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新型冠状病毒肺炎与钩端螺旋体病、肺部受累情况及对类固醇的反应:一项来自喀拉拉邦农村三级医疗中心的比较性观察研究

Covid-19 and leptospirosis, pulmonary involvement and response to steroids: A comparative observational study from a rural Tertiary care center in Kerala.

作者信息

Xavier Vinod, Baby Binitha, George Joemon M, Ittyachen Abraham M

机构信息

Department of Medicine, M.O.S.C Medical College and Hospital, Kolenchery, Ernakulam District, Kerala, India.

出版信息

J Family Med Prim Care. 2022 Jan;11(1):294-298. doi: 10.4103/jfmpc.jfmpc_1414_21. Epub 2022 Jan 31.

Abstract

BACKGROUND

COVID-19 is an emerging infectious disease with a global outreach. Leptospirosis is a zoonotic disease mainly confined to tropical areas. In both cases, most of those affected are asymptomatic or have only mild respiratory disease. Those who turn critical develop acute respiratory distress syndrome (ARDS) and/or multiple-organ failure occurs rapidly, with high fatality.

METHODOLOGY

This is a retrospective observational study from 2020 involving COVID-19 and leptospirosis patients. The data were collected using a semi-structured proforma, and analysis was performed using Easy R (EZR) software.

RESULTS

There were five patients with COVIDC-19 and four patients with leptospirosis; with pulmonary involvement. All the patients were males. There was no significant difference in age, the onset of pulmonary involvement, time of initiation of steroids, duration of steroids, and outcome between the two groups. However, in the case of COVID-19, it took a longer period for clearing of infiltrates.

CONCLUSION

Though COVID-19 and leptospirosis are two different diseases, both of them show a similar life-saving response to steroids, the common factor in the pathogenesis being cytokine storm. Primary care physicians in tropical areas of the world should be aware of the similarities between these two diseases, especially the initial clinical presentation, the pathogenesis, and the response to steroids.

摘要

背景

新型冠状病毒肺炎(COVID-19)是一种具有全球影响的新发传染病。钩端螺旋体病是一种主要局限于热带地区的人畜共患病。在这两种疾病中,大多数感染者无症状或仅患有轻度呼吸道疾病。病情危重者会发展为急性呼吸窘迫综合征(ARDS),和/或迅速出现多器官功能衰竭,病死率很高。

方法

这是一项2020年开展的涉及COVID-19和钩端螺旋体病患者的回顾性观察研究。数据通过半结构化表格收集,并使用简易R(EZR)软件进行分析。

结果

有5例COVID-19患者和4例钩端螺旋体病患者出现肺部受累。所有患者均为男性。两组在年龄、肺部受累发病时间、开始使用类固醇的时间、类固醇使用持续时间和结局方面无显著差异。然而,COVID-19患者肺部浸润影消散所需时间更长。

结论

尽管COVID-19和钩端螺旋体病是两种不同的疾病,但它们对类固醇均表现出相似的挽救生命的反应,发病机制中的共同因素是细胞因子风暴。世界热带地区的基层医疗医生应了解这两种疾病之间的相似之处,尤其是初始临床表现、发病机制和对类固醇的反应。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/82db/8930173/350db1a48176/JFMPC-11-294-g001.jpg

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