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1.
Renal Failure ; 42(1):950-957, 2020.
Article | WHO COVID | ID: covidwho-1124758

ABSTRACT

Background Novel coronavirus disease (COVID-19) is spreading rapidly, which poses great challenges to patients on maintenance hemodialysis Here we report the clinical features of 66 hemodialysis patients with laboratory confirmed COVID-19 infection Design, setting, participants, and measurements Retrospective, single-center case series of the 66 hemodialysis patients with confirmed COVID-19 from 1 January to 5 March 2020;the final date of follow-up was 25 March 2020 Results The clinical data were collected from 66 hemodialysis patients with confirmed COVID-19 The incidence of COVID-19 in our center was 11 0% (66/602), of which 18 patients died According to different prognosis, hemodialysis patients with COVID-19 were divided into the survival and death group A higher incidence of fever and dyspnea was found in the death group compared with the survival group Meanwhile, patients in the death group were often accompanied by higher white blood cell count, prolonged PT time, increased D-dimer (p <  05) More patients in the death group showed hepatocytes and cardiomyocytes damage Furthermore, logistic regression analysis suggested that fever, dyspnea, and elevated D-dimer were independent risk factors for death in hemodialysis patients with COVID-19 (OR, 1 077;95% CI, 1 014 to 1 439;p =  044;OR, 1 146;95% CI, 1 026 to 1 875;p =  034, OR, 4 974;95% CI, 3 315 to 6 263;p =  007, respectively) Conclusions The potential risk factors of fever, dyspnea, and elevated D-dimer could help clinicians to identify hemodialysis patients with poor prognosis at an early stage of COVID-19 infection

2.
Preprint | SciFinder | ID: ppcovidwho-3687

ABSTRACT

A review the outbreak of severe acute respiratory syndrome (SARS) in Feb 2003 in Guangdong, China, Middle east respiratory syndrome (MERS) in Sept 2010 in Kingdom of Saudi Arabia, and current COVID-19 pandemics in Dec 2019 in Wuhan, China, are all caused by coronaviruses, and patients primarily died of acute respiratory distress syndrome (ARDS) Compared with more than 5 years of wrecking havoc from JERS-CoV and Ebor, China successfully contains the SARS-CoV with in one year, which shows her advantage in political governance controlling such pandemics Many coronaviruses have been separated and their mol structures analyzed However, there is no specific anti-coronavirus drug developed in that world since the outbreaks the problem comes from not only pharmaceutical technol per se that must treat both coronaviruses and their life-threatening ARDS, but also the small size of patients who could immune against the coronaviruses after infections resulting in pharmaceutical reluctance to invest in the area Facing both the pharmaceutical and social economic bottlenecks, here, we summarized the current development of anti-coronavirus drugs, and proposed the strategies of repurposing existing drug and preparing their pharmacol combinations to fight the viruses including COVID-19 based on a well understanding of how the coronaviruses enter the host and damage our respiratory system

3.
Int Urol Nephrol ; 53(4): 797-802, 2021 Apr.
Article in English | MEDLINE | ID: covidwho-1002141

ABSTRACT

BACKGROUND: The recent outbreak of Coronavirus Disease 2019 (COVID-19) is a public health emergency of international concern. In China, Wuhan, Hubei Province was the epicenter. The disease is more severe in patients with high comorbidities and dialysis patients fall into this category. METHODS: In this report, we reviewed the whole course of the epidemic emerged in the HD center of Wuhan NO.1 Hospital by 28 February 2020. We compared the differences on the epidemiological characteristics and clinical features between patients surviving from COVID-19 and patients who died. RESULT: In this hospital, at time of the present report, 627 patients were on chronic hemodialysis and the prevalence of affected cases was 11.8% (74/627).The median age of the COVID-19-positive patients was 63 years (range 31-88), with an almost even gender distribution (females accounted for 54.4%).The most frequent presenting symptom was cough (41.9%), followed by fatigue (24.2%), fever (17.2%) and dyspnea (14.8%); 22.4% of the cases were and asymptomatic. Fourteen of the 74 patients died (19%), as for presenting symptoms, cough was more frequent in patients who died (P < 0.05). Surviving patients had higher levels of phosphate and albumin, and lower levels of C-reactive protein (CRP). Chest CT scan was positive in all cases, including in asymptomatic ones, and revealed in about three fourths of the cases bilateral (76.2%) lesions; in each lung lesions were multiple in about half of the cases of the cases (52.3%). After diagnosis, median time to death was 7 days in the 14 patients who died, with a range between 4 and 18 days. CONCLUSION: This preliminary, single Center study identifies hemodialysis patients as a population at high risk of severe, and deadly COVID-19 infection. While classic baseline clinical conditions, including age, kidney disease and gender, are not significantly associated with survival in COVID-19 infected hemodialysis, our study also suggests a significant association between risk of and death, poor nutritional status and less than optimal metabolic balance.


