SARS-CoV-2/DENV co-infection: a series of cases from the Federal District, Midwestern Brazil

Abstract Background Since the novel coronavirus disease outbreak, over 179.7 million people have been infected by SARS-CoV-2 worldwide, including the population living in dengue-endemic regions, particularly Latin America and Southeast Asia, raising concern about the impact of possible co-infections. Methods Thirteen SARS-CoV-2/DENV co-infection cases reported in Midwestern Brazil between April and September of 2020 are described. Information was gathered from hospital medical records regarding the most relevant clinical and laboratory findings, diagnostic process, therapeutic interventions, together with clinician-assessed outcomes and follow-up. Results Of the 13 cases, seven patients presented Acute Undifferentiated Febrile Syndrome and six had pre-existing co-morbidities, such as diabetes, hypertension and hypopituitarism. Two patients were pregnant. The most common symptoms and clinical signs reported at first evaluation were myalgia, fever and dyspnea. In six cases, the initial diagnosis was dengue fever, which delayed the diagnosis of concomitant infections. The most frequently applied therapeutic interventions were antibiotics and analgesics. In total, four patients were hospitalized. None of them were transferred to the intensive care unit or died. Clinical improvement was verified in all patients after a maximum of 21 days. Conclusions The cases reported here highlight the challenges in differential diagnosis and the importance of considering concomitant infections, especially to improve clinical management and possible prevention measures. Failure to consider a SARS-CoV-2/DENV co-infection may impact both individual and community levels, especially in endemic areas.

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The Impact of COVID-19 Infection on Oxygen Homeostasis: A Molecular Perspective

Frontiers in Physiology ◽

10.3389/fphys.2021.711976 ◽

2021 ◽

Vol 12 ◽

Author(s):

Abdu I. Alayash

Keyword(s):

Oxygen Sensing ◽

Hypoxia Inducible Factor ◽

Membrane Lipid ◽

Blood Oxygenation ◽

Therapeutic Interventions ◽

The Novel ◽

Structural Protein ◽

Oxygen Homeostasis ◽

Novel Coronavirus ◽

The Impact

The novel coronavirus (2019-nCoV/SARS-CoV-2) causes respiratory symptoms including a substantial pulmonary dysfunction with worsening arterial hypoxemia (low blood oxygenation), eventually leading to acute respiratory distress syndrome (ARDS). The impact of the viral infection on blood oxygenation and other elements of oxygen homeostasis, such as oxygen sensing and respiratory mitochondrial mechanisms, are not well understood. As a step toward understanding these mechanisms in the context of COVID-19, recent experiments revealed contradictory data on the impact of COVID-19 infection on red blood cells (RBCs) oxygenation parameters. However, structural protein damage and membrane lipid remodeling in RBCs from COVID-19 patients that may impact RBC function have been reported. Moreover, COVID-19 infection could potentially disrupt one, if not all, of the other major pathways of homeostasis. Understanding the nature of the crosstalk among normal homeostatic pathways; oxygen carrying, oxygen sensing (i.e., hypoxia inducible factor, HIF) proteins, and the mitochondrial respiratory machinery may provide a target for therapeutic interventions.

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Association and treatment of diabetes in patients affected by Covid-19

International Journal of Research in Pharmaceutical Sciences ◽

10.26452/ijrps.v11ispl1.3591 ◽

2020 ◽

Vol 11 (SPL1) ◽

pp. 1198-1201

Author(s):

Syed Yasir Afaque

Keyword(s):

