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Álvarez-Macías A, Úbeda-Iglesias A, Macías-Seda J, Gómez-Salgado J. Factors related to mortality of patients with COVID-19 who are admitted to the ICU: Prognostic mortality factors of COVID-19 patients. Medicine (Baltimore) 2024; 103:e38266. [PMID: 38787973 PMCID: PMC11124599 DOI: 10.1097/md.0000000000038266] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/14/2024] [Accepted: 04/26/2024] [Indexed: 05/26/2024] Open
Abstract
During the severe acute respiratory syndrome coronavirus 2 pandemic, hospital resources, particularly critical care units, were overburdened and this had a significant impact on both the therapies and the prognosis of these patients. This study aimed to identify factors and therapies that may improve prognosis and other factors associated with increased mortality. A secondary objective was to evaluate the impact that obesity had on these patients. An observational study was conducted on 482 patients aged 18 years or older who were diagnosed with SARS-CoV-2 pneumonia and admitted to the Intensive Care Units of 3 national hospitals registered in the CIBERESUCICOVID database between September 2020 and March 2021. After identifying the sample profile, risk factors were analyzed, the predictive model was constructed, and crude odd ratios were calculated for each factor. Additionally, logistic regression was used to build the multivariate model adjusting for potential confounders. The final model included only the variables selected using the Backward method. A sample of 335 men (69.5%) and 145 women (30.08%) aged 61.94 ± 12.75 years with a body mass index (BMI) of 28.05 (25.7; 31.2) was obtained. A total of 113 patients received noninvasive mechanical ventilation. The most common comorbidities were: high blood pressure (51.04%), obesity (28%), diabetes mellitus (23.44%), other metabolic diseases (21.16%), chronic heart failure (18.05%), chronic obstructive pulmonary disease (11.62%), and chronic kidney disease (10.16%). In-hospital, 3-month and 6-month post-discharge mortality in patients with BMI > 30 (n = 135) versus BMI ≤ 30 (n = 347) was significantly different (P = .06). Noninvasive mechanical ventilation failed in 42.4% of patients with BMI > 30 compared to 55% of patients with BMI ≤ 30. This study identified the factors associated with failure of mechanical ventilation. The most common comorbidities were congestive heart failure, high blood pressure, chronic kidney disease, severe liver disease, diabetes mellitus, and solid organ transplantation. In terms of ventilatory support, patients who received high-flow nasal oxygen therapy on admission had lower mortality rates. The use of renal replacement therapy was also significantly associated with higher mortality.
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Affiliation(s)
| | | | - Juana Macías-Seda
- Área de Gestión Sanitaria Campo de Gibraltar Oeste, Hospital Punta de Europa, Algeciras, Spain
| | - Juan Gómez-Salgado
- Department of Sociology, Social Work and Public Health, Faculty of Labour Sciences, University of Huelva, Huelva, Spain
- Safety and Health Postgraduate Programme, Universidad Espíritu Santo, Guayaquil, Ecuador
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2
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Briones-Claudett KH, Briones-Claudett MH, Bajaña Huilcapi CK, Tripul Villamar OE, Ochoa Vásquez R, Rivera Salas CDR, Briones-Zamora KH, Benites Solis J, Briones-Márquez DC, Freire AX, Grunauer M. Surfactant therapy using vibrating-mesh nebulizers in adults with COVID-19-induced ARDS: A case series. SAGE Open Med Case Rep 2024; 12:2050313X241236313. [PMID: 38444695 PMCID: PMC10913513 DOI: 10.1177/2050313x241236313] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2023] [Accepted: 02/14/2024] [Indexed: 03/07/2024] Open
Abstract
Coronavirus adult respiratory distress syndrome, characterized by decreased surfactant due to lysis of type II pneumocytes and hyaline membrane formation, contributes to severe hypoxemia. The administration of surfactant via high-flow nasal cannula (HFNC) may positively affect lung structure and function in this context. In this study, we report on five clinical cases, encompassing patients aged 40-60 years of both sexes, who tested positive for coronavirus disease 2019 via real-time polymerase chain reaction and exhibited significant pulmonary compromise with elevated inflammatory biomarkers. These patients were treated with aerosol therapy using surfactant delivered through vibrating-mesh nebulizers alongside HFNC. Of these patients, four demonstrated positive responses to the treatment, suggesting that aerosol therapy with surfactant through vibrating-mesh nebulizers could be a viable rescue therapy in adults receiving HFNC oxygen therapy for hypoxemic respiratory failure caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Unfortunately, one patient had a negative outcome and succumbed. The findings from these cases indicate that the use of aerosol therapy with vibrating-mesh nebulizers as rescue therapy might offer an alternative approach for managing adults with hypoxemic respiratory failure due to SARS-CoV-2, as evidenced by the positive outcomes in four out of the five cases presented.
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Affiliation(s)
- Killen H Briones-Claudett
- Facultad de Medicina, Universidad de Las Americas, Quito, Ecuador
- Intensive Care Unit, Ecuadorian Institute of Social Security, Babahoyo, Ecuador
| | | | | | | | | | | | | | | | | | - Amado X Freire
- Division of Pulmonary, Critical Care, and Sleep Medicine, The University of Tennessee Health Science Center, Memphis, TN, USA
| | - Michelle Grunauer
- School of Medicine, Universidad San Francisco de Quito, Quito, Ecuador
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González-Castro A, Cuenca Fito E, Fernandez A, Peñasco Y, Modesto I Alport V, Medina Villanueva A, Fajardo A, Escude-Acha P. [Cost-effectiveness analysis high flow oxygen therapy in the treatment of SARS-CoV-2 pneumonia]. J Healthc Qual Res 2023; 38:152-157. [PMID: 36400703 PMCID: PMC9595363 DOI: 10.1016/j.jhqr.2022.10.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2022] [Revised: 09/29/2022] [Accepted: 10/17/2022] [Indexed: 02/08/2023]
Abstract
INTRODUCTION high-oxygen nasal cannulas in patients with respiratory failure secondary to SARS-CoV-2 pneumonia have not been studied from a cost-effectiveness point of view. METHODS Retrospective analysis of patients who had entered the COVID-area of an intensive medicine service in a third reference hospital, between March-December 2020. An effectiveness cost analysis was carried out comparing 2therapeutic decisions: the experimental strategy was defined as a mixed strategy consisting of the initial application of high flow nasal oxygen (HFNO) and application of VMI only to HFNO failures. The optimal rational decision was defined as maximizing expected profit, and economic efficiency was assessed by calculating the Incremental Cost-Effectiveness Ratio (ICER) for years of life gained. RESULTS Of the 185 patients tested, 101 (55%) received invasive mechanical ventilation immediately and 84 (45%) were treated with HFNO at the outset. In the cost-effectiveness analysis, comparing both therapeutic strategies, the probability that the experimental strategy would be more effective was 0.974, reaching statistical significance: Difference in average proportions -0.113; 95% CI:-0.018 to -0.208. This corresponds to an NNT of 9 patients. The optimal decision was HFNO's strategy followed by VMI in HFNO failures. This option had an RCEI of 5582 euros per year of life gained. CONCLUSIONS It is important to establish in the future reliable markers in the use of HFNO so that this therapy improves its cost-effective benefits.
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Affiliation(s)
- A González-Castro
- Servicio de Medicina Intensiva, Hospital Universitario Marqués de Valdecilla, Santander, Cantabria, España.
| | - E Cuenca Fito
- Servicio de Medicina Intensiva, Hospital Universitario Marqués de Valdecilla, Santander, Cantabria, España
| | - A Fernandez
- Servicio de Medicina Intensiva, Hospital Universitario Marqués de Valdecilla, Santander, Cantabria, España
| | - Y Peñasco
- Servicio de Medicina Intensiva, Hospital Universitario Marqués de Valdecilla, Santander, Cantabria, España; Unidad de Cuidados Intensivos Pediátricos, Hospital Universitari i Politècnic La Fe, Valencia, España; Unidad de Cuidados Intensivos Pediátricos, Hospital Central de Asturias, Oviedo, Asturias, España; Unidad de Cuidados Intensivos, Hospital de Quilpué, Valparaíso, Chile
| | - V Modesto I Alport
- Unidad de Cuidados Intensivos Pediátricos, Hospital Universitari i Politècnic La Fe, Valencia, España
| | - A Medina Villanueva
- Unidad de Cuidados Intensivos Pediátricos, Hospital Central de Asturias, Oviedo, Asturias, España
| | - A Fajardo
- Unidad de Cuidados Intensivos, Hospital de Quilpué, Valparaíso, Chile
| | - P Escude-Acha
- Servicio de Medicina Intensiva, Hospital Universitario Marqués de Valdecilla, Santander, Cantabria, España
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Godoy DA, Longhitano Y, Fazzini B, Robba C, Battaglini D. High flow nasal oxygen and awake prone positioning - Two allies against COVID-19: A systematic review. Respir Physiol Neurobiol 2023; 310:104015. [PMID: 36646354 PMCID: PMC9838094 DOI: 10.1016/j.resp.2023.104015] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2022] [Revised: 12/29/2022] [Accepted: 01/12/2023] [Indexed: 01/15/2023]
Abstract
INTRODUCTION Severe acute respiratory distress syndrome coronavirus disease-2 (SARS-CoV-2) can lead to acute hypoxemic respiratory failure (AHRF) with possible multisystemic involvement. Ventilation/perfusion mismatch and shunt increase are critical determinants of hypoxemia. Understanding hypoxemia and the mechanisms involved in its genesis is essential to determine the optimal therapeutic strategy. High flow nasal oxygen (HFNO) and awake prone positioning (APP) in patients with COVID-19 AHRF showed promising benefits. The aim of this systematic review was to depict current situation around the combined use of HFNO and APP in patients with COVID-19 AHRF. Particularly, to investigate and report the pathophysiological rationale for adopting this strategy and to evaluate the (1) criteria for initiation, (2) timing, monitoring and discontinuation, and to assess the (3) impact of HFNO/ APP on outcome. METHODS We performed a systematic search collecting the articles present in PubMed, Scopus, EMBASE, and Cochrane databases with the following keywords: COVID-19 pneumonia, high flow nasal oxygen, awake prone position ventilation. RESULTS Thirteen studies displayed inclusion criteria and were included, accounting for 1242 patients who received HFNO/ APP. The combination of HFNO/ APP has an encouraging pathophysiological rationale for implementing this technique. The recognition of patients who can benefit from HFNO/ APP is difficult and there are no validated protocols to start, monitoring, and discontinue HFNO/ APP therapy. The most used method to monitor the efficacy and failure of this combined technique are oxygenation indexes, but discontinuation techniques are inconsistently and poorly described limiting possible generatability. Finally, this technique provided no clear benefits on outcome. CONCLUSIONS Our systematic search provided positive feedbacks for improving the utilization of this combination technique, although we still need further investigation about methods to guide timing, management, and discontinuation, and to assess the intervention effect on outcome.
