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Dassie-Leite AP, Gueths TP, Ribeiro VV, Pereira EC, Martins PDN, Daniel CR. Vocal Signs and Symptoms Related to COVID-19 and Risk Factors for their Persistence. J Voice 2024; 38:189-194. [PMID: 34583881 PMCID: PMC8354794 DOI: 10.1016/j.jvoice.2021.07.013] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2021] [Revised: 07/15/2021] [Accepted: 07/21/2021] [Indexed: 11/21/2022]
Abstract
OBJECTIVE To compare the occurrence of vocal signs and symptoms before, during, and after coronavirus disease (COVID-19) and analyze possible risk factors for the persistence of these signs and symptoms after disease resolution. METHODS This was an observational, analytical, and cross-sectional study. The participants were 45 individuals of both sexes, with a mean age of 44 years, who were previously affected by COVID-19. All participants answered a questionnaire about sociodemographic data, smoking history, disease course, vocal complaints, and the vocal signs and symptoms list (SSL), referring to three timepoints (before, during, and after COVID-19). RESULTS The most commonly reported vocal signs and symptoms before COVID-19 were phlegm (26.67%; n=12) and dry throat (24.44%; n=11). During COVID-19, the most frequent vocal signs and symptoms were tired voice after short-term use (73.33%; n=33) and dry throat (71.11%; n=32). After the disease, the most reported vocal signs and symptoms were dry throat (57.78%; n=26) and phlegm (53.33; n=24). The self-perception of vocal signs and symptoms before COVID-19 was lower than that during and after COVID-19 (P < 0.001). Vocal complaints after COVID-19 and oxygen therapy were predictors of self-perception of vocal signs and symptoms after COVID-19. CONCLUSIONS Individuals affected by COVID-19 had a higher frequency of vocal signs and symptoms during the disease. However, after remission, the frequency of vocal signs and symptoms was higher than that at baseline. The need for oxygen therapy may indicate a risk for a higher occurrence of vocal signs and symptoms after COVID-19.
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Affiliation(s)
- Ana Paula Dassie-Leite
- Professor at the Speech-Language Pathology Department, Universidade Estadual do Centro-Oeste - UNICENTRO. PR 156, Km 07; Irati, Paraná, Brazil; Professor at the Interdisciplinary Postgraduate Program in Community Development, Universidade Estadual do Centro-Oeste - UNICENTRO. PR 156, Km 07; Irati, Paraná, Brazil.
| | - Tatiane Prestes Gueths
- Speech Language Pahologist. Saldanha Marinho st, 2820. Bairro dos Estados; Guarapuava, Paraná, Brazil
| | - Vanessa Veis Ribeiro
- Professor at the Speech-Language Pathology Department, Universidade Federal de Sergipe - UFS. Governador Marcelo Dedá Avenue, 13, Centro, Lagarto, Sergipe, Brazil; Professor at the Associate Postgraduate Program in Speech-Language Pathology, Universidade Federal da Paraíba - UFPB. Cidade Universitária, Conjunto Presidente Castelo Branco III, João Pessoa, Paraíba, Brazil
| | - Eliane Cristina Pereira
- Professor at the Speech-Language Pathology Department, Universidade Estadual do Centro-Oeste - UNICENTRO. PR 156, Km 07; Irati, Paraná, Brazil
| | - Perla do Nascimento Martins
- Professor at the Speech-Language Pathology Department, Universidade Estadual do Centro-Oeste - UNICENTRO. PR 156, Km 07; Irati, Paraná, Brazil
| | - Christiane Riedi Daniel
- Professor at the Physioterapy Department, Universidade Estadual do Centro-Oeste - UNICENTRO. Alameda Élio Antonio Dalla Vecchia, 838 - CEP 85040-167 - Bairro - Vila Carli, Guarapuava, Brazil
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2
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Wu CC, Chen WL, Tseng CW, Su YC, Chen HL, Lin CL, Hung TY. Continuous aerosol monitoring and comparison of aerosol exposure based on smoke dispersion distance and concentrations during oxygenation therapy. Sci Rep 2023; 13:15910. [PMID: 37741874 PMCID: PMC10517922 DOI: 10.1038/s41598-023-42909-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2023] [Accepted: 09/15/2023] [Indexed: 09/25/2023] Open
Abstract
This study evaluated the aerosol exposure risks while using common noninvasive oxygenation devices. A simulated mannequin was designed to breathe at a minute ventilation of 20 L/min and used the following oxygen-therapy devices: nasal cannula oxygenation (NCO) at 4 and 15 L/min, nonrebreathing mask (NRM) at 15 L/min, simple mask at 6 L/min, combination of NCO at 15 L/min and NRM at 15 L/min, high-flow nasal cannula (HFNC) at 50 L/min, and flush rate NRM. Two-dimension of the dispersion distance and the aerosol concentrations were measured at head, trunk, and foot around the mannequin for over 10 min. HFNC and flush-rate NRM yielded the longest dispersion distance and highest aerosol concentrations over the three sites of the mannequin than the other oxygenation devices and should use with caution. For flow rates of < 15 L/min, oxygenation devices with mask-like effects, such as NRM or NCO with NRM, decreased aerosol dispersion more effectively than NCO alone or a simple mask. In the upright position, the foot area exhibited the highest aerosol concentration regardless of the oxygenation device than the head-trunk areas of the mannequin. Healthcare workers should be alert even at the foot side of the patient while administering oxygenation therapy.
