SARS-Cov-2, severe acute respiratory syndrome coronavirus 2

SARS - CoV - 2 , 严重急性呼吸系统综合症冠状病毒 2
  • 文章类型: Case Reports
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  • 文章类型: Journal Article
    在诊断2019年冠状病毒病(COVID-19)时,由于COVID-19和其他肺炎的图像特征相似,放射科医生无法做出准确的判断。随着机器学习的进步,人工智能(AI)模型在诊断COVID-19和其他肺炎方面显示出希望。我们进行了系统评价和荟萃分析,以评估模型的诊断准确性和方法学质量。
    我们搜索了PubMed,科克伦图书馆,WebofScience,和Embase,medRxiv和bioRxiv的预印本,以定位2021年12月之前发表的研究,没有语言限制。和质量评估(QUADAS-2),使用影像组学质量评分(RQS)工具和CLAIM检查表来评估每个研究的质量。我们使用随机效应模型来计算合并的敏感性和特异性,评估异质性的I2值,和Deeks'测试以评估发表偏差。
    我们从2001年检索的文章中筛选了32项研究,以纳入荟萃分析。我们将6737名参与者纳入测试或验证组。荟萃分析显示,基于胸部影像学的AI模型将COVID-19与其他肺炎区分开来:曲线下的合并面积(AUC)0.96(95%CI,0.94-0.98),灵敏度0.92(95%CI,0.88-0.94),合并特异性0.91(95%CI,0.87-0.93)。使用影像组学的13项研究的平均RQS评分为7.8,占总分的22%。使用深度学习方法的19项研究的CLAIM平均得分为20分,略低于理想得分为42.00分的一半(48.24%)。
    胸部成像的AI模型可以很好地诊断COVID-19和其他肺炎。然而,它尚未作为临床决策工具实施.未来的研究人员应该更加关注研究方法的质量,并进一步提高所开发预测模型的泛化性。
    UNASSIGNED: When diagnosing Coronavirus disease 2019(COVID-19), radiologists cannot make an accurate judgments because the image characteristics of COVID-19 and other pneumonia are similar. As machine learning advances, artificial intelligence(AI) models show promise in diagnosing COVID-19 and other pneumonias. We performed a systematic review and meta-analysis to assess the diagnostic accuracy and methodological quality of the models.
    UNASSIGNED: We searched PubMed, Cochrane Library, Web of Science, and Embase, preprints from medRxiv and bioRxiv to locate studies published before December 2021, with no language restrictions. And a quality assessment (QUADAS-2), Radiomics Quality Score (RQS) tools and CLAIM checklist were used to assess the quality of each study. We used random-effects models to calculate pooled sensitivity and specificity, I2 values to assess heterogeneity, and Deeks\' test to assess publication bias.
    UNASSIGNED: We screened 32 studies from the 2001 retrieved articles for inclusion in the meta-analysis. We included 6737 participants in the test or validation group. The meta-analysis revealed that AI models based on chest imaging distinguishes COVID-19 from other pneumonias: pooled area under the curve (AUC) 0.96 (95 % CI, 0.94-0.98), sensitivity 0.92 (95 % CI, 0.88-0.94), pooled specificity 0.91 (95 % CI, 0.87-0.93). The average RQS score of 13 studies using radiomics was 7.8, accounting for 22 % of the total score. The 19 studies using deep learning methods had an average CLAIM score of 20, slightly less than half (48.24 %) the ideal score of 42.00.
    UNASSIGNED: The AI model for chest imaging could well diagnose COVID-19 and other pneumonias. However, it has not been implemented as a clinical decision-making tool. Future researchers should pay more attention to the quality of research methodology and further improve the generalizability of the developed predictive models.