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Affiliation(s)
- Daniel Agustin Godoy
- Neurointensive Care Unit, Sanatorio Pasteur; Catamarca, Argentina; Intensive Care Unit, Hospital Carlos G. Malbran, Catamarca, Argentina
| | - Yaroslava Longhitano
- Department of Anesthesiology and Perioperative Medicine, University of Pittsburgh, Pittsburgh, PA, USA
| | - Brigitta Fazzini
- Adult Critical Care Unit, Royal London Hospital, Barts Health NHS Trust, London, United Kingdom
| | - Chiara Robba
- Anesthesia and Intensive Care, San Martino Policlinico Hospital, IRCCS for Oncology and Neurosciences, Genoa, Italy; Department of Surgical Sciences and Integrated Diagnostics, University of Genoa, Genoa, Italy
| | - Denise Battaglini
- Anesthesia and Intensive Care, San Martino Policlinico Hospital, IRCCS for Oncology and Neurosciences, Genoa, Italy.
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González-Castro A, Modesto I Alapont V, Medina A, Fajardo Campoverde A. Non-invasive mechanical ventilation or high-flow oxygen therapy in the COVID-19 pandemic: Dead heat broken. Med Intensiva 2023; 47:178-180. [PMID: 36402705 PMCID: PMC9606029 DOI: 10.1016/j.medine.2022.10.018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2022] [Accepted: 06/07/2022] [Indexed: 11/06/2022]
Affiliation(s)
- A González-Castro
- Servicio de Medicina Intensiva, Hospital Universitario Marqués de Valdecilla, Santander, Spain.
| | - V Modesto I Alapont
- Servicio de Pediatría, Unidad de Cuidados Intensivos Pediátricos, Hospital Universitari i Politècnic La Fe, Valencia, Spain
| | - A Medina
- Servicio de Pediatría, Unidad de Cuidados Intensivos Pediátricos, Hospital Universitario Central de Asturias, Oviedo, Asturias, Spain
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Zamarrón E, Carpio C, Villamañán E, Álvarez-Sala R, Borobia AM, Gómez-Carrera L, Buño A, Prados MC. Impact of systemic corticosteroids on length of hospitalization among patients with COVID-19. FARMACIA HOSPITALARIA 2023; 47:T55-T63. [PMID: 36894357 PMCID: PMC9902295 DOI: 10.1016/j.farma.2023.02.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2022] [Revised: 09/13/2022] [Indexed: 03/11/2023] Open
Abstract
OBJECTIVE The COVID-19 pandemic has posed a threat to hospital capacity due to the high number of admissions, which has led to the development of various strategies to release and create new hospital beds. Due to the importance of systemic corticosteroids in this disease, we assessed their efficacy in reducing the length of stay (LOS) in hospitals and compared the effect of 3 different corticosteroids on this outcome. MéTHOD: We conducted a real-world, controlled, retrospective cohort study that analysed data from a hospital database that included 3934 hospitalised patients diagnosed with COVID-19 in a tertiary hospital from April to May 2020. Hospitalised patients who received systemic corticosteroids (CG) were compared with a propensity score control group matched by age, sex and severity of disease who did not receive systemic corticosteroids (NCG). The decision to prescribe CG was at the discretion of the primary medical team. RESULTS A total of 199 hospitalized patients in the CG were compared with 199 in the NCG. The LOS was shorter for the CG than for the NCG (median=3 [interquartile range=0-10] vs. 5 [2-8.5]; p=0.005, respectively), showing a 43% greater probability of being hospitalised ≤4 days than >4 days when corticosteroids were used. Moreover, this difference was only noticed in those treated with dexamethasone (76.3% hospitalised ≤4 days vs. 23.7% hospitalised >4 days [p<0.001]). Serum ferritin levels, white blood cells and platelet counts were higher in the CG. No differences in mortality or intensive care unit admission were observed. CONCLUSIONS Treatment with systemic corticosteroids is associated with reduced LOS in hospitalised patients diagnosed with COVID-19. This association is significant in those treated with dexamethasone, but no for methylprednisolone and prednisone.
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Affiliation(s)
- Ester Zamarrón
- Departamento de Neumología, IdiPAZ-Hospital Universitario La Paz, Universidad Autónoma de Madrid, Madrid, España
| | - Carlos Carpio
- Departamento de Neumología, IdiPAZ-Hospital Universitario La Paz, Universidad Autónoma de Madrid, Madrid, España.
| | - Elena Villamañán
- Departamento de Farmacia, IdiPAZ-Hospital Universitario La Paz, Universidad Autónoma de Madrid, Madrid, España
| | - Rodolfo Álvarez-Sala
- Departamento de Neumología, IdiPAZ-Hospital Universitario La Paz, Universidad Autónoma de Madrid, Madrid, España
| | - Alberto M Borobia
- Departamento de Farmacología Clínica, IdiPAZ-Hospital Universitario La Paz, Universidad Autónoma de Madrid, Madrid, España
| | - Luis Gómez-Carrera
- Departamento de Neumología, IdiPAZ-Hospital Universitario La Paz, Universidad Autónoma de Madrid, Madrid, España
| | - Antonio Buño
- Departamento de Análisis Clínico, IdiPAZ-Hospital Universitario La Paz, Universidad Autónoma de Madrid, Madrid, España
| | - M Concepción Prados
- Departamento de Neumología, IdiPAZ-Hospital Universitario La Paz, Universidad Autónoma de Madrid, Madrid, España
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7
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Emergency endotracheal intubation in critically ill patients with COVID-19: management and clinical characteristics. ANESTHESIOLOGY AND PERIOPERATIVE SCIENCE 2023; 1:7. [PMCID: PMC10008717 DOI: 10.1007/s44254-023-00003-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 03/14/2023]
Abstract
Purposes SARS-CoV-2 have become widespread worldwide since the outbreak. Respiratory function deteriorates rapidly in critically ill patients infected with SARS-CoV-2. Endotracheal intubation is an indispensable therapeutic measure during the development of the disease. This study was intended to describe the experience of endotracheal intubation from front-line anesthesiologists and clinical prognosis of patients infected with Coronavirus disease-19 (COVID-19). Methods Fourteen critical patients infected with COVID-19 who underwent endotracheal intubation were included in this study. We collate and analyze the blood gas results before and after tracheal intubation of patients and clinical prognostic indicators such as length of stay and. mortality. The experience of anesthesiologists who intubated patients has also been recorded in detail. Results Patients had a mean time of 10.6 days from initial symptoms to endotracheal intubation. Most intubated patients had one or more underlying conditions: hypertension (8, 57.14%), diabetes (5, 35.71%), and cardiovascular and cerebrovascular diseases (2, 14.29%). The oxygenation index increased significantly after intubation compared with before intubation (148.80 ± 42.25 vs 284.43 ± 60.17 p < 0.001). 85.72% of patients required extra-corporeal membrane oxygenation (ECMO) due to inability to maintain oxygen saturation with standard therapeutic measures. Two patients underwent lung transplantation because their lungs were essentially nonfunctional, and they recovered well after surgery. As of this writing, all patients were discharged after satisfactory recovery. Conclusions Reasonable selection of intubation timing is particularly important. It is crucial to increase the patient's oxygen supply and reduce oxygen consumption as much as possible during endotracheal intubation. In addition, the personal protective measures of medical personnel participating in treatment should be scientific and standardized. Graphical Abstract ![]()
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Impact of systemic corticosteroids on hospital length of stay among patients with COVID-19. FARMACIA HOSPITALARIA 2022; 47:55-63. [PMID: 36823000 PMCID: PMC9747696 DOI: 10.1016/j.farma.2022.11.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2022] [Revised: 09/30/2022] [Indexed: 02/25/2023] Open
Abstract
BACKGROUND AND OBJECTIVE The COVID-19 pandemic has posed a threat to hospital capacity due to the high number of admissions, which has led to the development of various strategies to release and create new hospital beds. Due to the importance of systemic corticosteroids in this disease, we assessed their efficacy in reducing the length of stay (LOS) in hospitals and compared the effect of 3 different corticosteroids on this outcome. METHODS We conducted a real-world, controlled, retrospective cohort study that analysed data from a hospital database that included 3934 hospitalised patients diagnosed with COVID-19 in a tertiary hospital from April to May 2020. Hospitalised patients who received systemic corticosteroids (CG) were compared with a propensity score control group matched by age, sex and severity of disease who did not receive systemic corticosteroids (NCG). The decision to prescribe CG was at the discretion of the primary medical team. RESULTS A total of 199 hospitalized patients in the CG were compared with 199 in the NCG. The LOS was shorter for the CG than for the NCG (median = 3 [interquartile range = 0-10] vs. 5 [2-8.5]; p = 0.005, respectively), showing a 43% greater probability of being hospitalised ≤ 4 days than > 4 days when corticosteroids were used. Moreover, this difference was only noticed in those treated with dexamethasone (76.3% hospitalised ≤ 4 days vs. 23.7% hospitalised > 4 days [p < 0.001]). Serum ferritin levels, white blood cells and platelet counts were higher in the CG. No differences in mortality or intensive care unit admission were observed. CONCLUSIONS Treatment with systemic corticosteroids is associated with reduced LOS in hospitalised patients diagnosed with COVID-19. This association is significant in those treated with dexamethasone, but no for methylprednisolone and prednisone.
