In addition to common clinical features, patients with coronavirus disease 2019 (COVID-19) have varying degree of coagulation dysfunction with the risk of thrombosis and/or bleeding. COVID-19 related coagulation dysfunction is a dynamic process, which may be accompanied by the formation of disseminated intravascular coagulation and is related to the severity of the disease. The imbalance of the body's immune and inflammatory response caused by coronavirus infection is an important cause of coagulation dysfunction. Dynamic monitoring as well as early prevention and treatment are of great significance for improving the prognosis of patients. This article reviews the research progress of COVID-19 related coagulation dysfunction, to provide reference for clinical research and management.
Betacoronavirus ; Blood Coagulation Disorders ; etiology ; Coronavirus Infections ; complications ; Humans ; Pandemics ; Pneumonia, Viral ; complications

The coronavirus disease 2019 (COVID-19) has caused a global pandemic. All people including children are generally susceptible to COVID-19, but the condition is relatively mild for children. The diagnosis of COVID-19 is largely based on the epidemiological evidence and clinical manifestations, and confirmed by positive detection of virus nucleic acid in respiratory samples. The main symptoms of COVID-19 in children are fever and cough; the total number of white blood cell count is usually normal or decreased; the chest imaging is characterized by interstitial pneumonia, which is similar to other respiratory virus infections and infections. Early identification, early isolation, early diagnosis and early treatment are important for clinical management. The treatment of mild or moderate type of child COVID-19 is mainly symptomatic. For severe and critical ill cases, the oxygen therapy, antiviral drugs, antibacterial drugs, glucocorticoids, mechanical ventilation or even extracorporeal membrane oxygenation (ECMO) may be adopted, and the treatment plan should be adjusted timely through multi-disciplinary cooperation.
Betacoronavirus ; isolation & purification ; Child ; Coronavirus Infections ; diagnosis ; pathology ; therapy ; Humans ; Pandemics ; Pneumonia, Viral ; diagnosis ; diagnostic imaging ; etiology ; pathology ; therapy

Betacoronavirus ; COVID-19 ; Coronavirus Infections/complications* ; Disseminated Intravascular Coagulation/etiology* ; Humans ; Pandemics ; Pneumonia, Viral/complications* ; SARS-CoV-2

Betacoronavirus ; Blood Coagulation Disorders ; epidemiology ; etiology ; Coronavirus Infections ; complications ; Disseminated Intravascular Coagulation ; epidemiology ; etiology ; Fibrin Fibrinogen Degradation Products ; analysis ; Humans ; Pandemics ; Pneumonia, Viral ; complications ; Venous Thromboembolism ; epidemiology ; etiology

Infection with Middle East respiratory syndrome coronavirus (MERS-CoV) emerged in 2012 as an important respiratory disease with high fatality rates of 40%-60%. Despite the increased number of cases over subsequent years, the number of pediatric cases remained low. A review of studies conducted from June 2012 to April 19, 2016 reported 31 pediatric MERS-CoV cases. In this paper, we present the clinical and laboratory features of seven patients with pediatric MERS. Five patients had no underlying medical illnesses, and three patients were asymptomatic. Of the seven cases, four (57%) patients sought medical advice within 1-7 days from the onset of symptoms. The three other patients (43%) were asymptomatic and were in contact with patients with confirmed diagnosis of MERS-CoV. The most common presenting symptoms were fever (57%), cough (14%), shortness of breath (14%), vomiting (28%), and diarrhea (28%). Two (28.6%) patients had platelet counts of < 150 × 10/L, and one patient had an underlying end-stage renal disease. The remaining patients presented with normal blood count, liver function, and urea and creatinine levels. The documented MERS-CoV Ct values were 32-38 for four of the seven cases. Two patients (28.6%) had abnormal chest radiographic findings of bilateral infiltration. One patient (14.3%) required ventilator support, and two patients (28.6%) required oxygen supplementation. All the seven patients were discharged without complications.
Adolescent ; Child ; Coronavirus Infections ; diagnosis ; physiopathology ; Diarrhea ; etiology ; Dyspnea ; etiology ; Female ; Fever ; etiology ; Humans ; Infant ; Lung ; diagnostic imaging ; Male ; Middle East Respiratory Syndrome Coronavirus ; genetics ; Pleural Effusion ; diagnostic imaging ; Radiography, Thoracic ; Saudi Arabia

OBJECTIVE: To explore the risk factors of anxiety and depression in patients with suspected coronavirus disease 2019 (COVID-19) so as to achieve early intervention and better clinical prognosis. METHODS: Seventy-six patients with suspected COVID-19 in fever isolation wards of Second Hospital of Lanzhou University were enrolled From January 31, 2020 to February 22, 2020. Their clinical baseline data were collected. The anxiety of patients was assessed by Hamilton Anxiety Scale, and the depression of patients was assessed by Hamilton Depression Scale. Multivariate Logistic regression analysis was performed to explore the risk factors of anxiety and depression in these patients. RESULTS: Female patients are more likely to have anxiety (=3.206, 95%: 1.073-9.583, <0.05) and depression (=9.111, 95%: 2.143-38.729, <0.01) than male patients; patients with known contact history of epidemic area and personnel in epidemic area are more likely to have depression (=3.267, 95%: 1.082-9.597, <0.05). CONCLUSIONS During the isolation treatment of suspected COVID-19 patients, early psychological intervention should be carried out for the female patients with known contact history of epidemic area and personnel in epidemic area, and drug treatment should be given in advance if necessary.
Anxiety ; diagnosis ; etiology ; therapy ; Betacoronavirus ; isolation & purification ; Coronavirus Infections ; complications ; diagnosis ; psychology ; Depression ; diagnosis ; etiology ; Female ; Humans ; Logistic Models ; Male ; Pandemics ; Pneumonia, Viral ; complications ; diagnosis ; psychology ; Risk Factors

