Articles: coronavirus.
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Diabetes Metab Syndr · Jul 2020
Meta AnalysisDiabetes mellitus is associated with increased mortality and severity of disease in COVID-19 pneumonia - A systematic review, meta-analysis, and meta-regression.
Diabetes Mellitus (DM) is chronic conditions with devastating multi-systemic complication and may be associated with severe form of Coronavirus Disease 2019 (COVID-19). We conducted a systematic review and meta-analysis in order to investigate the association between DM and poor outcome in patients with COVID-19 pneumonia. ⋯ There were a total of 6452 patients from 30 studies. Meta-analysis showed that DM was associated with composite poor outcome (RR 2.38 [1.88, 3.03], p < 0.001; I2: 62%) and its subgroup which comprised of mortality (RR 2.12 [1.44, 3.11], p < 0.001; I2: 72%), severe COVID-19 (RR 2.45 [1.79, 3.35], p < 0.001; I2: 45%), ARDS (RR 4.64 [1.86, 11.58], p = 0.001; I2: 9%), and disease progression (RR 3.31 [1.08, 10.14], p = 0.04; I2: 0%). Meta-regression showed that the association with composite poor outcome was influenced by age (p = 0.003) and hypertension (p < 0.001). Subgroup analysis showed that the association was weaker in studies with median age ≥55 years-old (RR 1.92) compared to <55 years-old (RR 3.48), and in prevalence of hypertension ≥25% (RR 1.93) compared to <25% (RR 3.06). Subgroup analysis on median age <55 years-old and prevalence of hypertension <25% showed strong association (RR 3.33) CONCLUSION: DM was associated with mortality, severe COVID-19, ARDS, and disease progression in patients with COVID-19.
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Patients affected by severe acute respiratory syndrome coronavirus 2 disease (COVID-19) with respiratory distress may need invasive mechanical ventilation for a long period of time. Head and neck surgeons are becoming increasingly involved in the care of COVID-19 patients because of the rapidly increasing number of tracheotomies required. This procedure, when performed without protection, may lead to the infection of the medical and nursing staff caring for the patient. ⋯ None of the nursing/medical staff presented signs or symptoms of COVID-19 within 15 days after the procedure. Conclusion: The authors have prepared a protocol for performing a safe surgical tracheotomy in patients affected by COVID-19. Surgeons who might be involved in performing the tracheotomies should become familiar with these guidelines.
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J Clin Orthop Trauma · Jul 2020
ReviewInternet of Medical Things (IoMT) for orthopaedic in COVID-19 pandemic: Roles, challenges, and applications.
Internet of Medical Things (IoMT) is an innovative mean of amalgamating medical devices and their applications to connect with the healthcare information technology systems by using networking technologies. We have explored the possibilities of confronting the ongoing COVID-19 pandemic by implementing the IoMT approach while offering treatment to orthopaedic patients. ⋯ It can completely change the working layout of the healthcare facilities while treating orthopaedic patients with a superior level of care and more satisfaction, especially during this pandemic COVID-19 lockdown. Remote-location healthcare has also become feasible with the proposed IoMT approach.
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Multicenter Study
The role of extracorporeal life support for patients with COVID-19: Preliminary results from a statewide experience.
There is a paucity of clinical data on critically ill patients with COVID-19 requiring extracorporeal life support. ⋯ These preliminary multi-institutional data from a statewide collaborative offer insight into the clinical characteristics of the first 10 patients requiring ECMO for COVID-19 and their initial clinical course. Greater morbidity and mortality is likely to be seen in these critically ill patients with longer follow-up.