Spectrum and Clinical Characteristics of Symptomatic and Asymptomatic Coronavirus Disease 2019 (COVID-19) With and Without Pneumonia

Background: Coronavirus disease 2019 (COVID-19), caused by severe acute respiratory syndrome coronavirus 2, has become a global pandemic. Based on symptoms, COVID-19 cases can be classified as symptomatic or asymptomatic. However, there is limited information about the differences between COVID-19 patients with and without pneumonia. Our study aimed to further discuss the spectrum and clinical characteristics of symptomatic and asymptomatic COVID-19 patients with and without pneumonia.Methods: In China, all COVID-19 cases are hospitalized in designated hospitals until two continuous negative oropharyngeal swabs obtained, which allows the professional monitoring of symptoms and clinical characteristics. We stratified all COVID-19 cases in our database and evaluated clinical characteristics in different COVID-19 subgroups (symptomatic with pneumonia, symptomatic without pneumonia, asymptomatic with pneumonia, and asymptomatic without pneumonia).Results: According to symptoms and laboratory and radiologic findings, COVID-19 cases were defined as symptomatic with pneumonia, symptomatic without pneumonia, asymptomatic with pneumonia, or asymptomatic without pneumonia. There were differences in the clinical characteristics and prognosis among the four groups. Both non-invasive mechanical ventilation (18, 4.2%) and invasive mechanical ventilation (11, 2.6%) were applied in only the symptomatic with pneumonia group. Likewise, extracorporeal membrane oxygenation and continuous renal replacement therapy were applied in only the symptomatic with pneumonia group. There were no differences in viral load, the durations of viral shedding, and hospitalization among the four groups.Conclusion: We have defined a comprehensive spectrum of COVID-19 with and without pneumonia. The symptomatic with pneumonia group consumed more medical resources than the other groups, and extra caution and monitoring should be applied in this group. The asymptomatic COVID-19 group had a similar viral load and viral shedding duration as the symptomatic COVID-19 group.

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Spectrum and Clinical Characteristics of Symptomatic and Asymptomatic Coronavirus Disease 2019 (COVID-19) With and Without Pneumonia

10.21203/rs.3.rs-122864/v1 ◽

2020 ◽

Author(s):

Huihui Zeng ◽

Yiming Ma ◽

Zhiguo Zhou ◽

Wenlong Liu ◽

Peng Huang ◽

...

Keyword(s):

Mechanical Ventilation ◽

Renal Replacement Therapy ◽

Severe Acute Respiratory Syndrome ◽

Clinical Characteristics ◽

Invasive Mechanical Ventilation ◽

The Other ◽

Limited Information ◽

Viral Shedding ◽

Radiologic Findings ◽

Global Pandemic

Abstract BackgroundCoronavirus disease 2019 (COVID-19), caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), has become a global pandemic. Based on symptoms, COVID-19 cases can be classified as symptomatic or asymptomatic. However, there is limited information about the differences between COVID-19 patients with and without pneumonia. Our study aimed to further discuss the spectrum and clinical characteristics of symptomatic and asymptomatic COVID-19 patients with and without pneumonia. MethodsIn China, all COVID-19 cases are hospitalized in designated hospitals until two continuous negative oropharyngeal swabs obtained, which allows the professional monitoring of symptoms and clinical characteristics. We stratified all COVID-19 cases in our database, and evaluated clinical characteristics in different COVID-19 subgroups (symptomatic with pneumonia, symptomatic without pneumonia, asymptomatic with pneumonia and asymptomatic without pneumonia). ResultsAccording to symptoms and laboratory and radiologic findings, COVID-19 cases were defined as symptomatic with pneumonia, symptomatic without pneumonia, asymptomatic with pneumonia or asymptomatic without pneumonia. There were differences in the clinical characteristics and prognosis among the four groups. Both noninvasive (18, 4.2%) and invasive mechanical ventilation (11, 2.6%) were applied in only the symptomatic with pneumonia group. Likewise, extracorporeal membrane oxygenation (ECMO) and continuous renal replacement therapy (CRRT) were applied in only the symptomatic with pneumonia group. There were no differences in the durations of viral shedding and hospitalization among the four groups.ConclusionWe have defined a comprehensive spectrum of COVID-19 with and without pneumonia. The symptomatic with pneumonia group consumed more medical resources than the other groups, and extra caution and monitoring should be applied in this group. The asymptomatic COVID-19 group had a similar viral shedding duration as the symptomatic COVID-19 group.Trial registrationNot available

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Clinical characteristics of Chilean patients with rheumatic diseases and COVID-19: data from the Covid-19 Global Rheumatology Alliance physician-reported registry

10.1101/2021.12.07.21267429 ◽

2021 ◽

Author(s):

Oriela Martínez ◽

Francisca Valenzuela ◽

Sebastián Ibáñez

Keyword(s):

