Treatment of Six COVID-19 Patients with Convalescent Plasma (preprint)

Objective The global mortality toll of coronavirus disease 2019 (COVID-19) is rapidly increasing. Current antiviral therapy is insufficient, so it is crucial to develop new treatments. We assessed the efficacy of convalescent plasma transfusion for COVID-19 patients.Methods This retrospective, single-center study was conducted on six COVID-19 patients treated with convalescent plasma at Guizhou Provincial Jiangjunshan Hospital in China, from January 29 to April 30, 2020; the final follow-up data was collected on May 20, 2020. The efficacy of convalescent plasma was evaluated symptom relief and improvements in laboratory indicators and chest imaging abnormalities. Results Following treatment with convalescent plasma, the laboratory indicators and chest imaging examination of patients 1–3 changed from abnormal to normal. Regarding the relapsed patients (patients 4–6), two obtained negative severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) real-time polymerase chain reaction (RT-PCR) test results on consecutive throat swabs after receiving convalescent plasma therapy (on days 24 and 3 for patients 4 and 6, respectively). Patient 5 received only one round of convalescent plasma transfusion; this patient’s laryngeal swab test results for SARS-CoV-2 have remained consistently positive so far.Conclusions The clinical conditions of six patients with COVID-19 improved following treatment with antiviral drugs and systemic corticosteroids combined with appropriate rounds of convalescent plasma therapy, indicating that infusion with convalescent plasma may be beneficial for patients with COVID-19.This study was registered in Chinese Clinical Trial Registry Center. (CCTR number: ChiCTR 2000033056, registered 19 May 2020)

Treatment of 6 COVID-19 Patients with Convalescent Plasma (preprint)

Objective To describe the efficacy of convalescent plasma transfusion for COVID-19 patients. Methods This is a retrospective study of 6 COVID-19 patients with convalescent plasma at Guizhou Provincial Jiangjunshan Hospital [boxh] a tertial hospital, in Guiyang, Guizhou, China, from January 29, to April 30, 2020; final data of follow-up was May 12, 2020. Through the review of the electronic medical records of Guizhou Jiangjunshan Hospital, clinical data of 6 patients were obtained. Three patients with worsening symptoms after empirical treatment with antivirals were transfused convalescent plasma therapy for the first treatment, while the other three severe or critical COVID-19 patients with rapid progression were transfused. The efficacy of convalescent plasma depends on the relief of symptoms, changes in laboratory indicators and chest imaging abnormalities. Results The PaO2 / FiO2 and lymphocyte count of patients 1, 2 and 3 treated with convalescent plasma treatment for the first treatment period were changed from abnormal to normal. The levels of inflammation markers CRP and IL-6 of the patients decreased significantly. Chest imaging examination showed that the lung lesions gradually subsided. The relapsed patients (No. 4 and No. 6), after using convalescent plasma therapy, turned negative on two consecutive throat swab tests on Day 24 and Day 3, respectively. Conclusions Convalescent plasma treatment of COVID-19 is beneficial for those patients with be difficult to turn to negative or re-positive RT-PCR.

Leukopenia of Asymptomatic COVID-19 Infections under 18 Years Old in Recovery Stage (preprint)

Objectives In December, 2019, a type of novel coronavirus which was designated novel coronavirus 2019 (2019-nCoV) by World Health Organization (WHO) occurred in Wuhan, Hubei, China. The epidemiological and clinical characteristics of those patients under 18 years old in the recovery stage are limited. To compare the difference of epidemiological and clinical characteristics of COVID-19 involving 25 patients under 18 years old in recovery stage between confirmed and asymptomatic infections. Methods Retrospective, single-center cohort study of COVID-19 involving 25 patients under 18 years old in the recovery stage at Guizhou Provincial Staff Hospital in Guiyang, China, from January 29, to March 31, 2020; final date of follow-up was April 22. Epidemiological, demographic, clinical, laboratory, radiological, and treatment data were collected and analyzed. Epidemiological and clinical characteristics of confirmed COVID-19 infections and asymptomatic infections were compared. Results Among the 25 COVID infections under 18 years old, 16 (64%) were mild or moderate confirmed cases, and 9 (36%) were asymptomatic. The shortest treatment period was 6 days, the longest 26 days, and the average treatment period 14 days. Four cases (44.4%) had visited Wuhan or had a living story in the city. There were 9 (100%) asymptomatic cases were familial cluster outbreak, with an average infection number was 6 cases among all families. The number of asymptomatic COVID-19 infections with leukopenia were significantly more than confirmed cases (p=0.04). Conclusions Leukopenia mostly occurred in asymptomatic COVID-19 infections under 18 years old compared with the confirmed patients.

