The identification of novel antibodies that could neutralize SARS-CoV-2 is one of the novel approaches to use in combating COVID-19. This study aimed to explore the level of neutralizing antibodies (NAbs) in asymptomatic close contacts of COVID-19 patients and asymptomatic healthcare workers. In vitro qualitative detection of serum antibodies of participants from both populations was done using an anti-SARS-CoV-2 immunoassay. The study included 107 participants, of which 59.8% were healthcare workers and 40.2% were family contacts of confirmed COVID-19 cases. Their median age was 22 years. The percentage of positivity and median titer for NAbs were significantly higher among family contacts than mong healthcare workers (P= 0.013 and< 0.001, respectively). We also measured C-reactive protein (CRP) levels and the median value of CRP was significantly higher in the family members who had been in contact with COVID-19 patients than in healthcare workers (P< 0.001). In the family contact group, there was a significant negative correlation between the absolute lymphocyte count and CRP (r=− 0.409, P= 0.034). There was no significant correlation between neutralizing antibody titers and either CRP or absolute lymphocyte count (P> 0.05 for both). In conclusion, the indication of elevated NAb titers in asymptomatic family contacts could help lay the groundwork for further studies to explore the potential utility of these antibodies to provide future immunity from infection within a family as well as for potential use in general during passive antibody therapies for COVID-19 patients.

Purpose

To accommodate the unprecedented number of critically ill patients with pneumonia caused by coronavirus disease 2019 (COVID-19) expansion of the capacity of intensive care unit (ICU) to clinical areas not previously used for critical care was necessary. We describe the global burden of COVID-19 admissions and the clinical and organizational characteristics associated with outcomes in critically ill COVID-19 patients.

Methods

Multicenter, international, point prevalence study, including adult patients with SARS-CoV-2 infection confirmed by polymerase chain reaction (PCR) and a diagnosis of COVID-19 admitted to ICU between February 15th and May 15th, 2020.

Results

4994 patients from 280 ICUs in 46 countries were included. Included ICUs increased their total capacity from 4931 to 7630 beds, deploying personnel from other areas. Overall, 1986 (39.8%) patients were admitted to surge capacity beds

SARS-CoV-2 has been associated with an increased rate of venous thromboembolism in critically ill patients. Since surgical patients are already at higher risk of venous thromboembolism than general populations, this study aimed to determine if patients with peri-operative or prior SARS-CoV-2 were at further increased risk of venous thromboembolism. We conducted a planned sub-study and analysis from an international, multicentre, prospective cohort study of elective and emergency patients undergoing surgery during October 2020. Patients from all surgical specialties were included. The primary outcome measure was venous thromboembolism (pulmonary embolism or deep vein thrombosis) within 30 days of surgery. SARS-CoV-2 diagnosis was defined as peri-operative (7 days before to 30 days after surgery); recent (1-6 weeks before surgery); previous (≥7 weeks before surgery); or none. Information on prophylaxis regimens or pre-operative anti-coagulation for baseline comorbidities was not available. Postoperative venous thromboembolism rate was 0.5% (666/123,591) in patients without SARS-CoV-2; 2.2% (50/2317) in patients with peri-operative SARS-CoV-2; 1.6% (15/953) in patients with recent SARS-CoV-2; and 1.0% (11/1148) in patients with previous SARS-CoV-2. After adjustment for confounding factors, patients with peri-operative (adjusted odds ratio 1.5 (95%CI 1.1-2.0)) and recent SARS-CoV-2 (1.9 (95%CI 1.2-3.3)) remained at higher risk of venous thromboembolism, with a borderline finding in previous SARS-CoV-2 (1.7 (95%CI 0.9-3.0)). Overall, venous thromboembolism was independently associated with 30-day …

Background

The COVID-19 pandemic presented major challenges for critical care facilities worldwide. Infections which develop alongside or subsequent to viral pneumonitis are a challenge under sporadic and pandemic conditions; however, data have suggested that patterns of these differ between COVID-19 and other viral pneumonitides. This secondary analysis aimed to explore patterns of co-infection and intensive care unit-acquired infections (ICU-AI) and the relationship to use of corticosteroids in a large, international cohort of critically ill COVID-19 patients.

Methods

This is a multicenter, international, observational study, including adult patients with PCR-confirmed COVID-19 diagnosis admitted to ICUs at the peak of wave one of COVID-19 (February 15th to May 15th, 2020). Data collected included investigator-assessed co-infection at ICU admission, infection acquired in ICU, infection with multi-drug …

Background

The coronavirus disease 19 (COVID-19) pandemic has spread rapidly around the globe with considerable morbidity and mortality. Coexistence of comorbidities with COVID-19 had consistently been reported as risk factors for unfavorable outcome. We aimed to evaluate the impact of comorbidities in COVID-19 patients on the outcome and determine predictors of prolonged hospital stay, requisite for intensive care unit (ICU) admission. Four hundred and thirty-nine adult patients who are admitted through (June and July 2020) in our University Hospitals were included in the study. All participants were diagnosed with COVID-19 according to Egyptian Ministry of Health guidance as definite case or probable case.

