TY  - JOUR
T1  - Impact of high altitude on pregnancy and newborn parameters
A1  - Gonzales, Gustavo F.
Y1  - 2012///
KW  - Altitude
KW  - Child
KW  - Fetal death
KW  - Gestational age
KW  - Pre-eclampsia
KW  - Pregnancy
JF  - Revista Peruana de Medicina Experimental y Salud Publica
VL  - 29
IS  - 2
SP  - 242
EP  - 249
DO  - 10.1590/S1726-46342012000200013
L1  - file:///C:/Users/sony/AppData/Local/Mendeley Ltd./Mendeley Desktop/Downloaded/Gonzales - 2012 - Impact of high altitude on pregnancy and newborn parameters.pdf
N2  - This review describes adverse outcomes in pregnancy after brief, intermittent, or permanent residence at high altitudes. Review of literature shows that congenital malformations rates are higher at high altitudes. Additionally, rates of stillbirths, small size for gestational age, and preeclampsia are increased in populations living at high altitudes and are associated with high maternal hemoglobin levels (>14.5 g/dl). In conclusion, a pregnant woman exposed briefly, intermittently, or permanently to high altitudes results in increased risk of adverse outcomes when compared to pregnancies observed at sea level.
ER  - 
TY  - JOUR
T1  - Human genetic adaptation to high altitudes: Current status and future prospects
A1  - Moore, Lorna G.
Y1  - 2017///
KW  - AMPK
KW  - Evolution
KW  - Fetal growth
KW  - HIF
KW  - Pregnancy
PB  - Elsevier Ltd
JF  - Quaternary International
VL  - 461
SP  - 4
EP  - 13
DO  - 10.1016/j.quaint.2016.09.045
UR  - http://dx.doi.org/10.1016/j.quaint.2016.09.045
L1  - file:///C:/Users/sony/AppData/Local/Mendeley Ltd./Mendeley Desktop/Downloaded/Moore - 2017 - Human genetic adaptation to high altitudes Current status and future prospects.pdf
N2  - The question of whether human populations have adapted genetically to high altitude has been of interest since studies began there in the early 1900s. Initially there was debate as to whether genetic adaptation to high altitude has taken place based, in part, on disciplinary orientation and the sources of evidence being considered. Studies centered on short-term responses, termed acclimatization, and the developmental changes occurring across lifetimes. A paradigm shift occurred with the advent of single nucleotide polymorphism (SNP) technologies and statistical methods for detecting evidence of natural selection, resulting in an exponential rise in the number of publications reporting genetic adaptation. Reviewed here are the various kinds of evidence by which adaptation to high altitude has been assessed and which have led to widespread acceptance of the idea that genetic adaptation to high altitude has occurred. While methodological and other challenges remain for determining the specific gene or genes involved and the physiological mechanisms by which they are exerting their effects, considerable progress has been realized as shown by recent studies in Tibetans, Andeans and Ethiopians. Further advances are anticipated with the advent of new statistical methods, whole-genome sequencing and other molecular techniques for finer-scale genetic mapping, and greater intradisciplinary and interdisciplinary collaboration to identify the functional consequences of the genes or gene regions implicated and the time scales involved.
ER  - 
TY  - JOUR
T1  - Humans at high altitude: Hypoxia and fetal growth
A1  - Moore, Lorna G.
A1  - Charles, Shelton M.
A1  - Julian, Colleen G.
Y1  - 2011///
KW  - Adaptation
KW  - Andean
KW  - Genetic
KW  - Pregnancy
KW  - Tibetan
KW  - Uteroplacental blood flow
PB  - Elsevier B.V.
JF  - Respiratory Physiology and Neurobiology
VL  - 178
IS  - 1
SP  - 181
EP  - 190
DO  - 10.1016/j.resp.2011.04.017
UR  - http://dx.doi.org/10.1016/j.resp.2011.04.017
L1  - file:///C:/Users/sony/AppData/Local/Mendeley Ltd./Mendeley Desktop/Downloaded/Moore, Charles, Julian - 2011 - Humans at high altitude Hypoxia and fetal growth.pdf
N2  - High-altitude studies offer insight into the evolutionary processes and physiological mechanisms affecting the early phases of the human lifespan. Chronic hypoxia slows fetal growth and reduces the pregnancy-associated rise in uterine artery (UA) blood flow. Multigenerational vs. shorter-term high-altitude residents are protected from the altitude-associated reductions in UA flow and fetal growth. Presently unknown is whether this fetal-growth protection is due to the greater delivery or metabolism of oxygen, glucose or other substrates or to other considerations such as mechanical factors protecting fragile fetal villi, the creation of a reserve protecting against ischemia/reperfusion injury, or improved placental O 2 transfer as the result of narrowing the A-V O 2 difference and raising uterine PvO2. Placental growth and development appear to be normal or modified at high altitude in ways likely to benefit diffusion. Much remains to be learned concerning the effects of chronic hypoxia on embryonic development. Further research is required for identifying the fetoplacental and maternal mechanisms responsible for transforming the maternal vasculature and regulating UA blood flow and fetal growth. Genomic as well as epigenetic studies are opening new avenues of investigation that can yield insights into the basic pathways and evolutionary processes involved. © 2011 Elsevier B.V.
ER  - 
TY  - JOUR
T1  - High Altitude During Pregnancy
A1  - Julian, Colleen Glyde
Y1  - 2011///
KW  - Altitude
KW  - Fetal growth
KW  - Hypoxia
KW  - Preeclampsia
KW  - Pregnancy
PB  - Elsevier Ltd
JF  - Clinics in Chest Medicine
VL  - 32
IS  - 1
SP  - 21
EP  - 31
DO  - 10.1016/j.ccm.2010.10.008
UR  - http://dx.doi.org/10.1016/j.ccm.2010.10.008
L1  - file:///C:/Users/sony/AppData/Local/Mendeley Ltd./Mendeley Desktop/Downloaded/Julian - 2011 - High Altitude During Pregnancy.pdf
N2  - One of the greatest physiologic challenges during pregnancy is to maintain an adequate supply of oxygenated blood to the uteroplacental circulation for fetal development. This challenge is magnified under conditions of limited oxygen availability. High altitude impairs fetal growth, increases the incidence of preeclampsia, and, as a result, significantly increases the risk of perinatal and/or maternal morbidity and mortality. This review summarizes the clinical consequences and physiologic challenges that emerge when pregnancy and high altitude coincide and highlights the adaptations that serve to protect oxygenation and fetal growth under conditions of chronic hypoxia. © 2011 Elsevier Inc.
ER  - 
TY  - JOUR
T1  - Are Permanent Residents of High Altitude Fully Adapted to Their Hypoxic Environment?
A1  - West, John B.
Y1  - 2017///
KW  - cognitive function
KW  - hypoxemia
KW  - oxygen conditioning
KW  - physical power
JF  - High Altitude Medicine and Biology
VL  - 18
IS  - 2
SP  - 135
EP  - 139
DO  - 10.1089/ham.2016.0152
L1  - file:///C:/Users/sony/AppData/Local/Mendeley Ltd./Mendeley Desktop/Downloaded/West - 2017 - Are Permanent Residents of High Altitude Fully Adapted to Their Hypoxic Environment.pdf
N2  - Millions of people live permanently at high altitude and many have been there for generations. It is sometimes claimed that these people have completely adapted to their environment, and certainly some remarkable genetic adaptations have recently been described. However there is now strong evidence that permanent residents are not completely adapted to the high altitude in the sense that they have fully compensated for the environmental hypoxia. By sea level standards, highlanders have severe chronic arterial hypoxemia. Furthermore, their maximum oxygen uptake increases if they descend, and recent measurements suggest that cognitive function is reduced in this population compared with a matched group at a lower altitude. Reproductive success is reduced at high altitude because neonatal mortality increases with altitude. The topic has recently gained importance because new technology enables the physiological altitude of permanent residents to be reduced by adding oxygen to the air of buildings on a large scale, a procedure known as oxygen conditioning. Its feasibility has been questioned, but in essence it is no different from air conditioning that is universally used to improve the well-being and productivity of millions of people in hot climates. Oxygen conditioning has the potential to do the same for permanent residents of high altitude.
ER  - 
TY  - JOUR
T1  - A quasi-experimental analysis of maternal altitude exposure and infant birth weight
A1  - Zahran, Sammy
A1  - Breunig, Ian M.
A1  - Link, Bruce G.
A1  - Snodgrass, Jeffrey G.
A1  - Weiler, Stephan
Y1  - 2014///
JF  - American Journal of Public Health
VL  - 104
IS  - SUPPL. 1
SP  - 166
EP  - 175
DO  - 10.2105/AJPH.2013.301725
L1  - file:///C:/Users/sony/AppData/Local/Mendeley Ltd./Mendeley Desktop/Downloaded/Zahran et al. - 2014 - A quasi-experimental analysis of maternal altitude exposure and infant birth weight.pdf
N2  - Objectives. We analyzed singleton births to determine the relationship between birth weight and altitude exposure. Methods. We analyzed 715 213 singleton births across 74 counties from the western states of Arizona, California, Colorado, Idaho, Montana, Nevada, New Mexico, Oregon, Utah, and Washington from January 1, 2000, to December 31, 2000. Birth data were obtained from the Division of Vital Statistics, National Center for Health Statistics, for registered births. Results. Regression analyses supported previous research by showing that a 1000-meter increase in maternal altitude exposure in pregnancy was associated with a 75.9-gram reduction in birth weight (95% confidence interval = -84.1, -67.6). Quantile regression models indicated significant and near-uniform depressant effects from altitude exposure across the conditional distribution of birth weight. Bivariate sample-selection models showed that a 1000-meter increase in altitude exposure, over and above baseline residential altitude, decreased birth weight by an additional 58.8 grams (95% confidence interval = -98.4, -19.2). Conclusions. Because of calculable health care-related costs associated with lower birth weight, our reported results might be of interest to clinicians practicing at higher altitudes.
ER  - 
TY  - JOUR
T1  - High-altitude residence alters blood-pressure course and increases hypertensive disorders of pregnancy hypertensive disorders of pregnancy
A1  - Bailey, Beth
A1  - Euser, Anna G
A1  - Bol, Kirk A
A1  - Julian, Colleen G
A1  - Moore, Lorna G
A1  - Bailey, Beth
A1  - Euser, Anna G
A1  - Bol, Kirk A
A1  - Julian, Colleen G
Y1  - 2020///
PB  - Taylor & Francis
JF  - The Journal of Maternal-Fetal & Neonatal Medicine
VL  - 0
IS  - 0
SP  - 1
EP  - 8
DO  - 10.1080/14767058.2020.1745181
UR  - https://doi.org/10.1080/14767058.2020.1745181
L1  - file:///C:/Users/sony/AppData/Local/Mendeley Ltd./Mendeley Desktop/Downloaded/Bailey et al. - 2020 - High-altitude residence alters blood-pressure course and increases hypertensive disorders of pregnancy hypertensi.pdf
ER  - 
TY  - RPRT
T1  - High-altitude hypoxia and preeclampsia
A1  - Zamudio, Stacy
KW  - Growth Factors
KW  - Hypoxemia
KW  - Oxidative Stress
KW  - Pregnancy
KW  - Review
KW  - Uteroplacental Blood Flow
KW  - Vascular Reactivity
JF  - Front Biosci
VL  - 12
SP  - 2967
EP  - 2977
L1  - file:///C:/Users/sony/AppData/Local/Mendeley Ltd./Mendeley Desktop/Downloaded/Zamudio - Unknown - High-altitude hypoxia and preeclampsia.pdf
N2  - The influence of hypoxia (lowered arterial blood and/or tissue PO 2) on fetoplacental development and the role of hypoxia in preeclampsia are major research foci in perinatal biology. While animal and cell models are of utility, we do not know whether artificial hypoxic stimuli mimic the pathological conditions attributed to hypoxic stress in vivo; we cannot distinguish the effects of hypoxia from under-or overlying pathologies. High altitude (>2700 m) is the natural experiment we can use to distinguish pathology from adaptation in human pregnancy. The two best known impacts of high altitude on pregnancy outcome are reduced fetal growth and an increased incidence preeclampsia. This review focuses on the mechanisms by which altitude increases maternal risk for the development of preeclampsia. The review first considers the evidence that placental hypoxia is causally involved in the development of preeclampsia. It then focuses on how data from studies of pregnant women at high altitude support (or do not support) etiological models of preeclampsia. Considered are the theories that reduced uteroplacental blood flow, circulating factors of placental origin, placental oxidative stress and increased maternal vascular reactivity are etiological in preeclampsia. The data suggest that oxidative stress and endothelial dysfunction have pathophysiological origins that are independent of placental hypoxia. We conclude that altitude shifts the individual risk for the development of preeclampsia because of impacts on multiple physiological systems, no one of which can be specifically pointed to as causal. The ancient Greeks gave eclampsia (lightning) its name because the disease struck quickly and without warning. Pre-eclampsia, the prodromal state, was characterized by racing pulses, a symptom that would now be recognized as hypertension. After more than 2000 years, the cause of preeclampsia remains unknown.
ER  - 
TY  - JOUR
T1  - High Altitude Adaptation in Tibetans
A1  - Wu, Tianyi
A1  - Kayser, Bengt
Y1  - 2006/09//
JF  - High Altitude Medicine & Biology
VL  - 7
IS  - 3
SP  - 193
EP  - 208
DO  - 10.1089/ham.2006.7.193
UR  - http://www.liebertpub.com/doi/10.1089/ham.2006.7.193
N2  - Since the beginning of the Himalayan climbing era, the anecdotal extraordinary physical performance at high altitude of Sherpas and Tibetans has intrigued scientists interested in altitude adaptation. These ethnic groups may have been living at high altitude for longer than any other population, and the hypothesis of a possible evolutionary genetic adaptation to altitude makes sense. Reviewed here is the evidence as to whether Tibetans are indeed better adapted for life and work at high altitude as compared to other populations and, if so, whether this better adaptation might be inborn. Tibetans, compared to lowlanders, maintain higher arterial oxygen saturation at rest and during exercise and show less loss of aerobic performance with increasing altitude. Tibetans have greater hypoxic and hypercapnic ventilatory responsiveness, larger lungs, better lung function, and greater lung diffusing capacity than lowlanders. Blood hemoglobin concentration is lower in Tibetans than in lowlanders or Andeans living at similar altitudes. Tibetans develop only minimal hypoxic pulmonary hypertension and have higher levels of exhaled nitric oxide than lowlanders or Andeans. Tibetans' sleep quality at altitude is better and they desaturate less at night. Several of these findings are also found in Tibetans born at low altitude when exposed for the first time to high altitude once adult. In conclusion, Tibetans indeed seem better adapted to life and work at high altitude, and this superior adaptation may very well be inborn, even though its exact genetic basis remains to be elucidated. © Mary Ann Liebert, Inc.
ER  - 
TY  - JOUR
T1  - Birth weight and altitude: A study in Peruvian communities
A1  - Mortola, Jacopo P.
A1  - Frappell, Peter B.
A1  - Aguero, Lourdes
A1  - Armstrong, Kathy
Y1  - 2000///
JF  - Journal of Pediatrics
VL  - 136
IS  - 3
SP  - 324
EP  - 329
DO  - 10.1067/mpd.2000.103507
L1  - file:///C:/Users/sony/AppData/Local/Mendeley Ltd./Mendeley Desktop/Downloaded/Mortola et al. - 2000 - Birth weight and altitude A study in Peruvian communities.pdf
N2  - We tested the hypothesis that at high altitude birth weight decreases once a critical barometric pressure (Pb) is reached. Birth weight data covering the 1-year period from November 1997 to October 1998 were collected in Peru from the data files of 15 community and mining centers between sea level and 4575 m altitude. These centers are scattered along the main road that joins Lima (on the Pacific shore) to Cerro de Pasco (4330 m) and surroundings. Above ~2000 m (ie, at Pb below ~590 mm Hg, inspired O2 partial pressure of ~114 mm Hg) and up to ~4500 m altitude birth weight declined at an average of 65 g for every additional 500 m altitude (or 105 g for every additional 50 mm Hg drop in Pb). This pattern did not differ between sexes. Averages and modal distributions of the birth weight from 2 hospitals in Cerro de Pasco (4330 m) serving different social groups were similar. Body length at birth was similar at various altitudes, with the exception of the 2 highest locations above 4500 m, where it was slightly reduced. From these data, together with additional data collected in the North of Peru (Chacas, 3360 m) and with results from other ethnic groups previously published, we conclude that the drop in birth weight at altitude is (1) apparent once the critical Pb of ~590 mm Hg is reached, corresponding to an altitude of ~2000 m, (2) proportional to the increase in altitude between ~2000 m and 4500 m, and (3) independent from socioeconomic factors.
ER  - 
TY  - ICOMM
T1  - altitud | Definición |
A1  - Diccionario de la lengua española | RAE
UR  - https://dle.rae.es/altitud
ER  - 
TY  - JOUR
T1  - Effects on cognitive functioning of acute, subacute and repeated exposures to high altitude
A1  - Pun, Matiram
A1  - Guadagni, Veronica
A1  - Bettauer, Kaitlyn M.
A1  - Drogos, Lauren L.
A1  - Aitken, Julie
A1  - Hartmann, Sara E.
A1  - Furian, Michael
A1  - Muralt, Lara
A1  - Lichtblau, Mona
A1  - Bader, Patrick R.
A1  - Rawling, Jean M.
A1  - Protzner, Andrea B.
A1  - Ulrich, Silvia
A1  - Bloch, Konrad E.
A1  - Giesbrecht, Barry
A1  - Poulin, Marc J.
Y1  - 2018///
JF  - Frontiers in Physiology
VL  - 9
IS  - AUG
SP  - 1
EP  - 15
DO  - 10.3389/fphys.2018.01131
N2  - Objective: Neurocognitive functions are affected by high altitude, however the altitude effects of acclimatization and repeated exposures are unclear. We investigated the effects of acute, subacute and repeated exposure to 5,050 m on cognition among altitude-naïve participants compared to control subjects tested at low altitude. Methods: Twenty-one altitude-naïve individuals (25.3 ± 3.8 years, 13 females) were exposed to 5,050 m for 1 week (Cycle 1) and re-exposed after a week of rest at sea-level (Cycle 2). Baseline (BL, 520 m), acute (Day 1, HA1) and acclimatization (Day 6, HA6, 5,050 m) measurements were taken in both cycles. Seventeen control subjects (24.9 ± 2.6 years, 12 females) were tested over a similar period in Calgary, Canada (1,103 m). The Reaction Time (RTI), Attention Switching Task (AST), Rapid Visual Processing (RVP) and One Touch Stockings of Cambridge (OTS) tasks were administered and outcomes were expressed in milliseconds/frequencies. Lake Louise Score (LLS) and blood oxygen saturation (SpO2) were recorded. Results: In both cycles, no significant changes were found with acute exposure on the AST total score, mean latency and SD. Significant changes were found upon acclimatization solely in the altitude group, with improved AST Mean Latency [HA1 (588 ± 92) vs. HA6 (526 ± 91), p < 0.001] and Latency SD [HA1 (189 ± 86) vs. HA6 (135 ± 65), p < 0.001] compared to acute exposure, in Cycle 1. No significant differences were present in the control group. When entering Acute SpO2 (HA1-BL), Acclimatization SpO2 (HA6-BL) and LLS score as covariates for both cycles, the effects of acclimatization on AST outcomes disappeared indicating that the changes were partially explained by SpO2 and LLS. The changes in AST Mean Latency [ΔBL (-61.2 ± 70.2) vs. ΔHA6 (-28.0 ± 58), p = 0.005] and the changes in Latency SD [ΔBL (-28.4 ± 41.2) vs. ΔHA6 (-0.2235 ± 34.8), p = 0.007] across the two cycles were smaller with acclimatization. However, the percent changes did not differ between cycles. These results indicate independent effects of altitude across repeated exposures. Conclusions: Selective and sustained attention are impaired at altitude and improves with acclimatization.The observed changes are associated, in part, with AMS score and SpO2. The gains in cognition with acclimatization during a first exposure are not carried over to repeated exposures.
ER  - 
TY  - JOUR
T1  - Diffuse Alveolar Damage-The Role of Oxygen, Shock, and Related Factors A Review
A1  - Katzenstein, Anna-Luise A
A1  - Bloor, Colin M
A1  - Leibow, Averill A
Y1  - 1976///
JF  - American Journal of Pathology
VL  - 85
IS  - 1
SP  - 210
EP  - 224
L1  - file:///C:/Users/sony/AppData/Local/Mendeley Ltd./Mendeley Desktop/Downloaded/Katzenstein, Bloor, Leibow - 1976 - Diffuse Alveolar Damage-The Role of Oxygen, Shock, and Related Factors A Review.pdf
N2  - EVIDENCE HAS ACCUMULATED that diffuse alveolar damage (DAD) can be produced in association with shock, by exposure of the lungs to oxygen at sufficiently high tension for a sufficient length of time, and during hypoperfusion as in pulmonary bypass, or by some combination of these factors. In fact, thev can potentiate each other. Diffuse alveolar damage is manifested b injur to alveolar lining and endothelial cells, pulmonary edema, hyaline membrane formation, and later by pro-liferative changes involving alveolar and bronchiolar lining cells, and interstitial cells."2 Such damage, while it may differ from case to case in intimate detail of pathogenesis and morphologx, represents a type of response of the lung to injury. It can be produced not only under the several circumstances mentioned but also by a multitude of other agents and mechanisms. There can be varying degrees of damage, and it is quite clear that many patients with DAD recover, and that the changes can resolve. In those with the more severe degrees of damage there can be progress to pulmonary fibrosis of a predominantly interstitial type, but occasionally also intraalveolar type. In fact, such DAD is an excellent model of the classic or 'usual" interstitial pneumonia (UIP) with changes indistinguishable from those described by Hamman and Rich.3 It is the aim of this review to consider factors in the pathogenesis of DAD and to enlarge upon concepts both of the complexity and non-specificity of the lesion. We will concentrate primarily upon the pulmonary lesions of oxygen toxicitv, shock, and related factors which, because thev have been so thoroughly studied, may be considered excellent models for the pathogenesis of DAD due to many other causes. The various pathologic stages in the evolution of oxygen-induced DAD wvill be described in detail using case material from our own consultation file. Finally, other factors which are unrelated but which produce similar pulmonary lesions will be briefly reviewed.
ER  - 
TY  - JOUR
T1  - Chronology of histological lesions in acute respiratory distress syndrome with diff use alveolar damage: A prospective cohort study of clinical autopsies
A1  - Thille, Arnaud W.
A1  - Esteban, Andrés
A1  - Fernández-Segoviano, Pilar
A1  - Rodriguez, José María
A1  - Aramburu, José Antonio
A1  - Vargas-Errázuriz, Patricio
A1  - Martín-Pellicer, Ana
A1  - Lorente, José A.
A1  - Frutos-Vivar, Fernando
Y1  - 2013/07//
PB  - Lancet Publishing Group
JF  - The Lancet Respiratory Medicine
VL  - 1
IS  - 5
SP  - 395
EP  - 401
DO  - 10.1016/S2213-2600(13)70053-5
UR  - http://www.thelancet.com/article/S2213260013700535/fulltext
UR  - http://www.thelancet.com/article/S2213260013700535/abstract
UR  - https://www.thelancet.com/journals/lanres/article/PIIS2213-2600(13)70053-5/abstract
N2  - Summary Background Diff use alveolar damage is the histological hallmark of acute respiratory distress syndrome (ARDS). However, the chronology of histological lesions is not well established. We aimed to determine the time to onset of exudative or proliferative changes and end-stage fi brosis in ARDS. Methods We analysed all patients who died between Jan 1, 1991, and Dec 31, 2010, in the intensive-care unit at the Hospital Universitario de Getafe, Madrid, Spain, and who had a clinical autopsy. Patients had to have clinical criteria for ARDS at time of death and histological features of diff use alveolar damage at autopsy examination. Capillary congestion and intra-alveolar oedema characterised the exudative phase whereas proliferation of alveolar cell type 2 or fi broblasts, or fi brosis characterised the proliferative phase. Findings We analysed 159 patients. The prevalence of exudative changes decreased over time, being reported in 74 (90%) of 82 patients with ARDS of less than 1 week duration, 40 (74%) of 54 patients with disease of 1-3 week duration, and only four (17%) of 23 patients with disease of longer than 3 weeks' duration (p<0·0001). The incidence of proliferative changes increased over time, and was reported in 44 (54%) of 82 patients with ARDS of less than 1-week duration, 42 (78%) of 54 patients with disease duration of 1-3 weeks, and 23 (100%) of 23 patients with disease duration longer than 3 weeks (p<0·0001). Fibrosis was noted in three (4%) of 82 patients with disease of less than 1 week duration, 13 (24%) of 54 patients with disease of 1-3-weeks' duration, and 14 (61%) of 23 patients with disease longer than 3-week duration (p<0·0001). Fibrosis was more frequent in ARDS of pulmonary origin than in that of extrapulmonary origin. Interpretation Histological features of the lungs were related to duration of ARDS. Within the fi rst week of evolution, exudative changes were predominant and fi brosis was rarely noted. Beyond the third week of evolution, proliferative changes were noted in all patients and fi brosis in two-thirds of them. Treatments with a potential eff ect on infl ammation or fi brosis, or both, should probably focus on the fi rst week after the onset of ARDS. Funding None.
ER  - 
TY  - JOUR
T1  - Prone position in patients with acute respiratory distress syndrome
A1  - Setten, Mariano
A1  - Plotnikow, Gustavo Adrián
A1  - Accoce, Matías
Y1  - 2016///
KW  - Acute
KW  - Complications
KW  - Etiology
KW  - Mechanical ventilation
KW  - Prone position
KW  - Refractory hypoxemia
KW  - Respiratory distress syndrome
JF  - Revista Brasileira de Terapia Intensiva
VL  - 28
IS  - 4
SP  - 452
EP  - 462
DO  - 10.5935/0103-507X.20160066
L1  - file:///C:/Users/sony/AppData/Local/Mendeley Ltd./Mendeley Desktop/Downloaded/Setten, Plotnikow, Accoce - 2016 - Prone position in patients with acute respiratory distress syndrome(2).pdf
N2  - Acute respiratory distress syndrome occupies a great deal of attention in intensive care units. Despite ample knowledge of the physiopathology of this syndrome, the focus in intensive care units consists mostly of life-supporting treatment and avoidance of the side effects of invasive treatments. Although great advances in mechanical ventilation have occurred in the past 20 years, with a significant impact on mortality, the incidence continues to be high. Patients with acute respiratory distress syndrome, especially the most severe cases, often present with refractory hypoxemia due to shunt, which can require additional treatments beyond mechanical ventilation, among which is mechanical ventilation in the prone position. This method, first recommended to improve oxygenation in 1974, can be easily implemented in any intensive care unit with trained personnel. Prone position has extremely robust bibliographic support. Various randomized clinical studies have demonstrated the effect of prone decubitus on the oxygenation of patients with acute respiratory distress syndrome measured in terms of the PaO2/FiO2 ratio, including its effects on increasing patient survival. The members of the Respiratory Therapists Committee of the Sociedad Argentina de Terapia Intensiva performed a narrative review with the objective of discovering the available evidence related to the implementation of prone position, changes produced in the respiratory system due to the application of this maneuver, and its impact on mortality. Finally, guidelines are suggested for decision-making.