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Liu L, Zhang Y, Chen Y, Zhao Y, Shen J, Wu X, Li M, Chen M, Li X, Sun Y, Gu L, Li W, Wang F, Yao L, Zhang Z, Xiao Z, Du F. Therapeutic prospects of ceRNAs in COVID-19. Front Cell Infect Microbiol 2022; 12:998748. [PMID: 36204652 PMCID: PMC9530275 DOI: 10.3389/fcimb.2022.998748] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2022] [Accepted: 08/29/2022] [Indexed: 01/08/2023] Open
Abstract
Since the end of 2019, COVID-19 caused by SARS-CoV-2 has spread worldwide, and the understanding of the new coronavirus is in a preliminary stage. Currently, immunotherapy, cell therapy, antiviral therapy, and Chinese herbal medicine have been applied in the clinical treatment of the new coronavirus; however, more efficient and safe drugs to control the progress of the new coronavirus are needed. Long noncoding RNAs (lncRNAs), microRNAs (miRNAs), and circular RNAs (circRNAs) may provide new therapeutic targets for novel coronavirus treatments. The first aim of this paper is to review research progress on COVID-19 in the respiratory, immune, digestive, circulatory, urinary, reproductive, and nervous systems. The second aim is to review the body systems and potential therapeutic targets of lncRNAs, miRNAs, and circRNAs in patients with COVID-19. The current research on competing endogenous RNA (ceRNA) (lncRNA-miRNA-mRNA and circRNA-miRNA-mRNA) in SARS-CoV-2 is summarized. Finally, we predict the possible therapeutic targets of four lncRNAs, MALAT1, NEAT1, TUG1, and GAS5, in COVID-19. Importantly, the role of PTEN gene in the ceRNA network predicted by lncRNA MALAT1 and lncRNA TUG1 may help in the discovery and clinical treatment of effective drugs for COVID-19.
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Affiliation(s)
- Lin Liu
- Laboratory of Molecular Pharmacology, Department of Pharmacology, School of Pharmacy, Southwest Medical University, Luzhou, China
- Cell Therapy & Cell Drugs of Luzhou Key Laboratory, Luzhou Science and Technology Bureau, Luzhou, China
- South Sichuan Institute of Translational Medicine, Luzhou, China
| | - Yao Zhang
- Laboratory of Molecular Pharmacology, Department of Pharmacology, School of Pharmacy, Southwest Medical University, Luzhou, China
- Cell Therapy & Cell Drugs of Luzhou Key Laboratory, Luzhou Science and Technology Bureau, Luzhou, China
- South Sichuan Institute of Translational Medicine, Luzhou, China
| | - Yu Chen
- Laboratory of Molecular Pharmacology, Department of Pharmacology, School of Pharmacy, Southwest Medical University, Luzhou, China
- Cell Therapy & Cell Drugs of Luzhou Key Laboratory, Luzhou Science and Technology Bureau, Luzhou, China
- South Sichuan Institute of Translational Medicine, Luzhou, China
| | - Yueshui Zhao
- Laboratory of Molecular Pharmacology, Department of Pharmacology, School of Pharmacy, Southwest Medical University, Luzhou, China
- Cell Therapy & Cell Drugs of Luzhou Key Laboratory, Luzhou Science and Technology Bureau, Luzhou, China
- South Sichuan Institute of Translational Medicine, Luzhou, China
| | - Jing Shen
- Laboratory of Molecular Pharmacology, Department of Pharmacology, School of Pharmacy, Southwest Medical University, Luzhou, China
- Cell Therapy & Cell Drugs of Luzhou Key Laboratory, Luzhou Science and Technology Bureau, Luzhou, China
- South Sichuan Institute of Translational Medicine, Luzhou, China
| | - Xu Wu
- Laboratory of Molecular Pharmacology, Department of Pharmacology, School of Pharmacy, Southwest Medical University, Luzhou, China
- Cell Therapy & Cell Drugs of Luzhou Key Laboratory, Luzhou Science and Technology Bureau, Luzhou, China
- South Sichuan Institute of Translational Medicine, Luzhou, China
| | - Mingxing Li
- Laboratory of Molecular Pharmacology, Department of Pharmacology, School of Pharmacy, Southwest Medical University, Luzhou, China
- Cell Therapy & Cell Drugs of Luzhou Key Laboratory, Luzhou Science and Technology Bureau, Luzhou, China
- South Sichuan Institute of Translational Medicine, Luzhou, China
| | - Meijuan Chen
- Laboratory of Molecular Pharmacology, Department of Pharmacology, School of Pharmacy, Southwest Medical University, Luzhou, China
| | - Xiaobing Li
- Laboratory of Molecular Pharmacology, Department of Pharmacology, School of Pharmacy, Southwest Medical University, Luzhou, China
| | - Yuhong Sun
- Laboratory of Molecular Pharmacology, Department of Pharmacology, School of Pharmacy, Southwest Medical University, Luzhou, China
| | - Li Gu
- Laboratory of Molecular Pharmacology, Department of Pharmacology, School of Pharmacy, Southwest Medical University, Luzhou, China
| | - Wanping Li
- Laboratory of Molecular Pharmacology, Department of Pharmacology, School of Pharmacy, Southwest Medical University, Luzhou, China
| | - Fang Wang
- Laboratory of Molecular Pharmacology, Department of Pharmacology, School of Pharmacy, Southwest Medical University, Luzhou, China
| | - Lei Yao
- Experiment Medicine Center, The Affiliated Hospital of Southwest Medical University, Luzhou, China
| | - Zhuo Zhang
- Laboratory of Molecular Pharmacology, Department of Pharmacology, School of Pharmacy, Southwest Medical University, Luzhou, China
- *Correspondence: Zhuo Zhang, ; Zhangang Xiao, ; Fukuan Du,
| | - Zhangang Xiao
- Laboratory of Molecular Pharmacology, Department of Pharmacology, School of Pharmacy, Southwest Medical University, Luzhou, China
- Cell Therapy & Cell Drugs of Luzhou Key Laboratory, Luzhou Science and Technology Bureau, Luzhou, China
- South Sichuan Institute of Translational Medicine, Luzhou, China
- Department of Oncology, Affiliated Hospital of Southwest Medical University, Luzhou, China
- *Correspondence: Zhuo Zhang, ; Zhangang Xiao, ; Fukuan Du,
| | - Fukuan Du
- Laboratory of Molecular Pharmacology, Department of Pharmacology, School of Pharmacy, Southwest Medical University, Luzhou, China
- Cell Therapy & Cell Drugs of Luzhou Key Laboratory, Luzhou Science and Technology Bureau, Luzhou, China
- South Sichuan Institute of Translational Medicine, Luzhou, China
- *Correspondence: Zhuo Zhang, ; Zhangang Xiao, ; Fukuan Du,
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10
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Hussain Khan Z, Maki Aldulaimi A, Varpaei HA, Mohammadi M. Various Aspects of Non-Invasive Ventilation in COVID-19 Patients: A Narrative Review. IRANIAN JOURNAL OF MEDICAL SCIENCES 2022; 47:194-209. [PMID: 35634520 PMCID: PMC9126903 DOI: 10.30476/ijms.2021.91753.2291] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Subscribe] [Scholar Register] [Received: 07/03/2021] [Revised: 09/21/2021] [Accepted: 10/01/2021] [Indexed: 01/08/2023]
Abstract
Non-invasive ventilation (NIV) is primarily used to treat acute respiratory failure. However, it has broad applications to manage a range of other diseases successfully.
