新型冠状病毒肺炎期间方舱CT感染防控经验

新型冠状病毒肺炎（COVID-19）爆发后,胸部CT迅速成为COVID-19诊断、治疗、随访等必不可少的检查手段,但影像科内交叉感染的风险也随之升高。为降低此风险,方舱CT被专门用于疑似和确诊患者的CT检查。本研究结合实际工作经验,从方舱CT的安装环境及功能划分及操作步骤、患者检查次序、技师的排班管理及感控措施、CT设备与机房内物表消毒等方面,介绍疫情期间方舱CT的检查流程及防控策略。     

药物临床试验在新型冠状病毒肺炎疫情防控期间的运行管理

2019 年 12 月以来,新型冠状病毒肺炎(corona virus disease 2019,COVID-19)疫情迅速蔓延,我国 30 个省市自治区相继启动重大突发公共卫生事件一级响应.为做好 COVID-19 疫情防控,我国多个部门根据新型冠状病毒病原体的特点及 COVID-19 临床诊疗经验发布了一系列诊疗与...     

新型冠状病毒肺炎疫情防控常态化期间武汉地区大学生心理状况

目的:了解新型冠状病毒肺炎(COVID—19)疫情防控常态化阶段武汉地区大学生心理健康状况,为推进高校开学复课,制定心理健康教育工作方案提供支持.方法:采用网络问卷发放,使用一般资料问卷、心理健康自评量表(SRQ—20)、广泛性焦虑量表(GAD—7)、抑郁症状群量表(PHQ—9)对武汉地区大学生共3179人进行问卷调查...     

新型冠状病毒肺炎期间方舱CT感染防控经验（英文）

新型冠状病毒肺炎(COVID-19)爆发后,胸部CT迅速成为COVID-19诊断、治疗、随访等必不可少的检查手段,但影像科内交叉感染的风险也随之升高。为降低此风险,方舱CT被专门用于疑似和确诊患者的CT检查。本研究结合实际工作经验,从方舱CT的安装环境及功能划分及操作步骤、患者检查次序、技师的排班管理及感控措施、CT设备与机房内物表消毒等方面,介绍疫情期间方舱CT的检查流程及防控策略。     

新型冠状病毒肺炎疫情防控期间遗传性共济失调患者管理策略专家共识

2019年12月以来,在湖北省武汉市陆续发现了一系列传染性极强的不明原因肺炎病例,后经证实为感染"严重急性呼吸道综合症冠状病毒2型(severe acute respiratory syndrome coronavirus 2,SARS-CoV-2)"所致的"2019冠状病毒病(corona virus disease 2019,COVID-19)"。SARS-CoV-2病毒能够侵犯人体肺部等多个系统,中枢神经系统受累者会表现出一系列的神经症状,容易误诊漏诊,从而增加了COVID-19扩散的风险。遗传性共济失调(hereditary ataxia)是一大类具有高度的临床和遗传异质性、病死率和病残率较高的神经系统退行性疾病。鉴于疫情的严重性,政府采取的一系列防控措施,使得许多患者去医院的随访和诊疗受到了限制,对于患者的心身健康产生了较大的影响。为使患者在疫情防控期间得到规范的管理,中国医师协会神经内科医师分会神经遗传专委会特别制定了本共识,旨在帮助患者共克时艰,平安度过防疫期。     

云南省大学生新型冠状病毒肺炎疫情防控期间焦虑与恐惧状况分析

目的 调查新型冠状病毒肺炎疫情期间云南省大学生的焦虑与恐惧状况.方法 采用网络调查方式,运用90项症状自评量表之焦虑和恐惧分量表和针对肺炎疫情自编的问卷,对429名大学生进行调查.结果 ①疫情期间被调查者的恐惧水平差于普通时期全国大学生平均水平(d=1.00,P<0.01).②情绪基本正常组的焦虑水平好于普通时期全国大...     

