Food Sources May Affect the Symptom Rates of COVID-19, an Epidemiological Analysis Based on the Public Data in Gansu Province, China, During the Summer Epidemic Cycle in 2022.

According to the public data collected from the Health Commission of Gansu Province, China, regarding the COVID-19 pandemic during the summer epidemic cycle in 2022, the epidemiological analysis showed that the pandemic spread stability and the symptom rate (the number of confirmed cases divided by the sum of the number of asymptomatic cases and the number of confirmed cases) of COVID-19 were different among 3 main epidemic regions, Lanzhou, Linxia, and Gannan; both the symptom rate and the daily instantaneous symptom rate (daily number of confirmed cases divided by the sum of daily number of asymptomatic cases and daily number of confirmed cases) in Lanzhou were substantially higher than those in Linxia and Gannan. The difference in the food sources due to the high difference of the population ethnic composition in the 3 regions was probably the main driver for the difference of the symptom rates among the 3 regions. This work provides potential values for prevention and control of COVID-19 in different regions.

Gastrointestinal Symptoms Are Associated with Increased Risk of Progression from Non- severe to Severe Illness in COVID-19 Patients (preprint)

BackgroundThe involvement of gastrointestinal (GI) symptoms in the progression of illness in COVID-19 patients has not been illustrated, with the association between GI symptoms and illness severity remaining controversial. The present study aimed to evaluate the association between GI symptoms and the illness progression, severity, and prognosis in COVID-19 patients.MethodsThis study retrospectively recruited consecutive patients with laboratory-confirmed COVID-19 from three hospitals in Wuhan. The severity of illness was classified as non-severe and severe for analyses. The primary outcome was the association between GI symptoms and progression from non-severe to severe illness (PNTS) in COVID-19 patients. ResultsOf the 934 COVID-19 patients (mean age 59.3 years; 43.7% males), the prevalence of overall and specific GI symptoms at/prior to admission were 59.9% and 13.0%, respectively. Patients with GI symptoms were associated with increased risk of fever (56.1% vs. 48.1%; P=0.02), increased IL-6 (18.2% vs. 11.7%; P=0.04), ground-glass opacity (56.8% vs. 43.1%; P<0.001), bilateral pneumonia (80.4% vs. 72.3%; P=0.005), secondary infections (12.6% vs. 6.5%;, P=0.003), and hypoalbuminemia (26.2% vs. 18.4%; P=0.01). Patients with GI symptoms had a higher risk for PNTS (2.9% vs. 0.6%; P=0.02), even after full adjustments (OR, 6.50; (95%CI:1.34-31.6); P=0.02), but comparable risk for severe illness or deaths. GI symptoms and the specific GI symptoms were identified as the independent risk factors for PNTS.Conclusions The occurrence of GI symptoms is proved to be an independent risk factor for PNTS, which might be a predicting indicator in the prevention of illness deterioration at an early stage.

Retrospective study of risk factors of 43 patients with severe coronavirus disease 2019 pneumonia

Objective To explore the risk factors of 43 patients with severe coronavirus disease 2019 pneumonia(COVID-19) in Hangzhou. Methods The clinical and epidemiological data of COVID-19 confirmed patients during 1 st January 2020 and 20 th March 2020 in Hangzhou were collected.The risk factors of the severe cases were analyzed by univariate and multivariate logistic regression. Results Up to 20 th March 2020,a total of 169 patients were reported in Hangzhou, among which, 43(25.44%) were severe cases.The analysis showed that over 60 years old[χ~2=6.16,P=0.01;OR(95%CI)=3.35(1.29-8.69)],hypertension[χ~2=6.91,P<0.001;OR(95%CI)=3.80(1.40-10.28)],headache as initial onset symptom [χ~2=4.80,P=0.03;OR(95%CI)=3.02(1.12-8.09)] and delayed hospitalization(Z=-2.21,P=0.03) were statistically significant. Conclusions Age over 60 years, hypertension, headache as initial onset symptom are risk factors and delayed hospitalization is influencing factor of severe COVID-19 patients.It is necessary to monitor COVID-19 patients′ condition and take effective treatment timely.

Gastrointestinal Symptoms Are Associated with the Increased Risk of Progression from Non-Severe to Severe Illness in COVID-19 Patients: A Multicenter, Retrospective Study (preprint)

Background: The involvement of gastrointestinal (GI) symptoms in the progression of COVID-19 patients has not been illustrated, with the association between GI symptoms and severity of illness remaining controversial. The present study aimed to evaluate the association between GI symptoms and the illness progression, severity, and prognosis of COVID-19 patients. Design: This retrospective study recruited 1024 consecutive patients with laboratory-confirmed COVID-19 from three hospitals in Wuhan. The severity of illness was classified as non-severe and severe for analyses. The primary outcome was the association between GI symptoms and the progression from non-severe to severe illness (PNTS) in COVID-19 patients. Results: Of the 934 COVID-19 patients (mean age 59.3 years; 43.7% males), the prevalence of overall and specific GI symptoms at/prior to admission were 59.9% and 13.0%, respectively. Patients with GI symptoms were associated with increased risk of fever (56.1% vs. 48.1%; P=0.02), increased IL-6 (18.2% vs. 11.7%; P=0.04), ground-glass opacity (56.8% vs. 43.1%; P<0.001), bilateral pneumonia (80.4% vs. 72.3%; P=0.005), secondary infections (12.6% vs. 6.5%;, P=0.003), and hypoalbuminemia (26.2% vs. 18.4%; P=0.01). Patients with GI symptoms had a higher risk for PNTS (2.9% vs. 0.6%; P=0.02), even after full adjustments (OR, 6.50; (95%CI:1.34-31.6); P=0.02), but no risk for severe illness or deaths. GI symptoms and the specific GI symptoms were identified as the independent risk factors for PNTS. Conclusion: The occurrence of GI symptoms is proved to be the independent risk factor for PNTS, which might be a crucial indicator in the early prevention of illness deterioration.Funding Statement: National Key R&D Program of China (2018YFC1313103), and National Natural Science Foundation of China (Grant No. 81670473 and 81873546), "Shu Guang" project of Shanghai Municipal Education Commission and Shanghai Education Development Foundation (No. 19SG30).Declaration of Interests: There is no conflict of interests for each authorEthics Approval Statement: This study was approved by the Ethics Committee of the Changhai hospitals. The requirement for informed patient consent was waived by the ethics committee due to the retrospective design and as the data analyzed were considered as a part of a continuing investigation of a public health emergency of international concern by the National Health Commission (NHC) of the People's Republic of China.