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Dragomir RE, Toader DO, Gheoca Mutu DE, Dogaru IA, Răducu L, Tomescu LC, Moleriu LC, Bordianu A, Petre I, Stănculescu R. Consequences of Maternal Vitamin D Deficiency on Newborn Health. Life (Basel) 2024; 14:714. [PMID: 38929697 PMCID: PMC11204719 DOI: 10.3390/life14060714] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2024] [Revised: 05/27/2024] [Accepted: 05/29/2024] [Indexed: 06/28/2024] Open
Abstract
BACKGROUND AND OBJECTIVES Maternal-fetal gestational pathology is one of the biggest challenges in the field of health at this moment. The current study is designed to determine the effects of vitamin D on pregnancy, starting with the idea that impairment of vitamin D status is thought to be correlated with impairment of the newborn's health. MATERIALS AND METHODS In this retrospective study, we tried to establish the link between vitamin D deficiency and maternal characteristics and also how it impacted the clinical status of the newborn. We analyzed a group of 260 patients: 130 pregnant women and 130 newborns, in whom vitamin D status was detected using the serum levels of 25-hydroxyvitamin D (25-(OH)D). RESULTS The results showed that vitamin D deficiency has a high incidence among pregnant women, as was presented in many important international studies. Our study also showed a positive, direct correlation between the mother's and newborn's vitamin D status. CONCLUSIONS Taking into consideration that vitamin D deficiency has been correlated with many complications, both in maternal and newborn health, a serum level determination of 25-(OH)D is necessary in the first trimester of pregnancy, and after that, adequate supplementation is necessary in order to prevent any negative effects.
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Affiliation(s)
- Ramona Elena Dragomir
- Doctoral School, “Carol Davila” University of Medicine and Pharmacy, 020021 Bucharest, Romania; (R.E.D.); (I.A.D.); (R.S.)
| | - Daniela Oana Toader
- Department of Obstetrics and Gynecology, “Carol Davila” University of Medicine and Pharmacy, 020021 Bucharest, Romania;
| | - Daniela Elena Gheoca Mutu
- Discipline of Anatomy, Department 2—Morphological Sciences, “Carol Davila” University of Medicine and Pharmacy, 020021 Bucharest, Romania
| | - Iulian Alexandru Dogaru
- Doctoral School, “Carol Davila” University of Medicine and Pharmacy, 020021 Bucharest, Romania; (R.E.D.); (I.A.D.); (R.S.)
- Discipline of Anatomy, Department 2—Morphological Sciences, “Carol Davila” University of Medicine and Pharmacy, 020021 Bucharest, Romania
| | - Laura Răducu
- Discipline of Plastic Surgery, “Carol Davila” University of Medicine and Pharmacy, 020021 Bucharest, Romania;
| | - Laurențiu Cezar Tomescu
- Department of Obstetrics and Gynecology, “Ovidius” University of Constanța, 900527 Constanța, Romania;
| | - Lavinia Cristina Moleriu
- Discipline of Medical Informatics and Biostatistics, Department 3—Functional Sciences, “Victor Babeș” University of Medicine and Pharmacy, 300041 Timisoara, Romania; (L.C.M.); (I.P.)
| | - Anca Bordianu
- Discipline of Plastic Surgery, “Carol Davila” University of Medicine and Pharmacy, 020021 Bucharest, Romania;
| | - Ion Petre
- Discipline of Medical Informatics and Biostatistics, Department 3—Functional Sciences, “Victor Babeș” University of Medicine and Pharmacy, 300041 Timisoara, Romania; (L.C.M.); (I.P.)
| | - Ruxandra Stănculescu
- Doctoral School, “Carol Davila” University of Medicine and Pharmacy, 020021 Bucharest, Romania; (R.E.D.); (I.A.D.); (R.S.)
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Stoicescu ER, Iacob R, Iacob ER, Ghenciu LA, Oancea C, Manolescu DL. Tiny Lungs, Big Differences: Navigating the Varied COVID-19 Landscape in Neonates vs. Infants via Biomarkers and Lung Ultrasound. Biomedicines 2024; 12:425. [PMID: 38398027 PMCID: PMC10886952 DOI: 10.3390/biomedicines12020425] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2024] [Revised: 02/07/2024] [Accepted: 02/12/2024] [Indexed: 02/25/2024] Open
Abstract
Due to their susceptibilities, neonates and infants face unique SARS-CoV-2 challenges. This retrospective study will compare the illness course, symptoms, biomarkers, and lung damage in neonates and infants with SARS-CoV-2 infection from February 2020 to October 2023. This study was conducted at two hospitals in Timisoara, Romania, using real-time multiplex PCR to diagnose and lung ultrasonography (LUS) to assess lung involvement. Neonates had a more severe clinical presentation, an increased immune response, and greater lung involvement. Neonates had more PCR-positive tests (p = 0.0089) and longer hospital stays (p = 0.0002). In neonates, LDH, CRP, and ferritin levels were higher, indicating a stronger inflammatory response. Reduced oxygen saturation in neonates indicates respiratory dysfunction. The symptoms were varied. Infants had fever, cough, and rhinorrhea, while neonates had psychomotor agitation, acute dehydration syndrome, and candidiasis. This study emphasizes individualized care and close monitoring for neonatal SARS-CoV-2 infections. Newborn lung ultrasonography showed different variances and severity levels, emphasizing the need for targeted surveillance and therapy. Newborns have high lung ultrasound scores (LUSS), indicating significant lung involvement. Both groups had initial lung involvement, but understanding these modest differences is crucial to improving care for these vulnerable populations.
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Affiliation(s)
- Emil Robert Stoicescu
- Department of Radiology and Medical Imaging, ‘Victor Babes’ University of Medicine and Pharmacy Timisoara, Eftimie Murgu Square No. 2, 300041 Timisoara, Romania; (E.R.S.); (D.L.M.)
- Research Center for Pharmaco-Toxicological Evaluations, ‘Victor Babes’ University of Medicine and Pharmacy Timisoara, Eftimie Murgu Square No. 2, 300041 Timisoara, Romania
- Field of Applied Engineering Sciences, Specialization Statistical Methods and Techniques in Health and Clinical Research, Faculty of Mechanics, ‘Politehnica’ University Timisoara, Mihai Viteazul Boulevard No. 1, 300222 Timisoara, Romania
| | - Roxana Iacob
- Field of Applied Engineering Sciences, Specialization Statistical Methods and Techniques in Health and Clinical Research, Faculty of Mechanics, ‘Politehnica’ University Timisoara, Mihai Viteazul Boulevard No. 1, 300222 Timisoara, Romania
- Department of Anatomy and Embriology, ‘Victor Babes’ University of Medicine and Pharmacy Timisoara, 300041 Timisoara, Romania
| | - Emil Radu Iacob
- Department of Pediatric Surgery, ‘Victor Babes’ University of Medicine and Pharmacy, Eftimie Murgu Square No. 2, 300041 Timisoara, Romania;
| | - Laura Andreea Ghenciu
- Department of Functional Sciences, ‘Victor Babes’ University of Medicine and Pharmacy Timisoara, Eftimie Murgu Square No. 2, 300041 Timisoara, Romania;
| | - Cristian Oancea
- Center for Research and Innovation in Precision Medicine of Respiratory Diseases (CRIPMRD), ‘Victor Babes’ University of Medicine and Pharmacy, 300041 Timisoara, Romania;
- Department of Pulmonology, ‘Victor Babes’ University of Medicine and Pharmacy, 300041 Timisoara, Romania
| | - Diana Luminita Manolescu
- Department of Radiology and Medical Imaging, ‘Victor Babes’ University of Medicine and Pharmacy Timisoara, Eftimie Murgu Square No. 2, 300041 Timisoara, Romania; (E.R.S.); (D.L.M.)
