Non-SARS Non-MERS Human Coronaviruses: Clinical Characteristics and Outcome

Human coronaviruses (HCoVs) have become evident sources of human respiratory infections with new emerging HCoVs as a significant cause of morbidity and mortality. The common four coronaviruses (229E, HKU1, NL63, and OC43) are known to cause respiratory illness in humans, but their clinical impact is poorly described in the literature. We analyzed the data of all patients who tested positive for at least one of the four HCoVs from October 2015 to January 2020 in a tertiary care center. HCoVs were detected in 1062 specimens, with an incidence rate of 1.01%, out of all documented respiratory illnesses. Detection of these viruses was reported sporadically throughout the years, with a peak of occurrence during winter seasons. OC43 had the highest incidence (53.7%), followed by NL63 (21.9%), HKU1 (12.6%), and 229E (11.8%). Most of these infections were community-acquired, with symptoms of both upper and lower respiratory tract. Co-detection with other viruses were observed, mostly with rhinovirus. 229E was the most frequent (26.4%) HCoV in patients requiring intensive care, while NL63 and 229E were the most common in patients requiring invasive ventilation. The highest 30-day mortality rate was observed in patients infected with 229E (6.4%). HCoVs are common circulating pathogens that have been present for decades, with 229E being the most virulent in this study cohort.

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Status of Geriatric Patients with Abdominal Pain Presented To Emergency Department

Journal of Chitwan Medical College ◽

10.3126/jcmc.v9i2.24562 ◽

2019 ◽

Vol 9 (2) ◽

pp. 90-96

Author(s):

Daya Ram Lamsal ◽

Jeetendra Bhandari

Keyword(s):

Emergency Department ◽

Abdominal Pain ◽

Care Center ◽

Tertiary Care ◽

Medical Officer ◽

Common System ◽

Life Expectancy At Birth ◽

Chief Complaints ◽

Life Threatening ◽

The Common

Background: As the development of better health facilities with advanced tools for diagnosis and management our country is not away from global trend. Nepal’s life expectancy at birth is increasing at its pace, it has increased in about 30 years in last 4 decades. Among the various problem presenting to ED abdominal pain is one of the common complain elderly patients are greater risk of missing life-threatening causes during evaluation and investigation. The aim of the study wasEdit to identify the frequency, cause and outcome of patient presenting in Emergency department with abdominal pain. Methods: It is a retrospective study conducted in tertiary care center at Chitwan, Nepal during the period from 01/09/2017 to 30/08/2018. Electronic data entered by medical officer were retrieved and analyzed. Statistical analysis of the record was done using SPSS 16 software. Results: Elderly population who presented with chief complaints of abdominal pain was 1160 (21.79%). Among the patient presented with abdominal pain 605(52.2%) were male and 555(47.8%) were female. Mean age of patients was 71.72±8.50 years. Most common system involved was gastrointestinal and biliary problem 730(62.93%). Most common diagnosis was Urinary tract infection 269 (23.2%) among them, 487(41.98%) required hospital admission. Conclusions: Abdominal pain is one of the common presentations of elderly to emergency department. Disorders of Gastrointestinal and biliary system were among leading causes of emergency visit. Emergency physician should be tactful to identify life threatening conditions and emergency management.

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Effect of a novel coronavirus in human and its clinical diagnosis and implications by students of community pharmacy

International Journal of Basic & Clinical Pharmacology ◽

10.18203/2319-2003.ijbcp20202956 ◽

2020 ◽

Vol 9 (7) ◽

pp. 1140

Author(s):

Kanamala Arun Chand Roby ◽

Singamala Lakshmi Bhargavi ◽

Gali Devi Sri ◽

Avula Madhuri ◽

Sannadi Kamakshi ◽

...

