post-COVID complications

  • 文章类型: Case Reports
    自2019年冠状病毒病(COVID-19)在全球爆发以来,它与各种肺外表现有关。其罕见的并发症之一是格林-巴利综合征(GBS),一种感染后神经系统疾病,表现为特征性的上行肢体瘫痪。这里,我们描述了一例非典型病例,即一名42岁的非裔美国男性在COVID-19检测呈阳性后5周内出现双侧面瘫.最初的诊断影像学和血液研究对急性病理学均为阴性。在随后对患者脑脊液的分析中发现的白蛋白细胞解离及其对静脉免疫球蛋白(IVIg)的适当治疗反应表明GBS是最可能的诊断。
    Coronavirus disease (COVID-19) has been associated with a diverse range of extrapulmonary manifestations since its global outbreak in 2019. One of its rare complications is Guillain-Barre Syndrome (GBS), a post-infectious neurological disorder that manifests with a characteristic ascending limb paralysis. Here, we describe the atypical case of a 42-year-old African American male who developed bilateral facial paralysis within five weeks of testing positive for COVID-19. Initial diagnostic imaging and blood studies were negative for acute pathology. Albuminocytological dissociation found in a subsequent analysis of the patient\'s cerebrospinal fluid and his appropriate therapeutic response to intravenous immunoglobulin (IVIg) indicated GBS as the most likely diagnosis.
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  • 文章类型: Review
    The pandemic of coronavirus infection existed from 2019 to 2023. The World Health Organization (WHO) has announced on May 5, 2023 that the pandemic had ended. However, it does not cease to have an adverse effect on the health of the world population. Necrotic lesions of the bones of the facial skeleton are now a characteristic sign of a severe coronavirus infection. We conducted a review of scientific publications that reflected the relationship between coronavirus and necrotic processes of the skull bones, methods of treatment, prevention and the latest developments in this direction. The purpose of this article is to review existing studies on Post-Covid osteomyelitis of facial bones, its impact, features of the clinical picture of this disease, analysis of methods and means of treatment of this group of patients. Analysis of literature data has shown that the search for an ideal dressing material continues, especially the developments of native developers stand emphasized. The advantages of modern materials over traditional ones have become unquestionable, but further research in this direction is required.
    Пандемия коронавирусной инфекции длилась с 2019 по 2023 г. Всемирной организацией здравоохранения 5 мая 2023 г. пандемия была объявлена завершенной, однако до сих пор она не перестает оказывать неблагоприятное влияние на состояние здоровья мирового населения. Некротические поражения костей лицевого скелета теперь являются характерным признаком тяжело перенесенной коронавирусной инфекции. Нами был проведен обзор научных публикаций, в которых были отражены взаимосвязь коронавируса и некротических процессов костей лицевого отдела черепа, методы лечения, профилактика и последние разработки в этом направлении. Цель статьи — обзор существующих исследований по постковидному остеомиелиту лицевых костей, особенностям клинической картины этого заболевания, а также анализ методов и средств лечения этой группы пациентов. Анализ литературных данных показал, что поиск совершенного перевязочного материала продолжается, особенно выделяются разработки отечественных производителей. Преимущества современных материалов над традиционными стали неоспоримыми, тем не менее требуется проведение дальнейших исследований в этом направлении.