- Center for Research and Innovation in Precision Medicine of Respiratory Diseases (CRIPMRD), ‘Victor Babes’ University of Medicine and Pharmacy, 300041 Timisoara, Romania;
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Nasiri K, Tehrani S, Mohammadikhah M, Banakar M, Alaeddini M, Etemad‐Moghadam S, Fernandes GVO, Heboyan A, Imannezhad S, Abbasi F. Oral manifestations of COVID-19 and its management in pediatric patients: A systematic review and practical guideline. Clin Exp Dent Res 2023; 9:922-934. [PMID: 37602892 PMCID: PMC10582234 DOI: 10.1002/cre2.776] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2023] [Revised: 08/09/2023] [Accepted: 08/10/2023] [Indexed: 08/22/2023] Open
Abstract
OBJECTIVES The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) virus causes coronavirus disease 2019 (COVID-19), a respiratory infection that has spread worldwide and is responsible for a high death toll. Although respiratory symptoms are the most common, there is growing evidence that oral signs of COVID-19 can also be seen in children. The purpose of this systematic review is to provide a comprehensive analysis of the available data on the oral manifestations of COVID-19 in children and to recommend appropriate methods of diagnosis and treatment. METHODS A systematic search of the MEDLINE, EMBASE, Scopus, and Web of Science databases was done to discover relevant papers published between their establishment and January 2023. Articles detailing oral symptoms in pediatric patients with confirmed COVID-19 infection were included, and data on clinical characteristics, diagnosis, treatment, and outcomes were extracted and evaluated. RESULTS A total of 24 studies involving 2112 pediatric patients with COVID-19 were included in the review. The most common presentations are oral lesions, taste and smell disorders, oral candidiasis, hemorrhagic crust, tongue discoloration, lip and tongue fissuring, gingivitis, and salivary gland inflammation. These manifestations were sometimes associated with multi-system inflammatory syndrome in children (MIS-C) or Kawasaki disease (KD). Management strategies varied depending on the severity of the oral manifestation and ranged from symptomatic relief with topical analgesics to systemic medications. CONCLUSION Oral symptoms of COVID-19 are relatively prevalent in juvenile patients and can be accompanied by severe systemic diseases, such as MIS-C or Kawasaki illness. Early detection and adequate care of these oral symptoms are critical for the best patient results. Understanding the underlying pathophysiology and developing targeted treatments requires more investigation.
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Affiliation(s)
- Kamyar Nasiri
- Department of DentistryIslamic Azad UniversityTehranIran
| | - Sahar Tehrani
- Department of Pediatric Dentistry, School of DentistryAhvaz Jundishapour University of Medical SciencesAhvazIran
| | - Meysam Mohammadikhah
- Department of Oral and Maxillofacial SurgerySchool of Dentistry, Alborz University of Medical SciencesKarajIran
| | - Morteza Banakar
- Dental Research Center, Dentistry Research InstituteTehran University of Medical SciencesTehranIran
- Department of Pediatric Dentistry, Faculty of DentistryShahed UniversityTehranIran
| | - Mojgan Alaeddini
- Dental Research Center, Dentistry Research InstituteTehran University of Medical SciencesTehranIran
| | - Shahroo Etemad‐Moghadam
- Dental Research Center, Dentistry Research InstituteTehran University of Medical SciencesTehranIran
| | - Gustavo V. O. Fernandes
- Department of Periodontics and Oral MedicineUniversity of Michigan School of DentistryAnn ArborMichiganUSA
- Centre for Interdisciplinary Research in Health (CIIS)Universidade Católica PortuguesaViseuPortugal
| | - Artak Heboyan
- Department of Prosthodontics, Faculty of StomatologyYerevan State Medical University after Mkhitar HeratsiArmenia
| | - Shima Imannezhad
- Department of Pediatrics, Faculty of MedicineMashhad University of Medical SciencesMashhadIran
| | - Farid Abbasi
- Department of Oral Medicine, Faculty of DentistryShahed UniversityTehranIran
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Oral Manifestations in Children Diagnosed with COVID-19: A Narrative Review. Healthcare (Basel) 2023; 11:healthcare11030288. [PMID: 36766863 PMCID: PMC9914393 DOI: 10.3390/healthcare11030288] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2022] [Revised: 01/04/2023] [Accepted: 01/16/2023] [Indexed: 01/19/2023] Open
Abstract
The COVID-19 disease has many symptoms, including fever, dry cough, tachypnea, and shortness of breath, but other symptoms can accompany the disease. The disease can also have oral manifestations. The aim of this narrative review is to describe the oral manifestations of COVID-19 in children and adolescents by summarizing the current knowledge as it was described in various case reports and original articles. A review of the literature was carried out by searching the online databases PubMed, Web of Science and Scopus, between October 2022 and 12 November 2022. For this narrative review, 890 articles from three databases and manual search were screened. Saliva was discovered to be a potential screening tool for the infection with the SARS-CoV-2, although it is most reliable in the first few days of infection. Different alteration of the oral mucosa, such as ulcers, erosions and gingivitis were reported. Oral manifestations accompanied children with COVID-19-related multisystem inflammatory syndrome, Kawasaki disease, thrombocytopenic purpura and erythema multiforme. COVID-19 had an indirect effect on oral harmful habits by decreasing their frequency during the lockdown. Although they occur more rarely, oral manifestations can accompany COVID-19 disease in children and adolescents, and they can be an early sign of the disease.
