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COVID-19: clinical course and outcomes of 36 hemodialysis patients in Spain.

新型冠状病毒肺炎: 西班牙 36 例血液透析患者的临床过程和结果。

  • 影响因子:4.48
  • DOI:10.1016/j.kint.2020.04.031
  • 作者列表:"Goicoechea M","Sánchez Cámara LA","Macías N","Muñoz de Morales A","Rojas ÁG","Bascuñana A","Arroyo D","Vega A","Abad S","Verde E","García Prieto AM","Verdalles Ú","Barbieri D","Delgado AF","Carbayo J","Mijaylova A","Acosta A","Melero R","Tejedor A","Benitez PR","Pérez de José A","Rodriguez Ferrero ML","Anaya F","Rengel M","Barraca D","Luño J","Aragoncillo I
  • 发表时间:2020-07-01
Abstract

:Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pneumonia emerged in Wuhan, China in December 2019. Unfortunately, there is a lack of evidence about the optimal management of novel coronavirus disease 2019 (COVID-19), and even less is available in patients on maintenance hemodialysis therapy than in the general population. In this retrospective, observational, single-center study, we analyzed the clinical course and outcomes of all maintenance hemodialysis patients hospitalized with COVID-19 from March 12th to April 10th, 2020 as confirmed by real-time polymerase chain reaction. Baseline features, clinical course, laboratory data, and different therapies were compared between survivors and nonsurvivors to identify risk factors associated with mortality. Among the 36 patients, 11 (30.5%) died, and 7 were able to be discharged within the observation period. Clinical and radiological evolution during the first week of admission were predictive of mortality. Among the 36 patients, 18 had worsening of their clinical status, as defined by severe hypoxia with oxygen therapy requirements greater than 4 L/min and radiological worsening. Significantly, 11 of those 18 patients (61.1%) died. None of the classical cardiovascular risk factors in the general population were associated with higher mortality. Compared to survivors, nonsurvivors had significantly longer dialysis vintage, increased lactate dehydrogenase (490 U/l ± 120 U/l vs. 281 U/l ± 151 U/l, P = 0.008) and C-reactive protein levels (18.3 mg/dl ± 13.7 mg/dl vs. 8.1 mg/dl ± 8.1 mg/dl, P = 0.021), and a lower lymphocyte count (0.38 ×103/µl ± 0.14 ×103/µl vs. 0.76 ×103/µl ± 0.48 ×103/µl, P = 0.04) 1 week after clinical onset. Thus, the mortality among hospitalized hemodialysis patients diagnosed with COVID-19 is high. Certain laboratory tests can be used to predict a worsening clinical course.

摘要

: 2019 年 12 月中国武汉市出现新型冠状病毒 (SARS-CoV-2) 肺炎。不幸的是,缺乏关于新型冠状病毒疾病 2019 (新型冠状病毒肺炎) 的最佳管理的证据,并且在维持性血液透析治疗的患者中获得的证据比普通人群更少。在这项回顾性、观察性、单中心研究中,我们分析了 3 月 12 日至 4 月 10 日期间所有维持性血液透析患者因新型冠状病毒肺炎住院的临床过程和结局。2020 年经实时聚合酶链反应证实。比较生存者和非生存者的基线特征、临床病程、实验室数据和不同治疗方法,以确定与死亡率相关的危险因素。36 例患者中,11 例 (30.5%) 死亡,7 例能够在观察期内出院。入院第一周的临床和放射学演变是死亡率的预测因素。在 36 例患者中,18 例临床状态恶化,定义为严重缺氧,氧疗需求大于 4 L/min,放射学恶化。值得注意的是,这 18 例患者中有 11 例 (61.1%) 死亡。一般人群中没有一个经典的心血管危险因素与较高的死亡率相关。C与s u rvivors相比,nons u rvivors的透析时间明显c长,c的la c tate脱氢酶 (490 U/l ± 120 U/l vs. 281 U/l ± 151 U/l,P = 0.008) 和C-rea c蛋白水平 (18.3 mg/dl ± 13.7 mg/dl vs. 8.1 mg/dl ± 8.1 mg/dl,P = 0.021),和一个低淋巴c yte c o u nt(0.38 × 1 03/µ l ± 0.1 4 × 1 03/µ l vs. 0.76 × 1 03/µ l ± 0.48 × 1 03/µ l,P = 0.04) 临床发病后 1 周。因此,新型冠状病毒肺炎血液透析患者的病死率较高。某些实验室检查可用于预测恶化的临床过程。

