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Emergency and Intensive Care Medicine for COVID-19 Infections
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Emergency and Intensive Care Medicine for COVID-19 Infections

A special issue of Journal of Clinical Medicine (ISSN 2077-0383). This special issue belongs to the section "Emergency Medicine".

Deadline for manuscript submissions: closed (30 September 2021) | Viewed by 8698

Special Issue Editors

Dr. Jacopo M. Legramante

E-Mail Website1 Website2
Guest Editor
1. Department of Systems Medicine, University of Rome "Tor Vergata", Rome, Italy
2. Emergency Medicine Unit, Emergency Department, Policlinico Tor Vergata, Rome, Italy
Interests: biomarkers; emergency medicine; SARS-CoV-2; risk stratification in the emergency room; managing complex patients in the emergency room
Dr. Paola Rogliani

E-Mail Website1 Website2
Guest Editor
1. Department of Experimental Medicine, University of Rome "Tor Vergata", Rome, Italy
2. Respiratory Medicine Unit, Emergency Department, Policlinico Tor Vergata, Rome, Italy
Interests: clinical respiratory pharmacology; biomarkers; inhaled treatments; comorbidities; COPD; asthma; respiratory failure; COVID-19

Special Issue Information

Dear Colleagues,

Since December 2019, the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic has spread around the world and reached catastrophic proportions. The clinical spectrum of SARS-CoV-2 infection appears to be wide, encompassing asymptomatic infection, mild upper respiratory tract illness, and severe viral pneumonia with respiratory failure. Most patients in the latter category require admission to hospital, stressing the capacity of public health systems and resulting in a high mortality rate. The need to differentiate care pathways to avoid the spread of the infection has reduced the receptive capacity of emergency rooms, thus dramatically increasing the workload in emergency departments. Therefore, the pressing need to optimize resources through risk stratification for critically ill COVID-19 patients has become crucial.

Furthermore, recent experience has shown that the timing from drug treatment to oxygen therapy to non-invasive ventilation is crucial for the outcome of patients with SARS-CoV-2-related respiratory failure.

The aim of this Special Issue is to gather in one collection reviews and original contributions to illustrate the state-of-the-art and the envisaged future of the management of patients referring to the emergency department with clinical signs suggestive of COVID 19 infections.

Dr. Jacopo M. Legramante
Dr. Paola Rogliani
Guest Editors

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Journal of Clinical Medicine is an international peer-reviewed open access semimonthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2600 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • biomarkers
  • emergency medicine
  • risk stratification in the emergency room
  • managing complex patients in the emergency room
  • pharmacological treatment
  • comorbidities
  • COPD
  • asthma
  • respiratory failure
  • non-invasive mechanical ventilation
  • COVID-19

Published Papers (3 papers)