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Samaranayake LP, Fakhruddin KS, Ngo HC, Bandara MHMN, Leung YY. Oro-facial Mycoses in Coronavirus Disease-2019 (COVID-19): A Systematic Review. Int Dent J 2022; 72:607-620. [PMID: 35367044 PMCID: PMC8885299 DOI: 10.1016/j.identj.2022.02.010] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2022] [Revised: 02/21/2022] [Accepted: 02/22/2022] [Indexed: 12/22/2022] Open
Abstract
Objectives Studies reviewing orofacial mycoses in coronavirus disease-2019 (COVID-19) caused by severe acute respiratory syndrome 2 (SARS-CoV-2) infection are sparse. Here we review the major oral and maxillofacial mycoses of COVID-19, the associated comorbidities, and the probable precipitating factors. Methods English-language manuscripts published between March 2020 and October 2021 were searched using PubMed, OVID, SCOPUS, and Web of Science databases, using appropriate keywords. Results We identified 30 articles across 14 countries, which met the inclusion criteria of PRISMA guidelines. These yielded a total of 292 patients with laboratory-confirmed COVID-19, 51.4% (n = 150) of whom presented with oral and maxillofacial fungal infections, mainly comprising candidosis, mucormycosis, and aspergillosis. Candida infections were the most prevalent, present in 64% (n = 96), followed by mucormycosis, and only a single case of aspergillosis was noted. Oral and maxillofacial mycoses were predominantly seen in those with comorbidities, especially in those with diabetes (52.4%). Oral mucormycosis was noted in 8.6% (n = 13) and mainly manifested on the hard palate. An overall event rate of oral/maxillofacial mucormycosis manifestation in patients with COVID-19 with diabetes mellitus type 1/2 was about 94% (49/52; 95% confidence interval, 0.73%-0.89%), implying a very high association between diabetes mellitus and the latter condition. All fungal infections appeared either concurrently with COVID-19 symptoms or during the immediate recovery period. Conclusions SARS-CoV-2 infection–related immunosuppression, steroid therapy, as well as comorbidities such as diabetic hyperglycemia appear to be the major predisposing factors for the onset of oral and maxillofacial mycoses in patients with COVID-19 across all age groups.
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COVID-19 in Neonates with Positive RT–PCR Test. Systematic Review. Arch Med Res 2022; 53:252-262. [PMID: 35321802 PMCID: PMC8919773 DOI: 10.1016/j.arcmed.2022.03.001] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2021] [Revised: 02/18/2022] [Accepted: 03/04/2022] [Indexed: 12/24/2022]
Abstract
Background Objective Methods Results Conclusion
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Stoicescu ER, Ciuca IM, Iacob R, Iacob ER, Marc MS, Birsasteanu F, Manolescu DL, Iacob D. Is Lung Ultrasound Helpful in COVID-19 Neonates?-A Systematic Review. Diagnostics (Basel) 2021; 11:diagnostics11122296. [PMID: 34943533 PMCID: PMC8699875 DOI: 10.3390/diagnostics11122296] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2021] [Revised: 12/01/2021] [Accepted: 12/03/2021] [Indexed: 12/23/2022] Open
Abstract
Background: The SARS-CoV-2 infection has occurred in neonates, but it is a fact that radiation exposure is not recommended given their age. The aim of this review is to assess the evidence on the utility of lung ultrasound (LUS) in neonates diagnosed with COVID-19. Methods: A systematic literature review was performed so as to find a number of published studies assessing the benefits of lung ultrasound for newborns diagnosed with COVID and, in the end, to make a comparison between LUS and the other two more conventional procedures of chest X-rays or CT exam. The key terms used in the search of several databases were: “lung ultrasound”, “sonography”, “newborn”, “neonate”, and “COVID-19′. Results: In total, 447 studies were eligible for this review, and after removing the duplicates, 123 studies referring to LU were further examined, but only 7 included cases of neonates. These studies were considered for the present research paper. Conclusions: As a non-invasive, easy-to-use, and reliable method for lung lesion detection in neonates with COVID-19, lung ultrasound can be used as a useful diagnosis tool for the evaluation of COVID-19-associated lung lesions. The benefits of this method in this pandemic period are likely to arouse interest in opening new research horizons, with immediate practical applicability.
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Affiliation(s)
- Emil Robert Stoicescu
- Department of Radiology and Medical Imaging, ‘Victor Babes’ University of Medicine and Pharmacy Timisoara, Eftimie Murgu Square No. 2, 300041 Timisoara, Romania; (E.R.S.); (R.I.); (F.B.); (D.L.M.)
- Research Center for Pharmaco-Toxicological Evaluations, ‘Victor Babes’ University of Medicine and Pharmacy Timisoara, Eftimie Murgu Square No. 2, 300041 Timisoara, Romania;
| | - Ioana Mihaiela Ciuca
- Pediatric Department, ‘Victor Babes’ University of Medicine and Pharmacy Timisoara, Eftimie Murgu Square No. 2, 300041 Timisoara, Romania
- Correspondence:
| | - Roxana Iacob
- Department of Radiology and Medical Imaging, ‘Victor Babes’ University of Medicine and Pharmacy Timisoara, Eftimie Murgu Square No. 2, 300041 Timisoara, Romania; (E.R.S.); (R.I.); (F.B.); (D.L.M.)
| | - Emil Radu Iacob
- Department of Pediatric Surgery, ‘Victor Babes’ University of Medicine and Pharmacy, Eftimie Murgu Square 2, 300041 Timisoara, Romania;
| | - Monica Steluta Marc
- Pulmonology Department, ‘Victor Babes’ University of Medicine and Pharmacy, Eftimie Murgu Square 2, 300041 Timisoara, Romania;
| | - Florica Birsasteanu
- Department of Radiology and Medical Imaging, ‘Victor Babes’ University of Medicine and Pharmacy Timisoara, Eftimie Murgu Square No. 2, 300041 Timisoara, Romania; (E.R.S.); (R.I.); (F.B.); (D.L.M.)
| | - Diana Luminita Manolescu
- Department of Radiology and Medical Imaging, ‘Victor Babes’ University of Medicine and Pharmacy Timisoara, Eftimie Murgu Square No. 2, 300041 Timisoara, Romania; (E.R.S.); (R.I.); (F.B.); (D.L.M.)
- Center for Research and Innovation in Precision Medicine of Respiratory Diseases (CRIPMRD), ‘Victor Babeș’ University of Medicine and Pharmacy, 300041 Timișoara, Romania
| | - Daniela Iacob
- Research Center for Pharmaco-Toxicological Evaluations, ‘Victor Babes’ University of Medicine and Pharmacy Timisoara, Eftimie Murgu Square No. 2, 300041 Timisoara, Romania;
- Department of Neonatology, ‘Victor Babes’ University of Medicine and Pharmacy Timisoara, Eftimie Murgu Square No. 2, 300041 Timisoara, Romania
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Orilisi G, Mascitti M, Togni L, Monterubbianesi R, Tosco V, Vitiello F, Santarelli A, Putignano A, Orsini G. Oral Manifestations of COVID-19 in Hospitalized Patients: A Systematic Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph182312511. [PMID: 34886241 PMCID: PMC8656958 DOI: 10.3390/ijerph182312511] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/04/2021] [Revised: 11/24/2021] [Accepted: 11/25/2021] [Indexed: 12/21/2022]
Abstract
Background: COVID-19 disease first appeared in 2019 and quickly spread worldwide, causing a global pandemic. The oral cavity represents a target of SARS-CoV-2, and oral lesions are observed in both non-hospitalized and hospitalized patients. This systematic review aims to investigate the frequency of oral manifestations in COVID-19 hospitalized patients. Methods: An electronic search was conducted in PubMed, Scopus, and Web of Science databases, including articles published up to September 2021. The review protocol was based on PRISMA-P. The risk of bias of the studies was assessed using the Joana Briggs Institute. The certainty of evidence was assessed using the GRADE instrument. Results: Fifty-nine articles were included: 19 case reports, 17 case series, 2 case-control studies, 13 cross-sectional studies, 4 observational studies, and 4 retrospective studies. Oral ulcers, cheilitis, and tongue lesions were more common in patients before hospitalization, while perioral pressure ulcers, macroglossia, blisters, and oral candidiasis were more recurrent in patients during hospitalization. The first could be related directly to COVID-19, while the latter could be caused by medical devices, treatments, prone position, and immunological impairment. Conclusions: An accurate oral examination during the hospital admission of all confirmed COVID-19 cases is encouraged to recognize oral early manifestations and to apply appropriate treatments.