The main advantage of NIV lies in its capability to provide the same physiological effects as invasive ventilation while avoiding the placement of an
artificial airway and its associated life-threatening complications. The war on the COVID-19 pandemic is far from over. The present narrative review aimed at identifying various aspects of NIV usage, in COVID-19 and other patients,
such as the onset time, mode, setting, positioning, sedation, and types of interface. A search for articles published from May 2020 to April 2021 was conducted using MEDLINE,
PMC central, Scopus, Web of Science, Cochrane Library, and Embase databases. Of the initially identified 5,450 articles, 73 studies and 24 guidelines on the use of NIV were included.
The search was limited to studies involving human cases and English language articles. Despite several reported benefits of NIV, the evidence on the use of NIV in
COVID-19 patients does not yet fully support its routine use.
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Affiliation(s)
- Zahid Hussain Khan
- Department of Anesthesiology and Critical Care, Imam Khomeini Medical Complex, Tehran University of Medical Sciences, Tehran, Iran
| | - Ahmed Maki Aldulaimi
- Al-furat Al-awsat Hospital, Al-furat Al-awsat Technical University, Health and Medical Technical College, Department of Anesthesia and Critical Care, Kufa, Iraq
| | - Hesam Aldin Varpaei
- Department of Nursing and Midwifery, School of Nursing, Islamic Azad University Tehran Medical Sciences, Tehran, Iran
| | - Mostafa Mohammadi
- Department of Anesthesiology and Critical Care, Tehran University of Medical Sciences, Tehran. Iran
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11
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He Y, Liu N, Zhuang X, Wang X, Ma W. High-flow nasal cannula versus noninvasive ventilation in patients with COVID-19: a systematic review and meta-analysis. Ther Adv Respir Dis 2022; 16:17534666221087847. [PMID: 35318888 PMCID: PMC8972939 DOI: 10.1177/17534666221087847] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022] Open
Abstract
Background: During the novel coronavirus disease 2019 (COVID-19) pandemic raging around
the world, the effectiveness of respiratory support treatment has dominated
people’s field of vision. This study aimed to compare the effectiveness and
value of high-flow nasal cannula (HFNC) with noninvasive ventilation (NIV)
for COVID-19 patients. Methods: A comprehensive systematic review via PubMed, Web of
Science, Cochrane, Scopus, WHO database, China Biology Medicine Disc
(SINOMED), and China National Knowledge Infrastructure (CNKI) databases was
conducted, followed by meta-analysis. RevMan 5.4 was used to analyze the
results and risk of bias. The primary outcome is the number of deaths at day
28. The secondary outcomes are the occurrence of invasive mechanical
ventilation (IMV), the number of deaths (no time-limited), length of
intensive care unit (ICU) and hospital stay, ventilator-free days, and
oxygenation index [partial pressure of arterial oxygen
(PaO2)/fraction of inhaled oxygen (FiO2)] at 24 h. Results: In total, nine studies [one randomized controlled trial (RCT), seven
retrospective studies, and one prospective study] totaling 1582 patients
were enrolled in the meta-analysis. The results showed that the incidence of
IMV, number of deaths (no time-limited), and length of ICU stay were not
statistically significant in the HFNC group compared with the NIV group
(ps = 0.71, 0.31, and 0.33, respectively). Whereas the
HFNC group performed significant advantages in terms of the number of deaths
at day 28, length of hospital stay and oxygenation index
(p < 0.05). Only in the ventilator-free days did NIV
show advantages over the HFNC group (p < 0.0001). Conclusion: For COVID-19 patients, the use of HFNC therapy is associated with the
reduction of the number of deaths at day 28 and length of hospital stay, and
can significantly improve oxygenation index
(PaO2/FiO2) at 24 h. However, there was no favorable
between the HFNC and NIV groups in the occurrence of IMV. NIV group was
superior only in terms of ventilator-free days.
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Affiliation(s)
- Yuewen He
- Department of Anesthesiology, The First Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, P.R. China
| | - Na Liu
- Weihai Municipal Affiliated Hospital of Shandong University, Weihai, China
| | - Xuhui Zhuang
- Department of Anesthesiology, The First Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, P.R. China
| | - Xia Wang
- Department of Anesthesiology, The First Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, P.R. China
| | - Wuhua Ma
- Department of Anesthesiology, The First Affiliated Hospital of Guangzhou University of Chinese Medicine, 12 Jichang Road, Guangzhou, Guangdong 510405, P.R. China
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12
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High flow oxygen therapy in the treatment of SARS-CoV-2 pneumonia. Med Intensiva 2021; 46:105-107. [PMID: 34887233 PMCID: PMC8616732 DOI: 10.1016/j.medine.2021.11.017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2020] [Revised: 12/07/2020] [Accepted: 12/29/2020] [Indexed: 11/24/2022]
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13
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Belenguer-Muncharaz A, Hernández-Garcés H. Indication of high-flow oxygen therapy in patients with SARS-CoV-2 pneumonia. Med Intensiva 2021; 46:111. [PMID: 34863666 PMCID: PMC8612811 DOI: 10.1016/j.medine.2021.11.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2020] [Accepted: 11/14/2020] [Indexed: 11/25/2022]
Affiliation(s)
- A Belenguer-Muncharaz
- Servicio de Medicina Intensiva, Hospital Universitario Dr. Peset, Valencia, Spain; Unidad Predepartamental Medicina, Facultad de Ciencias de la Salud, Universitat Jaume I (UJI), Castelló de la Plana, Spain.
| | - H Hernández-Garcés
- Servicio de Medicina Intensiva, Hospital Universitario Dr. Peset, Valencia, Spain
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14
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Méndez L, Ferreira J, Caneiras C. Hafnia alvei Pneumonia: A Rare Cause of Infection in a Patient with COVID-19. Microorganisms 2021; 9:microorganisms9112369. [PMID: 34835494 PMCID: PMC8620350 DOI: 10.3390/microorganisms9112369] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2021] [Revised: 11/11/2021] [Accepted: 11/12/2021] [Indexed: 01/08/2023] Open
Abstract
Herein, we describe a case report of a critically ill patient, a 48-year-old man without comorbidities admitted to the hospital with a serious type 1 (hypoxemic) respiratory insufficiency and confirmed diagnosis of COVID-19. After 5 days with invasive mechanical ventilation, the patient developed a bacterial co-infection, namely a pneumonia by Hafnia alvei, requiring the last line of respiratory support: extracorporeal membrane oxygenation (ECMO). Subsequently, his clinical situation gradually stabilized, until he was discharged from the hospital on day 61, being accompanied in ambulatory consultation by the physical medicine and pulmonology department during the post-COVID-19 recovery. H. alvei is a Gram-negative bacterium that is rarely isolated from human specimens and is rarely considered to be pathogenic. However, COVID-19 disease can cause substantial organ dysfunction and can be associated with bacterial secondary infections which can favor the emergence of rare infectious diseases by uncommon microorganisms.
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Affiliation(s)
- Lucía Méndez
- Microbiology Research Laboratory on Environmental Health (EnviHealthMicro Lab), Institute of Environmental Health (ISAMB), Faculty of Medicine, Universidade de Lisboa, 1649-028 Lisboa, Portugal;
- Pulmonology Department, Centro Hospitalar Entre o Douro e Vouga, 4520-221 Santa Maria da feira, Portugal;
| | - Jorge Ferreira
- Pulmonology Department, Centro Hospitalar Entre o Douro e Vouga, 4520-221 Santa Maria da feira, Portugal;
| | - Cátia Caneiras
- Microbiology Research Laboratory on Environmental Health (EnviHealthMicro Lab), Institute of Environmental Health (ISAMB), Faculty of Medicine, Universidade de Lisboa, 1649-028 Lisboa, Portugal;
- Institute of Preventive Medicine and Public Health, Faculty of Medicine, Universidade de Lisboa, 1649-028 Lisboa, Portugal
- Microbiology and Immunology Department, Faculty of Pharmacy, Universidade de Lisboa, 1649-003 Lisboa, Portugal
- Correspondence:
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15
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Hernández-Tejedor A, Martín Delgado MC. An ethics crisis within the health crisis due to COVID-19. Med Intensiva 2021; 45:563-565. [PMID: 34776405 PMCID: PMC8542435 DOI: 10.1016/j.medine.2021.10.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2021] [Accepted: 03/15/2021] [Indexed: 11/01/2022]
Affiliation(s)
| | - M C Martín Delgado
- Junta Directiva de SEMICYUC, Hospital Universitario de Torrejón, Torrejón de Ardoz, Madrid, Spain
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16
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Custódio ACD, Ribas FV, Toledo LV, Carvalho CJD, Lima LM, Freitas BACD. Hospitalizations and mortality by severe acute respiratory syndrome: comparison between the pre-pandemic and pandemic periods. REVISTA BRASILEIRA DE EPIDEMIOLOGIA 2021; 24:e210052. [PMID: 34730711 DOI: 10.1590/1980-549720210052] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2021] [Accepted: 08/16/2021] [Indexed: 01/05/2023] Open
Abstract
OBJECTIVE To analyze the characteristics and the factors associated with mortality of cases hospitalized for severe acute respiratory syndrome in a health region, in pre-pandemic and pandemic periods. METHODS A retrospective documentary study of epidemiological surveillance carried out with secondary data from the Influenza Epidemiological Surveillance Information System, regarding the cases of patients belonging to a health region of Minas Gerais, Brazil. RESULTS During the pandemic period, there was an increase in the number of hospitalizations and deaths due to severe acute respiratory syndrome, in addition to differences between sociodemographic and clinical-epidemiological characteristics. In both periods, the age and the use of invasive ventilatory support were the predictors of hospital mortality. The mortality in the pandemic period was also associated with male gender, presence of risk factors, admission to an intensive care unit, use of non-invasive ventilatory support, and infection by COVID-19. CONCLUSIONS In 2020, the detection rate of severe acute respiratory syndrome was 21 times higher than in 2019 and new symptoms, such as anosmia and ageusia, were included in their investigation. In both periods evaluated, elderly patients and patients on invasive mechanical ventilation had a higher risk of mortality. With the pandemic, there was a greater number of hospitalizations and factors associated with mortality.
