Background: Mycoplasma pneumoniae (MP) is the primary causative agent of community-acquired pneumonia, which has increasingly become resistant to macrolides, complicating treatment regimens, especially with the co-inf...Background: Mycoplasma pneumoniae (MP) is the primary causative agent of community-acquired pneumonia, which has increasingly become resistant to macrolides, complicating treatment regimens, especially with the co-infection factor. Its worldwide prevalence has fluctuated due to the influence of the COVID-19 pandemic. The study investigated co-infection patterns in children diagnosed with Mycoplasma pneumoniae pneumonia (MPP). Methods: From June 2022 to December 2023, we retrospectively analyzed the clinical data for hospitalized children with Mycoplasma pneumoniae pneumonia in Wuhan, China. We collected data on age, sex, clinical information, and pathogenic results. We also collected sputum or bronchoalveolar lavage fluid (BALF) samples to test respiratory pathogens and macrolide resistance using targeted microbial next-generation sequencing (tNGS). We analyzed the data using SPSS. Results: The study involved 417 patients diagnosed with MPP, of whom 86.33% had co-infections. Co-infections were notably linked to lobar pneumonia, prominent imaging shadows and higher macrolide resistance rate. Key bacterial pathogens were Streptococcus pneumoniae, Haemophilus influenzae, Staphylococcus aureus, rhinoviruses, and human adenoviruses (HADV). In MPP cases, Candida albicans was the fungal pathogen related to co-infections. The co-infection with HADV and human bocavirus 1 (HBoV1) correlated with prolonged fever, whereas Bordetella pertussis was linked to prolonged cough. In contrast, Candida albicans exhibited a weaker association with diffuse large-area infiltration on chest imaging, and its co-infection was less likely to result in severe disease. Conclusion: These results offer valuable insight into Mycoplasma pneumoniae pneumonia in children, highlighting the impact of co-infections on the disease’s clinical outcomes.展开更多
Objective:To investigate long-term symptoms after acute COVID-19,the link between symptoms and respiratory function,radiological changes in the post-COVID period,and risk factors for post-COVID syndrome.Methods:In thi...Objective:To investigate long-term symptoms after acute COVID-19,the link between symptoms and respiratory function,radiological changes in the post-COVID period,and risk factors for post-COVID syndrome.Methods:In this cross-sectional study,123 participants who were admitted within the first 3 months were categorized as group 1,and those who applied after 3 months were categorized as group 2.According to thoracic imaging and pulmonary function tests,patients were split into 3 groups as mild,moderate and severe.Results:At least one symptom was present in 91.9%and 61.8%in acute and post-COVID period,respectively.Pulmonary function tests were normal in 60(70.6%)in the first three months,and 30(78.9%)in 91-days to 1-year period after acute COVID-19 infection.After 3 months,22.4%of chest X-rays and 7.9%of computerized tomography revealed progression.Patients who developed acute complications(OR 9.91,95%CI 1.93-50.87),had 2 or more symptoms at admission(OR 7.73,95%CI 2.56-23.33),had 1%to 14%CT involvement(OR 3.05,95%CI 1.06-8.79),or had 50%or more CT involvement(OR 14.68,95%CI 1.24-172.55)had a higher risk of developing post-COVID syndrome.Conclusions:COVID-19 symptoms can last for long time.Severity of symptoms,acute complications,and the extent of radiological involvement may all contribute to elevated risk of post-COVID syndrome.As a result,patients with COVID-19 should be checked for long-term clinical difficulties on regular basis.展开更多
Objective:To assess the effectiveness of simulation-based learning regarding the management of post-COVID complications in terms of knowledge,clinical decision-making ability,and self-efficacy among nursing students.M...Objective:To assess the effectiveness of simulation-based learning regarding the management of post-COVID complications in terms of knowledge,clinical decision-making ability,and self-efficacy among nursing students.Methods:This was a quasi-experimental study conducted among 1152nd-year nursing students.The participants were selected by a simple random sampling technique.The participants were divided into an experimental(n=56)and a comparison group(n=59)by a random table method.Data were analyzed using descriptive and inferential statistics with SPSS version 20.Results:There were significant differences in mean post-test knowledge scores(P=0.03)and mean post-test self-efficacy scores(P=0.001)between the experimental and the comparison groups while the difference in mean post-test clinical decision-making ability scores between the two groups was non-significant(P=0.07).A positive correlation was found between knowledge and clinical decision-making ability in pre-test(P=0.03)and in post-test(P<0.001)and a non-significant correlation was found between pre-test knowledge and self-efficacy score(P=0.52)among the experimental group.Conclusions:Simulation-based learning regarding the management of post-COVID complications is effective among nursing students.Simulation labs should be established in health care settings where simulation training can be provided for updating the knowledge,clinical decision-making ability,and self-efficacy of nursing personnel during program installment and continuous nursing education.展开更多