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  • 文章类型: Journal Article
    大流行COVID-19(2019年冠状病毒病)是由严重急性呼吸道综合症冠状病毒2(SARS-CoV-2)引起的,摧毁了全球经济和医疗体系。感染导致COVID-19患者出现不可预见的上升,并增加了全球死亡率。这项研究给出了关于宿主-病原体相互作用的总体思路,对COVID-19的免疫反应,感染的恢复状态,靶器官和相关并发症,以及恢复期受试者和未感染个体感染后免疫的比较。COVID-19感染的变异和发作的出现使情况恶化。及时引入疫苗和预防措施有助于控制感染的严重程度。稍后,从COVID-19中恢复的人口显著增长。然而,了解感染后医疗问题的影响对于改善个人的健康状况至关重要。现在已经认识到,COVID-19感染影响多个器官,并表现出广泛的临床表现。所以,COVID-19感染后,在已经普遍存在健康并发症的个体中产生高风险。识别COVID-19后相关的健康问题及其适当的管理对于改善患者的生活质量更为重要。坚持,通常在初次感染恢复后持续数周至数月的后遗症和其他医学并发症与COVID-19有关。制定预防措施需要多学科的方法,在长期护理方面,康复技术和临床管理策略。
    The pandemic COVID-19 (coronavirus disease 2019) is caused by the severe acute respiratory syndrome corona virus 2 (SARS-CoV-2), which devastated the global economy and healthcare system. The infection caused an unforeseen rise in COVID-19 patients and increased the mortality rate globally. This study gives an overall idea about host-pathogen interaction, immune responses to COVID-19, recovery status of infection, targeted organs and complications associated, and comparison of post-infection immunity in convalescent subjects and non-infected individuals. The emergence of the variants and episodes of COVID-19 infections made the situation worsen. The timely introduction of vaccines and precautionary measures helped control the infection\'s severity. Later, the population that recovered from COVID-19 grew significantly. However, understanding the impact of healthcare issues resulting after infection is paramount for improving an individual\'s health status. It is now recognised that COVID-19 infection affects multiple organs and exhibits a broad range of clinical manifestations. So, post COVID-19 infection creates a high risk in individuals with already prevailing health complications. The identification of post-COVID-19-related health issues and their appropriate management is of greater importance to improving patient\'s quality of life. The persistence, sequelae and other medical complications that normally last from weeks to months after the recovery of the initial infection are involved with COVID-19. A multi-disciplinary approach is necessary for the development of preventive measures, techniques for rehabilitation and strategies for clinical management when it comes to long-term care.
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  • 文章类型: Journal Article
    由新型冠状病毒SARS-CoV-2引起的冠状病毒病(COVID-19)大流行对全球健康产生了深远的影响,导致研究激增,以更好地了解疾病的病理生理学。在调查的各个方面中,矿物质稳态的破坏已经成为一个关键的关注领域。这篇综述旨在概述目前与钙有关的证据,磷和镁异常与COVID-19感染有关,并探讨了该疾病急性期以外的潜在影响。除了COVID-19的急性期,有证据表明这些矿物质异常对长期健康结果有潜在影响。钙的持续变化,磷和镁水平与心血管风险增加有关,骨骼并发症和代谢紊乱,保证对COVID-19后患者进行持续监测和管理。
    The coronavirus disease (COVID-19) pandemic caused by the novel coronavirus SARS-CoV-2 has had a profound impact on global health, leading to a surge in research to better understand the pathophysiology of the disease. Among the various aspects under investigation, disruptions in mineral homeostasis have emerged as a critical area of interest. This review aims to provide an overview of the current evidence linking calcium, phosphorus and magnesium abnormalities with COVID-19 infection and explores the potential implications beyond the acute phase of the disease. Beyond the acute phase of COVID-19, evidence suggests a potential impact of these mineral abnormalities on long-term health outcomes. Persistent alterations in calcium, phosphorus and magnesium levels have been linked to increased cardiovascular risk, skeletal complications and metabolic disorders, warranting continuous monitoring and management in post-COVID-19 patients.