ER  - 
TY  - JOUR
T1  - Nucleated red blood cells as predictors of mortality in patients with acute respiratory distress syndrome (ARDS): an observational study
A1  - Menk, Mario
A1  - Giebelhäuser, Lena
A1  - Vorderwülbecke, Gerald
A1  - Gassner, Martina
A1  - Graw, Jan A.
A1  - Weiss, Björn
A1  - Zimmermann, Mathias
A1  - Wernecke, Klaus D.
A1  - Weber-Carstens, Steffen
Y1  - 2018/12//
KW  - ARDS
KW  - Nucleated red blood cells
KW  - Outcome
KW  - Predictive value
KW  - Risk stratification
PB  - Springer Verlag
JF  - Annals of Intensive Care
VL  - 8
IS  - 1
SP  - 42
EP  - 42
DO  - 10.1186/s13613-018-0387-5
UR  - /pmc/articles/PMC5869325/
UR  - /pmc/articles/PMC5869325/?report=abstract
UR  - https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5869325/
L1  - file:///C:/Users/sony/AppData/Local/Mendeley Ltd./Mendeley Desktop/Downloaded/Menk et al. - 2018 - Nucleated red blood cells as predictors of mortality in patients with acute respiratory distress syndrome (ARDS) an.pdf
N2  - Background: Nucleated red blood cells (NRBCs) in critically ill patients are associated with increased mortality and poor outcome. The aim of the present study was to evaluate the predictive value of NRBCs in patients with acute respiratory distress syndrome (ARDS). Methods: This observational study was conducted at an ARDS referral center and included patients from 2007 to 2014. Daily NRBC counts were assessed and the predictive validity of NRBCs on mortality was statistically evaluated. A cutoff for prediction of mortality based on NRBCs was evaluated using ROC analysis and specified according to Youden’s method. Multivariate nonparametric analysis for longitudinal data was applied to prove for differences between groups over the whole time course. Independent predictors of mortality were identified with multiple logistic and Cox’ regression analyses. Kaplan–Meier estimations visualized the survival; the corresponding curves were tested for differences with the log-rank test. Results: A total of 404 critically ill ARDS patients were analyzed. NRBCs were found in 75.5% of the patients, which was associated with longer length of ICU stay [22 (11; 39) vs. 14 (7; 26) days; p < 0.05] and higher mortality rates (50.8 vs. 27.3%; p < 0.001). Logistic regression analysis with mortality as response showed NRBC positivity per se to be an independent risk factor for mortality in ARDS with a doubled risk for ICU death (OR 2.03; 95% CI 1.16–3.55; p < 0.05). Also, NRBC value at ICU admission was found to be an independent risk factor for mortality (OR 3.25; 95% CI 1.09–9.73, p = 0.035). A cutoff level of 220 NRBC/µl was associated with a more than tripled risk of ICU death (OR 3.2; 95% CI 1.93–5.35; p < 0.0001). ARDS patients below this threshold level had a significant survival advantage (median survival 85 days vs. 29 days; log rank p < 0.001). Presence of a severe ARDS was identified as independent risk factor for the occurrence of NRBCs > 220/µl (OR 1.81; 95% CI 1.1–2.97; p < 0.05). Conclusions: NRBCs may predict mortality in ARDS with high prognostic power. The presence of NRBCs in the blood might be regarded as a marker of disease severity indicating a higher risk of ICU death.
ER  - 
TY  - JOUR
T1  - No evidence of hemoglobin damage by SARS-CoV-2 infection
A1  - DeMartino, Anthony W.
A1  - Rose, Jason J.
A1  - Amdahl, Matthew B.
A1  - Dent, Matthew R.
A1  - Shah, Faraaz A.
A1  - Bain, William
A1  - McVerry, Bryan J.
A1  - Kitsios, Georgios D.
A1  - Tejero, Jesús
A1  - Gladwin, Mark T.
Y1  - 2020///
JF  - Haematologica
VL  - 105
IS  - 12
SP  - 2769
EP  - 2773
DO  - 10.3324/haematol.2020.264267
L1  - file:///C:/Users/sony/AppData/Local/Mendeley Ltd./Mendeley Desktop/Downloaded/DeMartino et al. - 2020 - No evidence of hemoglobin damage by SARS-CoV-2 infection.pdf
N2  - The severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) disease (COVID-19) has affected over 22 million patients worldwide as of August 2020. As the medical community seeks better understanding of the underlying pathophysiology of COVID-19, several theories have been proposed. One widely shared theory suggests that SARS-CoV-2 proteins directly interact with human hemoglobin (Hb) and facilitate removal of iron from the heme prosthetic group, leading to the loss of functional hemoglobin and accumulation of iron. Herein, we refute this theory. We compared clinical data from 21 critically ill COVID-19 patients to 21 non-COVID-19 acute respiratory distress syndrome (ARDS) patient controls, generating hemoglobin-oxygen dissociation curves from venous blood gases. This curve generated from the COVID-19 cohort matched the idealized oxygen-hemoglobin dissociation curve well (Pearson correlation R2=0.97, P<0.0001; a coefficient of variation of the root-mean-square deviation [CV(RMSD)] =7.3%). We further analyzed hemoglobin, total bilirubin, lactate dehydrogenase, iron, ferritin, and haptoglobin levels. For all analyzed parameters, patients with COVID-19 had similar levels compared to patients with ARDS without COVID-19. These results indicate that patients with COVID-19 do not exhibit any hemolytic anemia or a shift in the normal hemoglobin-oxygen dissociation curve. We therefore conclude that COVID-19 does not impact oxygen delivery through a mechanism involving red cell hemolysis and subsequent removal of iron from the heme prosthetic group in hemoglobin.
ER  - 
TY  - JOUR
T1  - Heme/Hemeoxygenase-1 System Is a Potential Therapeutic Intervention for COVID-19 Patients with Severe Complications
A1  - Maiti, Biplab K.
Y1  - 2020///
KW  - CO therapy
KW  - COVID-19
KW  - Hb-HO-1 system
KW  - iron chelation therapy
KW  - iron homeostasis
JF  - ACS Pharmacology and Translational Science
VL  - 3
IS  - 5
SP  - 1032
EP  - 1034
DO  - 10.1021/acsptsci.0c00136
L1  - file:///C:/Users/sony/AppData/Local/Mendeley Ltd./Mendeley Desktop/Downloaded/Maiti - 2020 - HemeHemeoxygenase-1 System Is a Potential Therapeutic Intervention for COVID-19 Patients with Severe Complications.pdf
N2  - Acute respiratory distress syndrome (ARDS) is one of the critical stages of COVID-19, leading to lung injury and hemolysis. Dysfunctional hemoglobin (Hb) suffers low-level oxygenation, overloaded iron, and down-regulation of hemeoxygenase-1 (HO-1), representing potential therapeutic interventions. This Viewpoint outlines the Hb-HO-1 system as a host-cell target, and proposes possible therapies, including iron chelation and CO therapies, against COVID-19 with ARDS.
ER  - 
TY  - GEN
T1  - Hemoglobin value may be decreased in patients with severe coronavirus disease 2019
A1  - Lippi, Giuseppe
A1  - Mattiuzzi, Camilla
Y1  - 2020/04//
PB  - Elsevier Editora Ltda
JF  - Hematology, Transfusion and Cell Therapy
VL  - 42
IS  - 2
SP  - 116
EP  - 117
DO  - 10.1016/j.htct.2020.03.001
UR  - /pmc/articles/PMC7128154/
UR  - https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7128154/
L1  - file:///C:/Users/sony/AppData/Local/Mendeley Ltd./Mendeley Desktop/Downloaded/Lippi, Mattiuzzi - 2020 - Hemoglobin value may be decreased in patients with severe coronavirus disease 2019.pdf
ER  - 
TY  - JOUR
T1  - Heights and haematology: the story of haemoglobin at altitude
A1  - Windsor, Jeremy S
Y1  - 2007///
JF  - Postgrad Med J
VL  - 83
SP  - 148
EP  - 151
DO  - 10.1136/pgmj.2006.049734
UR  - www.postgradmedj.com
L1  - file:///C:/Users/sony/AppData/Local/Mendeley Ltd./Mendeley Desktop/Downloaded/Windsor - 2007 - Heights and haematology the story of haemoglobin at altitude.pdf
ER  - 
TY  - GEN
T1  - The role of red blood cells and cell-free hemoglobin in the pathogenesis of ARDS
A1  - Janz, David R.
A1  - Ware, Lorraine B.
Y1  - 2015/06//
KW  - ARDS
KW  - Cell-free hemoglobin
KW  - Critical illness
KW  - Red blood cell
KW  - Sepsis
PB  - BioMed Central Ltd.
JF  - Journal of Intensive Care
VL  - 3
IS  - 1
SP  - 20
EP  - 20
DO  - 10.1186/s40560-015-0086-3
UR  - http://www.jintensivecare.com/content/3/1/20
L1  - file:///C:/Users/sony/AppData/Local/Mendeley Ltd./Mendeley Desktop/Downloaded/Janz, Ware - 2015 - The role of red blood cells and cell-free hemoglobin in the pathogenesis of ARDS.pdf
N1  - SDRA ocurre inflamación y coagulación. 
Obj: revisr cambios en rbc en enf critica
N2  - The primary focus of research into the pathophysiology of the acute respiratory distress syndrome (ARDS) has been on the interaction between the lung, underlying causes of ARDS, and the role of white blood cells and platelets in contributing to lung injury. Given a lack of specific therapies for this common complication of critical illness, further insight into the pathophysiology of this syndrome is greatly needed to develop targeted interventions. The red blood cell (RBC) has been reported to undergo deleterious changes in critical illness and be present in the alveoli of patients with ARDS. Release of RBC contents is known to be injurious in other conditions but has only recently been studied in critical illness and ARDS. The contribution of the RBC to ARDS represents a new avenue of research that may produce new, targeted therapies for this deadly syndrome.
ER  - 
TY  - JOUR
T1  - Derivation and validation of SpO2 /FiO2 ratio to impute for PaO2 / FiO2 ratio in the respiratory component of the Sequential Organ Failure Assessment (SOFA) Score
A1  - Pratik P. Pandharipande
A1  - Shintani, Ayumi K.
A1  - Hagerman, Heather E.
A1  - Jacques, Paul J. St
A1  - Rice, Todd W.
A1  - Sanders, Neal W.
A1  - Ware, Lorraine B.
A1  - Bernard, Gordon R.
A1  - Ely, E. Wesley
Y1  - 2008///
KW  - epiblast
KW  - gfp fusion
KW  - histone h2b-
KW  - icm
KW  - lineage specification
KW  - live imaging
KW  - mouse blastocyst
KW  - pdgfr α
KW  - primitive endoderm
JF  - Bone
VL  - 23
IS  - 1
SP  - 1
EP  - 7
SN  - 6176321972
DO  - 10.1097/CCM.0b013e31819cefa9.Derivation
UR  - https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3624763/pdf/nihms412728.pdf
L1  - file:///C:/Users/sony/AppData/Local/Mendeley Ltd./Mendeley Desktop/Downloaded/Pratik P. Pandharipande et al. - 2008 - Derivation and validation of SpO2 FiO2 ratio to impute for PaO2 FiO2 ratio in the respiratory c.pdf
L1  - file:///C:/Users/sony/AppData/Local/Mendeley Ltd./Mendeley Desktop/Downloaded/Pratik P. Pandharipande et al. - 2008 - Derivation and validation of SpO2 FiO2 ratio to impute for PaO2 FiO2 ratio in the respiratory(2).pdf
ER  - 
TY  - JOUR
T1  - Comparison of the SpO2/FIO2 ratio and the PaO 2/FIO2 ratio in patients with acute lung injury or ARDS
A1  - Rice, Todd W.
A1  - Wheeler, Arthur P.
A1  - Bernard, Gordon R.
A1  - Hayden, Douglas L.
A1  - Schoenfeld, David A.
A1  - Ware, Lorraine B.
Y1  - 2007///
KW  - ARDS
KW  - Acute lung injury
KW  - Definition
KW  - Pao2/fraction of inspired oxygen ratio
JF  - Chest
VL  - 132
IS  - 2
SP  - 410
EP  - 417
DO  - 10.1378/chest.07-0617
L1  - file:///C:/Users/sony/AppData/Local/Mendeley Ltd./Mendeley Desktop/Downloaded/Rice et al. - 2007 - Comparison of the SpO2FIO2 ratio and the PaO 2FIO2 ratio in patients with acute lung injury or ARDS.pdf
N2  - Background: The diagnostic criteria for acute lung injury (ALI) and ARDS utilize the PaO2/fraction of inspired oxygen (FIO2) [P/F] ratio measured by arterial blood gas analysis to assess the degree of hypoxemia. We hypothesized that the pulse oximetric saturation (SpO2)/FIO 2 (S/F) ratio can be substituted for the P/F ratio in assessing the oxygenation criterion of ALI. Methods: Corresponding measurements of SpO 2 (values ≤ 97%) and PaO2 from patients enrolled in the ARDS Network trial of a lower tidal volume ventilator strategy (n = 672) were compared to determine the relationship between S/F and P/F. S/F threshold values correlating with P/F ratios of 200 (ARDS) and 300 (ALI) were determined. Similar measurements from patients enrolled in the ARDS Network trial of lower vs higher positive end-expiratory pressure (n = 402) were utilized for validation. Results: In the derivation data set (2,613 measurements), the relationship between S/F and P/F was described by the following equation: S/F = 64 + 0.84 x (P/F) [p < 0.0001; r = 0.89). An S/F ratio of 235 corresponded with a P/F ratio of 200, while an S/F ratio of 315 corresponded with a P/F ratio of 300. The validation database (2,031 measurements) produced a similar linear relationship. The S/F ratio threshold values of 235 and 315 resulted in 85% sensitivity with 85% specificity and 91% sensitivity with 56% specificity, respectively, for P/F ratios of 200 and 300. Conclusion: S/F ratios correlate with P/F ratios. S/F ratios of 235 and 315 correlate with P/F ratios of 200 and 300, respectively, for diagnosing and following up patients with ALI and ARDS.
ER  - 
TY  - JOUR
T1  - Hospital incidence and outcomes of the acute respiratory distress syndrome using the Kigali modification of the Berlin definition
A1  - Riviello, Elisabeth D.
A1  - Kiviri, Willy
A1  - Twagirumugabe, Theogene
A1  - Mueller, Ariel
A1  - Banner-Goodspeed, Valerie M.
A1  - Officer, Laurent
A1  - Novack, Victor
A1  - Mutumwinka, Marguerite
A1  - Talmor, Daniel S.
A1  - Fowler, Robert A.
Y1  - 2016///
KW  - Acute respiratory distress syndrome
KW  - Africa
KW  - Epidemiology
JF  - American Journal of Respiratory and Critical Care Medicine
VL  - 193
IS  - 1
SP  - 52
EP  - 59
DO  - 10.1164/rccm.201503-0584OC
L1  - file:///C:/Users/sony/AppData/Local/Mendeley Ltd./Mendeley Desktop/Downloaded/Riviello et al. - 2016 - Hospital incidence and outcomes of the acute respiratory distress syndrome using the Kigali modification of the.pdf
N2  - Rationale: Estimates of the incidence of the acute respiratory distress syndrome (ARDS) in high- and middle-income countries vary from 10.1 to 86.2 per 100,000 person-years in the general population. The epidemiology of ARDS has not been reported for a low-income country at the level of the population, hospital, or intensive care unit (ICU). The Berlin definition may not allow identification of ARDS in resource-constrained settings. Objectives: To estimate the incidence and outcomes of ARDS at a Rwandan referral hospital using the Kigali modification of the Berlin definition: without requirement for positive endexpiratory pressure, hypoxia cutoff of SpO2/FIO2 less than or equal to 315, and bilateral opacities on lung ultrasound or chest radiograph. Methods: We screened every adult patient for hypoxia at a public referral hospital in Rwanda for 6 weeks. For every patient with hypoxia, we collected data on demographics and ARDS risk factors, performed lung ultrasonography, and evaluated chest radiography when available. Measurements and Main Results: Forty-two (4.0%) of 1,046 hospital admissions met criteria for ARDS. Using various prespecified cutoffs for the SpO2/FIO2 ratio resulted in almost identical hospital incidence values. Median age for patients with ARDS was 37 years, and infection was the most common risk factor (44.1%). Only 30.9% of patients with ARDS were admitted to an ICU, and hospital mortality was 50.0%. Using traditional Berlin criteria, no patients would have met criteria for ARDS. Conclusions: ARDS seems to be a common and fatal syndrome in a hospital in Rwanda, with few patients admitted to an ICU. The Berlin definition is likely to underestimate the impact of ARDS in low-income countries, where resources to meet the definition requirements are lacking. Although the Kigali modification requires validation before widespread use, we hope this study stimulates further work in refining an ARDS definition that can be consistently used in all settings.
ER  - 
TY  - JOUR
T1  - Nonlinear Imputation of PaO 2 /FIO 2 From SpO 2 /FIO 2 Among Patients With Acute Respiratory Distress Syndrome
A1  - Brown, Samuel M
A1  - Grissom, Colin K
A1  - Moss, Marc
A1  - Rice, Todd W
A1  - Schoenfeld, David
A1  - Hou, Peter C
A1  - Thompson, ; B Taylor
A1  - Brower, Roy G
Y1  - 2016///
KW  - acute respiratory distress syndrome
KW  - pulse oximetry
KW  - respiratory failure
KW  - severity scores
JF  - CHEST
VL  - 150
SP  - 307
EP  - 313
DO  - 10.1016/j.chest.2016.01.003
UR  - http://dx.doi.org/10.1016/j.chest.2016.01.003
L1  - file:///C:/Users/sony/AppData/Local/Mendeley Ltd./Mendeley Desktop/Downloaded/Brown et al. - 2016 - Nonlinear Imputation of PaO 2 FIO 2 From SpO 2 FIO 2 Among Patients With Acute Respiratory Distress Syndrome.pdf
ER  - 
TY  - RPRT
T1  - Seroprevalencia de SARS-CoV-2 durante la epidemia en Colombia: estudio país
A1  - Instituto Nacional de Salud
Y1  - 2020///
SP  - 1
EP  - 14
CY  - Bogotá
SN  - 0000158534
DO  - 10.4269/ajt
UR  - http://www.ajtmh.org/content/journals/10.4269/ajt-
L1  - file:///C:/Users/sony/AppData/Local/Mendeley Ltd./Mendeley Desktop/Downloaded/Instituto Nacional de Salud - 2020 - Seroprevalencia de SARS-CoV-2 durante la epidemia en Colombia estudio país.pdf
ER  - 
TY  - JOUR
T1  - Proportion of asymptomatic coronavirus disease 2019: A systematic review and meta-analysis
A1  - He, Jingjing
A1  - Guo, Yifei
A1  - Mao, Richeng
A1  - Zhang, Jiming
Y1  - 2021/02//
KW  - COVID-19
KW  - Coronavirus disease 2019
KW  - SARS-CoV-2
KW  - asymptomatic infection
KW  - children coronavirus disease 2019
KW  - presymptomatic infection
PB  - John Wiley and Sons Inc
JF  - Journal of Medical Virology
VL  - 93
IS  - 2
SP  - 820
EP  - 830
DO  - 10.1002/jmv.26326
UR  - https://pubmed.ncbi.nlm.nih.gov/32691881/
L1  - file:///C:/Users/sony/AppData/Local/Mendeley Ltd./Mendeley Desktop/Downloaded/He et al. - 2021 - Proportion of asymptomatic coronavirus disease 2019 A systematic review and meta-analysis.pdf
N2  - We aim to systematically review the characteristics of asymptomatic infection in the coronavirus disease 2019 (COVID-19). PubMed and EMBASE were electronically searched to identify original studies containing the rate of asymptomatic infection in COVID-19 patients before 20 May 2020. Then mate-analysis was conducted using R version 3.6.2. A total of 50 155 patients from 41 studies with confirmed COVID-19 were included. The pooled percentage of asymptomatic infection is 15.6% (95% CI, 10.1%-23.0%). Ten included studies contain the number of presymptomatic patients, who were asymptomatic at screening point and developed symptoms during follow-up. The pooled percentage of presymptomatic infection among 180 initially asymptomatic patients is 48.9% (95% CI, 31.6%-66.2%). The pooled proportion of asymptomatic infection among 1152 COVID-19 children from 11 studies is 27.7% (95% CI, 16.4%-42.7%), which is much higher than patients from all aged groups. Abnormal CT features are common in asymptomatic COVID-19 infection. For 36 patients from 4 studies that CT results were available, 15 (41.7%) patients had bilateral involvement and 14 (38.9%) had unilateral involvement in CT results. Reduced white blood cell count, increased lactate dehydrogenase, and increased C-reactive protein were also recorded. About 15.6% of confirmed COVID-19 patients are asymptomatic. Nearly half of the patients with no symptoms at detection time will develop symptoms later. Children are likely to have a higher proportion of asymptomatic infection than adults. Asymptomatic COVID-19 patients could have abnormal laboratory and radiational manifestations, which can be used as screening strategies to identify asymptomatic infection.
ER  - 
TY  - ICOMM
T1  - COVID-19: What proportion are asymptomatic? - The Centre for Evidence-Based Medicine
A1  - Carl Heneghan
A1  - Jon Brassey
A1  - Jefferson, Tom
Y1  - 2020///
UR  - https://www.cebm.net/covid-19/covid-19-what-proportion-are-asymptomatic/
ER  - 
TY  - JOUR
T1  - Characterisation of the first 250 000 hospital admissions for COVID-19 in Brazil: a retrospective analysis of nationwide data
A1  - Ranzani, Otavio T.
A1  - Bastos, Leonardo S.L.
A1  - Gelli, João Gabriel M.
A1  - Marchesi, Janaina F.
A1  - Baião, Fernanda
A1  - Hamacher, Silvio
A1  - Bozza, Fernando A.
Y1  - 2021///
PB  - Lancet Publishing Group
JF  - The Lancet Respiratory Medicine
VL  - 0
IS  - 0
DO  - 10.1016/S2213-2600(20)30560-9
UR  - http://www.thelancet.com/article/S2213260020305609/fulltext
UR  - http://www.thelancet.com/article/S2213260020305609/abstract
UR  - https://www.thelancet.com/journals/lanres/article/PIIS2213-2600(20)30560-9/abstract
L1  - file:///C:/Users/sony/AppData/Local/Mendeley Ltd./Mendeley Desktop/Downloaded/Ranzani et al. - 2021 - Characterisation of the first 250 000 hospital admissions for COVID-19 in Brazil a retrospective analysis of nat.pdf
N2  - Background: Most low-income and middle-income countries (LMICs) have little or no data integrated into a national surveillance system to identify characteristics or outcomes of COVID-19 hospital admissions and the impact of the COVID-19 pandemic on their national health systems. We aimed to analyse characteristics of patients admitted to hospital with COVID-19 in Brazil, and to examine the impact of COVID-19 on health-care resources and in-hospital mortality. Methods: We did a retrospective analysis of all patients aged 20 years or older with quantitative RT-PCR (RT-qPCR)-confirmed COVID-19 who were admitted to hospital and registered in SIVEP-Gripe, a nationwide surveillance database in Brazil, between Feb 16 and Aug 15, 2020 (epidemiological weeks 8–33). We also examined the progression of the COVID-19 pandemic across three 4-week periods within this timeframe (epidemiological weeks 8–12, 19–22, and 27–30). The primary outcome was in-hospital mortality. We compared the regional burden of hospital admissions stratified by age, intensive care unit (ICU) admission, and respiratory support. We analysed data from the whole country and its five regions: North, Northeast, Central-West, Southeast, and South. Findings: Between Feb 16 and Aug 15, 2020, 254 288 patients with RT-qPCR-confirmed COVID-19 were admitted to hospital and registered in SIVEP-Gripe. The mean age of patients was 60 (SD 17) years, 119 657 (47%) of 254 288 were aged younger than 60 years, 143 521 (56%) of 254 243 were male, and 14 979 (16%) of 90 829 had no comorbidities. Case numbers increased across the three 4-week periods studied: by epidemiological weeks 19–22, cases were concentrated in the North, Northeast, and Southeast; by weeks 27–30, cases had spread to the Central-West and South regions. 232 036 (91%) of 254 288 patients had a defined hospital outcome when the data were exported; in-hospital mortality was 38% (87 515 of 232 036 patients) overall, 59% (47 002 of 79 687) among patients admitted to the ICU, and 80% (36 046 of 45 205) among those who were mechanically ventilated. The overall burden of ICU admissions per ICU beds was more pronounced in the North, Southeast, and Northeast, than in the Central-West and South. In the Northeast, 1545 (16%) of 9960 patients received invasive mechanical ventilation outside the ICU compared with 431 (8%) of 5388 in the South. In-hospital mortality among patients younger than 60 years was 31% (4204 of 13 468) in the Northeast versus 15% (1694 of 11 196) in the South. Interpretation: We observed a widespread distribution of COVID-19 across all regions in Brazil, resulting in a high overall disease burden. In-hospital mortality was high, even in patients younger than 60 years, and worsened by existing regional disparities within the health system. The COVID-19 pandemic highlights the need to improve access to high-quality care for critically ill patients admitted to hospital with COVID-19, particularly in LMICs. Funding: National Council for Scientific and Technological Development (CNPq), Coordinating Agency for Advanced Training of Graduate Personnel (CAPES), Carlos Chagas Filho Foundation for Research Support of the State of Rio de Janeiro (FAPERJ), and Instituto de Salud Carlos III.
