Viral pneumonia: features of diagnostics, clinical course and treatment

MedAlliance ◽  
2020 ◽  
Vol 8 (4) ◽  
pp. 32-39
Keyword(s):  
Clinical Features ◽  
Viral Infections ◽  
Clinical Course ◽  
Care Delivery ◽  
Laboratory Data ◽  
Clinical Manifestations ◽  
Epidemiological Data ◽  
Viral Pneumonia ◽  
Differential Diagnostics ◽  
Rapid Diagnostics

Viral pneumonia is a significant cause of morbidity and mortality. This review looks at the clinical features, diag-nostics, clinical course, as well as options of treatment of viral infections and associated pneumonias, the necessi-ty of differential diagnostics between viral and bacterial pneumonias. The emergence of such infections as severe acute respiratory syndrome, Middle East respiratory syn-drome, and the rise of COVID-19 pandemic have posed new challenges for clinicians in terms of rapid diagnostics and medical care delivery for patients with viral pneu-monia. The clinical manifestations of diseases are often indistinguishable from infections of other etiologies, and epidemiological data are necessary for diagnosis. Many researchers report that among clinical features of viral pneumonia, including COVID-19, the risk of developing respiratory distress syndrome and multiple organ failure are noteworthy. Laboratory data show a tendency to lym-phocytopenia. Radiological signs include ground-glass opacities, areas of consolidation, often located subpleu-rally. In addition, potassium loss, as well as predisposition to hypercoagulation with further thrombogenesis are also a concern in COVID-19 patients, and have to be ad-dressed accordingly. Etiotropic therapy options for viral pneumonia, including COVID-19, are scarce today, vari-ous medications are being discussed.

scholarly journals Pediatric COVID-19 and the Factors That May Mitigate Its Clinical Course

2020 ◽  
Vol 10 (01) ◽  
pp. e137-e140
Author(s):  
Mosaad Abdel-Aziz ◽  
Nada M. Abdel-Aziz ◽  
Dina M. Abdel-Aziz ◽  
Noha Azab
Keyword(s):  
Clinical Features ◽  
Clinical Symptoms ◽  
Clinical Course ◽  
Clinical Manifestations ◽  
Gastrointestinal Symptoms ◽  
Angiotensin Converting Enzyme 2 ◽  
Compulsory Vaccination ◽  
Specific Factors ◽  
Novel Coronavirus ◽  
Radiographic Data

AbstractThe clinical manifestations of novel coronavirus disease 2019 (COVID-19) vary from mild flu-like symptoms to severe fatal pneumonia. However, children with COVID-19 may be asymptomatic or may have mild clinical symptoms. The aim of this study was to investigate clinical features of pediatric COVID-19 and to search for the factors that may mitigate the disease course. We reviewed the literature to realize the clinical features, laboratory, and radiographic data that may be diagnostic for COVID-19 among children. Also, we studied the factors that may affect the clinical course of the disease. Fever, dry cough, and fatigue are the main symptoms of pediatric COVID-19, sometimes flu-like symptoms and/or gastrointestinal symptoms may be present. Although some infected children may be asymptomatic, a recent unusual hyperinflammatory reaction with overlapping features of Kawasaki's disease and toxic shock syndrome in pediatric COVID-19 has been occasionally reported. Severe acute respiratory syndrome-coronvirus-2 (SARS-CoV-2) nucleic acid testing is the corner-stone method for the diagnosis of COVID-19. Lymphocyte count and other inflammatory markers are not essentially diagnostic; however, chest computed tomography is highly specific. Factors that may mitigate the severity of pediatric COVID-19 are home confinement with limited children activity, trained immunity caused by compulsory vaccination, the response of the angiotensin-converting enzyme 2 receptors in children is not the same as in adults, and that children are less likely to have comorbidities. As infected children may be asymptomatic or may have only mild respiratory and/or gastrointestinal symptoms that might be missed, all children for families who have a member diagnosed with COVID-19 should be investigated.

scholarly journals Clinical Features of Plastic Bronchitis Related to Respiratory Tract Infection in 269 Children