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  • 文章类型: Journal Article
    严重急性呼吸系统综合症冠状病毒2(SARS-CoV-2)主要影响呼吸系统,但也可能导致神经系统并发症。在COVID-19患者中,内皮被认为是致命弱点。SARS-CoV-2感染和随后的内皮炎可导致多种内皮功能障碍,比如血管张力改变,氧化应激,和细胞因子风暴。引起的脑血流动力学损害与COVID-19患者发生严重疾病的可能性较高和预后不良相关。这篇综述总结了关于血管舒缩反应性(VMR)在COVID-19患者中的作用的最相关文献。对研究文章进行了概述。大多数研究支持COVID-19患者发生内皮功能障碍和脑VMR损伤的假设。研究人员认为,这些改变可能是由于病毒对大脑的直接入侵或间接影响,如炎症和细胞因子。最近,研究人员得出结论,人类疱疹病毒8和汉坦病毒等病毒主要影响内皮细胞,因此,影响脑血流动力学。特别是在COVID-19患者中,受损的VMR与更高的严重疾病风险和不良预后相关.使用VMR,人们可以获得对患者疾病进展的宝贵见解,并就适当的治疗方案做出更明智的决定。COVID-19病毒或其他病毒可能会爆发新的大流行,这使得医疗保健提供者和研究人员必须继续专注于开发新的策略来提高此类患者的生存率,尤其是那些有脑血管危险因素的人。
    Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) primarily affects the respiratory system but can also lead to neurological complications. Among COVID-19 patients, the endothelium is considered the Achilles heel. A variety of endothelial dysfunctions may result from SARS-CoV-2 infection and subsequent endotheliitis, such as altered vascular tone, oxidative stress, and cytokine storms. The cerebral hemodynamic impairment that is caused is associated with a higher probability of severe disease and poor outcomes in patients with COVID-19. This review summarizes the most relevant literature on the role of vasomotor reactivity (VMR) in COVID-19 patients. An overview of the research articles is presented. Most of the studies have supported the hypothesis that endothelial dysfunction and cerebral VMR impairment occur in COVID-19 patients. Researchers believe these alterations may be due to direct viral invasion of the brain or indirect effects, such as inflammation and cytokines. Recently, researchers have concluded that viruses such as the Human Herpes Virus 8 and the Hantavirus predominantly affect endothelial cells and, therefore, affect cerebral hemodynamics. Especially in COVID-19 patients, impaired VMR is associated with a higher risk of severe disease and poor outcomes. Using VMR, one can gain valuable insight into a patient\'s disease progression and make more informed decisions regarding appropriate treatment options. A new pandemic may develop with the COVID-19 virus or other viruses, making it essential that healthcare providers and researchers remain focused on developing new strategies for improving survival in such patients, particularly those with cerebrovascular risk factors.
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  • 文章类型: Journal Article
    COVID-19是由严重急性呼吸综合征冠状病毒-2,SARS-CoV-2引起的。COVID-19改变了世界格局,并在全球范围内造成了死亡。从COVID-19中康复的患者表现出神经系统,心理,肾,心血管,肺,和血液学并发症。在一些患者中,并发症持续6个月以上。然而,对COVID后并发症的关注明显较少。目前可用的药物用于解决并发症,但是新的干预措施必须解决这个问题。最近对来自天然来源的植物化学物质进行了评估,以治愈或缓解COVID-19症状。一种可食用的植物,龙葵,正如印度AYUSH部门在大流行期间规定的那样,在治疗COVID-19时可能是有治疗作用的。黑草具有抗炎作用,免疫调节,和抗病毒作用,以治疗SARS-CoV-2感染及其后并发症。植物的不同部分代表促炎细胞因子的减少,并通过保护各种器官来防止多器官衰竭(肝脏,肾,心,神经,和肺)。该综述基于计算机对接和药理学研究,提出了植物黑草在控制COVID-19症状及其后COVID并发症中的可能作用。需要进一步的系统和实验研究来验证我们的假设。
    COVID-19 is caused by severe acute respiratory syndrome coronavirus-2, SARS-CoV-2. COVID-19 has changed the world scenario and caused mortality around the globe. Patients who recovered from COVID-19 have shown neurological, psychological, renal, cardiovascular, pulmonary, and hematological complications. In some patients, complications lasted more than 6 months. However, significantly less attention has been given to post-COVID complications. Currently available drugs are used to tackle the complications, but new interventions must address the problem. Phytochemicals from natural sources have been evaluated in recent times to cure or alleviate COVID-19 symptoms. An edible plant, Solanum nigrum, could be therapeutic in treating COVID-19 as the AYUSH ministry of India prescribes it during the pandemic. S. nigrum demonstrates anti-inflammatory, immunomodulatory, and antiviral action to treat the SARS-CoV-2 infection and its post-complications. Different parts of the plant represent a reduction in proinflammatory cytokines and prevent multi-organ failure by protecting various organs (liver, kidney, heart, neuro, and lung). The review proposes the possible role of the plant S. nigrum in managing the symptoms of COVID-19 and its post-COVID complications based on in silico docking and pharmacological studies. Further systematic and experimental studies are required to validate our hypothesis.
