ABSTRACT
BACKGROUND: The aim of this study was to determine whether Arbidol has a good antiviral effect on coronavirus disease 2019 (COVID-19). METHODS: A retrospective cohort study was performed in one of the treatment centers for COVID-19 patients in China from January 2020 to March 2020. The antiviral drug Arbidol (ARB) was administrated to some of the patients at 0.2 g tid po for 7 to 10 days. According to whether patients were given ARB, they were divided into 2 groups: the ARB group and the Non-ARB group. The primary outcome was the 14-day COVID-19 negativity rate. RESULTS: Of 146 patients, 140 were included. A total of 79 (56.4%) patients received ARB during hospitalization. In the overall cohort, the time of COVID-19 negativity in the ARB group compared with the Non-ARB group was 12.9 days versus 12.7 days (P=0.175; >0.05). The rates of 14-day COVID-19 negativity were 60.8% and 65.6% in the ARB and non-ARB groups, respectively (P=0.559; >0.05). Using an adjusted model, there were no obvious differences in the time of COVID-19 negativity and the rates of 14-day COVID-19 negativity (P>0.05). According to Kaplan-Meier analysis, the probabilities of 14-day COVID-19 negativity were similar in the 2 groups (log-rank P=0.130; >0.05). In a multivariate Cox analysis, the variables of age [hazard ratio (HR) 0.91, 95% confidence interval (CI): 0.83 to 0.99; P=0.039] and glucose (HR 0.90, 95% CI: 0.82 to 0.98; P=0.021) were independently associated with 14-day COVID-19 negativity. CONCLUSIONS: Our results suggest that there was no apparent favorable clinical response with ARB both in clinical symptoms and the 14-day COVID-19 negativity rate.
Subject(s)
COVID-19 , SARS-CoV-2 , Angiotensin Receptor Antagonists , Angiotensin-Converting Enzyme Inhibitors , Cohort Studies , Humans , Indoles , Retrospective StudiesABSTRACT
BACKGROUND: The aim of this study was to investigate the pulmonary function of patients with 2019 novel coronavirus (COVID-19)-induced pneumonia. METHODS: A retrospective analysis of 137 patients with COVID-19-induced pneumonia who were discharged from the Enze Hospital, Taizhou Enze Medical Center (Group) from January 31 2020 to March 11 2020 was conducted. Follow-up occurred 2 weeks after hospital discharge, during which patients underwent a pulmonary function test. RESULTS: Of the 137 patients who underwent a pulmonary function test 2 weeks after discharge, 51.8% were male, and the mean age was 47 years. Only 19.7% of the patients were identified as having severe COVID-19-induced pneumonia. The pulmonary function tests showed that for a small number of patients the forced expiratory volume in one second/forced vital capacity ratio (FEV1/FVC)/% values were <70%, and the mean forced inspiratory volume (IVC) and FVC values were 2.4±0.7 and 3.2±0.8 L, respectively. In severe cases, 88.9% of patients had an IVC <80% of the predicted value, and 55.6% of patients had an FVC <80% of the predicted value. The proportion of patients with maximum expiratory flow rate at 25%, 50% and 75% of the vital capacity (MEF25, MEF50, and MEF75) values <70% were 55.6%, 40.7%, and 25.9%, respectively. In the non-severe group, 79.1% of patients had an IVC <80% of the predicted value, and 16.4% of patients had an FVC <80% of the predicted value. The mean MEF25, MEF50, and MEF75 <70% values were 57.3%, 30%, and 13.6%, respectively. CONCLUSIONS: Our results demonstrated that the pulmonary function of patients with COVID-19-induced pneumonia predominantly manifested as restrictive ventilation disorder and small airway obstruction, which was increased in critically ill patients.
Subject(s)
Coronavirus Infections/physiopathology , Lung/physiopathology , Pneumonia, Viral/physiopathology , Respiratory Function Tests , Adult , Betacoronavirus , COVID-19 , Critical Illness , Female , Follow-Up Studies , Forced Expiratory Volume , Humans , Inspiratory Capacity , Male , Maximal Expiratory Flow Rate , Middle Aged , Pandemics , Peak Expiratory Flow Rate , Retrospective Studies , SARS-CoV-2 , Severity of Illness Index , Vital CapacityABSTRACT
OBJECTIVES: Host immune responses are indispensable to combat the disease. We report the dynamics of peripheral immune cells, cytokines, and human leucocyte antigen-G (HLA-G) and its receptor expressions in a patient suffering from critical COVID-19 pneumonia to convalescence. METHODS: Clinical data of the patient were collected from medical records. The expressions of HLA-G and receptors ILT2, ILT4 and KIR2DL4 in peripheral immune cells were measured with flow cytometry. RESULTS: From critical COVID-19 to the convalescent stage, early lymphopenia was improved (median: 0.6 × 109 L-1 vs. 0.9 × 109 L-1, P = 0.009), and an obvious fluctuation in WBC and neutrophil counts was observed. Initially, low levels of CD4+ T cells (from 120 to 528 µL-1) and CD8+ T cells (from 68 to 362 µL-1) gradually increased to normal levels. Meanwhile, high IL-6 (from 251.8 to 6.32 pg mL-1), IL-10 (from 39.53 to 5.21 pg mL-1) and IFN-γ (from 13.55 to 3.16 pg mL-1) levels decreased, and IL-4 (from 2.36 to 3.19 pg mL-1) and TNF-α (from 2.27 to 20.2 pg mL-1) levels increased quickly when the viral RNA returned negative. Moreover, the percentage of HLA-G+ T cells, B cells and monocytes follows high-low-high pattern, while the percentage of receptors ILT2-, ILT4- and KIR2DL4-expressing cells remained relatively stable. CONCLUSION: Our findings provide valuable information on the dynamics of early peripheral immunological responses in SARS-CoV-2 infection. CD4+ and CD8+ T cells, cytokines and HLA-G+ immune cells are associated with the natural history of the critical COVID-19 patient; however, future studies are necessary.