Rheumatoid Arthritis ◽

Mechanical Ventilation ◽

Mortality Rate ◽

Rheumatic Disease ◽

Rheumatic Diseases ◽

Clinical Characteristics ◽

Invasive Mechanical Ventilation ◽

List Type ◽

Non Invasive ◽

Rheumatic Patients

AbstractObjectiveThe coronavirus disease 2019 (COVID-19) pandemic, caused by the severe acute respiratory syndrome coronavirus 2 (SARS-Cov-2), has registered more than 234 million confirmed cases and more than 4.7 million deaths throughout the world until October 2, 2021. During the last few months, a significant number of reports of COVID-19 in patients with rheumatic diseases have been published. In this study the objective is to report the clinical characteristics of Chilean patients with rheumatic diseases and COVID-19 reported in the “Global Rheumatology Alliance” (GRA) physician registration platform.MethodsChilean patients with rheumatic diseases and COVID-19 were included in the Covid-19 GRA physician-reported registry.Results54 patients were included. The most common primary rheumatic disease was rheumatoid arthritis (RA) with 28 cases (51.9%). 30 patients (55.6%) used corticosteroids, of which 20 (66.7%) used a dose of 10 mg or less. 33 patients (61.1%) only used conventional DMARDs, 4 (7.4%) only biological, and 6 (11.1%) the combination. A total of 35 patients (64.8%) had to be hospitalized. 2 patients (3.7%) died. 26 patients of the 35 hospitalized (74.2%) required some type of ventilatory support, of which 5 (19.2%) required non-invasive and 8 (30.8%) invasive mechanical ventilation or extracorporeal membrane oxygenation (ECMO).DiscussionMost of included Chilean rheumatic patients were hospitalized, with a low mortality rate but with a high percentage of patients requiring at least non-invasive mechanical ventilation.Key Points-The most common primary rheumatic disease was rheumatoid arthritis (RA) followed by lupus (LES)-Most of the included Chilean rheumatic patients were hospitalized, with a high percentage of patients requiring at least non-invasive mechanical ventilation, but with a low mortality rate.-Worsening of arthralgias or activation of the rheumatic disease was not reported.

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Person in Need of Airway Cleaning and Use of Mechanical Insufflator-Exsufflator

Advances in Medical Diagnosis, Treatment, and Care - Noninvasive Ventilation Technologies and Healthcare for Geriatric Patients ◽

10.4018/978-1-7998-3531-8.ch012 ◽

2020 ◽

pp. 193-208

Author(s):

Ana Daniela Costa ◽

Rogério Ferrinho Ferreira ◽

Raquel Cruz Amorim ◽

João Vitor Vieira

Keyword(s):

Mechanical Ventilation ◽

Intensive Care ◽

Muscle Strength ◽

Invasive Mechanical Ventilation ◽

The Other ◽

Review Of The Literature ◽

Non Invasive ◽

Airway Clearance ◽

Ventilation Performance ◽

Airway Permeability

Clearing of the airways in patients undergoing invasive mechanical ventilation (IMV) or non-invasive mechanical ventilation (NIMV) is a fundamental intervention that should be performed regularly, not only to avoid accumulation of secretions, but also to prevent the accumulation of secretions. One of the most relevant interventions in this type of patients is the use of the mechanical insufflator-exsufflator (MI-E), commonly known as cough assist. On the other hand, respiratory functional reeducation (RFR) involves a set of non-invasive procedures that allow the secretion to be released. The efficacy of the RFR associated with the use of MI-E presents gains resulting from this conjugation, namely when the person does not cooperate, when he/she shows a decrease in muscle strength or fails to present an effective cough. The integrative review of the literature has made evident the gains that exist for the person in intensive care, using MI-E associated with airway clearance, ventilation performance, airway permeability, decreased complications, and rate mortality.

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Dynamic PEEP Study: A Non-Invasive Diagnostic Exam to Assess for Effective PEEP in Fragile Children With Severe BPD

10.21203/rs.3.rs-919559/v1 ◽

2021 ◽

Author(s):

Cassie Montoya ◽

Robin Steinhorn ◽

John Berger ◽

Harutyun Haroyan ◽

Mariam Said ◽

...