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  • 文章类型: Case Reports
    尽管一些有免疫能力的患者发展为侵袭性曲霉病,绝大多数病例见于免疫功能低下的患者。有人提出COVID-19感染会导致免疫功能障碍或抑制,这使患者容易发生真菌共感染,如毛霉菌病和曲霉病。
    一名58岁的妇女因困惑入院,构音障碍,和失去知觉。该患者有1个月的严重COVID-19感染史。计算机断层扫描(CT)扫描和磁共振成像(MRI)显示脑室内病变伴有病灶周围水肿和明显的中线移位,最初被认为是脑室内肿瘤。后顶叶开颅手术后,通过经皮质入路从后顶区到右侧脑室切除病变.组织病理学结果证实了脑室内曲霉病(IVA)。患者接受静脉注射两性霉素B治疗2个月,口服雷立康唑治疗4个月。
    Covid-19感染可导致真菌疾病如曲霉病的传播。作为脑曲霉病的次要组成部分,预后不良,脑室内曲霉病需要及时治疗,其中包括手术切除和抗真菌药物的施用。
    感染COVID-19会导致免疫功能障碍,导致真菌共感染,包括中枢神经系统曲霉病。因此,所有出现急性神经系统症状的COVID-19患者在鉴别诊断时应考虑中枢神经系统曲霉病.
    UNASSIGNED: Although some immunocompetent patients have developed invasive aspergillosis, the vast majority of cases are seen in immunocompromised patients. COVID-19 infection has been proposed to cause immune dysfunction or suppression, which predisposes patients to fungal co-infections such as mucormycosis and aspergillosis.
    UNASSIGNED: A 58-year-old woman was admitted to the hospital with confusion, dysarthria, and loss of consciousness. The patient had a 1-month prior history of severe COVID-19 infection. A computerized tomography (CT) scan and a magnetic resonance imaging (MRI) revealed an intraventricular lesion with perilesional edema and a significant midline shift, which was initially thought to be an intraventricular tumor. Following a posterior parietal craniotomy, the lesion was resected via a transcortical approach from the posterior parietal region to the right lateral ventricle. Histopathological findings confirmed intraventricular aspergillosis (IVA). The patient was treated with intravenous amphotericin B for two months and discharged with oral variconazole for 4 months.
    UNASSIGNED: Covid-19 infections can result in- dissemination of fungal diseases such as aspergillosis. As a minor component of cerebral aspergillosis with a poor prognosis, intraventricular aspergillosis necessitates prompt treatment, which includes surgical resection and the administration of anti-fungal medications.
    UNASSIGNED: Infection with COVID-19 causes immune dysfunction, which leads to fungal co-infection, including CNS aspergillosis. As a result, all COVID-19 patients who present with acute neurologic symptoms should have CNS aspergillosis considered in their differential diagnosis.
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  • 文章类型: Journal Article
    自2019年由严重急性呼吸道综合症冠状病毒2(SARS-CoV-2)引起的冠状病毒病(COVID-19)大流行以来,全球范围内都实施了新型和常规疫苗接种策略。尽管在治疗和预防这种传染病的传播方面取得了各种医学进展,它仍然是一个主要的公共卫生威胁,死亡率很高。随着几种致命的SARS-CoV-2变体不断出现,几种疫苗和药物的开发,每个都有一定的优点和缺点,正在进行中。此外,许多模式处于研发或临床试验的不同阶段。这里,我们总结了新兴的SARS-CoV-2变体,包括三角洲,omicron,和“隐形omicron,以及可用的COVID-19口服药物。我们还讨论了除受体结合域蛋白之外的其他可能的候选抗原,以开发通用的COVID-19疫苗。本综述将为未来对抗COVID-19的疫苗和药物开发提供有用的资源。
    Both novel and conventional vaccination strategies have been implemented worldwide since the onset of coronavirus disease 2019 (COVID-19) pandemic caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Despite various medical advances in the treatment and prevention of the spread of this contagious disease, it remains a major public health threat with a high mortality rate. As several lethal SARS-CoV-2 variants continue to emerge, the development of several vaccines and medicines, each with certain advantages and disadvantages, is underway. Additionally, many modalities are at various stages of research and development or clinical trials. Here, we summarize emerging SARS-CoV-2 variants, including delta, omicron, and \"stealth omicron,\" as well as available oral drugs for COVID-19. We also discuss possible antigen candidates other than the receptor-binding domain protein for the development of a universal COVID-19 vaccine. The present review will serve as a helpful resource for future vaccine and drug development to combat COVID-19.
