Showing papers in "The Lancet Respiratory Medicine in 2020"

TL;DR: The clinical course and outcomes of critically ill patients with SARS-CoV-2 pneumonia who were admitted to the intensive care unit (ICU) of Wuhan Jin Yin-tan hospital between late December, 2019 and Jan 26, 2020 are described.

TL;DR: O surto do novo coronavírus (COVID-19) em Wuhan, China, iniciado em dezembro de 2019, evoluiu para se tornar uma pandemia global A.

TL;DR: It is suggested that patients with cardiac diseases, hypertension, or diabetes, who are treated with ACE2increasing drugs, are at higher risk for severe COVID-19 infection and, therefore, should be monitored for ACE2-modulating medications, such as ACE inhibitors or ARBs.

TL;DR: Streamlining of workflows for rapid diagnosis and isolation, clinical management, and infection prevention will matter not only to patients with COVID-19, but also to health-care workers and other patients who are at risk from nosocomial transmission.

TL;DR: Key pathological states, including thrombotic and microangiopathic pathology in the lungs, that contributed to death in patients with severe COVID-19 and decompensation in this demographic are identified and management of these patients should include treatment to target these pathological mechanisms.

TL;DR: It is shown that chronic respiratory diseases remain a leading cause of death and disability worldwide, with growth in absolute numbers but sharp declines in several age-standardised estimators since 1990.

TL;DR: Data from previous coronavirus infections such as severe acute respiratory syndrome and Middle East respiratory syndrome, as well as emerging data from the COVID-19 pandemic, suggest there could be substantial fibrotic consequences following SARS-CoV-2 infection.

TL;DR: Early administration of dexamethasone could reduce duration of mechanical ventilation and overall mortality in patients with established moderate-to-severe ARDS.

TL;DR: The findings question the role of a cytokine storm in COVID-19-induced organ dysfunction and the potential role of anti-cytokine and immune-modulating treatments in patients with the disease.

TL;DR: In the German health-care system, in which hospital capacities have not been overwhelmed by the COVID-19 pandemic, mortality has been high for patients receiving mechanical ventilation, particularly for patients aged 80 years or older and those requiring dialysis, and has been considerably lower for patients younger than 60 years.

TL;DR: The current literature does not support smoking as a predisposing factor in men or any subgroup for infection with SARS-CoV-2, but there might be a sex predisposition to COVID-19, with men more prone to being affected.

TL;DR: Patients with COVID-19-associated ARDS have a form of injury that, in many aspects, is similar to that of those with ARDS unrelated to CO VID-19, who have a reduction in respiratory system compliance together with increased D-dimer concentrations have high mortality rates.

TL;DR: Evaluate its tissue and cellular tropism in human respiratory tract, conjunctiva, and innate immune responses in comparison with other coronavirus and influenza virus to provide insights into COVID-19 pathogenesis and provide important insights into transmissibility and pathogenesis of SARS-CoV-2.

TL;DR: ECMO preparedness for the COVID-19 pandemic is important in view of the high transmission rate of the virus and respiratory-related mortality and ensuring that systems enable safe and coordinated movement of critically ill patients, staff, and equipment is important to improve ECMO access.

TL;DR: Advances in clinical care have been multifaceted and include earlier diagnosis through the implementation of newborn screening programmes, formalised airway clearance therapy, and reduced malnutrition through the use of effective pancreatic enzyme replacement and a high-energy, high-protein diet.

TL;DR: An understanding of the pathophysiology and mechanisms of kidney damage and AKI in the setting of critical illness and COVID-19 is emerging, although further research is needed to identify patients at risk of AKI and to guide management strategies.

TL;DR: In this article, a view of infectious aerosols is intended to inform appropriate infection control measures to protect health-care workers from inhaling infectious aerosol, with a predominance of pathogens in small particles (<5 μm.

TL;DR: In this paper, SARS-CoV-2 viral load at the time of presentation is an independent predictor of COVID-19 mortality in a large patient cohort (n=1,145).

TL;DR: A multicentre, double-blind, randomised, placebo-controlled phase 2 trial to assess the efficacy and safety of pirfenidone in patients with progressive fibrosing unclassifiable ILD, which is characterised by progressive fibrosis of the lung.

TL;DR: This Viewpoint addresses ventilatory strategies in the context of recent discussions on phenotypic heterogeneity in patients with COVID-19-associated ARDS, and strongly recommends adherence to evidence-based management, informed by bedside physiology, as resources permit.

TL;DR: Prone positioning was feasible and effective in rapidly ameliorating blood oxygenation in awake patients with COVID-19-related pneumonia requiring oxygen supplementation and the effect was maintained after resupination in half of the patients.

TL;DR: It is shown that hrsACE2 can reduce SARS-CoV-2 load by a factor of 1000–5000 in in-vitro cell-culture experiments and engineered organoids, directly demonstrating that ACE2 can effectively neutralise Sars-Cov-2.

TL;DR: The clinical characteristics and outcomes of patients with respiratory failure and COVID-19 treated with ECMO were established and ECMO should be considered for patients developing refractory respiratory failure despite optimised care.