1.Coronavirus disease 2019 and hypertension in 2 children.
Chinese Journal of Contemporary Pediatrics 2020;22(5):425-428
This article reports the diagnosis and treatment of two children with coronavirus disease 2019 (COVID-19) and hypertension. Case 1 was a boy aged 13 years and 3 months, with the main manifestations of fever and dry cough; chest CT showed ground-glass opacities, and the nucleic acid test of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) yielded a positive result. Case 2 was a boy aged 13 years and 8 months and had no clinical symptoms; chest CT showed no abnormality, while the nucleic acid test of SARS-CoV-2 yielded a positive result. Both cases were shown with family aggregation of SARS-CoV-2 infection. They had obesity and a family history of hypertension. Continuous blood pressure monitoring in the resting state during hospitalization showed that blood pressure was above the 95% reference interval of normal value for children of the same age, and the two boys were given calcium channel blockers or β-receptor blockers and were then recovered. It is concluded that comprehensive management of children with COVID-19 and underlying cardiovascular diseases, including hypertension, should be taken seriously during the epidemic.
Adolescent
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Betacoronavirus
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Coronavirus Infections
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complications
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Humans
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Hypertension
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complications
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Male
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Pandemics
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Pneumonia, Viral
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complications
2.Coagulation dysfunction in COVID-19.
Yiming XU ; Dandan LYU ; Kejing YING
Journal of Zhejiang University. Medical sciences 2020;49(3):340-346
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
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Blood Coagulation Disorders
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etiology
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Coronavirus Infections
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complications
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Humans
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Pandemics
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Pneumonia, Viral
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complications
3.Expert consensus on management of analgesia and sedation for patients with severe coronavirus disease 2019.
Xiang-Hong YANG ; Bo HU ; You SHANG ; Jiao LIU ; Ming ZHONG ; Xiu-Lling SHANG ; Zhi-Xiong WU ; Zhui YU ; Ren-Hua SUN ; Hong-Liang WANG ; Ming-Yan ZHAO ; Mei MENG ; Qiang-Hong XU ; Xia ZHENG ; De-Chang CHEN
Chinese Medical Journal 2020;133(18):2186-2188
7.Clinical feature of four cases with bronchiolitis obliterans.
Xiu-yun LIU ; Zai-fang JIANG ; Kun-ling SHEN ; Jin-jin ZENG ; Sai-ying XU
Chinese Journal of Pediatrics 2003;41(11):839-841
OBJECTIVETo recognize the clinical features of the bronchiolitis obliterans.
METHODClinical manifestation, chest X-ray, computed tomography (CT) and pulmonary function of 4 cases with bronchiolitis obliterans were retrospectively analyzed.
RESULTTwo cases were after Stevens-Johnson syndrome (SJS), the other 2 were after severe pneumonia, including one suffered from adenovirus pneumonia. Cough, tachypnea and wheezing persisted in all the 4 patients. The symptoms lasted for at least 6 weeks, in one case for over one year. Crackles and wheezing were present in all the 4 cases. Hyperinflation was seen in chest radiographs in all cases. On pulmonary CT/high-resolution CT (HRCT), patchy opacity and bronchial wall thickening were seen in each patient. Areas of air trapping were seen in three cases. Bronchiectasis was seen in 2 cases, atelectasis and mosaic perfusion were seen respectively in one case. PO(2) was low in all the four cases. Wheezing was not responsive to beta(2) agonist and other bronchodilating therapy. Prednisone was used at a dose of 1 mg/(kg.d) in 3 cases. Two cases were followed up for 3 months. The clinical condition of one case was improved, whose wheezing and bronchiolar constriction disappeared, cough and dyspnea were also relieved. However, the condition of one patient was not improved, although the wheezing disappeared. The HRCT of these two cases showed no improvement.
CONCLUSIONClinical symptoms of BO were cough, tachypnea, and wheezing after acute lung injury. Crackles and wheezing were the most common signs in the BO. Chest radiographs showed hyperinflation. Pulmonary CT showed bronchial wall thickening, bronchiectasis, atelectasis, and mosaic perfusion. Pulmonary function tests suggested obstruction of small airway.
Bronchiolitis Obliterans ; etiology ; pathology ; physiopathology ; Child ; Child, Preschool ; Humans ; Infant ; Male ; Pneumonia ; complications ; Pneumonia, Viral ; complications ; Prognosis ; Respiratory Function Tests ; Stevens-Johnson Syndrome ; complications ; Tomography, X-Ray Computed
8.Anesthesia management in cesarean section for patient with COVID-19: a case report.
Xianhui KANG ; Rong ZHANG ; Huiliang HE ; Yongxing YAO ; Yueying ZHENG ; Xiaohong WEN ; Shengmei ZHU
Journal of Zhejiang University. Medical sciences 2020;49(2):249-252
Since the coronavirus disease 2019 (COVID-19) affects the cardio-pulmonary function of pregnant women, the anesthetic management and protection of medical staff in the cesarean section is significantly different from that in ordinary surgical operation. This paper reports a case of cesarean section for a woman with COVID-19, which was successfully performed in the First Affiliated Hospital of Zhejiang University School of Medicine on February 8, 2020. Anesthetic management, protection of medical staff and psychological intervention for the pregnant woman during the operation were discussed. Importance has been attached to the preoperative evaluation of pregnant women with COVID-19 and the implementation of anesthesia plan. For moderate patients, intraspinal anesthesia is preferred in cesarean section, and try to reduce its influence in respiration and circulation in both maternal and infant; general anesthesia with endotracheal intubation should be adopted for severe or critically ill patients. Ensure the safety of medical environment, and anesthetists should carry out level-Ⅲ standard protection. Special attention and support should be paid to maternal psychology: fully explanation before operation to reduce anxiety; relieve the discomfort during operation, so as to reduce tension; avoid the bad mood due to pain after operation.
Anesthesia
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Betacoronavirus
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isolation & purification
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Cesarean Section
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methods
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Coronavirus Infections
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complications
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Female
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Humans
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Infant
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Injections, Spinal
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Pandemics
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Pneumonia, Viral
;
complications
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Pregnancy