新型冠状病毒肺炎(COVID-19)流行期间传染病专科医院护士心理健康状况

目的:比较传染病专科医院新冠肺炎科室与非新冠肺炎科室护士面对重大突发公共卫生事件—新冠病毒肺炎疫情的心理应激症状的差异,为对其开展相应的心理干预提供依据。方法:通过微信工作群发放电子调查问卷,对传染病专科医院新冠肺炎科室护士和非新冠肺炎科室护士进行心理状况调查。采用行为医学量表(2005版)中"突发性公共卫生事件心理问卷"进行测评,调查问卷涉及抑郁、神经衰弱、恐惧、强迫-焦虑和疑病5个维度,并进行评价。采用秩和检验(Mann-Whitney U检验)分析两组护士各因子得分的差异,并进行分析。结果:共收回调查问卷94份,新冠肺炎科室护士和非新冠肺炎科室护士各47份,回收率为94.0%(94/100)。新冠肺炎科室护士的负性情绪得分较高,从高到低依次为恐惧(M=1.00分),抑郁(M=0.33分),神经衰弱(M=0.20分),强迫-焦虑(M=0.00分),疑病(M=0.00分)。新冠肺炎科室护士心理应激症状在抑郁、神经衰弱、强迫-焦虑维度高于非新冠肺炎科室护士,差异有统计学意义(U=817.5,860.5,824.5;P0.05),两组恐惧维度分值在心理应激症状中最为突出(M=1.00分)。讨论:新冠肺炎疫情期间传染病医院护士,尤其是新冠肺炎科室护士存在明显心理应激症状,应对其尽早进行相应心理干预。     

新型冠状病毒肺炎的临床特征

本文总结了新型冠状病毒的特点,新型冠状病毒肺炎的发病特点、临床症状、实验室检查等临床特征,以及目前诊断标准包括临床症状、实验室检查、CT等,以提高公众对新型冠状病毒肺炎的认识和防控,同时为诊断研究提供基础。     

新型冠状病毒肺炎疫情期间生物样本库工作流程管理实践

正根据国家卫生健康委2020年第1号文件,新型冠状病毒感染的肺炎已纳入《中华人民共和国传染病防治法》规定的乙类传染病,并采取甲类传染病的预防、控制措施。经过全民鏖战数月,这场阻击新冠肺炎的战"疫"取得初步成功。随着疫情逐渐被控制,各地医院也开始陆续全面复工。生物样本库作为临床研究的重要基石,为确保疫情防控和科研服务两不误,在疫情期间样本收集相关工作须以控制新型冠状病毒肺炎疫情为首要原则,样本捐献者和研究人员安全应放在首位。因此,做好工作流程管理是各大研究型医院生物样本库的首要任务。结合我院生物样本库在疫情期间的病毒防治工作的实际管理总结以下经验。     

新型冠状病毒肺炎疫情期间儿童烧伤防治的探讨

我国新型冠状病毒肺炎疫情的快速上升趋势得到控制,但其他国家确诊和死亡病例不断增加,境外输入病例正在增多,各地中小学陆续开学,疫情防控仍不容松懈。本文结合新型冠状病毒肺炎疫情防控期间居家、出行、工作、学习等行为模式改变带来的特殊性,对儿童烧伤的预防、急救和居家护理,以及居家功能康复等进行探讨,以供广大医护工作者参考。     

烧伤科在抗击新型冠状病毒肺炎疫情中的优势及作用

自2019年12月新型冠状病毒肺炎疫情在武汉出现并蔓延以来,武汉大学同仁医院暨武汉市第三医院烧伤科发挥其在重症监护、脏器衰竭救治与生命支持、多学科团队作战及灾害救援等方面的学科优势及经验优势。疫情期间,武汉大学同仁医院暨武汉市第三医院被定为新型冠状病毒肺炎定点收治医院,作为湖北省唯一保留烧伤救治工作的科室,在派出大批医务人员参与抗击新型冠状病毒肺炎的同时,还接管了全院其他专科无法出院的所有危重症患者。在圆满完成抗击疫情及烧伤救治工作的同时,烧伤患者、陪护家属及医务人员均未发生院内新型冠状病毒感染,较好地发挥了国家重点烧伤专科的优势与作用。     

北京市烧伤专科应对新型冠状病毒肺炎疫情的防控建议

北京市因常住人口多(2 153.6万)、外来人口比例高(34.6%)、返京人口流量大、入境人员密集等原因,新型冠状病毒肺炎疫情的防控形势较湖北省以外的其他地区更加严峻。解放军总医院第四医学中心烧伤整形科,依据新型冠状病毒肺炎疫情防控相关指导文件,结合北京市的特殊性和烧伤专科工作特点,如:烧伤创面暴露、常因行动不便陪诊家属多、小儿烧伤易合并发热以及需要反复门诊换药等,制定和实施了网络预约挂号、预检分诊、诊疗分区、车内等候-电话叫号和微信指导患者居家换药、入院筛查、设置新入院患者过渡隔离病房、停止探视、手术分类管理、加强通风和消毒等系列措施,并引导医务人员正确认识北京市疫情防控工作的特殊性,重视医务人员相互防护,实施工作人员分区、分时段进餐等,形成了北京市烧伤专科应对新型冠状病毒肺炎疫情的防控建议。     

7例儿童新型冠状病毒肺炎病例的临床特征

目的:回顾性分析新型冠状病毒肺炎(COVID-19)儿童确诊病例的流行病学及临床特征,为儿童感染新型冠状病毒(2019-nCoV)的临床诊疗提供建议。方法:选取2020年1～2月在襄阳市中心医院发热病房收治的7例COVID-19儿童患者为研究对象,收集临床资料,分析一般情况、临床症状、血液学检验及CT影像学等特征。结果...     