Keyword(s):

Respiratory Infections ◽

Specific Treatment ◽

Respiratory Illness ◽

Respiratory Illnesses ◽

Runny Nose ◽

Corona Virus ◽

Respiratory Tract Illnesses ◽

Control And Prevention ◽

Novel Coronavirus ◽

Corona Viruses

Coronavirus are coming under a broad family of virus that can cause respiratory illnesses such as the common cold, according to the centers for disease control and prevention (CDC). They are usual in many different species of animals, including camels and bats. Unusually, these corona viruses can evolve and infect humans and then spread between humans. Recent examples of this include SARS-CoV and MERS-CoV. 2019 Novel Corona virus (2019-nCoV) is a virus identified as the cause of an outbreak of respiratory illness first detected in Wuhan, China. In some cases, the viruses can cause lower-respiratory tract illnesses such as pneumonia and bronchitis. In human corona viruses are currently classified into seven types that are HCoV-229E, HCoV-OC43, HCoV-NL63, SARS-CoV, HKU1, MERS-CoV and 2019-nCoV. These two types of corona virus (MERS-CoV and SARS-CoV) are more dangerous. Some of corona viruses like HCoV-229E, HCo-OC43, HCoNL63 and HKU1 that are continuously circulate in the population of human and cause respiratory infections in human either may children and adults world-wide. They are generally transmitted between animals and humans through sneezing, coughing, touching or shaking hands and making contact with a surface or object. The symptoms of corona virus are sneezing, cough, fatigue, runny nose, sore throat, breathing difficulty and exacerbated. In more severe cases SARS, kidney failure, pneumonia and even death. Diagnosis can be carried out by healthcare provider in laboratory test on respiratory specimens and serum to detect human corona virus. For this virus no specific treatment like vaccines and antiviral drugs but symptoms can be treated.

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Comparing India's second COVID wave with the first wave, a single center experience

10.1101/2021.06.03.21258009 ◽

2021 ◽

Author(s):

Mayank Kapoor ◽

Budha O Singh ◽

Prasan Kumar Panda ◽

Pathik Dhangar ◽

Anant Kataria

Keyword(s):

Care Center ◽

Tertiary Care ◽

Management Strategies ◽

Case Fatality ◽

Severity Of Illness ◽

Population Group ◽

Target Population ◽

Invasive Ventilation ◽

Single Center Experience ◽

Second Wave

Background The COVID-19 pandemic has resurfaced in India in the form of a hard-hitting second wave. This study aims to compare the clinical profile of the first wave (April-June 2020) and the second wave (March-May 2021) of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in a single tertiary care center of India. This will help prioritize the target population group and management strategies in the upcoming third wave if any. Methods In this retrospective observational study, we examined the demographic profile, symptoms at presentation, the severity of illness, baseline investigations, treatments received, underlying comorbidities, and outcomes of the COVID-19 patients belonging to the first (W1) and the second wave (W2) of the pandemic in India. Findings Among 106 patients in W1 and 104 patients in W2, the age group affected most was 37.1 (SD=16.9) years compared with 50.5 (SD=17.7) years respectively. The baseline oxygen saturation is lower in W2, being 84.0 (13.4) % compared with 91.9 (7.4) % in W1. 70.2 % of the cases belonged to the severe category in W2 compared to 37.5% in W1. W2 patients demonstrated higher transaminase levels [SGOT, 108.3 (99.3) v/s 54.6 (69.3); SGPT, 97.6 (82.3) v/s 58.7 (69.7)] with respect to W1. Similarly, the CT severity score for W2 [29.5 (6.7)] was higher than W1 [23.2 (11.5)][All P<0.05]. The proportion of patients requiring oxygen (81.8% v/s 11.2%), high flow nasal cannula (11.4% v/s 5.6%), non-invasive ventilation (41.2% v/s 1.5%), invasive ventilation (24.5% v/s 0.9%), as well as ICU/HDU admissions (56.4% v/s 12.0%) was higher for W2 as compared with W1. The measured case fatality rate varies from 29% for W2 to 9.6% for W1. Interpretation Higher age, oxygen requirement, ventilator requirement, ICU admission, and organ impairment are more prevalent in the admitted COVID-19 cases during the second wave that has hit India compared to the first wave and associated with more fatalities. Strategy for another wave should be planned accordingly.

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Serial Procalcitonin Levels Correlate with Microbial Etiology in Hospitalized Patients with Pneumonia

Open Forum Infectious Diseases ◽

10.1093/ofid/ofx163.846 ◽

2017 ◽

Vol 4 (suppl_1) ◽

pp. S351-S351 ◽

Cited By ~ 1

Author(s):

Pierre Ankomah ◽

Suzanne Mccluskey ◽

Michael Abers ◽

Benjamin Bearnot ◽

Shreya Patel ◽

...