Diabetes Mellitus ◽

Prognostic Value ◽

Heart Diseases ◽

The Novel ◽

The World ◽

Treatment Of Diabetes ◽

Coronavirus Infection ◽

Composite Outcomes ◽

Novel Coronavirus ◽

The Impact

In December 2019, a unique coronavirus infection, SARS-CoV-2, was first identified in the province of Wuhan in China. Since then, it spread rapidly all over the world and has been responsible for a large number of morbidity and mortality among humans. According to a latest study, Diabetes mellitus, heart diseases, Hypertension etc. are being considered important risk factors for the development of this infection and is also associated with unfavorable outcomes in these patients. There is little evidence concerning the trail back of these patients possibly because of a small number of participants and people who experienced primary composite outcomes (such as admission in the ICU, usage of machine-driven ventilation or even fatality of these patients). Until now, there are no academic findings that have proven independent prognostic value of diabetes on death in the novel Coronavirus patients. However, there are several conjectures linking Diabetes with the impact as well as progression of COVID-19 in these patients. The aim of this review is to acknowledge about the association amongst Diabetes and the novel Coronavirus and the result of the infection in such patients.

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Local hospital experience of emergency management in the response to SARS (Preprint)

10.2196/preprints.20287 ◽

2020 ◽

Author(s):

Ying Yan

Keyword(s):

Emergency Management ◽

Infection Prevention ◽

Public Health Emergency ◽

The Novel ◽

Prevention Measures ◽

Hospital Emergency ◽

Local Hospital ◽

Referral Network ◽

Novel Coronavirus ◽

Hospital Transmission

UNSTRUCTURED The ongoing outbreak of SARS-CoV-2 infection was first identified in Wuhan, China at the late of 2019. Following the acceleration of the novel coronavirus spreading, person-person transmissions in family residences, hospitals and other public environments have led to a major public hazard in China. Currently, the SARS-CoV-2 outbreak has been further developed into a public health emergency of international concern. In response to an occurring pandemic, hospitals need an emergency strategy and plan to manage their space, staff, and other essential resources, therefore, to provide optimum care to patients involved. In addition, infection prevention measures urgently need to be implemented to reduce in-hospital transmission and avoid the occurrence of virus super-spreading. For hospitals without capacity to manage severe patients, a referral network is often needed. We present our successful field experience regarding hospital emergency management and local hospitals network model in response to SARS-CoV-2 emerging epidemic.

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Acute motor-sensory axonal polyneuropathy variant of Guillain–Barre syndrome complicating the recovery phase of coronavirus disease 2019 infection: a case report

Journal of Medical Case Reports ◽

10.1186/s13256-021-02988-y ◽

2021 ◽

Vol 15 (1) ◽

Author(s):

Ahmed Maseh Haidary ◽

Sarah Noor ◽

Esmatullah Hamed ◽

Tawab Baryali ◽

Soma Rahmani ◽

...

Keyword(s):

Recovery Phase ◽

Sudden Onset ◽

Therapeutic Interventions ◽

Guillain Barre Syndrome ◽

The Novel ◽

Case Presentation ◽

Progressive Muscle Weakness ◽

Guillain Barré Syndrome ◽

Novel Coronavirus ◽

Guillain Barré

Abstract Introduction The novel coronavirus, since its first identification in China, in December 2019, has shown remarkable heterogeneity in its clinical behavior. It has affected humans on every continent. Clinically, it has affected every organ system. The outcome has also been variable, with most of the older patients showing grave outcomes as compared with the younger individuals. Here we present a rare and severe variant of Guillain–Barre syndrome that complicated the disease in recovery phase. Case presentation A 60-year-old Afghan man, who had been recovering from symptoms related to novel coronavirus associated disease, presented with sudden onset of progressive muscle weakness and oxygen desaturation. Electrophysiological workup confirmed the diagnosis of Guillain–Barre syndrome, and early institution of intravenous immunoglobulin resulted in complete resolution. Conclusion Guillain–Barre syndrome has recently been reported in many patients diagnosed with novel coronavirus associated disease. While clinical suspicion is mandatory to guide towards an effective diagnostic workup, early diagnosis of this complication and timely institution of therapeutic interventions are indispensable and lifesaving.

