The First COVID-19 Mortality in Batu Pahat, Johor: Lesson Learnt

Author(s):  
Shu Ann Hon ◽  
Lian Thai Lee ◽  
Qin Jian Low

COVID-19 had been declared as a global pandemic on 11 March 2020. This case report is about Severe Acute Respiratory Infection (SARI) due to COVID-19 (Corona Virus-19). A 68-yearold lady with underlying hypertension and congestive cardiac failure presented with fever and productive cough for 5 days duration. One week before her presentation, she had travelled to Kluang, Johor for a wedding gathering which was later found to have contributed to a cluster of COVID-19 cases. Otherwise, she denied any sick or known COVID-19 contact. Respiratory examination revealed left lower zonecrepitations. She was tachypnoeic on a high flow mask 15 L and hypotensive (BP 90/70 mm Hg) on arrival at the hospital. Chest radiograph showed bilateral asymmetrical consolidations. There was a presence of lymphopenia while her dengue serology result was negative. She was treated as SARI secondary to pneumonia with septic shock and required mechanical ventilation due to respiratory failure. Nasopharyngeal swab for SARS CoV-2 (Severe Acute Respiratory Syndrome Corona Virus-2) was taken as positive for COVID-19 on the third day of admission. Apart from supportive andintensive care measures, she was commenced on oral hydroxychloroquine, subcutaneous Interferon Beta and syrup lopinavir/ritonavir per local guidelines during that period. Unfortunately, she developed acute respiratory distress syndrome (ARDS) on day 3 of admission and passed away due to respiratory failure. Clinicians should pay attention to the COVID-19 critical disease profile and mortality risks. By identifying high-risk patients early, medical resources can be administered in an organized way and timely way to improve the efficacy of the healthcare services.

2020 ◽  
Vol 5 (1) ◽  
Author(s):  
Nisha Durand ◽  
Jorge Mallea ◽  
Abba C. Zubair

Abstract The emergence of severe acute respiratory syndrome corona virus 2 (SARS-CoV-2) at the end of 2019 in Hubei province China, is now the cause of a global pandemic present in over 150 countries. COVID-19 is a respiratory illness with most subjects presenting with fever, cough and shortness of breath. In a subset of patients, COVID-19 progresses to hypoxic respiratory failure and acute respiratory distress syndrome (ARDS), both of which are mediated by widespread inflammation and a dysregulated immune response. Mesenchymal stem cells (MSCs), multipotent stromal cells that mediate immunomodulation and regeneration, could be of potential benefit to a subset of COVID-19 subjects with acute respiratory failure. In this review, we discuss key features of the current COVID-19 outbreak, and the rationale for MSC-based therapy in this setting, as well as the limitations associated with this therapeutic approach.


Author(s):  
Syed Ziaur Rahman ◽  
Saif Khan

Corona virus Disease 2019 (COVID-19) is a severe acute respiratory infection caused by corona virus-2 (SARS-CoV-2). It originated from Wuhan city of China in December 2019 and spread like a wild fire to the entire globe and was declared as global pandemic by WHO on March 11, 2020. With no available cure and vaccine, this disease has taken a mammoth toll on the human life; therefore, SMS (‘Social Distancing’, use of ‘Mask’ and regular hand washing with ‘Soap’) has emerged as a sole tool to prevent its spread. The Indian government declared the first lockdown from March 25th 2020 with subsequent second, third and fourth lockdowns up to 31st March 2020 to decrease the disease transmission and flatten the disease transmission curve. Aligarh Muslim University is one of the prestigious central and residential universities in India. It is located in Aligarh district adjoining national capital region. The university has an attached tertiary care ‘Jawaharlal Nehru Medical College Hospital’. This narrative review discusses the various steps and procedures taken up by the university and hospital administration, other functionaries, faculty members and doctors in tackling the serious pandemic until 22nd June 2020. The proactive role of administration, dedication and hard work of health care professionals and innovation of some academicians has given a new vista of opportunities to tackle this global health pandemic. The recovery rate of coronavirus patients at AMU hospital is recorded as 71.9%, which is much higher than national average recovery rate (56%). Thus, AMU model gives some positive insights to fight the current global pandemic. Bangladesh Journal of Medical Science Vol.19(0) 2020 p. S 28-S 35


