Ultrasound-guided minimally invasive autopsies: A protocol for the study of pulmonary and systemic involvement of COVID-19

Considering that female sexual hormones may modulate the inflammatory response and also exhibit direct effects on the cells of the immune system, herein, we intend to discuss the sex differences and the role of estradiol in modulating the lung and systemic inflammatory response, focusing on its possible application as a treatment modality for SARS-CoV-2 patients. COVID-19 patients develop severe hypoxemia early in the course of the disease, which is silent most of the time. Small fibrinous thrombi in pulmonary arterioles and a tumefaction of endothelial were observed in the autopsies of fatal COVID-19 cases. Studies showed that the viral infection induces a vascular process in the lung, which included vasodilation and endothelial dysfunction. Further, the proportions of CD4+ T and CD8+ T lymphocytes were strongly reduced in patients with severe SARS-CoV-2 infection. Estradiol is connected with CD4+ T cell numbers and increases T-reg cell populations, affecting immune responses to infection. It is known that estradiol exerts a protective effect on endothelial function, activating the generation of nitric oxide (NO) via endothelial nitric oxide synthase. Estrogen attenuates the vasoconstrictor response to various stimuli and induces vasodilation in the pulmonary vasculature during stress situations like hypoxia. It exerts a variety of rapid actions, which are initiated after its coupling with membrane receptors, which in turn, may positively modulate vascular responses in pulmo...
Source: Clinics - Category: General Medicine Source Type: research

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CONCLUSIONS: This translational diagnostic tool will assist emergency and primary care clinicians, as well as out-of-hospital providers, in effectively managing people with suspected or confirmed SARS-CoV-2. PMID: 32633414 [PubMed - in process]
Source: European Review for Medical and Pharmacological Sciences - Category: Drugs & Pharmacology Tags: Eur Rev Med Pharmacol Sci Source Type: research
CONCLUSION: Transient fetal skin edema noted in these two patients with COVID-19 in the second trimester may represent results of fetal infection or altered fetal physiology due to maternal disease or may be unrelated to the maternal illness. PMID: 32649505 [PubMed - as supplied by publisher]
Source: Obstetrics and Gynecology - Category: OBGYN Authors: Tags: Obstet Gynecol Source Type: research
Lung ultrasound (LU) has a multitude of features and capacities that make it a useful medical tool to assist physicians contending with the pandemic spread of novel coronavirus disease-2019 (COVID-19) caused by coronavirus severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Thus, an LU approach to patients with suspected COVID-19 is being implemented worldwide. In noncritical COVID-19 patients, 2 new LU signs have been described and proposed, the “waterfall” and the “light beam” signs.
Source: Journal of Cardiothoracic and Vascular Anesthesia - Category: Anesthesiology Authors: Tags: Review Article Source Type: research
AbstractIn December 2019, a novel coronavirus (SARS-Cov-2) was first reported in Wuhan, China, and rapidly spread around the world, leading to an international emerging public health emergency. As reported from Chinese experiences, approximately 20% of patients had a severe course, requiring intensive care, with an overall case fatality rate of 2.3%. In diagnosis, chest computed tomography most commonly showed ground-glass opacity with or without consolidative patterns.Herein, we report a case of a patient affected by COVID-19 pneumonia referred in the emergency department of our institution on April 4, 2020, with peculiar...
Source: Journal of Ultrasound - Category: Radiology Source Type: research
On March 11, 2020, the World Health Organization declared coronavirus disease 2019 (COVID-19), caused by severe respiratory syndrome coronavirus-2 (SARS-CoV-2), a worldwide pandemic. Severe acute respiratory failure due to SARS-CoV-2 requiring invasive mechanical ventilation in the intensive care unit is associated with high mortality.1-3 Patient self-inflicted lung injury and ventilator-associated lung injury potentially could exacerbate lung inflammation and biotrauma, increasing further the mortality of that very sick patient population.
Source: Journal of Cardiothoracic and Vascular Anesthesia - Category: Anesthesiology Authors: Tags: Editorial Source Type: research
The novel coronavirus SARS-CoV-2 has caused a pandemic overwhelming healthcare systems around the world. Hospitals around the world, including the United States, have been struggling to adapt to the influx of patients with COVID-19, the illness caused by SARS-CoV2, given limited resources and high demand for medical care. Point of care ultrasound provides numerous benefits to emergency providers caring for patients with COVID-19 including decreasing resource utilization, assisting in diagnosis, guiding management of the critically ill patient, and aiding in rapid triage of patients under investigations for COVID-19.
Source: The Journal of Emergency Medicine - Category: Emergency Medicine Authors: Tags: Ultrasound in Emergency Medicine Source Type: research
Abstract COVID-19 is a pandemic infection due to a novel coronavirus (SARS-CoV-2) spreading, resulting in a wide range of clinical features, from asyntomatic carriers to acute respiratory distress syndrome. The gold standard for diagnosis is nucleic acid detection by real-time reverse-transcriptase-polymerase-chain-reaction (RT-PCR) in naso-pharyngeal swabs, but, due to limitations in its sensitivity, thoracic imaging plays a crucial, complementary role in diagnostic work-up and it allows also to reveal atypical findings and potential alternative target for sampling, such as pleural effusion. Although not common, ...
Source: Chest - Category: Respiratory Medicine Authors: Tags: Chest Source Type: research
The global pandemic of coronavirus disease 2019 (COVID-19) (severe acute respiratory syndrome coronavirus 2 [SARS-CoV-2]) is an unprecedented event that is overloading health services worldwide. In M éxico, the situation is no less worrying. When we started working with lung ultrasound (LUS) in México, 118 cases and 1 death had been registered in the country; at the time of writing of this article, 56,594 cases and 6090 deaths had been confirmed. The increase in cases and saturation of all med ical services at all levels call for swift action and close attention, as well as precise diagnoses, especially in pa...
Source: Ultrasound in Medicine and Biology - Category: Radiology Authors: Tags: Letter to the Editor Source Type: research
Conditions:   SARS-CoV 2;   COVID Interventions:   Behavioral: Telephonic medical visit;   Procedure: Gastrointestinal endoscopy;   Procedure: Abdominal ultrasound Sponsor:   Hospital del Río Hortega Recruiting
Source: ClinicalTrials.gov - Category: Research Source Type: clinical trials
Abstract OBJECTIVE: To evaluate the effects of coronavirus disease 2019 (COVID-19) on maternal, perinatal and neonatal outcomes by performing a systematic review of available published literature on pregnancies affected by COVID-19. METHODS: We performed a systematic review to evaluate the effects of COVID-19 on pregnancy, perinatal and neonatal outcomes. We conducted a comprehensive literature search using PubMed, EMBASE, the Cochrane Library, China National Knowledge Infrastructure Database and Wan Fang Data until 20 April 2020 (studies were identified through PubMed alert after that date). For the research...
Source: The Ultrasound Review of Obstetrics and Gynecology - Category: Radiology Authors: Tags: Ultrasound Obstet Gynecol Source Type: research
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