Asymptomatic COVID-19 Have Longer Treatment Cycle Than Moderate Type of Confirmed Patients (preprint)

Objectives A kind of pneumonia caused by unknown causes that occurred in Wuhan, Hubei, China in December 2019, was reported as a result of novel coronavirus infection on January 7, 2020, and then WHO named it COVID-19. To compare the difference of epidemiology and clinical characteristics between asymptomatic COVID-19 infections and moderate type of confirmed cases. Methods Retrospective, single-center cohort study of COVID-19 involving 52 infections of both 26 asymptomatic and 26 moderate type of confirmed cases in the recovery stage at Guizhou Provincial Staff Hospital in Guiyang, China, from January 29, to March 31, 2020; final date of follow-up was April 22. This study was registered in Chinese Clinical Trial Registry Center. Documented the asymptomatic COVID-19 infections and moderate type of confirmed cases. Epidemiological, demographic, clinical, laboratory, radiological, and treatment data were collected and analyzed. Epidemiological and clinical characteristics of asymptomatic COVID-19 infections and moderate type of confirmed cases were compared. Results The median treatment cycle of asymptomatic COVID-19 infections was 16 days (interquartile range, 11-20 days) and longer than 13 days (interquartile range, 10-15 days) of moderate type of confirmed cases (p=0.049). The median incubation period of asymptomatic COVID-19 infections was 10 days (interquartile range, 0-21 days), while the control group was 7 days (interquartile range, 1-15 days) (p=0.27). On the initial chest computerized tomography (CT) check, 18 (69.2%, 18/26) asymptomatic COVID-19 infections were no imaging changes, which was of no significance compared with 12 (46.2%, 12/26) patients with moderate type of confirmed patients (p=0.092). Conclusions In this single-center study, we found that asymptomatic COVID-19 infections have longer treatment cycle than those moderate type of confirmed cases.

Leukopenia of Asymptomatic COVID-19 Infections under 18 Years Old in Recovery Stage (preprint)

Background In December, 2019, a type of novel coronavirus which was designated novel coronavirus 2019 (2019-nCoV) by World Health Organization (WHO) occurred in Wuhan, Hubei, China. The epidemiological and clinical characteristics of those patients under 18 years old in the recovery stage are limited. To compare the difference of epidemiological and clinical characteristics of COVID-19 involving 25 patients under 18 years old in recovery stage between confirmed and asymptomatic infections.Methods Retrospective, single-center cohort study of COVID-19 involving 25 patients under 18 years old in the recovery stage at Guizhou Provincial Staff Hospital in Guiyang, China, from January 29, to March 31, 2020; final date of follow-up was April 22. Epidemiological, demographic, clinical, laboratory, radiological, and treatment data were collected and analyzed. Epidemiological and clinical characteristics of confirmed COVID-19 infections and asymptomatic infections were compared.Results Among the 25 COVID infections under 18 years old, 16 (64%) were mild or moderate confirmed cases, and 9 (36%) were asymptomatic. The shortest treatment period was 6 days, the longest 26 days, and the average treatment period 14 days. Four cases (44.4%) had visited Wuhan or had a living story in the city. There were 9 (100%) asymptomatic cases were familial cluster outbreak, with an average infection number was 6 cases among all families. The number of asymptomatic COVID-19 infections’ Leukopenia were significantly more than confirmed cases (p = 0.04).Conclusions Leukopenia mostly occurred in asymptomatic COVID-19 infections under 18 years old compared with the confirmed patients.

Therapeutic Effects and Molecular Network Mechanism of Chinese herbs for Coronavirus Disease-19 (preprint)

Background: The coronavirus disease-19 (COVID-19) outbreak on December 2019.The present study was aimed to explore the therapeutic effects and the network pharmacology mechanism of Chinese herbs in COVID-19 patients.Methods: In this retrospective study, demographic, clinical signs, radiography, and laboratory of 78 patients were analysis from patients' medical records. Network pharmacology was applied to characterize the action mechanism of herbs decoction. Results: Of all patients were imported cases with familial aggregation. Survival analysis showed that the proportion of cough (χ2 =3.864, P=0.049) and fever (χ2 =5.549, P=0.018) in TCM group declined faster than control group. There was a significant radiographic lesions remission difference between groups (χ2 =7.666, P=0.006). After adjusted by baseline data, the changes of Lymphocytes, ALT and LDH were greater in TCM group (P=0.023, 0.005, 0.015, respectively). A total of 1852 ingredients in 13 herbs were obtained, among which, the ingredients-target network included 168 compounds and 189 targets, 38 GO terms and 63 pathways were found in enrichment analysis. Conclusion: The therapeutic effect of Chinese herbs was amelioration of cough and fever, facilitated the absorption of inflammatory infiltrates seen in the lungs, and increased the number of lymphocytes, protection of liver function via the mechanism of inhibition of coronavirus attack organs and immune cells directly. Molecular mechanisms need to be further validate in vitro and vivo.