Subject(s)
/mortality , Kidney Failure, Chronic/mortality , Renal Dialysis , Adult , Aged , Aged, 80 and over , /diagnosis , China , Female , Hospitalization , Humans , Kidney Failure, Chronic/complications , Kidney Failure, Chronic/therapy , Male , Middle Aged , Retrospective Studies , Survival Rate
5.
Ann Palliat Med ; 9(5): 3304-3312, 2020 Sep.
Article in English | MEDLINE | ID: covidwho-854828

ABSTRACT

BACKGROUND: In recent years, disasters occurred frequently all over the world, and the role of nurses in public health emergencies and disaster emergencies was highlighted under the background of the covid19 epidemic. However, there was a lack of education and evaluation. Our study aims to cross-cultural adapt the Nurses' Perceptions of Disaster Core Competencies Scale (NPDCC) and evaluate the reliability and validity of the Chinese version. METHODS: We translated the scale following the translation-integration-back translation-expert review procedure, adapted according to Chinese culture. We evaluated the reliability and validity of the scale, and a total sample of 911 nurse data from the Yangtze River Delta Regional Nursing Alliance Hospital was gathered. RESULTS: The Chinese version of NPDCC included 45 items, 5 factors (critical thinking skills, special diagnostic skills, general diagnostic skills, technical skills, and communication skills) were extracted from the analysis, which could explain the 68.289% of the total variance. The content validity index was 0.925. The Cronbach's α of the total NPDCC score was 0.978, and 0.884-0.945 for every factor. The split-half for the scale was 0.930, and every factor was 0.861-0.894. CONCLUSIONS: The Chinese version of NPDCC has excellent reliability and validity, and it is suitable to measure nurses' perceptions of disaster core competencies in China. The next step is to promote the application in a large scale.

6.
Front Oncol ; 10: 1272, 2020.
Article in English | MEDLINE | ID: covidwho-853981

ABSTRACT

Background: A recent outbreak of severe acute respiratory syndrome coronavirus 2 (SARS-Cov-2), which began in Wuhan, China, with a high level of human-to-human transmission has been reported. There are limited data available on Coronavirus Disease 2019 (COVID-19) patients with hematological malignancies with more than 60 days of follow-up. This study describes the clinical characteristics, including multiple recurrences of COVID-19, in a patient with chronic lymphocytic leukemia (CLL) during 69 days of follow-up. Case Presentation: A 72-year-old female was admitted to hospital isolation after being infected with COVID-19 as part of a family cluster on January 30, 2020. Apart from SARS-Cov-2 virus infection, laboratory results revealed lymphocytosis of uncertain etiology and abnormal distribution of T lymphocytes. On blood smears, small blue lymphocytes with scant cytoplasm were observed, and the presence of high levels of circulating clonal B cells was also demonstrated by flow cytometry. The patient was diagnosed with COVID-19 and CLL. Among her family members, she had the highest viral loads and the fastest progression on lung injury and developed severe pneumonia. Serological results showed she had both 2019-nCoV-specific IgM and IgG antibodies; however, only IgG antibodies were detected in her husband's plasma. Results: A combination regimen of antiviral therapy and high-dose intravenous immunoglobulin (IVIG) in the early stage seemed to be effective for treating CLL and SARS-Cov-2 infection. Because of the low humoral immune response, the CLL patient could not effectively clear the SARS-Cov-2 infection and suffered from recurrence twice during the 69-day follow-up. Conclusion: In CLL, a neoplastic antigen-specific B-cell clone proliferates, and the progeny cells accumulate and outgrow other B cells, leading to immune deficiency. Considering the low humoral immune response and ineffective clearance of SARS-Cov-2 in CLL patients, the follow-up and home quarantine period should be extended. We need further studies to clarify suspending or continuing CLL therapy during COVID infection. For those patients who are prone to progression to severe disease, administering humoral immunity therapies can help to prevent disease progression and quickly meet the cure criteria.

