scholarly journals Presentations and mechanisms of CNS disorders related to COVID-19

2020 ◽  
Vol 8 (1) ◽  
pp. e923
Author(s):  
Marta Bodro ◽  
Yaroslau Compta ◽  
Raquel Sánchez-Valle
Keyword(s):  
Severe Acute Respiratory Syndrome ◽  
Critically Ill ◽  
Cognitive Dysfunction ◽  
Critically Ill Patients ◽  
Respiratory Symptoms ◽  
Septic Encephalopathy ◽  
Cns Disorders ◽  
Relative Contribution ◽  
Wide Range ◽  
Cns Dysfunction

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is the cause of the coronavirus disease 2019 (COVID-19) pandemic. In addition to severe respiratory symptoms, there are a growing number of reports showing a wide range of CNS complications in patients with COVID-19. Here, we review the literature on these complications, ranging from nonspecific symptoms to necrotizing encephalopathies, encephalitis, myelitis, encephalomyelitis, endotheliitis, and stroke. We postulate that there are several different mechanisms involved in COVID-19–associated CNS dysfunction, particularly activation of inflammatory and thrombotic pathways and, in a few patients, a direct viral effect on the endothelium and the parenchyma. Last, critically ill patients frequently present with protracted cognitive dysfunction in the setting of septic encephalopathy likely due to multifactorial mechanisms. Further studies are needed to clarify the relative contribution of each of these mechanisms, but available data suggest that CNS complications in COVID-19 are rare and probably not directly caused by the virus.

scholarly journals Treatment With Convalescent Plasma for Critically Ill Patients With Severe Acute Respiratory Syndrome Coronavirus 2 Infection

CHEST Journal ◽  
2020 ◽  
Vol 158 (1) ◽  
pp. e9-e13 ◽  
Author(s):  
Bin Zhang ◽  
Shuyi Liu ◽  
Tan Tan ◽  
Wenhui Huang ◽  
Yuhao Dong ◽  
...  
Keyword(s):  
Severe Acute Respiratory Syndrome ◽  
Critically Ill ◽  
Critically Ill Patients

scholarly journals Short-term outcome of critically ill patients with severe acute respiratory syndrome

2004 ◽  
Vol 30 (3) ◽  
pp. 381-387 ◽  
Author(s):  
Charles D. Gomersall ◽  
Gavin M. Joynt ◽  
Philip Lam ◽  
Thomas Li ◽  
Florence Yap ◽  
...  
Keyword(s):  
Severe Acute Respiratory Syndrome ◽  
Critically Ill ◽  
Critically Ill Patients ◽  
Short Term ◽  
Term Outcome ◽  
Short Term Outcome

scholarly journals Detectable Serum Severe Acute Respiratory Syndrome Coronavirus 2 Viral Load (RNAemia) Is Closely Correlated With Drastically Elevated Interleukin 6 Level in Critically Ill Patients With Coronavirus Disease 2019

2020 ◽  
Vol 71 (8) ◽  
pp. 1937-1942 ◽  
Author(s):  
Xiaohua Chen ◽  
Binghong Zhao ◽  
Yueming Qu ◽  
Yurou Chen ◽  
Jie Xiong ◽  
...  
Keyword(s):  
Viral Load ◽  
Severe Acute Respiratory Syndrome ◽  
Critically Ill ◽  
Critically Ill Patients ◽  
Interleukin 6 ◽  
Laboratory Data ◽  
Specific Class ◽  
Sixth Edition ◽  
Severity Of The Disease ◽  
Detectable Serum