ER  - 
TY  - JOUR
T1  - Proportion of asymptomatic infection among COVID-19 positive persons and their transmission potential: A systematic review and meta-analysis
A1  - Yanes-Lane, Mercedes
A1  - Winters, Nicholas
A1  - Fregonese, Federica
A1  - Bastos, Mayara
A1  - Perlman-Arrow, Sara
A1  - Campbell, Jonathon R.
A1  - Menzies, Dick
ED  - Serra, Raffaele
Y1  - 2020/11//
KW  - COVID 19
KW  - Coughing
KW  - Infectious disease epidemiology
KW  - Metaanalysis
KW  - Nursing homes
KW  - Obstetrics and gynecology
KW  - Systematic reviews
KW  - Virus testing
PB  - Public Library of Science
JF  - PLOS ONE
VL  - 15
IS  - 11
SP  - e0241536
EP  - e0241536
DO  - 10.1371/journal.pone.0241536
UR  - https://dx.plos.org/10.1371/journal.pone.0241536
L1  - file:///C:/Users/sony/AppData/Local/Mendeley Ltd./Mendeley Desktop/Downloaded/Yanes-Lane et al. - 2020 - Proportion of asymptomatic infection among COVID-19 positive persons and their transmission potential A syste.pdf
N2  - Background The study objective was to conduct a systematic review and meta-analysis on the proportion of asymptomatic infection among coronavirus disease 2019 (COVID-19) positive persons and their transmission potential. Methods We searched Embase, Medline, bioRxiv, and medRxiv up to 22 June 2020. We included cohorts or cross-sectional studies which systematically tested populations regardless of symptoms for COVID-19, or case series of any size reporting contact investigations of asymptomatic index patients. Two reviewers independently extracted data and assessed quality using pre-specified criteria. Only moderate/high quality studies were included. The main outcomes were proportion of asymptomatic infection among COVID-19 positive persons at testing and through follow-up, and secondary attack rate among close contacts of asymptomatic index patients. A qualitative synthesis was performed. Where appropriate, data were pooled using random effects meta-analysis to estimate proportions and 95% confidence intervals (95% CI). Results Of 6,137 identified studies, 71 underwent quality assessment after full text review, and 28 were high/moderate quality and were included. In two general population studies, the proportion of asymptomatic COVID-19 infection at time of testing was 20% and 75%, respectively; among three studies in contacts it was 8.2% to 50%. In meta-analysis, the proportion (95% CI) of asymptomatic COVID-19 infection in obstetric patients was 95% (45% to 100%) of which 59% (49% to 68%) remained asymptomatic through follow-up; among nursing home residents, the proportion was 54% (42% to 65%) of which 28% (13% to 50%) remained asymptomatic through follow-up. Transmission studies were too heterogenous to meta-analyse. Among five transmission studies, 18 of 96 (18.8%) close contacts exposed to asymptomatic index patients were COVID-19 positive. Conclusions Despite study heterogeneity, the proportion of asymptomatic infection among COVID-19 positive persons appears high and transmission potential seems substantial. To further our understanding, high quality studies in representative general population samples are required.
ER  - 
TY  - ICOMM
T1  - Coronavirus Colombia
A1  - Instituto Nacional de Salud
Y1  - 2020///
UR  - https://www.ins.gov.co/Noticias/Paginas/Coronavirus.aspx
ER  - 
TY  - JOUR
T1  - Acute respiratory distress syndrome: The Berlin definition
A1  - Ranieri, V. Marco
A1  - Rubenfeld, Gordon D.
A1  - Thompson, B. Taylor
A1  - Ferguson, Niall D.
A1  - Caldwell, Ellen
A1  - Fan, Eddy
A1  - Camporota, Luigi
A1  - Slutsky, Arthur S.
Y1  - 2012///
JF  - JAMA - Journal of the American Medical Association
VL  - 307
IS  - 23
SP  - 2526
EP  - 2533
DO  - 10.1001/jama.2012.5669
L1  - file:///C:/Users/sony/AppData/Local/Mendeley Ltd./Mendeley Desktop/Downloaded/Ranieri et al. - 2012 - Acute respiratory distress syndrome The Berlin definition.pdf
N2  - The acute respiratory distress syndrome (ARDS) was defined in 1994 by the American-European Consensus Conference (AECC); since then, issues regarding the reliability and validity of this definition have emerged. Using a consensus process, a panel of experts convened in 2011 (an initiative of the European Society of Intensive Care Medicine endorsed by the American Thoracic Society and the Society of Critical Care Medicine) developed the Berlin Definition, focusing on feasibility, reliability, validity, and objective evaluation of its performance. A draft definition proposed 3 mutually exclusive categories of ARDS based on degree of hypoxemia: mild (200 mm Hg < PaO 2/FIO 2 ≤ 300 mmHg), moderate (100mmHg < PaO 2/FIO 2 ≤ 200mmHg), and severe (PaO 2/FIO 2 ≤ 100mmHg) and 4 ancillary variables for severe ARDS: radiographic severity, respiratory system compliance (≤40 mL/cm H 2O), positive endexpiratory pressure (≥10 cm H 2O), and corrected expired volume per minute (≥10 L/min). The draft Berlin Definition was empirically evaluated using patient-level meta-analysis of 4188 patients with ARDS from 4 multicenter clinical data sets and 269 patients with ARDS from 3 single-center data sets containing physiologic information. The 4 ancillary variables did not contribute to the predictive validity of severe ARDS for mortality and were removed from the definition. Using the Berlin Definition, stages of mild, moderate, and severe ARDS were associated with increased mortality (27%;95%CI, 24%-30%; 32%;95% CI, 29%-34%; and 45%; 95% CI, 42%-48%, respectively; P < .001) and increased median duration of mechanical ventilation in survivors (5 days; interquartile [IQR], 2-11; 7 days; IQR, 4-14; and 9 days; IQR, 5-17, respectively; P < .001). Compared with the AECC definition, the final Berlin Definition had better predictive validity for mortality, with an area under the receiver operating curve of 0.577 (95% CI, 0.561-0.593) vs 0.536 (95% CI, 0.520-0.553; P < .001). This updated and revised Berlin Definition for ARDS addresses a number of the limitations of the AECC definition. The approach of combining consensus discussions with empirical evaluation may serve as a model to create more accurate, evidence-based, critical illness syndrome definitions and to better inform clinical care, research, and health services planning. ©2012 American Medical Association. All rights reserved.
ER  - 
TY  - JOUR
T1  - Delivered oxygen concentrations using low-flow and high-flow nasal cannulas
A1  - Wettstein, Richard B.
A1  - Shelledy, David C.
A1  - Peters, Jay I.
Y1  - 2005///
KW  - Delivered oxygen concentration
KW  - FIO2
KW  - Nasal cannula
KW  - Oxygen
JF  - Respiratory Care
VL  - 50
IS  - 5
SP  - 604
EP  - 609
L1  - file:///C:/Users/sony/AppData/Local/Mendeley Ltd./Mendeley Desktop/Downloaded/Wettstein, Shelledy, Peters - 2005 - Delivered oxygen concentrations using low-flow and high-flow nasal cannulas.pdf
N2  - INTRODUCTION: Nasal cannulas are commonly used to deliver oxygen in acute and chronic care settings; however, there are few data available on delivered fraction of inspired oxygen (FIO2). The purposes of this study were to determine the delivered FIO2 on human subjects using low-flow and high-flow nasal cannulas, and to determine the effects of mouth-closed and mouth-open breathing on FIO2. METHODS: We measured the pharyngeal FIO2 delivered by adult nasal cannulas at 1-6 L/min and high-flow nasal cannulas at 6-15 L/min consecutively in 10 normal subjects. Oxygen was initiated at 1 L/min, with the subject at rest, followed by a period of rapid breathing. Gas samples were aspirated from a nasal catheter positioned with the tip behind the uvula. This process was repeated at each liter flow. Mean, standard deviation, and range were calculated at each liter flow. F IO2 during mouth-open and mouth-closed breathing were compared using the dependent t test for paired values, to determine if there were significant differences. RESULTS: The mean resting FIO2 ranged from 0.26-0.54 at 1-6 L/min to 0.54-0.75 at 6-15 L/min. During rapid breathing the mean F IO2 ranged from 0.24-0.45 at 1-6 L/min to 0.49-0.72 at 6-15 L/min. The mean FIO2 increased with increasing flow rates. The standard deviation (± 0.04-0.15) and range were large, and FIO2 varied widely within and between subjects. FIO2 during mouth-open breathing was significantly (p < 0.05) greater than that during mouth-closed breathing. CONCLUSIONS: FIO2 increased with increasing flow. Subjects who breathed with their mouths open attained a significantly higher FIO2, compared to those who breathed with their mouths closed. © 2005 Daedalus Enterprises.
ER  - 
TY  - JOUR
T1  - Role of HIF-1α in the regulation ACE and ACE2 expression in hypoxic human pulmonary artery smooth muscle cells
A1  - Zhang, Ruifeng
A1  - Wu, Yingli
A1  - Zhao, Meng
A1  - Liu, Chuanxu
A1  - Zhou, Lin
A1  - Shen, Shaoming
A1  - Liao, Shihua
A1  - Yang, Kun
A1  - Li, Qingyun
A1  - Wan, Huanying
Y1  - 2009///
KW  - Angiotensin II
KW  - Angiotensin-converting enzyme 2
KW  - Hypoxia
KW  - Hypoxia-inducible factor 1α
PB  - Am J Physiol Lung Cell Mol Physiol
JF  - American Journal of Physiology - Lung Cellular and Molecular Physiology
VL  - 297
IS  - 4
DO  - 10.1152/ajplung.90415.2008
UR  - https://pubmed.ncbi.nlm.nih.gov/19592460/
L1  - file:///C:/Users/sony/AppData/Local/Mendeley Ltd./Mendeley Desktop/Downloaded/Zhang et al. - 2009 - Role of HIF-1α in the regulation ACE and ACE2 expression in hypoxic human pulmonary artery smooth muscle cells.pdf
N2  - Angiotensin-converting enzyme (ACE) enhances the proliferation and migration of pulmonary artery smooth muscle cells (PASMCs), which contribute to the pathogenesis of hypoxic pulmonary hypertension (HPH). Previous reports have demonstrated that hypoxia upregulates ACE expression, but the underlying mechanism is unknown. Here, we found that ACE is persistently upregulated in PASMCs on the transcriptional level during hypoxia. Hypoxia-inducible factor 1α (HIF-1α), a key transcription factor activated during hypoxia, was able to upregulate ACE protein expression under normoxia, whereas knockdown of HIF-1α expression in PASMCs inhibited hypoxia-induced ACE upregulation. Furthermore, HIF-1α can bind and transactivate the ACE promoter directly. Therefore, we report that ACE is a novel target of HIF-1α. Recently, a homolog of ACE, ACE2, was reported to counterbalance the function of ACE. In contrast to ACE, we found that ACE2 mRNA and protein levels increased during the early stages of hypoxia and decreased to near-baseline levels at the later stages after HIF-1α accumulation. Thus HIF-1α inhibited ACE2 expression, and the accumulated ANG II catalyzed by ACE is a key mediator in the downregulation of ACE2 by HIF-1α. Moreover, a reduction of ACE2 expression in PASMCs by RNA interference was accompanied by significantly enhanced proliferation and migration during hypoxia. We conclude that ACE is directly regulated by HIF-1α, whereas ACE2 is regulated in a bidirectional way during hypoxia and may play a protective role during the development of HPH. In sum, these findings contribute to the understanding of the pathogenesis of HPH. Copyright © 2009 the American Physiological Society.
ER  - 
TY  - JOUR
T1  - Hematocrit and incidence of venous thromboembolism
A1  - Folsom, Aaron R.
A1  - Wang, Wendy
A1  - Parikh, Romil
A1  - Lutsey, Pamela L.
A1  - Beckman, Joan D.
A1  - Cushman, Mary
Y1  - 2020/03//
KW  - hematocrit
KW  - hemoglobin
KW  - prospective studies
KW  - pulmonary embolism
KW  - venous thrombosis
PB  - Wiley
JF  - Research and Practice in Thrombosis and Haemostasis
VL  - 4
IS  - 3
SP  - 422
EP  - 428
DO  - 10.1002/rth2.12325
UR  - https://onlinelibrary.wiley.com/doi/full/10.1002/rth2.12325
UR  - https://onlinelibrary.wiley.com/doi/abs/10.1002/rth2.12325
UR  - https://onlinelibrary.wiley.com/doi/10.1002/rth2.12325
L1  - file:///C:/Users/sony/AppData/Local/Mendeley Ltd./Mendeley Desktop/Downloaded/Folsom et al. - 2020 - Hematocrit and incidence of venous thromboembolism.pdf
N2  - <h4>Background</h4>Patients with polycythemia vera with high hematocrit have increased risk of venous thromboembolism (VTE).<h4>Objective</h4>To determine whether high hematocrit in the general population is also associated with elevated VTE risk.<h4>Methods</h4>The prospective Atherosclerosis Risk in Communities Study performed a complete blood count in 13 891 adults aged 45 to 64 in 1987 to 1989. We identified incident hospitalized VTEs through 2015 and performed proportional hazards regression analyses using race-sex-specific categorization of hematocrit percentiles (ie, <5th, 5th to <25th, 25th to <75th, 75th to <95th, and 95th-100th percentiles, with the 25th to <75th percentile serving as the reference).<h4>Results</h4>Over a median follow-up of 26 years, 800 participants had an incident venous thrombosis of the leg and/or a pulmonary embolism. There was a nonlinear association of hematocrit with VTE incidence, with risk elevated 72% for participants above the 95th percentile of hematocrit compared with the reference. Specifically, hazard ratios (95% confidence intervals) of incident VTE were 1.27 (0.91-1.76), 1.06 (0.87-1.28), 1 (reference), 1.17 (0.98-1.40) and 1.72 (1.30-2.27) across the 5 hematocrit percentiles, adjusted for age, race, sex, body mass index, smoking status and pack-years, and other confounding variables. The association of high hematocrit with VTE was limited to provoked VTE, with little evidence for unprovoked VTE. Hemoglobin above the 95th percentile also was associated with an increased risk of VTE. In contrast, there were no significant associations of platelet, leukocyte, neutrophil, or lymphocyte counts with VTE incidence.<h4>Conclusion</h4>High hematocrit and hemoglobin in a general middle-aged population sample were associated with increased long-term risk of VTE, particularly provoked VTE.
ER  - 
TY  - JOUR
T1  - Flawed methods in “COVID-19: Attacks the 1-Beta Chain of Hemoglobin and Captures the Porphyrin to Inhibit Human Heme Metabolism”
A1  - R, Read
Y1  - 2020/04//
KW  - Europe PMC
KW  - Europe PubMed Central
KW  - ORCIDs
KW  - REST APIs
KW  - abstracts
KW  - bioinformatics
KW  - biological patents
KW  - biomedical journals
KW  - biomedical research
KW  - citation networks
KW  - citation search
KW  - clinical guidelines
KW  - full text
KW  - journal articles
KW  - life sciences
KW  - literature search
KW  - open access
KW  - research articles
KW  - text mining
DO  - 10.26434/CHEMRXIV.12120912.V1
UR  - https://europepmc.org/article/PPR/PPR151013
L1  - file:///C:/Users/sony/AppData/Local/Mendeley Ltd./Mendeley Desktop/Downloaded/R - 2020 - Flawed methods in “COVID-19 Attacks the 1-Beta Chain of Hemoglobin and Captures the Porphyrin to Inhibit Human Heme Metabolis.pdf
ER  - 
TY  - JOUR
T1  - Why COVID-19 silent hypoxemia is baffling to physicians
A1  - Tobin, Martin J.
A1  - Laghi, Franco
A1  - Jubran, Amal
Y1  - 2020/08//
KW  - COVID-19
KW  - Control of breathing
KW  - Dyspnea
KW  - Hypoxemia
KW  - Pulse oximetry
PB  - American Thoracic Society
JF  - American Journal of Respiratory and Critical Care Medicine
VL  - 202
IS  - 3
SP  - 356
EP  - 360
DO  - 10.1164/rccm.202006-2157CP
UR  - /pmc/articles/PMC7397783/
UR  - /pmc/articles/PMC7397783/?report=abstract
UR  - https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7397783/
L1  - file:///C:/Users/sony/AppData/Local/Mendeley Ltd./Mendeley Desktop/Downloaded/Tobin, Laghi, Jubran - 2020 - Why COVID-19 silent hypoxemia is baffling to physicians.pdf
N2  - Patients with coronavirus disease (COVID-19) are described as exhibiting oxygen levels incompatible with life without dyspnea. The pairing - dubbed happy hypoxia but more precisely termed silent hypoxemia - is especially bewildering to physicians and is considered as defying basic biology. This combination has attracted extensive coverage in media but has not been discussed in medical journals. It is possible that coronavirus has an idiosyncratic action on receptors involved in chemosensitivity to oxygen, but well-established pathophysiological mechanisms can account for most, if not all, cases of silent hypoxemia. These mechanisms include the way dyspnea and the respiratory centers respond to low levels of oxygen, the way the prevailing carbon dioxide tension (PaCO2) blunts the brain's response to hypoxia, effects of disease and age on control of breathing, inaccuracy of pulse oximetry at low oxygen saturations, and temperature-induced shifts in the oxygen dissociation curve. Without knowledge of these mechanisms, physicians caring for patients with hypoxemia free of dyspnea are operating in the dark, placing vulnerable patients with COVID-19 at considerable risk. In conclusion, features of COVID-19 that physicians find baffling become less strange when viewed in light of long-established principles of respiratory physiology; an understanding of these mechanisms will enhance patient care if the much-anticipated second wave emerges.
ER  - 
TY  - JOUR
T1  - Timing of intubation and clinical outcomes in adults with acute respiratory distress syndrome
A1  - Kangelaris, Kirsten Neudoerffer
A1  - Ware, Lorraine B.
A1  - Wang, Chen Yu
A1  - Janz, David R.
A1  - Zhuo, Hanjing
A1  - Matthay, Michael A.
A1  - Calfee, Carolyn S.
Y1  - 2016/01//
KW  - acute lung injury
KW  - acute respiratory distress syndrome
KW  - acute respiratory failure
KW  - clinical outcomes
KW  - critical care
KW  - critical illness
KW  - early acute lung injury
KW  - intensive care
KW  - mechanical ventilation
PB  - Lippincott Williams and Wilkins
JF  - Critical Care Medicine
VL  - 44
IS  - 1
SP  - 120
EP  - 129
DO  - 10.1097/CCM.0000000000001359
UR  - /pmc/articles/PMC4774861/
UR  - /pmc/articles/PMC4774861/?report=abstract
UR  - https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4774861/
L1  - file:///C:/Users/sony/AppData/Local/Mendeley Ltd./Mendeley Desktop/Downloaded/Kangelaris et al. - 2016 - Timing of intubation and clinical outcomes in adults with acute respiratory distress syndrome.pdf
N2  - Objective: The prevalence, clinical characteristics, and outcomes of critically ill, nonintubated patients with evidence of the acute respiratory distress syndrome remain inadequately characterized. Design: Secondary analysis of a prospective observational cohort study. Setting: Vanderbilt University Medical Center. Patients: Among adult patients enrolled in a large, multi-ICU prospective cohort study between the years of 2006 and 2011, we studied intubated and nonintubated patients with acute respiratory distress syndrome as defined by acute hypoxemia (Pao2/Fio2 ≤ 300 or Spo2/Fio2 ≤ 315) and bilateral radiographic opacities not explained by cardiac failure. We excluded patients not committed to full respiratory support. Interventions: None. Measurements and Main Results: Of 457 patients with acute respiratory distress syndrome, 106 (23%) were not intubated at the time of meeting all other acute respiratory distress syndrome criteria. Nonintubated patients had lower morbidity and severity of illness than intubated patients; however, mortality at 60 days was the same (36%) in both groups (p = 0.91). Of the 106 nonintubated patients, 36 (34%) required intubation within the subsequent 3 days of follow-up; this late-intubation subgroup had significantly higher 60-day mortality (56%) when compared with the both early intubation group (36%, P<0.03) and patients never requiring intubation (26%; p = 0.002). Increased mortality in the late intubation group persisted at 2-year follow-up. Adjustment for baseline clinical and demographic differences did not change the results. Conclusions: A substantial proportion of critically ill adults with acute respiratory distress syndrome were not intubated in their initial days of intensive care, and many were never intubated. Late intubation was associated with increased mortality. Criteria defining the acute respiratory distress syndrome prior to need for positive pressure ventilation are required so that these patients can be enrolled in clinical studies and to facilitate early recognition and treatment of acute respiratory distress syndrome.
ER  - 
TY  - JOUR
T1  - Silent hypoxia in COVID-19: pathomechanism and possible management strategy
A1  - Rahman, Ahsab
A1  - Tabassum, Tahani
A1  - Araf, Yusha
A1  - Abdullah, ·
A1  - Nahid, Al
A1  - Ullah, Md Asad
A1  - Mohammad, ·
A1  - Hosen, Jakir
Y1  - 2021///
KW  - COVID-19
KW  - Dyspnoea
KW  - Management
KW  - Pathomechanism
KW  - Silent hypoxia
JF  - Molecular Biology Reports
VL  - 48
SP  - 3863
EP  - 3869
SN  - 0123456789
DO  - 10.1007/s11033-021-06358-1
UR  - https://doi.org/10.1007/s11033-021-06358-1
L1  - file:///C:/Users/sony/AppData/Local/Mendeley Ltd./Mendeley Desktop/Downloaded/Rahman et al. - 2021 - Silent hypoxia in COVID-19 pathomechanism and possible management strategy.pdf
N2  - The novel coronavirus disease 2019 (COVID-19) has become a severe health issue, especially to the patients who develop silent hypoxia condition after SARS-CoV-2 infection. Due to the lack of dyspnoea and extremely low oxygen saturation level, these patients are at exceptionally higher risk. Although the prevalence of silent hypoxia in COVID-19 patients has been evident in several cases, the underlying pathomechanism behind this condition is still unclear. Silent hypoxia in SARS-CoV-2 infected patients can be diagnosed with the help of a pulse oximeter, blood gas levels, and a 6-min walking test. While the clinicians and researchers figure out the exact reason for this phenomenon, the patients must be under strict day-today monitoring. In this article, we aim to provide comprehensive insights into the underlying symptoms, mechanism, and possible factors behind the occurrence of silent hypoxia among COVID-19 patients.
ER  - 
TY  - JOUR
T1  - Assessment of the SpO2/FiO2 ratio as a tool for hypoxemia screening in the emergency department
A1  - Catoire, Pierre
A1  - Tellier, Eric
A1  - de la Rivière, Caroline
A1  - Beauvieux, Marie Christine
A1  - Valdenaire, Guillaume
A1  - Galinski, Michel
A1  - Revel, Philippe
A1  - Combes, Xavier
A1  - Gil-Jardiné, Cédric
Y1  - 2021/06//
KW  - COVID-19
KW  - Oximetry
KW  - ROC curve
KW  - Respiratory insufficiency
KW  - Triage
PB  - W.B. Saunders
JF  - American Journal of Emergency Medicine
VL  - 44
SP  - 116
EP  - 120
DO  - 10.1016/j.ajem.2021.01.092
UR  - /pmc/articles/PMC7865090/
UR  - /pmc/articles/PMC7865090/?report=abstract
UR  - https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7865090/
L1  - file:///C:/Users/sony/AppData/Local/Mendeley Ltd./Mendeley Desktop/Downloaded/Catoire et al. - 2021 - Assessment of the SpO2FiO2 ratio as a tool for hypoxemia screening in the emergency department.pdf
N2  - Objective: We assessed the performance of the ratio of peripheral arterial oxygen saturation to the inspired fraction of oxygen (SpO2/FiO2) to predict the ratio of partial pressure arterial oxygen to the fraction of inspired oxygen (PaO2/FiO2) among patients admitted to our emergency department (ED) during the SARS-CoV-2 outbreak. Methods: We retrospectively studied patients admitted to an academic-level ED in France who were undergoing a joint measurement of SpO2 and arterial blood gas. We compared SpO2 with SaO2 and evaluated performance of the SpO2/FiO2 ratio for the prediction of 300 and 400 mmHg PaO2/FiO2 cut-off values in COVID-19 positive and negative subgroups using receiver-operating characteristic (ROC) curves. Results: During the study period from February to April 2020, a total of 430 arterial samples were analyzed and collected from 395 patients. The area under the ROC curves of the SpO2/FiO2 ratio was 0.918 (CI 95% 0.885–0.950) and 0.901 (CI 95% 0.872–0.930) for PaO2/FiO2 thresholds of 300 and 400 mmHg, respectively. The positive predictive value (PPV) of an SpO2/FiO2 threshold of 350 for PaO2/FiO2 inferior to 300 mmHg was 0.88 (CI95% 0.84–0.91), whereas the negative predictive value (NPV) of the SpO2/FiO2 threshold of 470 for PaO2/FiO2 inferior to 400 mmHg was 0.89 (CI95% 0.75–0.96). No significant differences were found between the subgroups. Conclusions: The SpO2/FiO2 ratio may be a reliable tool for hypoxemia screening among patients admitted to the ED, particularly during the SARS-CoV-2 outbreak.