Coronavirus Disease 2019 (COVID-19) in Kenya: Preparedness,response and transmissibility

The world and Kenya face a potential pandemic as the respiratory virus Coronavirus Disease 2019 (COVID-19) affects world populations. Nations have been forced to intervene and issue directions under executive orders to ensure the pandemic is contained. Kenya has reported 110 confirmed COVID-19 cases (as at 2nd April, 2020), three persons have succumbed and 2 people have fully recovered. Most of the affected people had entered/returned to Kenya from different parts of the world. Most of the people who have contracted COVID 19 are between the 16–74 years of age. As a result, since February 2020, Kenya put in place several precautionary measures to mitigate the pandemic in its early stages. However, the economic status of the population of country won't be simple to control COVID 19, if government won't integrate the realistic feasible timely plans. This article highlights the preparedness, response, transmissibility of Covid-19 and proposes intuitions to manage COVID-19 in Kenya. Currently it is clear that since first confirmation to current, the transmission of the COVID-19 is exponentially increasing in Kenya.     

Impact of the Coronavirus Disease 2019 (COVID-19) Pandemic on Medical Use of Military Hospitals in Korea

BackgroundThe coronavirus disease 2019 (COVID-19) pandemic began in December 2019. While it has not yet ended, COVID-19 has already created transitions in health care, one of which is a decrease in medical use for health-related issues other than COVID-19 infection. Korean soldiers are relatively homogeneous in terms of age and physical condition. They show a similar disease distribution pattern every year and are directly affected by changes in government attempts to control COVID-19 with nonpharmaceutical interventions. This study aimed to identify the changes in patterns of outpatient visits and admissions to military hospitals for a range of disease types during a pandemic.MethodsOutpatient attendance and admission data from all military hospitals in South Korea from January 2016 to December 2020 were analyzed. Only active enlisted soldiers aged 18–32 years were included. Outpatient visits where there was a diagnosis of pneumonia, acute upper respiratory tract infection, infectious conjunctivitis, infectious enteritis, asthma, allergic rhinitis, allergic conjunctivitis, atopic dermatitis, urticaria, and fractures were analyzed. Admissions for pneumonia, acute enteritis, and fractures were also analyzed. All outpatient visits and admissions in 2020 for each disease were counted on a weekly basis and compared with the average number of visits over the same period of each year from 2016 to 2019. The corrected value was calculated by dividing the ratio of total weekly number of outpatient visits or admissions to the corresponding medical department in 2020 to the average in 2016–2019.ResultsA total of 5,813,304 cases of outpatient care and 143,022 cases of admission were analyzed. For pneumonia, the observed and corrected numbers of outpatient visits and admissions in 2020 decreased significantly compared with the average of other years (P < 0.001). The results were similar for outpatient visits for acute upper respiratory tract infection and infectious conjunctivitis (P < 0.001), while the corrected number of outpatient visits for infectious enteritis showed a significant increase in 2020 (P = 0.005). The corrected number of outpatient visits for asthma in 2020 did not differ from the average of the previous 4 years but the number of visits for the other allergic diseases increased significantly (P < 0.001). For fractures, the observed and corrected numbers of outpatient visits and admissions in 2020 decreased significantly compared with the average of other years (P < 0.001).ConclusionDuring the COVID-19 pandemic, outpatient visits to military hospitals for respiratory and conjunctival infections and fractures decreased, whereas visits for allergic diseases did not change or increased only slightly. Admissions for pneumonia decreased significantly in 2020, while those for acute enteritis and fractures also decreased, but showed an increased proportion compared with previous years. These results are important because they illustrate the changing patterns in lifestyle as a result of public encouragement to adopt nonpharmaceutical interventions during the pandemic and their effect on medical needs for both infectious and noninfectious diseases in a select group.     

Understanding the Role of Blood Vessels in the Neurologic Manifestations of Coronavirus Disease 2019 (COVID-19)

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) was originally identified as an outbreak in Wuhan, China, toward the end of 2019 and quickly became a global pandemic, with a large death toll. Originally identified as a respiratory disease, similar to previously discovered SARS and Middle East respiratory syndrome (MERS), concern has since been raised about the effects of SARS-CoV-2 infection on the vasculature. This viral-vascular involvement is of particular concern with regards to the small vessels present in the brain, with mounting evidence demonstrating that SARS-CoV-2 is capable of crossing the blood-brain barrier. Severe symptoms, termed coronavirus disease 2019 (COVID-19), often result in neurologic complications, regardless of patient age. These neurologic complications range from mild to severe across all demographics; however, the long-term repercussions of neurologic involvement on patient health are still unknown.

