Articles: covid-19.
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The coronavirus Disease 2019 (COVID-19) pandemic has disproportionately impacted long-term care facilities (LTCFs), revealing vulnerabilities due to residents' advanced age, comorbidities, and facility infrastructures. In Taiwan, the Central Epidemic Control Center implemented a range of strategies to protect LTCF residents. These included early containment measures to allow time for preparing pharmaceutical intervention, the establishment of infection prevention and control guidelines, the implementation of comprehensive screening and testing protocols, the prioritization of vaccination for both residents and staff, and the expansion of the national stockpile of oral antiviral agents. ⋯ All measures were made and adjusted based on community prevalence, evolving knowledge about the virus, and balancing the negative impacts on LTCF residents. These multifaceted efforts effectively mitigated transmission, maintained essential healthcare services, and supported LTCF staff, demonstrating the critical importance of coordinated, adaptive strategies in managing the impact of COVID-19 on vulnerable populations in LTCFs. By learning from the COVID-19 pandemic, we can develop more effective and resilient responses for managing future epidemics in LTCFs in Taiwan.
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Review Meta Analysis
Differences of the Chest Images Between Coronavirus Disease 2019 (COVID-19) Patients and Influenza Patients: A Systematic Review and Meta-analysis.
Background: Coronavirus disease 2019 (COVID-19) and influenza are two infectious diseases that can pose a great threat to human health. We aimed to compare the differences in chest images between patients with COVID-19 and influenza to deepen the understanding of these two diseases. Methods: We searched PubMed, Embase and Web of Science for articles published before December 25, 2023, and performed a meta-analysis using Stata 14.0 with a random-effects model. ⋯ Patients with COVID-19 showed more ground-glass opacities (OR=2.83, 95% CI: 1.85-4.32), reverse halo signs (OR=3.47, 95% CI: 2.37-5.08), interlobular septal thickening (OR=2.16, 95% CI: 1.55-3.01), vascular enlargement (OR=5.00, 95% CI: 1.80-13.85) and crazy-paving patterns (OR=2.63, 95% CI: 1.57-4.41) on chest images than patients with influenza. We also found that compared with influenza patients, pleural effusion was rare in COVID-19 patients (OR=0.15, 95% CI: 0.07-0.31). Conclusions: There are some differences in the manifestations and distributions of lesions between patients with COVID-19 and influenza on chest images, which is helpful to distinguish these two infectious diseases.
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Patients with SARS-CoV-2 infection carry an increased risk of cardiovascular disease encompassing various implications, including acute myocardial injury or infarction, myocarditis, heart failure, and arrhythmias. A growing volume of evidence correlates SARS-CoV-2 infection with myocardial injury, exposing patients to higher mortality risk. SARS-CoV-2 attacks the coronary arterial bed with various mechanisms including thrombosis/rupture of preexisting atherosclerotic plaque, de novo coronary thrombosis, endotheliitis, microvascular dysfunction, vasculitis, vasospasm, and ectasia/aneurysm formation. ⋯ In patients presenting with coronary vasospasm, nitrates and calcium channel blockers are preferred, while treatment of coronary ectasia/aneurysm mandates the use of antiplatelets/anticoagulants, corticosteroids, immunoglobulin, and biologic agents. It is crucial to untangle the exact mechanisms of coronary involvement in COVID-19 in order to ensure timely diagnosis and appropriate treatment. We have reviewed the current literature and provide a detailed overview of the pathophysiology and clinical spectrum associated with coronary implications of SARS-COV-2 infection.
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Critical care clinics · Jan 2025
Review Comparative StudyClinical Comparison of Post-intensive Care Syndrome and Long Coronavirus Disease.
Post-intensive care syndrome (PICS) encompasses persistent physical, psychological, and cognitive impairments. The coronavirus disease of 2019 (COVID-19) pandemic highlighted parallels between PICS and "long COVID". There is an overlap between the 2 in risk factors, symptoms, and pathophysiology. ⋯ Mental health issues consist of depression, anxiety, and posttraumatic stress disorder in both disease states. Long COVID and PICS impact families, with multifaceted effects on physical health, mental well-being, and socioeconomic stability. Understanding these syndromes is crucial for comprehensive patient care and family support.
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Persistence of COVID-19 symptoms may follow severe acute respiratory syndrome coronavirus 2 infection. The incidence of long COVID increases with the severity of acute disease, but even mild disease can be associated with sequelae. ⋯ Elevated levels of complement are present in acute COVID-19 patients and may persist at lower levels in long COVID. Evidence supports complement activation, with endotheliopathy-associated disease as the molecular mechanism causing both acute and long COVID.