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14 pages, 1523 KiB  
Article
Soluble Urokinase Receptor as a Promising Marker for Early Prediction of Outcome in COVID-19 Hospitalized Patients
by Filomena Napolitano, Gaetano Di Spigna, Maria Vargas, Carmine Iacovazzo, Biagio Pinchera, Daniela Spalletti Cernia, Margherita Ricciardone, Bianca Covelli, Giuseppe Servillo, Ivan Gentile, Loredana Postiglione and Nunzia Montuori
J. Clin. Med. 2021, 10(21), 4914; https://doi.org/10.3390/jcm10214914 - 24 Oct 2021
Cited by 14 | Viewed by 2222
Abstract
The Coronavirus disease 2019 (COVID-19), caused by SARS-CoV-2, has rapidly spread to become a global pandemic, putting a strain on health care systems. SARS-CoV-2 infection may be associated with mild symptoms or, in severe cases, lead patients to the intensive care unit (ICU) [...] Read more.
The Coronavirus disease 2019 (COVID-19), caused by SARS-CoV-2, has rapidly spread to become a global pandemic, putting a strain on health care systems. SARS-CoV-2 infection may be associated with mild symptoms or, in severe cases, lead patients to the intensive care unit (ICU) or death. The critically ill patients suffer from acute respiratory distress syndrome (ARDS), sepsis, thrombotic complications and multiple organ failure. For optimization of hospital resources, several molecular markers and algorithms have been evaluated in order to stratify COVID-19 patients, based on the risk of developing a mild, moderate, or severe disease. Here, we propose the soluble urokinase receptor (suPAR) as a serum biomarker of clinical severity and outcome in patients who are hospitalized with COVID-19. In patients with mild disease course, suPAR levels were increased as compared to healthy controls, but they were dramatically higher in severely ill patients. Since early identification of disease progression may facilitate the individual management of COVID-19 symptomatic patients and the time of admission to the ICU, we suggest paying more clinical attention on patients with high suPAR levels. Full article
(This article belongs to the Special Issue Emergency and Intensive Care Medicine for COVID-19 Infections)
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17 pages, 9150 KiB  
Article
A Retrospective Cohort Study of Clinical Factors Associated with Transitions of Care among COVID-19 Patients
by Dennis Swearingen, Gregory Boverman, Kristen Tgavalekos, David P. Noren, Shreyas Ravindranath, Erina Ghosh, Minnan Xu, Lisa Wondrely, Pam Thompson, J. David Cowden and Corneliu Antonescu
J. Clin. Med. 2021, 10(19), 4605; https://doi.org/10.3390/jcm10194605 - 8 Oct 2021
Cited by 3 | Viewed by 2354
Abstract
Coronavirus Disease 2019 (COVID-19) is an international health crisis. In this article, we report on patient characteristics associated with care transitions of: 1) hospital admission from the emergency department (ED) and 2) escalation to the intensive care unit (ICU). Analysis of data from [...] Read more.
Coronavirus Disease 2019 (COVID-19) is an international health crisis. In this article, we report on patient characteristics associated with care transitions of: 1) hospital admission from the emergency department (ED) and 2) escalation to the intensive care unit (ICU). Analysis of data from the electronic medical record (EMR) was performed for patients with COVID-19 seen in the ED of a large Western U.S. Health System from April to August of 2020, totaling 10,079 encounters. Of these, 5172 resulted in admission as an inpatient within 72 h. Inpatient encounters (n = 6079) were also considered for patients with positive COVID-19 test results, of which 970 resulted in a transfer to the ICU or in-hospital mortality. Laboratory results, vital signs, symptoms, and comorbidities were investigated for each of these care transitions. Different top risk factors were found, but two factors common to hospital admission and ICU transfer were respiratory rate and the need for oxygen support. Comorbidities common to both settings were cerebrovascular disease and congestive heart failure. Regarding laboratory results, the neutrophil-to-lymphocyte ratio was associated with transitions to higher levels of care, along with the ratio of aspartate aminotransferase (AST) to alanine aminotransferase (ALT). Full article
(This article belongs to the Special Issue Emergency and Intensive Care Medicine for COVID-19 Infections)
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6 pages, 547 KiB  
Brief Report
Dexamethasone in Patients Hospitalized with COVID-19: Whether, When and to Whom
by Luigino Calzetta, Marina Aiello, Annalisa Frizzelli, Paola Rogliani and Alfredo Chetta
J. Clin. Med. 2021, 10(8), 1607; https://doi.org/10.3390/jcm10081607 - 10 Apr 2021
Cited by 20 | Viewed by 3406
Abstract
A clinical interpretation of the Randomized Evaluation of COVID-19 Therapy (RECOVERY) study was performed to provide a useful tool to understand whether, when, and to whom dexamethasone should be administered during hospitalization for COVID-19. A post hoc analysis of data published in the [...] Read more.
A clinical interpretation of the Randomized Evaluation of COVID-19 Therapy (RECOVERY) study was performed to provide a useful tool to understand whether, when, and to whom dexamethasone should be administered during hospitalization for COVID-19. A post hoc analysis of data published in the preliminary report of the RECOVERY study was performed to calculate the person-based number needed to treat (NNT) and number needed to harm (NNH) of 6 mg dexamethasone once daily for up to 10 days vs. usual care with respect to mortality. At day 28, the NNT of dexamethasone vs. usual care was 36.0 (95%CI 24.9–65.1, p < 0.05) in all patients, 8.3 (95%CI 6.0–13.1, p < 0.05) in patients receiving invasive mechanical ventilation, and 34.6 (95%CI 22.1–79.0, p < 0.05) in patients receiving oxygen only (with or without noninvasive ventilation). Dexamethasone increased mortality compared with usual care in patients not requiring oxygen supplementation, leading to a NNH value of 26.7 (95%CI 18.1–50.9, p < 0.05). NNT of dexamethasone vs. usual care was 17.3 (95%CI 14.9–20.6) in subjects <70 years, 27.0 (95%CI 18.5–49.8) in men, and 16.2 (95%CI 13.2–20.8) in patients in which the onset of symptoms was >7 days. Dexamethasone is effective in male subjects < 70 years that require invasive mechanical ventilation experiencing symptoms from >7 days and those patients receiving oxygen without invasive mechanical ventilation; it should be avoided in patients not requiring respiratory support. Full article
(This article belongs to the Special Issue Emergency and Intensive Care Medicine for COVID-19 Infections)
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