Critical care management of adults with community-acquired severe respiratory viral infection

AbstractWith the expanding use of molecular assays, viral pathogens are increasingly recognized among critically ill adult patients with community-acquired severe respiratory illness; studies have detected respiratory viral infections (RVIs) in 17 –53% of such patients. In addition, novel pathogens including zoonotic coronaviruses like the agents causing Severe Acute Respiratory Syndrome (SARS), Middle East Respiratory Syndrome (MERS) and the 2019 novel coronavirus (2019 nCoV) are still being identified. Patients with severe RVIs requiring ICU care present typically with hypoxemic respiratory failure. Oseltamivir is the most widely used neuraminidase inhibitor for treatment of influenza; data suggest that early use is associated with reduced mortality in critically ill patients with influenza. At present, there are no antiviral therap ies of proven efficacy for other severe RVIs. Several adjunctive pharmacologic interventions have been studied for their immunomodulatory effects, including macrolides, corticosteroids, cyclooxygenase-2 inhibitors, sirolimus, statins, anti-influenza immune plasma, and vitamin C, but none is recommen ded at present in severe RVIs. Evidence-based supportive care is the mainstay for management of severe respiratory viral infection. Non-invasive ventilation in patients with severe RVI causing acute hypoxemic respiratory failure and pneumonia is associated with a high likelihood of transition to inv asive ventilation. Limited existing knowledge...
Source: Intensive Care Medicine - Category: Intensive Care Source Type: research

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FDA has granted Emergency Use Authorization (EUA) to Battelle's CCDS Critical Care Decontamination System for processing up to 80,000 respirator masks per system each day. CCDS employs concentrated, vapor-phase hydrogen peroxide (VPHP) for decontamination. The system has been validated to decontaminate masks of SARS-CoV-2, the company reported. The masks are placed on shelves inside a container, and a portable, external VPHP system is hooked up to the outside of container. The system was first envisioned by Battelle as part of a study commissioned by FDA in 2015. That study involved determining the feasibility of N95 respi...
Source: MDDI - Category: Medical Devices Authors: Tags: Sterilization Source Type: news
Publication date: 4–10 April 2020Source: The Lancet, Volume 395, Issue 10230Author(s): Anna Petherick
Source: The Lancet - Category: General Medicine Source Type: research
Authors: Hong KH, Lee SW, Kim TS, Huh HJ, Lee J, Kim SY, Park JS, Kim GJ, Sung H, Roh KH, Kim JS, Kim HS, Lee ST, Seong MW, Ryoo N, Lee H, Kwon KC, Yoo CK, Korean Society for Laboratory Medicine, COVID-19 Task Force and the Center for Laboratory Control of Infectious Diseases, the Korea Centers for Disease Control and Prevention Abstract The outbreak of coronavirus disease 2019 (COVID-19), which began in December 2019, is still ongoing in Korea, with>9,000 confirmed cases as of March 25, 2020. COVID-19 is a severe acute respiratory syndrome Coronavirus 2 (SARS-CoV-2) infection, and real-time reverse transcriptio...
Source: Annals of Laboratory Medicine - Category: Laboratory Medicine Tags: Ann Lab Med Source Type: research
CONCLUSIONS: The ability to rapidly identify, propagate, and internationally share our SARS-CoV-2 isolate is an important step in collaborative scientific efforts to deal effectively with this international public health emergency by developing better diagnostic procedures, vaccine candidates, and antiviral agents. PMID: 32237278 [PubMed - as supplied by publisher]
Source: Medical Journal of Australia - Category: General Medicine Tags: Med J Aust Source Type: research
Authors: Kaur P, Kumar P, Randev S, Guglani V Abstract Allergic bronchopulmonary aspergillosis (ABPA) is an immunological disease complicating asthma or cystic fibrosis. An 8-year-old girl with no previous respiratory morbidity was diagnosed with ABPA on the basis of a raised eosinophil count and total and specific serum IgE levels combined with a positive skin-prick test for aspergillus and typical CT images of finger-in-glove hilar opacities and hyperattenuating mucous. She responded to treatment with itraconazole and corticosteroids and remains well. As far as we are aware, she is only the second child to be dia...
Source: Paediatrics and international child health - Category: Pediatrics Tags: Paediatr Int Child Health Source Type: research
Critics say that the plan may not go to hospitals in the states hit the hardest so far and that it fails to address the problems of uninsured people more generally.
Source: NYT - Category: American Health Authors: Tags: Coronavirus Aid, Relief, and Economic Security Act (2020) Coronavirus (2019-nCoV) Health Insurance and Managed Care Hospitals Source Type: news
In conclusion, the five differentially expressed miRNAs may be considered as diagnostic biomarkers for patients with hepatocellular carcinoma. In addition, the differential expression levels of the targets of these five mRNAs, including SFRP1, EDNRB, NR4A3, FHL2, NKX3‑1, IL6ST and FOXO1, may be involved in hepatocellular carcinoma tumorigenesis. PMID: 32236623 [PubMed - as supplied by publisher]
Source: Oncology Reports - Category: Cancer & Oncology Tags: Oncol Rep Source Type: research
Drs David and Rachel Kerr of the University of Oxford present suggested guidance for the management of patients during the novel coronavirus pandemic.Medscape Oncology
Source: Medscape Hematology-Oncology Headlines - Category: Cancer & Oncology Tags: Hematology-Oncology Commentary Source Type: news
Authors: Zhang Y, Wang Q, Reynolds GP, Yue W, Deng W, Yan H, Tan L, Wang C, Yang G, Lu T, Wang L, Zhang F, Yang J, Li K, Lv L, Tan Q, Li Y, Yu H, Zhang H, Ma X, Yang F, Li L, Chen Q, Wei W, Zhao L, Wang H, Li X, Guo W, Hu X, Tian Y, Ren H, Ma X, Coid J, Zhang D, Li T, Chinese Antipsychotics Pharmacogenomics Consortium Abstract OBJECTIVE: To compare longitudinal metabolic effects of 7 antipsychotics, including body mass index (BMI), waist circumference (WC), blood pressure (BP), glucose, triglycerides (TG), high-density lipoprotein cholesterol (HDL-C), and low-density lipoprotein cholesterol (LDL-C); to investigate ...
Source: Journal of Clinical Psychiatry - Category: Psychiatry Tags: J Clin Psychiatry Source Type: research
The outbreak of coronavirus disease 2019 (COVID-19) may be stressful – it can be difficult to cope with fear and anxiety, changing daily routines, and a general sense of uncertainty. Taking steps to care for your mental health can help you manage stress.
Source: National Institute of Mental Health - Category: Psychiatry Authors: Source Type: news
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