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Affiliation(s)
- Chih-Chieh Wu
- Department of Emergency Medicine, Zhong-Xing Branch, Taipei City Hospital, Taipei, Taiwan
| | - Wei-Lun Chen
- Department of Emergency Medicine, Zhong-Xing Branch, Taipei City Hospital, Taipei, Taiwan
| | - Cheng-Wei Tseng
- Department of Emergency Medicine, Zhong-Xing Branch, Taipei City Hospital, Taipei, Taiwan
| | - Yung-Cheng Su
- School of Medicine, Tzu Chi University, Hualien County, Hualien, Taiwan
- Department of Emergency, Ditmanson Medical Foundation, Chiayi Christian Hospital, Chiayi County, Chiayi, Taiwan
| | - Hsin-Ling Chen
- Department of Emergency Medicine, Zhong-Xing Branch, Taipei City Hospital, Taipei, Taiwan
| | - Chun-Lung Lin
- Department of Emergency Medicine, Zhong-Xing Branch, Taipei City Hospital, Taipei, Taiwan
| | - Tzu-Yao Hung
- Department of Emergency Medicine, Zhong-Xing Branch, Taipei City Hospital, Taipei, Taiwan.
- School of Medicine, National Yang-Ming Chiao Tung University, Taipei, Taiwan.
- CrazyatLAB (Critical Airway Training Laboratory), Taipei, Taiwan.
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Teppo AM, Rossi H, Rajamäki MM, Hyytiäinen HK. Proposed protocol for utilising high-flow nasal oxygen therapy in treatment of dogs hospitalised due to pneumonia. BMC Vet Res 2023; 19:167. [PMID: 37735404 PMCID: PMC10512590 DOI: 10.1186/s12917-023-03737-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2023] [Accepted: 09/14/2023] [Indexed: 09/23/2023] Open
Abstract
BACKGROUND High-flow nasal oxygen (HFNO) therapy is a non-invasive respiratory support method that provides oxygen-enriched, warmed, and humidified air to respiratory-compromised patients. It is widely used in human medical care, but in veterinary medicine it is still a relatively new method. No practical guidelines exist for its use in canine pneumonia patients, although they could potentially benefit from HFNO therapy. This study aims to provide a new, safe, non-invasive, and effective treatment protocol for oxygen supplementation of non-sedated dogs with pneumonia. METHODS Twenty privately owned dogs with pneumonia will receive HFNO therapy at a flow rate of 1-2 L/kg, and the fraction of inspired oxygen will be determined individually (ranging from 21% to 100%). HFNO therapy will continue as long as oxygen support is needed based on clinical evaluation. Patients will be assessed thrice daily during their hospitalisation, with measured primary outcomes including partial pressure of oxygen, oxygen saturation, respiratory rate and type, days in hospital, and survival to discharge. DISCUSSION The proposed protocol aims to provide a practical guideline for applying HFNO to dogs hospitalised due to pneumonia. The protocol could enable more efficient and well-tolerated oxygenation than traditional methods, thus hastening recovery and improving survival of pneumonia patients.