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Affiliation(s)
- Giulia Orilisi
- Department of Clinical, Specialistic and Dental Sciences, Marche Polytechnic University, Via Tronto 10, 60126 Ancona, Italy; (G.O.); (M.M.); (L.T.); (R.M.); (V.T.); (F.V.); (A.S.); (A.P.)
| | - Marco Mascitti
- Department of Clinical, Specialistic and Dental Sciences, Marche Polytechnic University, Via Tronto 10, 60126 Ancona, Italy; (G.O.); (M.M.); (L.T.); (R.M.); (V.T.); (F.V.); (A.S.); (A.P.)
| | - Lucrezia Togni
- Department of Clinical, Specialistic and Dental Sciences, Marche Polytechnic University, Via Tronto 10, 60126 Ancona, Italy; (G.O.); (M.M.); (L.T.); (R.M.); (V.T.); (F.V.); (A.S.); (A.P.)
| | - Riccardo Monterubbianesi
- Department of Clinical, Specialistic and Dental Sciences, Marche Polytechnic University, Via Tronto 10, 60126 Ancona, Italy; (G.O.); (M.M.); (L.T.); (R.M.); (V.T.); (F.V.); (A.S.); (A.P.)
| | - Vincenzo Tosco
- Department of Clinical, Specialistic and Dental Sciences, Marche Polytechnic University, Via Tronto 10, 60126 Ancona, Italy; (G.O.); (M.M.); (L.T.); (R.M.); (V.T.); (F.V.); (A.S.); (A.P.)
| | - Flavia Vitiello
- Department of Clinical, Specialistic and Dental Sciences, Marche Polytechnic University, Via Tronto 10, 60126 Ancona, Italy; (G.O.); (M.M.); (L.T.); (R.M.); (V.T.); (F.V.); (A.S.); (A.P.)
| | - Andrea Santarelli
- Department of Clinical, Specialistic and Dental Sciences, Marche Polytechnic University, Via Tronto 10, 60126 Ancona, Italy; (G.O.); (M.M.); (L.T.); (R.M.); (V.T.); (F.V.); (A.S.); (A.P.)
- Dentistry Clinic, National Institute of Health and Science of Aging, IRCCS INRCA, Via Tronto 10, 60126 Ancona, Italy
| | - Angelo Putignano
- Department of Clinical, Specialistic and Dental Sciences, Marche Polytechnic University, Via Tronto 10, 60126 Ancona, Italy; (G.O.); (M.M.); (L.T.); (R.M.); (V.T.); (F.V.); (A.S.); (A.P.)
| | - Giovanna Orsini
- Department of Clinical, Specialistic and Dental Sciences, Marche Polytechnic University, Via Tronto 10, 60126 Ancona, Italy; (G.O.); (M.M.); (L.T.); (R.M.); (V.T.); (F.V.); (A.S.); (A.P.)
- Correspondence: ; Tel.: +39-34-7248-3290
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Arvinti B, Iacob ER, Isar A, Iacob D, Costache M. Automated Medical Care: Bradycardia Detection and Cardiac Monitoring of Preterm Infants. MEDICINA (KAUNAS, LITHUANIA) 2021; 57:1199. [PMID: 34833417 PMCID: PMC8625917 DOI: 10.3390/medicina57111199] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/30/2021] [Revised: 10/19/2021] [Accepted: 11/01/2021] [Indexed: 02/07/2023]
Abstract
Background and Objectives: Prematurity of birth occurs before the 37th week of gestation and affects up to 10% of births worldwide. It is correlated with critical outcomes; therefore, constant monitoring in neonatal intensive care units or home environments is required. The aim of this work was to develop solutions for remote neonatal intensive supervision systems, which should assist medical diagnosis of premature infants and raise alarm at cardiac abnormalities, such as bradycardia. Additionally, the COVID-19 pandemic has put a worldwide stress upon the medical staff and the management of healthcare units. Materials and Methods: A traditional medical diagnosing scheme was set up, implemented with the aid of powerful mathematical operators. The algorithm was tailored to the infants' personal ECG characteristics and was tested on real ECG data from the publicly available PhysioNet database "Preterm Infant Cardio-Respiratory Signals Database". Different processing problems were solved: noise filtering, baseline drift removal, event detection and compression of medical data using the à trous wavelet transform. Results: In all 10 available clinical cases, the bradycardia events annotated by the physicians were correctly detected using the RR intervals. Compressing the ECG signals for remote transmission, we obtained compression ratios (CR) varying from 1.72 to 7.42, with the median CR value around 3. Conclusions: We noticed that a significant amount of noise can be added to a signal while monitoring using standard clinical sensors. We tried to offer solutions for these technical problems. Recent studies have shown that persons infected with the COVID-19 disease are frequently reported to develop cardiovascular symptoms and cardiac arrhythmias. An automatic surveillance system (both for neonates and adults) has a practical medical application. The proposed algorithm is personalized, no fixed reference value being applied, and the algorithm follows the neonate's cardiac rhythm changes. The performance depends on the characteristics of the input ECG. The signal-to-noise ratio of the processed ECG was improved, with a value of up to 10 dB.