2020 ◽  
Vol 2 (1) ◽  
pp. 1-2
Author(s):  
Hanevi Djasri

Badan Kesehatan Dunia (WHO) telah mengeluarkan pedoman tatalaksana infeksi saluran pernapasan akut berat (severe acute respiratory infection/SARI) yang diduga karena COVID-19. Pedoman tersebut ditujukan untuk para dokter yang merawat pasien di rumah sakit untuk memberikan kemudahan akses terhadap panduan terkini dalam rangka memastikan tatalaksana terbaik bagi pasien. Pedoman tersebut memuat: 1) proses triage untuk mengenali dan menyortir pasien dengan SARI; 2) tindakan segera untuk pencegahan dan pengendalian infeksi dengan tepat; 3) pemberian terapi dan pemantauan; 4) pengumpulan spesimen untuk diagnosis laboratorium; 5) tatakelola gagal napas hipoksemia dan sindrom gangguan pernapasan akut acute respiratory distress syndrome/ARDS); 6) manajemen syok septik; 7) pencegahan komplikasi; 8) perawatan khusus anti COVID-19; dan pertimbangan khusus untuk pasien hamil. Sebagai pengelola rumah sakit, ketersediaan pedoman internasional ini perlu dicermati, diadopsi menjadi pedoman klinis (clinical guidelines), diterapkan dan dievaluasi sebagai bagian dari manajemen mutu pelayanan klinis. Dalam standar akreditasi rumah sakit di Indonesia, penyusunan dan penerapan pedoman klinis memang disyaratkan dalam bentuk Panduan Praktik Klinis (PPK), terlebih untuk tatalaksana pasien dengan risiko tinggi. Standar akreditasi juga meminta agar PPK juga menjadi dasar untuk melakukan evaluasi mutu dan keselamatan asuhan pasien yang diberikan oleh setiap klinisi.


2020 ◽  
Vol 17 ◽  
Author(s):  
Ajoy Basak ◽  
Sarmistha Basak

: The current global pandemic outbreak of a novel type of corona virus termed by World Health Organization as COVID-19 became an grave concern and worry to human health and world economy. Intense research efforts are now underway worldwide to combat and prevent the spread of this deadly disease. This zoonotic virus, a native to bat population is most likely transmitted to human via a host reservoir. Due to its close similarity to previously known SARS CoV (Severe Acute Respiratory Syndrome Corona Virus) of 2002 and related MERS CoV (Middle East Respiratory Syndrome Corona Virus) of 2012, it is also known as SARS CoV2. But unlike them it is far too infectious, virulent and lethal. Among its various proteins, the surface spike glycoprotein “S” has drawn significant attention because of its implication in viral recognition and host-virus fusion process. A detail comparative analysis of “S” proteins of SARS CoV (now called SARS CoV1), SARS CoV2 (COVID-19) and MERS CoV based on structure, sequence alignment, host cleavage sites, receptor binding domains, potential glycosylation and Cys-disulphide bridge locations has been performed. It revealed some key features and variations that may elucidate the high infection and virulence character of COVID-19. Moreover this crucial information may become useful in our quest for COVID-19 therapeutics and vaccines.


2021 ◽  
Vol 07 ◽  
Author(s):  
Mahfuza Marzan ◽  
Md. Shahedur Rahman ◽  
Md. Abu Hena Mostofa Jamal ◽  
Mohammad Hossain Shariare ◽  
Md. Anowar Khasru Parvez

: COVID-19, a viral disease caused by SARS-CoV-2 is the reason of a global pandemic since the starting of the year 2020. The characteristic of the disease varies from mild common cold like symptoms to acute respiratory distress syndrome and multi-organ failure leading to death. World has already observed 213,453 deaths from this disease while 3,095,839 have been infected in 210 countries in total till 28 April, 2020. This disease has a devastating impact over the health care system because of its high infectivity, easy mode of transmission, lack of proper medicine and vaccine and deficiency of enough supportive healthcare arrangement. On verge of this situation scientists are searching the treatment options. However, nature has provided us with enormous herbs which have disease preventive as well as have medicinal properties. In this article we have reviewed several of these plants (ginger, clove, tea, black seed, tulsi, neem) and some vitamins (vitamin C and vitamin D) and zinc which have antiviral, anti-inflammatory, antioxidant, anti-asthmatic properties with scientific evidence. The intake of these products regularly to keep the immune system active, to experience its positive aspects might be supportive to prevent infection with the new coronavirus or to treat COVID-19.


Membranes ◽  
2021 ◽  
Vol 11 (7) ◽  
pp. 491
Author(s):  
Danielle Feldhaus ◽  
Daniel Brodie ◽  
Philippe Lemaitre ◽  
Joshua Sonett ◽  
Cara Agerstrand

Extracorporeal membrane oxygenation (ECMO) has been used with increasing frequency to support patients with acute respiratory failure, most commonly, and severe forms of acute respiratory distress syndrome (ARDS). The marked increase in the global use of ECMO followed the publication of a large randomized trial in 2009 and the experience garnered during the 2009 influenza A (H1N1) pandemic, and has been further supported by the release of a large, randomized clinical trial in 2018, confirming a benefit from using ECMO in patients with severe ARDS. Despite a rapid expansion of ECMO-related publications, optimal management of patients receiving ECMO, in terms of patient selection, ventilator management, anticoagulation, and transfusion strategies, is evolving. Most recently, ECMO is being utilized for an expanding variety of conditions, including for cases of severe pulmonary or cardiac failure from coronavirus disease 2019 (COVID-19). This review evaluates modern evidence for ECMO for respiratory failure and the current challenges in the field.