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Affiliation(s)
- Anna-Maija Teppo
- Department of Equine and Small Animal Medicine, Faculty of Veterinary Medicine, University of Helsinki, Helsinki, Finland
| | - Heini Rossi
- Department of Equine and Small Animal Medicine, Faculty of Veterinary Medicine, University of Helsinki, Helsinki, Finland.
| | - Minna M Rajamäki
- Department of Equine and Small Animal Medicine, Faculty of Veterinary Medicine, University of Helsinki, Helsinki, Finland
| | - Heli K Hyytiäinen
- Department of Equine and Small Animal Medicine, Faculty of Veterinary Medicine, University of Helsinki, Helsinki, Finland
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4
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Bepouka B, Odio O, Mayasi N, Longokolo M, Mangala D, Mandina M, Mbula M, Kayembe JM, Situakibanza H. Prevalence and Outcomes of COVID -19 Patients with Happy Hypoxia: A Systematic Review. Infect Drug Resist 2022; 15:5619-5628. [PMID: 36172621 PMCID: PMC9512283 DOI: 10.2147/idr.s378060] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2022] [Accepted: 09/14/2022] [Indexed: 01/08/2023] Open
Abstract
Background In Coronavirus disease 2019 (COVID-19), some patients have low oxygen saturation without any dyspnea. This has been termed “happy hypoxia.” No worldwide prevalence survey of this phenomenon has been conducted. This review aimed to summarize information on the prevalence, risk factors, and outcomes of patients with happy hypoxia to improve their management. Methods We conducted a systematic search of electronic databases for all studies published up to April 30, 2022. We included high-quality studies using the Newcastle-Ottawa Scale (NOS) tool for qualitative assessment of searches. The prevalence of happy hypoxia, as well as the mortality rate of patients with happy hypoxia, were estimated by pooled analysis and heterogeneity by I2. Results Of the 25,086 COVID-19 patients from the 7 studies, the prevalence of happy hypoxia ranged from 4.8 to 65%. The pooled prevalence was 6%. Happy hypoxia was associated with age > 65 years, male sex, body mass index (BMI)> 25 kg/m2, smoking, chronic obstructive pulmonary disease, diabetes mellitus, high respiratory rate, and high d-dimer. Mortality ranged from 01 to 45.4%. The pooled mortality was 2%. In 2 studies, patients with dyspnea were admitted to intensive care more often than those with happy hypoxia. One study reported that the length of stay in intensive care did not differ between patients with dyspnea and those with happy hypoxia at admission. One study reported the need for extracorporeal membrane oxygenation (ECMO) in patients with happy hypoxia. Conclusion The pooled prevalence and mortality of patients with happy hypoxia were not very high. Happy hypoxia was associated with advanced age and comorbidities. Some patients were admitted to the intensive care unit, although fewer than dyspneic patients. Its early detection and management should improve the prognosis.
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Affiliation(s)
- Ben Bepouka
- Department of Internal Medicine, University of Kinshasa, Kinshasa, The Democratic Republic of the Congo
| | - Ossam Odio
- Department of Internal Medicine, University of Kinshasa, Kinshasa, The Democratic Republic of the Congo
| | - Nadine Mayasi
- Department of Internal Medicine, University of Kinshasa, Kinshasa, The Democratic Republic of the Congo
| | - Murielle Longokolo
- Department of Internal Medicine, University of Kinshasa, Kinshasa, The Democratic Republic of the Congo
| | - Donat Mangala
- Department of Internal Medicine, University of Kinshasa, Kinshasa, The Democratic Republic of the Congo
| | - Madone Mandina
- Department of Internal Medicine, University of Kinshasa, Kinshasa, The Democratic Republic of the Congo
| | - Marcel Mbula
- Department of Internal Medicine, University of Kinshasa, Kinshasa, The Democratic Republic of the Congo
| | - Jean Marie Kayembe
- Department of Internal Medicine, University of Kinshasa, Kinshasa, The Democratic Republic of the Congo