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Affiliation(s)
- Beatrice Arvinti
- Fundamentals of Physics for Engineers Department, “Politehnica” University Timisoara, Bd. Vasile Pârvan 2, 300223 Timisoara, Romania;
| | - Emil Radu Iacob
- Department of Pediatric Surgery, “Victor Babes” University of Medicine and Pharmacy, Eftimie Murgu Square 2, 300041 Timisoara, Romania;
| | - Alexandru Isar
- Faculty of Electronics, Telecommunications and Information Technologies, “Politehnica” University Timisoara, Bd. Vasile Pârvan 2, 300223 Timisoara, Romania;
| | - Daniela Iacob
- Department of Neonatology, “Victor Babes” University of Medicine and Pharmacy, Eftimie Murgu Square 2, 300041 Timisoara, Romania;
| | - Marius Costache
- Fundamentals of Physics for Engineers Department, “Politehnica” University Timisoara, Bd. Vasile Pârvan 2, 300223 Timisoara, Romania;
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Nambiar M, Varma SR, Jaber M, Sreelatha SV, Thomas B, Nair AS. Mycotic infections - mucormycosis and oral candidiasis associated with Covid-19: a significant and challenging association. J Oral Microbiol 2021; 13:1967699. [PMID: 34527182 PMCID: PMC8436966 DOI: 10.1080/20002297.2021.1967699] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023] Open
Abstract
Introduction Bacterial and fungal secondary infections following COVID-19 disease are widely being reported and are an area that should receive careful attention. Mucormycosis is a fatal fungal condition affecting immunocompromised patients caused by a group of mold mucoromycetes. Candida albicans (C. albicans) is an oral commensal present in almost 40–65% of healthy oral cavities in adults. Several cases of mucormycosis and oral candidiasis have been reported lately in COVID-19 patients, and it may elevate the associated risks of morbidity and mortality. Materials and Methods Articles were taken from a period of 2020 to April 2021 using search sources such as Cochrane, PubMed, Fungiscope and Mycobank using keywords mucormycosis, Black fungus, oral candidiasis, white fungus, COVID-19, Sars-Cov-2. Discussion The development of oral mucocutaneous lesions, such as mucormycosis and candidiasis in COVID-19 patients could be due to inhaling spores resulting in pulmonary and/or sinus congestion and prolonged mechanical ventilation in the ICU settings and the long-term use of broad-spectrum antibiotics respectively. The onset of candidiasis after the emergence of COVID-19 clinical signs and symptoms varied considerably and is reported within 1–30 days in most of the cases reported in the literature. Biofilms present on the denture surfaces are predisposing factors to oral candidiasis. We aim to summarize the limited data available regarding diagnosis, clinical presentation, and therapeutic approaches for the management of Mucormycosis and oral candidiasis in COVID-19 patients. Conclusion Careful monitoring of oral lesions should be instituted through interdisciplinary telemedicine and teleconsultation to aid in primary diagnosis, thereby avoiding personal attendance during the pandemic. Dental practitioners should be included among the interdisciplinary teams for exhaustive intraoral examination and reduce the risk of morbidity and mortality.
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Affiliation(s)
- Manjusha Nambiar
- Department of Periodontics, College of Dentistry, Sri Rajiv Gandhi, College of Dental Sciences and Hospital, Benguluru, India
| | - Sudhir Rama Varma
- Department of Clinical Sciences, College of Dentistry, Ajman University, Ajman, UAE.,Centre of Medical and Bio-allied Health Sciences Research, Ajman University, Ajman, UAE
| | - Mohamed Jaber
- Department of Oral and Maxillofacial Surgery, College of Dentistry, Ajman University, Ajman, UAE
| | - S V Sreelatha
- Department of Oral Pathology, College of Dentistry, Ab Shetty Institute of Dental Sciences- (Nitte to Be Deemed University), Manguluru, India
| | - Biju Thomas
- Department of Periodontics, College of Dentistry, Ab Shetty Institute of Dental Sciences- (Nitte to Be Deemed University), Manguluru, India
| | - Arathi S Nair
- Department of Conservative Dentistry & Endodontics, Sri Rajiv Gandhi College of Dental Sciences and Hospital, Benguluru, India
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11
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Aragoneses J, Suárez A, Algar J, Rodríguez C, López-Valverde N, Aragoneses JM. Oral Manifestations of COVID-19: Updated Systematic Review With Meta-Analysis. Front Med (Lausanne) 2021; 8:726753. [PMID: 34513886 PMCID: PMC8424005 DOI: 10.3389/fmed.2021.726753] [Citation(s) in RCA: 27] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2021] [Accepted: 08/04/2021] [Indexed: 12/11/2022] Open
Abstract
There is increasing evidence for oral lesions and manifestations of COVID-19. The aim of this meta-analysis was to investigate the types of oral manifestations of COVID-19 and their prevalence. PubMed/Medline, Scopus, Web of Science, and Google Scholar databases were used to search for publications on oral manifestations in patients with PCR-confirmed COVID-19. A total of 310 records were selected, and 74 were included. Oral lesions in COVID-19 were classified according to their etiologies, including iatrogenic lesions caused by intubation and opportunistic infections. Of the included studies, 35 reported oral lesions probably caused by severe acute respiratory syndrome-Coronavirus-2 (SARS-CoV-2) infection. Meta-analysis of prevalence data on oral manifestations and aphthous lesions indicated high heterogeneity, while meta-analysis of xerostomia prevalence data revealed a pooled prevalence, with considerable heterogeneity. In conclusion, the meta-analysis yielded high heterogeneity between studies: oral lesions yielded a prevalence of 0.33 (95% CI 0.11-0.60), xerostomia lesions a prevalence of 0.44 (95% CI 0.36-0.52) and aphthous lesions 0.10 (95% CI 0.01-0.24). In addition, a gap in the evidence regarding the prevalence of oral lesions in COVID-19 was identified and the need for further observational studies focusing on this issue and on the causal relationships between oral lesions and COVID-19 was highlighted.
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Affiliation(s)
- Javier Aragoneses
- Department of Medicine and Medical Specialties, Faculty of Medicine and Health Sciences, University of Alcalá, Alcalá de Henares, Spain
| | - Ana Suárez
- Department of Preclinical Dentistry, School of Biomedical Sciences, Universidad Europea de Madrid, Madrid, Spain
| | - Juan Algar
- Department of Clinical Dentistry, School of Biomedical Sciences, Universidad Europea de Madrid, Madrid, Spain
| | - Cinthia Rodríguez
- Department of Dentistry, Federico Henriquez y Carvajal University, Santo Domingo, Dominican Republic
| | - Nansi López-Valverde
- Department of Surgery, Instituto de Investigación Biomédica de Salamanca (IBSAL), University of Salamanca, Salamanca, Spain
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12
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Irfan O, Muttalib F, Tang K, Jiang L, Lassi ZS, Bhutta Z. Clinical characteristics, treatment and outcomes of paediatric COVID-19: a systematic review and meta-analysis. Arch Dis Child 2021; 106:440-448. [PMID: 33593743 PMCID: PMC8070630 DOI: 10.1136/archdischild-2020-321385] [Citation(s) in RCA: 120] [Impact Index Per Article: 40.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/11/2020] [Revised: 01/25/2021] [Accepted: 01/27/2021] [Indexed: 02/06/2023]
Abstract
OBJECTIVE Compare paediatric COVID-19 disease characteristics, management and outcomes according to World Bank country income level and disease severity. DESIGN Systematic review and meta-analysis. SETTING Between 1 December 2019 and 8 January 2021, 3350 articles were identified. Two reviewers conducted study screening, data abstraction and quality assessment independently and in duplicate. Observational studies describing laboratory-confirmed paediatric (0-19 years old) COVID-19 were considered for inclusion. MAIN OUTCOMES AND MEASURES The pooled proportions of clinical findings, treatment and outcomes were compared according to World Bank country income level and reported disease severity. RESULTS 129 studies were included from 31 countries comprising 10 251 children of which 57.4% were hospitalised. Mean age was 7.0 years (SD 3.6), and 27.1% had a comorbidity. Fever (63.3%) and cough (33.7%) were common. Of 3670 cases, 44.1% had radiographic abnormalities. The majority of cases recovered (88.9%); however, 96 hospitalised children died. Compared with high-income countries, in low-income and middle-income countries, a lower proportion of cases were admitted to intensive care units (ICUs) (9.9% vs 26.0%) yet pooled proportion of deaths among hospitalised children was higher (relative risk 2.14, 95% CI 1.43 to 3.20). Children with severe disease received antimicrobials, inotropes and anti-inflammatory agents more frequently than those with non-severe disease. Subgroup analyses showed that a higher proportion of children with multisystem inflammatory syndrome (MIS-C) were admitted to ICU (47.1% vs 22.9%) and a higher proportion of hospitalised children with MIS-C died (4.8% vs 3.6%) compared with the overall sample. CONCLUSION Paediatric COVID-19 has a favourable prognosis. Further severe disease characterisation in children is needed globally.