COVID-19 is a multisystem disease that can cause various symptoms which last even after the acute stage and negatively impact the quality of life of patients. It is of utmost importance to comprehensively evaluate how...COVID-19 is a multisystem disease that can cause various symptoms which last even after the acute stage and negatively impact the quality of life of patients. It is of utmost importance to comprehensively evaluate how COVID-19 affects not only patients’ physical and mental health, but also their family and social life. This knowledge plays a significant role in the creation of effective ways to assist those suffering from long COVID to address health-related quality of life issues in a timely manner.展开更多
COVID-19 generates systematic alterations in humans both in active stages of infection and over time, called post-COVID syndrome. Cortisol is a hormone that is overexpressed in inflammation and cellular stress process...COVID-19 generates systematic alterations in humans both in active stages of infection and over time, called post-COVID syndrome. Cortisol is a hormone that is overexpressed in inflammation and cellular stress processes. Its main function is to return to physiological homeostasis, so its evaluation together with other clinical parameters can allow us to determine the degree of systemic affectation by COVID-19. Objective: To evaluate changes in clinical parameters and plasma cortisol concentrations in patients with active COVID-19 and post-COVID syndrome. Material and Methods: Healthy patients, in stages of mild infection, critical and with post-COVID syndrome, were recruited, obtaining, through clinical diagnoses and interviews, their main clinical characteristics, in addition to plasma, in which cortisol concentrations were determined using competitive ELISA. Results: The critical stage group had higher frequencies of comorbidities, clinical symptoms, as well as more altered laboratory parameters compared to the other subgroups. In the post-COVID syndrome group after the initial infection, most laboratory parameters recovered, however, several clinical symptoms remained latent over time. The determination of cortisol showed an increase in its concentration, being higher in patients in critical stage and with post-COVID syndrome. Conclusion: COVID-19 disease generates clinical alterations that trigger an increase in plasma cortisol. These alterations increase as the stages of infection become more severe and some of them remain altered in patients with post-COVID syndrome.展开更多
Background Pediatric post coronavirus disease 2019(COVID-19)condition(PPCC)is a heterogeneous syndrome,which can significantly affect the daily lives of children.This study aimed to identify clinically meaningful phen...Background Pediatric post coronavirus disease 2019(COVID-19)condition(PPCC)is a heterogeneous syndrome,which can significantly affect the daily lives of children.This study aimed to identify clinically meaningful phenotypes in children with PPCC,to better characterize and treat this condition.Methods Participants were children with physician-diagnosed PPCC,referred to the academic hospital Amsterdam UMC in the Netherlands between November 2021 and March 2023.Demographic factors and information on post-COVID symptoms,comorbidities,and impact on daily life were collected.Clinical clusters were identified using an unsupervised and unbiased approach for mixed data types.Results Analysis of 111 patients(aged 3–18 years)revealed three distinct clusters within PPCC.Cluster 1(n=62,median age=15 years)predominantly consisted of girls(74.2%).These patients suffered relatively more from exercise intolerance,dyspnea,and smell disorders.Cluster 2(n=33,median age=13 years)contained patients with an even gender distribution(51.5%girls).They suffered from relatively more sleep problems,memory loss,gastrointestinal symptoms,and arthralgia.Cluster 3(n=16,median age=11 years)had a higher proportion of boys(75.0%),suffered relatively more from fever,had significantly fewer symptoms(median of 5 symptoms compared to 8 and 10 for clusters 1 and 2 respectively),and experienced a lower impact on daily life.Conclusions This study identified three distinct clinical PPCC phenotypes,with variations in sex,age,symptom patterns,and impact on daily life.These findings highlight the need for further research to understand the potentially diverse underlying mechanisms contributing to post-COVID symptoms in children.展开更多