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  • 文章类型: Case Reports
    冠状病毒病-2019(COVID-19)胆管病是最近已知的实体。肝移植治疗COVID-19诱导的胆管病变的报道很少。众所周知,疫苗可以预防严重疾病并改善预后。然而,目前尚无关于COVID-19疫苗对胆汁淤积的影响的报道。因此,我们旨在比较接种疫苗和未接种疫苗的人群中发生COVID-19感染后发生胆汁淤积的患者的病程和结局.方法:在排除其他胆汁淤积原因后,将在大流行期间诊断为COVID后胆汁淤积的患者纳入研究。
    8名未接种疫苗和7名接种疫苗的个体在COVID-19感染后出现胆汁淤积。基线人口统计,介绍,严重程度,两组的COVID-19管理相似。然而,未接种疫苗组的患者病程延长.在接种组中,ALP峰值为312(239-517)U/L,在未接种组中为571.5(368-1058)U/L(P=0.02)。同样,接种疫苗组的γ-谷氨酰转肽酶(GGT)峰值(325[237-600]U/L)低于未接种疫苗组(832[491-1640]U/L;P=0.004).然而,总胆红素的峰值,转氨酶,两组的INR和INR相似。未接种疫苗组有5例患者逐渐出现腹水,而接种疫苗组无一例出现腹水。对五名患者进行了血浆置换,在未接种疫苗的组中,有2例成功连接到活体肝移植。在未接种疫苗的组中,只有两名患者通过保守治疗康复,而接种组通过保守治疗全部康复。未接种疫苗组的其他四名患者计划进行肝移植。
    COVID-19后胆汁淤积与高发病率和高死亡率相关,值得早期识别和适当的管理。疫苗接种可以改变严重COVID-19感染的过程并改善预后。
    UNASSIGNED: Coronavirus disease-2019 (COVID-19) cholangiopathy is a recently known entity. There are very few reports of liver transplantation for COVID-19 induced cholangiopathy. It is well-known that vaccines can prevent severe disease and improve outcomes. However, there are no reports on the impact of COVID-19 vaccines on cholestasis. Therefore, we aimed to compare the course and outcome of patients who developed cholestasis following COVID-19 infection among vaccinated and unvaccinated individuals. Methods: Patients diagnosed with post-COVID cholestasis during the pandemic were included in the study after excluding other causes of cholestasis.
    UNASSIGNED: Eight unvaccinated and seven vaccinated individuals developed cholestasis following COVID-19 infection. Baseline demographics, presentation, severity, and management of COVID-19 were similar in both groups. However, patients in the unvaccinated group had a protracted course. The peak ALP was 312 (239 - 517) U/L in vaccinated group and 571.5 (368-1058) U/L in unvaccinated group (P = 0.02). Similarly, the peak γ-glutamyl transpeptidase (GGT) values were lower in vaccinated (325 [237-600] U/L) than in unvaccinated group (832 [491-1640] U/L; P = 0.004). However, the peak values of total bilirubin, transminases, and INR were similar in both groups. Five patients developed ascites gradually in unvaccinated group while none in vaccinated group developed ascites. Plasma exchange was done in five patients, and two were successfully bridged to living donor liver transplantation in unvaccinated group. Only two patients recovered with conservative management in the unvaccinated group, while all recovered with conservative management in the vaccinated group. The other four patients in unvaccinated group were planned for liver transplantation.
    UNASSIGNED: Post-COVID-19 cholestasis is associated with high morbidity and mortality, meriting early identification and appropriate management. Vaccination can modify the course of severe COVID-19 infection and improve outcomes.
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  • 文章类型: Journal Article
    COVID-19幸存者的长期预后仍然知之甚少。事实证明,肺是COVID-19幸存者的主要受损器官,最明显的是肺弥散功能受损。因此,我们对恢复期COVID-19患者一氧化碳弥散能力(DLCO)受损的潜在危险因素进行了荟萃分析.