ER  - 
TY  - GEN
T1  - "Obesity paradox" in acute respiratory distress syndrome: Asystematic review and meta-analysis
A1  - Guo, Zhi
A1  - Wang, Xin
A1  - Wang, Ying
A1  - Xing, Guohong
A1  - Liu, Shuying
Y1  - 2016/09//
KW  - Guo Zhi
KW  - Liu Shuying
KW  - MEDLINE
KW  - NCBI
KW  - NIH
KW  - NLM
KW  - National Center for Biotechnology Information
KW  - National Institutes of Health
KW  - National Library of Medicine
KW  - PMC5042414
KW  - PubMed Abstract
KW  - Wang Xin
KW  - doi:10.1371/journal.pone.0163677
KW  - pmid:27684705
PB  - Public Library of Science
JF  - PLoS ONE
VL  - 11
IS  - 9
DO  - 10.1371/journal.pone.0163677
UR  - https://pubmed.ncbi.nlm.nih.gov/27684705/
L1  - file:///C:/Users/sony/AppData/Local/Mendeley Ltd./Mendeley Desktop/Downloaded/Guo et al. - 2016 - Obesity paradox in acute respiratory distress syndrome Asystematic review and meta-analysis.pdf
N2  - Background: It is unclear whether an "obesity paradox" exists in the respiratory system, especially in acute respiratory distress syndrome (ARDS) and acute lung injury (ALI). Previous studies have postulated a causal relation between obesity and ARDS/ALI but have lacked power to form a definitive conclusion. Objective: To investigate the relationships between obesity, ARDS/ALIrisk, and mortality. Methods: A systematic search current to April 2016 was performed in Pubmed, EMBASE, Medline, Cochrane databases to find relevant studies. All studies that estimate the effect of obesity in the morbidity and mortality of ARDS/ALI were included. Results: A total of 24 studies including 9,187,248 subjects were analyzed. The combined results from 16 studies that examined the effect of obesity in morbidity of ARDS/ALI showed an89% increase in odds ratio(pooled odds ratios (OR) 1.89, 95% confidence intervals (CI) 1.45 to 2.47). In subgroup analysis, compared to normal weight, obesity was associated with an increased risk of ARDS/ALI (OR1.57, 95% CI 1.30-1.90 for obese (BMI30-39.9kg/m2); OR1.75, 95% CI 1.42-2.15 for obese(BMI≥30kg/m2); OR1.67, 95% CI 1.04-2.68 for morbid obese(BMI≥40kg/m2)). The combined results from 9 studies that examined the effect of obesity in mortality of ARDS/ALI had a pooled odds ratio(pooled OR 0.63, 95% CI 0.41 to 0.98). Inversely, obesity was significantly associated with reduced risk of ARDS/ALI mortality(OR0.88, 95% CI 0.78-1.00 for overweight(BMI≤18.5m2); OR0.74, 95% CI 0.64-0.84 for obese (BMI30-39.9kg/m2);OR0.84, 95% CI 0.75-0.94 for 60days mortality; OR0.38, 95% CI 0.22-0.66 for 90days mortality). Conclusions: Our data identify obesity as an important risk factor for the development of ARDS/ALI; however, ARDS/ALI outcomes are improved in this population when compared to individuals with a normal body mass index. This meta-analysis results supported "obesity paradox" in ARDS/ALI.
ER  - 
TY  - JOUR
T1  - Obesity is associated with improved survival in community-acquired pneumonia
A1  - Singanayagam, Anika
A1  - Singanayagam, Aran
A1  - Chalmers, James D.
Y1  - 2013/07//
PB  - European Respiratory Society
JF  - European Respiratory Journal
VL  - 42
IS  - 1
SP  - 180
EP  - 187
DO  - 10.1183/09031936.00115312
UR  - http://ow.ly/kFUQu
L1  - file:///C:/Users/sony/AppData/Local/Mendeley Ltd./Mendeley Desktop/Downloaded/Singanayagam, Singanayagam, Chalmers - 2013 - Obesity is associated with improved survival in community-acquired pneumonia.pdf
N2  - Obesity has been identified as a risk factor for adverse outcomes of 2009 H1N1 influenza. However, the impact of obesity on outcomes of infection remains controversial. There are limited data investigating the effect of obesity on outcomes of community-acquired pneumonia (CAP). This prospective observational study included patients presenting with CAP who had body mass index (BMI) measured on admission. Outcome measures included 30-day mortality and need for mechanical ventilation or inotropic support (MV/IS). 1079 patients were included, with 21%classified as obese (BMI ≥30 kg·m-2). Obesity was independently associated with reduced 30-day mortality from CAP on multivariate analysis (HR 0.53, 95%CI 0.29-0.98). This was not explained by differences in severity of disease on admission or requirement for MV/IS between obese and nonobese groups. Obese patients had higher median C-reactive protein levels and a higher frequency of sepsis using the systemic inflammatory response syndrome criteria (72.4%versus 64.1%; p50.03), than nonobese patients, suggesting greater systemic inflammation. Obesity was associated with reduced 30-day mortality in patients hospitalised with CAP. Copyright © ERS 2013.
ER  - 
TY  - JOUR
T1  - A systematic review and meta-analysis of obesity and COVID-19 outcomes
A1  - Zhang, Xinya
A1  - Lewis, Alexander M.
A1  - Moley, John R.
A1  - Brestoff, Jonathan R.
Y1  - 2021/12//
KW  - Medical research
KW  - Outcomes research
KW  - Risk factors
PB  - Nature Research
JF  - Scientific Reports
VL  - 11
IS  - 1
SP  - 7193
EP  - 7193
DO  - 10.1038/s41598-021-86694-1
UR  - https://doi.org/10.1038/s41598-021-86694-1
L1  - file:///C:/Users/sony/AppData/Local/Mendeley Ltd./Mendeley Desktop/Downloaded/Zhang et al. - 2021 - A systematic review and meta-analysis of obesity and COVID-19 outcomes.pdf
N2  - Some studies report that obesity is associated with more severe symptoms following SARS-CoV-2 infection and worse COVID-19 outcomes, however many other studies have not reproduced these findings. Therefore, it is uncertain whether obesity is in fact associated with worse COVID-19 outcomes compared to non-obese individuals. We conducted a systematic search of PubMed (including MEDLINE) and Google Scholar on May 18, 2020 to identify published studies on COVID-19 outcomes in non-obese and obese patients, covering studies published during the first 6 months of the pandemic. Meta-analyses with random effects modeling was used to determine unadjusted odds ratios (OR) and 95% confidence intervals (CI) for various COVID-19 outcomes in obese versus non-obese patients. By quantitative analyses of 22 studies from 7 countries in North America, Europe, and Asia, we found that obesity is associated with an increased likelihood of presenting with more severe COVID-19 symptoms (OR 3.03, 95% CI 1.45–6.28, P = 0.003; 4 studies, n = 974), developing acute respiratory distress syndrome (ARDS; OR 2.89, 95% CI 1.14–7.34, P = 0.025; 2 studies, n = 96), requiring hospitalization (OR 1.68, 95% CI 1.14–1.59, P < 0.001; 4 studies, n = 6611), being admitted to an intensive care unit (ICU; OR 1.35, 95% CI 1.15–1.65, P = 0.001; 9 studies, n = 5298), and undergoing invasive mechanical ventilation (IMV; OR 1.76, 95% CI 1.29–2.40, P < 0.001; 7 studies, n = 1558) compared to non-obese patients. However, obese patients had similar likelihoods of death from COVID-19 as non-obese patients (OR 0.96, 95% CI 0.74–1.25, P = 0.750; 9 studies, n = 20,597). Collectively, these data from the first 6 months of the pandemic suggested that obesity is associated with a more severe COVID-19 disease course but may not be associated with increased mortality.
ER  - 
TY  - JOUR
T1  - Associations between body-mass index and COVID-19 severity in 6·9 million people in England: a prospective, community-based, cohort study
A1  - Gao, Min
A1  - Piernas, Carmen
A1  - Astbury, Nerys M
A1  - Hippisley-Cox, Julia
A1  - O'Rahilly, Stephen
A1  - Aveyard, Paul
A1  - Jebb, Susan A
Y1  - 2021/06//
PB  - Elsevier BV
JF  - The Lancet Diabetes & Endocrinology
VL  - 9
IS  - 6
SP  - 350
EP  - 359
DO  - 10.1016/s2213-8587(21)00089-9
UR  - www.thelancet.com/diabetes-endocrinology
L1  - file:///C:/Users/sony/AppData/Local/Mendeley Ltd./Mendeley Desktop/Downloaded/Gao et al. - 2021 - Associations between body-mass index and COVID-19 severity in 6·9 million people in England a prospective, community.pdf
N2  - Background: Obesity is a major risk factor for adverse outcomes after infection with SARS-CoV-2. We aimed to examine this association, including interactions with demographic and behavioural characteristics, type 2 diabetes, and other health conditions. Methods: In this prospective, community-based, cohort study, we used de-identified patient-level data from the QResearch database of general practices in England, UK. We extracted data for patients aged 20 years and older who were registered at a practice eligible for inclusion in the QResearch database between Jan 24, 2020 (date of the first recorded infection in the UK) and April 30, 2020, and with available data on BMI. Data extracted included demographic, clinical, clinical values linked with Public Health England's database of positive SARS-CoV-2 test results, and death certificates from the Office of National Statistics. Outcomes, as a proxy measure of severe COVID-19, were admission to hospital, admission to an intensive care unit (ICU), and death due to COVID-19. We used Cox proportional hazard models to estimate the risk of severe COVID-19, sequentially adjusting for demographic characteristics, behavioural factors, and comorbidities. Findings: Among 6 910 695 eligible individuals (mean BMI 26·78 kg/m2 [SD 5·59]), 13 503 (0·20%) were admitted to hospital, 1601 (0·02%) to an ICU, and 5479 (0·08%) died after a positive test for SARS-CoV-2. We found J-shaped associations between BMI and admission to hospital due to COVID-19 (adjusted hazard ratio [HR] per kg/m2 from the nadir at BMI of 23 kg/m2 of 1·05 [95% CI 1·05–1·05]) and death (1·04 [1·04–1·05]), and a linear association across the whole BMI range with ICU admission (1·10 [1·09–1·10]). We found a significant interaction between BMI and age and ethnicity, with higher HR per kg/m2 above BMI 23 kg/m2 for younger people (adjusted HR per kg/m2 above BMI 23 kg/m2 for hospital admission 1·09 [95% CI 1·08–1·10] in 20–39 years age group vs 80–100 years group 1·01 [1·00–1·02]) and Black people than White people (1·07 [1·06–1·08] vs 1·04 [1·04–1·05]). The risk of admission to hospital and ICU due to COVID-19 associated with unit increase in BMI was slightly lower in people with type 2 diabetes, hypertension, and cardiovascular disease than in those without these morbidities. Interpretation: At a BMI of more than 23 kg/m2, we found a linear increase in risk of severe COVID-19 leading to admission to hospital and death, and a linear increase in admission to an ICU across the whole BMI range, which is not attributable to excess risks of related diseases. The relative risk due to increasing BMI is particularly notable people younger than 40 years and of Black ethnicity. Funding: NIHR Oxford Biomedical Research Centre.
ER  - 
TY  - GEN
T1  - Obesity and survival in critically ill patients with acute respiratory distress syndrome: A paradox within the paradox
A1  - Ball, Lorenzo
A1  - Serpa Neto, Ary
A1  - Pelosi, Paolo
Y1  - 2017/05//
KW  - ARDS
KW  - ICU
KW  - Obesity
PB  - BioMed Central Ltd.
JF  - Critical Care
VL  - 21
IS  - 1
DO  - 10.1186/s13054-017-1682-5
UR  - /pmc/articles/PMC5440996/
UR  - https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5440996/
L1  - file:///C:/Users/sony/AppData/Local/Mendeley Ltd./Mendeley Desktop/Downloaded/Ball, Serpa Neto, Pelosi - 2017 - Obesity and survival in critically ill patients with acute respiratory distress syndrome A paradox wit.pdf
ER  - 
TY  - BOOK
T1  - Generalized additive models
A1  - .Wood, Simon N
ED  - Blitzstein, Joseph K.
ED  - Faraway, Julian J.
ED  - Tanner, Martin
ED  - Zidek, Jim
Y1  - 1986///
KW  - Generalized linear models
KW  - Nonlinearity
KW  - Nonpara-metric regression
KW  - Partial residuals
KW  - Smoothing
PB  - CRC Press
JF  - Statistical Science
VL  - 1
ET  - 2° Ed
IS  - 3
SP  - 297
EP  - 310
DO  - 10.1214/ss/1177013604
L1  - file:///C:/Users/sony/AppData/Local/Mendeley Ltd./Mendeley Desktop/Downloaded/.Wood - 1986 - Generalized additive models.pdf
N2  - Likelihood-based regression models such as the normal linear regression model and the linear logistic model, assume a linear (or some other parametric) form for the covariates X1, X2,…, Xp. We introduce the class of generalized additive models which replaces the linear form Σ βjXj by a sum of smooth functions Σ sj(Xj). The sj(·)‘s are unspecified functions that are estimated using a scatterplot smoother, in an iterative procedure we call the local scoring algorithm. The technique is applicable to any likelihood-based regression model: the class of generalized linear models contains many of these. In this class the linear predictor η = Σ βjXj is replaced by the additive predictor Σ sj(Xj); hence, the name generalized additive models. We illustrate the technique with binary response and survival data. In both cases, the method proves to be useful in uncovering nonlinear covariate effects. It has the advantage of being completely automatic, i.e., no "detective work" is needed on the part of the statistician. As a theoretical underpinning, the technique is viewed as an empirical method of maximizing the expected log likelihood, or equivalently, of minimizing the Kullback-Leibler distance to the true model. © 1986, Institute of Mathematical Statistics. All Rights Reserved.
ER  - 
TY  - JOUR
T1  - Abnormal immunity of non-survivors with COVID-19: Predictors for mortality
A1  - Zhao, Yang
A1  - Nie, Han Xiang
A1  - Hu, Ke
A1  - Wu, Xiao Jun
A1  - Zhang, Yun Ting
A1  - Wang, Meng Mei
A1  - Wang, Tao
A1  - Zheng, Zhi Shui
A1  - Li, Xiao Chen
A1  - Zeng, Shao Lin
Y1  - 2020/08//
KW  - COVID-19
KW  - Cellular immunity
KW  - Humoral immunity
KW  - Mortality
PB  - BioMed Central
JF  - Infectious Diseases of Poverty
VL  - 9
IS  - 1
DO  - 10.1186/s40249-020-00723-1
UR  - /pmc/articles/PMC7396941/
UR  - /pmc/articles/PMC7396941/?report=abstract
UR  - https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7396941/
L1  - file:///C:/Users/sony/AppData/Local/Mendeley Ltd./Mendeley Desktop/Downloaded/Zhao et al. - 2020 - Abnormal immunity of non-survivors with COVID-19 Predictors for mortality.pdf
N2  - Background: The number of coronavirus disease 2019 (COVID-19) cases has rapidly increased all over the world. Specific information about immunity in non-survivors with COVID-19 is scarce. This study aimed to analyse the clinical characteristics and abnormal immunity of the confirmed COVID-19 non-survivors. Methods: In this single-centered, retrospective, observational study, we enrolled 125 patients with COVID-19 who were died between January 13 and March 4, 2020 in Renmin Hospital of Wuhan University. A total of 414 randomly recruited patients with confirmed COVID-19 who were discharged from the same hospital during the same period served as control. The demographic, clinical characteristics and laboratory findings at admission, and treatment used in these patients were collected. The immunity-related risk factors associated with in-hospital death were tested by logistic regression models and Receiver Operating Characteristic (ROC) curve. Results: Non-survivors (70 years, IQR: 61.5-80) were significantly older than survivors (54 years, IQR: 37-65) (P < 0.001). 56.8% of non-survivors was male. Nearly half of the patients (44.9%) had chronic medical illness. In non-survivors, hypertension (49.6%) was the most common comorbidity, followed by diabetes (20.0%) and coronary heart disease (16.0%). The common signs and symptoms at admission of non-survivors were fever (88%), followed by cough (64.8%), dyspnea (62.4%), fatigue (62.4%) and chest tightness (58.4%). Compared with survivors, non-survivors had higher white blood cell (WBC) count (7.85 vs 5.07 × 109/L), more elevated neutrophil count (6.41 vs 3.08 × 109/L), smaller lymphocyte count (0.69 vs 1.20 × 109/L) and lower platelet count (172 vs 211 × 109/L), raised concentrations of procalcitonin (0.21 vs 0.06 ng/mL) and CRP (70.5 vs 7.2 mg/L) (P < 0.001). This was accompanied with significantly decreased levels of CD3+ T cells (277 vs 814 cells/μl), CD4+ T cells (172 vs 473 cells/μl), CD8+ T cells (84 vs 262.5 cells/μl, P < 0.001), CD19+ T cells (88 vs 141 cells/μl) and CD16+ 56+ T cells (79 vs 128.5 cells/μl) (P < 0.001). The concentrations of immunoglobulins (Ig) G (13.30 vs 11.95 g/L), IgA (2.54 vs 2.21 g/L), and IgE (71.30 vs 42.25 IU/ml) were increased, whereas the levels of complement proteins (C)3 (0.89 vs 0.99 g/L) and C4 (0.22 vs 0.24 g/L) were decreased in non-survivors when compared with survivors (all P < 0.05). The non-survivors presented lower levels of oximetry saturation (90 vs 97%) at rest and lactate (2.40 vs 1.90 mmol/L) (P < 0.001). Old age, comorbidity of malignant tumor, neutrophilia, lymphocytopenia, low CD4+ T cells, decreased C3, and low oximetry saturation were the risk factors of death in patients with confirmed COVID-19. The frequency of CD4+ T cells positively correlated with the numbers of lymphocytes (r = 0.787) and the level of oximetry saturation (r = 0.295), Whereas CD4+ T cells were negatively correlated with age (r =-0.323) and the numbers of neutrophils (r = - 0.244) (all P < 0.001). Conclusions: Abnormal cellular immunity and humoral immunity were key features of non-survivors with COVID-19. Neutrophilia, lymphocytopenia, low CD4+ T cells, and decreased C3 were immunity-related risk factors predicting mortality of patients with COVID-19.
ER  - 
TY  - JOUR
T1  - Increased age, neutrophil-to-lymphocyte ratio (NLR) and white blood cells count are associated with higher COVID-19 mortality
A1  - Vafadar Moradi, Elnaz
A1  - Teimouri, Ali
A1  - Rezaee, Ramin
A1  - Morovatdar, Negar
A1  - Foroughian, Mahdi
A1  - Layegh, Parvaneh
A1  - Rezvani Kakhki, Behrang
A1  - Ahmadi Koupaei, Seyed Reza
A1  - Ghorani, Vahideh
Y1  - 2021/02//
KW  - COVID-19
KW  - Coronavirus
KW  - Survival
PB  - W.B. Saunders
JF  - American Journal of Emergency Medicine
VL  - 40
SP  - 11
EP  - 14
DO  - 10.1016/j.ajem.2020.12.003
UR  - https://pubmed.ncbi.nlm.nih.gov/33333477/
L1  - file:///C:/Users/sony/AppData/Local/Mendeley Ltd./Mendeley Desktop/Downloaded/Vafadar Moradi et al. - 2021 - Increased age, neutrophil-to-lymphocyte ratio (NLR) and white blood cells count are associated with highe.pdf
N2  - Objective: Coronavirus disease 19 (COVID-19) caused by the highly pathogenic SARS-CoV-2, was first reported from Wuhan, China, in December 2019. The present study assessed possible associations between one-month mortality and demographic data, SpO2, underlying diseases and laboratory findings, in COVID-19 patients. Also, since recent studies on COVID-19, have focused on Neutrophil-to-lymphocyte ratio (NLR) as an independent risk factor of the in-hospital death and a significant prognostic biomarker of outcomes in critically ill patients, in this study, we assessed predictive potential of this factor in terms of one-month mortality. Methods: Patients admitted to Imam Reza hospital, affiliated to Mashhad University of Medical Sciences, Mashhad, Iran, from March to June 2020, with positive RT-PCR results for SARS-CoV-2, were included in this study. Kaplan-Meier survival analysis and Cox proportional hazard model were used to respectively estimate one-month mortality since admission and determine factors associated with one-month mortality. Results: In this retrospective cohort study, 219 patients were included (137 men and 82 women (mean age 58.2 ± 16 and 57 ± 17.3 years old, respectively)). Hypertension, ischemic heart disease and diabetes were respectively the most common comorbidities. Among these patients, 63 patients were admitted to the ICU and 31 deaths occurred during one-month follow-up. With respect to mean peripheral capillary oxygen saturation (SpO2), 142 patients had SpO2 ≤ 90%. Based on our analysis, older age and increased Neutrophil-to-lymphocyte ratio (NLR), and White blood cells (WBC) count were associated with increased risk of one-month mortality. Patients with SpO2 ≤ 90% had a 3.8-fold increase in risk of one-month death compared to those with SpO2 > 90%, although the difference did not reach a significant level. Conclusion: Multivariate analysis introduced age, WBC count, and NLR as predictors of one-month mortality in COVID-19 patients.
ER  - 
TY  - JOUR
T1  - The diagnostic and predictive role of NLR, d-NLR and PLR in COVID-19 patients
A1  - Yang, Ai Ping
A1  - Liu, Jian ping
A1  - Tao, Wen qiang
A1  - Li, Hui ming
Y1  - 2020/07//
KW  - Age
KW  - COVID-19
KW  - Neutrophil-to-lymphocyte ratio
KW  - Platelet-to-LYM ratio
KW  - Predictive
PB  - Elsevier B.V.
JF  - International Immunopharmacology
VL  - 84
DO  - 10.1016/j.intimp.2020.106504
UR  - https://pubmed.ncbi.nlm.nih.gov/32304994/
L1  - file:///C:/Users/sony/AppData/Local/Mendeley Ltd./Mendeley Desktop/Downloaded/Yang et al. - 2020 - The diagnostic and predictive role of NLR, d-NLR and PLR in COVID-19 patients.pdf
N2  - Aim: To accumulate evidence that indicated the key role played by virus-triggered inflammation in the 2019-novel coronavirus disease (COVID-19) which emerged in Wuhan City and rapidly spread throughout China. Methods: Age, neutrophil(NEU)-to-lymphocyte (LYM) ratio (NLR), lymphocyte-to-monocyte (MON) ratio, platelet-to-lymphocyte ratio (PLR), and C-reactive protein (CRP) of 93 patients with laboratory confirmed COVID-19 were investigated and compared. The receiver operating characteristic curve was applied to determine the thresholds for five bio-markers, and their prognostic values were assessed via the Kaplan–Meier curve and multivariate COX regression models. Results: The median age was 46.4 years old, and 37cases were females. A total of 27.8% of patients had been to Wuhan, and 73.1% had contacted with people from Wuhan. Fever (83.8%) and cough (70.9%) were the two most common symptoms. Elevated NLR and age were significantly associated with illness severity. The binary logistic analysis identified elevated NLR (hazard risk [HR] 2.46, 95% confidence interval [CI] 1.98–4.57) and age (HR 2.52, 95% CI 1.65–4.83) as independent factors for poor clinical outcome of COVID-19. NLR exhibited the largest area under the curve at 0.841, with the highest specificity (63.6%) and sensitivity (88%). Conclusions: Elevated age and NLR can be considered independent biomarkers for indicating poor clinical outcomes.
ER  - 
TY  - ICOMM
T1  - Pobreza y desigualdad
A1  - Departamento Administrativo Nacional de Estadística
Y1  - 2021///
UR  - https://www.dane.gov.co/index.php/estadisticas-por-tema/pobreza-y-condiciones-de-vida/pobreza-monetaria
ER  - 
TY  - JOUR
T1  - The Burden of Malnutrition and Fatal COVID-19: A Global Burden of Disease Analysis
A1  - Mertens, Elly
A1  - Peñalvo, José L.
Y1  - 2021/01//
KW  - BMI
KW  - COVID-19 mortality
KW  - global burden
KW  - malnutrition
KW  - overnutrition
KW  - undernutrition
PB  - Frontiers Media S.A.
JF  - Frontiers in Nutrition
VL  - 7
SP  - 619850
EP  - 619850
DO  - 10.3389/fnut.2020.619850
UR  - www.frontiersin.org
L1  - file:///C:/Users/sony/AppData/Local/Mendeley Ltd./Mendeley Desktop/Downloaded/Mertens, Peñalvo - 2021 - The Burden of Malnutrition and Fatal COVID-19 A Global Burden of Disease Analysis.pdf
N2  - Background: Although reasonable to assume, it is not yet clear whether malnourished countries are at higher risk for severe or fatal coronavirus disease 2019 (COVID-19). This study aims to identify the countries where prevalent malnutrition may be a driving factor for fatal disease after severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. Methods: Using estimates from the Global Burden of Disease 2019, country-level burden of malnutrition was quantified using four indicators: death rates for child growth failure (underweight, stunting, and/or wasting) and years lived with disability (YLD) attributed to iron and vitamin A deficiencies and high body mass index (BMI). Global mortality descriptors of the ongoing COVID-19 pandemic were extracted from the European Centre for Disease Prevention and Control, and case fatality ratios (CFRs) were calculated introducing a lag time of 10 weeks after the first death of a confirmed case. Bivariate analyses for 172 countries were carried out for malnutrition indicators and fatal COVID-19. Correlations between burden indicators were characterized by Spearman's rank correlation coefficients (ρ) and visually by scatterplots. Restricted cubic splines and underlying negative binomial regressions adjusted for countries' age-structure, prevalent chronic comorbidities related to COVID-19, population density, and income group were used to explore non-linear relationships. Results: Stratified by the World Bank income group, a moderate positive association between YLD rates for iron deficiency and CFRs for COVID-19 was observed for low-income countries (ρ = 0.60, p = 0.027), whereas no clear indications for the association with child growth failure, vitamin A deficiency, or high BMI were found (ρ < 0.30). Countries ranking high on at least three malnutrition indicators and presenting also an elevated CFR for COVID-19 are sub-Saharan African countries, namely, Angola, Burkina Faso, Chad, Liberia, Mali, Niger, Sudan, and Tanzania, as well as Yemen and Guyana. Conclusions: Population-level malnutrition appears to be related to increased rates of fatal COVID-19 in areas with an elevated burden of undernutrition, such as countries in the Sahel strip. COVID-19 response plans in malnourished countries, vulnerable to fatal COVID-19, should incorporate food security, nutrition, and social protection as a priority component in order to reduce COVID-19 fatality.
ER  - 
TY  - GEN
T1  - Immune Dysfunction as a Cause and Consequence of Malnutrition
A1  - Bourke, Claire D.
A1  - Berkley, James A.
A1  - Prendergast, Andrew J.
Y1  - 2016/06//
KW  - Enteropathy
KW  - Immunodeficiency
KW  - Infection
KW  - Inflammation
KW  - Malnutrition
KW  - Metabolism
PB  - Elsevier Ltd
JF  - Trends in Immunology
VL  - 37
IS  - 6
SP  - 386
EP  - 398
DO  - 10.1016/j.it.2016.04.003
UR  - /pmc/articles/PMC4889773/
UR  - /pmc/articles/PMC4889773/?report=abstract
UR  - https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4889773/
L1  - file:///C:/Users/sony/AppData/Local/Mendeley Ltd./Mendeley Desktop/Downloaded/Bourke, Berkley, Prendergast - 2016 - Immune Dysfunction as a Cause and Consequence of Malnutrition.pdf
N2  - Malnutrition, which encompasses under- and overnutrition, is responsible for an enormous morbidity and mortality burden globally. Malnutrition results from disordered nutrient assimilation but is also characterized by recurrent infections and chronic inflammation, implying an underlying immune defect. Defects emerge before birth via modifications in the immunoepigenome of malnourished parents, and these may contribute to intergenerational cycles of malnutrition. This review summarizes key recent studies from experimental animals, in vitro models, and human cohorts, and proposes that immune dysfunction is both a cause and a consequence of malnutrition. Focusing on childhood undernutrition, we highlight gaps in current understanding of immune dysfunction in malnutrition, with a view to therapeutically targeting immune pathways as a novel means to reduce morbidity and mortality.