Keyword(s):

Mechanical Ventilation ◽

Clinical Course ◽

Imaging Modality ◽

Invasive Mechanical Ventilation ◽

Chest Ct ◽

The Other ◽

Non Invasive ◽

Reduced Dose ◽

Ct Protocol ◽

Ventilator Settings

Abstract ObjectiveTracheobronchomalacia (TBM) is common in neonates with bronchopulmonary dysplasia (BPD) and is associated with higher morbidity. This study evaluates the value of a CT protocol to assess the degree of TBM and gauge the adequacy of prescribed PEEP. Study DesignFour infants with severe BPD on invasive mechanical ventilation underwent a chest CT protocol, including limited reduced- dose expiratory scans with varying PEEP levels. ResultsBaseline PEEP was adjusted in all subjects after performing the Dynamic PEEP CT. In two infants, the PEEP was increased due to significant TBM, and in the other, two without signs of TBM PEEP was decreased. The clinical course improved in all patients after adjusting PEEP. ConclusionA "Dynamic PEEP" study is a highly reliable and non-invasive imaging modality for the evaluation of adequate ventilator settings in infants with severe BPD who are not optimal candidates for bronchoscopy.

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Saliva is superior over nasopharyngeal swab for detecting SARS-CoV2 in COVID-19 patients

Scientific Reports ◽

10.1038/s41598-021-02097-2 ◽

2021 ◽

Vol 11 (1) ◽

Author(s):

Getachew Tesfaye Beyene ◽

Fekadu Alemu ◽

Eyerusalem Solomon Kebede ◽

Dawit Hailu Alemayehu ◽

Tamirayehu Seyoum ◽

...

Keyword(s):

Viral Load ◽

Low Cost ◽

Good Alternative ◽

Nasopharyngeal Swab ◽

Sample Collection ◽

Viral Shedding ◽

Non Invasive ◽

Global Pandemic ◽

Diagnostic Capacity ◽

Different Populations

AbstractScaling up of diagnostic capacity is needed to mitigate the global pandemic of SARS-CoV2. However, there are challenges including shortage of sample collection swabs and transport medium. Saliva has been recommended as a simple, low-cost, non-invasive option. However, data from different populations and settings are limited. Here, we showed that saliva could be a good alternative sample to diagnose COVID-19 patients. Pair of NPS-saliva samples was collected from 152 symptomatic; confirmed COVID-19 patients, and compared their positivity rate, viral load, and duration of viral shedding. From 152 patients, 80 (52.63%) tested positive and 72 (47.37%) were negative for SARSA-CoV2 in NPS sample. In saliva, 129 (92.14%) were tested positive and 11 (7.86%) were negative on the day of admission to hospital. The overall percent agreement of RT-PCR result of Saliva to NPS was 70% (196/280). A comparison of viral load from 72 NPS-saliva pair samples on day of admission shows saliva contains significantly higher viral load (P < 0.001). In conclusion, saliva has higher yield in detecting SARS-CoV2, and COVID-19 patients show higher viral load and prolonged period of viral shedding in saliva. Therefore, we recommend saliva as a better alternative sample to NPS to diagnose COVID-19 patients.

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Pneumococcal Burden in Hospitalized Adults in Bogotá, Colombia.

10.21203/rs.3.rs-147690/v1 ◽

2021 ◽

Author(s):

Paula Narvaez ◽

Salome Gomez-Duque ◽

Juan Alarcon ◽

Paula Ramirez-Valbuena ◽

Cristian Serrano-Mayorga ◽

...

Keyword(s):

Mechanical Ventilation ◽

Clinical Characteristics ◽

Invasive Mechanical Ventilation ◽

Geographic Location ◽

Vaccine Uptake ◽

Surveillance Program ◽

Limited Data ◽

Serotype Distribution ◽

Non Invasive ◽

Number Of Factors

Abstract Background: The incidence of invasive pneumococcal disease (IPD) varies depending on a number of factors, including vaccine uptake, in both children and adults, the geographic location, and local serotype prevalence. There are limited data about the burden of Streptococcus pneumoniae (Spn), serotype distribution, and clinical characteristics of adults hospitalized due to IPD in Colombia. Thus, this study will attempt to bridge this gap in the literature. Methods: This was an observational, retrospective, a citywide study conducted between 2012 and 2019 in Bogotá, Colombia. We analyzed reported positive cases of IPD from 55 hospitals in a governmental pneumococcal surveillance program. Pneumococcal strains were isolated in each hospital and typified in a centralized laboratory. The objectives of this study included assessment of Spn serotype distribution, clinical characteristics, mortality, ICU admission, and the need for mechanical ventilation. Results: A total of 310 patients with IPD were included, of whom 45.5% were female. The leading cause of IPD was pneumonia (60%, 186/310), followed by meningitis. The most frequent serotypes isolated were 19A (13.87%, 43/310) and 3 (11.94%, 37/310). The overall hospital mortality rate was 30.3% (94/310). Moreover, 52.6% (163/310 patients) were admitted to the ICU, 45.5% (141/310) required invasive mechanical ventilation and 5.1% (16/310) non-invasive mechanical ventilation. Conclusion: Pneumococcal pneumonia is the most prevalent cause of IPD, with serotypes 19A and 3 being the leading cause of IPD in Colombian adults. Mortality due to IPD in adults continues to be very high. 

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