Keyword(s):

Respiratory Infections ◽

Statistical Significance ◽

Care Center ◽

Tertiary Care ◽

Pneumococcal Infections ◽

Significant Difference ◽

Prognostic Utility ◽

Microbial Etiology ◽

Hospital Days ◽

The Relationship

Abstract Background Procalcitonin (PCT) is a biomarker that is finding increasing diagnostic and prognostic utility in lower respiratory infections. It remains unclear, however, whether it can be helpful in predicting the bacterial etiology of pneumonia, with a view to informing antibiotic choice and duration. This study examines the relationship between serial PCT measurements and microbial etiology in patients hospitalized for pneumonia to determine whether changes in PCT levels provide discriminatory information on microbial etiology. Methods We performed a subgroup analysis of data from a prospective cohort study of 505 patients admitted to a tertiary care center with findings concerning for pneumonia. Microbial etiology of pneumonia was determined from high quality respiratory samples, blood cultures or other relevant diagnostic tests according to standard protocols. Procalcitonin levels were measured serially during the first four days of hospitalization. We compared procalcitonin levels between different bacterial etiologies over the first four days of admission, using the Mann–Whitney-U test to assess for statistical significance. Results Out of 505 patients, the diagnosis of pneumonia was adjudicated in 317, and bacterial etiology determined in 62 cases. The predominant pathogens were Staphylococcus aureus (N = 18), Streptococcus pneumoniae (N = 6), Pseudomonas aeruginosa (N = 11) and Haemophilus influenza (N = 5). Admission levels of PCT were lowest in Pseudomonas infections and highest in pneumococcal infections, though not reaching statistical significance. On hospital days two and three, pneumococcal procalcitonin levels were significantly higher than all other etiologies, but on day four, there was no statistically significant difference in PCT values for different microbial etiologies. Conclusion Serial procalcitonin levels during the early course of bacterial pneumonia reveal a difference between pneumococcal and other bacterial etiologies, and may have an adjunct role in guiding antibiotic choice and duration. Disclosures All authors: No reported disclosures.

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COLD AGGLUTININS, EATON AGENT, AND RESPIRATORY INFECTIONS OF CHILDREN

PEDIATRICS ◽

10.1542/peds.38.4.571 ◽

1966 ◽

Vol 38 (4) ◽

pp. 571-577

Author(s):

Sidney J. Sussman ◽

Robert L. Magoffin ◽

Edwin H. Lennette ◽

Jack Schieble

Keyword(s):

Mycoplasma Pneumoniae ◽

Antibody Titer ◽

Respiratory Infections ◽

Respiratory Illness ◽

Inpatient Service ◽

Older Children ◽

Respiratory Illnesses ◽

Cold Agglutinins ◽

Pediatric Inpatient ◽

Sporadic Cases

Twenty-eight of 444 children under 4 years of age developed cold agglutinins in association with a respiratory illness. Infection with the Eaton agent, Mycoplasma pneumoniae, could not be established by C-F tests in any of these 28 cases. In 18 cases, pathogens other than the Eaton agent were implicated. A positive cold agglutinin test was of no value in making an etiologic diagnosis. Complement-fixation tests for antibody to the Eaton agent in 106 children with respiratory illnesses showed an antibody titer rise in 1 case and stationary titers in 12 others. These observations covered a 4-year period on the pediatric inpatient service of a large metropolitan general hospital. Sporadic cases of pneumonia due to Mycoplasma pneumoniae, confirmed by C-F antibody titer rises, were observed in older children and adults in the same metropolitan area during this period, but no evidence of epidemic occurrence was observed.

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Principal Infectious Diseases of Childhood

PEDIATRICS ◽

10.1542/peds.38.1.157a ◽

1966 ◽

Vol 38 (1) ◽

pp. 157-158

Author(s):

HEINZ F. EICHENWALD

Keyword(s):

Respiratory Tract ◽

Lower Respiratory Tract ◽

Respiratory Tract Infections ◽

Respiratory Virus ◽

Respiratory Infections ◽

Atypical Pneumonia ◽

Lower Respiratory Tract Infections ◽

Respiratory Illnesses ◽

The Common ◽

Tract Infections

When the reviewer began to peruse this volume, he was unable to put it down until he had completed reading it. The book is full of fascinating items of information, a few of which might be cited: "the common cold and minor respiratory illnesses are most likely caused by the group of bacteria found in upper and lower respiratory tract infections (usually the pneumonococcus, and streptococcus);" "(the etiology of primary atypical pneumonia) is obscure but it is believed that a specific respiratory virus will eventually be recovered;" "meningitis . . . is so serious a disease that one must recommend that most upper and lower respiratory infections be treated with sulfonamide and/or antibiotics;" "(sepsis neonatorum should be treated) with sulfadiazine or some other intravenous sulfonamide."

