新型冠状病毒肺炎与甲状腺疾病

自新型冠状病毒肺炎(coronavirus disease 2019, COVID-19)疫情暴发以来, 出现了若干COVID-19相关甲状腺疾病的报道, 包括亚急性甲状腺炎、自身免疫性甲状腺疾病、非甲状腺疾病综合征以及原因未明的甲状腺功能异常。本综述旨在对COVID-19相关甲状腺疾病的临床特点进行总结, 并探究可能的发生机制。     

新型冠状病毒肺炎防控期间手术患者麻醉管理和防控工作总结

目的通过对疫情期间常规患者临床特征的观察分析,旨在提高对新型冠状病毒肺炎(COVID-19)的再认识,增强疾病筛查能力。方法分析了2020年1月25日～3月25日住院手术患者3488例,纳入资料完整患者3061例,参照第六版COVID-19诊断标准和感染者症状特点,选择观察统计指标。结果体温37.3℃者37例,白细胞数减少者45例,淋巴细胞数减少者306例,胸部CT有COVID-19症状者69例。结论非感染者出现COVID-19类似症状,多为原发疾病所致。因此,广大医务人员应结合患者原发疾病进行鉴别诊断,通过三级筛查体系正确开展疫情后期的临床工作,做到疫情防控工作常态化。     

COVID-19疫情下影像科室的应急管理策略

COVID-19疫情传播速度快、波及范围广，严重危害人民的健康，早期发现并隔离疑似或确诊患者对控制疫情至关重要。COVID-19的筛查离不开影像检查。本文总结了影像学在COVID-19疫情管理中的作用，并分析了影像检查流程中可能发生的院内感染因素，提出COVID-19疫情期间影像科室的应急管理策略，包括成立疫情防控管理小组、感染控制区域划分及严格管理、防护级别管理和用品配置、放射检查分类防控管理、提高诊断医师对疾病的鉴别能力、规范受检患者、场地环境、仪器设备和工作人员的管理等，以期对疫情防控有所帮助。      

新型冠状病毒肺炎患者的康复治疗探讨

新型冠状病毒肺炎(COVID-19)疫情在全国范围内流行,经过1个多月的严防严控,疫情形势得到控制,大部分患者已康复出院。针对出院患者,不仅要继续做好医学观察,也要进行康复治疗,促进患者身体机能尽早恢复,早日回归社会。本文通过分析COVID-19患者的疾病特点和治疗情况,检索现有相关共识和文献资料,探讨COVID-19患者的康复治疗方法。     

新型冠状病毒肺炎痰标本2019-nCoV核酸阳性3例报道:对咽拭子检测假阴性问题的思考及建议

由新型冠状病毒2019-nCoV引起的肺炎(COVID-19)目前疫情仍十分严峻.2019-nCoV的核酸检测是COVID-19确诊的必要指标之一.临床对标本类型的选择影响2019-nCoV核酸检出率.本文报道3例COVID-19患者的确诊经过,分析采用咽拭子和痰标本检测2019-nCoV的效果,为临床诊断COVID-...     

新冠肺炎疫情期间糖尿病患者中西医结合管理建议

2019年底我国湖北省爆发了新冠肺炎(COVID-19)疫情,近期已在世界多国传播,其传染性强,治疗难度大,严重威胁民众健康。从此次疫情数据来看,糖尿病患者的COVID-19的患病率、重症率和病死率相对正常人明显偏高,因此科学有效的管理对于加强疫情期间糖尿病患者病情转归和预后极其重要。中西医结合治疗在本次抗击疫情中疗效明显,得到社会各界的认可,因此笔者从中西医结合角度出发,阐述糖尿病患者易感COVID-19的原因,分析中西医管理的必要性,对合并COVID-19的糖尿病住院患者及未合并COVID-19的非住院患者的管理提出建议,为糖尿病临床管理提供参考。     

2例新型冠状病毒肺炎粪便SARS-CoV-2核酸阳性临床启示

目前中国新型冠状病毒肺炎(COVID-19)疫情仍十分严峻,及时、早期地识别COVID-19患者是控制疫情的关键步骤。而新型冠状病毒(SARS-CoV-2)核酸检测作为诊断COVID-19的金标准,不但对检测技术提出更高的要求,同时对不同病程患者如何选择标本类型也是一个挑战。本文报道2例COVID-19确诊病例的诊疗经过,并分析采用不同类型标本检测SARS-CoV-2核酸的检出情况,为临床诊断COVID-19时如何选择标本类型和如何提高核酸检出率提供参考。     

中医药防治新型冠状病毒感染的研究进展

严重急性呼吸系统综合征冠状病毒2 (SARS-COV-2)引发的新型冠状病毒感染(COVID-19)自2019年底暴发以来,已致全球数亿人感染和数百万人死亡。SARS-COV-2极易快速突变导致疫苗失效。药物治疗是目前防治COVID-19的有效手段,针对疾病临床特征辨证施治的中医药疗法在中国疫情防治中发挥了极其重要的作用。鉴于此,笔者依据中国中医药防治COVID-19的临床经验,对临床用于治疗COVID-19的清热药、解表药、芳香化湿药和补虚药等方药特点及其多途径、多靶点发挥综合治疗COVID-19作用的药效机制进行综述,以期为临床随症组方治疗此类疾病提供参考。     

新型冠状病毒肺炎疫情期间医院呼吸科防护工作管理

新型冠状病毒肺炎(COVID-19,以下简称新冠肺炎)是一种由新型冠状病毒(以下简称新冠病毒)引发的急性呼吸道传染病。感染该病毒的患者会出现发热、全身乏力、干咳、呼吸困难等症状。该病具有极强的传染性,人群普遍易感。本文对新冠肺炎疫情期间医院呼吸科的医护人员培训和防护、入院患者排查以及消毒等防护工作进行总结论述,以期为防疫提供临床经验。     