| | - Hippolyte Situakibanza
- Department of Internal Medicine, University of Kinshasa, Kinshasa, The Democratic Republic of the Congo
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5
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Martínez-Gómez LE, Ibarra-González I, Fernández-Lainez C, Tusie T, Moreno-Macías H, Martinez-Armenta C, Jimenez-Gutierrez GE, Vázquez-Cárdenas P, Vidal-Vázquez P, Ramírez-Hinojosa JP, Rodríguez-Zulueta AP, Vargas-Alarcón G, Rojas-Velasco G, Sánchez-Muñoz F, Posadas-Sanchez R, Martínez-Ruiz FDJ, Zayago-Angeles DM, Moreno ML, Barajas-Galicia E, Lopez-Cisneros G, Gonzalez-Fernández NC, Ortega-Peña S, Herrera-López B, Olea-Torres J, Juárez-Arias M, Rosas-Vásquez M, Cabrera-Nieto SA, Magaña JJ, Camacho-Rea MDC, Suarez-Ahedo C, Coronado-Zarco I, Valdespino-Vázquez MY, Martínez-Nava GA, Pineda C, Vela-Amieva M, López-Reyes A. Metabolic Reprogramming in SARS-CoV-2 Infection Impacts the Outcome of COVID-19 Patients. Front Immunol 2022; 13:936106. [PMID: 36341434 PMCID: PMC9634751 DOI: 10.3389/fimmu.2022.936106] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2022] [Accepted: 06/10/2022] [Indexed: 11/25/2023] Open
Abstract
Severe acute respiratory syndrome-coronavirus 2 (SARS-CoV-2) infection triggers inflammatory clinical stages that affect the outcome of patients with coronavirus disease 2019 (COVID-19). Disease severity may be associated with a metabolic imbalance related to amino acids, lipids, and energy-generating pathways. The aim of this study was to characterize the profile of amino acids and acylcarnitines in COVID-19 patients. A multicenter, cross-sectional study was carried out. A total of 453 individuals were classified by disease severity. Levels of 11 amino acids, 31 acylcarnitines, and succinylacetone in serum samples were analyzed by electrospray ionization-triple quadrupole tandem mass spectrometry. Different clusters were observed in partial least squares discriminant analysis, with phenylalanine, alanine, citrulline, proline, and succinylacetone providing the major contribution to the variability in each cluster (variable importance in the projection >1.5). In logistic models adjusted by age, sex, type 2 diabetes mellitus, hypertension, and nutritional status, phenylalanine was associated with critical outcomes (odds ratio=5.3 (95% CI 3.16-9.2) in the severe vs. critical model, with an area under the curve of 0.84 (95% CI 0.77-0.90). In conclusion the metabolic imbalance in COVID-19 patients might affect disease progression. This work shows an association of phenylalanine with critical outcomes in COVID-19 patients, highlighting phenylalanine as a potential metabolic biomarker of disease severity.
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Affiliation(s)
- Laura E. Martínez-Gómez
- Laboratorio de Gerociencias, Laboratorio Facilitador, Laboratorio de Medicina Genómica, Dirección General, Instituto Nacional de Rehabilitación Luis Guillermo Ibarra Ibarra, Secretaría de Salud, Ciudad de México, Mexico
| | - Isabel Ibarra-González
- Unidad de Genética de la Nutrición, Instituto de Investigaciones Biomédicas, Universidad Nacional Autónoma de México (UNAM), Ciudad de México, Mexico
| | - Cynthia Fernández-Lainez
- Laboratorio de Errores Innatos del Metabolismo y Tamiz, Instituto Nacional de Pediatría, Secretaría de Salud, Ciudad de México, Mexico
| | - Teresa Tusie
- Unidad de Biología Molecular y Medicina Genómica, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Instituto de Investigaciones Biomédicas UNAM, Ciudad de México, Mexico
| | - Hortensia Moreno-Macías
- Unidad de Biología Molecular y Medicina Genómica, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Instituto de Investigaciones Biomédicas UNAM, Ciudad de México, Mexico
- Departamento de Economía. División de Ciencias Sociales y Humanidades, Universidad Autónoma Metropolitana, Iztapalapa, Ciudad de México, Mexico
| | - Carlos Martinez-Armenta
- Posgrado en Biología Experimental, Dirección de Ciencias Biológicas y de la Salud (DCBS), Universidad Autónoma Metropolitana Iztapalapa, Ciudad de México, Mexico