2021 ◽  
Vol 9 ◽  
pp. 232470962098630
Author(s):  
Riwaj Bhagat ◽  
Barbara Kwiecinska ◽  
Nolan Smith ◽  
Matthew Peters ◽  
Christopher Shafer ◽  
...  

With the outbreak of COVID-19 (coronavirus disease 2019) as a global pandemic, various of its neurological manifestations have been reported. We report a case of a 54-year-old male with new-onset seizure who tested positive for severe acute respiratory syndrome coronavirus 2 from a nasopharyngeal swab sample. Investigative findings, which included contrast-enhancing right posterior temporal lobe T2-hyperintensity on brain magnetic resonance imaging, right-sided lateralized periodic discharges on the electroencephalogram, and elevated protein level on cerebrospinal fluid analysis, supported the diagnosis of possible encephalitis from COVID-19 infection. The findings in this case are placed in the context of the existing literature.


2020 ◽  
Vol 7 (1) ◽  
pp. e000711 ◽  
Author(s):  
Stuart Winearls ◽  
Ema L Swingwood ◽  
Charlotte L Hardaker ◽  
Amy M Smith ◽  
Fraser M Easton ◽  
...  

The global pandemic of COVID-19 has challenged the management of hypoxaemic respiratory failure and strained intensive care unit resources. While prone positioning (PP) is an established therapy in mechanically ventilated patients with acute respiratory distress syndrome (ARDS), its role in conscious patients is less well defined. We retrospectively reviewed our experience of implementing early PP in a cohort of 24 patients with acute hypoxaemic respiratory failure due to COVID-19 who required support with continuous positive airway pressure (CPAP). The use of PP alongside CPAP significantly increased both the ROX index and arterial oxygen pressure:fractional inspired oxygen (PaO2:FiO2) ratio from baseline values (ROX index: 7.0±2.5 baseline vs 11.4±3.7 CPAP+PP, p<0.0001; PaO2:FiO2 ratio: 143±73 mm Hg baseline vs 252±87 mm Hg CPAP+PP, p<0.01), and the changes to both the ROX index and PaO2:FiO2 ratio remained significant 1 hour after cessation of proning. The mean duration of PP in the first 24 hours was 8±5 hours. Few complications were observed and PP was continued for a mean of 10±5 days. From our experience in a dedicated COVID-19 respiratory high care unit, PP alongside CPAP therapy was feasible, tolerated, safe and improved oxygenation. The use of conscious PP in ARDS warrants further investigation in randomised controlled trials.


PEDIATRICS ◽  
1993 ◽  
Vol 92 (1) ◽  
pp. 135-139
Author(s):  
Hatem Khammash ◽  
Max Perlman ◽  
Julian Wojtulewicz ◽  
Michael Dunn

Objective. In light of the paucity of published data on the use of surfactant in full-term infants with respiratory failure due to meconium aspiration syndrome and respiratory distress syndrome, we report our experience with this therapy. Our goal was to explore possible justification for randomized controlled trials of surfactant treatment in similar patients at an earlier, less severe stage of the disease. Methods. Retrospective consecutive case series of 20 infants with severe meconium aspiration syndrome and 29 infants with severe respiratory distress syndrome who received bovine surfactant between March 1990 and December 1992 in three neonatal intensive care units in a regionalized setting. Outcome of treatment was assessed by comparing changes in several respiratory indices including the oxygenation index, between 4 and 6 hours and 1 and 3 hours before and after the first dose of surfactant. Differences were analyzed using analysis of variance for repeated measures, with treatment and time as co-variates. Results. In the meconium aspiration group the mean oxygenation index decreased from 36 ± 12 at 1 to 3 hours presurfactant to 24 ± 14 at 1 to 3 hours postsurfactant (P &lt; .001). In the patients with respiratory distress syndrome the mean oxygenation index fell from 30 ± 17 at 1 to 3 hours presurfactant to 12 ± 6 at 1 to 3 hours postsurfactant (P = .0001). Three of 20 patients with meconium aspiration syndrome and 3 of 29 patients with respiratory distress syndrome received extracorporeal membrane oxygenation. Conclusions. Surfactant therapy in full-term infants with respiratory failure due to the meconium aspiration and respiratory distress syndromes is often effective in improving gas exchange. A randomized controlled trial of surfactant therapy at an earlier stage in the course of the illness should be performed.


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