2022 ◽  
Author(s):  
xiaojian cui ◽  
Wei Guo ◽  
Lihua Zhao ◽  
Tongqiang Zhang ◽  
Jiafeng Zheng ◽  
...  
Keyword(s):  
Tract Infection ◽  
Respiratory Tract ◽  
Respiratory Tract Infection ◽  
Clinical Features ◽  
Laboratory Data ◽  
Clinical Manifestations ◽  
Multivariate Logistic Regression Analysis ◽  
Fiberoptic Bronchoscopy ◽  
Plastic Bronchitis ◽  
D Dimer

Abstract Background. Plastic bronchitis (PB) is a pulmonary disease characterized by the formation of bronchial casts (BCs) that lead to airway blockage. The study aimed to investigate the clinical features of PB related to respiratory tract infection. Methods. A retrospective analysis was performed on data collected over a 5-year period (from January 2015 to December 2019) on children with PB (n=269). The clinical manifestations, laboratory data, imaging findings and management, were investigated. The single fiberoptic bronchoscopy (FOB, n=144) and multiple-treatment groups (n=125) were compared.Results. A total of 269 PB children were included with a mean age of 6.7 ± 2.8 years. The majority of cases (n=241, 89.6%) were diagnosed with Mycoplasma pneumonia (MP) infection. The mean duration of fever and hospitalization was 10.6 ± 3.7 and 9.3 ± 3.2 days, respectively. All patients presented with cough and fever, 62 (23.0%) suffered from hypoxemia, and 144 (53.5%) had extrapulmonary complications. Higher levels of ESR, CRP, PCT, IL-6, LA, LDH, FER and D-dimer were observed. CT findings, including pulmonary consolidation, segmental or lobar atelectasis, pleural effusion and pleural thickening, were observed in 97.4%, 46.5%, 47.9% and 63.2% of cases, respectively. Furthermore, multivariate logistic regression analysis showed that N% >75.5%, LDH >598.5U/L, and D-dimer>1.2mg/L were independent risk factors for multiple therapeutic FOB. Conclusions. MP is a major pathogen responsible for PB in children. Patients with PB are more likely to experience persistent fever and excessive inflammation and have severe radiological findings. FOB is an effective treatment for patients with PB, and children may require multiple FOBs for cast removal. N% >75.5%, LDH >598.5U/L and D-dimer > 1.2mg/L are independent predictors of multiple FOB treatment.

scholarly journals Clinical Features of Hypertensive Patients With Covid-19 Compared With a Normotensive Group

2020 ◽  
Author(s):  
shuang wang ◽  
qiang zhang ◽  
zhao bin zheng ◽  
peng wang ◽  
hua hong ye ◽  
...  
Keyword(s):  
Clinical Features ◽  
Inflammatory Responses ◽  
Angiotensin Receptor Blockers ◽  
Laboratory Data ◽  
Ground Glass Opacity ◽  
Angiotensin Converting Enzyme Inhibitors ◽  
Viral Pneumonia ◽  
Converting Enzyme Inhibitors ◽  
Hypertensive Patients ◽  
Increased Risk