    我们对PubMed进行了系统搜索,WebofScience,Embase,和Ovid数据库从开始到2022年1月7日的相关研究,仅限于涉及人类受试者的论文。对方法学质量的研究进行了综述。使用固定效应和随机效应模型来汇集结果。使用I2评估异质性。使用Egger检验评估发表偏倚。PROSPERO注册:CRD42021265377。
    共确定了18篇合格文章,并将其纳入系统评价,12项研究纳入荟萃分析.我们的结果显示,女性(OR:4.011;95%CI:2.928-5.495),改变的胸部计算机断层扫描(CT)(OR:3.002;95%CI:1.319-6.835),年龄(OR:1.018;95%CI:1.007-1.030),较高的D-二聚体水平(OR:1.012;95%CI:1.001-1.023)和尿素氮(OR:1.004;95%CI:1.002-1.007)被确定为DLCO受损的危险因素.
    肺弥散能力是COVID-19康复患者中最常见的肺功能受损。几个危险因素,比如女性,胸部CT改变,年龄较大,较高的D-二聚体水平和尿素氮与DLCO的损害相关。提高对可能的可改变的危险因素的认识和实施干预措施对于肺康复可能是有价值的。
    这项工作得到了广州实验室应急重点项目(EKPG21-29,EKPG21-31)的资助,广州医科大学国家杰出青年科学基金孵化计划(GMU2020-207).
    UNASSIGNED: The long-term prognosis of COVID-19 survivors remains poorly understood. It is evidenced that the lung is the main damaged organ in COVID-19 survivors, most notably in impairment of pulmonary diffusion function. Hence, we conducted a meta-analysis of the potential risk factors for impaired diffusing capacity for carbon monoxide (DLCO) in convalescent COVID-19 patients.
    UNASSIGNED: We performed a systematic search of PubMed, Web of Science, Embase, and Ovid databases for relevant studies from inception until January 7, 2022, limited to papers involving human subjects. Studies were reviewed for methodological quality. Fix-effects and random-effects models were used to pool results. Heterogeneity was assessed using I2. The publication bias was assessed using the Egger\'s test. PROSPERO registration: CRD42021265377.
    UNASSIGNED: A total of eighteen qualified articles were identified and included in the systematic review, and twelve studies were included in the meta-analysis. Our results showed that female (OR: 4.011; 95% CI: 2.928-5.495), altered chest computerized tomography (CT) (OR: 3.002; 95% CI: 1.319-6.835), age (OR: 1.018; 95% CI: 1.007-1.030), higher D-dimer levels (OR: 1.012; 95% CI: 1.001-1.023) and urea nitrogen (OR: 1.004;95% CI: 1.002-1.007) were identified as risk factors for impaired DLCO.
    UNASSIGNED: Pulmonary diffusion capacity was the most common impaired lung function in recovered patients with COVID-19. Several risk factors, such as female, altered chest CT, older age, higher D-dimer levels and urea nitrogen are associated with impairment of DLCO. Raising awareness and implementing interventions for possible modifiable risk factors may be valuable for pulmonary rehabilitation.
    UNASSIGNED: This work was financially supported by Emergency Key Program of Guangzhou Laboratory (EKPG21-29, EKPG21-31), Incubation Program of National Science Foundation for Distinguished Young Scholars by Guangzhou Medical University (GMU2020-207).
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  • 文章类型: Journal Article
    2019年冠状病毒病(COVID-19)的大流行使生物织物,包括口罩和防护服,在我们的日常生活中非常熟悉。生物织物是超出我们想象的一类广泛的纺织品。目前,生物织物已被常规用于各种生物医学领域,比如日常保护,伤口愈合,组织再生,药物输送,和感应,改善个人的健康和医疗条件。然而,这些生物织物通常用直径为微米级(>10μm)的纤维制造。最近,纳米纤维材料由于纳米直径的纤维表现出明显优越的性能,在纤维科学和纺织工程领域引起了广泛的关注,如尺寸和表面/界面效应以及光学,电气,机械,和生物学特性,与微纤维相比。创新的静电纺丝技术和传统的纺织品成型策略的结合为纳米纤维生物织物的产生打开了新的窗口,以更新和更新传统的微纤维生物织物。在过去的二十年里,传统的静电纺丝装置已经被广泛地改进以产生纤维直径小于1000nm的纳米纤维纱线(NYs)。电纺NYs可以进一步用作主要加工单元,用于使用各种纺织品形成策略制造新一代纳米纺织品。在这次审查中,从常规静电纺丝技术的基本信息开始,我们总结了用于NY制造的创新静电纺丝策略,并批判性地讨论了它们的优势和局限性。这篇综述进一步涵盖了基于NY的静电纺丝纳米织物的构建进展及其在生物医学领域的最新应用。主要包括外科缝合,用于组织工程的各种支架和植入物,智能可穿戴生物电子学,以及它们在COVID-19大流行中的当前和潜在应用。最后,这篇综述强调并确定了用于临床的静电纺丝NYs和基于NY的纳米织物的未来需求和机会.
