CINTIA JOHNSTON
Projetos de Pesquisa
Unidades Organizacionais
Instituto da Criança, Hospital das Clínicas, Faculdade de Medicina
4 resultados
Resultados de Busca
Agora exibindo 1 - 4 de 4
- COVID-19 and Liver Damage: Narrative Review and Proposed Clinical Protocol for Critically ill Pediatric Patients(2020) LUGLIO, Michele; TANNURI, Uenis; CARVALHO, Werther Brunow de; BASTOS, Karina Lucio de Medeiros; RODRIGUEZ, Isadora Souza; JOHNSTON, Cintia; DELGADO, Artur FigueiredoSARS-CoV-2 shares nearly 80% of its' genomic sequence with SARS-CoV and MERS-CoV, both viruses known to cause respiratory symptoms and liver impairment. The emergence of pediatric cases of multisystem inflammatory syndrome related to the SARS-CoV-2 infection (PIM-TS) has raised concerns over the issue of hepatic damage and liver enzyme elevation in the critically ill pediatric population with COVID-19. Some retrospective cohorts and case series have shown various degrees of ALT/AST elevation in SARS-CoV-2 infections. A limited number of liver histopathological studies are available that show focal hepatic periportal necrosis. This liver damage was associated with higher levels of inflammatory markers, C-reactive protein (CRP), and pro-calcitonin. Proposed pathophysiological mechanisms include an uncontrolled exacerbated inflammatory response, drug-induced liver injury, direct viral infection and damage to cholangiocytes, hypoxic-ischemic lesions, and micro-thrombosis in the liver. Based on the physiopathological characteristics described, our group proposes a clinical protocol for the surveillance, evaluation, management, and follow-up of critically ill pediatric COVID-19 patients with liver damage.
- Proposed recommendations for antithrombotic pro-phylaxis for children and adolescents with severe infection and/or multisystem inflammatory syndrome caused by SARS-CoV-2(2020) CARNEIRO, Jorge David Aivazoglou; RAMOS, Gabriel Frizzo; CARVALHO, Werther Brunow de; JOHNSTON, Cintia; DELGADO, Artur Figueiredo
- Electrical Impedance Tomography in Congenital Diaphragmatic Hernia(2021) COMPARINI, Rafael Goncalves; FALCAO, Mario Cicero; JOHNSTON, Cintia; CARVALHO, Werther Brunow de
- Update on the diagnosis and management of COVID-19 in pediatric patients(2020) CARLOTTI, Ana Paula de Carvalho Panzeri; CARVALHO, Werther Brunow de; JOHNSTON, Cintia; GILIO, Alfredo Elias; MARQUES, Heloisa Helena de Sousa; FERRANTI, Juliana Ferreira; RODRIGUEZ, Isadora Souza; DELGADO, Artur FigueiredoCoronavirus disease (COVID-19), caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), became a pandemic in March 2020, affecting millions of people worldwide. However, COVID-19 in pediatric patients represents 1-5% of all cases, and the risk for developing severe disease and critical illness is much lower in children with COVID-19 than in adults. Multisystem inflammatory syndrome in children (MIS-C), a possible complication of COVID-19, has been described as a hyperinflammatory condition with multiorgan involvement similar to that in Kawasaki disease or toxic shock syndrome in children with evidence of SARS-CoV-2 infection. This review presents an update on the diagnostic methods for COVID-19, including reverse-transcriptase polymerase chain reaction (RT-PCR) tests, serology tests, and imaging, and summarizes the current recommendations for the management of the disease. Particular emphasis is placed on respiratory support, which includes noninvasive ventilation and invasive mechanical ventilation strategies according to lung compliance and pattern of lung injury. Pharmacological treatment, including pathogen-targeted drugs and host-directed therapies, has been addressed. The diagnostic criteria and management of MIS-C are also summarized.