Abstract Background: The novel coronavirus (COVID-19), which began in Wuhan, China, in December 2019, has spread worldwide and poses a great threat to human health. Among COVID-19 patients, those with hypertension have been reported to have higher morbidity and mortality. This study was conducted to provide the international community with a deeper understanding of COVID-19 with hypertension.Methods: A total of 188 COVID-19 patients were studied from January to March 2020. The epidemiology, clinical features, and laboratory data of hypertensive patients with COVID-19 were collected, retrospectively analyzed, and compared with a normotensive group. The use of anti-hypertensive drugs, general treatment, and clinical outcomes of hypertensive patients were also analyzed.Results: The median ages in hypertensive patients with mild and severe COVID-19 were both significantly greater than the median age in the normotensive group. But there was no significant gender difference between the hypertensive and normotensive groups. All patients had lived in the Wuhan area. Common symptoms of all of the patients included fever, cough, and fatigue. Chest CT scans showed bilateral patchy shadows or ground glass opacity in the lungs of all of the patients. All (98 [100%]) of the hypertensive patients received antiviral therapy (Arbidol was used alone or in combination with Ribavirin), antibiotic therapy (85 [86.7%]), and corticosteroids (31 [31.6%]). It has been suggested that the combination of Arbidol and Ribavirin as initial therapy for hypertensive patients with COVID-19 is effective and safe. There were no significant differences in laboratory data between the mild cases in the hypertensive and the normotensive groups. In the severe cases, the hypertensive patients had higher plasma levels of D-dimer, C-reactive protein (CRP), and Interleukin-6 (IL-6) (P < 0.05). Furthermore, the hypertensive patients who were treated with angiotensin-converting enzyme inhibitors/angiotensin receptor blockers (ACEI/ARB) had no statistically significant differences between the mild and severe groups (p > 0.05).Conclusion: In this study, we demonstrated that the hypertensive patients who were treated with ACEI/ARB did not have an increased risk of developing severe COVID-19. Arbidol and Ribavirin played an important role in the treatment of the viral pneumonia. Hypertensive patients with severe viral pneumonia had stronger inflammatory responses than non-hypertensive patients.

Deleterious effects of viral pneumonia on cardiovascular system

2020 ◽  
Vol 41 (19) ◽  
pp. 1833-1838 ◽  
Author(s):  
Jiahao Duan ◽  
Yeshun Wu ◽  
Cunming Liu ◽  
Chun Yang ◽  
Ling Yang
Keyword(s):  
Viral Infection ◽  
Cardiovascular System ◽  
Cardiovascular Events ◽  
Causes Of Death ◽  
Viral Infections ◽  
Cardiovascular Response ◽  
Clinical Manifestations ◽  
Viral Pneumonia ◽  
Influenza Pandemics ◽  
Epidemiological Characteristics

Abstract Viral pneumonia has a significant effect on the cardiovascular system through various mechanisms; even though it is traditionally regarded as a pulmonary disease characterized by dyspnoea and hypoxaemia. Recent research works have shown that cardiovascular events outweigh all other causes of death in various influenza pandemics. Therefore, the exploration of the effects of viral pneumonia on cardiovascular system becomes increasingly essential. The objective of this review is three-fold: first, to summarize the knowledge about the epidemiological characteristics and clinical manifestations of viral infections that are the recent causes of global pandemics; second, to explore the cardiovascular response to these infections; and third, to attempt in identifying the possible coping strategies of the Wuhan epidemic and the future viral infection pandemics.

scholarly journals Clinical features of hypertensive patients with COVID-19 compared with a normotensive group: Single-center experience in China

Open Medicine ◽  
2021 ◽  
Vol 16 (1) ◽  
pp. 367-374
Author(s):  
Shuang Wang ◽  
Qiang Zhang ◽  
Peng Wang ◽  
Huahong Ye ◽  
Xiaoqing Jing ◽  
...  
Keyword(s):  
Clinical Features ◽  
Inflammatory Responses ◽  
Antihypertensive Drugs ◽  
Angiotensin Receptor Blockers ◽  
Laboratory Data ◽  
Ground Glass Opacity ◽  
Viral Pneumonia ◽  
Converting Enzyme Inhibitors ◽  
Hypertensive Patients ◽  
Increased Risk

