Articles: coronavirus.
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Korean J. Intern. Med. · Nov 2020
ReviewRecommendations for the management of patients with systemic rheumatic diseases during the coronavirus disease pandemic.
Patients with systemic rheumatic diseases (SRD) are vulnerable for coronavirus disease (COVID-19). The Korean College of Rheumatology recognized the urgent need to develop recommendations for rheumatologists and other physicians to manage patients with SRD during the COVID-19 pandemic. The working group was organized and was responsible for selecting key health questions, searching and reviewing the available literature, and formulating statements. ⋯ Medicinal treatments were categorized according to the status with respect to both COVID-19 and SRD. These recommendations should serve as a reference for individualized treatment for patients with SRD. As new evidence is emerging, an immediate update will be required.
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Observational Study
Impact of COVID-19 on liver function: results from an internal medicine unit in Northern Italy.
Little is known regarding coronavirus disease 2019 (COVID-19) clinical spectrum in non-Asian populations. We herein describe the impact of COVID-19 on liver function in 100 COVID-19 consecutive patients (median age 70 years, range 25-97; 79 males) who were admitted to our internal medicine unit in March 2020. We retrospectively assessed liver function tests, taking into account demographic characteristics and clinical outcome. ⋯ Only one patient developed acute liver failure. In patients with altered liver function tests, PaO2/FiO2 < 200 was associated with greater mortality and need for intensive care (HR 2.34, 95% CI 1.07-5.11, p = 0.033). To conclude, a high prevalence of altered liver function tests was noticed in Italian patients with COVID-19, and this was associated with worse outcomes when developing severe acute respiratory distress syndrome.
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Mayo Clinic proceedings · Nov 2020
Observational StudyImpact of the SARS-CoV-2 Pandemic on Emergency Department Presentations in an Integrated Health System.
To quantify the impact of the severe acute respiratory syndrome coronavirus 2 pandemic on emergency department volumes and patient presentations and evaluate changes in community mortality for the purpose of characterizing new patterns of emergency care use. ⋯ Fewer patients presenting with acute and time-sensitive diagnoses suggests that patients are deferring care. This may be further supported by an increase in out-of-hospital mortality. Understanding which patients are deferring care and why will allow us to develop outreach strategies and ensure that those in need of rapid assessment and treatment will do so, preventing downstream morbidity and mortality.
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This study aimed to portray the prevalence and associated factors of psychological distress among frontline nurses during COVID-19 outbreak. ⋯ This study highlighted that the frontline nurses were suffering from varying degrees of psychological distress, which needed early screening and supportive intervention for preventing more serious psychological impact on frontline nurses. Beside, more specific measurement should be combined with the GHQ-12 to assess the varying degrees of psychological distress in frontline nurses.
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Minerva anestesiologica · Nov 2020
CommentManagement of critically ill patients with COVID-19: suggestions and instructions from the coordination of intensive care units of Lombardy.
With 63,098 confirmed cases on 17 April 2020 and 11,384 deaths, Lombardy has been the most affected region in Italy by coronavirus disease 2019 (COVID-19). To cope with this emergency, the COVID-19 Lombardy intensive care units (ICU) network was created. The network identified the need of defining a list of clinical recommendations to standardize treatment of patients with COVID-19 admitted to Intensive Care Unit (ICU). ⋯ For patients admitted to ICU with COVID-19 interstitial pneumonia, we do not recommend empiric antibiotic therapy for community-acquired pneumonia. Consultation of an infectious disease specialist is suggested before start of any antiviral therapy. In conclusion, the COVID-19 Lombardy ICU Network identified a list of best practice statements supported by the available evidence and clinical experience or identified as panel members expert opinions for the management of critically ill patients with COVID-19.