ER  - 
TY  - JOUR
T1  - Impact of malnutrition on immunty and infection
A1  - França TGD
A1  - Ishikawa LLW
A1  - Zozella-Pezavento
A1  - Chisuo-Minicucci F
A1  - da Cunha MLRS
A1  - Sartori A
Y1  - 2009/08//
KW  - experimental models
KW  - immunity
KW  - infection
KW  - malnutrition
JF  - J Venom Anim Toxins incl Trop Dis
VL  - 15
IS  - 3
SP  - 374
EP  - 390
L1  - file:///C:/Users/sony/AppData/Local/Mendeley Ltd./Mendeley Desktop/Downloaded/França TGD et al. - 2009 - Impact of malnutrition on immunty and infection.pdf
N2  - Malnutrition may be a consequence of energy deficit or micronutrient deficiency. It is considered the most relevant risk factor for illness and death, particularly in developing countries. In this review we described the magnitude of this problem, as well as its direct effect on the immune system and how it results in higher susceptibility to infections. A special emphasis was given to experimental models used to investigate the relationship between undernutrition and immunity. Malnutrition is obviously a challenge that must be addressed to health authorities and the scientific community.
ER  - 
TY  - GEN
T1  - A comparison of mortality-related risk factors of COVID-19, SARS, and MERS: A systematic review and meta-analysis
A1  - Lu, Lvliang
A1  - Zhong, Wenyu
A1  - Bian, Ziwei
A1  - Li, Zhiming
A1  - Zhang, Ke
A1  - Liang, Boxuan
A1  - Zhong, Yizhou
A1  - Hu, Manjiang
A1  - Lin, Li
A1  - Liu, Jun
A1  - Lin, Xi
A1  - Huang, Yuji
A1  - Jiang, Junying
A1  - Yang, Xingfen
A1  - Zhang, Xin
A1  - Huang, Zhenlie
Y1  - 2020/10//
KW  - COVID-19
KW  - MERS
KW  - Meta-analysis
KW  - Mortality
KW  - Risk factors
KW  - SARS
PB  - W.B. Saunders Ltd
JF  - Journal of Infection
VL  - 81
IS  - 4
SP  - e18
EP  - e25
DO  - 10.1016/j.jinf.2020.07.002
UR  - https://pubmed.ncbi.nlm.nih.gov/32634459/
L1  - file:///C:/Users/sony/AppData/Local/Mendeley Ltd./Mendeley Desktop/Downloaded/Lu et al. - 2020 - A comparison of mortality-related risk factors of COVID-19, SARS, and MERS A systematic review and meta-analysis.pdf
N2  - Objective: Coronavirus Disease 2019 (COVID-19) is a pandemic. This systematic review compares mortality risk factors including clinical, demographic and laboratory features of COVID-19, Severe Acute Respiratory Syndrome (SARS) and Middle East Respiratory Syndrome (MERS). The aim is to provide new strategies for COVID-19 prevention and treatment. Methods: We performed a systematic review with meta-analysis, using five databases to compare the predictors of death for COVID-19, SARS and MERS. A random-effects model meta-analysis calculated odds ratios (OR) and 95% confidence intervals (95% CI). Results: 845 articles up through 11/4/2020 were retrieved, but only 28 studies were included in this meta-analysis. The results showed that males had a higher likelihood of death than females (OR = 1.82, 95% CI 1.56–2.13). Age (OR = 7.86, 95% CI 5.46–11.29), diabetes comorbidity (OR = 3.73, 95% CI 2.35–5.90), chronic lung disease (OR = 3.43, 95% CI 1.80–6.52) and hypertension (OR = 3.38, 95% CI 2.45–4.67) were the mortality risk factors. The laboratory indicators lactic dehydrogenase (OR = 37.52, 95% CI 24.68–57.03), C-reactive protein (OR = 12.11, 95% CI 5.24–27.98), and neutrophils (OR = 17.56, 95% CI 10.67–28.90) had stronger correlations with COVID-19 mortality than with SARS or MERS mortality. Consolidation and ground-glass opacity imaging features were similar among COVID-19, SARS, and MERS patients. Conclusions: COVID-19′s mortality factors are similar to those of SARS and MERS. Age and laboratory indicators could be effective predictors of COVID-19 mortality outcomes.
ER  - 
TY  - JOUR
T1  - Neutrophil-to-lymphocyte ratio predicts critical illness patients with 2019 coronavirus disease in the early stage
A1  - Liu, Jingyuan
A1  - Liu, Yao
A1  - Xiang, Pan
A1  - Pu, Lin
A1  - Xiong, Haofeng
A1  - Li, Chuansheng
A1  - Zhang, Ming
A1  - Tan, Jianbo
A1  - Xu, Yanli
A1  - Song, Rui
A1  - Song, Meihua
A1  - Wang, Lin
A1  - Zhang, Wei
A1  - Han, Bing
A1  - Yang, Li
A1  - Wang, Xiaojing
A1  - Zhou, Guiqin
A1  - Zhang, Ting
A1  - Li, Ben
A1  - Wang, Yanbin
A1  - Chen, Zhihai
A1  - Wang, Xianbo
Y1  - 2020/05//
KW  - 2019-nCoV
KW  - COVID-19
KW  - Model
KW  - NLR
KW  - Prognosis
KW  - SARS-CoV
PB  - BioMed Central
JF  - Journal of Translational Medicine
VL  - 18
IS  - 1
SP  - 206
EP  - 206
DO  - 10.1186/s12967-020-02374-0
UR  - https://doi.org/10.1186/s12967-020-02374-0
L1  - file:///C:/Users/sony/AppData/Local/Mendeley Ltd./Mendeley Desktop/Downloaded/Liu et al. - 2020 - Neutrophil-to-lymphocyte ratio predicts critical illness patients with 2019 coronavirus disease in the early stage.pdf
N2  - Background: Patients with critical illness due to infection with the 2019 coronavirus disease (COVID-19) show rapid disease progression to acute respiratory failure. The study aimed to screen the most useful predictive factor for critical illness caused by COVID-19. Methods: The study prospectively involved 61 patients with COVID-19 infection as a derivation cohort, and 54 patients as a validation cohort. The predictive factor for critical illness was selected using LASSO regression analysis. A nomogram based on non-specific laboratory indicators was built to predict the probability of critical illness. Results: The neutrophil-to-lymphocyte ratio (NLR) was identified as an independent risk factor for critical illness in patients with COVID-19 infection. The NLR had an area under receiver operating characteristic of 0.849 (95% confidence interval [CI], 0.707 to 0.991) in the derivation cohort and 0.867 (95% CI 0.747 to 0.944) in the validation cohort, the calibration curves fitted well, and the decision and clinical impact curves showed that the NLR had high standardized net benefit. In addition, the incidence of critical illness was 9.1% (1/11) for patients aged ≥ 50 and having an NLR < 3.13, and 50% (7/14) patients with age ≥ 50 and NLR ≥ 3.13 were predicted to develop critical illness. Based on the risk stratification of NLR according to age, this study has developed a COVID-19 pneumonia management process. Conclusions: We found that NLR is a predictive factor for early-stage prediction of patients infected with COVID-19 who are likely to develop critical illness. Patients aged ≥ 50 and having an NLR ≥ 3.13 are predicted to develop critical illness, and they should thus have rapid access to an intensive care unit if necessary.
ER  - 
TY  - JOUR
T1  - Mechanism of inflammatory response in associated comorbidities in COVID-19
A1  - de Lucena, Thays Maria Costa
A1  - da Silva Santos, Ariane Fernandes
A1  - de Lima, Brenda Regina
A1  - de Albuquerque Borborema, Maria Eduarda
A1  - de Azevêdo Silva, Jaqueline
Y1  - 2020/07//
KW  - Diabetes mellitus
KW  - Hypertension arterial
KW  - Immune response
KW  - Obesity
KW  - Vitamin D
PB  - Elsevier Ltd
JF  - Diabetes and Metabolic Syndrome: Clinical Research and Reviews
VL  - 14
IS  - 4
SP  - 597
EP  - 600
DO  - 10.1016/j.dsx.2020.05.025
UR  - /pmc/articles/PMC7215143/
UR  - /pmc/articles/PMC7215143/?report=abstract
UR  - https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7215143/
L1  - file:///C:/Users/sony/AppData/Local/Mendeley Ltd./Mendeley Desktop/Downloaded/de Lucena et al. - 2020 - Mechanism of inflammatory response in associated comorbidities in COVID-19.pdf
N2  - Background and aims: The outbreak of the new coronavirus, SARS-CoV-2, causes a respiratory disease and individuals with pre-existing cardiometabolic disorders display worse prognosis through the infection course. The aim of this minireview is to present epidemiological data related to metabolic comorbidities in association with the SARS-CoV-2. Methods: This is a narrative mini-review with Pubmed search until April 23, 2020 using the keywords COVID-19, SARS-CoV-2, treatment of coronavirus and following terms: diabetes mellitus, obesity, arterial hypertension, ACE-inhibitors, cytokine storm, immune response and vitamin D. Results: Studies indicate that obese individuals are more likely to develop infections, and that adipose tissue serves as a pathogen reservoir. In diabetic individuals higher rate of inflammatory processes is seen due to constant glucose recognition by C type lectin receptors. Hypertensive individuals, usually grouped with other conditions, are treated with drugs to reduce blood pressure mostly through ACEi and ARB, that leads to increased ACE2 expression, used by SARS-CoV-2 for human's cell entry. Until now, the studies have shown that individuals with those conditions and affected by COVID-19 present an uncontrolled release of pro-inflammatory cytokines and an unbalanced immune response, leading to the cytokine storm phenomenon. Vitamin D is highlighted as a potential therapeutic target, because in addition to acting on the immune system, it plays an important role in the control of cardiometabolic diseases. Conclusion: Currently, since there is no proven and effective antiviral therapy for SARS-CoV-2, the efforts should focus on controlling inflammatory response and reduce the risks of associated complications.
ER  - 
TY  - BOOK
T1  - Applied Logistic Regression.
A1  - Scott, A. J.
A1  - Hosmer, D. W.
A1  - Lemeshow, S.
Y1  - 1991///
JF  - Biometrics
VL  - 47
IS  - 4
SP  - 1632
EP  - 1632
SN  - 9780470582473
DO  - 10.2307/2532419
L1  - file:///C:/Users/sony/AppData/Local/Mendeley Ltd./Mendeley Desktop/Downloaded/Scott, Hosmer, Lemeshow - 1991 - Applied Logistic Regression.pdf
N2  - A new edition of the definitive guide to logistic regression modeling for health science and other applicationsThis thoroughly expanded Third Edition provides an easily accessible introduction to the logistic regression (LR) model and highlights the power of this model by examining the relationship between a dichotomous outcome and a set of covariables. Applied Logistic Regression, Third Edition emphasizes applications in the health sciences and handpicks topics that best suit the use of modern statistical software. The book provides readers with state-of-the-art techniques for building, interpreting, and assessing the performance of LR models. New and updated features include: A chapter on the analysis of correlated outcome data. A wealth of additional material for topics ranging from Bayesian methods to assessing model fit Rich data sets from real-world studies that demonstrate each method under discussion. Detailed examples and interpretation of the presented results as well as exercises throughout Applied Logistic Regression, Third Edition is a must-have guide for professionals and researchers who need to model nominal or ordinal scaled outcome variables in public health, medicine, and the social sciences as well as a wide range of other fields and disciplines
ER  - 
TY  - JOUR
T1  - Gender effect on in vitro lymphocyte subset levels of healthy individuals
A1  - Abdullah, Maha
A1  - Chai, Pei Shin
A1  - Chong, Mun Yee
A1  - Tohit, Eusni Rahayu Mohd
A1  - Ramasamy, Rajesh
A1  - Pei, Chong Pei
A1  - Vidyadaran, Sharmili
Y1  - 2012///
KW  - Gender
KW  - Healthy individuals
KW  - In vitro
KW  - In vivo
KW  - PBMC
KW  - Phenotype
KW  - Whole blood
PB  - Cell Immunol
JF  - Cellular Immunology
VL  - 272
IS  - 2
SP  - 214
EP  - 219
DO  - 10.1016/j.cellimm.2011.10.009
UR  - https://pubmed.ncbi.nlm.nih.gov/22078320/
N2  - Differences in gender immune response have resulted in differences in immune protection and susceptibility to inflammatory diseases. Cultured peripheral blood mononuclear cells (PBMC) are widely used in immunomodulation studies, yet the influence of gender is usually not considered. We examined the effect of in vitro culture and phytohaemagglutinin (PHA) stimulation on PBMC lymphocyte subsets using flowcytometry. Full blood counts of whole blood showed higher levels of lymphocyte in male subjects. Lymphocyte subsets enumeration revealed higher NK cell counts in males and higher B cells in females. Cultured PBMC resulted in significant increases in B and total T cell percentages among females and NK cells among males. PHA stimulated significantly increased percentages of NK and total T cells in males and total activated T cells (CD69+) in females. Our results showed significant gender differences in lymphocyte subsets in cultured conditions. This may affect experimental outcome. © 2011 Elsevier Inc.
ER  - 
TY  - JOUR
T1  - The pattern of Middle east respiratory syndrome coronavirus in Saudi Arabia: A descriptive epidemiological analysis of data from the Saudi Ministry of Health
A1  - Alghamdi, Ibrahim G.
A1  - Hussain, Issam I.
A1  - Almalki, Shaia S.
A1  - Alghamdi, Mohamed S.
A1  - Alghamdi, Mansour M.
A1  - El-Sheemy, Mohammed A.
Y1  - 2014/08//
KW  - Case fatality rate
KW  - Descriptive epidemiology
KW  - Humidity
KW  - Middle East respiratory syndrome
KW  - Temperature
PB  - Dove Medical Press Ltd.
JF  - International Journal of General Medicine
VL  - 7
SP  - 417
EP  - 423
DO  - 10.2147/IJGM.S67061
UR  - https://pubmed.ncbi.nlm.nih.gov/25187734/
L1  - file:///C:/Users/sony/AppData/Local/Mendeley Ltd./Mendeley Desktop/Downloaded/Alghamdi et al. - 2014 - The pattern of Middle east respiratory syndrome coronavirus in Saudi Arabia A descriptive epidemiological analy.pdf
N2  - Purpose: This study describes the epidemiology of Middle East respiratory syndrome coronavirus (MERS-CoV) in Saudi Arabia. Patients and methods: Epidemiological analysis was performed on data from all MERS-CoV cases recorded by the Saudi Ministry of Health between June 6, 2013 and May 14, 2014. The frequency of cases and deaths was calculated and adjusted by month, sex, age group, and region. The average monthly temperature and humidity of infected regions throughout the year was also calculated. Results: A total of 425 cases were recorded over the study period. The highest number of cases and deaths occurred between April and May 2014. Disease occurrence among men (260 cases [62%]) was higher than in women (162 cases [38%]), and the case fatality rate was higher for men (52%) than for women (23%). In addition, those in the 45-59 years and ≥60 years age groups were most likely to be infected, and the case fatality rate for these people was higher than for other groups. The highest number of cases and deaths were reported in Riyadh (169 cases; 43 deaths), followed by Jeddah (156 cases; 36 deaths) and the Eastern Region (24 cases; 22 deaths). The highest case fatality rate was in the Eastern Region (92%), followed by Medinah (36%) and Najran (33%). MERS-CoV infection actively causes disease in environments with low relative humidity (<20%) and high temperature (15°C-35°C). Conclusion: MERS-CoV is considered an epidemic in Saudi Arabia. The frequency of cases and deaths is higher among men than women, and those above 45 years of age are most affected. Low relative humidity and high temperature can enhance the spread of this disease in the entire population. Further analytical studies are required to determine the source and mode of infection in Saudi Arabia. © 2014 Alghamdi et al.
ER  - 
TY  - JOUR
T1  - Do Men Have a Higher Case Fatality Rate of Severe Acute Respiratory Syndrome than Women Do?
A1  - Karlberg, Johan
A1  - Chong, D. S.Y.
A1  - Lai, W. Y.Y.
Y1  - 2004/02//
KW  - Case mortality
KW  - Hong Kong
KW  - SARS virus
PB  - Am J Epidemiol
JF  - American Journal of Epidemiology
VL  - 159
IS  - 3
SP  - 229
EP  - 231
DO  - 10.1093/aje/kwh056
UR  - https://pubmed.ncbi.nlm.nih.gov/14742282/
L1  - file:///C:/Users/sony/AppData/Local/Mendeley Ltd./Mendeley Desktop/Downloaded/Karlberg, Chong, Lai - 2004 - Do Men Have a Higher Case Fatality Rate of Severe Acute Respiratory Syndrome than Women Do.pdf
N2  - Severe acute respiratory syndrome (SARS) has been reported in 30 countries and regions, with a cumulative total of 8,099 probable cases and 774 deaths as of July 31, 2003, according to the World Health Organization. In Hong Kong, People's Republic of China, 1,755 SARS cases and 299 deaths had occurred as of September 22, 2003. The authors analyzed data from the Department of Health, Hong Kong SAR. The data series includes details regarding sex, age, and chronic disease history. Using data from early March to September 22, 2003, the authors found that males had a significantly (p < 0.0001) higher case fatality rate than females did, 21.9% versus 13.2%; the relative risk was 1.66 (95% confidence interval (CI): 1.35, 2.05), and it was 1.62 (95% CI: 1.21, 2.16) after adjustment for age. Subgroup analysis was conducted by excluding health care workers (n = 386) from the analysis. The overall crude relative risk of mortality was 1.41 (95% CI: 1.15, 1.74), and the adjusted relative risk was 1. 48 (95% CI: 1.10, 2.00). Thus, among SARS patients, males may be more severely affected by the disease than females are. This finding could be related to a nonuniform case definition of SARS disease, a different treatment regimen, a past smoking history, work-environment factors, or gender-specific immune-defense factors, for instance.
ER  - 
TY  - JOUR
T1  - Male sex identified by global COVID-19 meta-analysis as a risk factor for death and ITU admission
A1  - Peckham, Hannah
A1  - de Gruijter, Nina M.
A1  - Raine, Charles
A1  - Radziszewska, Anna
A1  - Ciurtin, Coziana
A1  - Wedderburn, Lucy R.
A1  - Rosser, Elizabeth C.
A1  - Webb, Kate
A1  - Deakin, Claire T.
Y1  - 2020/12//
KW  - Epidemiology
KW  - Risk factors
KW  - Systems analysis
KW  - Viral infection
PB  - Nature Research
JF  - Nature Communications
VL  - 11
IS  - 1
SP  - 1
EP  - 10
DO  - 10.1038/s41467-020-19741-6
UR  - https://doi.org/10.1038/s41467-020-19741-6
L1  - file:///C:/Users/sony/AppData/Local/Mendeley Ltd./Mendeley Desktop/Downloaded/Peckham et al. - 2020 - Male sex identified by global COVID-19 meta-analysis as a risk factor for death and ITU admission.pdf
N2  - Anecdotal evidence suggests that Coronavirus disease 2019 (COVID-19), caused by the coronavirus SARS-CoV-2, exhibits differences in morbidity and mortality between sexes. Here, we present a meta-analysis of 3,111,714 reported global cases to demonstrate that, whilst there is no difference in the proportion of males and females with confirmed COVID-19, male patients have almost three times the odds of requiring intensive treatment unit (ITU) admission (OR = 2.84; 95% CI = 2.06, 3.92) and higher odds of death (OR = 1.39; 95% CI = 1.31, 1.47) compared to females. With few exceptions, the sex bias observed in COVID-19 is a worldwide phenomenon. An appreciation of how sex is influencing COVID-19 outcomes will have important implications for clinical management and mitigation strategies for this disease.
ER  - 
TY  - GEN
T1  - Immunosenescence and inflamm-aging as two sides of the same coin: Friends or Foes?
A1  - Fulop, Tamas
A1  - Larbi, Anis
A1  - Dupuis, Gilles
A1  - Page, Aurélie Le
A1  - Frost, Eric H.
A1  - Cohen, Alan A.
A1  - Witkowski, Jacek M.
A1  - Franceschi, Claudio
Y1  - 2018/01//
KW  - Healthspan
KW  - Immune-adaptation
KW  - Immunometabolism
KW  - Immunoremodeling
KW  - Immunosenescence
KW  - Inflamm-aging
KW  - Longevity
PB  - Frontiers Media S.A.
JF  - Frontiers in Immunology
VL  - 8
IS  - JAN
DO  - 10.3389/fimmu.2017.01960
UR  - https://pubmed.ncbi.nlm.nih.gov/29375577/
L1  - file:///C:/Users/sony/AppData/Local/Mendeley Ltd./Mendeley Desktop/Downloaded/Fulop et al. - 2018 - Immunosenescence and inflamm-aging as two sides of the same coin Friends or Foes.pdf
N2  - The immune system is the most important protective physiological system of the organism. It has many connections with other systems and is, in fact, often considered as part of the larger neuro-endocrine-immune axis. Most experimental data on immune changes with aging show a decline in many immune parameters when compared to young healthy subjects. The bulk of these changes is termed immunosenescence. Immunosenescence has been considered for some time as detrimental because it often leads to subclinical accumulation of pro-inflammatory factors and inflamm-aging. Together, immunosenescence and inflamm-aging are suggested to stand at the origin of most of the diseases of the elderly, such as infections, cancer, autoimmune disorders, and chronic inflammatory diseases. However, an increasing number of immune-gerontologists have challenged this negative interpretation of immunosenescence with respect to its significance in aging-related alterations of the immune system. If one considers these changes from an evolutionary perspective, they can be viewed preferably as adaptive or remodeling rather than solely detrimental. Whereas it is conceivable that global immune changes may lead to various diseases, it is also obvious that these changes may be needed for extended survival/longevity. Recent cumulative data suggest that, without the existence of the immunosenescence/inflamm-aging duo (representing two sides of the same phenomenon), human longevity would be greatly shortened. This review summarizes recent data on the dynamic reassessment of immune changes with aging. Accordingly, attempts to intervene on the aging immune system by targeting its rejuvenation, it may be more suitable to aim to maintain general homeostasis and function by appropriately improving immune-inflammatory-functions.
ER  - 
TY  - JOUR
T1  - Prognostic factors for severity and mortality in patients infected with COVID-19: A systematic review
A1  - Izcovich, Ariel
A1  - Ragusa, Martín Alberto
A1  - Tortosa, Fernando
A1  - Marzio, María Andrea Lavena
A1  - Agnoletti, Camila
A1  - Bengolea, Agustín
A1  - Ceirano, Agustina
A1  - Espinosa, Federico
A1  - Saavedra, Ezequiel
A1  - Sanguine, Verónica
A1  - Tassara, Alfredo
A1  - Cid, Candelaria
A1  - Catalano, Hugo Norberto
A1  - Agarwal, Arnav
A1  - Foroutan, Farid
A1  - Rada, Gabriel
Y1  - 2020/11//
KW  - Aged
KW  - Aging
KW  - Ariel Izcovich
KW  - Betacoronavirus
KW  - COVID-19
KW  - Comorbidity
KW  - Coronavirus Infections / epidemiology*
KW  - Coronavirus Infections / mortality*
KW  - Data Management
KW  - Female
KW  - Gabriel Rada
KW  - Humans
KW  - MEDLINE
KW  - Male
KW  - Martín Alberto Ragusa
KW  - Middle Aged
KW  - NCBI
KW  - NIH
KW  - NLM
KW  - National Center for Biotechnology Information
KW  - National Institutes of Health
KW  - National Library of Medicine
KW  - PMC7671522
KW  - Pandemics
KW  - Pneumonia
KW  - Prognosis
KW  - PubMed Abstract
KW  - Risk Factors
KW  - SARS-CoV-2
KW  - Socioeconomic Factors
KW  - Systematic Review
KW  - Viral / epidemiology*
KW  - Viral / mortality*
KW  - doi:10.1371/journal.pone.0241955
KW  - pmid:33201896
PB  - Public Library of Science
JF  - PLoS ONE
VL  - 15
IS  - 11 November
DO  - 10.1371/journal.pone.0241955
UR  - https://pubmed.ncbi.nlm.nih.gov/33201896/
L1  - file:///C:/Users/sony/AppData/Local/Mendeley Ltd./Mendeley Desktop/Downloaded/Izcovich et al. - 2020 - Prognostic factors for severity and mortality in patients infected with COVID-19 A systematic review.pdf
N2  - Background and purpose The objective of our systematic review is to identify prognostic factors that may be used in decision-making related to the care of patients infected with COVID-19. Data sources We conducted highly sensitive searches in PubMed/MEDLINE, the Cochrane Central Register of Controlled Trials (CENTRAL) and Embase. The searches covered the period from the inception date of each database until April 28, 2020. No study design, publication status or language restriction were applied. Study selection and data extraction We included studies that assessed patients with confirmed or suspected SARS-CoV-2 infectious disease and examined one or more prognostic factors for mortality or disease severity. Reviewers working in pairs independently screened studies for eligibility, extracted data and assessed the risk of bias. We performed meta-analyses and used GRADE to assess the certainty of the evidence for each prognostic factor and outcome. Results We included 207 studies and found high or moderate certainty that the following 49 variables provide valuable prognostic information on mortality and/or severe disease in patients with COVID-19 infectious disease: Demographic factors (age, male sex, smoking), patient history factors (comorbidities, cerebrovascular disease, chronic obstructive pulmonary disease, chronic kidney disease, cardiovascular disease, cardiac arrhythmia, arterial hypertension, diabetes, dementia, cancer and dyslipidemia), physical examination factors (respiratory failure, low blood pressure, hypoxemia, tachycardia, dyspnea, anorexia, tachypnea, haemoptysis, abdominal pain, fatigue, fever and myalgia or arthralgia), laboratory factors (high blood procalcitonin, myocardial injury markers, high blood White Blood Cell count (WBC), high blood lactate, low blood platelet count, plasma creatinine increase, high blood D-dimer, high blood lactate dehydrogenase (LDH), high blood C-reactive protein (CRP), decrease in lymphocyte count, high blood aspartate aminotransferase (AST), decrease in blood albumin, high blood interleukin-6 (IL-6), high blood neutrophil count, high blood B-type natriuretic peptide (BNP), high blood urea nitrogen (BUN), high blood creatine kinase (CK), high blood bilirubin and high erythrocyte sedimentation rate (ESR)), radiological factors (consolidative infiltrate and pleural effusion) and high SOFA score (sequential organ failure assessment score). Conclusion Identified prognostic factors can help clinicians and policy makers in tailoring management strategies for patients with COVID-19 infectious disease while researchers can utilise our findings to develop multivariable prognostic models that could eventually facilitate decision-making and improve patient important outcomes.