Abstract Background SARS-CoV-2 has spread worldwide and poses a great threat to human health. Among COVID-19 patients, those with hypertension have been reported to have higher morbidity and mortality. This study was conducted to provide the international community with a deeper understanding of COVID-19 with hypertension. Methods A total of 623 COVID-19 patients enrolled in Wuhan’s hospital were studied from January to March 2020. The epidemiology, clinical features, and laboratory data of hypertensive patients with COVID-19 were collected, retrospectively analyzed, and compared with a normotensive group. The use of antihypertensive drugs, general treatment, and clinical outcomes of hypertensive patients were also analyzed. Results The median ages in hypertensive patients with mild and severe COVID-19 were both significantly greater than the median age in the normotensive group. But there was no significant gender difference between the hypertensive and normotensive groups. All patients had lived in Wuhan area. Common symptoms of all patients included fever, cough, and fatigue. Chest computed tomography (CT) scans showed bilateral patchy shadows or ground glass opacity in the lungs of all patients. All (315 (100%)) of the hypertensive patients received antiviral therapy (Umifenovir was used alone or in combination with Ribavirin), antibiotic therapy (215 (68.3%)), and corticosteroids (118 (37.5%)). The results suggest that the combination of Umifenovir and Ribavirin as initial therapy for hypertensive patients with COVID-19 is effective and safe. There were no significant differences in laboratory data between the mild cases in the hypertensive and the normotensive groups. In the severe cases, the hypertensive patients had higher plasma levels of D-dimer, C-reactive protein (CRP), and Interleukin-6 (IL-6) (P < 0.05). Furthermore, the hypertensive patients who were treated with angiotensin-converting enzyme inhibitors/angiotensin receptor blockers (ACEI/ARB) were not represented in a statistically significant manner between the mild and severe groups (p > 0.05). Conclusion In this study, we demonstrated that the hypertensive patients who were treated with ACEI/ARB did not have an increased risk of developing severe COVID-19. Umifenovir and Ribavirin played an important role in the treatment of viral pneumonia. Hypertensive patients with severe viral pneumonia had stronger inflammatory responses than nonhypertensive patients.

scholarly journals Clinical Findings, Laboratory Assessment, and Outcomes of 44 Infants Born to Mothers with Confirmed or Suspected COVID-19: A Multicenter Cohort Study

2021 ◽  
Vol 31 (4) ◽  
Author(s):  
Ziba Mosayebi ◽  
Tahereh Esmaeilnia ◽  
Vafa Ghorban Sabagh ◽  
Amir Naddaf ◽  
Setareh Sagheb ◽  
...  
Keyword(s):  
Cohort Study ◽  
Respiratory Distress ◽  
Clinical Features ◽  
Laboratory Data ◽  
Clinical Manifestations ◽  
Clinical Feature ◽  
X Rays ◽  
Multicenter Cohort Study ◽  
Multicenter Cohort ◽  
Gastrointestinal Problems

Background: Coronavirus disease 2019 caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has spread worldwide, causing a significant public health disaster. Objectives: The present study aimed to evaluate the clinical features and laboratory data of neonates born to mothers with COVID-19. Methods: A retrospective multicenter cohort study was conducted from March 20 to September 5, 2020, on all neonates born to mothers with positive real-time reverse transcriptase-polymerase chain reaction for SARS-CoV-2 or clinically suspected COVID-19. Neonates enrolled in this study were from five different hospitals affiliated with the Tehran University of Medical Sciences. All the newborns were tested for SARS-CoV-2 using nasopharyngeal swabs during the first 24 - 48 hours of life, and a second-time swabbing was performed as indicated at subsequent visits. All categorical data were manifested as frequency (%), and continuous data were shown as mean ± SD. Results: Forty-four neonates born to 39 infected mothers were evaluated during the study period. Nineteen women had complications during pregnancy, including hypertensive disorders, gestational diabetes, preterm labor, etc. Besides, 54.5% of the neonates were born preterm. The mean gestational age and birth weight were 35.11 ± 4.01 weeks and 2,567 ± 898 g, respectively. Fifteen (34.1%) neonates were symptomatic at birth, and during the observation, more neonates became symptomatic. Finally, 27/44 (61.3%) neonates became symptomatic, and 17/44 remained asymptomatic. The most common clinical manifestations were respiratory distress (77.7%), followed by fever or hypothermia (18.5%), gastrointestinal problems (14.8%), and neurologic findings (3.7%). Also, the most common clinical feature of eight neonates with positive RT-PCR was respiratory distress, followed by neurologic symptoms, temperature instability, and gastrointestinal disorder, in sequence. Few abnormalities were seen in laboratory findings. Chest X-rays were abnormal in 22.2% of the neonates. Conclusions: The SARS-CoV-2 infection during pregnancy may cause severe maternal and neonatal morbidities. Neonates with positive SARS-CoV-2 may demonstrate a spectrum of clinical features. The most common feature of neonates born to mothers with COVID-19 was respiratory distress.