2019冠状病毒病多系统受累的研究进展

<正>2019年年底,2019冠状病毒病(COVID-19)疫情开始出现,随后COVID-19在局部地区扩散并迅速蔓延至全世界,在全球范围内引起密切关注^[1]。2020年2月,引起COVID-19的病毒被国际病毒分类委员会正式命名为新型冠状病毒(SARS-CoV-2)^[2]。截至2021年8月27日,全球确诊病例已超过2亿例,约400多万COVID-19患者在感染病毒不久后死亡。     

Liver manifestations in COVID-19 patients: A review article

The coronavirus disease 2019 (COVID-19) initially presented as a disease that affected the lungs. Then, studies revealed that it intricately affected disparate organs in the human body, with the liver being one of the most affected organs. This review aimed to assess the association between COVID-19 and liver function, shedding light on its clinical implication. However, its exact pathophysiology remains unclear, involving many factors, such as active viral replication in the liver cells, direct cytotoxic effects of the virus on the liver or adverse reactions to viral antigens. Liver symptoms are mild-to-moderate transaminase elevation. In some patients, with underlying liver disease, more serious outcomes are observed. Thus, liver function should be meticulously considered in patients with COVID-19.     

Prolonged presence of SARS-CoV-2 in a COVID-19 case with rheumatoid arthritis taking iguratimod treated with ciclesonide

We report a coronavirus disease 2019 (COVID-19) case with rheumatoid arthritis taking iguratimod. The patient who continued iguratimod therapy without dose reduction was treated with ciclesonide had an uneventful clinical course, but prolonged detection of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) was observed after resolution of symptoms. The effects of disease-modifying antirheumatic drugs (DMARDs) and ciclesonide on clinical course and viral shedding remain unknown and warrant further investigation.     

Duration of infectious viral shedding in patients with mild to moderate COVID-19 treated with REGN-CoV2

IntroductionNew treatment methods, such as REGN-CoV2, have been approved for patients with coronavirus disease (COVID-19) caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). However, the effect of the drug on the duration of infectious viral shedding and viral mutations is unknown. In this study, we investigated the clinical efficacy of REGN-CoV2 treatment in patients with mild to moderate disease and compared its antiviral effects against different strains of SARS-CoV-2.MethodsViral culture and PCR testing were performed on the pharyngeal swabs collected from 28 patients with COVID-19 who were admitted and treated at Hiroshima University Hospital during the study period. Of these, 23 patients were treated with REGN-CoV2. The patients were classified into the REGN-CoV2(+) and REGN-CoV2(?) groups, and the clinical course was compared between the groups. The 50% inhibitory concentrations (IC₅₀) of REGN-CoV2 against the isolated virus strains were determined.ResultsAfter treatment with REGN-CoV2, the virus culture positivity rate was greatly reduced. The time to negative viral culture was significantly shorter in the REGN-CoV2(+) group than in the REGN-CoV2(?) group. In vitro evaluation of REGN-CoV2 against isolated virus strains also showed efficacy.ConclusionsREGN-CoV2 treatment was effective in patients with mild COVID-19 and could shorten the period of infectious viral shedding. This may be an important factor in preventing the spread of infection. It may be possible to revise the isolation period for patients with mild disease treated with REGN-CoV2.     

COVID-19, Hyperglycemia,and New-Onset Diabetes

Certain chronic comorbidities, including diabetes, are highly prevalent in people with coronavirus disease 2019 (COVID-19) and are associated with an increased risk of severe COVID-19 and mortality. Mild glucose elevations are also common in COVID-19 patients and associated with worse outcomes even in people without diabetes. Several studies have recently reported new-onset diabetes associated with COVID-19. The phenomenon of new-onset diabetes following admission to the hospital has been observed previously with other viral infections and acute illnesses. The precise mechanisms for new-onset diabetes in people with COVID-19 are not known, but it is likely that a number of complex interrelated processes are involved, including previously undiagnosed diabetes, stress hyperglycemia, steroid-induced hyperglycemia, and direct or indirect effects of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) on the β-cell. There is an urgent need for research to help guide management pathways for these patients. In view of increased mortality in people with new-onset diabetes, hospital protocols should include efforts to recognize and manage acute hyperglycemia, including diabetic ketoacidosis, in people admitted to the hospital. Whether new-onset diabetes is likely to remain permanent is not known, as the long-term follow-up of these patients is limited. Prospective studies of metabolism in the setting of postacute COVID-19 will be required to understand the etiology, prognosis, and treatment opportunities.     

Human menstrual blood-derived stem cells as immunoregulatory therapy in COVID-19: A case report and review of the literature

BACKGROUNDThe coronavirus disease 2019 (COVID-19) caused by novel coronavirus 2019 in December 2019 has spread all around the globe and has caused a pandemic. There is still no current effective guidance on the clinical management of COVID-19. Mesenchymal stem cell therapy has been shown to be one of the therapeutic approaches to alleviate pneumonia and symptoms through their immunomo-dulatory effect in COVID-19 patients.CASE SUMMARYWe describe the first confirmed case of COVID-19 in Hangzhou to explore the role of human menstrual blood-derived stem cells (MenSCs) in the treatment of COVID-19. Moreover, we review the immunomodulation effect including non-specific and specific immune functions of MenSCs for the therapy of COVID-19.CONCLUSIONMenSCs can be helpful to find a promising therapeutic approach for COVID-19.