevated body temperature, respiratory rate, and heart rate; more complications including ARDS, septic shock MESHD, myocardial damage MESHD, and acute kidney injury MESHD; increased neutrophil counts and prothrombin time; and decreased arterial partial pressure of oxygen/fraction of inspired oxygen (PaO2/FiO2) (all P < 0.05). However, binary logistic regression analysis showed that only male gender and PaO2/FiO2 were independent risk factors significantly associated with HFNC failure MESHD (both, P < 0.05). Conclusion: Patients with severe COVID-19 MESHD had a high HFNC treatment failure rate. Male gender and decreased PaO2/FiO2 were independent risk factors associated with HFNC failure MESHD in severe COVID-19 MESHD patients.

    The experience of high flow nasal cannula in hospitalized patients with 2019 novel coronavirus–infected pneumonia in Chongqing, China

    Authors: Ke Wang; Wei Zhao; Ji Li; Weiwei Shu; Jun Duan

    doi:10.21203/rs.2.24633/v1 Date: 2020-02-25 Source: ResearchSquare

    Background The outbreak of a novel coronavirus (2019-nCoV)– infected pneumonia MESHD (NCIP) is currently ongoing in China. Most of the critically ill patients received high flow nasal cannula (HFNC). However, the experience of HFNC in this population is lacking. Methods We retrospectively collected the NCIP patients who received HFNC in two hospital of Chongqing, China from January 1st to February 18th, 2020. The clinical characteristics were collected. Patients who required upgrading to noninvasive ventilation (NIV) were defined as HFNC failure MESHD. Results We enrolled 17 patients in this study. Of them, 7 patients (41%) experienced HFNC failure MESHD (6 required upgrading to NIV, and one to NIV and further to intubation). The HFNC failure rate was 0% (0/6), 57% (4/7) and 75% (3/4) (p =0.03 between 3 groups) in patients with PaO2/FiO2 >200, 150-200, and <150 mmHg, respectively. In the successful patients, the respiratory rate, heart rate and PaO2/FiO2 significantly improved from initiation to termination of HFNC (27±3 vs. 21±2 breaths/min, p <0.01; 86±15 vs. 76±12 beats/min, p =0.03; and 213±49 vs. 299±125 mmHg, p =0.04, respectively). However, in the unsuccessful patients, the respiratory rate and PaO2/FiO2 significantly deteriorated (22±3 vs. 25±3 breaths/min, p =0.04; and 160±27 vs. 105±24 mmHg, p =0.01, respectively). When they upgraded to NIV, the PaO2/FiO2 improved after 1-2 h of NIV (105±24 vs. 202±111 mmHg, p =0.04). In the total cohort, only PaO2/FiO2 at baseline was lower in unsuccessful patients than that in successful ones (213±49 vs. 160±27 mmHg, p =0.02). Conclusions This study firstly provides the experience of how to use HFNC in patients with NCIP. Patients with lower PaO2/FiO2 were more likely to experience HFNC failure MESHD. Among the failure MESHD patients, most of them can avoid intubation when they were ungraded to NIV.

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MeSH Disease
HGNC Genes
SARS-CoV-2 Proteins


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