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《Lancet，3月6日，Managing neonates with respiratory failure due to SARS-CoV-2》

  • 来源专题：COVID-19科研动态监测
  • 编译者： xuwenwhlib
  • 发布时间：2020-03-07

  • Managing neonates with respiratory failure due to SARS-CoV-2

    Daniele De Luca

    Published:March 06, 2020DOI:https://doi.org/10.1016/S2352-4642(20)30073-0

    In their Comment in The Lancet Child & Adolescent Health, Jianhui Wang and colleagues1 suggested a plan to handle neonates with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infections and outbreaks in neonatal intensive care units (NICUs). This is a timely reflection, given the public health problem represented by this infection and the need to anticipate any critical care issue, irrespective of patients' ages.

    However, the plan is incomplete or unsuitable in many points. We do not know anything about neonatal SARS-CoV-2 infections, and we must reasonably follow data from adult critical care. First, testing all NICU-admitted neonates for SARS-CoV-2 represents a wrongful use of resources. Neonatal respiratory failure can result from a wide range of causes, and testing everybody when other causes are reasonably suspected will divert laboratory resources from adult critical care. Tests should be done for infants from families infected by SARS-CoV-2 or exposed to other infected people, irrespective of their symptoms.

  • 原文来源：https://www.thelancet.com/journals/lanchi/article/PIIS2352-4642(20)30073-0/fulltext
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  • 《Lancet，3月6日，Managing neonates with respiratory failure due to SARS-CoV-2 – Authors' reply》
    • 来源专题：COVID-19科研动态监测
    • 编译者：xuwenwhlib
    • 发布时间：2020-03-07
    • Managing neonates with respiratory failure due to SARS-CoV-2 – Authors' reply Jianhui Wang Yuan Shi Published:March 06, 2020DOI:https://doi.org/10.1016/S2352-4642(20)30072-9 We thank Daniele De Luca for his reflections on our Comment.1 We agree that testing all admitted neonates for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is not necessary. We recommended screening all newly admitted infants at high risk of coronavirus disease 2019 (COVID-19) on the basis of their family history. Only high-risk patients should receive a nucleic acid test for SARS-CoV-2. However, all high-risk neonates should be isolated in a single room, preferably in a neonatal intensive care unit (NICU). Based on existing experience, some patients initially present with mild flu-like symptoms but rapidly develop respiratory distress and multiple organ failure. Admitting all neonates with COVID-19 to the NICU could ensure the availability of close monitoring and necessary interventions.2 However, each clinical setting should consider its bed surge capacity in case of a COVID-19 outbreak and adopt a flexible and variable approach to admitting patients.
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  • 《Lancet，6月18日，Severity of respiratory failure and outcome of patients needing a ventilatory support in the Emergency Department during Italian novel coronavirus SARS-CoV2 outbreak》
    • 来源专题：COVID-19科研动态监测
    • 编译者：zhangmin
    • 发布时间：2020-06-19
    • Severity of respiratory failure and outcome of patients needing a ventilatory support in the Emergency Department during Italian novel coronavirus SARS-CoV2 outbreak: Preliminary data on the role of Helmet CPAP and Non-Invasive Positive Pressure Ventilation Andrea Duca Irdi Memaj Federico Zanardi Carlo Preti Andrea Alesi Lorenzo Della Bella et al. Show all authors Open AccessPublished:June 18, 2020DOI:https://doi.org/10.1016/j.eclinm.2020.100419 Abstract Background Novel Coronavirus SARS-CoV-2 pandemic is spreading around the world. At the end of February, the outburst of the pandemic has hit hard on northern Italian's hospitals. As of today, no data have been published regarding the severity of respiratory failure of patients presenting to the Emergency Departments. Moreover, the outcome the patients forced to undergo Continuous Positive Airway Pressure (CPAP) or Non-Invasive Positive Pressure Ventilation (NIPPV) due to lack of Intensive Care resources is unknown. “Papa Giovanni XXIII” hospital (HPG23) of Bergamo is one of the largest hospitals in the Country, with an Emergency Department (ED) managing over 100,000 patients per year. Methods This is a retrospective observational study based on chart review of patients presenting to the Emergency Department of HPG23 from 29/02/2020 to 10/03/2020 with a clinical condition highly suspicious for COVID-19 infection. Registration of admission rates, severity of respiratory failure (ARDS classification), need of respiratory support, SARS-CoV-2 PCR test and outcome of patients treated with a ventilatory support were registered on 10th of May 2020.
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