Abstract Background Although the detection of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) viral load in respiratory specimens has been widely used to diagnose coronavirus disease 2019 (COVID-19), it is undeniable that serum SARS-CoV-2 nucleic acid (RNAemia) could be detected in a fraction of COVID-19 patients. However, it is not clear whether testing for RNAemia is correlated with the occurrence of cytokine storms or with the specific class of patients. Methods This study enrolled 48 patients with COVID-19 admitted to the General Hospital of Central Theater Command, People’s Liberation Army, a designated hospital in Wuhan, China. The patients were divided into 3 groups according to the Diagnosis and Treatment of New Coronavirus Pneumonia (sixth edition) guidelines issued by the National Health Commission of China. Clinical and laboratory data were collected, and the serum viral load and interleukin 6 (IL-6) level were determined. Results Analysis of clinical characteristics of 48 cases of COVID-19 showed that RNAemia was diagnosed only in the critically ill group and seemed to reflect the severity of the disease. Furthermore, the level of the inflammatory cytokine IL-6 in critically ill patients increased significantly, almost 10 times that in other patients. More importantly, the extremely high IL-6 level was closely correlated with the detection of RNAemia (R = 0.902). Conclusions Detectable serum SARS-CoV-2 RNA (RNAemia) in patients with COVID-19 was associated with elevated IL-6 concentration and poor prognosis. Because elevated IL-6 may be part of a larger cytokine storm that could worsen outcome, IL-6 could be a potential therapeutic target for critically ill patients with an excessive inflammatory response.

scholarly journals Physiotherapy during the Covid-19 pandemic: management of critically ill patients in the ICU and follow-up care

2021 ◽  
Vol 1 (1) ◽  
pp. 1-8
Author(s):  
Clément Médrinal ◽  
Tristan Bonnevie ◽  
Pauline Smondack ◽  
Francis Edouard Gravier ◽  
Marius Lebret ◽  
...  
Keyword(s):  
Intensive Care ◽  
Severe Acute Respiratory Syndrome ◽  
Critically Ill ◽  
Critically Ill Patients ◽  
Acute Respiratory Infection ◽  
Care Providers ◽  
Severe Acute Respiratory Infection ◽  
Follow Up Care ◽  
The World

The coronavirus disease 2019 (COVID-19) is caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) which is responsible for the current pandemic and results in a large number of hospitalizations. This highly contagious disease causes severe acute respiratory infection; thus, many patients require management in intensive care. At a time when there is a high influx of patients with COVID-19 in Intensive Care Units (ICU) all over the world, there is little literature concerning the physiotherapy management of these patients. This article provides information based on the latest evidence to help physiotherapists optimize care, to protect patients and care providers in the ICU, and for follow-up care.

Prevalence of thrombocytosis in critically ill patients and its association with symptomatic acute pulmonary embolism

2013 ◽  
Vol 109 (02) ◽  
pp. 272-279 ◽  
Author(s):  
Shaila Chavan ◽  
Kwok Ho
Keyword(s):  
Pulmonary Embolism ◽  
Intensive Care ◽  
Platelet Count ◽  
Critically Ill ◽  
Critically Ill Patients ◽  
Acute Pulmonary Embolism ◽  
Increased Risk ◽  
Wide Range ◽  
The Relationship ◽  
Acute Pe

SummaryIt is uncertain whether thrombocytosis without underlying myeloproliferative diseases is associated with an increased risk of acute pulmonary embolism (PE). We investigated the relationship between thrombocytosis and risk of symptomatic acute PE, and whether Pulmonary Embolism Severity Index (PESI) was reliable in predicting mortality of acute PE. This multicentre registry study involved a total of 609,367 critically ill patients admitted to 160 intensive care units (ICUs) in Australia or New Zealand between 2006 and 2011. Forward stepwise logistic regression was used to assess the relationship between risk of acute PE and platelet counts on intensive care unit (ICU) admission. Acute PE (n=3387) accounted for 0.9% of all emergency ICU admissions. Over 20% of all PE required mechanical ventilation, 4.2% had cardiac arrest, and the mortality was high (14.8%). Thrombocytosis, defined by a platelet count >500×109 per litre, occurred in 2.1% of the patients and was more common in patients with acute PE than other diagnoses (3.4 vs. 2.0%). The platelet counts explained about 4.5% of the variability and had a linear relationship with the risk of acute PE (odds ratio 1.19 per 100×109 per litre increment in platelet count, 95% confidence interval 1.06–1.34), after adjusting for other covariates. The PESI had a reasonable discriminative ability (area under receiver-operating-characteristic curve = 0.78) and calibration to predict mortality across a wide range of severity of acute PE. In summary, thrombocytosis was associated with an increased risk of symptomatic acute PE. PESI was useful in predicting mortality across a wide range of severity of acute PE.

scholarly journals Biomarkers associated with delirium in critically ill patients and their relation with long-term subjective cognitive dysfunction; indications for different pathways governing delirium in inflamed and noninflamed patients