| | - Guadalupe Elizabeth Jimenez-Gutierrez
- Laboratorio de Gerociencias, Laboratorio Facilitador, Laboratorio de Medicina Genómica, Dirección General, Instituto Nacional de Rehabilitación Luis Guillermo Ibarra Ibarra, Secretaría de Salud, Ciudad de México, Mexico
| | - Paola Vázquez-Cárdenas
- Centro de Innovación Médica Aplicada, Subdirección de Epidemiología e Infectología, Hospital General Dr. Manuel Gea González, Secretaría de Salud, Ciudad de México, Mexico
| | - Patricia Vidal-Vázquez
- Centro de Innovación Médica Aplicada, Subdirección de Epidemiología e Infectología, Hospital General Dr. Manuel Gea González, Secretaría de Salud, Ciudad de México, Mexico
| | - Juan P. Ramírez-Hinojosa
- Centro de Innovación Médica Aplicada, Subdirección de Epidemiología e Infectología, Hospital General Dr. Manuel Gea González, Secretaría de Salud, Ciudad de México, Mexico
| | - Ana P. Rodríguez-Zulueta
- Centro de Innovación Médica Aplicada, Subdirección de Epidemiología e Infectología, Hospital General Dr. Manuel Gea González, Secretaría de Salud, Ciudad de México, Mexico
| | - Gilberto Vargas-Alarcón
- Departamentos de Biología Molecular, Inmunología, Endocrinologia y Unidad de Cuidados Intensivos, Instituto Nacional de Cardiología Ignacio Chavez, Secretaría de Salud, Ciudad de México, Mexico
| | - Gustavo Rojas-Velasco
- Departamentos de Biología Molecular, Inmunología, Endocrinologia y Unidad de Cuidados Intensivos, Instituto Nacional de Cardiología Ignacio Chavez, Secretaría de Salud, Ciudad de México, Mexico
| | - Fausto Sánchez-Muñoz
- Departamentos de Biología Molecular, Inmunología, Endocrinologia y Unidad de Cuidados Intensivos, Instituto Nacional de Cardiología Ignacio Chavez, Secretaría de Salud, Ciudad de México, Mexico
| | - Rosalinda Posadas-Sanchez
- Departamentos de Biología Molecular, Inmunología, Endocrinologia y Unidad de Cuidados Intensivos, Instituto Nacional de Cardiología Ignacio Chavez, Secretaría de Salud, Ciudad de México, Mexico
| | - Felipe de J. Martínez-Ruiz
- Nuevo Hospital General Delegación Regional Sur de la Ciudad de México, Instituto de Seguridad y Servicios Sociales para los Trabajadores del Estado (ISSSTE), Ciudad de México, Mexico
| | - Dulce M. Zayago-Angeles
- Nuevo Hospital General Delegación Regional Sur de la Ciudad de México, Instituto de Seguridad y Servicios Sociales para los Trabajadores del Estado (ISSSTE), Ciudad de México, Mexico
| | - Mariana L. Moreno
- Nuevo Hospital General Delegación Regional Sur de la Ciudad de México, Instituto de Seguridad y Servicios Sociales para los Trabajadores del Estado (ISSSTE), Ciudad de México, Mexico
| | - Edith Barajas-Galicia
- Hospital Central Norte Petróleos Mexicanos (PEMEX), Estado de México, Mexico City, Mexico
| | - Gerardo Lopez-Cisneros
- Hospital Central Norte Petróleos Mexicanos (PEMEX), Estado de México, Mexico City, Mexico
| | | | - Silvestre Ortega-Peña
- Laboratorio de Gerociencias, Laboratorio Facilitador, Laboratorio de Medicina Genómica, Dirección General, Instituto Nacional de Rehabilitación Luis Guillermo Ibarra Ibarra, Secretaría de Salud, Ciudad de México, Mexico
| | - Brígida Herrera-López
- Laboratorio de Gerociencias, Laboratorio Facilitador, Laboratorio de Medicina Genómica, Dirección General, Instituto Nacional de Rehabilitación Luis Guillermo Ibarra Ibarra, Secretaría de Salud, Ciudad de México, Mexico
| | - Jessel Olea-Torres
- Laboratorio de Gerociencias, Laboratorio Facilitador, Laboratorio de Medicina Genómica, Dirección General, Instituto Nacional de Rehabilitación Luis Guillermo Ibarra Ibarra, Secretaría de Salud, Ciudad de México, Mexico
| | - Manuel Juárez-Arias
- Unidad de Investigación y Desarrollo en Alimentos, Tecnológico Nacional de México/Instituto Tecnológico (IT) Veracruz, Veracruz, Mexico
| | - Maritza Rosas-Vásquez
- Unidad de Investigación y Desarrollo en Alimentos, Tecnológico Nacional de México/Instituto Tecnológico (IT) Veracruz, Veracruz, Mexico
| | - Sara Aileen Cabrera-Nieto
- Posgrado en Ciencias Médicas, Facultad de Ciencias de la Salud, Universidad Anáhuac, Ciudad de México, Mexico
