SARS-CoV infection

SARS - CoV 感染
  • 文章类型: Journal Article
    乳酸脱氢酶(LDH)和天冬氨酸氨基转移酶(AST)是心血管疾病的重要指标,肌肉和肝脏病变,可作为传染病的预后指标,如2019年冠状病毒病(COVID-19)。本系统评价和荟萃分析评估了LDH和AST水平对COVID-19严重程度的预后价值。Ovid-Medline,PubMed,Embase和Cochrane图书馆被用来搜索文章,根据纳入和排除标准,直到2022年7月。使用Revman5.3和Stata15.1进行荟萃分析。使用随机效应模型分析LDH和AST浓度的标准化平均差(SMD)和95%置信区间(CIs)。使用荟萃回归和亚组方法调查异质性。本研究共纳入23篇文献中的4342例COVID-19患者。重度COVID-19患者的LDH(SMD=1.21;95%CI:0.98,1.44)和AST(SMD=0.68;95%CI:0.54,0.81)明显高于非重度COVID-19患者。COVID-19危重症患者血清LDH和AST水平升高,提示LDH和AST水平与COVID-19的严重程度之间存在相关性。这些发现可能有助于开发一种风险分层的方法来治疗这种疾病的患者。
    Lactate dehydrogenase (LDH) and aspartate aminotransferase (AST) are important indicators of cardiovascular, muscle and liver lesions, and can be used as prognostic indicators for infectious diseases, such as coronavirus disease 2019 (COVID-19). The present systematic review and meta-analysis assessed the prognostic value of LDH and AST levels for COVID-19 severity. Ovid-Medline, PubMed, Embase and The Cochrane Library were used to search for articles, according to the inclusion and exclusion criteria, until July 2022. The meta-analysis was performed using Revman5.3 and Stata15.1. Standardized mean difference (SMD) and 95% confidence intervals (CIs) of LDH and AST concentrations were analyzed using a random-effects model. Heterogeneity was investigated using meta-regression and subgroup methods. A total of 4,342 patients with COVID-19 in 23 articles were included in the present study. LDH (SMD=1.21; 95% CI: 0.98, 1.44) and AST (SMD=0.68; 95% CI: 0.54, 0.81) were significantly higher in patients with severe COVID-19 compared with in those with non-severe COVID-19. Serum LDH and AST levels in critically ill patients with COVID-19 were increased, suggesting a correlation between the levels of LDH and AST and the severity of COVID-19. These findings may help to develop a risk-stratified approach to the care of patients with this disease.
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  • 文章类型: Journal Article
    目标:SARS-CoV-2或COVID-19的流行极大地造成了全球经济失衡。随着病例数量的指数增长,并不断检查社区传播,诊断试剂盒的需求很高,严重短缺。合并样本策略被证明是有希望的策略,旨在确定资源有限且不损失测试灵敏度和特异性的样本的最佳测试。这项研究是用标准的分子生物学分级实验室设备进行的,FDA批准的COVID-19RNA提取,和SARS-CoV-2检测试剂盒。
    方法:本研究旨在比较分析3,5和8样本中相同患者样本的鼻咽标本样本和RNA的汇集策略,而测试可用性没有显着损失。研究的另一个主要重点是在合并策略中检测到低或临界SARS-CoV-2阳性。总共300个样品(240个阳性和60个阴性)针对3、5和8个样本样品池和RNA洗脱物进行测试。
    结果:比较分析确定三池和五池策略的敏感性高于98%,八池策略的敏感性为100%。
    结论:RNA洗脱汇集策略的一致性率优于样本汇集,特异性为100%。因此,在全球大流行的巨大资源危机中,SARS-CoV-2的合并方法在5%的低患病率下是可行的。
    The pandemic of SARS-CoV-2 or COVID-19 has hugely created an economic imbalance worldwide. With the exponential increase in the number of cases and to keep in check on the community transmission, there is high demand and acute shortage of diagnostic kits. The pooled-sample strategy turns out to be the promising strategy intended to determine the optimal testing for specimens with limited resources and without losing the test sensitivity and specificity. The study was performed with standard molecular biology graded lab equipment, FDA-approved COVID-19 RNA extraction, and SARS-CoV-2 tests kits.