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Affiliation(s)
| | - Fábio Vieira Ribas
- Postgraduate Program in Health Sciences, Universidade Federal de Viçosa - Viçosa (MG), Brazil
| | - Luana Vieira Toledo
- Department of Medicine and Nursing, Universidade Federal de Viçosa - Viçosa (MG), Brazil
| | | | - Luciana Moreira Lima
- Department of Medicine and Nursing, Universidade Federal de Viçosa - Viçosa (MG), Brazil
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17
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Belenguer-Muncharaz A, Hernández-Garcés H. Failure of non-invasive ventilation after use of high-flow oxygen therapy in patients with SARS-Coronavirus-2 pneumonia. Med Intensiva 2021; 45:e37-e39. [PMID: 34456176 PMCID: PMC8379093 DOI: 10.1016/j.medine.2021.08.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2020] [Accepted: 06/17/2020] [Indexed: 12/03/2022]
Affiliation(s)
- A Belenguer-Muncharaz
- Servicio de Medicina Intensiva, Hospital Universitario Dr. Peset, Valencia, Spain; Unidad Predepartamental Medicina, Facultad de Ciencias de la Salud, Universitat Jaume I (UJI), Castelló de la Plana, Spain.
| | - H Hernández-Garcés
- Servicio de Medicina Intensiva, Hospital Universitario Dr. Peset, Valencia, Spain
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18
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García-Alegría J, Garrido-López P. The role of scientific societies in a post-COVID world. Rev Clin Esp 2021; 221:468-469. [PMID: 34257039 PMCID: PMC9766756 DOI: 10.1016/j.rceng.2021.04.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2021] [Accepted: 04/19/2021] [Indexed: 12/24/2022]
Affiliation(s)
- J. García-Alegría
- Federación de las Asociaciones Científico Médicas Españolas (FACME), Marbella, Málaga, Spain,Sociedad Española de Medicina Interna, Marbella, Málaga, Spain,Servicio de Medicina Interna, Agencia Sanitaria Costa del Sol, Málaga, Spain,Corresponding author
| | - P. Garrido-López
- Federación de las Asociaciones Científico Médicas Españolas (FACME), Marbella, Málaga, Spain,Sociedad Española de Oncología Médica, Marbella, Málaga, Spain,Servicio de Oncología Médica, Hospital Universitario Ramón y Cajal, Madrid, Spain
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19
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Evaluation of Aerosol Drug Delivery Options during Adult Mechanical Ventilation in the COVID-19 Era. Pharmaceutics 2021; 13:pharmaceutics13101574. [PMID: 34683867 PMCID: PMC8539467 DOI: 10.3390/pharmaceutics13101574] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2021] [Revised: 09/17/2021] [Accepted: 09/24/2021] [Indexed: 12/12/2022] Open
Abstract
Drug delivery devices used for aerosol therapy during mechanical ventilation to ease the symptoms of respiratory diseases provide beneficial treatment but can also pose challenges. Reflecting the significant changes in global guidance around aerosol usage and lung-protective ventilation strategies, seen in response to the COVID-19 pandemic, for the first time, we describe the drug delivery performance of commonly used devices under these conditions. Here, vibrating mesh nebuliser (VMN), jet nebuliser (JN) and pressurised metered-dose inhaler (pMDI) performance was assessed during simulated adult mechanical ventilation. Both standard test breathing patterns and those representatives of low tidal volume (LTV) ventilation with concurrent active and passive humidification were investigated. Drug delivery using a VMN was significantly greater than that with a JN and pMDI for both standard and LTV ventilation. Humidification type did not affect the delivered dose across all device types for standard ventilation. Significant variability in the pMDI dosing was evident, depending on the timing of actuation and the adapter type used. pMDI actuation synchronised with inspiration resulted in a higher delivered drug dose. The type of adapter used for pMDI actuation influenced drug delivery, with the highest dose observed using the CombiHaler.
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20
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Villodres GC, García-Pérez L, Corpas JM, Muros JJ. Influence of Confinement Due to COVID-19 on Physical Activity and Mediterranean Diet Adherence and Its Relationship with Self-Esteem in Pre-Adolescent Students. CHILDREN (BASEL, SWITZERLAND) 2021; 8:848. [PMID: 34682113 PMCID: PMC8534558 DOI: 10.3390/children8100848] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 08/30/2021] [Revised: 09/15/2021] [Accepted: 09/23/2021] [Indexed: 11/17/2022]
Abstract
Regular physical activity and good adherence to the Mediterranean diet are important for improving physical and mental health. Confinement due to the COVID-19 pandemic has led to a lack of exercise and poor nutrition. Preadolescent mental health, specifically regarding self-esteem, may have been affected. This is particularly relevant between the ages of 10 and 14. The influence of total confinement due to COVID-19 on physical activity and Mediterranean diet adherence, and its relationship with self-esteem was studied in third-year primary school students and first-year secondary school students in the provinces of Granada and Malaga, Spain. Validated questionnaires were administered to evaluate physical activity (PAQ-C), Mediterranean diet adherence (KIDMED) and self-esteem (Rosenberg Scale). In the same way, the FAS III test was used to evaluate socioeconomic status and an ad-hoc questionnaire was developed to collect sociodemographic data and evaluate screen time. Data were analyzed using IBM SPSS 25.0 statistical software. During the period of total confinement, statistically significant differences were found between examined variables, according to sex, school year, school type, socioeconomic status and whether or not the participant had contracted COVID-19. These data were compared with those collected during a previous time period. Those with a low socioeconomic status and girls were most affected.
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Affiliation(s)
| | | | | | - José Joaquín Muros
- Department of Didactics of Corporal Expression, University of Granada, 18071 Granada, Spain; (G.C.V.); (L.G.-P.); (J.M.C.)
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21
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Wang R, He M, Kang Y. Hypophosphatemia at Admission is Associated with Increased Mortality in COVID-19 Patients. Int J Gen Med 2021; 14:5313-5322. [PMID: 34526806 PMCID: PMC8435477 DOI: 10.2147/ijgm.s319717] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2021] [Accepted: 08/18/2021] [Indexed: 02/05/2023] Open
Abstract
Background Electrolyte disturbances are commonly observed in patients with coronavirus disease 2019 (COVID-19) and associated with outcome in these patients. Our study was designed to examine whether hypophosphatemia is associated with mortality in COVID-19 patients. Methods Patients diagnosed with COVID-19 and hospitalized in Renmin Hospital of Wuhan University between January 30 and February 24, 2020 were included in this study. Patients were divided into two groups, a hypophosphatemia group and a non-hypophosphatemia group, based on a serum phosphate level of 0.8 mmol/L. Logistic regression was performed to analyze the relationship between hypophosphatemia and mortality. A locally weighted scatterplot smoothing (LOWESS) curve was plotted to show the detailed association between mortality rate and serum phosphate level. A Kaplan–Meier survival curve was drawn to compare the difference in cumulative survival between the two groups. Results Hypophosphatemia at admission occurred in 33 patients, with an incidence of 7.6%. The hypophosphatemia group had a significantly higher incidence of respiratory failure (54.5% vs 32.6%, p=0.013) and mortality (57.6% vs 15.2%, p<0.001). Multivariate logistic regression indicated that age (OR=1.059, p<0.001), oxygen saturation (OR=0.733, p<0.001), white blood cells (OR=1.428, p<0.001), lymphocytes (OR=0.075, p<0.001) and hypophosphatemia (OR=3.636, p=0.015) were independently associated with mortality in the included patients. The hypophosphatemia group had significantly shorter survival than the non-hypophosphatemia group (p<0.001). Conclusion Hypophosphatemia at admission is associated with increased mortality in COVID-19 patients. More attention and medical care should be given to COVID-19 patients with hypophosphatemia at admission.