Objectives:Persistent olfactory dysfunction(OD)following loss of smell associated with SARS-CoV-2 infection is a major feature of long COVID.Perspectives on the prevalence of persistent OD predominantly rely on self-r...Objectives:Persistent olfactory dysfunction(OD)following loss of smell associated with SARS-CoV-2 infection is a major feature of long COVID.Perspectives on the prevalence of persistent OD predominantly rely on self-reported olfactory function.Few studies have tracked longitudinal rates of recovery using psychophysical assessment among patients presenting for evaluation of persistent OD beyond a window of acute recovery.Data anchored in standardized testing methods are needed to counsel patients who fail to acutely regain their sense of smell.This study aims to quantify the degree of persistent OD in post-COVID-19 patients who experience subjective and psychophysical OD.Methods:We grouped participants presenting for OD evaluation into cohorts based on both subjective and psychophysical olfactory status at a baseline assessment and assessed their olfactory abilities with a visual analogue scale and the Sniffin'Sticks extended test at baseline and 1-year time points.Participants had confirmed a history of COVID-19 by lab evaluation or clinical diagnosis if lab evaluation was not available.Results:Baseline olfactory evaluation was completed by 122 participants,53 of whom completed the 1-year follow-up assessment.Among participants presenting with perceived OD,74.5%had confirmed psychophysical OD at baseline,with 55.1%at 1-year follow-up.Participants had reliable trends in self-rated versus psychophysically tested olfactory function at both time points.The total threshold,discrimination,and identification(TDI)score improved by+3.25 points in the cohort with psychophysical OD(p=0.0005),with this improvement largely attributable to an increase in median threshold scores(+2.75 points;p=0.0004).Conclusions:OD persists in a significant number of patients who fail to acutely recovery their sense of smell after COVID-19,with many demonstrating lingering deficits at 1-year.Improvements in threshold,but not discrimination or identification,most significantly mediate improvement of total TDI score at follow-up.展开更多
目的:通过分析国内外长新冠失眠的相关文献,总结研究热点,分析目前临床研究的现状与问题。方法:检索国家知识基础设施数据库(CNKI)、中国学术期刊数据库(CSPD)、中文科技期刊数据库(CCD)、Web of Science(SCI)和Pub Med数据库自建库至2...目的:通过分析国内外长新冠失眠的相关文献,总结研究热点,分析目前临床研究的现状与问题。方法:检索国家知识基础设施数据库(CNKI)、中国学术期刊数据库(CSPD)、中文科技期刊数据库(CCD)、Web of Science(SCI)和Pub Med数据库自建库至2024年6月收录的长新冠失眠相关的中英文临床文献。对研究长新冠失眠患病率、病因病机、疗效指标、治疗手段作提取和分析。结果:共检索到相关文献436篇,其中符合标准的中文文献有23篇、英文文献有52篇,共75篇临床研究纳入分析,总体发文量自2020年呈上升趋势,但中文文献数量相对较少。长新冠失眠患病率国内外占比不同,国外研究占比相对较高,多在40%~80%之间。系统全面的横断面研究较少,且目前研究多采用主观量表,缺乏客观指标。治疗手段多样,但缺少综合手段和规范化流程。结论:长新冠失眠相关研究逐渐成为国内外研究热点,但还存在诸多不足,如目前中西医结合治疗长新冠失眠的研究较少,多为个案及小样本研究,建议开展系统的横断面调查,主客观疗效指标相结合,探索长新冠失眠最佳治疗方案。展开更多
文摘Background: Mycoplasma pneumoniae (MP) is the primary causative agent of community-acquired pneumonia, which has increasingly become resistant to macrolides, complicating treatment regimens, especially with the co-infection factor. Its worldwide prevalence has fluctuated due to the influence of the COVID-19 pandemic. The study investigated co-infection patterns in children diagnosed with Mycoplasma pneumoniae pneumonia (MPP). Methods: From June 2022 to December 2023, we retrospectively analyzed the clinical data for hospitalized children with Mycoplasma pneumoniae pneumonia in Wuhan, China. We collected data on age, sex, clinical information, and pathogenic results. We also collected sputum or bronchoalveolar lavage fluid (BALF) samples to test respiratory pathogens and macrolide resistance using targeted microbial next-generation sequencing (tNGS). We analyzed the data using SPSS. Results: The study involved 417 patients diagnosed with MPP, of whom 86.33% had co-infections. Co-infections were notably linked to lobar pneumonia, prominent imaging shadows and higher macrolide resistance rate. Key bacterial pathogens were Streptococcus pneumoniae, Haemophilus influenzae, Staphylococcus aureus, rhinoviruses, and human adenoviruses (HADV). In MPP cases, Candida albicans was the fungal pathogen related to co-infections. The co-infection with HADV and human bocavirus 1 (HBoV1) correlated with prolonged fever, whereas Bordetella pertussis was linked to prolonged cough. In contrast, Candida albicans exhibited a weaker association with diffuse large-area infiltration on chest imaging, and its co-infection was less likely to result in severe disease. Conclusion: These results offer valuable insight into Mycoplasma pneumoniae pneumonia in children, highlighting the impact of co-infections on the disease’s clinical outcomes.