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DOI:10.3346/jkms.2020.35.e79
作者列表:["Lim J","Jeon S","Shin HY","Kim MJ","Seong YM","Lee WJ","Choe KW","Kang YM","Lee B","Park SJ"]

METHODS::Since mid-December of 2019, coronavirus disease 2019 (COVID-19) infection has been spreading from Wuhan, China. The confirmed COVID-19 patients in South Korea are those who came from or visited China. As secondary transmissions have occurred and the speed of transmission is accelerating, there are rising concerns about community infections. The 54-year old male is the third patient diagnosed with COVID-19 infection in Korea. He is a worker for a clothing business and had mild respiratory symptoms and intermittent fever in the beginning of hospitalization, and pneumonia symptoms on chest computerized tomography scan on day 6 of admission. This patient caused one case of secondary transmission and three cases of tertiary transmission. Hereby, we report the clinical findings of the index patient who was the first to cause tertiary transmission outside China. Interestingly, after lopinavir/ritonavir (Kaletra, AbbVie) was administered, β-coronavirus viral loads significantly decreased and no or little coronavirus titers were observed.

影响因子:4.36
发表时间:2020-02-17
DOI:10.1080/22221751.2020.1729071
作者列表:["Zhang W","Du RH","Li B","Zheng XS","Yang XL","Hu B","Wang YY","Xiao GF","Yan B","Shi ZL","Zhou P"]

METHODS::In December 2019, a novel coronavirus (2019-nCoV) caused an outbreak in Wuhan, China, and soon spread to other parts of the world. It was believed that 2019-nCoV was transmitted through respiratory tract and then induced pneumonia, thus molecular diagnosis based on oral swabs was used for confirmation of this disease. Likewise, patient will be released upon two times of negative detection from oral swabs. However, many coronaviruses can also be transmitted through oral-fecal route by infecting intestines. Whether 2019-nCoV infected patients also carry virus in other organs like intestine need to be tested. We conducted investigation on patients in a local hospital who were infected with this virus. We found the presence of 2019-nCoV in anal swabs and blood as well, and more anal swab positives than oral swab positives in a later stage of infection, suggesting shedding and thereby transmitted through oral-fecal route. We also showed serology test can improve detection positive rate thus should be used in future epidemiology. Our report provides a cautionary warning that 2019-nCoV may be shed through multiple routes.

翻译标题与摘要 下载文献
影响因子:2.48
发表时间:2020-04-01
来源期刊:Infection
DOI:10.1007/s15010-020-01401-y
作者列表:["Cheng ZJ","Shan J"]

METHODS::There is a current worldwide outbreak of a new type of coronavirus (2019-nCoV), which originated from Wuhan in China and has now spread to 17 other countries. Governments are under increased pressure to stop the outbreak spiraling into a global health emergency. At this stage, preparedness, transparency, and sharing of information are crucial to risk assessments and beginning outbreak control activities. This information should include reports from outbreak sites and from laboratories supporting the investigation. This paper aggregates and consolidates the virology, epidemiology, clinical management strategies from both English and Chinese literature, official news channels, and other official government documents. In addition, by fitting the number of infections with a single-term exponential model, we report that the infection is spreading at an exponential rate, with a doubling period of 1.8 days.

呼吸道感染方向

呼吸道感染分为上呼吸道感染与下呼吸道感染。上呼吸道感染是指自鼻腔至喉部之间的急性炎症的总称,是最常见的感染性疾病。下呼吸道感染是最常见的感染性疾患,治疗时必须明确引起感染的病原体以选择有效的抗生素。

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