7.
Mediators of Inflammation ; : 1-10, 2020.
Article in English | WHO COVID | ID: covidwho-852759

ABSTRACT

This study aimed at determining the relationship between baseline cystatin C levels and coronavirus disease 2019 (COVID-19) and investigating the potential prognostic value of serum cystatin C in adult patients with COVID-19 481 patients with COVID-19 were consecutively included in this study from January 2, 2020, and followed up to April 15, 2020 All clinical and laboratory data of COVID-19 patients with definite outcomes were reviewed For every measure, COVID-19 patients were grouped into quartiles according to the baseline levels of serum cystatin C The highest cystatin C level was significantly related to more severe inflammatory conditions, worse organ dysfunction, and worse outcomes among patients with COVID-19 (P values < 0 05) In the adjusted logistic regression analyses, the highest cystatin C level and ln-transformed cystatin C levels were independently associated with the risks of developing critically ill COVID-19 and all-cause death either in overall patients or in patients without chronic kidney disease (P values < 0 05) As a potential inflammatory marker, increasing baseline levels of serum cystatin C might independently predict adverse outcomes for COVID-19 patients Serum cystatin C could be routinely monitored during hospitalization, which showed clinical importance in prognosticating for adult patients with COVID-19 [ABSTRACT FROM AUTHOR] Copyright of Mediators of Inflammation is the property of Hindawi Limited and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission However, users may print, download, or email articles for individual use This abstract may be abridged No warranty is given about the accuracy of the copy Users should refer to the original published version of the material for the full abstract (Copyright applies to all Abstracts )

8.
Int J Med Sci ; 17(16): 2468-2476, 2020.
Article in English | MEDLINE | ID: covidwho-827890

ABSTRACT

Rationale: Coronavirus disease 2019 (COVID-19) was first announced in Wuhan, and has rapidly evolved into a pandemic. However, the risk factors associated with the severity and mortality of COVID-19 are yet to be described in detail. Methods: We retrospectively reviewed the information of 1525 cases from the Leishenshan Hospital in Wuhan. Univariate and multivariate Cox regression analyses were generated to explore the relationship between procalcitonin (PCT) level and the progression and prognosis of COVID-19. Univariate and multivariate logistic regression analyses were performed to explore the relationship between disease severity in hospitalized patients and their PCT levels. Survival curves and the cumulative hazard function for COVID-19 progression were conducted in the two groups. To further detect the relationship between the computed tomography score and survival days, curve-fitting analyses were performed. Results: Patients in the elevated PCT group had a higher incidence of severe and critical severity conditions (P < 0.001), death, and higher computed tomography (CT) scores. There was an association between elevated PCT levels and mortality in the univariate ((hazard ratio [1], 3.377; 95% confidence interval [2], 1.012-10.344; P = 0.033) and multivariate Cox regression analysis (HR, 4.933; 95% CI, 1.170-20.788; P = 0.030). Similarly, patients with elevated PCT were more likely to have critically severe disease conditions in the univariate (odds ratio [2], 7.247; 95% CI, 3.559-14.757; P < 0.001) and multivariate logistic regression analysis (OR, 10.679; 95% CI, 4.562-25.000; P < 0.001). Kaplan-Meier curves showed poorer prognosis for patients with elevated PCT (P = 0.024). The CT score 1 for patients with elevated PCT peaked at day 40 following the onset of symptoms then decreased gradually, while their total CT score was relatively stable. Conclusion: PCT level was shown as an independent risk factor of in-hospital mortality among COVID-19 patients. Compared with inpatients with normal PCT levels, inpatients with elevated PCT levels had a higher risk for overall mortality and critically severe disease. These findings may provide guidance for improving the prognosis of patients with critically severe COVID-19.


Subject(s)
Betacoronavirus , Coronavirus Infections/etiology , Coronavirus Infections/mortality , Pneumonia, Viral/etiology , Pneumonia, Viral/mortality , Procalcitonin/blood , Aged , Anti-Bacterial Agents/therapeutic use , Antiviral Agents/therapeutic use , Betacoronavirus/drug effects , China/epidemiology , Comorbidity , Coronavirus Infections/diagnostic imaging , Coronavirus Infections/drug therapy , Disease Progression , Female , Hospitalization , Humans , Kaplan-Meier Estimate , Male , Middle Aged , Pandemics , Pneumonia, Viral/diagnostic imaging , Prognosis , Retrospective Studies , Tomography, X-Ray Computed
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