| | - Jonathan J. Magaña
- Laboratorio de Gerociencias, Laboratorio Facilitador, Laboratorio de Medicina Genómica, Dirección General, Instituto Nacional de Rehabilitación Luis Guillermo Ibarra Ibarra, Secretaría de Salud, Ciudad de México, Mexico
| | - María del Carmen Camacho-Rea
- Departamento de Nutrición Animal, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Secretaría de Salud, Ciudad de México, Mexico
| | - Carlos Suarez-Ahedo
- Laboratorio de Gerociencias, Laboratorio Facilitador, Laboratorio de Medicina Genómica, Dirección General, Instituto Nacional de Rehabilitación Luis Guillermo Ibarra Ibarra, Secretaría de Salud, Ciudad de México, Mexico
| | - Irma Coronado-Zarco
- Instituto Nacional de Perinatología Isidro Espinosa de los Reyes, Ciudad de México, Mexico
| | | | - Gabriela Angélica Martínez-Nava
- Laboratorio de Gerociencias, Laboratorio Facilitador, Laboratorio de Medicina Genómica, Dirección General, Instituto Nacional de Rehabilitación Luis Guillermo Ibarra Ibarra, Secretaría de Salud, Ciudad de México, Mexico
| | - Carlos Pineda
- Laboratorio de Gerociencias, Laboratorio Facilitador, Laboratorio de Medicina Genómica, Dirección General, Instituto Nacional de Rehabilitación Luis Guillermo Ibarra Ibarra, Secretaría de Salud, Ciudad de México, Mexico
| | - Marcela Vela-Amieva
- Laboratorio de Errores Innatos del Metabolismo y Tamiz, Instituto Nacional de Pediatría, Secretaría de Salud, Ciudad de México, Mexico
| | - Alberto López-Reyes
- Laboratorio de Gerociencias, Laboratorio Facilitador, Laboratorio de Medicina Genómica, Dirección General, Instituto Nacional de Rehabilitación Luis Guillermo Ibarra Ibarra, Secretaría de Salud, Ciudad de México, Mexico
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Cosentini R, Groff P, Brambilla AM, Camajori Todeschini R, Gangitano G, Ingrassia S, Marino R, Nori F, Pagnozzi F, Panero F, Ferrari R. SIMEU position paper on non-invasive respiratory support in COVID-19 pneumonia. Intern Emerg Med 2022; 17:1175-1189. [PMID: 35103926 PMCID: PMC8803573 DOI: 10.1007/s11739-021-02906-6] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/12/2021] [Accepted: 12/06/2021] [Indexed: 12/19/2022]
Abstract
The rapid worldwide spread of the Coronavirus disease (COVID-19) crisis has put health systems under pressure to a level never experienced before, putting intensive care units in a position to fail to meet an exponentially growing demand. The main clinical feature of the disease is a progressive arterial hypoxemia which rapidly leads to ARDS which makes the use of intensive care and mechanical ventilation almost inevitable. The difficulty of health systems to guarantee a corresponding supply of resources in intensive care, together with the uncertain results reported in the literature with respect to patients who undergo early conventional ventilation, make the search for alternative methods of oxygenation and ventilation and potentially preventive of the need for tracheal intubation, such as non-invasive respiratory support techniques particularly valuable. In this context, the Emergency Department, located between the area outside the hospital and hospital ward and ICU, assumes the role of a crucial junction, due to the possibility of applying these techniques at a sufficiently early stage and being able to rapidly evaluate their effectiveness. This position paper describes the indications for the use of non-invasive respiratory support techniques in respiratory failure secondary to COVID-19-related pneumonia, formulated by the Non-invasive Ventilation Faculty of the Italian Society of Emergency Medicine (SIMEU) on the base of what is available in the literature and on the authors' direct experience. Rationale, literature, tips & tricks, resources, risks and expected results, and patient interaction will be discussed for each one of the escalating non-invasive respiratory techniques: standard oxygen, HFNCO, CPAP, NIPPV, and awake self-repositioning. The final chapter describes our suggested approach to the failing patient.