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Affiliation(s)
- Omar Irfan
- Centre for Global Child Health, The Hospital for Sick Children, Toronto, Ontario, Canada
| | - Fiona Muttalib
- Centre for Global Child Health, The Hospital for Sick Children, Toronto, Ontario, Canada
| | - Kun Tang
- Centre for Global Child Health, The Hospital for Sick Children, Toronto, Ontario, Canada
- Vanke School of Public Health, Tsinghua University, Beijing, China
| | - Li Jiang
- Centre for Global Child Health, The Hospital for Sick Children, Toronto, Ontario, Canada
| | - Zohra S Lassi
- Robinson Research Institute, Adelaide Medical School, The University of Adelaide, Adelaide, South Australia, Australia
| | - Zulfiqar Bhutta
- Centre for Global Child Health, The Hospital for Sick Children, Toronto, Ontario, Canada
- Institute for Global Health & Development, Aga Khan University, Karachi, Pakistan
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13
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Liu W, Huang J, Zhang F, Zhang CC, Li RS, Wang YL, Wang CR, Liang XM, Zhang WD, Yang L, Liu P, Ge GB. Comprehensive profiling and characterization of the absorbed components and metabolites in mice serum and tissues following oral administration of Qing-Fei-Pai-Du decoction by UHPLC-Q-Exactive-Orbitrap HRMS. Chin J Nat Med 2021; 19:305-320. [PMID: 33875170 DOI: 10.1016/s1875-5364(21)60031-6] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2021] [Indexed: 12/12/2022]
Abstract
Qing-Fei-Pai-Du decoction (QFPDD) is a Chinese medicine compound formula recommended for combating corona virus disease 2019 (COVID-19) by National Health Commission of the People's Republic of China. The latest clinical study showed that early treatment with QFPDD was associated with favorable outcomes for patient recovery, viral shedding, hospital stay, and course of the disease. However, the effective constituents of QFPDD remain unclear. In this study, an UHPLC-Q-Orbitrap HRMS based method was developed to identify the chemical constituents in QFPDD and the absorbed prototypes as well as the metabolites in mice serum and tissues following oral administration of QFPDD. A total of 405 chemicals, including 40 kinds of alkaloids, 162 kinds of flavonoids, 44 kinds of organic acids, 71 kinds of triterpene saponins and 88 kinds of other compounds in the water extract of QFPDD were tentatively identified via comparison with the retention times and MS/MS spectra of the standards or refereed by literature. With the help of the standards and in vitro metabolites, 195 chemical components (including 104 prototypes and 91 metabolites) were identified in mice serum after oral administration of QFPDD. In addition, 165, 177, 112, 120, 44, 53 constituents were identified in the lung, liver, heart, kidney, brain, and spleen of QFPDD-treated mice, respectively. These findings provided key information and guidance for further investigation on the pharmacologically active substances and clinical applications of QFPDD.
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Affiliation(s)
- Wei Liu
- Key Laboratory of Liver and Kidney Diseases (Ministry of Education), Institute of Liver Diseases, Shanghai Key Laboratory of Traditional Chinese Clinical Medicine, Shuguang Hospital Affiliated to Shanghai University of Traditional Chinese Medicine, Shanghai 201203, China
| | - Jian Huang
- Institute of Interdisciplinary Integrative Medicine Research, Shanghai University of Traditional Chinese Medicine, Shanghai 201203, China
| | - Feng Zhang
- Institute of Interdisciplinary Integrative Medicine Research, Shanghai University of Traditional Chinese Medicine, Shanghai 201203, China
| | - Cong-Cong Zhang
- Key Laboratory of Liver and Kidney Diseases (Ministry of Education), Institute of Liver Diseases, Shanghai Key Laboratory of Traditional Chinese Clinical Medicine, Shuguang Hospital Affiliated to Shanghai University of Traditional Chinese Medicine, Shanghai 201203, China; Institute of Chinese Materia Medica, Shanghai University of Traditional Chinese Medicine, Shanghai 201203, China
| | - Rong-Sheng Li
- Key Laboratory of Liver and Kidney Diseases (Ministry of Education), Institute of Liver Diseases, Shanghai Key Laboratory of Traditional Chinese Clinical Medicine, Shuguang Hospital Affiliated to Shanghai University of Traditional Chinese Medicine, Shanghai 201203, China
| | - Yong-Li Wang
- Institute of Chinese Materia Medica, Shanghai University of Traditional Chinese Medicine, Shanghai 201203, China
| | - Chao-Ran Wang
- Dalian Institute of Chemical Physics, Chinese Academy of Sciences, Dalian 116023, China
| | - Xin-Miao Liang
- Dalian Institute of Chemical Physics, Chinese Academy of Sciences, Dalian 116023, China
| | - Wei-Dong Zhang
- Institute of Interdisciplinary Integrative Medicine Research, Shanghai University of Traditional Chinese Medicine, Shanghai 201203, China
| | - Ling Yang
- Institute of Interdisciplinary Integrative Medicine Research, Shanghai University of Traditional Chinese Medicine, Shanghai 201203, China
| | - Ping Liu
- Key Laboratory of Liver and Kidney Diseases (Ministry of Education), Institute of Liver Diseases, Shanghai Key Laboratory of Traditional Chinese Clinical Medicine, Shuguang Hospital Affiliated to Shanghai University of Traditional Chinese Medicine, Shanghai 201203, China; Institute of Interdisciplinary Integrative Medicine Research, Shanghai University of Traditional Chinese Medicine, Shanghai 201203, China.
| | - Guang-Bo Ge
- Institute of Interdisciplinary Integrative Medicine Research, Shanghai University of Traditional Chinese Medicine, Shanghai 201203, China.