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Validity and Cost-Effectiveness of Pediatric Home Respiratory Polygraphy for the Diagnosis of Obstructive Sleep Apnea in Children: Rationale, Study Design, and Methodology

Methods and Protocols ◽

10.3390/mps4010009 ◽

2021 ◽

Vol 4 (1) ◽

pp. 9

Author(s):

Esther Oceja ◽

Paula Rodríguez ◽

María Jurado ◽

Maria Luz Alonso ◽

Genoveva del Río ◽

...

Keyword(s):

Obstructive Sleep Apnea ◽

Cost Effectiveness ◽

Sleep Apnea ◽

Therapeutic Interventions ◽

Diagnostic Process ◽

Urine Biomarkers ◽

Obstructive Sleep ◽

Respiratory Polygraphy ◽

The Cost ◽

The Impact

Obstructive sleep apnea (OSA) in children is a prevalent, albeit largely undiagnosed disease associated with a large spectrum of morbidities. Overnight in-lab polysomnography remains the gold standard diagnostic approach, but is time-consuming, inconvenient, and expensive, and not readily available in many places. Simplified Home Respiratory Polygraphy (HRP) approaches have been proposed to reduce costs and facilitate the diagnostic process. However, evidence supporting the validity of HRP is still scarce, hampering its implementation in routine clinical use. The objectives were: Primary; to establish the diagnostic and therapeutic decision validity of a simplified HRP approach compared to PSG among children at risk of OSA. Secondary: (a) Analyze the cost-effectiveness of the HRP versus in-lab PSG in evaluation and treatment of pediatric OSA; (b) Evaluate the impact of therapeutic interventions based on HRP versus PSG findings six months after treatment using sleep and health parameters and quality of life instruments; (c) Discovery and validity of the urine biomarkers to establish the diagnosis of OSA and changes after treatment.

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Pediatric Endocrinology in the Time of COVID-19: Considerations for the Rapid Implementation of Telemedicine and Management of Pediatric Endocrine Conditions

Hormone Research in Paediatrics ◽

10.1159/000513060 ◽

2020 ◽

Vol 93 (6) ◽

pp. 343-350

Author(s):

Molly O. Regelmann ◽

Rushika Conroy ◽

Evgenia Gourgari ◽

Anshu Gupta ◽

Ines Guttmann-Bauman ◽

...

Keyword(s):

Patient Care ◽

Care Patient ◽

The Novel ◽

Patient Privacy ◽

Pediatric Endocrinology ◽

Quality Of Patient Care ◽

Care Outcomes ◽

Novel Coronavirus ◽

The Impact

Background: Pediatric endocrine practices had to rapidly transition to telemedicine care at the onset of the novel coronavirus disease 2019 (COVID-19) pandemic. For many, it was an abrupt introduction to providing virtual healthcare, with concerns related to quality of patient care, patient privacy, productivity, and compensation, as workflows had to change. Summary: The review summarizes the common adaptations for telemedicine during the pandemic with respect to the practice of pediatric endocrinology and discusses the benefits and potential barriers to telemedicine. Key Messages: With adjustments to practice, telemedicine has allowed providers to deliver care to their patients during the COVID-19 pandemic. The broader implementation of telemedicine in pediatric endocrinology practice has the potential for expanding patient access. Research assessing the impact of telemedicine on patient care outcomes in those with pediatric endocrinology conditions will be necessary to justify its continued use beyond the COVID-19 pandemic.

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Persistent SARS-CoV-2-positive over 4 months in a COVID-19 patient with CHB

Open Medicine ◽

10.1515/med-2021-0283 ◽

2021 ◽

Vol 16 (1) ◽

pp. 749-753

Author(s):

Wenyuan Li ◽

Beibei Huang ◽

Qiang Shen ◽

Shouwei Jiang ◽

Kun Jin ◽

...

