scholarly journals Clinical features of 375 COVID-19 cases imported from Russia through the Suifenhe port and countermeasures

PLoS ONE ◽  
2021 ◽  
Vol 16 (12) ◽  
pp. e0261437
Author(s):  
Kai Kang ◽  
Yi Yang ◽  
Xiangdong Guan ◽  
Yan Kang ◽  
Mingyan Zhao ◽  
...  
Keyword(s):  
Body Temperature ◽  
Clinical Features ◽  
Clinical Data ◽  
Oxygen Therapy ◽  
Asymptomatic Infection ◽  
Critical Groups ◽  
Oxygen Inhalation ◽  
High Flow Oxygen ◽  
Initial Symptoms ◽  
Imported Cases

Background and objectives At present, the focus of the fighting against COVID-19 in China is shifting to strictly prevent the entrance of cases from abroad and disease transmission. Therefore, it is extremely urgent to better understand the clinical features of imported cases from overseas countries, which is conductive to formulate the corresponding countermeasures. This study aimed to describe the clinical features of COVID-19 cases imported from Russia through the Suifenhe port, in order to identify baseline and clinical data associated with disease progression and present corresponding countermeasures. Methods All COVID-19 cases imported from Russia through the Suifenhe port were included in this retrospective study. According to the “Diagnosis and Treatment Protocol for Novel Coronavirus Pneumonia (seventh edition)”, imported COVID-19 cases were divided into asymptomatic infection, mild, moderate, severe, and critical groups. Baseline and clinical data, including age, gender, comorbidities, disease severity, symptoms at onset, body temperature, white blood cell (WBC) count, lymphocyte (LYMPH) count, lymphocyte percentage (LYM%), C-reactive protein (CRP), oxygenation index (OI), and the use therapeutic modalities were obtained on admission, and then compared between groups. Results A total of 375 COVID-19 cases imported from Russia through Suifenhe port were included, of whom the asymptomatic infection, mild, moderate, severe, and critical groups accounted for 4.0%, 13.9%, 75.5%, 5.3%, and 1.3%, respectively. The majority of the imported COVID-19 cases were men (61.9%) with a median age of 38.72 years who had no comorbidity (87.7%). Nearly one-third of them (33.1%) were asymptomatic at onset, and common initial symptoms included fever (36.5%), cough (36.0%), pharyngeal discomfort (12.3%), expectoration (8.0%), and chest tightness (5.3%). In total, 180 (48%) and 4 (1.1%) enrolled imported cases received nasal tube oxygen inhalation therapy and high-flow oxygen absorption, respectively; the remaining patients did not undergo oxygen therapy. The values of age, body temperature, WBC, LYMPH, LYM%, CRP, and OI were 38.72 ± 10.50, 35.10 ± 7.92, 5.59 ± 1.97, 1.67 ± 0.68, 31.05 ± 10.22, 8.00 ± 14.75, and 389.03 ± 74.07, respectively. Gender, age, LYMPH, LYM%, symptoms at onset, cough, fever, other rare symptoms, and oxygen therapy showed significant differences between groups (P = 0.036, < 0.001, < 0.001, < 0.001, < 0.001, < 0.001, < 0.001, = 0.045, < 0.001, respectively). Conclusions Compared with domestic confirmed patients, COVID-19 patients who arrived at China from Russia through the Suifenhe port had significantly different clinical features, and the differences in gender, age, LYMPH, LYM%, symptoms at onset, cough, fever, other rare symptoms, and oxygen therapy between groups were statistically significant. Therefore, detailed and comprehensive countermeasures were developed to manage and prevent another outbreak based on these clinical features.

scholarly journals Efficacy of Tocilizumab in the treatment of severe COVID-19 patients with respiratory failure

2021 ◽  
Vol 8 (2) ◽  
pp. 86-90
Author(s):  
Esra Adıyeke ◽  
Nilüfer Coşkun ◽  
Nurten Bakan ◽  
Serkan Demir ◽  
Murat Cihan ◽  
...  
Keyword(s):  
Respiratory Failure ◽  
Body Temperature ◽  
Clinical Features ◽  
Troponin I ◽  
C Reactive Protein ◽  
Reactive Protein ◽  
Oxygen Inhalation ◽  
End Tidal ◽  
The Impact ◽  
End Tidal Co2

Objective: This study aimed to investigate the impact of tocilizumab, an IL6R inhibitor, on clinical features and laboratory tests of subjects admitted with severe COVID-19 and respiratory failure. Material and Methods: A total of 30 patients with positive polymerase chain reaction for COVID-19 and respiratory failure were analyzed in a retrospective manner. All patients received 8mg/kg body weight tocilizumab i.v. once in addition to the standard COVID-19 treatment protocol, including Oseltamivir phosphate 75mg twice daily, hydroxychloroquine 200 mg twice daily, and azitromycine 250 mg once daily following a 500 mg loading dose. Demographic characteristics, and clinical features including oxygen saturation, the concentration of oxygen inhalation, body temperature, mean arterial pressure and heart rate, and SpO2, end-tidal CO2, and blood tests including complete blood count, procalcitonin, C-reactive protein (CRP), Troponin-I, D-dimer, and liver and kidney function tests were recorded before and after treatment with tocilizumab. Results: A significant increase occurred in SaO2 on first and third days following treatment with tocilizumab (84.3 % and 90.3%, respectively, p<0.001 for both recordings compared to baseline). There was also a significant increase in end-tidal CO2. The increase in mean SaO2 after tocilizumab was followed by a decline in respiratory rate on the first and third days of treatment.  A dramatic decline was observed in body temperature from the first day of treatment with tocilizumab. Lymphocyte count increased following tocilizumab and C-reactive protein and Troponin I levels were reduced. Conclusion: Tocilizumab appears as an effective therapeutic option for improving oxygenation, symptoms and laboratory surrogates of ongoing inflammation in subjects with severe COVID-19.

