Articles: sars-cov-2.
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Respir Med Case Rep · Jan 2020
Case ReportsSARS-CoV2 induced pulmonary embolism and complications from anticoagulation.
Coronavirus disease (COVID-19) pandemic has rapidly spread around the world. As new complications associated with the virus become more apparent, concerns in the medical community continue to grow. One of the more commonly encountered and more troubling complications in critically ill patients has been hypercoagulable state and subsequent thrombotic events. ⋯ Literature review suggests that pulmonary clot burden in COVID-19 patients could be due to pulmonary thrombus rather than pulmonary embolism and is triggered by profuse vascular damage and severe inflammatory response. Literature review also proposes changes to the diagnostic work up in COVID-19 patients, such as earlier screening for pulmonary embolism in critically ill. In addition, rare and severe complications of current anticoagulation therapy is illustrated and discussed through one of the cases presented.
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As SARS-CoV-2 rapidly spread across the globe, short-term modeling forecasts provided time-critical information for containment and mitigation strategies. Global projections had so far incorrectly predicted large numbers of COVID-19 cases in Africa and that its health systems would be overwhelmed. Significantly higher COVID-19-related mortality were expected in Africa mainly because of its poor socio-economic determinants that make it vulnerable to public health threats, including diseases of epidemic potential. ⋯ WHO recommends lifting of lockdowns should depend on the ability to contain SARS-CoV-2 and protect the public once restrictions are lifted. Yet, the greatest challenge is the critical decision which must be made in this time of uncertainties. We propose simple strategies on how to ease lockdowns in Africa based on evidence, disease dynamics, situational analysis and ability of national governments to handle upsurges.
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The COVID-19 pandemic is stretching medical resources internationally, sometimes creating ventilator shortages that complicate clinical and ethical situations. The possibility of needing to ventilate multiple patients with a single ventilator raises patient health and safety concerns in addition to clinical conditions needing treatment. Wherever ventilators are employed, additional tubing and splitting adaptors may be available. Adjustable flow-compensating resistance for differences in lung compliance on individual limbs may not be readily implementable. By exploring a number and range of possible contributing factors using computational simulation without risk of patient harm, this paper attempts to define useful bounds for ventilation parameters when compensatory resistance in limbs of a shared breathing circuit is not possible. This desperate approach to shared ventilation support would be a last resort when alternatives have been exhausted. ⋯ In resource-limited regions of the world, the COVID-19 pandemic will result in equipment shortages. While single-patient ventilation is preferable, if that option is unavailable and ventilator sharing using limbs without flow resistance compensation is the only available alternative, these simulations provide a conceptual framework and guidelines for clinical patient selection.
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This study aimed to develop a deep-learning model and a risk-score system using clinical variables to predict intensive care unit (ICU) admission and in-hospital mortality in COVID-19 patients. ⋯ Deep learning and the resultant risk score have the potential to provide frontline physicians with quantitative tools to stratify patients more effectively in time-sensitive and resource-constrained circumstances.
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To differentiate between respiratory infections caused by SARS-CoV-2 and other respiratory pathogens during the COVID-19 outbreak in Wuhan, we simultaneously tested for SARS-CoV-2 and pathogens associated with CAP to determine the incidence and impact of respiratory coinfections in COVID-19 patients. ⋯ Coinfections in COVID-19 patients are common. The coinfecting pathogens can be detected at variable intervals during COVID-19 disease course and remain an important consideration in targeted treatment strategies for COVID-19 patients.