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14
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Kim DH. Clinical implications of coronavirus disease 2019 in neonates. Clin Exp Pediatr 2021; 64:157-164. [PMID: 33539697 PMCID: PMC8024123 DOI: 10.3345/cep.2020.01795] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/26/2020] [Revised: 01/12/2021] [Accepted: 01/19/2021] [Indexed: 12/30/2022] Open
Abstract
Since the emergence of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in December 2019, a small number of coronavirus disease 2019 (COVID-19) cases in neonates have been reported worldwide. Neonates currently account for only a minor proportion of the pediatric population affected by COVID-19. Thus, data on the epidemiological and clinical features of COVID-19 in neonates are limited. Approximately 3% of neonates born to mothers with COVID-19 reportedly tested positive for SARS-CoV-2. Current limited data on neonates with COVID-19 suggest that neonatal COVID-19 shows a relatively benign course despite a high requirement for mechanical ventilation. However, neonates with pre-existing medical conditions and preterm infants appear to be at a higher risk of developing severe COVID-19. The greatest perinatal concern of the COVID-19 pandemic is the possibility of vertical transmission, especially transplacental transmission of SARS-CoV-2. Although direct evidence of the vertical transmission of SARS-CoV-2 is lacking, its possibility during late pregnancy cannot be ruled out. This review summarizes available case studies on COVID-19 in neonates and introduces what is currently known about neonatal COVID-19 with focus on its vertical transmission.
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Affiliation(s)
- Do-Hyun Kim
- Department of Pediatrics, Dongguk University Ilsan Hospital, Goyang, Korea
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15
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Riad A, Gomaa E, Hockova B, Klugar M. Oral candidiasis of COVID-19 patients: Case report and review of evidence. J Cosmet Dermatol 2021; 20:1580-1584. [PMID: 33713390 PMCID: PMC8251428 DOI: 10.1111/jocd.14066] [Citation(s) in RCA: 37] [Impact Index Per Article: 12.3] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2020] [Revised: 02/17/2021] [Accepted: 03/08/2021] [Indexed: 12/25/2022]
Affiliation(s)
- Abanoub Riad
- Czech National Centre for Evidence-Based Healthcare and Knowledge Translation (Cochrane Czech Republic, Czech EBHC: JBI Centre of Excellence, Masaryk University GRADE Centre), Institute of Biostatistics and Analyses, Faculty of Medicine, Masaryk University, Brno, Czech Republic.,Department of Public Health, Faculty of Medicine, Masaryk University, Brno, Czech Republic
| | - Esraa Gomaa
- Department of Oral Medicine and Oral Radiology, Faculty of Dentistry, Egyptian Russian University, Cairo, Egypt
| | - Barbora Hockova
- Department of Prosthetic Dentistry, Faculty of Medicine and Dentistry, Palacky University, Olomouc, Czech Republic
| | - Miloslav Klugar
- Czech National Centre for Evidence-Based Healthcare and Knowledge Translation (Cochrane Czech Republic, Czech EBHC: JBI Centre of Excellence, Masaryk University GRADE Centre), Institute of Biostatistics and Analyses, Faculty of Medicine, Masaryk University, Brno, Czech Republic.,Department of Public Health, Faculty of Medicine, Masaryk University, Brno, Czech Republic
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16
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Cimolai N. A Comprehensive Analysis of Maternal and Newborn Disease and Related Control for COVID-19. SN COMPREHENSIVE CLINICAL MEDICINE 2021; 3:1272-1294. [PMID: 33754135 PMCID: PMC7968576 DOI: 10.1007/s42399-021-00836-0] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Accepted: 02/22/2021] [Indexed: 02/07/2023]
Abstract
The maternal-fetal/newborn unit is established at risk for COVID-19 infection. This narrative review summarizes the contemporary and cumulative publications which detail maternal infection, antenatal and newborn infections, and maternal/fetal/newborn management and prevention. There is a wide spectrum of maternal disease, but the potential for severe disease albeit in a minority is confirmed. COVID-19 carries risk for preterm delivery. Pregnant females can suffer multisystem disease, and co-morbidities play a significant role in risk. Congenital infection has been supported by several anecdotal reports, but strong confirmatory data are few. No typical congenital dysmorphisms are evident. Nevertheless, placental vascular compromise must be considered a risk for the fetus during advanced maternal infections. Clinical manifestations of newborn infection have been mild to moderate and relatively uncommon. Proven antiviral therapy is of yet lacking. The mode of delivery is a medical decision that must include patient risk assessment and patient directives. Both presymptomatic and asymptomatic mothers and offspring can complicate infection control management with the potential for spread to others in several regards. In the interim, infections of the maternal-fetal-newborn unit must be taken seriously both for the disease so caused and the potential for further dissemination of disease.
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Affiliation(s)
- Nevio Cimolai
- Faculty of Medicine, The University of British Columbia, Vancouver, Canada
- Children’s and Women’s Health Centre of British Columbia, 4480 Oak Street, Vancouver, B.C. V6H3V4 Canada
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17
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Hocková B, Riad A, Valky J, Šulajová Z, Stebel A, Slávik R, Bečková Z, Pokorná A, Klugarová J, Klugar M. Oral Complications of ICU Patients with COVID-19: Case-Series and Review of Two Hundred Ten Cases. J Clin Med 2021; 10:581. [PMID: 33557130 PMCID: PMC7913822 DOI: 10.3390/jcm10040581] [Citation(s) in RCA: 59] [Impact Index Per Article: 19.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2021] [Revised: 01/31/2021] [Accepted: 02/01/2021] [Indexed: 01/10/2023] Open
Abstract
BACKGROUND The critically ill patients suffering from coronavirus disease (COVID-19) and admitted to the intensive care units (ICUs) are susceptible to a wide array of complications that can be life-threatening or impose them to long-term complications. The COVID-19 oral mucocutaneous complications require multidisciplinary management and research for their pathophysiological course and epidemiological significance; therefore, the objective of this study was to evaluate the prevalence and characteristics of the critically ill COVID-19 patients with oral complications. METHODS We described the clinical and microbiological characteristics of the critically ill COVID-19 patients in our ICU department (Banska Bystrica, Slovakia). In addition, we reviewed the current body of evidence in Ovid MEDLINE®, Embase, Cochrane Library, and Google Scholar for the oral mucocutaneous complications of ICU patients with COVID-19. RESULTS Three out of nine critically ill patients (33.3%) in our ICU department presented with oral complications including haemorrhagic ulcers and necrotic ulcers affecting the lips and tongue. The microbiological assessment revealed the presence of opportunistic pathogens, confirming the possibility of co-infection. On reviewing the current literature, two hundred ten critically ill patients were reported to have oral complications due to their stay in the ICU setting. Perioral pressure ulcers were the most common complication, followed by oral candidiasis, herpetic and haemorrhagic ulcers, and acute onset macroglossia. The prolonged prone positioning and mechanical ventilation devices were the primary risk factors for those oral complications, in addition to the immunosuppressive drugs. CONCLUSIONS The multidisciplinary approach is strongly advocated for monitoring and management of COVID-19 patients, thus implying that dermatology and oral healthcare specialists and nurses should be integrated within the ICU teams.