ER  - 
TY  - JOUR
T1  - The Effect of Age on Mortality in Patients With COVID-19: A Meta-Analysis With 611,583 Subjects
A1  - Bonanad, Clara
A1  - García-Blas, Sergio
A1  - Tarazona-Santabalbina, Francisco
A1  - Sanchis, Juan
A1  - Bertomeu-González, Vicente
A1  - Fácila, Lorenzo
A1  - Ariza, Albert
A1  - Núñez, Julio
A1  - Cordero, Alberto
Y1  - 2020/07//
KW  - COVID-19
KW  - coronavirus
KW  - mortality
KW  - older adults
PB  - Elsevier Inc.
JF  - Journal of the American Medical Directors Association
VL  - 21
IS  - 7
SP  - 915
EP  - 918
DO  - 10.1016/j.jamda.2020.05.045
UR  - https://pubmed.ncbi.nlm.nih.gov/32674819/
L1  - file:///C:/Users/sony/AppData/Local/Mendeley Ltd./Mendeley Desktop/Downloaded/Bonanad et al. - 2020 - The Effect of Age on Mortality in Patients With COVID-19 A Meta-Analysis With 611,583 Subjects.pdf
N2  - Objectives: Initial data on COVID-19 infection has pointed out a special vulnerability of older adults. Design: We performed a meta-analysis with available national reports on May 7, 2020 from China, Italy, Spain, United Kingdom, and New York State. Analyses were performed by a random effects model, and sensitivity analyses were performed for the identification of potential sources of heterogeneity. Setting and participants: COVID-19–positive patients reported in literature and national reports. Measures: All-cause mortality by age. Results: A total of 611,1583 subjects were analyzed and 141,745 (23.2%) were aged ≥80 years. The percentage of octogenarians was different in the 5 registries, the lowest being in China (3.2%) and the highest in the United Kingdom and New York State. The overall mortality rate was 12.10% and it varied widely between countries, the lowest being in China (3.1%) and the highest in the United Kingdom (20.8%) and New York State (20.99%). Mortality was <1.1% in patients aged <50 years and it increased exponentially after that age in the 5 national registries. As expected, the highest mortality rate was observed in patients aged ≥80 years. All age groups had significantly higher mortality compared with the immediately younger age group. The largest increase in mortality risk was observed in patients aged 60 to 69 years compared with those aged 50 to 59 years (odds ratio 3.13, 95% confidence interval 2.61-3.76). Conclusions and Implications: This meta-analysis with more than half million of COVID-19 patients from different countries highlights the determinant effect of age on mortality with the relevant thresholds on age >50 years and, especially, >60 years. Older adult patients should be prioritized in the implementation of preventive measures.
ER  - 
TY  - RPRT
T1  - Informe de gestión 2020
A1  - Hospital Universitario Mayor Mederi
Y1  - 2020///
SP  - 135
EP  - 135
UR  - https://www.mederi.com.co/sites/default/files/Informe-Gestion-2020.pdf
ER  - 
TY  - JOUR
T1  - COVID-19 and coagulation: Bleeding and thrombotic manifestations of SARS-CoV-2 infection
A1  - Al-Samkari, Hanny
A1  - Karp Leaf, Rebecca S.
A1  - Dzik, Walter H.
A1  - Carlson, Jonathan C.T.
A1  - Fogerty, Annemarie E.
A1  - Waheed, Anem
A1  - Goodarzi, Katayoon
A1  - Bendapudi, Pavan K.
A1  - Bornikova, Larissa
A1  - Gupta, Shruti
A1  - Leaf, David E.
A1  - Kuter, David J.
A1  - Rosovsky, Rachel P.
Y1  - 2020/07//
KW  - bleeding rate
KW  - blood coagulation
KW  - coagulation process
KW  - thrombosis
KW  - thrombus
PB  - American Society of Hematology
JF  - Blood
VL  - 136
IS  - 4
SP  - 489
EP  - 500
DO  - 10.1182/BLOOD.2020006520
UR  - http://ashpublications.org/blood/article-pdf/136/4/489/1749047/bloodbld2020006520.pdf
L1  - file:///C:/Users/sony/AppData/Local/Mendeley Ltd./Mendeley Desktop/Downloaded/Al-Samkari et al. - 2020 - COVID-19 and coagulation Bleeding and thrombotic manifestations of SARS-CoV-2 infection.pdf
N2  - Patients with coronavirus disease 2019 (COVID-19) have elevated D-dimer levels. Early reports describe high venous thromboembolism (VTE) and disseminated intravascular coagulation (DIC) rates, but data are limited. This multicenter retrospective study describes the rate and severity of hemostatic and thrombotic complications of 400 hospital-admitted COVID-19 patients (144 critically ill) primarily receiving standard-dose prophylactic anticoagulation. Coagulation and inflammatory parameters were compared between patients with and without coagulation-associated complications. Multivariable logistic models examined the utility of these markers in predicting coagulation-associated complications, critical illness, and death. The radiographically confirmed VTE rate was 4.8% (95% confidence interval [CI], 2.9-7.3), and the overall thrombotic complication rate was 9.5% (95% CI, 6.8-12.8). The overall and major bleeding rates were 4.8% (95% CI, 2.9-7.3) and 2.3% (95% CI, 1.0-4.2), respectively. In the critically ill, radiographically confirmed VTE and major bleeding rates were 7.6% (95% CI, 3.9-13.3) and 5.6% (95% CI, 2.4-10.7), respectively. Elevated D-dimer at initial presentation was predictive of coagulation-associated complications during hospitalization (D-dimer >2500 ng/mL, adjusted odds ratio [OR] for thrombosis, 6.79 [95% CI, 2.39-19.30]; adjusted OR for bleeding, 3.56 [95% CI, 1.01-12.66]), critical illness, and death. Additional markers at initial presentation predictive of thrombosis during hospitalization included platelet count >450 3 109/L (adjusted OR, 3.56 [95% CI, 1.27-9.97]), C-reactive protein (CRP) >100 mg/L (adjusted OR, 2.71 [95% CI, 1.26-5.86]), and erythrocyte sedimentation rate (ESR) >40 mm/h (adjusted OR, 2.64 [95% CI, 1.07-6.51]). ESR, CRP, fibrinogen, ferritin, and procalcitonin were higher in patients with thrombotic complications than in those without. DIC, clinically relevant thrombocytopenia, and reduced fibrinogen were rare and were associated with significant bleeding manifestations. Given the observed bleeding rates, randomized trials are needed to determine any potential benefit of intensified anticoagulant prophylaxis in COVID-19 patients.
ER  - 
TY  - JOUR
T1  - Pulmonary Embolism and Deep Vein Thrombosis in COVID-19: A Systematic Review and Meta-Analysis
A1  - Suh, Young Joo
A1  - Hong, Hyunsook
A1  - Ohana, Mickaël
A1  - Bompard, Florian
A1  - Revel, Marie-Pierre
A1  - Valle, Clarissa
A1  - Gervaise, Alban
A1  - Poissy, Julien
A1  - Susen, Sophie
A1  - Hékimian, Guillaume
A1  - Artifoni, Mathieu
A1  - Periard, Daniel
A1  - Contou, Damien
A1  - Delaloye, Julie
A1  - Sanchez, Bienvenido
A1  - Fang, Cheng
A1  - Garzillo, Giorgio
A1  - Robbie, Hasti
A1  - Yoon, Soon Ho
Y1  - 2021/02//
PB  - Radiological Society of North America Inc.
JF  - Radiology
VL  - 298
IS  - 2
SP  - E70
EP  - E80
DO  - 10.1148/radiol.2020203557
UR  - http://pubs.rsna.org/doi/10.1148/radiol.2020203557
L1  - file:///C:/Users/sony/AppData/Local/Mendeley Ltd./Mendeley Desktop/Downloaded/Suh et al. - 2021 - Pulmonary Embolism and Deep Vein Thrombosis in COVID-19 A Systematic Review and Meta-Analysis.pdf
N2  - Background: The association of pulmonary embolism (PE) with deep vein thrombosis (DVT) in patients with coronavirus disease 2019 (COVID-19) remains unclear, and the diagnostic accuracy of D-dimer tests for PE is unknown. Purpose: To conduct meta-analysis of the study-level incidence of PE and DVT and to evaluate the diagnostic accuracy of D-dimer tests for PE from multicenter individual patient data. Materials and Methods: A systematic literature search identified studies evaluating the incidence of PE or DVT in patients with COVID-19 from January 1, 2020, to June 15, 2020. These outcomes were pooled using a random-effects model and were further evaluated using metaregression analysis. The diagnostic accuracy of D-dimer tests for PE was estimated on the basis of individual patient data using the summary receiver operating characteristic curve. Results: Twenty-seven studies with 3342 patients with COVID-19 were included in the analysis. The pooled incidence rates of PE and DVT were 16.5% (95% CI: 11.6, 22.9; I2 = 0.93) and 14.8% (95% CI: 8.5, 24.5; I2 = 0.94), respectively. PE was more frequently found in patients who were admitted to the intensive care unit (ICU) (24.7% [95% CI: 18.6, 32.1] vs 10.5% [95% CI: 5.1, 20.2] in those not admitted to the ICU) and in studies with universal screening using CT pulmonary angiography. DVT was present in 42.4% of patients with PE. D-dimer tests had an area under the receiver operating characteristic curve of 0.737 for PE, and D-dimer levels of 500 and 1000 mg/L showed high sensitivity (96% and 91%, respectively) but low specificity (10% and 24%, respectively). Conclusion: Pulmonary embolism (PE) and deep vein thrombosis (DVT) occurred in 16.5% and 14.8% of patients with coronavirus disease 2019 (COVID-19), respectively, and more than half of patients with PE lacked DVT. The cutoffs of D-dimer levels used to exclude PE in preexisting guidelines seem applicable to patients with COVID-19.
ER  - 
TY  - JOUR
T1  - Neurologic Manifestations of Hospitalized Patients with Coronavirus Disease 2019 in Wuhan, China
A1  - Mao, Ling
A1  - Jin, Huijuan
A1  - Wang, Mengdie
A1  - Hu, Yu
A1  - Chen, Shengcai
A1  - He, Quanwei
A1  - Chang, Jiang
A1  - Hong, Candong
A1  - Zhou, Yifan
A1  - Wang, David
A1  - Miao, Xiaoping
A1  - Li, Yanan
A1  - Hu, Bo
Y1  - 2020///
JF  - JAMA Neurology
VL  - 77
IS  - 6
SP  - 683
EP  - 690
DO  - 10.1001/jamaneurol.2020.1127
L1  - file:///C:/Users/sony/AppData/Local/Mendeley Ltd./Mendeley Desktop/Downloaded/Mao et al. - 2020 - Neurologic Manifestations of Hospitalized Patients with Coronavirus Disease 2019 in Wuhan, China(2).pdf
N2  - Importance: The outbreak of coronavirus disease 2019 (COVID-19) in Wuhan, China, is serious and has the potential to become an epidemic worldwide. Several studies have described typical clinical manifestations including fever, cough, diarrhea, and fatigue. However, to our knowledge, it has not been reported that patients with COVID-19 had any neurologic manifestations. Objective: To study the neurologic manifestations of patients with COVID-19. Design, Setting, and Participants: This is a retrospective, observational case series. Data were collected from January 16, 2020, to February 19, 2020, at 3 designated special care centers for COVID-19 (Main District, West Branch, and Tumor Center) of the Union Hospital of Huazhong University of Science and Technology in Wuhan, China. The study included 214 consecutive hospitalized patients with laboratory-confirmed diagnosis of severe acute respiratory syndrome coronavirus 2 infection. Main Outcomes and Measures: Clinical data were extracted from electronic medical records, and data of all neurologic symptoms were checked by 2 trained neurologists. Neurologic manifestations fell into 3 categories: central nervous system manifestations (dizziness, headache, impaired consciousness, acute cerebrovascular disease, ataxia, and seizure), peripheral nervous system manifestations (taste impairment, smell impairment, vision impairment, and nerve pain), and skeletal muscular injury manifestations. Results: Of 214 patients (mean [SD] age, 52.7 [15.5] years; 87 men [40.7%]) with COVID-19, 126 patients (58.9%) had nonsevere infection and 88 patients (41.1%) had severe infection according to their respiratory status. Overall, 78 patients (36.4%) had neurologic manifestations. Compared with patients with nonsevere infection, patients with severe infection were older, had more underlying disorders, especially hypertension, and showed fewer typical symptoms of COVID-19, such as fever and cough. Patients with more severe infection had neurologic manifestations, such as acute cerebrovascular diseases (5 [5.7%] vs 1 [0.8%]), impaired consciousness (13 [14.8%] vs 3 [2.4%]), and skeletal muscle injury (17 [19.3%] vs 6 [4.8%]). Conclusions and Relevance: Patients with COVID-19 commonly have neurologic manifestations. During the epidemic period of COVID-19, when seeing patients with neurologic manifestations, clinicians should suspect severe acute respiratory syndrome coronavirus 2 infection as a differential diagnosis to avoid delayed diagnosis or misdiagnosis and lose the chance to treat and prevent further transmission.
ER  - 
TY  - JOUR
T1  - Guillain-Barré Syndrome Associated with SARS-CoV-2 infection
A1  - Esteban Molina, A.
A1  - Mata Martínez, M.
A1  - Sánchez Chueca, P.
A1  - Carrillo López, A.
A1  - Sancho Val, I.
A1  - Sanjuan-Villarreal, T. A.
Y1  - 2020/11//
PB  - Ediciones Doyma, S.L.
JF  - Medicina Intensiva
VL  - 44
IS  - 8
SP  - 513
EP  - 514
DO  - 10.1016/j.medin.2020.04.015
UR  - http://www.medintensiva.org/es-sindrome-guillain-barre-asociado-infeccion-por-articulo-S0210569120301546
L1  - file:///C:/Users/sony/AppData/Local/Mendeley Ltd./Mendeley Desktop/Downloaded/Esteban Molina et al. - 2020 - Guillain-Barré Syndrome Associated with SARS-CoV-2 infection.pdf
ER  - 
TY  - JOUR
T1  - Renal complications in COVID-19: a systematic review and meta-analysis
A1  - Kunutsor, Setor K
A1  - Laukkanen, Jari A
Y1  - 2020///
KW  - COVID-19
KW  - Renal complications
KW  - acute kidney injury
KW  - meta-analysis
DO  - 10.1080/07853890.2020.1790643
UR  - https://www.tandfonline.com/action/journalInformation?journalCode=iann20
L1  - file:///C:/Users/sony/AppData/Local/Mendeley Ltd./Mendeley Desktop/Downloaded/Kunutsor, Laukkanen - 2020 - Renal complications in COVID-19 a systematic review and meta-analysis(2).pdf
N2  - Purpose: Emerging data suggest that coronavirus disease 2019 (COVID-19) has extrapulmonary manifestations but its renal manifestations are not clearly defined. We aimed to evaluate renal complications of COVID-19 and their incidence using a systematic meta-analysis. Design: Observational studies reporting renal complications in COVID-19 patients were sought from MEDLINE, Embase and the Cochrane Library from 2019 to June 2020. The nine-star Newcastle-Ottawa Scale was used to evaluate methodological quality. Incidence with 95% confidence intervals (CIs) were pooled using random-effects models. Results: We included 22 observational cohort studies comprising of 17,391 COVID-19 patients. Quality scores of studies ranged from 4 to 6. The pooled prevalence of pre-existing chronic kidney disease (CKD) and end-stage kidney disease was 5.2% (2.8-8.1) and 2.3% (1.8-2.8), respectively. The pooled incidence over follow-up of 2-28 days was 12.5% (10.1-15.0) for electrolyte disturbance (e.g. hyperkalaemia), 11.0% (7.4-15.1) for acute kidney injury (AKI) and 6.8% (1.0-17.0) for renal replacement therapy (RRT). In subgroup analyses, there was a higher incidence of AKI in US populations and groups with higher prevalence of pre-existing CKD. Conclusions: Frequent renal complications reported among hospitalized COVID-19 patients are electrolyte disturbance, AKI and RRT. Aggressive monitoring and management of these renal complications may help in the prediction of favourable outcomes. Systematic review registration: PROSPERO 2020: CRD42020186873 KEY MESSAGES COVID-19 affects multiple organs apart from the respiratory system; however, its renal manifestations are not clearly defined. In this systematic meta-analysis of 22 observational cohort studies, the prevalence of pre-existing chronic kidney disease (CKD) in COVID-19 patients was 5.2%. The most frequent renal complication was electrolyte disturbance (particularly hyperkalaemia) with an incidence of 12.5% followed by acute kidney injury (AKI) with an incidence of 11.0%; US populations and groups with higher prevalence of CKD had higher incidence of AKI. ARTICLE HISTORY
ER  - 
TY  - GEN
T1  - Cardiac complications in COVID-19: A systematic review and meta-analysis
A1  - Sahranavard, Mehrdad
A1  - Rezayat, Arash Akhavan
A1  - Bidary, Mohammad Zamiri
A1  - Omranzadeh, Alireza
A1  - Rohani, Farahnaz
A1  - Farahani, Ramin Hamidi
A1  - Hazrati, Ebrahim
A1  - Mousavi, Seyyed Hossein
A1  - Ardalan, Mohamed Afshar
A1  - Soleiman-Meigooni, Saeed
A1  - Hosseini-Shokouh, Seyyed Javad
A1  - Hejripour, Zia
A1  - Nassireslami, Ehsan
A1  - Laripour, Reza
A1  - Salarian, Amirahmad
A1  - Nourmohammadi, Abbas
A1  - Mosaed, Reza
Y1  - 2021/02//
KW  - COVID-19
KW  - Cardiac complications
KW  - Creatine kinase MB form
KW  - Myocardial injury
PB  - Academy of Medical Sciences of I.R. Iran
JF  - Archives of Iranian Medicine
VL  - 24
IS  - 2
SP  - 152
EP  - 163
DO  - 10.34172/AIM.2021.24
UR  - https://pubmed.ncbi.nlm.nih.gov/33636985/
L1  - file:///C:/Users/sony/AppData/Local/Mendeley Ltd./Mendeley Desktop/Downloaded/Sahranavard et al. - 2021 - Cardiac complications in COVID-19 A systematic review and meta-analysis.pdf
N2  - Background: The newly emerged coronavirus disease 2019 (COVID-19) seems to involve different organs, including the cardiovascular system. We systematically reviewed COVID-19 cardiac complications and calculated their pooled incidences. Secondarily, we compared the cardiac troponin I (cTnI) level between the surviving and expired patients. Methods: A systematic search was conducted for manuscripts published from December 1, 2019 to April 16, 2020. Cardiovascular complications, along with the levels of cTnI, creatine kinase (CK), and creatine kinase MB (CK-MB) in hospitalized PCR-confirmed COVID-19 patients were extracted. The pooled incidences of the extracted data were calculated, and the unadjusted cTnI level was compared between the surviving and expired patients. Results: Out of 1094 obtained records, 22 studies on a total of 4,157 patients were included. The pooled incidence rate of arrhythmia was 10.11%. Furthermore, myocardial injury had a pooled incidence of 17.85%, and finally, the pooled incidence for heart failure was 22.34%. The pooled incidence rates of cTnI, CK-MB, and CK elevations were also reported at 15.16%, 10.92%, and 12.99%, respectively. Moreover, the pooled level of unadjusted cTnI was significantly higher in expired cases compared with the surviving (mean difference = 31.818, 95% CI = 17.923-45.713, P value <0.001). Conclusion: COVID-19 can affect different parts of the heart; however, the myocardium is more involved.
ER  - 
TY  - JOUR
T1  - Cardiovascular complications in COVID-19: A systematic review and meta-analysis
A1  - Kunutsor, Setor K
A1  - Laukkanen, Jari A
Y1  - 2020///
JF  - Journal of Infection
VL  - 81
SP  - e139
EP  - e141
DO  - 10.1016/j.jinf.2020.05.068
UR  - https://doi.org/10.1016/j.jinf.2020.05.068
L1  - file:///C:/Users/sony/AppData/Local/Mendeley Ltd./Mendeley Desktop/Downloaded/Kunutsor, Laukkanen - 2020 - Cardiovascular complications in COVID-19 A systematic review and meta-analysis.pdf
ER  - 
TY  - JOUR
T1  - Lower Incidence of COVID-19 at High Altitude: Facts and Confounders
A1  - Pun, Matiram
A1  - Turner, Rachel
A1  - Strapazzon, Giacomo
A1  - Brugger, Hermann
A1  - Swenson, Erik R.
Y1  - 2020///
KW  - COVID-19
KW  - SARS-CoV-2
KW  - UV rays
KW  - high altitude
KW  - hypoxia
KW  - public health
JF  - High Altitude Medicine and Biology
VL  - 21
IS  - 3
SP  - 217
EP  - 222
DO  - 10.1089/ham.2020.0114
L1  - file:///C:/Users/sony/AppData/Local/Mendeley Ltd./Mendeley Desktop/Downloaded/Pun et al. - 2020 - Lower Incidence of COVID-19 at High Altitude Facts and Confounders.pdf
N2  - Pun, Matiram, Rachel Turner, Giacomo Strapazzon, Hermann Brugger, and Erik R. Swenson. Lower incidence of COVID-19 at high altitude: Facts and confounders. High Alt Med Biol. 21:217-222, 2020. - The rapid transmission, increased morbidity, and mortality of coronavirus disease 2019 (COVID-19) has exhausted many health care systems and the global economy. Large variations in COVID-19 prevalence and incidence have been reported across and within many countries worldwide; however, this remains poorly understood. The variability and susceptibility across the world have been mainly attributed to differing socioeconomic status, burden of chronic diseases, access to health care, strength of health care systems, and early or late adoption of control measures. Environmental factors such as pollution, ambient temperature, humidity, and seasonal weather patterns at different latitudes may influence how severe the pandemic is and the incidence of infection in any part of the world. In addition, recent epidemiological data have been used to propose that altitude of residence may not only influence those environmental features considered key to lesser viral transmission, but also susceptibility to more severe forms of COVID-19 through hypoxic-hypobaria driven genomic or nongenomic adaptations specific to high-altitude populations. In this review, we critically examine these factors and attempt to determine based upon available scientific and epidemiological data whether living in high-altitude regions might be protective against COVID-19 as recent publications have claimed.
ER  - 
TY  - JOUR
T1  - Epidemiological, clinical characteristics of cases of SARS-CoV-2 infection with abnormal imaging findings
A1  - Zhang, Xiaoli
A1  - Cai, Huan
A1  - Hu, Jianhua
A1  - Lian, Jiangshan
A1  - Gu, Jueqing
A1  - Zhang, Shanyan
A1  - Ye, Chanyuan
A1  - Lu, Yingfeng
A1  - Jin, Ciliang
A1  - Yu, Guodong
A1  - Jia, Hongyu
A1  - Zhang, Yimin
A1  - Sheng, Jifang
A1  - Li, Lanjuan
A1  - Yang, Yida
Y1  - 2020/05//
KW  - Clinical
KW  - Epidemiological
KW  - Imaging findings
KW  - Predictive factors
KW  - SRAS-CoV-2
PB  - Elsevier B.V.
JF  - International Journal of Infectious Diseases
VL  - 94
SP  - 81
EP  - 87
DO  - 10.1016/j.ijid.2020.03.040
UR  - https://doi.org/10.1016/j.ijid.2020.03.040
L1  - file:///C:/Users/sony/AppData/Local/Mendeley Ltd./Mendeley Desktop/Downloaded/Zhang et al. - 2020 - Epidemiological, clinical characteristics of cases of SARS-CoV-2 infection with abnormal imaging findings.pdf
N2  - Purpose: To investigate the epidemiological and clinical characteristics of COVID-19 patients with abnormal imaging findings. Methods: Patients confirmed with SARS-CoV-2 infection in Zhejiang province from January 17 to February 8 who had undergone CT or X-ray were enrolled. Epidemiological and clinical data were analyzed among those with abnormal or normal imaging findings. Results: Excluding 72 patients with normal images, 230 of 573 patients showed abnormalities affecting more than two lung lobes. The median radiographic score was 2.0, and there was a negative correlation between that score and the oxygenation index (ρ = −0.657, P < 0.001). Patients with abnormal images were older (46.65 ± 13.82), with a higher rate of coexisting condition (28.8%), a lower rate of exposure history, and longer time between onset and confirmation (5 days) than non-pneumonia patients (all P < 0.05). A higher rate of fever, cough, expectoration and headache, a lower level of lymphocytes, albumin, and serum sodium levels and a higher total bilirubin, creatine kinase, lactate dehydrogenase, and C-reactive protein levels and a lower oxygenation index were observed in pneumonia patients (all P < 0.05). Muscle ache, shortness of breath, nausea and vomiting, lower lymphocytes levels, and higher serum creatinine and radiographic score at admission were predictive factors for the severe/critical subtype. Conclusion: Patients with abnormal images have more obvious clinical manifestations and laboratory changes. Combing clinical features and radiographic scores can effectively predict severe/critical types.
ER  - 
TY  - JOUR
T1  - Does the pathogenesis of SARS-CoV-2 virus decrease at high-altitude?
A1  - Arias-Reyes, Christian
A1  - Zubieta-DeUrioste, Natalia
A1  - Poma-Machicao, Liliana
A1  - Aliaga-Raduan, Fernanda
A1  - Carvajal-Rodriguez, Favio
A1  - Dutschmann, Mathias
A1  - Schneider-Gasser, Edith M.