Currently, there are approximately 140 million confirmed infections with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) worldwide, and about 3,000,000 deaths associated with SARS-CoV-2 infection (Johns Hopkins University & Medicine, Coronavirus Resource Center, https://coronavirus.jhu.edu, last accessed April 17, 2021) manifesting as severe coronavirus disease 2019, or coronavirus disease 2019 (COVID-19). Approximately 15% of individuals affected by COVID-19 develop severe disease, and 6% are critically ill, resulting in respiratory failure and/or multiple organ dysfunction or failure.¹ The original outbreak of SARS-CoV-2 infection originated from Wuhan, Hubei province, China, in late 2019.^2,3Genomic characterization indicates that bats and rodents are the likely gene sources of α- and β-coronaviruses (CoVs), whereas γ- and δ-CoVs likely arise from avian sources.⁴ To date, seven human coronaviruses have been identified with the ability to cause respiratory, enteric, hepatic, and neurologic diseases in different animal species, including cattle and cats. These viruses are responsible for about 5% to 10% of acute respiratory infections, including the common cold.^4,5 SARS-CoV-2 is a member of the β- coronaviruses and is closely related to severe acute respiratory syndrome coronavirus (SARS-CoV) and Middle East respiratory syndrome coronavirus (MERS-CoV) with high sequence homology.⁶ These coronaviruses appear to infect the respiratory and gastrointestinal tract, with patients presenting symptoms of fever, cough, and shortness of breath, whereas less common symptoms include diarrhea, vomiting, and nausea.⁷ In addition, cytokine release syndrome was found to be the major cause of morbidity in patients infected with SARS-CoV and MERS-CoV.⁸Aside from the respiratory system, with acute respiratory distress syndrome affecting roughly one-third of COVID-19 hospitalized patients,⁹ COVID-19 appears to also involve multiple organ systems with pathologic manifestations, including the heart, kidney, and brain.10, 11, 12, 13, 14 Because of the multiorgan involvement of COVID-19, it has been hypothesized that COVID-19 is a vascular disease that primarily affects endothelial cells.^15,16 These organs, and their associated blood vessels, may be affected by direct viral tissue injury and localized disordered cytokine release.¹⁷ This direct injury and release of inflammatory and apoptosis inducing mediators leads to localized microvascular inflammation, which triggers endothelial activation, leading to vasodilation and prothrombotic conditions, which cause increased patient mortality.¹⁸Viral infections of the brain are less common than those of other organs as they involve penetration of the blood-brain barrier (BBB). Several viruses, including polio and West Nile virus, are able to cause neurologic complications, but the reasons why they occur in <1 in 100 patients are not understood.¹⁹ The route of entry of the virus into the brain, such as in the blood supply, or by direct infection of vascular endothelial cells, plays a role in the number and type of neurologic symptoms presented by the patient.^19,20 Investigations into MERS-CoV indicated that viral particles enter the bloodstream and are able to infect endothelial cells.²¹ In the case of SARS-CoV-2, viral-like particles have been seen in brain capillary endothelium and actively budding across endothelial cells.²²Although the route of entry of the virus may still be unknown, recent publications have highlighted neurologic manifestations that have been observed in 42% of COVID-19 patients at disease onset, 63% during hospitalization, and 82% at some time during the course of the disease.^23,24 In addition, a significant link was seen between magnetic resonance imaging abnormalities and persistent neurologic deficits, which continued 3 months after disease onset in 55% of patients.²³This review explores the role of the vasculature, specifically within the context of the neurologic manifestations of COVID-19. Herein, the neurologic manifestations reported with SARS-CoV-2 infection are reviewed. The evidence that suggests blood vessels are involved in SARS-CoV-2 infection is surveyed. Finally, the multiple pathologic processes (thromboembolic, inflammatory, and secondary processes) within blood vessels that may contribute to the neurologic manifestations of COVID-19 infection are considered.     

武汉大学同仁医院暨武汉市第三医院烧伤科在应对新型冠状病毒肺炎疫情下的应急管理策略

武汉市作为新型冠状病毒肺炎疫情重灾区,新型冠状病毒肺炎患者数量自始至终占到全国的绝大多数,对本地医疗系统形成严峻挑战,尤其是对普通疾病治疗造成了巨大冲击。本文介绍了疫情暴发以来的战时状态下,武汉大学同仁医院暨武汉市第三医院烧伤科在医疗处置、感染防控、人力资源管理、工作模式转换、医务人员人性化关怀等方面采取的管理举措,以期对疫情期间各地烧伤科的临床工作提供参考与借鉴。