    The pandemic of the coronavirus disease 2019 (COVID-19) has made biotextiles, including face masks and protective clothing, quite familiar in our daily lives. Biotextiles are one broad category of textile products that are beyond our imagination. Currently, biotextiles have been routinely utilized in various biomedical fields, like daily protection, wound healing, tissue regeneration, drug delivery, and sensing, to improve the health and medical conditions of individuals. However, these biotextiles are commonly manufactured with fibers with diameters on the micrometer scale (> 10 μm). Recently, nanofibrous materials have aroused extensive attention in the fields of fiber science and textile engineering because the fibers with nanoscale diameters exhibited obviously superior performances, such as size and surface/interface effects as well as optical, electrical, mechanical, and biological properties, compared to microfibers. A combination of innovative electrospinning techniques and traditional textile-forming strategies opens a new window for the generation of nanofibrous biotextiles to renew and update traditional microfibrous biotextiles. In the last two decades, the conventional electrospinning device has been widely modified to generate nanofiber yarns (NYs) with the fiber diameters less than 1000 nm. The electrospun NYs can be further employed as the primary processing unit for manufacturing a new generation of nano-textiles using various textile-forming strategies. In this review, starting from the basic information of conventional electrospinning techniques, we summarize the innovative electrospinning strategies for NY fabrication and critically discuss their advantages and limitations. This review further covers the progress in the construction of electrospun NY-based nanotextiles and their recent applications in biomedical fields, mainly including surgical sutures, various scaffolds and implants for tissue engineering, smart wearable bioelectronics, and their current and potential applications in the COVID-19 pandemic. At the end, this review highlights and identifies the future needs and opportunities of electrospun NYs and NY-based nanotextiles for clinical use.
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  • 文章类型: Case Reports
    未经批准:2019年冠状病毒病(COVID-19)是由严重急性呼吸道综合症冠状病毒2(SARS-CoV-2)引起的传染病。喉支气管炎(croup)是COVID-19在成人中的一种罕见表现。
    UNASSIGNED:一名52岁女性因呼吸急促和吸气性喘鸣出现在急诊科(ED)。
    未经ASSIGNED:头颈部体格检查显示咽后壁充血。用70度刚性内窥镜进行的喉内窥镜检查显示水肿,双侧移动的声带。胸部X光片显示上气管逐渐变细(“尖顶”标志),这在副流感相关的哮吼感染中观察到。
    UNASSIGNED:患者被送入重症监护病房(ICU),以密切观察可能的气道受损和需要插管。据此,通过对鼻咽样本进行聚合酶链反应检测,她的COVID-19检测呈阳性。头孢曲松的治疗方案,雾化外消旋肾上腺素,并开始使用地塞米松。
    未经批准:在当前的COVID-19大流行期间,强烈建议进行SARS-Cov-2的早期诊断测试,即使在COVID-19症状不典型的情况下也是如此。
    UNASSIGNED: Coronavirus disease 2019 (COVID-19) is an infectious disease caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Laryngotracheitis (croup) is a rare manifestation of COVID-19 in adults.
    UNASSIGNED: A 52-year-old female presented to the emergency department (ED) with shortness of breath and inspiratory stridor.
    UNASSIGNED: Physical examination of the head and neck revealed a congested posterior pharyngeal wall. Laryngeal endoscopy with a 70-degree rigid endoscope demonstrated an edematous, bilaterally moving vocal cords. Chest radiographs showed tapering of the upper trachea (the \"steeple\" sign), which is observed in parainfluenza-associated croup infections.