文摘Objective:To investigate long-term symptoms after acute COVID-19,the link between symptoms and respiratory function,radiological changes in the post-COVID period,and risk factors for post-COVID syndrome.Methods:In this cross-sectional study,123 participants who were admitted within the first 3 months were categorized as group 1,and those who applied after 3 months were categorized as group 2.According to thoracic imaging and pulmonary function tests,patients were split into 3 groups as mild,moderate and severe.Results:At least one symptom was present in 91.9%and 61.8%in acute and post-COVID period,respectively.Pulmonary function tests were normal in 60(70.6%)in the first three months,and 30(78.9%)in 91-days to 1-year period after acute COVID-19 infection.After 3 months,22.4%of chest X-rays and 7.9%of computerized tomography revealed progression.Patients who developed acute complications(OR 9.91,95%CI 1.93-50.87),had 2 or more symptoms at admission(OR 7.73,95%CI 2.56-23.33),had 1%to 14%CT involvement(OR 3.05,95%CI 1.06-8.79),or had 50%or more CT involvement(OR 14.68,95%CI 1.24-172.55)had a higher risk of developing post-COVID syndrome.Conclusions:COVID-19 symptoms can last for long time.Severity of symptoms,acute complications,and the extent of radiological involvement may all contribute to elevated risk of post-COVID syndrome.As a result,patients with COVID-19 should be checked for long-term clinical difficulties on regular basis.
文摘Objective:To assess the effectiveness of simulation-based learning regarding the management of post-COVID complications in terms of knowledge,clinical decision-making ability,and self-efficacy among nursing students.Methods:This was a quasi-experimental study conducted among 1152nd-year nursing students.The participants were selected by a simple random sampling technique.The participants were divided into an experimental(n=56)and a comparison group(n=59)by a random table method.Data were analyzed using descriptive and inferential statistics with SPSS version 20.Results:There were significant differences in mean post-test knowledge scores(P=0.03)and mean post-test self-efficacy scores(P=0.001)between the experimental and the comparison groups while the difference in mean post-test clinical decision-making ability scores between the two groups was non-significant(P=0.07).A positive correlation was found between knowledge and clinical decision-making ability in pre-test(P=0.03)and in post-test(P<0.001)and a non-significant correlation was found between pre-test knowledge and self-efficacy score(P=0.52)among the experimental group.Conclusions:Simulation-based learning regarding the management of post-COVID complications is effective among nursing students.Simulation labs should be established in health care settings where simulation training can be provided for updating the knowledge,clinical decision-making ability,and self-efficacy of nursing personnel during program installment and continuous nursing education.
文摘COVID-19 is a multisystem disease that can cause various symptoms which last even after the acute stage and negatively impact the quality of life of patients. It is of utmost importance to comprehensively evaluate how COVID-19 affects not only patients’ physical and mental health, but also their family and social life. This knowledge plays a significant role in the creation of effective ways to assist those suffering from long COVID to address health-related quality of life issues in a timely manner.
文摘COVID-19 generates systematic alterations in humans both in active stages of infection and over time, called post-COVID syndrome. Cortisol is a hormone that is overexpressed in inflammation and cellular stress processes. Its main function is to return to physiological homeostasis, so its evaluation together with other clinical parameters can allow us to determine the degree of systemic affectation by COVID-19. Objective: To evaluate changes in clinical parameters and plasma cortisol concentrations in patients with active COVID-19 and post-COVID syndrome. Material and Methods: Healthy patients, in stages of mild infection, critical and with post-COVID syndrome, were recruited, obtaining, through clinical diagnoses and interviews, their main clinical characteristics, in addition to plasma, in which cortisol concentrations were determined using competitive ELISA. Results: The critical stage group had higher frequencies of comorbidities, clinical symptoms, as well as more altered laboratory parameters compared to the other subgroups. In the post-COVID syndrome group after the initial infection, most laboratory parameters recovered, however, several clinical symptoms remained latent over time. The determination of cortisol showed an increase in its concentration, being higher in patients in critical stage and with post-COVID syndrome. Conclusion: COVID-19 disease generates clinical alterations that trigger an increase in plasma cortisol. These alterations increase as the stages of infection become more severe and some of them remain altered in patients with post-COVID syndrome.