scholarly journals New Possibilities of Antibiotic Therapy for Blepharoconjunctivitis in Children

2021 ◽  
Vol 18 (4) ◽  
pp. 932-937
Author(s):  
E. L. Efimova ◽  
V. V. Brzheskiy
Keyword(s):  
Clinical Course ◽  
Laboratory Data ◽  
Clinical Signs ◽  
Clinical Manifestations ◽  
Immunohistochemical Analysis ◽  
Data Detection ◽  
Antibacterial Drug ◽  
Eye Infections ◽  
Ophthalmic Ointment ◽  
Group I

The problem of drug therapy for bacterial eye infections in children has remained relevant for many years. The greatest interest of ophthalmologists in recent years is associated with the use of fluoroquinolones in the treatment of inflammatory eye diseases of the bacterial etiology. At the same time, new ophthalmic dosage forms of fluoroquinolones that have appeared in recent years naturally require additional research on their effectiveness.Objective: to study the clinical efficacy of the antibacterial drug Oftocypro (0.3 % cyprofloxacin in ophthalmic ointment) in the treatment of chronic blepharoconjunctivitis in children.Materials. The study involved 38 children aged 3 to 18 years (mean age 10.3 ± 2.7 years) with clinical manifestations of blepharoconjunctivitis. All patients were divided into 2 groups of equal size: 18 children (36 eyes) — with bacterial blepharoconjunctivitis and 20 (40) — with chlamydial blepharoconjunctivitis. The diagnosis was verified based on the clinical picture of blepharoconjunctivitis and laboratory data: detection of pathogenic microflora in the conjunctival cavity of patients of the first group and chlamydia antigen — in epithelial cells in scraping material from the conjunctiva by immunohistochemical analysis.Results. The analysis of the data obtained during the examination and treatment of children with blepharoconjunctivitis of bacterial etiology (group I), a reliable dynamics of controlled clinical and laboratory parameters was established. There was a significant positive dynamics of all controlled parameters of the clinical course of chronic bacterial blepharoconjunctivitis against the background of the drug Oftocipro ophthalmic ointment 0.3 % use. All children with chronic chlamydial blepharoconjunctivitis with the background of treatment with Oftocypro, ophthalmic ointment 0.3 %, showed a steady tendency towards relief of the estimated clinical signs of the disease. According to the results of laboratory studies, it was found that on the 28th day of treatment with Oftocypro chlamydia in the cells of the epithelium of the conjunctiva was re-detected in 4 out of 20 patients (20 %).Conclusion. The high efficacy of the drug Oftocypro ophthalmic ointment 0.3 %, in combination with the absence of pronounced side effects, makes it possible to recommend this drug for wider practical use.

Acute respiratory viral infections in COVID-19 pandemic in practice of polyclinic doctor

2021 ◽  
Vol 1 (11) ◽  
pp. 29-33
Author(s):  
V. V. Nikiforov ◽  
N. V. Orlova ◽  
V. V. Lomaychikov
Keyword(s):  
Differential Diagnosis ◽  
Viral Infections ◽  
Clinical Course ◽  
Respiratory Infections ◽  
Clinical Manifestations ◽  
Acute Respiratory Infections ◽  
Interferon Inducer ◽  
Coronary Syndrome ◽  
Respiratory Viral Infections ◽  
High Level

Acute respiratory viral infections (ARVI), including influenza, remain the most common infectious diseases. In the context of COVID‑19 pandemic, there is a need for differential diagnosis of respiratory syndrome. The clinic of ARVI, depending on the pathogen, may have its own characteristics. Influenza and COVID‑19 have common pathways of transmission of the pathogen and similar symptoms, so the optimal differential diagnosis is the use of test systems for both viruses. Against the background of influenza and other acute respiratory infections, complications from various organs and systems can develop. The article discusses in detail the issues of the clinical course of ARVI, differential diagnosis, modern approaches to therapyand prophylactic. Complications of influenza from the cardiovascular system are considered in detail. The data of our own observations on the risk of developing acute coronary syndrome in persons who have undergone COVID‑19 are presented. Prevention of the development of complications of influenza and other acute respiratory infections is the early appointment of antiviral therapy. Numerous studies confirm the effectiveness of interferon inducers in the treatment of influenza and other ARVI. The article presents the results of clinical studies confirming the effectiveness of therapy with the interferon inducer Kagocel. Against the background of its use, a decrease in the severity of clinical manifestations, a reduction in the duration of the disease, and the prevention of complications were noted. In studies, the drug has shown a high level of safety. The article discusses studies on the effectiveness of chemoprophylaxis of influenza and other acute respiratory infections.

