Corpus overview


Overview

MeSH Disease

Human Phenotype

Transmission

Seroprevalence

There are no seroprevalence terms in the subcorpus

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    Obstetrical and intensive care strategies in a high-risk pregnancy with critical respiratory failure HP due to COVID-19: a case report

    Authors: Zuzana Kolkova; Martin Bjurstrom; John-Kalle Lansberg; Eimantas Svedas; Maria Andrada; Stefan Hansson; Andreas Herbst; Mehreen Zaigham

    doi:10.21203/rs.3.rs-39188/v1 Date: 2020-06-30 Source: ResearchSquare

    BackgroundWith the disease MESHD burden increasing daily, there is a lack of evidence regarding the impact of COVID-19 in pregnancy. Healthy pregnant women are still not regarded as a susceptible group despite physiological changes that make pregnant women more vulnerable to severe infection HP infection MESHD. However, high-risk pregnancies may be associated with severe COVID-19 disease MESHD with respiratory failure HP, as outlined in this report. We discuss the importance of timely delivery and antenatal steroid administration in a critically ill patient.CaseA 27-year-old pregnant woman (1-para) with type I diabetes, morbid obesity MESHD obesity HP, hypothyroidism and a previous Caesarean section, presented with critical respiratory failure HP secondary to COVID-19 at 32 weeks of gestation. A preterm emergency MESHD Caesarean section was performed, after steroid treatment for foetal lung maturation. The patient benefited from prone positioning however, transient acute renal injury, rhabdomyolysis MESHD rhabdomyolysis HP and sepsis MESHD sepsis HP led to prolonged intensive care and mechanical ventilation for 26 days post-Caesarean. The baby had an uncomplicated recovery.ConclusionCOVID-19 infection MESHD in high-risk pregnancies may result in severe maternal-neonatal outcomes such as critical respiratory failure requiring mechanical ventilation and premature termination of the pregnancy. Antenatal steroids may be of benefit for foetal lung maturation but should not delay delivery in severe cases.

    A short therapeutic regimen based on hydroxychloroquine plus azithromycin for the treatment of COVID-19 in patients with non-severe disease MESHD. A strategy associated with a reduction in hospital admissions and complications.

    Authors: José A. Oteo; Pedro Marco; Luis Ponce de León; Alejandra Roncero; Teófilo Lobera; Valentín Lisa

    doi:10.1101/2020.06.10.20101105 Date: 2020-06-12 Source: medRxiv

    The new SARS-CoV-2 infection MESHD named COVID-19 has severely hit our Health System. At the time of writing this paper no medical therapy is officially recommended or has shown results in improving the outcomes in COVID-19 patients. With the aim of diminishing the impact in Hospital admissions and reducing the number of medical complications, we implemented a strategy based on a Hospital Home-Care Unit (HHCU) using an easy-to-use treatment based on an oral administration regimen outside the hospital with hydroxychloroquine (HCQ) plus azithromycin (AZM) for a short period of 5 days. Patients and methods: Patients [≥] 18 years old visiting the emergency MESHD room at the Hospital Universitario San Pedro de Logrono (La Rioja) between March, 31st and April, 12th diagnosed with COVID-19 with confirmed SARS-CoV-2 infection MESHD by a specific PCR, as follows: Patients with pneumonia MESHD pneumonia HP (CURB [≤] 1) who did not present severe comorbidities and had no processes that contraindicated this therapeutic regime. Olygosimptomatic patients without pneumonia MESHD pneumonia HP aged TRANS [≥] 55 years. Patients [≥] 18 years old without pneumonia MESHD pneumonia HP with significant comorbidities. We excluded patients with known allergies HP to some of the antimicrobials used and patients treated with other drugs that increase the QTc or with QTc >450msc. The therapeutic regime was: HCQ 400 mg every twice in a loading dose followed by 200 mg twice for 5 days, plus AZM 500 mg on the first day followed by 250 mg daily for 5 days. A daily telephone follow-up was carried out from the hospital by the same physician. The end-points of our study were: 1.- To measure the need for hospital admission within 15 days after the start of treatment. 2.- To measure the need to be admitted to the intensive care unit (ICU) within 15 days after the start of the treatment. 3.- To describe the severity of the clinical complications developed. 4.- To measure the mortality within 30 days after starting treatment (differentiating if the cause is COVID-19 or something else). 5.-To describe the safety and adverse effects of the therapeutic regime. Results: During the 13 days studied a total of 502 patients were attended in the emergency MESHD room due to COVID-19. Forty-two were sent at home; 80 were attended by the HHCU (patients on this study) and 380 were admitted to the Hospital. In our series there were a group of 69 (85.18%) patients diagnosed with pneumonia MESHD pneumonia HP (37 males TRANS and 32 females TRANS). Most of them, 57 (82.60%) had a CURB65 score of <1 (average age TRANS 49) and 12 (17.40%) a CURB score of 1 (average age TRANS 63). Eighteen (22.50%) of the pneumonia MESHD pneumonia HP patients also had some morbidity as a risk factor. 11 patients (13.75%) without pneumonia MESHD pneumonia HP were admitted to the HHCU because comorbidities or age TRANS [≥] 55 years. Six patients with pneumonia MESHD pneumonia HP had to be hospitalized during the observation period, 3 of them because side effects and 3 because of worsening. One of these patients, with morbid obesity MESHD obesity HP and asthma MESHD asthma HP, had clinical worsening needing mechanical ventilation at ICU and developed acute distress respiratory HP syndrome MESHD. With the exception of the patient admitted to the ICU, the rest of the patients were discharged at home in the following 8 days (3 to 8 days). Twelve patients (15%), 11 of whom had pneumonia MESHD pneumonia HP, experienced side effects affecting mainly the digestive. In another patient a QTc interval prolongation (452 msc) was observed. In total 3 of these patients had to be admitted in the Hospital, 2 because of vomiting MESHD vomiting HP and 1 because a QTc interval lengthening. None of the patients needed to stop the HCQ or AZM and all the 80 patients finished the therapeutic strategy. From the group without pneumonia MESHD pneumonia HP only a patient developed diarrhea MESHD diarrhea HP that did not require hospitalization or stop the medication. Conclusions: Our strategy has been associated with a reduction in the burden of hospital pressure, and it seems to be successful in terms of the number of patients who have developed serious complications and / or death MESHD. None of the patients died in the studied period and only 6 have to be admitted in conventional hospitalization area.

