International journal of infectious diseases : IJID : official publication of the International Society for Infectious Diseases
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Tocilizumab (TCZ) is an interleukin-6 receptor antagonist, which has been used for the treatment of severe SARS-CoV-2 pneumonia (SSP), which aims to ameliorate the cytokine release syndrome (CRS) induced acute respiratory distress syndrome (ARDS). However, there are no consistent data about who might benefit most from it. ⋯ TCZ is well tolerated in patients with SSP, but it has a limited effect on the evolution of cases with high oxygen support needs.
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Describe and evaluate the outcome of a coronavirus disease-2019 (COVID-19) patient without shortness of breath. ⋯ The absence of shortness of breath in an old patient with comorbidity merit medical attention and should not be considered as a good sign of well-being. The poor prognosis of asymptomatic hypoxia, highlight the severity of this mild clinical presentation. In these patients, pulse oximetry is an important mean to predict the outcome along with news score and LDCT scanner.
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Int. J. Infect. Dis. · Jan 2021
Randomized Controlled TrialRandomized controlled open label trial on the use of favipiravir combined with inhaled interferon beta-1b in hospitalized patients with moderate to severe COVID-19 pneumonia.
To evaluate the therapeutic effectiveness of favipiravir combined with inhaled interferon beta-1b in adult patients hospitalized with moderate to severe COVID-19 pneumonia. ⋯ No differences in clinical outcomes were found between favipiravir plus inhaled interferon beta-1b and hydroxychloroquine in adults hospitalized with moderate to severe COVID-19 pneumonia.
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Int. J. Infect. Dis. · Jan 2021
Presenting Symptoms and Predictors of Poor Outcomes Among 2,184 Patients with COVID-19 in Lagos State, Nigeria.
Lagos state remains the epicentre of COVID-19 in Nigeria. We describe the symptoms and signs of the first 2,184 PCR-confirmed COVID-19 patients admitted at COVID-19 treatment centers in Lagos State. We also assessed the relationship between patients' presenting symptoms, sociodemographic and clinical characteristics and COVID-19 deaths.. ⋯ Primary care physicians and COVID-19 frontline workers should maintain a high index of suspicion and prioritize the care of patients presenting with these symptoms. Community members should be educated on such predictors and ensure that patients with these symptoms seek care early to reduce the risk of deaths associated with COVID-19.
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Int. J. Infect. Dis. · Jan 2021
Therapeutic plasma exchange followed by convalescent plasma transfusion in critical COVID-19-An exploratory study.
The pathophysiology of severe coronavirus disease 2019 (COVID-19) is primarily a host immune interplay to virus invasion. The therapeutic options have been explored either against hyperinflammation from dysregulated adaptive immunity or direct virus neutralization using antibodies from convalescent plasma (CP) of a recovered patient. The therapeutic plasma exchange (TPE) for removal of excessive inflammatory cytokines has been tried with success in COVID-19. ⋯ The median duration ICU and hospital LOS were 12 (5-42) days and 18 (12-47) days respectively. No patient developed transfusion-associated complications, but three patients developed secondary bacterial sepsis within 14 days of therapy, and one died. This case series demonstrated the sequential use of TPE followed by CP transfusion as a therapeutic option in critical COVID-19.