AB0 Blood Groups and Coronary Heart Disease (CHD)

1980 ◽  
Vol 43 (02) ◽  
pp. 137-140 ◽  
Author(s):  
Jan Erikssen ◽  
Erik Thaulow ◽  
Helge Stormorken ◽  
Ole Brendemoen ◽  
Arvid Hellem
Keyword(s):  
Coronary Artery ◽  
Blood Group ◽  
Artery Bypass ◽  
Laboratory Data ◽  
Epidemiological Data ◽  
Consecutive Series ◽  
Related Factors ◽  
Ab0 Blood Groups ◽  
Clinically Significant ◽  
Artery Disease

SummaryThe view based on epidemiological and laboratory data that blood group A subjects (=A) have clinically significant higher thrombotic potential than blood group 0 subjects (= O), is supported by the present finding of a significantly higher platelet retention in A than 0.The completely normal ABO distribution found among 71 cases of proven latent CHD, and the disproportionate excess of 0 vs. A in a consecutive series of 191 coronary artery bypass candidates apparently conflict with epidemiological data indicating a higher risk of achieving CHD in A than 0. The conflict may be solved by suggestinga) that the »thrombotic proneness« in A compared with 0 causes a poorer prognosis in CHD among the former, leaving a disproportionate excess of 0 among longterm CHD survivors, and b) that AB0-related factors have had an insignificant, independent impact on the evolution of preclinical coronary artery disease in our 71 men with latent CHD.

Cerebral Amyloid Angiopathy in Combination with Paroxysmal Atrial Fibrillation

2020 ◽  
Vol 25 (4) ◽  
pp. 31-37
Author(s):  
A. A. Kornilova ◽  
O. V. Lagoda ◽  
M. M. Tanashyan
Keyword(s):  
Atrial Fibrillation ◽  
Cerebral Amyloid Angiopathy ◽  
Paroxysmal Atrial Fibrillation ◽  
Past History ◽  
Laboratory Data ◽  
Clinical Manifestations ◽  
Cerebral Haemorrhage ◽  
Exclusion Criterion ◽  
Amyloid Angiopathy ◽  
Cerebral Amyloid

The present article addresses the definition of cerebral amyloid angiopathy (CAA) and its symptoms based on the analysis of the medical case; the issues of diagnosis and treatment of this pathology are discussed. The Boston criteria, which became the basis for diagnosis, study of clinical manifestations and progression of CAA and approaches to its therapy, are presented. Methods and modes of neuroimaging, including magnetic resonance imaging (MRI), which verify micro cerebral haemorrhage, are described. At the same time, the role and significance of cardiac arrhythmias in the genesis of ischemic stroke are discussed, and scales for assessing the risk of its occurrence are presented. The observation of the neurological, somatic, neuroimaging, neuropsychological status of a 62-year-old patient confirms quite rare combination of probable CAA, paroxysmal atrial fibrillation and repeated hemorrhagic functional apoplexy (FA). The relevance of the case described, is a complex clinical dilemma based on mutually exclusive recommendations for the pharmacological correction of such conditions. It is emphasized that in many multicenter clinical studies on the effectiveness of antithrombotic medication (antiaggregants, anticoagulants) in the treatment and prevention of ischaemic functional apoplexy , an important exclusion criterion is a hemorrhagic stroke in past history (including the multiple changes in haemostasis indicators). Taking into account the obtained clinical and laboratory data in the dynamics, the tactics of treating the described patient were determined. The results of studies related to the treatment of comorbid pathology that should become the subject of the development of a personalized algorithm for managing patients in each specific case, are discussed.

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