Novel coronavirus disease (COVID‐19) update on epidemiology, pathogenicity, clinical course and treatments

Abstract

During the December of 2019, a series of patients with pneumonia caused by novel coronavirus; the severe acute respiratory syndrome (SARS) corona (COV‐2), that is, COVID‐19. Since the first cluster of cases was reported in China on 31 December 2019 until the 28 April 2020, there were internationally reported 3’000’000 cases, in over 185 countries, and 207'265 deaths. To date, it is still not unanimously clear which effects parameters of virus and host are important for the development of severe disease course. According to the most updated internationally available online cases register, COVID‐19 disease has mild symptoms in around 85% of cases, there are 3%‐10% of critical cases, and mortality is around 5%‐7%. Since currently there is no available vaccine and no well‐established specific antiviral therapy, numerous agents are being tested in clinical scenarios. The most common regimens include remdesivir, convalescent plasma. Widely used chloroquine, hydroxychloroquine and azithromycin combinations, as well as lopinavir‐ritonavir were shown to have less efficient treatment effects. More severe cases of pneumonia and dyspnoea, or uncontrollable fever are treated as inpatients, and nearly 10% in intensive care units. Oxygen supplementation is indicated to maintain peripheral blood oxygenation over 90%‐96%. Advanced support systems include mechanical ventilation and extracorporeal membranous support; however, those without targeted antiviral therapy represent only temporary bridge for scarce potential restitution in patient themselves. The aim of review is to present current state of the art in epidemiology, pathogenesis, clinical course and treatment of COVID‐19 patients.

Emergent Pneumonia in Children

“…Risk factors for a serious infection are age >65 years, presence of comorbidities such as diabetes, chronic kidney failure, hypertension, obesity, immunosuppression. Overall mortality is 2.2% reaching up to 25% mortality in risk groups (17,19).…”

The best is the enemy of the good: Time for a biopsy‐sparing approach for Helicobacter pylori diagnosis and treatment in children in the COVID‐19 era?

“…In addition to the known high rate of clarithromycin resistance in Europe (25% in the pediatric population), 5 it is possible that primary resistance to clarithromycin could become even higher due to the widespread use of another macrolide antibiotic, azithromycin, in some therapeutic lines for COVID-19. 6 Undoubtedly, eradication should be assessed at least 4 weeks after completion of therapy by either a 13 C-UBT or a stool 2-step monoclonal H. pylori antigen test, as suggested by the Joint ESPGHAN/NASPGHAN guidelines, 1 and upper gastrointestinal endoscopy should be considered in case of eradication failure or persisting symptoms. We understand that this approach is far from the gold standard management recommended by the existing guidelines, but in this critical period in which the priorities have been necessarily revised, a temporary exception might be considered, only in the areas where strict adherence to the guidelines would be more harmful than beneficial, leaving symptomatic children untreated for a long time.…”

Regional distribution of COVID-19 mortality in Peru

“…En la actualidad, el COVID-19 se constituye como un problema de salud pública, en diciembre del 2019 se reportaron una serie de pacientes en China que cursaron con síndrome respiratorio agudo severo causado por el nuevo coronavirus y se categorizó como pandemia el 11 de marzo del mismo año (1) . A pesar de la difusión de las medidas de prevención del contagio como la distancia física, el uso de mascarillas y el lavado de manos, según la OMS (Organización Mundial de la Salud), solo hasta septiembre del 2020 fallecieron 1 millón de personas a nivel mundial a causa de la infección del patógeno respiratorio (2) .…”