    UNASSIGNED: The patient was admitted to the intensive care unit (ICU) for close observation for possible airway compromise and the need for intubation. Upon which, she tested positive for COVID-19 by polymerase chain reaction testing of nasopharyngeal samples. A regimen of ceftriaxone, nebulized racemic epinephrine, and dexamethasone was initiated.
    UNASSIGNED: During the current COVID-19 pandemic, early diagnostic testing for SARS-Cov-2 are strongly recommended even when symptoms are not typical of COVID-19.
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  • 文章类型: Case Reports
    在这项研究中,我们报道了1例以前免疫功能正常的患者,他在感染严重急性呼吸道综合征冠状病毒2(SARS-CoV-2)后出现巨细胞病毒诱导的胃溃疡.一名33岁的男子被转诊到我们的中心,抱怨持续性吞咽困难和吞咽困难,摄入固体或液体后的上腹痛和不适,在他入院治疗2019年冠状病毒病(新冠肺炎)后出院几天。内镜检查显示食道有炎症和白色渗出物,胃部有多个大的活动性溃疡.组织病理学和免疫组织化学结果强烈提示巨细胞病毒感染。
    In this study, we reported a previously immunocompetent patient who developed cytomegalovirus-induced gastric ulcers after severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. A 33-year-old man was referred to our center with complaints of persistent dysphagia and odynophagia, and epigastric pain and discomfort after ingesting solids or liquids, a few days after his hospital discharge following admission to treat coronavirus disease 2019 (Covid-19). Endoscopy revealed inflammation and a whitish exudate in the esophagus, and multiple large active ulcers in the stomach. Histopathological and immunohistochemical findings were strongly suggestive of cytomegalovirus infection.
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  • 文章类型: Journal Article
    冠状病毒病是由SARS-CoV-2病毒引起的。该病毒于2019年12月首次出现在武汉(中国),并已在全球传播。到现在为止,它影响了224个国家和地区的2.69亿人,530万人死亡。随着Omicron等变体的出现,COVID-19病例呈指数级增长,数千人死亡。COVID-19的一般症状包括发烧,喉咙痛,咳嗽,肺部感染,and,在严重的情况下,急性呼吸窘迫综合征,脓毒症,和死亡。SARS-CoV-2主要影响肺部,但它也会影响其他器官,如大脑,心,和胃肠系统。据观察,75%的住院COVID-19患者患有至少一种COVID-19相关的共病。最常见的合并症是高血压,NDS,糖尿病,癌症,内皮功能障碍,和CVD。此外,老年患者和既往复药患者的COVID-19相关并发症恶化。SARS-CoV-2还会导致坏疽等高凝问题,中风,肺栓塞,以及其他相关并发症。这篇综述旨在提供关于COVID-19对心血管疾病等现有合并症影响的最新信息,NDS,COPD,和其他并发症。这篇综述将帮助我们了解COVID-19和合并症的现状;因此,它将在解决此类并发症的管理和决策工作中发挥重要作用。
    Coronavirus disease is caused by the SARS-CoV-2 virus. The virus first appeared in Wuhan (China) in December 2019 and has spread globally. Till now, it affected 269 million people with 5.3 million deaths in 224 countries and territories. With the emergence of variants like Omicron, the COVID-19 cases grew exponentially, with thousands of deaths. The general symptoms of COVID-19 include fever, sore throat, cough, lung infections, and, in severe cases, acute respiratory distress syndrome, sepsis, and death. SARS-CoV-2 predominantly affects the lung, but it can also affect other organs such as the brain, heart, and gastrointestinal system. It is observed that 75 % of hospitalized COVID-19 patients have at least one COVID-19 associated comorbidity. The most common reported comorbidities are hypertension, NDs, diabetes, cancer, endothelial dysfunction, and CVDs. Moreover, older and pre-existing polypharmacy patients have worsened COVID-19 associated complications. SARS-CoV-2 also results in the hypercoagulability issues like gangrene, stroke, pulmonary embolism, and other associated complications. This review aims to provide the latest information on the impact of the COVID-19 on pre-existing comorbidities such as CVDs, NDs, COPD, and other complications. This review will help us to understand the current scenario of COVID-19 and comorbidities; thus, it will play an important role in the management and decision-making efforts to tackle such complications.
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