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The early use of sepsis scores to predict respiratory failure and mortality in non-ICU patients with COVID-19? Utilidad de las escalas de sepsis para predecir el fallo respiratorio y la muerte en pacientes con COVID-19 fuera de las Unidades de Cuidados Intensivos

ABSTRACT: This observational retrospective study aimed to investigate the usefulness of Sequential Organ Failure Assessment (SOFA), Quick SOFA (qSOFA), National Early Warning Score (NEWS), and quick NEWS in predicting respiratory failure and death among patients with COVID-19 hospitalized outside of intensive care units (ICU). We included 237 adults hospitalized with COVID-19 who were followed-up on for one month or until death. Respiratory failure was defined as a PaO2/FiO2 ratio ? 200 mmHg or the need for mechanical ventilation. Respiratory failure occurred in 77 patients (32.5%), 29 patients (12%) were admitted to the ICU, and 49 patients (20.7%) died. Discrimination of respiratory failure was slightly higher in NEWS, followed by SOFA. Regarding mortality, SOFA was more accurate than the other scores. In conclusion, sepsis scores are useful for predicting respiratory failure and mortality in COVID-19 patients. A NEWS score ? 4 was found to be the best cutoff point for predicting respiratory failure.

SUBMITTER: Lalueza A

PROVIDER: S-EPMC7888251 | biostudies-literature | 2021 Feb

REPOSITORIES: biostudies-literature

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Monoclonal antibodies as treatment for COVID-19 Anticuerpos monoclonales Como medida de tratamiento Para los pacientes con la COVID-19

Project description: Not available

| S-EPMC8527594 | biostudies-literature

Diagnosis and locoregional treatment of patients with breast cancer during the COVID-19 pandemic Diagnostico y tratamiento locorregional de las pacientes con cancer de mama durante la pandemia de la COVID-19

Project description:We are facing a pandemic that is going to affect a significant part of the population. At the end of April in the world there are about 3,000,000 cases, with 205,000 deaths and 860,000 patients recovered. The response to this pandemic has in many cases led to a significant change in the daily work of caring for cancer patients, the good results of which depend largely on time-adjusted protocols and multidisciplinary treatments. We present a review of local, surgical and radiotherapy treatment together with authors’ recommendations made from personal experience on ways to act in the diagnosis and surgical treatment of breast cancer during the COVID-19 pandemic. The multidisciplinary Breast Committees must continue to meet weekly in videoconference format. All surgical actions and irradiations must be carried out with maximum safety for both the patients and the participating teams. Hypofractionation in radiation therapy should be the standard treatment. Sometimes it is recommended to apply a primary systemic treatment or even a primary irradiation. Great coordination between the surgical and oncology teams, both medical and radiotherapeutic, is essential.

| S-EPMC7198217 | biostudies-literature

Mortality associated with cardiovascular disease in patients with COVID-19? Mortalidad asociada a las enfermedades cardiovasculares en pacientes con COVID-19

Project description:Introduction and objectives Cardiovascular disease (CVD) has been outlined as a possible risk factor for poorer outcomes in patients with COVID-19. Methods A meta-analysis was performed with currently available studies that report the prevalence of CVD in survivors vs non-survivors in patients with COVID-19 using reports available at 16 July 2020. Analyses were performed by a random effects model and sensitivity analyses were performed for the identification of potential sources of heterogeneity or to assess the small-study effects. Results A total of 307 596 patients from 16 reports were included and 46 321 (15.1%) had CVD. Globally, mortality rate was 8.2% (20 534 patients) and mortality rates were higher in hospital registries (48.7%) compared to national reports (23.1%). A total of 11 213 (24.2%) patients with CVD died and mortality rates were also higher in hospital registries (48.7%) compared to national reports (23.1%). CVD was associated to a 4-fold higher risk of mortality (OR, 4.33; 95%CI, 3.16–5.94). Data from 28 048 patients with diabetes was available. Diabetes was associated to higher mortality risk (OR, 2.41; 95%CI, 1.79–3.26; P < .001). From 40 173 subjects with hypertension it was concluded that hypertension was also a risk factor for higher mortality (OR, 2.60; 95%CI, 2.10–3.21; P < .001). Conclusions Patients with CVD and COVID-19 have a 4-fold higher risk of death. Diabetes and hypertension are also associated with higher mortality risk.

| S-EPMC7587172 | biostudies-literature

HLA genetic polymorphisms and prognosis of patients with COVID-19 Polimorfismos geneticos de los HLA y pronostico de pacientes con COVID-19

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| S-EPMC7905376 | biostudies-literature