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  • 文章类型: Observational Study
    目的:本研究旨在报告COVID相关性肺毛霉菌病的手术结局,特别强调手术死亡率。
    方法:这项前瞻性观察性研究是在Gurugram的一个专门的胸外科病房进行的,印度超过18个月。人口学分析,进行围手术期变量。分析了各种参数以评估影响死亡率的因素。
    结果:在研究期间对44例诊断为CAPM的患者进行了治疗。全部开始抗真菌治疗。然而,33例患者(75%)进行了手术,而其余11例(25%)被认为不适合手术。在手术队列中(n=33),有20名男性(60.6%)和13名女性(39.4%),平均年龄54.8岁(范围,33-72岁)。症状的平均持续时间为1.1周。5例(15.1%)进行非解剖楔形叶切除,26例(78.9%)需要肺叶切除/双叶切除,2例(6%)需要左肺切除.围手术期死亡5例(15.1%),都是因为真菌败血症.ECOG量表>2(P≤0.001),较高的Charlson合并症指数评分>2分(P=0.04)和肺切除术(P=0.02)是死亡率的预测因素.与NCPM相比,术后并发症发生率(P=0.50)和术后死亡率(P=0.69)无差异.
    结论:CAPM应提供具有清晰切缘的积极手术切除,只要可行。与非COVID肺毛霉菌病相比,CAPM手术与更高的术后并发症,包括死亡率无关。
    OBJECTIVE: This study aims at reporting the surgical outcomes of COVID associated pulmonary mucormycosis with special emphasis on surgical mortality.
    METHODS: This prospective observational study was conducted in a dedicated thoracic surgical unit in Gurugram, India over 18 months. An analysis of demography, peri-operative variables were carried out. Various parameters were analysed to assess the factors affecting mortality.
    RESULTS: Total of 44 patients with diagnosis of CAPM were managed during the study period. All were started on anti-fungal therapy. However, 33 patients (75%) were operated whereas rest 11 (25%) were not considered suitable for surgery. In the surgical cohort (n  =  33), there were 20 males (60.6%) and 13 females (39.4%), with a mean age of 54.8 years (range, 33-72 years). The mean duration of the symptoms was 1.1 weeks. Non-anatomical wedge resection of lobe(s) was performed in 5 patients (15.1%), lobectomy/bi-lobectomy was required in 26 patients (78.9%) and left pneumonectomy in 2 patients (6%). There were 5 peri-operative deaths (15.1%), all due to fungal sepsis. ECOG scale > 2 (P  ≤  0.001), higher Charlson Comorbidity Index score > 2 (P  =  0.04) and pneumonectomy (P  =  0.02) were the predictors of mortality. On comparison with NCPM, there was no difference in the incidence of post-operative complications (P  =  0.50) and the post-operative mortality (P  =  0.69).
    CONCLUSIONS: Aggressive surgical resection with clear margins should be offered in CAPM, whenever feasible. Surgery for CAPM was not associated with higher post-operative complications including mortality compared to Non-COVID Pulmonary Mucormycosis.
