Articles: coronavirus.
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The coronavirus disease (COVID-19) pandemic, caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), has spread exponentially worldwide. In Brazil, the number of infected people diagnosed has been increasing and, as in other countries, it has been associated with a high risk of contamination in healthcare teams. For healthcare professionals, the full use of personal protective equipment (PPE) is mandatory, such as wearing surgical or filtering facepiece class 2 (FFP2) masks, waterproof aprons, gloves, and goggles, in addition to training in care processes. ⋯ This is mandatory not only because of the risk of contamination of the surgical team but also because of the increased risk of postoperative complications and high risk of death. During this pandemic, the most effective safety measures are social distancing for the general public and the adequate availability and use of PPE in the healthcare field. The treatment of other chronic diseases, such as cancer, should be continued, as the damming of cases of these diseases will have a deleterious effect on the public healthcare system.
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Questions regarding the transmissibility of the novel coronavirus disease (COVID-19) remain unanswered. It is known that the transmission of the severe acute respiratory syndrome coronavirus (SARS-CoV) occurs predominantly through droplets and contact. However, aerosols can be generated in some situations, such as orotracheal intubation, ventilation, and the use of electric or ultrasonic scalpels, and can therefore potentially contaminate the care team if adequate protection is not used. ⋯ We do not have consistent evidence on the exposure of healthcare professionals assisting patients with COVID-19 undergoing laparoscopy or the impact of such exposure. In view of the evidence obtained and drawing parallels with other infectious and contagious diseases, medical personnel must wear complete protective attire for proper protection against the generated aerosol. Further studies are required to assess the impact of such surgeries on healthcare professionals conducing or assisting with these procedures.
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Review
Physiotherapy Care of Patients with Coronavirus Disease 2019 (COVID-19) - A Brazilian Experience.
Some patients with coronavirus disease (COVID-19) present with severe acute respiratory syndrome, which causes multiple organ dysfunction, besides dysfunction of the respiratory system, that requires invasive procedures. On the basis of the opinions of front-line experts and a review of the relevant literature on several topics, we proposed clinical practice recommendations on the following aspects for physiotherapists facing challenges in treating patients and containing virus spread: 1. personal protective equipment, 2. conventional chest physiotherapy, 3. exercise and early mobilization, 4. oxygen therapy, 5. nebulizer treatment, 6. non-invasive ventilation and high-flow nasal oxygen, 7. endotracheal intubation, 8. protective mechanical ventilation, 9. management of mechanical ventilation in severe and refractory cases of hypoxemia, 10. prone positioning, 11. cuff pressure, 12. tube and nasotracheal suction, 13. humidifier use for ventilated patients, 14. methods of weaning ventilated patients and extubation, and 15. equipment and hand hygiene. These recommendations can serve as clinical practice guidelines for physiotherapists. This article details the development of guidelines on these aspects for physiotherapy of patients with COVID-19.
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This paper is aimed at addressing the urgent need to develop a protocol that will address the operatory and clinical aspects of dental care during the Coronavirus disease 2019 (COVID-19) outbreak. ⋯ Logistic and clinical steps are required to provide dental care during the COVID-19 outbreak while preventing cross-contamination and protecting the dental team during the provision of care.
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At the end of December 2019, a novel coronavirus, the severe acute respiratory syndrome coronavirus 2, caused an outbreak of pneumonia spreading from Wuhan, Hubei province, to the whole country of China and then the entire world, forcing the World Health Organization to make the assessment that the coronavirus disease (COVID-19) can be characterized as a pandemic, the first ever caused by a coronavirus. To date, clinical evidence and guidelines based on reliable data and randomized clinical trials for the treatment of COVID-19 are lacking. In the absence of definitive management protocols, many treatments for COVID-19 are currently being evaluated and tested worldwide. ⋯ Corticosteroids and tocilizumab seem to guarantee positive results in selected patients so far, although the timing of starting therapy and the most appropriate therapeutic schemes remain to be clarified. Efficacy of the other drugs is still uncertain, and they are currently used as a cocktail of treatments in the absence of definitive guidelines. What will represent the real solution to the enormous problem taking place worldwide is the identification of a safe and effective vaccine, for which enormous efforts and investments are underway.