ObjectiveTo investigate the clinical characteristics and prognostic factors of severe viral pneumonia induced moderate to severe acute respiratory distress syndrome (ARDS). MethodsTwenty patients with severe viral pneumonia induced moderate to severe ARDS admitted in the Respiratory Intensive Care Unit(RICU) in Xiangya Hospital of Central South University from January 2011 to April 2014 were included in the study.The clinical characteristics and prognostic factors were analyzed retrospectively by analysis of variance(ANOVA). ResultsFive patients developed secondary bacterial infections,while three patients developed secondary fungal infections,among which 2 patients developed both bacterial and fungal infections.Fourteen patients died during hospitalization. ANOVA revealed that gender,body temperature,respiratory frequency,pulse frequency,white blood cell count (WBC),hemoglobin(Hb),platelet(Plt),prothrombin time (PT),albumin(Alb),blood urea nitrogen(BUN),serum creatinine(Scr),total bilirubin(TBIL),serum sodium,serum potassium,erythrocyte sedimentation rate (ESR),C-reactive protein(CRP),procalcitionin(PCT),pH,PaCO2,PaO2 and FiO2 were not significantly different between the dead patients and the alive patients (P>0.05).Whereas the age,length of hospital stay,duration of mechanical ventilation,oxygenation index,and the severity of ARDS were significantly different between the dead patients and the alive patients (P<0.05). ConclusionAge,oxygenation index and severity of ARDS can influence the prognosis of patients with severe viral pneumonia induced moderate to severe ARDS.
Respiratory viruses are important pathogens responsible for community- and hospital-acquired pneumonia in adults. Outbreaks of highly pathogenic viruses in recent years have made us aware of the difficulty and importance of diagnosis and treatment of viral pneumonia. This review summarized the current status of diagnosis and treatment of viral pneumonia in adults so as to improve our understanding of it.
Coronavirus disease 2019 (COVID-19) is an acute infectious respiratory disease. Ultrashort wave diathermy (USWD) for COVID-19 is recommended by some consensuses on COVID-19 rehabilitation diagnosis and treatment, while it is not mentioned in some other experts consensuses. Because the virus that causes COVID-19 is new and there are few related studies, this paper summarizes the research evidence and possible mechanisms of USWD in the treatment of viral pneumonia, and discusses the factors that need to be considered in the treatment of COVID-19. In this paper, it is suggested that before high-quality research evidence being obtained and under the condition of limited understanding of the pathogenesis and disease development of COVID-19, the application of USWD in COVID-19 should be cautious. To provide scientific and practical research evidence for the treatment of COVID-19 by USWD may be an urgent problem to be solved at present.
ObjectiveTo investigate the clinical characteristics and prognostic factors of influenza pneumonia from 2014 to early 2018.MethodsThe general information, clinical symptoms, laboratory examination and treatment of 69 patients with influenza pneumonia from October 2014 to March 2018 were collected. The clinical characteristics of 32 patients with influenza pneumonia from 2017 to 2018 were compared with 37 patients with influenza pneumonia from 2014 to 2016. The prognostic factors of influenza pneumonia were also investigated.ResultsThe median patient age was 68 (55-78) years, and 41 cases (59.4%) were men in 69 patients. The five most common comorbidities were hypertension (44.9%), diabetes (23.3%), chronic obstructive pulmonary disease (17.4%), coronary atherosclerotic heart disease (13.0%), and chronic kidney disease (10.1%). The median levels of fasting blood glucose, lactate dehydrogenase, C-reactive protein, and procalcitonin in the patients with influenza pneumonia in 2017-2018 were significantly higher than those in the same period of 2014-2016, which were respectively 7.1 (5.4 - 8.3)mmol/L vs. 5.2 (4.5 - 7.3)mmol/L (P=0.017), 213.0 (98.0 - 320.5)U/L vs. 178 (98.0 - 280.0)U/L (P=0.049), 65.5 (15.4 - 139.8)mg/L vs. 45.5 (14.1 - 75.3)mg/L (P=0.050), 0.66 (0.24 - 1.58)μg/L vs. 0.17 (0.11 - 0.43)μg/L (P=0.004). The proportion of bacterial infection, septic shock, acute renal failure and mortality in the patients with influenza pneumonia in 2017-2018 was higher than that in the 2014-2016 group, which were respectively 40.6% vs. 18.9% (P=0.047), 21.9% vs. 5.4% (P=0.043), 21.9% vs. 2.7% (P=0.035), 31.3% vs. 5.4% (P=0.005). Multivariate analysis showed that numbers of lymphocytes, blood urea nitrogen, and procalcitonin were independent risk factors for mortality in the patients with influenza pneumonia. The odds ratio was respectively 0.001 (95%CI 0.00 - 0.200), 1.342 (95%CI 0.996 - 1.808), 1.113. (95%CI 1.006 - 1.230).ConclusionsCompared with the patients with influenza pneumonia in 2014-2016, the patients in 2017-2018 have higher levels of fasting blood glucose and lactate dehydrogenase, and are also susceptible to secondary bacterial infection, septic shock, and acute renal failure. Decreased lymphocytes, elevated blood urea nitrogen, and elevated procalcitonin are independent risk factors for death in patients with influenza pneumonia.
ObjectivesTo overview the systematic reviews of traditional Chinese herb injections for viral pneumonia.MethodsCNKI, CBM, WanFang Data, VIP, PubMed, Web of Science, The Cochrane Library and EMbase databases were electronically searched to collect systematic reviews (SRs) of traditional Chinese herb injections for viral pneumonia from inception to March 2020. Two reviewers independently screened literature and extracted data. Then, AMSTAR 2 was used to assess the methodological quality and GRADE was used to grade the outcome indicators of included SRs.ResultsA total of 10 SRs were included, containing six Chinese herb injections (Xiyanping injection, Yanhuning injection, Tanreqing injection, Reduning injection, Shuanghuanglian injection, and Chuanhuning injection). Five items of AMSTAR 2 were reported well, and two items were not reported in any of the included SRs, and the quality was unsatisfactory. The efficacy of Chinese herb injection was superior than that of western medicine in many outcome indicators, such as antipyretic time, the pulmonary rales disappearing time, and the total clinical efficiency. The quality of evidence ranged from medium to very low.ConclusionsCurrent evidence shows that the quality of SRs of Chinese herb injections for viral pneumonia requires improvement, and most of the results show that Chinese herb injections are more effective than western medicines.