Since the outbreak of novel coronavirus pneumonia (coronavirus disease 2019, COVID-19), it has rapidly spread to 187 countries, causing serious harm to the health of people and a huge social burden. However, currently, drugs specifically approved for clinical use are not available, except for vaccines against COVID-19 that are being evaluated. Traditional Chinese medicine (TCM) is capable of performing syndrome differentiation and treatment according to the clinical manifestations of patients, and has a better ability of epidemic prevention and control. The authors comprehensively analyzed the etiology and pathogenesis of COVID-19 based on the theory of TCM, and discussed its syndrome differentiation, treatment and prevention measures so as to provide strategies and reference for the prevention and treatment with TCM.
Betacoronavirus ; Coronavirus Infections ; diagnosis ; etiology ; prevention & control ; therapy ; Humans ; Medicine, Chinese Traditional ; Pandemics ; prevention & control ; Pneumonia, Viral ; diagnosis ; etiology ; prevention & control ; therapy

No abstract available.
Acute Lung Injury/*etiology ; Adult ; Blood Transfusion/*adverse effects ; Coronavirus/genetics/isolation & purification ; Coronavirus Infections/*diagnosis/virology ; Humans ; Male ; Oximetry ; Real-Time Polymerase Chain Reaction ; Republic of Korea ; Viral Proteins/genetics/metabolism

PURPOSE: Emergency department (ED) nurses suffer from persistent stress after experiencing the traumatic event of exposure to Middle East respiratory syndrome coronavirus (MERS-CoV), which can subsequently lead to burnout. This study aimed to assess ED nurses' burnout level during an outbreak of MERS-CoV and to identify influencing factors in order to provide basic information for lowering and preventing the level of burnout. METHODS: Study participants were ED nurses working in eight hospitals designated for treating MERS-CoV-infected patients in Korea. We performed multiple regression analysis to explore the factors influencing burnout. RESULTS: The ED nurses' burnout was affected by job stress (β = 0.59, p < .001), poor hospital resources for the treatment of MERS-CoV (β = −0.19, p < .001) and poor support from family and friends (β = −0.14, p < .05). These three variables explained 47.3% of the variance in burnout. CONCLUSIONS: ED nurses taking care of MERS-CoV-infected patients should be aware that burnout is higher for nurses in their divisions than nurses in other hospital departments and that job stress is the biggest influential factor of burnout. To be ready for the outbreak of emerging contagious diseases such as MERS-CoV, efforts and preparations should be made to reduce burnout. Job stress should be managed and resolved. Working conditions for mitigating job stress and systematic stress management programs should be provided, and hospital resources for the treatment of MERS-CoV need to be reinforced. Moreover, promoting support from family and friends is required.
Adult ; Burnout, Professional/*epidemiology/etiology ; Coronavirus Infections/*epidemiology/psychology ; Cross-Sectional Studies ; Disease Outbreaks ; Emergency Nursing/*statistics & numerical data ; Female ; Humans ; Job Satisfaction ; Male ; Middle Aged ; *Middle East Respiratory Syndrome Coronavirus ; Nurses/*psychology ; Republic of Korea/epidemiology ; Young Adult

Acute respiratory failure due to acute hypoxemia is the major manifestation in severe coronavirus disease 2019 (COVID-19) induced by severe acute respiratory syndrome coronavirus 2 infection. Rational and effective respiratory support is crucial in the management of COVID-19 patients. High-flow nasal cannula (HFNC) has been utilized widely due to its superiority over other non-invasive respiratory support techniques. To avoid HFNC failure and intubation delay, the key issues are proper patients, timely application and improving compliance. It should be noted that elder patients are vulnerable for failed HFNC. We applied HFNC for oxygen therapy in severe and critical COVID-19 patients and summarized the following experiences. Firstly, to select the proper size of nasal catheter, to locate it at suitable place, and to confirm the nose and the upper respiratory airway unobstructed. Secondly, an initial flow of 60 L/min and 37℃ should be given immediately for patients with obvious respiratory distress or weak cough ability; otherwise, low-level support should be given first and the level gradually increased. Thirdly, to avoid hypoxia or hypoxemia, the treatment goal of HFNC should be maintained the oxygen saturation (SpO) above 95% for patients without chronic pulmonary disease. Finally, patients should wear a surgical mask during HFNC treatment to reduce the risk of virus transmission through droplets or aerosols.
Aged ; Betacoronavirus ; Cannula ; Coronavirus Infections ; complications ; therapy ; Humans ; Hypoxia ; etiology ; prevention & control ; therapy ; Masks ; Oxygen ; administration & dosage ; Oxygen Inhalation Therapy ; instrumentation ; standards ; Pandemics ; Pneumonia, Viral ; complications ; therapy