Comparison of Hospitalized Patients with Severe Pneumonia Caused by COVID-19 and Highly Pathogenic Avian Influenza (H7N9): A Retrospective Study from A Designated Hospital (preprint)

Background: Considerable attention has been focused on clinical features of Coronavirus Disease 2019 (COVID-19), it is also important for clinicians to differentiate it from influenza virus infections.Methods: The clinical data of 23 cases of H7N9 and 23 cases of COVID-19 with severe pneumonia were collected. The comparisons were performed with the t test, Mann-Whitney U test, Fisher exact test or the chi-squared test, and multivariable logistic regression analysis.Results: All of the cases were under the circumstance of sufficient medical staff and medical supplies. Radiologically, severe COVID-19 patients had less consolidation and pleural effusion, but more crazy-paving pattern than severe H7N9 patients (p<0.05). Clinically, compared to severe H7N9, severe COVID-19 patients were more inclined to surfer to relative better disease severity score, less secondary bacterial infection, a shorter time to beginning absorption on CT, but a longer duration of viral shedding from the admission (p<0.05). Although more severe H7N9 patients needed non-invasive respiratory support, these two groups ultimately yielded comparable mortality. Based on multiple logistic regression analysis, severe COVID-19 infection was associated with a lower risk of the presence of severe ARDS (OR 0.964, 95% [CI] 0.931-0.998, p=0.040), but exhibited longer duration of viral shedding (OR 0.734, 95% [CI] 0.550-0.980, p=0.036) than severe H7N9 infection.Conclusion: Although the conditions of severe H7N9 patients seemed to be more critical than those of severe COVID-19 patients, the relatively lower mortality of these two severe cases is to be expected in context of sufficient medical supplies.

Clinical characteristics and laboratory indicator analysis of 67 COVID-19 pneumonia patients in Suzhou, China (preprint)

Background: Sudden exacerbations and respiratory failure are major causes of death in patients with severe coronavirus disease 2019(COVID-19) pneumonia, but indicators for the prediction and treatment of severe patients are still lacking.MethodsA retrospective analysis of 67 collected cases was conducted and included approximately 67 patients with COVID-19 pneumonia who were admitted to the Suzhou Fifth People’s Hospital from January 1, 2020 to February 8, 2020. The epidemiological, clinical and imaging characteristics as well as laboratory data of the 67 patients were analyzed.ResultsThe study found that fibrinogen(FIB) was increased in 45 (65.2%) patients, and when FIB reached a critical value of 4.805 g/L, the sensitivity and specificity、DA, helping to distinguish general and severe cases, were 100% and 14%、92.9%, respectively, which were significantly better than those for lymphocyte count and myoglobin. Chest CT images indicated that the cumulative number of lung lobes with lesions in severe patients was significantly higher than that in general patients (P<0.05), and the cumulative number of lung lobes with lesions was negatively correlated with lymphocyte count and positively correlated with myoglobin and FIB. Our study also found that there was no obvious effect of hormone therapy in patients with severe COVID-19.ConclusionsBased on the retrospective analysis, FIB was found to be increased in severe patients and was better than lymphocyte count and myoglobin in distinguishing general and severe patients. The study also suggested that hormone treatment has no significant effect on COVID-19.

Comparison of Hospitalized Patients with Severe Pneumonia Caused by COVID-19 and Highly Pathogenic Avian Influenza (H7N9): A Retrospective Study from A Designated Hospital (preprint)

Background Considerable attention has been focused on clinical features of Coronavirus Disease 2019 (COVID-19), it is also important for clinicians to differentiate it from influenza virus infections.Methods The clinical data of 23 cases of H7N9 and 23 cases of COVID-19 with severe pneumonia were collected. The comparisons were performed with the t test, Mann-Whitney U test, Fisher exact test or the chi-squared test, and multivariable logistic regression analysis.Results All of the cases were under the circumstance of sufficient medical staff and medical supplies. The rate of coexisting disease was lower in the severe COVID-19 group than in the severe H7N9 group (p < 0.05). Radiologically, severe COVID-19 patients had less consolidation and pleural effusion, but more crazy-paving pattern than severe H7N9 patients (p < 0.05). Clinically, compared to severe H7N9, severe COVID-19 patients were more inclined to surfer to relative better disease severity score, less secondary bacterial infection, a shorter time to beginning absorption on CT, but a longer duration of viral shedding from the admission (p < 0.05). Although more severe H7N9 patients needed non-invasive respiratory support, these two groups ultimately yielded comparable mortality. Based on multiple logistic regression analysis, severe COVID-19 infection was associated with a lower risk of the presence of severe ARDS (OR 0.964, 95% [CI] 0.931–0.998, p = 0.040), but exhibited longer duration of viral shedding (OR 0.734, 95% [CI] 0.550–0.980, p = 0.036) than severe H7N9 infection.Conclusion Although the conditions of severe H7N9 patients seemed to be more critical than those of severe COVID-19 patients, the relatively lower mortality of these two severe cases is to be expected in context of sufficient medical supplies.

Clinical characteristics and laboratory indicator analysis of 69 COVID-19 pneumonia patients in Suzhou, China (preprint)

Background Sudden exacerbations and respiratory failure are major causes for the death of severe COVID-19 pneumonia patient and but now the detection and treatment of severe patients is still lack. Methods A retrospective analysis is conducted on 69 collected cases, which are about 69 patients with COVID-19 pneumonia who were admitted to the Suzhou Fifth People’s Hospital from January 1, 2020 to February 8, 2020. Their epidemiological, clinical and imaging characteristics as well as laboratory data of the 69 patients were analyzed. Results The study found fibrinogen increased in 45 (65.2%) patients and when the fibrinogen takes a critical value of 4.805 g/L, the sensitivity and specificity, helping distinguish general and severe classification, are 100% and 14%, respectively, which are significantly better than lymphocyte and myoglobin. Chest CT images indicate that the cumulative number of lung lobes in severe patients were significantly higher than that in general patients (P＜0.05) and the cumulative number of lung lobes in the lesions was negatively correlated with lymphocyte, and positively correlated with myoglobin and fibrinogen. Our study also found that there is no obvious effect of hormone therapy in severe patients with COVID-19. Conclusions Based on the retrospective analysis, the fibrinogen were found increased in severe patients and were better than lymphocyte and myoglobin in respect of distinguishing general and severe patients. And the study also suggested hormone treatment has no significant effect on COVID-19.