    COVID-19: Impact of Obesity MESHD Obesity HP and Diabetes in Disease MESHD Severity

    Authors: Salman K. Al-Sabah; Mohannad Al-Haddad; Sarah Al Youha; Mohammad H. Jamal; Sulaiman AlMazeedi

    doi:10.1101/2020.05.24.20111724 Date: 2020-05-26 Source: medRxiv

    Background: The Coronavirus disease MESHD 2019 (COVID19) pandemic is straining the healthcare system, particularly for patients with severe outcomes who require admittance to the intensive care unit (ICU). This study aimed to investigate the potential associations of obesity MESHD obesity HP and diabetes with COVID19 severe outcomes, assessed as ICU admittance. Subjects: Demographic and patient characteristics from a retrospective cohort of 1158 patients hospitalized with COVID19 in a single center in Kuwait, along with their medical history, were analyzed. Univariate and multivariate analyses were performed to explore the associations between different variables and ICU admittance. Results: From the 1158 hospitalized patients, 271 (23.4%) had diabetes, 236 (20.4%) had hypertension MESHD hypertension HP and 104 (9%) required admittance into the ICU. From patients with available measurements, 157 (21.6%) had body mass index (BMI)[≥]25 kg/m2. Univariate analysis showed that overweight MESHD overweight HP (BMI=25.0~29.9 kg/m2), obesity MESHD obesity class HP class I (BMI=30~34.9 kg/m2) and morbid obesity MESHD obesity HP (BMI[≥]40 kg/m2) associated with ICU admittance (odds ratio (OR) [95% confidence intervals (CI)]: 2.45 [1.26~4.74] p value=0.008; OR [95% CI]: 3.51 [1.60~7.69] p value=0.002; and OR [95% CI]: 5.18 [1.50~17.85] p value=0.009], respectively). Patients with diabetes were more likely to be admitted to ICU (OR [95% CI]: 9.38 [5.49~16.02]). Two models for multivariate regression analysis were used, assessing either BMI or diabetes on ICU outcomes. In the BMI model, class I obesity HP obesity and morbid MESHD obesity MESHD obesity HP were associated with ICU admittance (adjusted OR (AOR) [95% CI]: 2.7 [1.17~6.20] p value=0.019 and AOR [95% CI]: 3.95 [1.00~15.20] p value=0.046, respectively). In the diabetes model, diabetes was associated with higher ICU admittance (AOR [95% CI]: 5.49 [3.13~9.65] p value<0.001) whereas hypertension MESHD hypertension HP had a protective effect on ICU admittance (AOR [95% CI]: 0.51 (0.28-0.91). Conclusions: In our cohort, overweight MESHD overweight HP, obesity MESHD obesity HP and diabetes in patients with COVID19 were associated with ICU admittance, putting these patients at higher risk of poor outcomes.

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MeSH Disease
Human Phenotype
Transmission
Seroprevalence


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