Critical Care ◽  
2011 ◽  
Vol 15 (6) ◽  
pp. R297 ◽  
Author(s):  
Mark van den Boogaard ◽  
Matthijs Kox ◽  
Kieran L Quinn ◽  
Theo van Achterberg ◽  
Johannes G van der Hoeven ◽  
...  
Keyword(s):  
Critically Ill ◽  
Cognitive Dysfunction ◽  
Critically Ill Patients

scholarly journals Nutritional Management of Critically Ill Patients Infected with SARS-CoV-2

2021 ◽  
Vol 14 (01) ◽  
pp. 002-005
Author(s):  
Sérgio dos Anjos Garnes ◽  
Fernanda Lasakosvitsch ◽  
Adriana Bottoni ◽  
Andrea Bottoni
Keyword(s):  
Mechanical Ventilation ◽  
Severe Acute Respiratory Syndrome ◽  
Clinical Outcome ◽  
Critically Ill ◽  
Prone Position ◽  
Critically Ill Patients ◽  
Protein Intake ◽  
Nutritional Therapy ◽  
Nutritional Management

AbstractEarly nutritional therapy is essential to ensure the maintenance of adequate energy/protein intake for critically ill patients infected with severe acute respiratory syndrome caused by COVID-19 (SARS-CoV-2) infection. However, this poses a major challenge when it comes to individuals on mechanical ventilation in prone position. Therefore, the present work presents a nutritional therapy flowchart developed for patients with SARS-CoV-2 infection to guide nutritional management and ensure that energy/protein intake goals are met, thus favoring a positive clinical outcome.

scholarly journals Admission Serum Ionized and Total Calcium as New Predictors of Mortality in Patients with Cardiogenic Shock

2021 ◽  
Vol 2021 ◽  
pp. 1-15
Author(s):  
Yue Yu ◽  
Jingwen Yu ◽  
Renqi Yao ◽  
Pei Wang ◽  
Yufeng Zhang ◽  
...  
Keyword(s):  
Cardiogenic Shock ◽  
Critically Ill ◽  
Serum Calcium ◽  
Critically Ill Patients ◽  
Medical Information ◽  
Cox Regression ◽  
Nonlinear Relationship ◽  
Total Calcium ◽  
Increased Risk ◽  
Wide Range

Background. Although serum calcium has been proven to be a predictor of mortality in a wide range of diseases, its prognostic value in critically ill patients with cardiogenic shock (CS) remains unknown. This retrospective observational study is aimed at investigating the association of admission calcium with mortality among CS patients. Methods. Critically ill patients diagnosed with CS in the Medical Information Mart for Intensive Care-III (MIMIC-III) database were included in our study. The study endpoints included 30-day, 90-day, and 365-day all-cause mortalities. First, admission serum ionized calcium (iCa) and total calcium (tCa) levels were analyzed as continuous variables using restricted cubic spline Cox regression models to evaluate the possible nonlinear relationship between serum calcium and mortality. Second, patients with CS were assigned to four groups according to the quartiles (Q1-Q4) of serum iCa and tCa levels, respectively. In addition, multivariable Cox regression analyses were used to assess the independent association of the quartiles of iCa and tCa with clinical outcomes. Results. A total of 921 patients hospitalized with CS were enrolled in this study. A nonlinear relationship between serum calcium levels and 30-day mortality was observed (all P values for nonlinear trend < 0.001 ). Furthermore, multivariable Cox analysis showed that compared with the reference quartile (Q3: 1.11 ≤ iCa < 1.17   mmol / L ), the lowest serum iCa level quartile (Q1: iCa < 1.04   mmol / L ) was independently associated with an increased risk of 30-day mortality (Q1 vs. Q3: HR 1.35, 95% CI 1.00-1.83, P = 0.049 ), 90-day mortality (Q1 vs. Q3: HR 1.36, 95% CI 1.03-1.80, P = 0.030 ), and 365-day mortality (Q1 vs. Q3: HR 1.28, 95% CI 1.01-1.67, P = 0.046 ) in patients with CS. Conclusions. Lower serum iCa levels on admission were potential predictors of an increased risk of mortality in critically ill patients with CS.

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