文摘Background Pediatric post coronavirus disease 2019(COVID-19)condition(PPCC)is a heterogeneous syndrome,which can significantly affect the daily lives of children.This study aimed to identify clinically meaningful phenotypes in children with PPCC,to better characterize and treat this condition.Methods Participants were children with physician-diagnosed PPCC,referred to the academic hospital Amsterdam UMC in the Netherlands between November 2021 and March 2023.Demographic factors and information on post-COVID symptoms,comorbidities,and impact on daily life were collected.Clinical clusters were identified using an unsupervised and unbiased approach for mixed data types.Results Analysis of 111 patients(aged 3–18 years)revealed three distinct clusters within PPCC.Cluster 1(n=62,median age=15 years)predominantly consisted of girls(74.2%).These patients suffered relatively more from exercise intolerance,dyspnea,and smell disorders.Cluster 2(n=33,median age=13 years)contained patients with an even gender distribution(51.5%girls).They suffered from relatively more sleep problems,memory loss,gastrointestinal symptoms,and arthralgia.Cluster 3(n=16,median age=11 years)had a higher proportion of boys(75.0%),suffered relatively more from fever,had significantly fewer symptoms(median of 5 symptoms compared to 8 and 10 for clusters 1 and 2 respectively),and experienced a lower impact on daily life.Conclusions This study identified three distinct clinical PPCC phenotypes,with variations in sex,age,symptom patterns,and impact on daily life.These findings highlight the need for further research to understand the potentially diverse underlying mechanisms contributing to post-COVID symptoms in children.
基金National Institute on Deafness and Other Communication Disorders and the National Institutes of Health,Grant/Award Number:K23DC019678National Center for Advancing Translational Sciences,National Institutes of Health,Grant/Award Number:UL1TR001873。
文摘Objectives:Persistent olfactory dysfunction(OD)following loss of smell associated with SARS-CoV-2 infection is a major feature of long COVID.Perspectives on the prevalence of persistent OD predominantly rely on self-reported olfactory function.Few studies have tracked longitudinal rates of recovery using psychophysical assessment among patients presenting for evaluation of persistent OD beyond a window of acute recovery.Data anchored in standardized testing methods are needed to counsel patients who fail to acutely regain their sense of smell.This study aims to quantify the degree of persistent OD in post-COVID-19 patients who experience subjective and psychophysical OD.Methods:We grouped participants presenting for OD evaluation into cohorts based on both subjective and psychophysical olfactory status at a baseline assessment and assessed their olfactory abilities with a visual analogue scale and the Sniffin'Sticks extended test at baseline and 1-year time points.Participants had confirmed a history of COVID-19 by lab evaluation or clinical diagnosis if lab evaluation was not available.Results:Baseline olfactory evaluation was completed by 122 participants,53 of whom completed the 1-year follow-up assessment.Among participants presenting with perceived OD,74.5%had confirmed psychophysical OD at baseline,with 55.1%at 1-year follow-up.Participants had reliable trends in self-rated versus psychophysically tested olfactory function at both time points.The total threshold,discrimination,and identification(TDI)score improved by+3.25 points in the cohort with psychophysical OD(p=0.0005),with this improvement largely attributable to an increase in median threshold scores(+2.75 points;p=0.0004).Conclusions:OD persists in a significant number of patients who fail to acutely recovery their sense of smell after COVID-19,with many demonstrating lingering deficits at 1-year.Improvements in threshold,but not discrimination or identification,most significantly mediate improvement of total TDI score at follow-up.
文摘目的:通过分析国内外长新冠失眠的相关文献,总结研究热点,分析目前临床研究的现状与问题。方法:检索国家知识基础设施数据库(CNKI)、中国学术期刊数据库(CSPD)、中文科技期刊数据库(CCD)、Web of Science(SCI)和Pub Med数据库自建库至2024年6月收录的长新冠失眠相关的中英文临床文献。对研究长新冠失眠患病率、病因病机、疗效指标、治疗手段作提取和分析。结果:共检索到相关文献436篇,其中符合标准的中文文献有23篇、英文文献有52篇,共75篇临床研究纳入分析,总体发文量自2020年呈上升趋势,但中文文献数量相对较少。长新冠失眠患病率国内外占比不同,国外研究占比相对较高,多在40%~80%之间。系统全面的横断面研究较少,且目前研究多采用主观量表,缺乏客观指标。治疗手段多样,但缺少综合手段和规范化流程。结论:长新冠失眠相关研究逐渐成为国内外研究热点,但还存在诸多不足,如目前中西医结合治疗长新冠失眠的研究较少,多为个案及小样本研究,建议开展系统的横断面调查,主客观疗效指标相结合,探索长新冠失眠最佳治疗方案。