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  • 文章类型: Case Reports
    2019年冠状病毒病(COVID-19)的空化和气胸与高发病率和高死亡率独立相关。虽然在机械通气的COVID-19患者中通常观察到自发性(非创伤性)气胸形成,很少有COVID-19相关性气胸的罕见报道,没有任何气压伤和其他常规危险因素的病史.这里,我们报告了1例发生COVID-19后空化和张力性气胸的独特病例,该病例4周后出现严重COVID-19肺炎的年轻患者因水气胸形成而进一步复杂化.由于患者没有任何常规危险因素,我们认为,即使在COVID-19临床恢复后,持续的炎性肺泡损伤在肺空化和随后的气胸形成中起关键作用.随着临床和放射学对这些致命疾病的迅速识别,但可治疗的COVID-19肺炎并发症,病人获救并顺利康复。
    Cavitation and pneumothorax are independently associated with high morbidity and mortality in coronavirus disease-2019 (COVID-19). While spontaneous (non-traumatic) pneumothorax formation has commonly been observed among mechanically ventilated COVID-19 patients, there are few rare reports of COVID-19 associated pneumothorax without any history of barotrauma and other conventional risk factors. Here, we report a unique case of post-COVID-19 cavitation and tension pneumothorax which was further complicated by hydropneumothorax formation in a young patient who suffered severe COVID-19 pneumonia 4 weeks back. As the patient was devoid of any conventional risk factors, we believe that persistent inflammatory alveolar damage even after clinical recovery from COVID-19 played a key role in pulmonary cavitation followed by pneumothorax formation. With prompt clinical and radiological recognition of these fatal, yet treatable complications of COVID-19 pneumonia, the patient was saved and had an uneventful recovery.
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  • 文章类型: Case Reports
    本文介绍了通过吸入Xe和O2气体混合物缓解COVID后通气失败的理论基础和临床案例。冠状病毒病因的肺炎将表面活性剂的饱和磷脂转化为固体有序相,这会破坏表面张力,肺泡肺炎,和肺泡-毛细管气体交换。使用分子建模(B3LYP/lanl2dz;GAUSSIAN09),我们证明,由于范德华分散相互作用,Xe原子增加了磷脂酰基链之间的距离,从而提供了从固态到液相的相变,并恢复了表面活性单层表面活性剂膜。临床病例证实,短期吸入Xe和O2气体混合物可缓解通气功能不足的表现,并增加SpO2和肺部末端部分的气化。
    The article presents a theoretical rationale and a clinical case of relief of post-COVID ventilation failure by inhalation of Xe and O2 gas mixture. Pneumonitis of coronavirus etiology transforms saturated phospholipids of surfactant into a solid-ordered phase, which disrupts surface tension, alveolar pneumatization, and alveolar-capillary gas exchange. Using molecular modeling (B3LYP/lanl2dz; GAUSSIAN09), we demonstrated that Xe atom due to the van der Waals dispersion interaction increases the distance between the phospholipid acyl chains providing a phase transition from the solid-ordered to liquid phase and restored the surface-active monolayer surfactant film. A clinical case confirmed that short-term inhalations of the Xe and O2 gas mixture relieved manifestations of ventilation insufficiency and increased SpO2 and pneumatization of the terminal parts of the lungs.
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  • 文章类型: Case Reports
    冠状病毒病19(COVID-19)是由严重的急性呼吸道冠状病毒2(SARS-CoV-2)引起的。除了呼吸道表现,COVID-19由于其亲神经特征,可以影响神经系统。神经系统表现和并发症包括头痛,多发性神经病,脑血管意外,癫痫发作,脑病,和脱髓鞘疾病。我们描述了一例多发性硬化症,COVID-19感染后的脱髓鞘疾病,文献中很少报道。一名47岁的女性表现出疲劳,视力模糊,麻木,和COVID-19感染后三周出现的上运动神经元病变的迹象。大脑的磁共振成像显示两个半球的脑室周围区域脱髓鞘病变,提示脱髓鞘疾病.对多发性硬化症进行了临时诊断。甲基强的松龙开始后,她的病情有所改善。
    Coronavirus disease 19 (COVID-19) is caused by severe acute respiratory coronavirus 2 (SARS-CoV-2). Apart from respiratory manifestations, COVID-19 can affect the nervous system due to its neurotropic features. Neurological manifestations and complications include headache, polyneuropathies, cerebrovascular accidents, seizures, encephalopathy, and demyelinating disease. We describe a case of multiple sclerosis, a demyelinating disease following COVID-19 infection, rarely reported in the literature. A 47-year-old female presented with fatigue, blurry vision, numbness, and signs of upper motor neuron lesions that had occurred three weeks after COVID-19 infection. Magnetic resonance imaging of the brain revealed demyelinating lesions in the periventricular area of both hemispheres, suggesting a demyelinating disease. A provisional diagnosis of multiple sclerosis was made. Her condition improved after the commencement of methylprednisolone.
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