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Affiliation(s)
| | - Paolo Groff
- Pronto Soccorso e Osservazione Breve, Perugia, AO, Italy
| | | | | | | | - Stella Ingrassia
- Emergency Medicine Unit, Luigi Sacco Hospital, ASST FBF Sacco, Milan, Italy
| | - Roberta Marino
- Emergency Medicine, Sant'Andrea Hospital, Vercelli, Italy
| | - Francesca Nori
- Emergency Room, Emergency Care Unit, Santa Maria Della Scaletta Hospital, Imola, Italy
| | | | - Francesco Panero
- MECAU 2, Pronto Soccorso e Area Critica, ASL Città di Torino, Turin, Italy
| | - Rodolfo Ferrari
- Emergency Room, Emergency Care Unit, Santa Maria Della Scaletta Hospital, Imola, Italy
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7
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Abstract
Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is responsible for the disease COVID-19 that has decimated the health and economy of our planet. The virus causes the disease not only in people but also in companion and wild animals. As yet we do not know why the virus is highly successful in causing the pandemic within 3 months of its first report. Lack of a voice on how to handle the pandemic impacted the management of the disease globally. Publication of the importance of masks and social distancing in preprint servers reduced the spread of the disease and deaths associated with it. Very few countries have invested in science and research and development and that has impacted the development of therapies for the pandemic. Though vaccination against COVID-19 started in December 2020, slower rate of immunizations has resulted in rapid spread of the mutant strains of SARS-CoV-2. Lack of transparency and accountability coupled with anergic leadership was responsible for the high incidence of disease and death associated with the COVID-19 pandemic.
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Affiliation(s)
- Sunil Thomas
- Lankenau Institute for medical Research, Wynnewood, PA, USA.
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8
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Sanders JE, Chakare T, Mapota-Masoabi L, Ranyali M, Ramokhele MM, Rozario AM, McCollum ED. National hospital readiness for COVID-19 in Lesotho: evidence for oxygen ecosystem strengthening. Public Health Action 2021; 11:180-185. [PMID: 34956845 DOI: 10.5588/pha.21.0067] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2021] [Accepted: 08/17/2021] [Indexed: 11/10/2022] Open
Abstract
SETTING Sub-Saharan African country, Lesotho, during the SARS-CoV-2 COVID-19 pandemic. OBJECTIVE To evaluate COVID-19 hospital capacity in Lesotho. DESIGN We conducted a pragmatic assessment of all public hospitals in Lesotho using a WHO COVID-19 hospital assessment tool during July 2020 (baseline), with targeted follow-up in December 2020. We adapted the WHO tool into a questionnaire with a focus on hospital services and included oxygen ecosystem elements (pulse oximeters, oxygen, and advanced respiratory care). We converted qualitative questionnaire answers into quantitative ordinal variables and used standard statistics for analysis. RESULTS At baseline, we found all 12 questionnaire domains demonstrate both hospital preparedness and weakness in infection prevention and control. Key baseline gaps were lack of a dedicated team, and insufficient personal protective equipment and space for donning and doffing. Substantial limitations were noted in hypoxemia diagnosis and treatment; information management and care coordination pathways were also suboptimal. Targeted follow-up after 5 months revealed improvement in the availability of pulse oximetry, oxygen capacity, and heated high-flow nasal cannula devices. CONCLUSION Our baseline findings may reflect uneven early pandemic care quality; targeted follow-up suggests strengthening of the oxygen ecosystem.
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Affiliation(s)
| | | | | | - M Ranyali
- Ministry of Health, Maseru, Government of Lesotho
| | | | | | - E D McCollum
- Global Program in Respiratory Sciences, Eudowood Division of Pediatric Respiratory Sciences, Department of Pediatrics, School of Medicine, Johns Hopkins University, Baltimore, MD, USA.,Department of International Health, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, USA
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9
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Lack of effect on in-hospital mortality of drugs used during COVID-19 pandemic: Findings of the retrospective multicenter COVOCA study. PLoS One 2021; 16:e0256903. [PMID: 34520465 PMCID: PMC8439483 DOI: 10.1371/journal.pone.0256903] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2021] [Accepted: 08/17/2021] [Indexed: 02/05/2023] Open
Abstract
Introduction During COVID-19 pandemic, the use of several drugs has represented the worldwide clinical practice. However, though the current increase of knowledge about the disease, there is still no effective treatment for the usage of drugs. Thus, we retrospectively assessed use and effects of therapeutic regimens in hospitalized patients on in-hospital mortality. Methods COVOCA is a retrospective observational cohort study on 18 COVID centres throughout Campania Region Hospitals. We included adult patients with confirmed SARS-CoV-2 infection, discharged/dead between March/June 2020. Results 618 patients were included, with an overall in-hospital cumulative mortality incidence of 23.1%. Most prescribed early treatments were antivirals (72%), antibiotics (65%) and hydroxychloroquine/anticoagulants (≈50%). Tocilizumab, indeed, was largely prescribed late during hospitalization. Multivariable models, with a cut-off at day 2 for early COVID-19 therapy administration, did not disclose any significant association of a single drug administration on the clinical outcome. Discussion COVOCA represents the first multicenter database in Campania region. None drug class used during the pandemic significantly modified the outcome, regardless of therapy beginning, both overall and net of those already in non-invasive ventilation (NIV)/ orotracheal intubation (OTI) at hospitalization. Our cumulative incidence of mortality seems lower than other described during the same period, particularly in Northern Italy.