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Affiliation(s)
- Ruoran Wang
- Department of Critical Care Medicine, West China Hospital, Sichuan University, Chengdu, 610041, Sichuan Province, People's Republic of China
| | - Min He
- Department of Critical Care Medicine, West China Hospital, Sichuan University, Chengdu, 610041, Sichuan Province, People's Republic of China.,COVID19 Medical Team (Hubei) of West China Hospital, Sichuan University, Chengdu, People's Republic of China
| | - Yan Kang
- Department of Critical Care Medicine, West China Hospital, Sichuan University, Chengdu, 610041, Sichuan Province, People's Republic of China.,COVID19 Medical Team (Hubei) of West China Hospital, Sichuan University, Chengdu, People's Republic of China
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22
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Lopez A, Lakbar I, Delamarre L, Culver A, Arbelot C, Duclos G, Hammad E, Pastene B, Antonini F, Zieleskiewicz L, Leone M. Management of SARS-CoV-2 pneumonia in intensive care unit: An observational retrospective study comparing two bundles. J Crit Care 2021; 65:200-204. [PMID: 34225084 PMCID: PMC8238648 DOI: 10.1016/j.jcrc.2021.06.014] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2021] [Revised: 04/21/2021] [Accepted: 06/04/2021] [Indexed: 12/27/2022]
Abstract
Purpose To compare the effects of two therapeutic bundles of management in SARS-CoV2 ICU patients. Materials and methods Our retrospective, observational study was performed in a university ICU from March to June 2020 (first wave) and from September 2020 to January 2021 (second wave). In first wave, patients received bundle 1 including early invasive ventilation, hydroxychloroquine, cefotaxime and azithromycin. In second wave, bundle 2 included non-invasive oxygenation support and dexamethasone. The main outcome was in-hospital mortality. Secondary outcomes included ICU and hospital length of stay, ICU supportive therapies, viral clearance and antimicrobial resistance emergence. Results 129 patients with SARS-CoV-2 pneumonia were admitted to our ICU. Thirty-five were treated according to bundle 1 and 76 to bundle 2. In-hospital mortality was similar in the two groups (23%, p = 1). The hospital (p = 0.003) and ICU (p = 0.01) length of stay and ventilator-free days at 28 days (p = 0.03) were significantly reduced in bundle 2. Increasing age, vasopressor use and PaO2/FiO2 ratio < 125 were associated with in-hospital mortality. Conclusion Within the limitations of our study, changes in therapeutic bundles for SARS-Cov-2 ICU patients might have no effect on in-hospital mortality but were associated with less exposure to mechanical ventilation and reduced hospital length of stay.
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Affiliation(s)
- Alexandre Lopez
- Aix-Marseille University, Assistance Publique Hôpitaux de Marseille, Department of Anesthesiology and Intensive Care, Hôpital Nord, Marseille 13015, France.
| | - Ines Lakbar
- Department of Anesthesiology and Intensive Care Unit, Hôpital Nord, Toulouse, France
| | - Louis Delamarre
- Department of Anesthesiology and Intensive Care Unit, Hôpital Nord, Toulouse, France
| | - Aurélien Culver
- Aix-Marseille University, Assistance Publique Hôpitaux de Marseille, Department of Anesthesiology and Intensive Care, Hôpital Nord, Marseille 13015, France
| | - Charlotte Arbelot
- Aix-Marseille University, Assistance Publique Hôpitaux de Marseille, Department of Anesthesiology and Intensive Care, Hôpital Nord, Marseille 13015, France
| | - Gary Duclos
- Aix-Marseille University, Assistance Publique Hôpitaux de Marseille, Department of Anesthesiology and Intensive Care, Hôpital Nord, Marseille 13015, France
| | - Emmanuelle Hammad
- Aix-Marseille University, Assistance Publique Hôpitaux de Marseille, Department of Anesthesiology and Intensive Care, Hôpital Nord, Marseille 13015, France
| | - Bruno Pastene
- Aix-Marseille University, Assistance Publique Hôpitaux de Marseille, Department of Anesthesiology and Intensive Care, Hôpital Nord, Marseille 13015, France
| | - François Antonini
- Aix-Marseille University, Assistance Publique Hôpitaux de Marseille, Department of Anesthesiology and Intensive Care, Hôpital Nord, Marseille 13015, France
| | - Laurent Zieleskiewicz
- Aix-Marseille University, Assistance Publique Hôpitaux de Marseille, Department of Anesthesiology and Intensive Care, Hôpital Nord, Marseille 13015, France
| | - Marc Leone
- Aix-Marseille University, Assistance Publique Hôpitaux de Marseille, Department of Anesthesiology and Intensive Care, Hôpital Nord, Marseille 13015, France
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Herrera Carranza M. Regarding pandemics: Ibn Jatima from Almería anticipates the physiopathological concept of multi-organ failure in the 14th century. Med Intensiva 2021; 45:362-370. [PMID: 34103248 DOI: 10.1016/j.medine.2021.05.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2020] [Accepted: 05/19/2020] [Indexed: 12/15/2022]
Abstract
In 1348, a pandemic known as Black Death devastated humanity and changed social, economic and geopolitical world order, as is the current case with SARS-CoV-2 coronavirus. The doctor of the Nasrid Kingdom of Granada, Ibn-Jatima from Almeria, wrote "Treatise on the Plague", in which it may be found epidemiological and clinical similarities between both plagues. In the context of Greco-Arab medicine, he discovered respiratory and contact contagion of Pestis and attributed its physiopathology to a lack of pulmonary cooling of the innate heat, generated in the heart and carried by the blood humor. The process described was equivalent to the oxygen transport system. Furthermore, it was supposed to generate toxic residues, such as free radicals, leading to an irreversible multiple organ failure (MOF), considered a mortality factor as in Covid-19. Due to its similitude, it would be the first antecedent of the MOF physiopathological concept, a finding that enriches the scientific and historical heritage of our clinical specialty.
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Affiliation(s)
- M Herrera Carranza
- Ex-Jefe del Servicio de Cuidados Intensivos, Hospital Universitario Juan Ramón Jiménez, Huelva, Spain.
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24
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García-Alegría J, Garrido-López P. [The role of scientific societies in a post-COVID world]. Rev Clin Esp 2021; 221:468-469. [PMID: 34054134 PMCID: PMC8143917 DOI: 10.1016/j.rce.2021.04.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Affiliation(s)
- J García-Alegría
- Federación de las Asociaciones Científico Médicas Españolas (FACME), Marbella, Málaga, España.,Sociedad Española de Medicina Interna, Marbella, Málaga, España.,Servicio de Medicina Interna, Agencia Sanitaria Costa del Sol, Málaga, España
| | - P Garrido-López
- Federación de las Asociaciones Científico Médicas Españolas (FACME), Marbella, Málaga, España.,Sociedad Española de Oncología Médica, Marbella, Málaga, España.,Servicio de Oncología Médica, Hospital Universitario Ramón y Cajal, Madrid, España
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25
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Santillan-Garcia A. Living evidence for SARS-CoV-2. Med Intensiva 2021; 45:321-322. [PMID: 34059225 PMCID: PMC8085737 DOI: 10.1016/j.medine.2021.04.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2020] [Accepted: 04/20/2020] [Indexed: 11/21/2022]
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26
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González-Castro A, Fajardo Campoverde A, Medina A, Modesto I Alapont V. Non-invasive mechanical ventilation and high-flow oxygen therapy in the COVID-19 pandemic: the value of a draw. Med Intensiva 2021; 45:320-321. [PMID: 34059224 PMCID: PMC8041143 DOI: 10.1016/j.medine.2021.04.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2020] [Accepted: 04/29/2020] [Indexed: 11/26/2022]
Affiliation(s)
- A González-Castro
- Servicio de Medicina Intensiva, Hospital Universitario Marqués de Valdecilla, Santander, Spain.
| | - A Fajardo Campoverde
- Medicina Interna, Unidad de Paciente Critico, MsC en Medicina Intensiva, MsC en Ventilación Mecánica, Universitat de Valencia, Grupo de Ventilación Mecánica Chile-Drive Flow Org, Viña del Mar, Chile
| | - A Medina
- Servicio de Pediatría Unidad de Cuidados Intensivos Pediátricos, Hospital Universitario Central de Asturias, Oviedo, Spain
| | - V Modesto I Alapont
- Servicio de Pediatría, Unidad de Cuidados Intensivos Pediátricos, Hospital Universitari i Politècnic La Fe, Valencia, Spain
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27
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Hernández-Tejedor A, Martín Delgado MC. An ethics crisis within the health crisis due to COVID-19. Med Intensiva 2021; 45:S0210-5691(21)00056-5. [PMID: 33867176 PMCID: PMC7997308 DOI: 10.1016/j.medin.2021.03.006] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2021] [Revised: 03/11/2021] [Accepted: 03/15/2021] [Indexed: 11/22/2022]
Affiliation(s)
| | - M C Martín Delgado
- Junta Directiva de SEMICYUC, Hospital Universitario de Torrejón, Torrejón de Ardoz, Madrid, España
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28
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Ávila Reyes D, García P. BD, Salazar Gutierrez G, Gómez González JF, Echeverry Piedrahita DR, Galvis JC, Aguirre-Flórez M. Mechanical ventilation in SARS-CoV-2 patients: state of art. COLOMBIAN JOURNAL OF ANESTHESIOLOGY 2021. [DOI: 10.5554/22562087.e971] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023] Open
Abstract
COVID-19-associated infection leads to a pathology of yet unknown clinical behavior, confronting the clinician with various challenges. An extensive search was conducted based on review articles on SARS-CoV-2 infection and studies including mechanical ventilation management strategies in order to complete this narrative review. Evidenced-based treatment for SARS-CoV2 infection is still in the works. We have some tools from our knowledge from past experiences indicating that a step-wise management approach should be used, without neglecting other joint therapeutic measures for improved clinical outcomes of a condition with a high mortality. The current recommendations indicate that patients with severe acute respiratory failure due to SARS-CoV-2 should be managed with protective mechanical ventilation measures. No strong evidence is yet available on the individualization of mechanical ventilation therapy according to phenotypes.