Uso terapeutico de los inhibidores de la enzima convertidora de angiotensina en pacientes con COVID-19: las «dos caras de la moneda» Therapeutic use of angiotensin converting enzyme inhibitors in patients with COVID-19: the “two sides of the coin”

Project description:La evidencia actual es limitada para determinar el impacto del uso de los inhibidores de la enzima convertidora de angiotensina (IECA) en la predisposición al empeoramiento de la enfermedad del coronavirus 2019 (COVID-19). Inicialmente se reportó que en los pacientes con progresión grave de la COVID-19 existía una mortalidad elevada, los cuales tenían antecedentes de hipertensión arterial, diabetes mellitus, enfermedad cardiovascular y enfermedad renal crónica. Parte de estos pacientes también tenía en común que utilizaban IECA, lo cual alertó a la comunidad médica sobre su riesgo potencial en coexistencia con COVID-19. Sin embargo, estudios más recientes de casos-controles encontraron que los inhibidores del sistema renina-angiotensina, incluyendo los IECA, no incrementan el riesgo de COVID-19 o de requerir admisión hospitalaria por esta causa. Diferentes revistas científicas han facilitado el acceso a reportes preliminares, dejando a discreción de la comunidad médica y científica hacer uso de dicha información para promover el desarrollo de estudios que confirmen experimentalmente dichos hallazgos, preclínicos y epidemiológicos, que finalmente impacten en las decisiones de la práctica clínica para beneficiar a los pacientes con COVID-19. En esta revisión de la literatura se exploran los diferentes efectos mediados por los IECA que podrían estar relacionados con la respuesta inmune durante la infección y la transmisión de COVID-19, compilando evidencia disponible que evalúa si en realidad representan un riesgo o si, por el contrario, confieren un efecto protector.

| S-EPMC7365126 | biostudies-literature

TRASTORNOS DE LAS EMOCIONES A CONSECUENCIA DEL COVID-19 Y EL CONFINAMIENTO EN UNIVERSITARIOS DE LAS DIFERENTES ESCUELAS DE LA UNIVERSIDAD NACIONAL HERMILIO VALDIZAN. PERU.

Project description:The Covid-19 pandemic has transformed the way we live, and after mandatory confinement, the way we interact with people will also change drastically. And without going through the traumatic experience of hospitalization, society as a whole will suffer post-traumatic stress, due to home isolation. In many cases, the disease has directly impacted close people, which will translate into a higher prevalence of mental health-related problems. In this sense, no one doubts the psychological and social footprint that the pandemic will leave on the majority of the population. The work carried out has the objective of identifying the disorders of the emotions as a result of the covid-19 and the confinement in university students of the National University Hermilio Valdizán. The type and level of research was descriptive, exploratory, explanatory, applicative, analytical, prospective and cross-sectional, with a sample of 100 university students from the different academic professional schools of the university. For data collection, the questionnaire was used and the virtual survey was used as a technique. The main results show that university students present emotional disorders such as: sleep problems (85%) and feelings of depression and hopelessness (83%). It is concluded that as a result of confinement, university students present psychological problems of anxiety and depression (46%), 22% present depression and stress, while 17% of university students present post-traumatic stress as a result of COVID-19 and confinement.

| S-EPMC8087282 | biostudies-literature

Simulation of pooled-sample analysis strategies for COVID-19 mass testing Simulation de strategies d'analyse par echantillons groupes pour le depistage de masse de la COVID-19 Simulacion de estrategias en el analisis de muestras colectivas para las pruebas en masa de la COVID-19 ?????? ??????????? ????? ??????? ??????? ???????? ??????? ??????-19 ??????? 2019 ???????????????? ????????????? ????????? ??????? ? ??????????? ???????????? ???????? ??? ???????? ???????????? ?? COVID-19

Project description:Abstract Objective To evaluate two pooled-sample analysis strategies (a routine high-throughput approach and a novel context-sensitive approach) for mass testing during the coronavirus disease 2019 (COVID-19) pandemic, with an emphasis on the number of tests required to screen a population. Methods We used Monte Carlo simulations to compare the two testing strategies for different infection prevalences and pooled group sizes. With the routine high-throughput approach, heterogeneous sample pools are formed randomly for polymerase chain reaction (PCR) analysis. With the novel context-sensitive approach, PCR analysis is performed on pooled samples from homogeneous groups of similar people that have been purposively formed in the field. In both approaches, all samples contributing to pools that tested positive are subsequently analysed individually. Findings Both pooled-sample strategies would save substantial resources compared to individual analysis during surge testing and enhanced epidemic surveillance. The context-sensitive approach offers the greatest savings: for instance, 58–89% fewer tests would be required for a pooled group size of 3 to 25 samples in a population of 150?000 with an infection prevalence of 1% or 5%. Correspondingly, the routine high-throughput strategy would require 24–80% fewer tests than individual testing. Conclusion Pooled-sample PCR screening could save resources during COVID-19 mass testing. In particular, the novel context-sensitive approach, which uses pooled samples from homogeneous population groups, could substantially reduce the number of tests required to screen a population. Pooled-sample approaches could help countries sustain population screening over extended periods of time and thereby help contain foreseeable second-wave outbreaks.

| S-EPMC7463190 | biostudies-literature

Terapia de voz en el contexto de la pandemia covid-19; recomendaciones para la practica clinica.