Keyword(s):

The Novel ◽

Chain Reaction ◽

Health Crisis ◽

Public Health Crisis ◽

Oxygen Inhalation ◽

New Strategy ◽

Polymerase Chain ◽

Novel Coronavirus ◽

Specific Symptoms

Abstract In recent months, the novel coronavirus disease 2019 (COVID-19) pandemic has become a major public health crisis with takeover more than 1 million lives worldwide. The long-lasting existence of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has not yet been reported. Herein, we report a case of SARS-CoV-2 infection with intermittent viral polymerase chain reaction (PCR)-positive for >4 months after clinical rehabilitation. A 35-year-old male was diagnosed with COVID-19 pneumonia with fever but without other specific symptoms. The treatment with lopinavir-ritonavir, oxygen inhalation, and other symptomatic supportive treatment facilitated recovery, and the patient was discharged. However, his viral PCR test was continually positive in oropharyngeal swabs for >4 months after that. At the end of June 2020, he was still under quarantine and observation. The contribution of current antivirus therapy might be limited. The prognosis of COVID-19 patients might be irrelevant to the virus status. Thus, further investigation to evaluate the contagiousness of convalescent patients and the mechanism underlying the persistent existence of SARS-CoV-2 after recovery is essential. A new strategy of disease control, especially extending the follow-up period for recovered COVID-19 patients, is necessary to adapt to the current situation of pandemic.

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Coronavirus, the great toilet paper panic and civilisation

Thesis Eleven ◽

10.1177/07255136211033167 ◽

2021 ◽

pp. 072551362110331

Author(s):

Jon Stratton

Keyword(s):

General Population ◽

Federal Government ◽

Perceived Threat ◽

The Novel ◽

Social Breakdown ◽

Toilet Paper ◽

Western Civilisation ◽

Novel Coronavirus ◽

Key Aspects ◽

The Impact

Panic buying of toilet rolls in Australia began in early March 2020. This was related to the realisation that the novel coronavirus was spreading across the country. To the general population the impact of the virus was unknown. Gradually the federal government started closing the country’s borders. The panic buying of toilet rolls was not unique to Australia. It happened across all societies that used toilet paper rather than water to clean after defecation and urination. However, research suggests that the panic buying was most extreme in Australia. This article argues that the panic buying was closely linked to everyday notions of Western civilisation. Pedestal toilets and toilet paper are key aspects of civilisation and the fear of the loss of toilet paper is connected to anxiety about social breakdown, the loss of civilisation. This is the fear manifested in the perceived threat posed by the virus.

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Impact of joint management of a COVID-19 mother and her newborn on the virus transmission: a case report

Virology Journal ◽

10.1186/s12985-021-01598-w ◽

2021 ◽

Vol 18 (1) ◽

Author(s):

Maria Chiara De Nardo ◽

Anna Rita Bellomo ◽

Francesca Perfetti ◽

Francesco Antonino Battaglia ◽

Miriam Lichtner ◽

...

Keyword(s):

Infection Prevention ◽

Virus Transmission ◽

The Novel ◽

Transplacental Transmission ◽

Prevention Measures ◽

Infected Mother ◽

Case Presentation ◽

Joint Management ◽

Healthy Neonate

Abstract Background Since last year, COVID-19, the disease caused by the novel Sars-Cov-2 virus, has been globally spread to all the world. COVID-19 infection among pregnant women has been described. However, transplacental transmission of Sars-Cov-2 virus from infected mother to the newborn is not yet established. The appropriate management of infants born to mothers with confirmed or suspected COVID-19 and the start of early breastfeeding are being debated. Case presentation We report a case of the joint management of a healthy neonate with his mother tested positive for Covid-19 before the delivery and throughout neonatal follow-up. The infection transmission from the mother to her baby is not described, even after a long period of contact between them and breastfeeding. Conclusion It may consider an appropriate practice to keep mother and her newborn infant together in order to facilitate their contact and to encourage breastfeeding, although integration with infection prevention measures is needed.

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