High Flow Oxygen Therapy and the Pressure to Feed Infants With Acute Respiratory Illness

2020 ◽  
Vol 5 (4) ◽  
pp. 1006-1010
Author(s):  
Jennifer Raminick ◽  
Hema Desai
Keyword(s):  
Clinical Practice ◽  
Clinical Practice Guidelines ◽  
Practice Guidelines ◽  
Oxygen Therapy ◽  
Respiratory Illness ◽  
High Flow ◽  
Oral Feeding ◽  
Respiratory Support ◽  
Acute Respiratory Illness ◽  
High Flow Oxygen

Purpose Infants hospitalized for an acute respiratory illness often require the use of noninvasive respiratory support during the initial stage to improve their breathing. High flow oxygen therapy (HFOT) is becoming a more popular means of noninvasive respiratory support, often used to treat respiratory syncytial virus/bronchiolitis. These infants present with tachypnea and coughing, resulting in difficulties in coordinating sucking and swallowing. However, they are often allowed to feed orally despite having high respiratory rate, increased work of breathing and on HFOT, placing them at risk for aspiration. Feeding therapists who work with these infants have raised concerns that HFOT creates an additional risk factor for swallowing dysfunction, especially with infants who have compromised airways or other comorbidities. There is emerging literature concluding changes in pharyngeal pressures with HFOT, as well as aspiration in preterm neonates who are on nasal continuous positive airway pressure. However, there is no existing research exploring the effect of HFOT on swallowing in infants with acute respiratory illness. This discussion will present findings from literature on HFOT, oral feeding in the acutely ill infant population, and present clinical practice guidelines for safe feeding during critical care admission for acute respiratory illness. Conclusion Guidelines for safety of oral feeds for infants with acute respiratory illness on HFOT do not exist. However, providers and parents continue to want to provide oral feeds despite clinical signs of respiratory distress and coughing. To address this challenge, we initiated a process change to use clinical bedside evaluation and a “cross-systems approach” to provide recommendations for safer oral feeds while on HFOT as the infant is recovering from illness. Use of standardized feeding evaluation and protocol have improved consistency of practice within our department. However, further research is still necessary to develop clinical practice guidelines for safe oral feeding for infants on HFOT.

scholarly journals Impact of flow and temperature on non‐dyspnoeic dogs' tolerance undergoing high‐flow oxygen therapy

2020 ◽  
Author(s):  
C. Harduin ◽  
B. Allaouchiche ◽  
J. Nègre ◽  
I. Goy‐Thollot ◽  
A. Barthélemy ◽  
...  
Keyword(s):  
Oxygen Therapy ◽  
High Flow ◽  
High Flow Oxygen

scholarly journals Guillain-Barré syndrome triggered by surgery in a Chinese population: a multicenter retrospective study

BMC Neurology ◽  
2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Qiaoyu Gong ◽  
Shuping Liu ◽  
Yin Liu ◽  
Jiajia Yao ◽  
Xiujuan Fu ◽  
...  
Keyword(s):  
Clinical Features ◽  
Orthopedic Surgery ◽  
Southern China ◽  
Axonal Neuropathy ◽  
Trigger Factor ◽  
Guillain Barre Syndrome ◽  
Initial Symptoms ◽  
Guillain Barré Syndrome ◽  
Potential Trigger ◽  
Guillain Barré

Abstract Background Surgery is a potential trigger of Guillain-Barré syndrome (GBS), a disorder which leads to an autoimmune-mediated attack of peripheral nerves. The present study was designed to explore clinical features of post-surgical GBS compared with those of general GBS in order to provide better clinical advice to patients undergoing surgery. Methods The medical records of GBS patients who were seen at 31 tertiary hospitals in southern China between January 1, 2013 and September 30, 2016 were retrospectively analyzed. Post-surgical GBS was defined as symptoms of GBS within 6 weeks after surgery. Clinical features of post-surgical GBS are described and are compared with general GBS. Results Among the 1001 GBS patient cases examined in this study, 45 (4.5%) patient cases exhibited symptoms of GBS within 6 weeks of undergoing surgery. Within this group, 36 (80.0%) patients developed initial symptoms of limb weakness. The average interval between surgery and symptom onset was 13.31 days. The most common type of surgery which triggered GBS was orthopedic surgery, followed by neurological surgery. Compared to general GBS, post-surgical GBS was characterized by a higher proportion of severe patients (Hughes functional grading scale (HFGS) score ≥ 3) upon admission and at nadir, higher HFGS scores at discharge, and longer hospital stays. Post-surgical GBS patients also had a significantly higher frequency of the acute motor axonal neuropathy subtype (37.9 vs. 14.2, respectively; P = 0.001). Conclusion Surgery is probably a potential trigger factor for GBS, especially orthopedic surgery. Infections secondary to surgery may play a role. The possibility of preceding (post-operative) infections was not excluded in this study. Clinical presentation of post-surgical GBS is characterized by a more severe course and poorer prognosis, and should be closely monitored. Trial registration chicTR-RRc-17,014,152.

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