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The Role ofClostridium difficileand Viruses as Causes of Nosocomial Diarrhea in Children

Infection Control and Hospital Epidemiology ◽

10.1086/501990 ◽

2002 ◽

Vol 23 (11) ◽

pp. 660-664 ◽

Cited By ~ 38

Author(s):

Joanne M. Langley ◽

John C. LeBlanc ◽

Martha Hanakowski ◽

Olga Goloubeva

Keyword(s):

Respiratory Infections ◽

Care Center ◽

Tertiary Care ◽

Personal Contact ◽

First Episode ◽

Causative Organism ◽

Older Children ◽

Maritime Provinces ◽

Viral Diarrhea ◽

Nosocomial Diarrhea

Objective:We report surveillance of nosocomial diarrhea in children at our institution during the past decade and note different epidemiology of diarrhea due to viruses andClostridium difficile.Design:A prospective cohort study.Setting:A university-affiliated pediatric hospital with 180 beds serving an urban area and providing referral care for the Maritime Provinces of Canada.Participants:Children younger than 18 years.Methods:Surveillance was conducted from 1991 to 1999 using personal contact with personnel and review of microbiology and medical records. Nosocomial diarrhea was defined as loose stools occurring more than 48 hours after admission, with at least two loose stools in 12 hours and no likely non-infectious cause.Results:Nosocomial diarrhea was the third most common nosocomial infection (217 of 1,466; 15%), after bloodstream and respiratory infections, with from 0.5 to 1 episode per 1,000 patient-days. Of 217 nosocomial diarrhea episodes, 122 (56%) had identified pathogens:C. difficile(39 of 122; 32%), rotavirus (38 of 122; 31%), adenovirus (36 of 122; 30%), and other viral (9 of 122; 7%). The median age was 1.3 years (range, 11 days to 17.9 years), 0.80 year for children with viral diarrhea, 3.9 years for children withC. difficile, and 1.5 years for children with diarrhea without a causative organism identified (P< .0001). Most children with nosocomial diarrhea were incontinent (diapered) at the time of their first episode (138 of 185; 75%), but preexisting incontinence was more common in those with viral diarrhea (93%) compared with those with no organism identified (71%) or those withC. difficile-associated diarrhea (CDAD) (49%) (P< .0001).Conclusions:C. difficileis the single most common cause of nosocomial diarrhea in our tertiary-care center, although all viral pathogens account for 69% of cases. Diapered status appears to be a risk factor for CDAD in children, and CDAD occurs more often in older children than viral nosocomial diarrhea. Further characterization of risk factors for, and morbidity associated with, nosocomial CDAD in children is warranted.

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Viruses associated with acute respiratory infections 1961–71

Journal of Hygiene ◽

10.1017/s0022172400023664 ◽

1974 ◽

Vol 72 (3) ◽

pp. 425-432 ◽

Cited By ~ 17

Author(s):

P. G. Higgins

Keyword(s):

Sore Throat ◽

School Children ◽

Respiratory Infections ◽

Respiratory Illness ◽

Laboratory Diagnosis ◽

Acute Respiratory Infections ◽

Acute Respiratory Illness ◽

Pathogenic Organism ◽

Respiratory Illnesses ◽

Influenza Like Illness

SUMMARYInfluenza-like illness, cold and sore throat was the diagnosis given in over 80% of 5177 acute respiratory illnesses in patients swabbed over a 10-year-period. A pathogenic organism was isolated twice as frequently from patients with a sore throat or an influenza-like illness as from those diagnosed as suffering from croup or laryngitis and bronchitis. A laboratory diagnosis was commoner in school children than in older or younger persons.Most of the organisms isolated were found in association with all types of acute respiratory illness but, with increasing age of the patient, one particular agent or group of agents was more likely to be of aetiological significance.

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Study of impact of COVID-19 infection on ectopic pregnancy in a tertiary care center

International Journal of Reproduction Contraception Obstetrics and Gynecology ◽

10.18203/2320-1770.ijrcog20211154 ◽

2021 ◽

Vol 10 (4) ◽

pp. 1660

Author(s):

Niranjan N. Chavan ◽

Hitendrasing D. Rajput ◽

Dinesh Wade ◽

Shikhanshi .