Project description:INTRODUCTION:Since the beginning of the new pandemic, COVID-19 health services have had to face a new scenario. Voice therapy faces a double challenge, interventions using telepractice, and delivering rehabilitation services to a growing population of patients at risk of functional impairment related to the COVID-19 disease. Moreover, as COVID-19 is transmitted through droplets, it is critical to understand how to mitigate these risks during assessment and treatment. OBJECTIVE:To promote safety, and effective clinical practice to voice assessment and rehabilitation in the pandemic COVID-19 context for speech-language pathologists. METHODS:A group of 11 experts in voice and swallowing disorders from 5 different countries conducted a consensus recommendation following the American Academy of Otolaryngology-Head and Neck Surgery rules building a clinical guide for speech-language pathologists during this pandemic context. RESULTS:The clinical guide provides 79 recommendations for clinicians in the management of voice disorders during the pandemic and includes advice from assessment, direct treatment, telepractice, and teamwork. The consensus was reached 95% for all topics. CONCLUSION:This guideline should be taken only as recommendations; each clinician must attempt to mitigate the risk of infection and achieve the best therapeutic results taking into account the patient's particular reality.

| S-EPMC7442931 | biostudies-literature

Recommendations on the management of adult patients with rheumatic diseases in the context of SARS-CoV-2/COVID-19 infection. Colombian Association of Rheumatology☆ Recomendaciones sobre el manejo de pacientes adultos con enfermedades reumaticas en el contexto de la infeccion por SARS-CoV-2/COVID-19. Asociacion Colombiana de Reumatologia

Project description:Objective To produce recommendations for patients with rheumatological diseases receiving immunomodulatory and immunosuppressive therapies (conventional drugs, biologicals, and small molecules) during the COVID-19 pandemic. Materials and methods The recommendations were determined using the Delphi method as an agreement tool. A panel of experts was formed, with academic backgrounds and research experience in rheumatology. A literature search was conducted and 42 questions were generated. The level of agreement was made with 80% of approval by the participants. Results A group of eleven rheumatologists from 7 cities in the country participated. The response rate was 100% for the three consultation rounds. In the first round, agreement was reached on 35 questions, on 37 in the second round, and on 42 questions in the third round. Conclusion The recommendation for the majority of the pharmacological treatments used in rheumatology is to continue with immunomodulatory or immunosuppressive therapies in patients who do not have the infection, and to suspend it in patients with a diagnosis of SARS-CoV-2/COVID-19.

| S-EPMC7546262 | biostudies-literature

Recomendaciones sobre el manejo de pacientes adultos con enfermedades reumaticas en el contexto de la infeccion por SARS-CoV-2/COVID-19. Asociacion Colombiana de Reumatologia Recommendations on the management of adult patients with rheumatic diseases in the context of SARS-CoV-2/COVID-19 infection. Colombian Association of Rheumatology

Project description:Objetivo Generar las recomendaciones para la atención de pacientes con enfermedades reumáticas que reciben terapias inmunomoduladoras e inmunosupresoras (fármacos convencionales, biológicos y moléculas pequeñas) durante la pandemia por COVID-19. Materiales y métodos Las recomendaciones se realizaron utilizando el método Delphi como herramienta de acuerdo. Se conformó un panel de expertos con trayectoria académica y experiencia en investigación en reumatología. Se realizó la búsqueda de la literatura y se generó el cuestionario del ejercicio Delphi conformado por 42 preguntas. El grado de acuerdo se logró con el 80% de aprobación de los participantes. Resultados Se conformó un grupo de 11 reumatólogos de 7 ciudades del país. La tasa de respuesta fue del 100% para las 3 rondas de consulta. En la primera ronda se logró acuerdo en 35 preguntas, en la segunda ronda 37 y en la tercera ronda se logró el acuerdo de las 42 preguntas. Conclusión La recomendación para la mayoría de los tratamientos inmunomoduladores utilizados en reumatología es continuar con las terapias en pacientes que no tengan la infección y suspenderlas en aquellos con diagnóstico de SARS-CoV-2/COVID-19.

| S-EPMC7290203 | biostudies-literature

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