Results

Patients with comorbidities represented 61.7% of all cases. Constitutional symptoms especially myalgia and lower respiratory tract (LRT) symptoms such as dyspnea were significantly …

Background

Acute exacerbation of chronic obstructive pulmonary disease (AECOPD) is a major cause for hospital admission and COPD(chronic obstructive pulmonary disease) related morbidity. This encouraged clinicians to search for useful and easy inflammatory biomarkers for recognizing AECOPD.

Objective

To evaluate the role of the neutrophil/lymphocyte ratio (NLR) and C-reactive protein (CRP) in COPD patients for recognition of an acute exacerbation requiring hospital admission.

Patients and Methods

A prospective study included 100 hospitalized AECOPD patients, 88 stable COPD, and 80 sex and age matched healthy subjects. NLR and CRP were measured twice for each patient, first at hospital admission and the second was 3 months later as follow up. NLR was calculated from the complete blood count (CBC).

Results

The total white blood cell count (WBCs), Neutrophils, and NLR ratio were significantly higher in AECOPD group (P< 0.05 for each). CRP and forced expiratory volume in first second (FEV1% predicted) showed a significant correlation with NLR (P˂ 0.05). At cut off value˃ 3.26 for NLR the sensitivity and specificity were 84.7% and 78.0% respectively, whileat cut off value> 4.11 for CRP the sensitivity and specificity were 77.9 % and 68.2% respectively for the prediction of AECOPD.

Conclusion

Elevated NLR can be used as a marker similar to WBCs and CRP, in the detection of increased inflammation in hospitalized acutely exacerbated COPD patients.

Introduction

Cardiopulmonary exercise testing (CPET) is a non-invasive method for the determination of disability and comprehensive evaluation of exercise responses involving the cardiovascular, pulmonary and musculoskeletal systems.

Material and Methods

To assess exercise performance measured by CPET in different chronic obstructive pulmonary disease (COPD) stages and to compare between pulmonary function test (PFT) and CPET in assessing the degree of respiratory impairment. Sixty patients diagnosed with COPD were enrolled in the study. Modified Medical Research Council scale (mMRC) and COPD assessment test (CAT) to evaluate dyspnea symptom. PFT and CPET were performed.

Results

There was a significant decrease in peak VO 2 and anaerobic threshold in patients with stages III, IV (p< 0.001), while COPD stage I, II had significantly higher minute ventilation, tidal volume and oxygen pulse (p< 0.001). 76.67% of patients were similarly classified by CPET and PFT, while 23.33% were found to be less impaired according to CPET when compared to PFT. A significant correlation between both VE/VO2 (r= 0.31, 95% CI 0.19–0.92, p< 0.001) and VE/VCO2 (r= 0.69, 95% CI 0.86–1.08, P< 0.001) with FEV1. Whereas, an inverse correlation were found between both VE/VCO 2 (r=–0.34, 95% CI–0.77–1.11, p< 0.001) and VE/VO 2 (r=–0.55, 95% CI–0.88 to–0.15, p< 0.001), with the degree of air trapping as estimated by RV/TLC ratio. No significant correlation between neither CAT nor MRC and exercise testing parameters.

Conclusion

CPET is an extremely valuable method for the determination of functional capacity and …

Background

Noninvasive ventilation (NIV) is a promising alternative to invasive mechanical ventilation (IMV) with a particular importance amidst the shortage of intensive care unit (ICU) beds during the COVID-19 pandemic. We aimed to evaluate the use of NIV in Europe and factors associated with outcomes of patients treated with NIV.

Methods

This is a substudy of COVIP study—an international prospective observational study enrolling patients aged ≥ 70 years with confirmed COVID-19 treated in ICU. We enrolled patients in 156 ICUs across 15 European countries between March 2020 and April 2021.The primary endpoint was 30-day mortality.

Results

Cohort included 3074 patients, most of whom were male (2197/3074, 71.4%) at the mean age of 75.7 years (SD 4.6). NIV frequency was 25.7% and varied from 1.1 to 62.0% between participating countries. Primary NIV failure, defined as need for endotracheal …

Post COVID-19 syndrome, that is marked by dyspnea, fatigue, and functional impairment, is best treated with a non pharmacologic aproach entitled a physiotherapy intervention program.

Aim

To evaluate the effect of physiotherapy intervention program through telehealth on dyspnea, fatigue and functional status of post COVID-19 syndrome patients.

Design

The study utilized a one-group pre and posttest Quasi experimental design with a purposive sample of 60 post Covid-19 syndrome patients.

Setting

Isolation Medical Unit and Post Covid-19 follow up clinic in main Assiut University Hospital.

Tools

Data were collected using a structured interview Patient's assessment questionnaire, Modified Medical Research Council Dyspnoea Scale, Chalder fatigue scale, and Post COVID-19 Functional Status Scale.

Results

statistically extremely significant differences regarding degrees of dyspnea , extent of fatigue, and functional status of post Covid-19 syndrome patients in pre, post (8th wks.), and follow up (12th wk.) of program application with (p=0.001).

Conclusion

Physiotherapy intervention program applied through telehealth had significant improvement clinically and statistically on dyspnea, fatigue, and functional status.

Recommendations

Telehealth is especially important currently, as social distancing measures thus using this intervention program by nurses can be effective in improving post Covid-19 syndrome symptoms.