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29
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Godoy DA, Graneros N, Oyarzabal L, Murillo-Cabezas F. High-flow oxygen therapy in acute hypoxemic respiratory failure secondary to COVID-19 pneumonia. Med Intensiva 2021; 45:S0210-5691(21)00019-X. [PMID: 33707033 PMCID: PMC7891069 DOI: 10.1016/j.medin.2021.02.003] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2021] [Accepted: 02/07/2021] [Indexed: 11/23/2022]
Affiliation(s)
- D A Godoy
- Unidad de Cuidados Neurointensivos, Sanatorio Pasteur, Catamarca, Argentina; Unidad de Terapia Intensiva, Hospital Carlos G. Malbran, Catamarca, Argentina.
| | - N Graneros
- Unidad de Terapia Intensiva, Hospital Carlos G. Malbran, Catamarca, Argentina
| | - L Oyarzabal
- Unidad de Terapia Intensiva, Hospital Carlos G. Malbran, Catamarca, Argentina
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30
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Meiry G, Alkaher D, Mintz Y, Eran Y, Kohn A, Kornblau G, Shneorson Z, Alkaher S, Sonkin R, Jaffe E. The rapid development of AmboVent: a simple yet sustainable ventilation solution for use in a pandemic. MINIM INVASIV THER 2021; 31:556-566. [PMID: 33586579 DOI: 10.1080/13645706.2021.1881797] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
INTRODUCTION COVID-19 (SARS-CoV-2) emerged at the end of 2019, generating a rapidly evolving pandemic, raising serious global health implications. Among them was the fear of a mechanical ventilator shortage due to COVID-19's high contagion rate and pathophysiology. Fears of a ventilator shortage unleashed a wave of innovations. MATERIAL AND METHOD This manuscript describes the AmboVent, a ventilator, rapidly developed with a sense of urgency, by a group of Israeli volunteers. RESULTS Using a decentralized approach, we worked extensively and managed within ten days to create a working ventilator. It utilizes a 64-year-old technological concept, the bag valve mask (BVM), sometimes known by the proprietary name Ambu bag, which we transformed into an automatic, controlled, and feature-rich ventilator by endowing it with contemporary computing technology. CONCLUSIONS Applying a functional rather than a commercial-oriented approach can result in the ad hoc development of lifesaving solutions during a rapidly spreading pandemic.
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Affiliation(s)
- Gideon Meiry
- Galilee Medical Center, NanoMedTech, Nahariya, Israel
| | | | - Yoav Mintz
- Hadassah Hebrew-University Medical Center, Jerusalem, Israel.,Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem, Israel
| | - Yuval Eran
- FIRST (For Inspiration and Recognition of Science and Technology), Israel.,Magen David Adom, Tel Aviv-Jaffo, Israel
| | - Aryeh Kohn
- Tel Aviv Sourasky Medical Center, Tel Aviv-Jaffo, Israel
| | - Giora Kornblau
- FIRST (For Inspiration and Recognition of Science and Technology), Israel.,Terra Ventures, Yoqneam, Israel
| | - Zeev Shneorson
- FIRST (For Inspiration and Recognition of Science and Technology), Israel.,NovoCogito, Raanana, Israel
| | - Shlomo Alkaher
- Israeli Association for Development and Promotion of Life-saving Solutions, Haifa, Israel
| | | | - Eli Jaffe
- Magen David Adom, Tel Aviv-Jaffo, Israel.,Ben Gurion University of the Negev, Beer Sheva, Israel
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31
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Joyce M, McGrath JA, Mac Giolla Eain M, O’Sullivan A, Byrne M, MacLoughlin R. Nebuliser Type Influences Both Patient-Derived Bioaerosol Emissions and Ventilation Parameters during Mechanical Ventilation. Pharmaceutics 2021; 13:199. [PMID: 33540764 PMCID: PMC7912998 DOI: 10.3390/pharmaceutics13020199] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2021] [Revised: 01/28/2021] [Accepted: 01/30/2021] [Indexed: 12/11/2022] Open
Abstract
COVID-19 may lead to serious respiratory complications which may necessitate ventilatory support. There is concern surrounding potential release of patient-derived bioaerosol during nebuliser drug refill, which could impact the health of caregivers. Consequently, mesh nebulisers have been recommended by various clinical practice guidelines. Currently, there is a lack of empirical data describing the potential for release of patient-derived bioaerosol during drug refill. This study examined the release of simulated patient-derived bioaerosol, and the effect on positive end expiratory pressure during nebuliser refill during mechanical ventilation of a simulated patient. During jet nebuliser refill, the positive end expiratory pressure decreased from 4.5 to 0 cm H2O. No loss in pressure was noted during vibrating mesh nebuliser refill. A median particle number concentration of 710 particles cm-3 above ambient was detected when refilling the jet nebuliser in comparison to no increase above ambient detected when using the vibrating mesh nebuliser. The jet nebuliser with the endotracheal tube clamped resulted in 60 particles cm-3 above ambient levels. This study confirms that choice of nebuliser impacts both the potential for patient-derived bioaerosol release and the ability to maintain ventilator circuit pressures and validates the recommended use of mesh nebulisers during mechanical ventilation.
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Affiliation(s)
- Mary Joyce
- Aerogen Limited, Galway Business Park, H91 HE94 Galway, Ireland; (M.M.G.E.); (A.O.); (R.M.)
| | - James A. McGrath
- School of Physics & Ryan Institute’s Centre for Climate and Air Pollution Studies, National University of Ireland Galway, H91 CF50 Galway, Ireland; (J.A.M.); (M.B.)
| | - Marc Mac Giolla Eain
- Aerogen Limited, Galway Business Park, H91 HE94 Galway, Ireland; (M.M.G.E.); (A.O.); (R.M.)
| | - Andrew O’Sullivan
- Aerogen Limited, Galway Business Park, H91 HE94 Galway, Ireland; (M.M.G.E.); (A.O.); (R.M.)
| | - Miriam Byrne
- School of Physics & Ryan Institute’s Centre for Climate and Air Pollution Studies, National University of Ireland Galway, H91 CF50 Galway, Ireland; (J.A.M.); (M.B.)
| | - Ronan MacLoughlin
- Aerogen Limited, Galway Business Park, H91 HE94 Galway, Ireland; (M.M.G.E.); (A.O.); (R.M.)
- School of Pharmacy & Biomolecular Sciences, Royal College of Surgeons in Ireland, D02 YN77 Dublin, Ireland
- School of Pharmacy and Pharmaceutical Sciences, Trinity College, D02 PN40 Dublin, Ireland
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González-Castro A, Cuenca Fito E, Fernandez-Rodriguez A, Escudero Acha P, Rodríguez Borregán JC, Peñasco Y. High flow oxygen therapy in the treatment of SARS-CoV-2 pneumonia. Med Intensiva 2021; 46:S0210-5691(21)00003-6. [PMID: 33551112 PMCID: PMC7816877 DOI: 10.1016/j.medin.2020.12.004] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2020] [Revised: 12/07/2020] [Accepted: 12/29/2020] [Indexed: 01/08/2023]
Affiliation(s)
- A González-Castro
- Servicio de Medicina Intensiva, Hospital Universitario Marqués de Valdecilla, Santander, España.
| | - E Cuenca Fito
- Servicio de Medicina Intensiva, Hospital Universitario Marqués de Valdecilla, Santander, España
| | - A Fernandez-Rodriguez
- Servicio de Medicina Intensiva, Hospital Universitario Marqués de Valdecilla, Santander, España
| | - P Escudero Acha
- Servicio de Medicina Intensiva, Hospital Universitario Marqués de Valdecilla, Santander, España
| | - J C Rodríguez Borregán
- Servicio de Medicina Intensiva, Hospital Universitario Marqués de Valdecilla, Santander, España
| | - Y Peñasco
- Servicio de Medicina Intensiva, Hospital Universitario Marqués de Valdecilla, Santander, España
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33
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Belenguer-Muncharaz A, Hernández-Garcés H. Indication of high-flow oxygen therapy in patients with SARS-CoV-2 pneumonia. Med Intensiva 2020; 46:S0210-5691(20)30340-5. [PMID: 33358284 PMCID: PMC7687403 DOI: 10.1016/j.medin.2020.11.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2020] [Accepted: 11/14/2020] [Indexed: 01/16/2023]
Affiliation(s)
- A Belenguer-Muncharaz
- Servicio de Medicina Intensiva, Hospital Universitario Dr. Peset, Valencia, España; Unidad Predepartamental Medicina, Facultad de Ciencias de la Salud, Universitat Jaume I (UJI), Castelló de la Plana, España.
| | - H Hernández-Garcés
- Servicio de Medicina Intensiva, Hospital Universitario Dr. Peset, Valencia, España
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34
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Carrasco G, Morillas J, Calizaya M, Baeza I, Molina R, Meije Y. ICU decision making based on Living Systematic Review strategy during SARS-CoV-2 pandemic. Results of a prospective case serie. MEDICINA INTENSIVA (ENGLISH EDITION) 2020. [PMCID: PMC7519393 DOI: 10.1016/j.medine.2020.06.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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35
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Carrasco G, Morillas J, Calizaya M, Baeza I, Molina R, Meije Y. [ICU decision making based on Living Systematic Review strategy during SARS-CoV-2 pandemic. Results of a prospective case serie]. Med Intensiva 2020; 44:516-519. [PMID: 32653236 PMCID: PMC7287417 DOI: 10.1016/j.medin.2020.06.001] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2020] [Revised: 05/31/2020] [Accepted: 06/01/2020] [Indexed: 12/11/2022]
Affiliation(s)
- G Carrasco
- Servicio de Medicina Intensiva, SCIAS Hospital de Barcelona, Barcelona, España.