Keyword(s):

Ectopic Pregnancy ◽

Point Of Care ◽

Care Center ◽

Tertiary Care ◽

Clinical Signs ◽

Respiratory Illness ◽

Hemodynamic Instability ◽

Physical Symptoms ◽

Medical Emergency ◽

Special Treatment

Background: COVID-19 is an infectious disease caused by a recently discovered coronavirus (SARS-CoV-2). Most of the people infected with the coronavirus will experience mild to moderate respiratory illness and recover without requiring any special treatment. In current study we have studied impact COVID-19 pandemic on clinical outcome and management of ectopic pregnancy.Methods: Women with confirmed or suspected ectopic pregnancy admitted in emergency for further management and tested via nasopharyngeal (NP) or oropharyngeal swab for SARS-CoV-2 using reverse transcriptase polymerase chain reaction (RT-PCR) from April 1, 2020 to November 30, 2020 were included in the study.Results: In our study out of 32 case of ectopic pregnancy, 3 patients were COVID-19 positive. Total non COVID-19 patients were 29. Out of 32 ectopic pregnancies only 4 were unruptured ectopic pregnancy and rest 28 had ruptured ectopic pregnancy. Mortality among ectopic pregnancy was noted only in 1 case (3.12%).Conclusions: Timely diagnosis and initiating management at first point of care can reduce the morbidity and mortality due to ectopic pregnancy. Patient’s knowledge attitude and awareness will be achieved through health education. Women with clinical signs and physical symptoms of a ruptured ectopic pregnancy, such as hemodynamic instability or an acute abdomen, should be evaluated and treated urgently. In pandemic situation where some part of hospital facilities devoted to COVID-19 patients, so planned distribution of resources to tackle medical emergency will bear fruitful positive outcome.

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Characteristic of COVID-19 infection in pediatric patients: early findings from a tertiary care center, Nagercoil, Tamil Nadu, India

International Journal of Contemporary Pediatrics ◽

10.18203/2349-3291.ijcp20204051 ◽

2020 ◽

Vol 7 (10) ◽

pp. 2048

Author(s):

Babitha Rexlin G. ◽

Suresh P. M.

Keyword(s):

Tamil Nadu ◽

Care Center ◽

Tertiary Care ◽

Care Facility ◽

Retrospective Chart Review ◽

Respiratory Illness ◽

Family Welfare ◽

P Value ◽

Mild Disease ◽

Tertiary Care Facility

Background: The planet faces a new challenge with COVID-19 disease caused by novel SARS-CoV2. Pediatric COVID-19 is considered to be mild. Methods: The study aim was to describe the clinical presentation, diagnostic findings and outcome of a cohort of paediatric patients according to Ministry of health and family welfare (MOHFW) criteria, at KKGMCH a tertiary care facility in Kanyakumari district. It’s a retrospective chart review including data of children aged 0 to 12 years with COVID-19 from 20 March to 19 July 2020. Results: Of the 137 children with COVID-19, 17 (12.45%) were infants, 65 (35%) were 1-5 years and 72 (52.55%) were 6-12 years. Age didn’t have influence on acquiring the illness as p value is 0.125. Age had no influence on severity too as p value is 0.28. 46.7% were female and 53.3% were male. There was an apparent male preponderance with (OR 1.63, 95% CI 1.00 to 2.21) but a non-significant p value of 0.54. of the 34 (24.8%) mild symptomatic, 22 (64.7%) were males and 12 (35.2%) were females. The p value is 0.086 stating gender non-influential on severity. 129 (94.1%) children had contact history. The contacts were parents or close relatives. No child with comorbidity presented during this period. Most common clinical features were fever (8.76%), cough (6.6%), rhinorrhoea (2.2%), vomiting (2.9%) and diarrhoea (1.5%). Children never progressed to severe respiratory illness requiring intensive care as per MOHFW criteria. 1 (0.7%) presented with focal consolidation in chest x-ray. All 137 (100%) children got cured.Conclusion: Study concludes pediatric COVID-19 is a mild disease without mortality at beginning of pandemic in Kanyakumari district. Factors like age and gender neither influenced the occurrence of the disease nor the severity.

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