Diagnosis and Management of COVID-19 Disease

Jamil, Shazia; Mark, Nicholas M.; Carlos, Graham; Cruz, Charles S. Dela; Gross, Jane E.; Pasnick, Susan

doi:10.1164/rccm.2020c1

Cited by 79 publications

(68 citation statements)

References 1 publication

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“…This was also supported by the laboratory abnormalities found in our patient, which were lymphopenia, leucopenia, thrombocytopenia, elevated creatinine, AST and ALT, and hypoxemia from blood gas analysis, and also pneumonia by chest X-ray and CT scan findings (bilateral, peripheral, patchy opacities on chest X-ray and bilateral ground-glass opacities, crazy paving, and multifocal consolidation from chest CT scan) that suggest high probable for COVID-19 infection. It is suggested that findings from chest CT scans usually peak around 9-13 days [6,7]. WHO criteria for confirmed COVID-19 was based on the detection of unique sequences of virus SARS-CoV-2 RNA by nucleic acid amplification tests such as realtime RT-PCR and needed at least two positive results [8].…”

Section: Discussionmentioning

confidence: 99%

To reperfuse or not to reperfuse: a case report of Wellens’ syndrome with suspected COVID-19 infection

et al. 2020

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Background Wellens’ syndrome is known to be associated with left anterior descending artery occlusion that could lead to an extensive anterior wall myocardial infarction. Thus, emergency cardiac catheterization is needed. However, during coronavirus disease 2019 (COVID-19) pandemic, it is recommended for hemodynamically stable acute coronary syndrome patients with COVID-19 infection to be treated conservatively in an isolated hospital ward. Case presentation We report an 85-year-old patient with chief complaints of typical, squeezing chest pain in the past 4 h. The patient had a high fever, dyspnea, sore throat, and fatigue for 3 days. He had previously come into contact with COVID-19 positive relatives. The patient was hemodynamically stable and pulmonary auscultation revealed coarse rales in the entire lung. Electrocardiography (ECG) evaluation during the pain episode showed non-specific ST-T changes in lead V2-V5. After sublingual nitrate was administered, ECG evaluation during the pain-free period revealed a biphasic T wave inversion in lead V2 and V3. Laboratory workup showed elevated cardiac marker and leucopenia with neutrophilia and lymphopenia. Rapid immunochromatographic test and initial severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) reverse transcription-polymerase chain reaction (RT-PCR) evaluation from nasopharyngeal swab showed negative results. However, radiographic evaluations suggest the diagnosis of COVID-19 infection. While waiting for the second RT-PCR evaluation, the patient was diagnosed with Wellens’ syndrome with suspected COVID-19 infection. The patient was treated conservatively according to national guidelines and scheduled for elective cardiac catheterization. On the third day, the patient felt better and insisted on being discharged home. Ten days after discharged, the patient died of myocardial infarction. Conclusion Emergency cardiac catheterization should be done for patient with Wellens’ syndrome, regardless of the COVID-19 infection status.

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Section: Discussionmentioning

confidence: 99%

To reperfuse or not to reperfuse: a case report of Wellens’ syndrome with suspected COVID-19 infection

et al. 2020

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“…And the general centers systematically helped to prevent community spread across the country. Previous studies showed the necessity to prevent spread of COVID-19 in areas with high population density through control measures [17][18][19]. For this reason, South Korea appeared to distribute the general and DT screening centers in Seoul, Gyeonggi-do, and six large cities with high population density.…”

Section: Discussionmentioning

confidence: 99%

COVID-19 screening center models in South Korea

Kim

Lee

et al. 2020

J Public Health Pol

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In a recent report, the British Broadcasting Company (BBC) introduced South Korea’s measures to manage COVID-19 as role model for the world. Screening centers serve as frontiers for preventing community transmission of infectious diseases. COVID-19 screening centers in Korea operate 24 h a day, always open for individuals with suspected COVID-19 symptoms. South Korea concentrated COVID-19 screening centers around cities with high population density. Advanced screening centers (models C, D, and E) proved more effective and efficient in the prevention of COVID-19 than the traditional screening centers (models A and B). Particularly, screening centers at Incheon Airport in South Korea prevent transmission through imported cases effectively. It will be important elsewhere, as in South Korea, to establish an infectious disease delivery system that can lead to 'Test-Treat-Track' using an adequate model of screening centers.

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“…The most commonly used drugs are antibiotics, and the rational use of antibiotics may be helpful for the prognosis. For severe patients, clinical guidelines recommend experiential antibiotics [19,20]. For others, it remains controversial to decide when to start using antibiotics.…”

Section: Discussionmentioning

confidence: 99%

Favorable outcomes of elderly COVID-19 patients in Guangzhou, China: a retrospective, observational study

Zhao

Zhang

et al. 2020

Preprint

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Objective: To clarify the outcomes of elderly patients with COVID-19.Methods: All 265 confirmed adult patients with COVID-19 were included in this retrospective study, 43 (16.2%) of whom were 65 years and older. Electronic medical records of the subjects were reviewed to obtain information on clinical characteristics and outcomes. The allocations of medical resource were also recorded.Results: Only one death case occurred in the elderly. The mortality of elderly patients was no higher than that of young patients (2.3% vs. 0%, P = 0.126). The cure rate was 95.3% in elderly patients and 99.5% in young patients (P = 0.067), and the duration of hospitalization is 27 days in elderly patients and 18 days in young patients (P = 0.001). The elderly suffered from more comorbidities (67.4% vs. 24.8%, P < 0.001), most of which is hypertension. Significantly more severe cases occurred in elderly patients compared with young patients (37.2% vs. 16.7%, P = 0.004). The elderly were more likely to present with complications including acute respiratory distress syndrome, acute myocardial injury, septic shock and acute kidney injury (all P < 0.05), respectively. No medical staffs were infected during the treatment of COVID-19.Conclusion: The cure rate and the mortality of the elderly seemed to be no worse than that of the young, though the elderly were with longer hospitalization. Elderly patients with COVID-19 could be treatable if handled properly. More severe cases and complications in elderly patients should prompt for more complex treatment and special considerations.

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Diagnosis and Management of COVID-19 Disease

Cited by 79 publications

References 1 publication

To reperfuse or not to reperfuse: a case report of Wellens’ syndrome with suspected COVID-19 infection

To reperfuse or not to reperfuse: a case report of Wellens’ syndrome with suspected COVID-19 infection

COVID-19 screening center models in South Korea

Favorable outcomes of elderly COVID-19 patients in Guangzhou, China: a retrospective, observational study

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