    The study aims to comparatively analyze the pooling strategy of the naso-oropharyngeal specimen sample and RNA extracted from the same patient samples in the pool of 3,5, and 8 with no significant loss in test usability. Another primary focus of the study was detection of low or borderline SARS-CoV-2 positives in the pooling strategy. A total of 300 samples (240 positives and 60 negatives) were tested for 3, 5, and 8 pools of specimen samples and RNA elutes.
    The comparative analysis determined the sensitivity for three and five pool strategy to be above 98% and eight pool strategy to be 100%.
    The RNA elutes pooling strategy concordance rate is better than that of specimen pooling with 100% specificity. Thus, in the substantial crisis of resources with the global pandemic, pooling approaches for SARS-CoV-2 can be practical in a low prevalence rate of 5%.
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  • 文章类型: Journal Article
    UNASSIGNED: Few studies have reported the implications and adverse events of performing endotracheal intubation for critically ill COVID-19 patients admitted to intensive care units. The aim of the present study was to determine the adverse events related to tracheal intubation in COVID-19 patients, defined as the onset of hemodynamic instability, severe hypoxemia, and cardiac arrest.
    UNASSIGNED: Tertiary care medical hospitals, dual-centre study performed in Northern Italy from November 2020 to May 2021.
    UNASSIGNED: Adult patients with positive SARS-CoV-2 PCR test, admitted for respiratory failure and need of advanced invasive airways management.
    UNASSIGNED: Endotracheal Intubation Adverse Events.
    UNASSIGNED: The primary endpoint was to determine the occurrence of at least 1 of the following events within 30 minutes from the start of the intubation procedure and to describe the types of major adverse peri-intubation events: severe hypoxemia defined as an oxygen saturation as measured by pulse-oximetry <80%; hemodynamic instability defined as a SBP 65 mmHg recoded at least once or SBP < 90 mmHg for 30 minutes, a new requirement or increase of vasopressors, fluid bolus >15 mL/kg to maintain the target blood pressure; cardiac arrest.
    UNASSIGNED: Among 142 patients, 73.94% experienced at least one major adverse peri-intubation event. The predominant event was cardiovascular instability, observed in 65.49% of all patients undergoing emergency intubation, followed by severe hypoxemia (43.54%). 2.82% of the patients had a cardiac arrest.
    UNASSIGNED: In this study of intubation practices in critically ill patients with COVID-19, major adverse peri-intubation events were frequent.
    UNASSIGNED: www.clinicaltrials.gov identifier: NCT04909476.
    UNASSIGNED: Pocos estudios han informado las implicaciones y los eventos adversos de realizar una intubación endotraqueal para pacientes críticos con COVID-19 ingresados ​​en unidades de cuidados intensivos. El objetivo del presente estudio fue determinar los eventos adversos relacionados con la intubación traqueal en pacientes con COVID-19, definidos como la aparición de inestabilidad hemodinámica, hipoxemia severa y paro cardíaco.
    UNASSIGNED: Hospitales médicos de atención terciaria, estudio de doble centro realizado en el norte de Italia desde noviembre de 2020 hasta mayo de 2021.
    UNASSIGNED: Pacientes adultos con prueba PCR SARS-CoV-2 positiva, ingresados por insuficiencia respiratoria y necesidad de manejo avanzado de vías aéreas invasivas.
    UNASSIGNED: Eventos adversos de la intubación endotraqueal.
    UNASSIGNED: El punto final primario fue determinar la ocurrencia de al menos 1 de los siguientes eventos dentro de los 30 minutos posteriores al inicio del procedimiento de intubación y describir los tipos de eventos adversos periintubación mayores. : hipoxemia severa definida como una saturación de oxígeno medida por pulsioximetría <80%; inestabilidad hemodinámica definida como PAS 65 mmHg registrada al menos una vez o PAS < 90 mmHg durante 30 minutos, nuevo requerimiento o aumento de vasopresores, bolo de líquidos > 15 mL/kg para mantener la presión arterial objetivo; paro cardiaco.