| | - J Morillas
- Servicio de Medicina Intensiva, SCIAS Hospital de Barcelona, Barcelona, España
| | - M Calizaya
- Servicio de Medicina Intensiva, SCIAS Hospital de Barcelona, Barcelona, España
| | - I Baeza
- Servicio de Medicina Intensiva, SCIAS Hospital de Barcelona, Barcelona, España
| | - R Molina
- Servicio de Medicina Intensiva, SCIAS Hospital de Barcelona, Barcelona, España
| | - Y Meije
- Grupo UCI-Covidem, SCIAS Hospital de Barcelona, Barcelona, España
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36
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Analysis of Self-Concept in Adolescents before and during COVID-19 Lockdown: Differences by Gender and Sports Activity. SUSTAINABILITY 2020. [DOI: 10.3390/su12187792] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
An appeal has been issued to the scientific community to investigate physical, mental and emotional states, and pro-social behaviours during the COVID-19 pandemic. Hence, this study aims to investigate adolescents’ self-concept before and during a lockdown period in relation to gender and type/amount of physical activity or sports. The pre-lockdown sample of 366 adolescents were aged 13–17 years (M = 15.51 ± 0.65), of whom 192 (52.5%) were females and 174 (47.5%) were males. During the lockdown, the age range of the sample was 13–17 years (M = 14.57 ± 1.47), of whom 82 (60.3%) were females, and 54 (39.7%) were males. The Form-5 Self-concept Questionnaire (AF-5) was used to measure adolescents’ self-concept. There was a reduction in adolescents’ overall self-concept during the COVID-19 pandemic, which was positively associated with emotional well-being, with family and peers being essential factors in the development of an appropriate self-concept. Furthermore, girls’ self-concept, especially academic self-concept, was higher than that of boys during the lockdown. However, both physical and emotional self-concept were higher for boys than girls before the COVID-19 lockdown, although no differences were found during the lockdown. The findings reveal that physical activity was positively correlated to self-concept before and during the COVID-19 lockdown.
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Belenguer Muncharaz A, Hernández-Garcés H, López-Chicote C, Ribes-García S, Ochagavía-Barbarín J, Zaragoza-Crespo R. Effectiveness of non-invasive ventilation in intensive care unit admitted patients due to SARS-CoV-2 pneumonia. Med Intensiva 2020; 45:S0210-5691(20)30276-X. [PMID: 33077244 PMCID: PMC7472969 DOI: 10.1016/j.medin.2020.08.011] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2020] [Revised: 08/11/2020] [Accepted: 08/12/2020] [Indexed: 11/18/2022]
Affiliation(s)
- A Belenguer Muncharaz
- Servicio de Medicina Intensiva, Hospital Universitario Dr. Peset, Valencia, España; Unidad Predepartamental Medicina, Facultad de Ciencias de la Salud, Universitat Jaume I (UJI), Castellón de la Plana, España.
| | - H Hernández-Garcés
- Servicio de Medicina Intensiva, Hospital Universitario Dr. Peset, Valencia, España
| | - C López-Chicote
- Servicio de Medicina Intensiva, Hospital Universitario Dr. Peset, Valencia, España
| | - S Ribes-García
- Servicio de Medicina Intensiva, Hospital Universitario Dr. Peset, Valencia, España
| | - J Ochagavía-Barbarín
- Servicio de Medicina Intensiva, Hospital Universitario Dr. Peset, Valencia, España
| | - R Zaragoza-Crespo
- Servicio de Medicina Intensiva, Hospital Universitario Dr. Peset, Valencia, España
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38
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Ferrer R. COVID-19 Pandemic: the greatest challenge in the history of critical care. MEDICINA INTENSIVA (ENGLISH EDITION) 2020. [PMCID: PMC7336911 DOI: 10.1016/j.medine.2020.04.005] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
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39
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Ferrer R. [COVID-19 Pandemic: the greatest challenge in the history of critical care]. Med Intensiva 2020; 44:323-324. [PMID: 32376091 PMCID: PMC7151426 DOI: 10.1016/j.medin.2020.04.002] [Citation(s) in RCA: 43] [Impact Index Per Article: 10.8] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2020] [Accepted: 04/07/2020] [Indexed: 01/15/2023]
Affiliation(s)
- R Ferrer
- Shock, Organ Dysfunction, and Resuscitation Research Group (SODIR), Instituto de Investigación de Vall d'Hebron, Barcelona, España; Departmento de Medicina Intensiva, Hospital Universitario de Vall d́Hebron, Barcelona, España; Centro de Investigación Biomédica en Red (CIBER) de Enfermedades Respiratorias, España.
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40
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Herrera Carranza M. [Regarding pandemics: Ibn Jatima from Almería anticipates the physiopathological concept of multi-organ failure in the 14th century]. Med Intensiva 2020; 45:362-370. [PMID: 34629585 PMCID: PMC7367800 DOI: 10.1016/j.medin.2020.05.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2020] [Accepted: 05/19/2020] [Indexed: 12/15/2022]
Abstract
En el año 1348 una pandemia de la llamada «peste negra» asoló la humanidad y cambió el orden social, económico y geopolítico del mundo, tal como sucede actualmente con la causada por el coronavirus SARS-CoV-2. El médico del reino nazarí de Granada, Ibn Jatima de Almería, escribió un Tratado sobre la peste en el cual se encuentran semejanzas epidemiológicas y clínicas entre ambas plagas. Así, dentro del contexto de la medicina greco-árabe, descubrió el contagio respiratorio y por contacto de la peste, y atribuyó su fisiopatología a una insuficiente refrigeración pulmonar del calor innato generado en el corazón y vehiculizado por el humor sanguíneo, equivalente al sistema de trasporte de oxígeno, lo cual generaba residuos tóxicos, como los radicales libres, que abocaba a un fallo multiorgánico (FMO) irreversible, factor de mortalidad como en la Covid-19. Por su similitud, sería el primer antecedente conocido del concepto fisiopatológico de FMO, hallazgo que enriquece nuestro patrimonio científico-histórico de la especialidad.
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Affiliation(s)
- M Herrera Carranza
- Ex-Jefe del Servicio de Cuidados Intensivos, Hospital Universitario Juan Ramón Jiménez, Huelva, España
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41
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Belenguer-Muncharaz A, Hernández-Garcés H. Failure of non-invasive ventilation after use of high-flow oxygen therapy in patients with SARS-Coronavirus-2 pneumonia. Med Intensiva 2020; 45:S0210-5691(20)30220-5. [PMID: 32747154 PMCID: PMC7346782 DOI: 10.1016/j.medin.2020.06.012] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2020] [Revised: 06/15/2020] [Accepted: 06/17/2020] [Indexed: 01/16/2023]
Affiliation(s)
- Alberto Belenguer-Muncharaz
- Servicio de Medicina Intensiva, Hospital Universitario Dr. Peset, Valencia, España; Unidad Predepartamental Medicina, Facultad de Ciencias de la Salud, Universitat Jaume I (UJI), Castelló de la Plana, España.
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42
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A proposed lung ultrasound and phenotypic algorithm for the care of COVID-19 patients with acute respiratory failure. Can J Anaesth 2020; 67:1393-1404. [PMID: 32440906 PMCID: PMC7241588 DOI: 10.1007/s12630-020-01704-6] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2020] [Revised: 04/30/2020] [Accepted: 05/04/2020] [Indexed: 01/08/2023] Open
Abstract
Pulmonary complications are the most common clinical manifestations of coronavirus disease (COVID-19). From recent clinical observation, two phenotypes have emerged: a low elastance or L-type and a high elastance or H-type. Clinical presentation, pathophysiology, pulmonary mechanics, radiological and ultrasound findings of these two phenotypes are different. Consequently, the therapeutic approach also varies between the two. We propose a management algorithm that combines the respiratory rate and oxygenation index with bedside lung ultrasound examination and monitoring that could help determine earlier the requirement for intubation and other surveillance of COVID-19 patients with respiratory failure.
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43
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Blake A, Collins D, O'Connor E, Bergin C, McLaughlin AM, Martin-Loeches I. Clinical and biochemical characteristics of patients admitted to ICU with SARS-CoV-2. Med Intensiva 2020; 44:589-590. [PMID: 32425288 PMCID: PMC7229922 DOI: 10.1016/j.medin.2020.05.003] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Affiliation(s)
- A Blake
- Department of Intensive Care Medicine, St James's Hospital, Dublin, Ireland
| | - D Collins
- Department of Intensive Care Medicine, St James's Hospital, Dublin, Ireland
| | - E O'Connor
- Department of Intensive Care Medicine, St James's Hospital, Dublin, Ireland
| | - C Bergin
- Department of Infectious Diseases, St James's Hospital, Dublin, Ireland
| | - A M McLaughlin
- Department of Respiratory Medicine, St James's Hospital, Dublin, Ireland
| | - I Martin-Loeches
- Department of Intensive Care Medicine, St James's Hospital, Dublin, Ireland.
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44
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