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10
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Oliaei S, SeyedAlinaghi S, Mehrtak M, Karimi A, Noori T, Mirzapour P, Shojaei A, MohsseniPour M, Mirghaderi SP, Alilou S, Shobeiri P, Azadi Cheshmekabodi H, Mehraeen E, Dadras O. The effects of hyperbaric oxygen therapy (HBOT) on coronavirus disease-2019 (COVID-19): a systematic review. Eur J Med Res 2021; 26:96. [PMID: 34412709 PMCID: PMC8374420 DOI: 10.1186/s40001-021-00570-2] [Citation(s) in RCA: 38] [Impact Index Per Article: 12.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2021] [Accepted: 08/10/2021] [Indexed: 02/08/2023] Open
Abstract
Background Oxygenation serves as a cornerstone in the treatment of COVID-19, and several methods have been extensively studied so far. Herein, we aimed to systematically review the studies discussing hyperbaric oxygen therapy (HBOT) to examine its reported efficacy and adverse events in patients with COVID-19. Methods We systematically searched and retrieved the relevant articles using keywords on the online databases, including PubMed, Scopus, Embase, Web of Science, and Cochrane databases up to April 11th, 2021. The retrieved records underwent a two-step title/abstract and full-text screening process, and the eligible papers were identified. National Institutes of health (NIH) quality assessment tool was used for this study. This study was registered in the International Prospective Register of Systematic Reviews (PROSPERO) with ID CRD42021269821. Results Eight articles from three countries were included. All the included studies had good and fair quality scores, with no poor studies included in this systematic review (Good: n = 5, Fair: n = 3). Studies were divided into clinical trials and case reports/series. Most of the studies used HBOT less than 1.5–2 absolute atmospheres (ATA) for 90 min sessions and thereafter sessions were decreased to 60 min. Trials demonstrated most of the patients recovered after receiving HBOT, and blood oxygen saturation increased after several sessions of HBOT. Conclusion Overall, HBOT seems to be a safe and effective oxygenation method in patients with COVID-19. However, there is limited knowledge and evidence regarding the effects and mechanism of HBOT in COVID-19 treatment, and further evaluations require extensive well-designed studies.
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Affiliation(s)
- Shahram Oliaei
- HBOT Research Center, Golestan Hospital, Islamic Republic of Iran, Navy and AJA Medical University, Tehran, Iran
| | - SeyedAhmad SeyedAlinaghi
- Iranian Research Center for HIV/AIDS, Iranian Institute for Reduction of High Risk Behaviors, Tehran University of Medical Sciences, Tehran, Iran
| | - Mohammad Mehrtak
- Healthcare Services Management, School of Medicine and Allied Medical Sciences, Ardabil University of Medical Sciences, Ardabil, Iran
| | - Amirali Karimi
- School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - Tayebeh Noori
- Department of Health Information Technology, Zabol University of Medical Sciences, Zabol, Iran
| | - Pegah Mirzapour
- Iranian Research Center for HIV/AIDS, Iranian Institute for Reduction of High Risk Behaviors, Tehran University of Medical Sciences, Tehran, Iran
| | - Alireza Shojaei
- Iranian Research Center for HIV/AIDS, Iranian Institute for Reduction of High Risk Behaviors, Tehran University of Medical Sciences, Tehran, Iran
| | - Mehrzad MohsseniPour
- Iranian Research Center for HIV/AIDS, Iranian Institute for Reduction of High Risk Behaviors, Tehran University of Medical Sciences, Tehran, Iran
| | | | - Sanam Alilou
- School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - Parnian Shobeiri
- School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - Hadiseh Azadi Cheshmekabodi
- Health Information Technology, School of Health Information Management and Information Sciences, Iran University of Medical Sciences, Tehran, Iran
| | - Esmaeil Mehraeen
- AMAD Research Institute, Supreme National Defense University, Tehran, Iran. .,Department of Health Information Technology, Khalkhal University of Medical Sciences, 1419733141, Khalkhal, Iran.
| | - Omid Dadras
- Department of Global Health and Socioepidemiology, Graduate School of Medicine, Kyoto University, Kyoto, Japan
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