Articles: coronavirus.
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The most severe presentation of COVID-19 is characterized by a hyperinflammatory state attributed to the massive pro-inflammatory cytokine release, called "cytokine storm". Several specific anti-inflammatory/immunosuppressive agents are being evaluated by ongoing clinical trials; however, there is currently insufficient evidence for their efficacy and safety in COVID-19 treatment. Given the role of phosphodiesterase 4 (PDE) 4 and cyclic adenosine monophosphate in the inflammatory response, we hypothesize that selective PDE4 inhibition may attenuate the cytokine storm in COVID-19, through the upstream inhibition of pro-inflammatory molecules, particularly TNF-α, and the regulation of the pro-inflammatory/anti-inflammatory balance. ⋯ Furthermore, PDE4 inhibitors present several advantages including an excellent safety profile; the oral route of administration; the convenient dosing; and beneficial metabolic properties. Interestingly, obesity and diabetes mellitus type 2 have been reported to be risk factors for the severity of COVID-19. Therefore, randomized clinical trials of PDE4 inhibitors are necessary to explore their potential therapeutic effect as an adjunct to supportive measures and other therapeutic regiments.
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Coronavirus Disease 2019 (COVID-19) represents a global health crisis in which personal protective equipment has become increasingly limited. Dermatologists are poised to use technology, such as teledermatology, to innovate existing workflows and optimize dermatologic care. The state of Ohio has emerged as a leader in the United States with its response to the COVID-19 crisis. ⋯ This algorithm was quickly accepted by our hospital leadership and adopted by other inpatient consultative services. In this Viewpoint, we share our experience with early adoption of teledermatology in the inpatient consultative setting in light of the COVID-19 crisis. We also highlight the limitations, ethical considerations, and areas for future research with respect to the implementation of teledermatology.
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The purpose of our study was to investigate the predictive abilities of clinical and computed tomography (CT) features for outcome prediction in patients with coronavirus disease (COVID-19). ⋯ Underlying comorbidity, lymphocyte count and crazy-paving sign were independent predictors of adverse outcomes. The prognostic nomogram based on the combination of clinical and CT features could be a useful tool for predicting adverse outcomes of patients with COVID-19.