A1  - Zubieta-Calleja, Gustavo
A1  - Soliz, Jorge
Y1  - 2020/06//
KW  - COVID-19
KW  - Hypoxia
KW  - Lung remodeling
KW  - UV
PB  - Elsevier B.V.
JF  - Respiratory Physiology and Neurobiology
VL  - 277
SP  - 103443
EP  - 103443
DO  - 10.1016/j.resp.2020.103443
L1  - file:///C:/Users/sony/AppData/Local/Mendeley Ltd./Mendeley Desktop/Downloaded/Arias-Reyes et al. - 2020 - Does the pathogenesis of SARS-CoV-2 virus decrease at high-altitude.pdf
N2  - In the present study we analyze the epidemiological data of COVID-19 of Tibet and high-altitude regions of Bolivia and Ecuador, and compare to lowland data, to test the hypothesis that high-altitude inhabitants (+2,500 m above sea-level) are less susceptible to develop severe adverse effects in acute SARS-CoV-2 virus infection. Analysis of available epidemiological data suggest that physiological acclimatization/adaptation that counterbalance the hypoxic environment in high-altitude may protect from severe impact of acute SARS-CoV-2 virus infection. Potential underlying mechanisms such as: (i) a compromised half-live of the virus caused by the high-altitude environment, and (ii) a hypoxia mediated down regulation of angiotensin-converting enzyme 2 (ACE2), which is the main binding target of SARS-CoV-2 virus in the pulmonary epithelium are discussed.
ER  - 
TY  - JOUR
T1  - At High Altitude COVID-19 Is Less Frequent: The Experience of Peru
A1  - Accinelli, Roberto Alfonso
A1  - Leon-Abarca, Juan Alonso
Y1  - 2020/11//
PB  - Elsevier BV
JF  - Archivos de Bronconeumología (English Edition)
VL  - 56
IS  - 11
SP  - 760
EP  - 761
DO  - 10.1016/j.arbr.2020.09.004
L1  - file:///C:/Users/sony/AppData/Local/Mendeley Ltd./Mendeley Desktop/Downloaded/Accinelli, Leon-Abarca - 2020 - At High Altitude COVID-19 Is Less Frequent The Experience of Peru.pdf
ER  - 
TY  - JOUR
T1  - Acute respiratory distress syndrome
A1  - Matthay, Michael A.
A1  - Zemans, Rachel L.
A1  - Zimmerman, Guy A.
A1  - Arabi, Yaseen M.
A1  - Beitler, Jeremy R.
A1  - Mercat, Alain
A1  - Herridge, Margaret
A1  - Randolph, Adrienne G.
A1  - Calfee, Carolyn S.
Y1  - 2018/03//
KW  - Immunology
KW  - Respiratory distress syndrome
KW  - Respiratory tract diseases
KW  - Sepsis
PB  - Nature Publishing Group
JF  - Nature Reviews Disease Primers
VL  - 5
IS  - 1
SP  - 1
EP  - 22
DO  - 10.1038/s41572-019-0069-0
UR  - www.nature.com/nrdp
L1  - file:///C:/Users/sony/AppData/Local/Mendeley Ltd./Mendeley Desktop/Downloaded/Matthay et al. - 2018 - Acute respiratory distress syndrome.pdf
N2  - The acute respiratory distress syndrome (ARDS) is a common cause of respiratory failure in critically ill patients and is defined by the acute onset of noncardiogenic pulmonary oedema, hypoxaemia and the need for mechanical ventilation. ARDS occurs most often in the setting of pneumonia, sepsis, aspiration of gastric contents or severe trauma and is present in ~10% of all patients in intensive care units worldwide. Despite some improvements, mortality remains high at 30–40% in most studies. Pathological specimens from patients with ARDS frequently reveal diffuse alveolar damage, and laboratory studies have demonstrated both alveolar epithelial and lung endothelial injury, resulting in accumulation of protein-rich inflammatory oedematous fluid in the alveolar space. Diagnosis is based on consensus syndromic criteria, with modifications for under-resourced settings and in paediatric patients. Treatment focuses on lung-protective ventilation; no specific pharmacotherapies have been identified. Long-term outcomes of patients with ARDS are increasingly recognized as important research targets, as many patients survive ARDS only to have ongoing functional and/or psychological sequelae. Future directions include efforts to facilitate earlier recognition of ARDS, identifying responsive subsets of patients and ongoing efforts to understand fundamental mechanisms of lung injury to design specific treatments.
ER  - 
TY  - CHAP
T1  - Mechanics of Breathing
A1  - Levitzky, Michael G
Y1  - 2017/04//
PB  - McGraw-Hill Education
JF  - Pulmonary Physiology, 9e
CY  - New York, NY
UR  - http://accessmedicine.mhmedical.com/content.aspx?aid=1160935887
N2  - The  reader  understands  the  mechanical  properties  of  the  lung  and  the  chest  wall  during  breathing.Describes  the  generation  of  a  pressure  gradient  between  the  atmosphere  and  the  alveoli.Describes  the  passive  expansion  and  recoil  of  the  alveoli.Defines  the  mechanical  interaction  of  the  lung  and  the  chest  wall,  and  relates  this  concept  to  the  negative  intrapleural  pressure.Describes  the  pressure-volume  characteristics  of  the  lung  and  the  chest  wall,  and  predicts  changes  in  the  compliance  of  the  lung  and  the  chest  wall  in  different  physiologic  and  pathologic  conditions.States  the  roles  of  pulmonary  surfactant  and  alveolar  interdependence  in  the  recoil  and  expansion  of  the  lung.Defines  the  functional  residual  capacity  (FRC),  and  uses  his  or  her  understanding  of  lung-chest  wall  interactions  to  predict  changes  in  FRC  in  different  physiologic  and  pathologic  conditions.Defines  airways  resistance  and  lists  the  factors  that  contribute  to  or  alter  the  resistance  to  airflow.Describes  the  dynamic  compression  of  airways  during  a  forced  expiration.Relates  changes  in  the  dynamic  compliance  of  the  lung  to  alterations  in  airways  resistance.Lists  the  factors  that  contribute  to  the  work  of  breathing.Predicts  alterations  in  the  work  of  breathing  in  different  physiologic  and  pathologic  states.  
ER  - 
TY  - JOUR
T1  - Índices de oxigenación como predictores de ventilación mecánica en neumonía a 2600 metros de altitud
A1  - Gloria M. Martínez
A1  - Diana P. Casas
A1  - Alirio Rodrigo Bastidas
A1  - Paola A. Pinilla
A1  - Wilmer J. Calderón
A1  - Francisco Cuervo
Y1  - 2016///
JF  - Acta Médica Colombiana
VL  - 41
IS  - 3
SP  - 169
EP  - 175
L1  - file:///C:/Users/sony/AppData/Local/Mendeley Ltd./Mendeley Desktop/Downloaded/Gloria M. Martínez et al. - 2016 - Índices de oxigenación como predictores de ventilación mecánica en neumonía a 2600 metros de altitud.pdf
N2  - Resumen Antecedentes: los valores de la diferencia alveolo arterial de oxígeno D(A-a)O 2 y de la relación presión alveolar de oxígeno y fracción inspirada de oxígeno (PaO 2 /FiO 2), son pobremente conocidos a gran altitud para predecir ventilación mecánica (VM) en pacientes con neumonía adquirida en comunidad (NAC) mayores de 65 años. Objetivo: conocer los valores de D(A-a)O 2 y PaO 2 /FiO 2 en pacientes con NAC que requirieron soporte ventilatorio. Métodos: estudio de cohorte prospectivo donde se obtuvo la D(A-a)O 2 y PaO 2 /FiO 2 de los gases arteriales de ingreso a urgencias, con cálculo de sensibilidad (S), especificidad (E), valor predictivo positivo (VPP), valor predictivo negativo VPN) y área bajo la curva ROC para el requerimiento de VM en las primeras 72 horas. Resultados: se siguieron 247 pacientes, 37 (15%) requirieron VM, no se encontraron diferencias en edad, género, y comorbilidades entre los grupos de VM y no VM. El área bajo la curva ROC para D(A-a) O 2 como predictor de VM fue de 0.84 (IC95%:0.77-0.92), para la PaO 2 /FiO 2 de 0.85 (IC 5%: 0.78-0.92) (p<0.0001). Para una D(A-a)O 2 en 55 se obtuvo una sensibilidad para predecir VM en 70.27%, especificidad 86.19%, VPP: 47%, VPN: 94%, razón de verosimilitud positiva (LR+): 5.1, razón de verosimilitud negativa (LR-): 0.3. Una PaO 2 /FiO 2 de 180 tiene una sensibilidad para predecir VM de: 86.65%, especificidad: 70.27%, VPP: 34%, VPN: 97%, LR+: 2.9, LR-: 0.2. La mortalidad global fue 3.2%. Conclusión: los valores de D(A-a)O 2 y PaO 2 /FiO 2 se relacionan con el requerimiento de VM en pacientes mayores de 65 años con NAC. (Acta Med Colomb 2016; 41: 169-175). Palabras clave: neumonía, infección adquirida en la comunidad, puntaje, sensibilidad, espe-cificidad. Abstract Background: the values of the difference of alveolar arterial oxygen D(A-a)O 2 and ratio of the alveolar oxygen pressure and fraction of inspired oxygen (PaO 2 /FiO 2) are poorly known at high altitude to predict mechanical ventilation (MV) in patients over 65 years with community-acquired pneumonia (CAP). Objective: to know the values of D(A-a)O 2 and PaO 2 /FiO 2 in CAP patients requiring ventilatory support. Methods: prospective cohort study where D(A-a)O 2 y PaO 2 /FiO 2 were obtained from arterial blood gases at entrance to the emergency room, with calculation of sensitivity (S), specificity (E), positive predictive value (PPV), negative predictive value (NPP) and area under the ROC curve for MV requirement within the first 72 hours.
ER  - 
TY  - RPRT
T1  - Manejo clínico de la COVID-19: Orientaciones provisionales
A1  - Organización Mundial de la Salud OMS
Y1  - 2020/05//
L1  - file:///C:/Users/sony/AppData/Local/Mendeley Ltd./Mendeley Desktop/Downloaded/Organización Mundial de la Salud OMS - 2020 - Manejo clínico de la COVID-19 Orientaciones provisionales.pdf
ER  - 
TY  - JOUR
T1  - The 2019–2020 novel coronavirus (severe acute respiratory syndrome coronavirus 2) pandemic: A joint american college of academic international medicine-world academic council of emergency medicine multidisciplinary COVID-19 working group consensus paper
A1  - Stawicki, StanislawP
A1  - Jeanmonod, Rebecca
A1  - Miller, AndrewC
A1  - Paladino, Lorenzo
A1  - Gaieski, DavidF
A1  - Yaffee, AnnaQ
A1  - De Wulf, Annelies
A1  - Grover, Joydeep
A1  - Papadimos, ThomasJ
A1  - Bloem, Christina
A1  - Galwankar, SagarC
A1  - Chauhan, Vivek
A1  - Firstenberg, MichaelS
A1  - Di Somma, Salvatore
A1  - Jeanmonod, Donald
A1  - Garg, SonaM
A1  - Tucci, Veronica
A1  - Anderson, HarryL
A1  - Fatimah, Lateef
A1  - Worlton, TamaraJ
A1  - Dubhashi, SiddharthP
A1  - Glaze, KrystalS
A1  - Sinha, Sagar
A1  - Opara, IjeomaNnodim
A1  - Yellapu, Vikas
A1  - Kelkar, Dhanashree
A1  - El-Menyar, Ayman
A1  - Krishnan, Vimal
A1  - Venkataramanaiah, S
A1  - Leyfman, Yan
A1  - Saoud Al Thani, HassanAli
A1  - B Nanayakkara, PrabathW
A1  - Nanda, Sudip
A1  - Cioè-Peña, Eric
A1  - Sardesai, Indrani
A1  - Chandra, Shruti
A1  - Munasinghe, Aruna
A1  - Dutta, Vibha
A1  - Dal Ponte, SilvanaTeixeira
A1  - Izurieta, Ricardo
A1  - Asensio, JuanA
A1  - Garg, Manish
Y1  - 2020/04//
KW  - 2019-nCoV
KW  - COVID-19
KW  - International Health Security
KW  - coronavirus
KW  - global impact
KW  - pandemic
KW  - severe acute respiratory syndrome coronavirus 2
PB  - Wolters Kluwer Medknow Publications
JF  - Journal of Global Infectious Diseases
VL  - 12
IS  - 2
SP  - 47
EP  - 47
DO  - 10.4103/jgid.jgid_86_20
UR  - http://www.jgid.org/text.asp?2020/12/2/47/284626
N2  - What started as a cluster of patients with a mysterious respiratory illness in Wuhan, China, in December 2019, was later determined to be coronavirus disease 2019 (COVID-19). The pathogen severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), a novel Betacoronavirus, was subsequently isolated as the causative agent. SARS-CoV-2 is transmitted by respiratory droplets and fomites and presents clinically with fever, fatigue, myalgias, conjunctivitis, anosmia, dysgeusia, sore throat, nasal congestion, cough, dyspnea, nausea, vomiting, and/or diarrhea. In most critical cases, symptoms can escalate into acute respiratory distress syndrome accompanied by a runaway inflammatory cytokine response and multiorgan failure. As of this article's publication date, COVID-19 has spread to approximately 200 countries and territories, with over 4.3 million infections and more than 290,000 deaths as it has escalated into a global pandemic. Public health concerns mount as the situation evolves with an increasing number of infection hotspots around the globe. New information about the virus is emerging just as rapidly. This has led to the prompt development of clinical patient risk stratification tools to aid in determining the need for testing, isolation, monitoring, ventilator support, and disposition. COVID-19 spread is rapid, including imported cases in travelers, cases among close contacts of known infected individuals, and community-acquired cases without a readily identifiable source of infection. Critical shortages of personal protective equipment and ventilators are compounding the stress on overburdened healthcare systems. The continued challenges of social distancing, containment, isolation, and surge capacity in already stressed hospitals, clinics, and emergency departments have led to a swell in technologically-assisted care delivery strategies, such as telemedicine and web-based triage. As the race to develop an effective vaccine intensifies, several clinical trials of antivirals and immune modulators are underway, though no reliable COVID-19-specific therapeutics (inclusive of some potentially effective single and multi-drug regimens) have been identified as of yet. With many nations and regions declaring a state of emergency, unprecedented quarantine, social distancing, and border closing efforts are underway. Implementation of social and physical isolation measures has caused sudden and profound economic hardship, with marked decreases in global trade and local small business activity alike, and full ramifications likely yet to be felt. Current state-of-science, mitigation strategies, possible therapies, ethical considerations for healthcare workers and policymakers, as well as lessons learned for this evolving global threat and the eventual return to a 'new normal' are discussed in this article.
ER  - 
TY  - JOUR
T1  - Consenso colombiano de atención, diagnóstico y manejo de la infección por SARS-CoV-2/ Recomendaciones basadas en consenso de expertos
A1  - Asociación Colombiana de Infectología
A1  - Instituto de Evaluación Tecnológica en Salud
Y1  - 2020///
KW  - colombia
KW  - consensus reccomendations
KW  - covid-19
KW  - evidence based guidelines
KW  - sars cov-2
JF  - Infectio
VL  - 244
IS  - 3
SP  - 156
EP  - 156
DO  - 10.22354/in.v24i3.894
L1  - file:///C:/Users/sony/AppData/Local/Mendeley Ltd./Mendeley Desktop/Downloaded/Asociación Colombiana de Infectología, Instituto de Evaluación Tecnológica en Salud - 2020 - Consenso colombiano de atención, diagnóstic.pdf
ER  - 
TY  - JOUR
T1  - Lineamientos para la detección y manejo de casos de COVID-19 por los prestadores de servicios de salud en Colombia
A1  - Ministerio de Salud y Protección Social
Y1  - 2020///
SP  - 1
EP  - 14
L1  - file:///C:/Users/sony/AppData/Local/Mendeley Ltd./Mendeley Desktop/Downloaded/Ministerio de Salud y Protección Social - 2020 - Lineamientos para la detección y manejo de casos de COVID-19 por los prestadores de ser.pdf
ER  - 
TY  - JOUR
T1  - Prevalence of comorbidities and its effects in coronavirus disease 2019 patients: A systematic review and meta-analysis
A1  - Yang, Jing
A1  - Zheng, Ya
A1  - Gou, Xi
A1  - Pu, Ke
A1  - Chen, Zhaofeng
A1  - Guo, Qinghong
A1  - Ji, Rui
A1  - Wang, Haojia
A1  - Wang, Yuping
A1  - Zhou, Yongning
Y1  - 2020/05//
KW  - COVID-19
KW  - Clinical characteristics
KW  - Comorbidities
KW  - Epidemiology
KW  - Meta-analysis
KW  - SARS-CoV-2
PB  - Elsevier B.V.
JF  - International Journal of Infectious Diseases
VL  - 94
SP  - 91
EP  - 95
DO  - 10.1016/j.ijid.2020.03.017
UR  - /pmc/articles/PMC7194638/
UR  - /pmc/articles/PMC7194638/?report=abstract
UR  - https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7194638/
L1  - file:///C:/Users/sony/AppData/Local/Mendeley Ltd./Mendeley Desktop/Downloaded/Yang et al. - 2020 - Prevalence of comorbidities and its effects in coronavirus disease 2019 patients A systematic review and meta-analy.pdf
N2  - Background: An outbreak of coronavirus disease 2019 (COVID-19) occurred in Wuhan, China; the epidemic is more widespread than initially estimated, with cases now confirmed in multiple countries. Aims: The aim of this meta-analysis was to assess the prevalence of comorbidities in the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infected patients and the risk of underlying diseases in severe patients compared to non-severe patients. Methods: A literature search was conducted using the databases PubMed, EMBASE, and Web of Science through February 25, 2020. Odds ratios (ORs) and 95% confidence intervals (CIs) were pooled using random-effects models. Results: Seven studies were included in the meta-analysis, including 1 576 infected patients. The results showed the most prevalent clinical symptom was fever (91.3%, 95% CI: 86–97%), followed by cough (67.7%, 95% CI: 59–76%), fatigue (51.0%, 95% CI: 34–68%) and dyspnea (30.4%, 95% CI: 21–40%). The most prevalent comorbidities were hypertension (21.1%, 95% CI: 13.0–27.2%) and diabetes (9.7%, 95% CI: 7.2–12.2%), followed by cardiovascular disease (8.4%, 95% CI: 3.8–13.8%) and respiratory system disease (1.5%, 95% CI: 0.9–2.1%). When compared between severe and non-severe patients, the pooled OR of hypertension, respiratory system disease, and cardiovascular disease were 2.36 (95% CI: 1.46–3.83), 2.46 (95% CI: 1.76–3.44) and 3.42 (95% CI: 1.88–6.22) respectively. Conclusion: We assessed the prevalence of comorbidities in the COVID-19 patients and found that underlying disease, including hypertension, respiratory system disease and cardiovascular disease, may be risk factors for severe patients compared with non-severe patients.
ER  - 
TY  - GEN
T1  - Clinical, molecular, and epidemiological characterization of the SARS-CoV-2 virus and the Coronavirus Disease 2019 (COVID-19), a comprehensive literature review
A1  - Ortiz-Prado, Esteban
A1  - Simbaña-Rivera, Katherine
A1  - Gómez- Barreno, Lenin
A1  - Rubio-Neira, Mario
A1  - Guaman, Linda P.
A1  - Kyriakidis, Nikolaos C.
A1  - Muslin, Claire
A1  - Jaramillo, Ana María Gómez
A1  - Barba-Ostria, Carlos
A1  - Cevallos-Robalino, Doménica
A1  - Sanches-SanMiguel, Hugo
A1  - Unigarro, Luis
A1  - Zalakeviciute, Rasa
A1  - Gadian, Naomi
A1  - López-Cortés, Andrés
Y1  - 2020/09//
KW  - COVID-19
KW  - Coronavirus
KW  - Pandemic
KW  - Review
KW  - SARS-CoV-2
PB  - Elsevier Inc.
JF  - Diagnostic Microbiology and Infectious Disease
VL  - 98
IS  - 1
SP  - 115094
EP  - 115094
DO  - 10.1016/j.diagmicrobio.2020.115094
L1  - file:///C:/Users/sony/AppData/Local/Mendeley Ltd./Mendeley Desktop/Downloaded/Ortiz-Prado et al. - 2020 - Clinical, molecular, and epidemiological characterization of the SARS-CoV-2 virus and the Coronavirus Diseas.pdf
N2  - Coronaviruses are an extensive family of viruses that can cause disease in both animals and humans. The current classification of coronaviruses recognizes 39 species in 27 subgenera that belong to the family Coronaviridae. From those, at least 7 coronaviruses are known to cause respiratory infections in humans. Four of these viruses can cause common cold-like symptoms. Those that infect animals can evolve and become infectious to humans. Three recent examples of these viral jumps include SARS CoV, MERS-CoV and SARS CoV-2 virus. They are responsible for causing severe acute respiratory syndrome (SARS), Middle East respiratory syndrome (MERS) and the most recently discovered coronavirus disease during 2019 (COVID-19). COVID-19, a respiratory disease caused by the SARS-CoV-2 virus, was declared a pandemic by the World Health Organization (WHO) on 11 March 2020. The rapid spread of the disease has taken the scientific and medical community by surprise. Latest figures from 20 May 2020 show more than 5 million people had been infected with the virus, causing more than 330,000 deaths in over 210 countries worldwide. The large amount of information received daily relating to COVID-19 is so abundant and dynamic that medical staff, health authorities, academics and the media are not able to keep up with this new pandemic. In order to offer a clear insight of the extensive literature available, we have conducted a comprehensive literature review of the SARS CoV-2 Virus and the Coronavirus Diseases 2019 (COVID-19).
ER  - 
TY  - JOUR
T1  - Epidemiological analysis of COVID-19 and practical experience from China
A1  - Ye, Qing
A1  - Wang, Bili
A1  - Mao, Jianhua
A1  - Fu, Junfen
A1  - Shang, Shiqiang
A1  - Qiang, |
A1  - Md, Shu
A1  - Zhang, Ting
Y1  - 2020///
KW  - COVID‐19
KW  - epidemic
KW  - mortality
KW  - treatment
KW  - virus pneumonia
JF  - J Med Virol
DO  - 10.1002/jmv.25813
L1  - file:///C:/Users/sony/AppData/Local/Mendeley Ltd./Mendeley Desktop/Downloaded/Ye et al. - 2020 - Epidemiological analysis of COVID-19 and practical experience from China.pdf
N2  - The rapid spread of the epidemic has aroused widespread concern in the international community. Severe acute respiratory syndrome coronavirus 2 (SARS-COV-2) originated from Wuhan's Huanan wholesale seafood market, with bats as the likely original hosts and pangolins as potential intermediate hosts. The current source of the disease is mainly patients infected with SARS-COV-2. Patients in the incubation period may also become sources of infection. The virus is mainly transmitted via respiratory droplets and contact, and the population is generally susceptible. The epidemic has progressed through the local outbreak stage and community transmission stage due to exposure at Wuhan's Huanan wholesale seafood market and is now in the stage of large-scale transmission due to the spread of the epidemic. The basic productive number (R0) at the beginning of the epidemic was 2.2, with an average incubation period of 5.2 days. The proportion of critically ill patients was 23.4%, the mortality rate was lower than those of SARS and Middle East respiratory syndrome, and 96.5% of deaths occurred in Hubei Province, where the outbreak occurred first. Among them, elderly men with underlying diseases had a higher mortality rate. Chinese medical staff have summarized a set of effective strategies and methods in the diagnosis and treatment of this disease that are worthy of reference for their international counterparts. With powerful government intervention and the efforts of Chinese medical staff, China's outbreak has gradually improved.
ER  - 
TY  - ICOMM
T1  - Coronavirus Update (Live): Cases and Deaths from COVID-19 Virus Pandemic
A1  - Worldometer
Y1  - 2021///
UR  - https://www.worldometers.info/coronavirus/
ER  - 
TY  - JOUR
T1  - Variation in Hemoglobin Concentration Among Samples of High-Altitude Natives in the Andes and the Himalayas
A1  - Beall, Cynthia M.
A1  - Brittenham, Gary M.
A1  - Macuaga, Francisco
A1  - Barragan, Mario
Y1  - 1990///
JF  - American Journal of Human Biology
VL  - 651
SP  - 639
EP  - 651
L1  - file:///C:/Users/sony/AppData/Local/Mendeley Ltd./Mendeley Desktop/Downloaded/Beall et al. - 1990 - Variation in Hemoglobin Concentration Among Samples of High-Altitude Natives in the Andes and the Himalayas.pdf
ER  - 
TY  - JOUR
T1  - Letter to the Editor: Influence of Altitude on the Prevalence and Case Fatality Rate of COVID-19 in Peru
A1  - Intimayta-Escalante, Claudio
A1  - Rojas-Bolivar, Daniel
A1  - Hancco, Ivan
Y1  - 2020///
JF  - High Altitude Medicine and Biology
VL  - 21
IS  - 4
SP  - 426
EP  - 427
DO  - 10.1089/ham.2020.0133
ER  - 
TY  - JOUR
T1  - Letter to the Editor: COVID-19 Infections Do Not Change with Increasing Altitudes from 1,000 to 4,700 m
A1  - Castagnetto, Jesus M.
A1  - Segovia-Juarez, Jose
A1  - Gonzales, Gustavo F.
Y1  - 2020///
JF  - High Altitude Medicine and Biology
VL  - 21
IS  - 4
SP  - 428
EP  - 430
DO  - 10.1089/ham.2020.0173
ER  - 
TY  - JOUR
T1  - Hemoglobin concentration of high-altitude Tibetans and Bolivian Aymara
A1  - Beall, Cynthia M.
A1  - Brittenham, Gary M.
A1  - Strohl, Kingman P.
A1  - Blangero, John
A1  - Williams-Blangero, Sarah
A1  - Goldstein, Melvyn C.
A1  - Decker, Michael J.