    UNASSIGNED: Entre 142 pacientes, el 73,94% experimentó al menos un evento periintubación adverso importante. El evento predominante fue la inestabilidad cardiovascular, observada en el 65,49% de todos los pacientes sometidos a intubación de urgencia, seguido de la hipoxemia severa (43,54%). El 2,82% de los pacientes tuvo un paro cardíaco.
    UNASSIGNED: En este estudio de prácticas de intubación en pacientes críticos con COVID-19, los eventos adversos periintubación mayores fueron frecuentes.
    UNASSIGNED: www.clinicaltrials.gov identificador: NCT04909476.
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  • 文章类型: Observational Study
    Few studies have reported the implications and adverse events of performing endotracheal intubation for critically ill COVID-19 patients admitted to intensive care units. The aim of the present study was to determine the adverse events related to tracheal intubation in COVID-19 patients, defined as the onset of hemodynamic instability, severe hypoxemia, and cardiac arrest.
    Tertiary care medical hospitals, dual-centre study performed in Northern Italy from November 2020 to May 2021.
    Adult patients with positive SARS-CoV-2 PCR test, admitted for respiratory failure and need of advanced invasive airways management.
    Endotracheal Intubation Adverse Events.
    The primary endpoint was to determine the occurrence of at least 1 of the following events within 30 minutes from the start of the intubation procedure and to describe the types of major adverse peri-intubation events: severe hypoxemia defined as an oxygen saturation as measured by pulse-oximetry <80%; hemodynamic instability defined as a SBP 65 mmHg recoded at least once or SBP < 90 mmHg for 30 minutes, a new requirement or increase of vasopressors, fluid bolus >15 mL/kg to maintain the target blood pressure; cardiac arrest.
    Among 142 patients, 73.94% experienced at least one major adverse peri-intubation event. The predominant event was cardiovascular instability, observed in 65.49% of all patients undergoing emergency intubation, followed by severe hypoxemia (43.54%). 2.82% of the patients had a cardiac arrest.
    In this study of intubation practices in critically ill patients with COVID-19, major adverse peri-intubation events were frequent.
    www.
    gov identifier: NCT04909476.
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  • 文章类型: Journal Article
    UNASSIGNED: SARS-CoV attaches to human angiotensin-converting enzyme 2 receptor with the spike protein and infects cells. It can play a direct role in infection by acting as a receptor and/or co-receptor for blood group antigens, microorganisms, parasites, and viruses.
    UNASSIGNED: We aimed to compare the blood group distribution of patients with SARS-CoV-2 infection admitted to hospital and that of healthy donors.
    UNASSIGNED: A total of 823 patients with a positive SARS-CoV-2 test and clinical symptoms were included in the study. The results were compared with the normal blood group distribution in the region.
    UNASSIGNED: While the prevalence of COVID-19 in the A, B, and AB blood groups was higher than that in the healthy blood donors, it was lower in the O blood group (p = 0.009). The distribution of demographic and clinical characteristics based on blood groups did not differ significantly.
    UNASSIGNED: Our results are in agreement with other studies suggesting that blood group O individuals are somewhat more resistant to clinically overt infection with SARS-CoV-2 than other blood groups. However, this tendency is not sufficiently established to allow special prophylaxis recommendations for non-O individuals.
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  • 文章类型: Case Reports
    BACKGROUND: Venovenous extracorporeal membrane oxygenation (VV-ECMO) is a therapeutic strategy for the coronavirus disease 2019 (COVID-19) induced acute respiratory distress syndrome (ARDS). There are inconclusive data in this regard and causes of VV-ECMO failure are not yet understood well.
    METHODS: Here, seven patients with COVID-19-induced ARDS who underwent VV-ECMO introduced and causes of VV-ECMO failure discussed. Medical records of seven COVID-19 patients treated with VV-ECMO were retrospectively evaluated to determine the clinical outcomes of VV-ECMO. Oxygenator failure occurred in four patients whom needed to oxygenator replacement. Successful VV-ECMO decannulation was done in three patients, however finally one patient survived.
    CONCLUSIONS: Hypercoagulability state and oxygenator failure were the most main etiologies for VV-ECMO failure in our study. All patients with COVID-19 undergoing VV-ECMO should be monitored for such problems and highly specialized healthcare team should monitor the patients during VV-ECMO.
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