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Affiliation(s)
- Barbora Hocková
- Department of Maxillofacial Surgery, F. D. Roosevelt University Hospital, 975 17 Banska Bystrica, Slovakia; (B.H.); (A.S.); (R.S.)
- Department of Prosthetic Dentistry, Faculty of Medicine and Dentistry, Palacky University, 775 15 Olomouc, Czech Republic
| | - Abanoub Riad
- Czech National Centre for Evidence-Based Healthcare and Knowledge Translation (Cochrane Czech Republic, Czech EBHC: JBI Centre of Excellence, Masaryk University GRADE Centre), Institute of Biostatistics and Analyses, Faculty of Medicine, Masaryk University, 625 00 Brno, Czech Republic; (A.P.); (J.K.); (M.K.)
- Department of Public Health, Faculty of Medicine, Masaryk University, 625 00 Brno, Czech Republic
| | - Jozef Valky
- Department of Anaesthesiology, F. D. Roosevelt University Hospital, 975 17 Banska Bystrica, Slovakia; (J.V.); (Z.Š.)
| | - Zuzana Šulajová
- Department of Anaesthesiology, F. D. Roosevelt University Hospital, 975 17 Banska Bystrica, Slovakia; (J.V.); (Z.Š.)
| | - Adam Stebel
- Department of Maxillofacial Surgery, F. D. Roosevelt University Hospital, 975 17 Banska Bystrica, Slovakia; (B.H.); (A.S.); (R.S.)
| | - Rastislav Slávik
- Department of Maxillofacial Surgery, F. D. Roosevelt University Hospital, 975 17 Banska Bystrica, Slovakia; (B.H.); (A.S.); (R.S.)
| | - Zuzana Bečková
- Department of Clinical Microbiology, F. D. Roosevelt University Hospital, 975 17 Banska Bystrica, Slovakia;
- St. Elizabeth University of Health and Social Work, 812 50 Bratislava, Slovakia
| | - Andrea Pokorná
- Czech National Centre for Evidence-Based Healthcare and Knowledge Translation (Cochrane Czech Republic, Czech EBHC: JBI Centre of Excellence, Masaryk University GRADE Centre), Institute of Biostatistics and Analyses, Faculty of Medicine, Masaryk University, 625 00 Brno, Czech Republic; (A.P.); (J.K.); (M.K.)
- Department of Nursing and Midwifery, Faculty of Medicine, Masaryk University, 625 00 Brno, Czech Republic
| | - Jitka Klugarová
- Czech National Centre for Evidence-Based Healthcare and Knowledge Translation (Cochrane Czech Republic, Czech EBHC: JBI Centre of Excellence, Masaryk University GRADE Centre), Institute of Biostatistics and Analyses, Faculty of Medicine, Masaryk University, 625 00 Brno, Czech Republic; (A.P.); (J.K.); (M.K.)
- Department of Public Health, Faculty of Medicine, Masaryk University, 625 00 Brno, Czech Republic
| | - Miloslav Klugar
- Czech National Centre for Evidence-Based Healthcare and Knowledge Translation (Cochrane Czech Republic, Czech EBHC: JBI Centre of Excellence, Masaryk University GRADE Centre), Institute of Biostatistics and Analyses, Faculty of Medicine, Masaryk University, 625 00 Brno, Czech Republic; (A.P.); (J.K.); (M.K.)
- Department of Public Health, Faculty of Medicine, Masaryk University, 625 00 Brno, Czech Republic
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18
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Karabay M, Çınar N, Karakaya Suzan Ö, Yalnızoğlu Çaka S, Karabay O. Clinical characteristics of confirmed COVID-19 in newborns: a systematic review. J Matern Fetal Neonatal Med 2020; 35:4386-4397. [PMID: 33213230 DOI: 10.1080/14767058.2020.1849124] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
OBJECTIVE Aim of this systematic review is to investigate the available evidence describing neonatal outcomes in newborns who have SARS-CoV-2 infection in order to guide prevention of COVID-19 in newborns. METHODS This is the study protocol for a systematic review. MEDLINE, Web of Science, PubMed, Science Direct, CINAHL, Scopus, Cochrane, TUBİTAK databases, and key words of "Newborn" (neonatal OR clinical characteristics newborn OR infants less than 1 month OR infants less than 28 weeks OR Neonate) AND "clinical presentation" (epidemiology OR symptoms OR clinical course OR features) AND "COVID-19" (Coronavirus OR COVID-19 OR Sars-Cov2 OR coronavirus disease 2019 OR Novel Coronavirus OR 2019-nCoV) were searched for this systematic review. Randomized controlled trial, cross-sectional, case-control, and case reports, case reports examining neonatal outcomes in newborns who have SARS-CoV-2 infection were included. Studies were selected according to criteria around the population, intervention, comparator, outcome(s) of interest, and study design (PICOS framework). All citations and full-text articles were searched by independent five authors. The population that newborns with COVID-19 that confirmed within 28 d of birth are included. The interventions included in COVID-19 infection diagnosed via reverse transcription-polymerase chain reaction (RT-PCR) or serological. The primary outcomes were Neonatal clinical outcomes. The methodological quality of the studies was appraised using appropriate tools. Strength of the body of evidence was assessed according to the quality assessment tool for quantitative studies (QATQS). RESULTS The electronic search identified 1051 records that were examined, after evaluating 35 of them were included in the study. Seven studies were research articles and twenty-eight were case reports. Methodological quality was medium. Most of the clinical characteristics of newborns were respiratory difficulty and secondly fever. Some newborns gastrointestinal (GIS) symptoms in the form of diarrhea and feeding intolerance and abdominal distension were present in 50%. The fatality case did not exist in any newborn due to COVID-19. Death occurred in one case due to prematurity. CONCLUSIONS The most common symptoms in patients with COVID-19 infection in the neonatal period are respiratory tract symptoms and fever. It has been observed that the COVID-19 infection detected in the neonatal period is not fatal. However, data including more cases are needed.
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Affiliation(s)
- Meltem Karabay
- Department of Pedaitrics, Neonatology Unit, Faculty of Medicine, Sakarya University, Sakarya, Turkey
| | - Nursan Çınar
- Department of Pediatric Nursing, Faculty of Health Sciences, Sakarya University, Sakarya, Turkey
| | - Özge Karakaya Suzan
- Department of Pediatric Nursing, Faculty of Health Sciences, Sakarya University, Sakarya, Turkey
| | - Sinem Yalnızoğlu Çaka
- Department of Pediatric Nursing, Faculty of Health Sciences, Sakarya University, Sakarya, Turkey
| | - Oğuz Karabay
- Department of Infectious Diseases, Faculty of Medicine, Sakarya University, Sakarya, Turkey
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