A1  - Vargas, Enrique
A1  - Villena, Mercedes
A1  - Soria, Rudy
A1  - Alarcon, Ana Maria
A1  - Gonzales, Cristina
Y1  - 1998///
KW  - Heritability
KW  - High-altitude hypoxia
KW  - High-altitude natives
KW  - National Health and Nutrition Examination Survey
JF  - American Journal of Physical Anthropology
VL  - 106
IS  - 3
SP  - 385
EP  - 400
DO  - 10.1002/(SICI)1096-8644(199807)106:3<385::AID-AJPA10>3.0.CO;2-X
L1  - file:///C:/Users/sony/AppData/Local/Mendeley Ltd./Mendeley Desktop/Downloaded/Beall et al. - 1998 - Hemoglobin concentration of high-altitude Tibetans and Bolivian Aymara.pdf
N2  - Elevated hemoglobin concentrations have been reported for high-altitude sojourners and Andean high-altitude natives since early in the 20th century. Thus, reports that have appeared since the 1970s describing relatively low hemoglobin concentration among Tibetan high-altitude natives were unexpected. These suggested a hypothesis of population differences in hematological response to high-altitude hypoxia. A case of quantitatively different responses to one environmental stress would offer an opportunity to study the broad evolutionary question of the origin of adaptations. However, many factors may confound population comparisons. The present study was designed to test the null hypothesis of no difference in mean hemoglobin concentration of Tibetan and Aymara native residents at 3,800-4,065 meters by using healthy samples that were screened for iron deficiency, abnormal hemoglobins, and thalassemias, recruited and assessed using the same techniques. The hypothesis was rejected, because Tibetan males had a significantly lower mean hemoglobin concentration of 15.6 gm/dl compared with 19.2 gm/dl for Aymara males, and Tibetan females had a mean hemoglobin concentration of 14.2 gm/dl compared with 17.8 gm/dl for Aymara females. The Tibetan hemoglobin distribution closely resembled that from a comparable, sea-level sample from the United States, whereas the Aymara distribution was shifted toward 3-4 gm/dl higher values. Genetic factors accounted for a very high proportion of the phenotypic variance in hemoglobin concentration in both samples (0.86 in the Tibetan sample and 0.87 in the Aymara sample). The presence of significant genetic variance means that there is the potential for natural selection and genetic adaptation of hemoglobin concentration in Tibetan and Aymara high-altitude populations.
ER  - 
TY  - JOUR
T1  - Mortality Attributed to COVID-19 in High-Altitude Populations
A1  - Woolcott, Orison O.
A1  - Bergman, Richard N.
Y1  - 2020///
KW  - COVID-19
KW  - altitude
KW  - deaths
KW  - intubation
KW  - mortality
KW  - pneumonia
JF  - High Altitude Medicine and Biology
VL  - 21
IS  - 4
SP  - 409
EP  - 416
DO  - 10.1089/ham.2020.0098
N2  - Background: Since partial oxygen pressure decreases as altitude increases, environmental hypoxia could worsen Coronavirus Disease 2019 (COVID-19) patient's hypoxemia. We compared COVID-19 mortality at different altitudes. Methods: Retrospective analysis of population-level data on COVID-19 deaths was conducted in the United States (1,016 counties) and Mexico (567 municipalities). Mixed-model Poisson regression analysis of the association between altitude and COVID-19 mortality was conducted using individual-level data from 40,168 Mexican subjects with COVID-19, adjusting for multiple covariates. Results: Between January 20 and April 13, 2020, mortality rates were higher in U.S. counties located at ≥2,000 m elevation versus those located <1,500 m (12.3 vs. 3.2 per 100,000; p < 0.001). In Mexico, between March 13 and May 13, 2020, mortality rates were higher in municipalities located at ≥2,000 m versus those located <1,500 m (5.3 vs. 3.9 per 100,000; p < 0.001). Among Mexican subjects younger than 65 years, the risk of death was 36% higher in those living at ≥2,000 m versus those living at <1,500 m (adjusted incidence rate ratio [IRR]: 1.36; confidence interval [95% CI], 1.05-1.78; p = 0.022). Among Mexican men, the risk of death was 31% higher at ≥2,000 m versus that at <1,500 m (adjusted IRR: 1.31; 95% CI, 1.03-1.66; p = 0.025). No association between altitude and COVID-19 mortality was found among Mexican women or among Mexican subjects 65 years of age and older. Conclusions: Altitude is associated with COVID-19 mortality in men younger than 65 years.
ER  - 
TY  - ICOMM
T1  - Excess mortality during the Coronavirus pandemic (COVID-19) - Statistics and Research -
A1  - Our World in Data
Y1  - 2021///
JF  - Internet
UR  - https://ourworldindata.org/excess-mortality-covid
ER  - 
TY  - JOUR
T1  - Clinical features of patients infected with 2019 novel coronavirus in Wuhan, China
A1  - Huang, Chaolin
A1  - Wang, Yeming
A1  - Li, Xingwang
A1  - Ren, Lili
A1  - Zhao, Jianping
A1  - Hu, Yi
A1  - Zhang, Li
A1  - Fan, Guohui
A1  - Xu, Jiuyang
A1  - Gu, Xiaoying
A1  - Cheng, Zhenshun
A1  - Yu, Ting
A1  - Xia, Jiaan
A1  - Wei, Yuan
A1  - Wu, Wenjuan
A1  - Xie, Xuelei
A1  - Yin, Wen
A1  - Li, Hui
A1  - Liu, Min
A1  - Xiao, Yan
A1  - Gao, Hong
A1  - Guo, Li
A1  - Xie, Jungang
A1  - Wang, Guangfa
A1  - Jiang, Rongmeng
A1  - Gao, Zhancheng
A1  - Jin, Qi
A1  - Wang, Jianwei
A1  - Cao, Bin
Y1  - 2020///
JF  - The Lancet
VL  - 395
IS  - 10223
SP  - 497
EP  - 506
DO  - 10.1016/S0140-6736(20)30183-5
L1  - file:///C:/Users/sony/AppData/Local/Mendeley Ltd./Mendeley Desktop/Downloaded/Huang et al. - 2020 - Clinical features of patients infected with 2019 novel coronavirus in Wuhan, China.pdf
N2  - Background: A recent cluster of pneumonia cases in Wuhan, China, was caused by a novel betacoronavirus, the 2019 novel coronavirus (2019-nCoV). We report the epidemiological, clinical, laboratory, and radiological characteristics and treatment and clinical outcomes of these patients. Methods: All patients with suspected 2019-nCoV were admitted to a designated hospital in Wuhan. We prospectively collected and analysed data on patients with laboratory-confirmed 2019-nCoV infection by real-time RT-PCR and next-generation sequencing. Data were obtained with standardised data collection forms shared by WHO and the International Severe Acute Respiratory and Emerging Infection Consortium from electronic medical records. Researchers also directly communicated with patients or their families to ascertain epidemiological and symptom data. Outcomes were also compared between patients who had been admitted to the intensive care unit (ICU) and those who had not. Findings: By Jan 2, 2020, 41 admitted hospital patients had been identified as having laboratory-confirmed 2019-nCoV infection. Most of the infected patients were men (30 [73%] of 41); less than half had underlying diseases (13 [32%]), including diabetes (eight [20%]), hypertension (six [15%]), and cardiovascular disease (six [15%]). Median age was 49·0 years (IQR 41·0–58·0). 27 (66%) of 41 patients had been exposed to Huanan seafood market. One family cluster was found. Common symptoms at onset of illness were fever (40 [98%] of 41 patients), cough (31 [76%]), and myalgia or fatigue (18 [44%]); less common symptoms were sputum production (11 [28%] of 39), headache (three [8%] of 38), haemoptysis (two [5%] of 39), and diarrhoea (one [3%] of 38). Dyspnoea developed in 22 (55%) of 40 patients (median time from illness onset to dyspnoea 8·0 days [IQR 5·0–13·0]). 26 (63%) of 41 patients had lymphopenia. All 41 patients had pneumonia with abnormal findings on chest CT. Complications included acute respiratory distress syndrome (12 [29%]), RNAaemia (six [15%]), acute cardiac injury (five [12%]) and secondary infection (four [10%]). 13 (32%) patients were admitted to an ICU and six (15%) died. Compared with non-ICU patients, ICU patients had higher plasma levels of IL2, IL7, IL10, GSCF, IP10, MCP1, MIP1A, and TNFα. Interpretation: The 2019-nCoV infection caused clusters of severe respiratory illness similar to severe acute respiratory syndrome coronavirus and was associated with ICU admission and high mortality. Major gaps in our knowledge of the origin, epidemiology, duration of human transmission, and clinical spectrum of disease need fulfilment by future studies. Funding: Ministry of Science and Technology, Chinese Academy of Medical Sciences, National Natural Science Foundation of China, and Beijing Municipal Science and Technology Commission.
ER  - 
TY  - JOUR
T1  - Noninvasive SpO2/FiO2 ratio as surrogate for PaO2/FiO2 ratio during simulated prolonged field care and ground and high-altitude evacuation
A1  - Batchinsky, Andriy I.
A1  - Wendorff, Daniel
A1  - Jones, John
A1  - Beely, Brendan
A1  - Roberts, Teryn
A1  - Choi, Jae Hyek
A1  - Harea, George
A1  - Cancio, Leopoldo C.
A1  - Davis, Michael
A1  - Cannon, Jeremy
A1  - Sams, Valerie
Y1  - 2020///
KW  - acute respiratory distress syndrome
KW  - chest trauma
KW  - partial pressure of oxygen
KW  - pulse oximetry
KW  - swine
JF  - The journal of trauma and acute care surgery
VL  - 89
IS  - 2S Suppl 2
SP  - S126
EP  - S131
SN  - 0000000000
DO  - 10.1097/TA.0000000000002744
L1  - file:///C:/Users/sony/AppData/Local/Mendeley Ltd./Mendeley Desktop/Downloaded/Batchinsky et al. - 2020 - Noninvasive SpO2FiO2 ratio as surrogate for PaO2FiO2 ratio during simulated prolonged field care and ground a.pdf
N2  - BACKGROUND: Diagnosis of lung injury requires invasive blood draws to measure oxygen tension in blood. This capability is nonexistent in austere settings and during prolonged field care (PFC), that is, medical care characterized by inability to evacuate casualties from the point of injury for up to 72 hours. We analyzed pulse-oximeter-derived noninvasive SpO2 and assessed the SpO2/FiO2 ratio (SFR) as a surrogate for the PaO2/FiO2 ratio (PFR), an accepted marker of lung function. We hypothesized that SFR is a suitable surrogate for PFR in a data set from animal models of combat-relevant trauma, PFC, and aeromedical evacuation. METHODS: Data from anesthetized swine (N = 30) subjected to combat relevant trauma, resuscitation, and critical care interventions were analyzed. Pairwise correlations and Bland-Altman and regression analyses were performed to compare PFR and SFR, based on averaged SpO2 values obtained from two monitoring devices. RESULTS: We performed 683 pairwise correlations. SpO2/FiO2 ratio was numerically higher than PFR with a 313 cutoff values for acute respiratory distress syndrome (ARDS) (PFR ≥300). Sensitivity/specificity for detection of mild ARDS was 75%/73% with a 200 to 300 PFR range corresponding to 252 to 312 SFR range. For moderate ARDS, sensitivity/specificity was 61%/93% with a 100 to 200 PFR range corresponding to 191 to 251 SFR range. For severe ARDS, sensitivity/specificity was 49%/97% with a 0 to 100 PFR range corresponding to 0 to 190 SFR range. For all groups, areas under the receiver operating characteristic curves ranged from 0.76 to 0.98. CONCLUSION: SpO2/FiO2 ratio is a useful surrogate for PFR when arterial blood gas testing is not available during dynamically changing physiologic conditions, for example, during austere conditions, PFC, or aeromedical evacuation, and may permit early detection of casualties in need of lung-specific life-saving interventions. Studies in critically ill humans are warranted.
ER  - 
TY  - JOUR
T1  - COVID-19: Attacks the 1-Beta Chain of Hemoglobin and Captures the Porphyrin to Inhibit Human Heme Metabolism
A1  - Wenzhong, Liu
A1  - Hualan, Li
Y1  - 2020///
KW  - Ancient virus
KW  - Chloroquine
KW  - Coagulation
KW  - Cytokine Storm
KW  - E2 glycoprotein
KW  - Fibrosis
KW  - Ground-glass-Like Lung
KW  - ORF 3a protein
KW  - ORF8
KW  - Respiratory distress
KW  - blood
KW  - diabetic
KW  - fluorescence resonance energy transfer
KW  - novel coronavirus
KW  - orf1ab
JF  - ChemRxiv
SP  - 105
EP  - 105
DO  - 10.26434/chemrxiv.11938173
L1  - file:///C:/Users/sony/AppData/Local/Mendeley Ltd./Mendeley Desktop/Downloaded/Wenzhong, Hualan - 2020 - COVID-19 Attacks the 1-Beta Chain of Hemoglobin and Captures the Porphyrin to Inhibit Human Heme Metabolism.pdf
N2  - The novel coronavirus pneumonia (COVID-19) is an infectious acute respiratory caused by the novel coronavirus. The virus is the positive-strand RNA one with high homology to bat coronavirus. The pathogenic mechanism of the new coronavirus is still unclear, which is a significant obstacle to the development of drugs and patients' rescue. In this study, conserved domain analysis, homology modeling, and molecular docking were made to compare the biological roles of specific proteins belonging to the novel coronavirus. The conserved domain analysis showed envelope protein (E), nucleocapsid phosphoprotein (N) and ORF3a had heme linked sites, which Arg134 of ORF3a, Cys44 of E, Ile304 of N were the heme-iron linked site, respectively. ORF3a also possessed the conserved domains of human cytochrome C reductases and bacterial EFeB protein. These three domains were highly overlapping so that ORF3a could dissociate the iron of heme to form porphyrin. Heme linked sites of E protein may be relevant to the high infectivity, and the role of heme linked sites of N protein may be related to the virus replication. The docking results showed that orf1ab, ORF10, and ORF3a proteins coordinated to attack the 1-beta chain of hemoglobin, and some structural and non-structural viral proteins could bind porphyrin. Deoxyhemoglobin was more vulnerable to virus attacks than oxidized hemoglobin. But ORF3a was specific and would not attack blue blood protein, normal cytochrome C, and peroxidase. As for the attack, it would cause increasingly less hemoglobin that could carry oxygen and carbon dioxide, thus producing symptoms of respiratory distress and coagulation reaction, damaging many organs and tissues. The mechanism also interfered with the normal heme anabolic pathway of the human body, expecting to cause human diseases. Based on the small molecule drug library, drugbank, we searched for drugs bound to viral proteins by molecular docking. The results showed that some anticancer drugs could attach to the heme-iron linked site of ORF3a and N. Remdesivir was relatively more obvious than Hydroxychloroquine and Chloroquine in terms of the binding capacity of ORF3a, but the combined role of three drugs to ORF3a was lower. Unfortunately, no drug could bind to the heme-iron linked site of E. Besides, these higher binding energies may prevent all screened drugs from binding firmly to viral proteins. Since there were no clinical data, so inhibitory effects on ORF3a and N were still unclear. This theory is only for academic discussion and needed to be verified by other experiments. Please consult a qualified doctor for treatment details. Due to the toxicity and side effects of drugs, do not use medicines yourself. We expect these discoveries to bring more ideas to people to relieve patients' symptoms and save more lives.
ER  - 
TY  - RPRT
T1  - SO 2 /FIO 2 como predictor de mortalidad en pacientes con exacerbación de EPOC atendidos n el Hospital Militar Central
A1  - Mantilla, Barbarita Maria
A1  - Arturo Ramírez, Carlos
A1  - María, Barbarita
A1  - Cardozo, Mantilla
A1  - Arturo, Carlos
A1  - Sierra, Ramírez
A1  - Valbuena Benítez, Sebastián
A1  - Marrugo, Lilian Muñoz
A1  - Rodrigo, Alirio
A1  - Goyes, Bastidas
Y1  - 2017///
JF  - Acta Med colomb
VL  - 42
L1  - file:///C:/Users/sony/AppData/Local/Mendeley Ltd./Mendeley Desktop/Downloaded/Mantilla et al. - 2017 - SO 2 FIO 2 como predictor de mortalidad en pacientes con exacerbación de EPOC atendidos n el Hospital Militar C.pdf
N2  - ActA MédicA coloMbiAnA Vol. 42 n°4 ~ octubre-dicieMbre 2017 trAbAjos originAles Resumen Introducción: la validez de la relación saturación arterial de oxígeno y fracción inspiratoria de oxígeno (SaO 2 /FiO 2), calculada por oximetría de pulso y por gases arteriales en pacientes con exacerbación de la enfermedad pulmonar obstructiva crónica (E-EPOC) a la altitud de Bogotá no son conocidos, los pacientes con EPOC pueden presentar alteraciones en el intercambio de gases que pueden empeorar con los episodios de broncoespasmo, obtener valores de la SaO 2 por oximetría y FiO 2 puede brindar información valiosa sobre el curso de la exacerbación. Objetivo: determinar la validez de la relación SaO 2 /FiO 2 calculada por oximetría de pulso y por gases arteriales con relación a los desenlaces de ventilación mecánica (VM) y mortalidad a siete y 30 días. Métodos: se realizó un estudio de cohorte prospectivo con análisis de prueba diagnóstica cal-culando los puntajes DECAF, BAP-65, CURB-65, gases arteriales y oximetría de pulso al ingreso de pacientes con E-EPOC, se evaluó el desenlace de mortalidad a los siete y 30 días de ingreso y el requerimiento de VM durante su hospitalización, se calculó la relación SaO 2 /FiO 2 utilizando la SaO 2 obtenida en los gases arteriales y de manera independiente la relación SaO 2 /FiO 2 con la SaO 2 obtenida por oximetría de pulso, con los datos obtenidos se calculó los valores de sensibilidad (S), especificidad (E), valor predictivo positivo (VPP), valor predictivo negativo (VPN), razón de verosimilitud positiva (LR+), razón de verosimilitud negativa (LR-) y área bajo la curva de carac-terísticas operativas del receptor (ACOR). Resultados: se analizaron 462 E-EPOC, el requerimiento de VM fue de 14.3% y mortalidad a 30 días de 5.71%, la sensibilidad de la relación SaO 2 /FiO 2 calculada por oximetría de pulso para desenlace de VM fue de 84. LR: 0.37(IC95%:0.20-1.67), ACOR: 0.779% (IC95%:0.711-0.847) p<0.0001, la sensibilidad de relación SaO 2 /FiO 2 por gases arteriales para VM fue de 83% (IC95%:73.2-92.9), especificidad 57% (IC95%:51.9-62.2), VPP: 24.8% (IC95%:18.8-30.7), VPN: 95.2% (IC95%:92.2-98.2), LR+: 1.94 (IC95%:1.65-2.27), LR-: 0.30 (IC95%:0.17-0.51), ACOR: 0.799% (IC95%:0.737-0.861) p<0.0001, la sensibilidad de la relación SaO 2 /FiO 2 por oximetría para desenlace de mortalidad tiene una sensibilidad del 76.8% (IC95%:58.8-95), especificidad de 39.2% (IC95%:34.4-43.9), VPP: 7.1% (IC95%:3.9-10.3), VPN: 96.5% (IC95%:93.5-99.5), LR+: 1.26 (IC95%:1.01-1.58), LR-: 0.59 (IC95%:0.29-1.20), ACOR: 0.689% (IC95%:0.568-0.810) p<0.0001, la sensibilidad de la relación SaO 2 /FiO 2 por gases arteriales para mortalidad fue de 80.8% (IC95%:63.7-97.8), espe-cificidad 53.2%
ER  - 
TY  - GEN
T1  - High-altitude physiology and pathophysiology: Implications and relevance for intensive care medicine
A1  - Grocott, Michael
A1  - Montgomery, Hugh
A1  - Vercueil, Andre
Y1  - 2007/02//
KW  - Altitude Sickness / etiology
KW  - Altitude Sickness / genetics
KW  - Altitude Sickness / physiopathology*
KW  - Altitude*
KW  - Andre Vercueil
KW  - Hugh Montgomery
KW  - Humans
KW  - Hypoxia / complications
KW  - Hypoxia / physiopathology*
KW  - MEDLINE
KW  - Michael Grocott
KW  - NCBI
KW  - NIH
KW  - NLM
KW  - National Center for Biotechnology Information
KW  - National Institutes of Health
KW  - National Library of Medicine
KW  - PMC2151873
KW  - Peptidyl-Dipeptidase A / genetics
KW  - PubMed Abstract
KW  - Review
KW  - doi:10.1186/cc5142
KW  - pmid:17291330
PB  - Crit Care
JF  - Critical Care
VL  - 11
IS  - 1
DO  - 10.1186/cc5142
UR  - https://pubmed.ncbi.nlm.nih.gov/17291330/
L1  - file:///C:/Users/sony/AppData/Local/Mendeley Ltd./Mendeley Desktop/Downloaded/Grocott, Montgomery, Vercueil - 2007 - High-altitude physiology and pathophysiology Implications and relevance for intensive care medici.pdf
N2  - Cellular hypoxia is a fundamental mechanism of injury in the critically ill. The study of human responses to hypoxia occurring as a consequence of hypobaria defines the fields of high-altitude medicine and physiology. A new paradigm suggests that the physiological and pathophysiological responses to extreme environmental challenges (for example, hypobaric hypoxia, hyper-baria, microgravity, cold, heat) may be similar to responses seen in critical illness. The present review explores the idea that human responses to the hypoxia of high altitude may be used as a means of exploring elements of the pathophysiology of critical illness. © 2007 BioMed Central Ltd.
ER  - 
TY  - JOUR
T1  - Relation between Red Cell Distribution Width and Mortality in Critically Ill Patients with Acute Respiratory Distress Syndrome
A1  - Wang, Benji
A1  - Gong, Yuqiang
A1  - Ying, Binyu
A1  - Cheng, Bihuan
Y1  - 2019///
KW  - Aged
KW  - Benji Wang
KW  - Bihuan Cheng
KW  - Critical Illness
KW  - Erythrocyte Indices / physiology
KW  - Erythrocytes / pathology*
KW  - Female
KW  - Hospital Mortality
KW  - Humans
KW  - Logistic Models
KW  - MEDLINE
KW  - Male
KW  - Middle Aged
KW  - NCBI
KW  - NIH
KW  - NLM
KW  - National Center for Biotechnology Information
KW  - National Institutes of Health
KW  - National Library of Medicine
KW  - PMC6448335
KW  - Prognosis
KW  - PubMed Abstract
KW  - ROC Curve
KW  - Respiratory Distress Syndrome / mortality*
KW  - Respiratory Distress Syndrome / pathology*
KW  - Risk Factors
KW  - Yuqiang Gong
KW  - doi:10.1155/2019/1942078
KW  - pmid:31016186
PB  - Hindawi Limited
JF  - BioMed Research International
VL  - 2019
DO  - 10.1155/2019/1942078
UR  - https://pubmed.ncbi.nlm.nih.gov/31016186/
L1  - file:///C:/Users/sony/AppData/Local/Mendeley Ltd./Mendeley Desktop/Downloaded/Wang et al. - 2019 - Relation between Red Cell Distribution Width and Mortality in Critically Ill Patients with Acute Respiratory Distre.pdf
N2  - Currently, evidence regarding the predictive significance of red blood cell distribution width (RDW) among patients with acute respiratory distress syndrome (ARDS) remains scarce. The aim of this study was to determine the prognostic value of RDW for critically ill patients with ARDS. Methods. We studied all patients with ARDS from the Multiparameter Intelligent Monitoring in Intensive Care Database III (MIMIC-III) for whom RDW was available. The clinical outcomes were 30-day and 90-day mortality. Analyses included logistic multivariate regression model, Receiver Operating Characteristic (ROC) analysis, and subgroup analysis. Results. A total of 404 eligible ARDS patients were included. After adjustment for several clinical characteristics related to 30-day mortality, the adjusted OR (95% CIs) for RDW levels ≥14.5% was 1.91 (1.08, 3.39). A similar trend was observed for 90-day mortality. The RDW levels ≥14.5% were also an independent predictor of 90-day mortality (OR, 2.56; 95% CI, 1.50 to 4.37; P = 0.0006) compared with the low RDW levels (<14.5%). In subgroup analyses, RDW showed no significant interactions with other relevant risk factors for 30-day mortality. Conclusions. RDW appeared to be a novel, independent predictor of mortality in critically ill patients with ARDS.
ER  - 
TY  - JOUR
T1  - Red blood cell distribution width is associated with mortality risk in patients with acute respiratory distress syndrome based on the Berlin definition: A propensity score matched cohort study
A1  - Yu, Xue Shu
A1  - Chen, Zhi Qiang
A1  - Hu, Yu Feng
A1  - Chen, Jia Xiu
A1  - Xu, Wen Wei
A1  - Shu, Jie
A1  - Pan, Jing Ye
Y1  - 2020/09//
KW  - Acute respiratory distress syndrome
KW  - Medical information mart for intensive care
KW  - Mortality
KW  - Propensity score matching
KW  - Red blood cell distribution width
PB  - Mosby Inc.
JF  - Heart and Lung
VL  - 49
IS  - 5
SP  - 641
EP  - 645
DO  - 10.1016/j.hrtlng.2020.04.008
UR  - https://pubmed.ncbi.nlm.nih.gov/32434701/
L1  - file:///C:/Users/sony/AppData/Local/Mendeley Ltd./Mendeley Desktop/Downloaded/Yu et al. - 2020 - Red blood cell distribution width is associated with mortality risk in patients with acute respiratory distress syndr.pdf
N2  - Background: Acute respiratory distress syndrome (ARDS) is a severe inflammatory disorder of the lungs and is associated with oxidative damage. However, red blood cell distribution width (RDW), as an indicator of body response to inflammation and oxidative stress, has not been studied for its relationship with ARDS as diagnosed by the Berlin definition. Objectives: To examine the value of RDW in predicting the prognosis of in patients with ARDS. Methods: This is a retrospective study based on the Medical Information Mart for Intensive Care III (MIMIC-III) database. Berlin-defined ARDS patients using mechanical ventilation for more than 48 hours were selected using structured query language. The primary statistical methods were propensity score matching and sensitivity analysis, including an inverse probability weighting model to ensure the robustness of our findings. Results: A total of 529 intensive care unit (ICU) patients with ARDS according to the Berlin definition were enrolled in the study. The adjusted OR showed an adverse effect between the higher RDW group and 30-day mortality [OR 2.33, 95% CI (1.15–4.75), P=0.019]. However, we found that length of ICU stay was not related to RDW (P=0.167), and in the anaemia group, RDW was poorly predictive of 30-day mortality (P=0.307). Conclusion: In unselected ARDS patients, higher RDW was associated with higher 30-day mortality rate. Further investigation is required to validate this relationship with prospectively collected data.
ER  -