Your browser doesn't support javascript.
Show: 20 | 50 | 100
Results 1 - 20 de 22
Filter
1.
Ear Nose Throat J ; : 145561320943354, 2020 Jul 20.
Article in English | MEDLINE | ID: covidwho-655415

ABSTRACT

Acute airway obstruction caused by invasive laryngeal cancer can make surgeons reluctant to perform a high-risk tracheostomy, which is life-saving for such patients. In the setting of the current COVID19 pandemic, we present a case of severe transglottic stenosis due to stage IV laryngeal carcinoma, in which gaseous exchange was facilitated by venovenous (VV) extracorporeal membrane oxygenation prior to emergent tracheostomy. The VV technique can ensure adequate oxygenation and CO2 removal. Venovenous extracorporeal membrane oxygenation provided sufficient time for surgical planning and preparation. It reduced the formation of aerosol, lowered the risk associated with life-saving tracheostomy, and protected the patient from ischemia.

2.
Dig Endosc ; 2020 May 30.
Article in English | MEDLINE | ID: covidwho-767221

ABSTRACT

AIMS: To investigate control measures for COVID-19 pandemic in GIE centers in China. METHODS: This is a retrospective multi-center research, including seven centers. Data collection was from 1 February to 31 March 2020 and the same period in 2019. RESULTS: There were a total of 28 COVID-19 definite cases in these hospitals. Six out of seven GIE centers were arranged to shut down on 1 February, with a mean number of shutdown days of 23.6 ± 5.3. The actual workloads were only 10.3%-62.9% compared to those last year. All centers had a preoperative COVID-19 screening process. Epidemiological questionnaire, temperature taking and QR-code of journey were conducted. Chest CT scan was conducted during the shutdown period and continued in five centers after return to work. Antibody and nucleic acid test were applied in one to three centers. All endoscopists had advanced PPE. Five centers used surgical mask and the rest used N95 mask. Six centers used goggles or face shield. Five centers selected isolation gowns and the rest selected protective suits. The change frequency of these PPE was 4 h. Sterilizing measures were improved in six centers. Five centers utilized ultraviolet and six centers strengthened natural ventilation. Four and six centers used peracetic acid during the period of shutdown and return to work, alone or matched with OPA or acidified water. CONCLUSIONS: Many effective control measures were conducted in GIE centers during the outbreak, including patients' volume limitation, preoperative COVID-19 screening, advanced PPE and disinfection methods.

3.
Preprint | medRxiv | ID: ppmedrxiv-20166553

ABSTRACT

While the antibody response to SARS-CoV-2 has been extensively studied in blood, relatively little is known about the mucosal immune response and its relationship to systemic antibody levels. Since SARS-CoV-2 initially replicates in the upper airway, the antibody response in the oral cavity is likely an important parameter that influences the course of infection. We developed enzyme linked immunosorbent assays to detect IgA and IgG antibodies to the SARS-CoV-2 spike protein (full length trimer) and its receptor binding domain (RBD) in serum (n=496) and saliva (n=90) of acute and convalescent patients with laboratory-diagnosed COVID-19 ranging from 3-115 days post-symptom onset (PSO), compared to negative controls. Anti-CoV-2 antibody responses were readily detected in serum and saliva, with peak IgG levels attained by 16-30 days PSO. Whereas anti-CoV-2 IgA antibodies rapidly decayed, IgG antibodies remained relatively stable up to 115 days PSO in both biofluids. Importantly, IgG responses in saliva and serum were correlated, suggesting that antibodies in the saliva may serve as a surrogate measure of systemic immunity.

4.
Preprint | medRxiv | ID: ppmedrxiv-20157065

ABSTRACT

Objective To assess the association between the lockdowns due to COVID-19 and global online searches for toothache using Google Trends (GT). Methods We investigated GT online searches for the search terms toothache and tooth pain, within the past five years. The time frame for data gathering was considered as the initiation and end dates of national/regional lockdowns in each country. Relative search volumes (RSVs) for online Google Search queries in 2019 was considered as the control. We analysed data after normalising based on the Internet penetration rate. We used one-way ANOVA to identify statistical difference for RSVs between 2020 and 2016-2019 for each country. A linear regression model was used to assess whether there is a correlation between RSVs in 2020 and gross domestic production, COVID-19 deaths, dentists' density, YLDs of oral conditions, Internet access, lockdown duration, Education Index, and dental expenditure per capita. Results The results of worldwide RSVs for toothache and tooth pain also showed significantly higher values in 2020 compared to the previous four years. Of 23 included countries in our study, 16 showed significantly increased RSVs during the lockdown period compared to the same periods in the past four years. There was a statistically significant relationship between difference of RSVs means in 2020 and in 2016-2019 combined with percent of urban residency (B=-1.82; 95% CI: (-3.38, -0.26); p=0.026) and dental expenditure per capita (B=-0.42; 95% CI: (-0.80, -0.05); p=0.031) (R2=0.66). Conclusion Generally, the interest in toothache and tooth pain has significantly increased in 2020 compared to the last four years. This could implicitly reinforce the importance of dental care, as urgent medical care worldwide. Governments' expenditure on oral healthcare and the rate of urban residency, could be mentioned as important factors to direct general populations' online care-seeking behaviour with regard to dental pain.

5.
Preprint | medRxiv | ID: ppmedrxiv-20166504

ABSTRACT

Coronavirus disease (COVID-19) is an infectious disease caused by a newly discovered severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). In Myanmar, first COVID-19 reported cases were identified on 23rd March 2020. There were 336 reported confirmed cases, 261 recovered and 6 deaths through 13th July 2020. The study was a retrospective case series and all COVID-19 confirmed cases from 23rd March to 13th July 2020 were included. The data series of COVID-19 cases were extracted from the daily official reports of the Ministry of Health and Sports (MOHS), Myanmar and Centers for Disease Control and Prevention (CDC), Myanmar. Among 336 confirmed cases, there were 169 cases with reported transmission events. The median serial interval was 4 days (IQR 3, 2-5) with the range of 0 - 26 days. The mean of the reproduction number was 1.44 with (95% CI = 1.30-1.60) by exponential growth method and 1.32 with (95% CI = 0.98-1.73) confident interval by maximum likelihood method. This study outlined the epidemiological characteristics and epidemic parameters of COVID-19 in Myanmar. The estimation parameters in this study can be comparable with other studies and variability of these parameters can be considered when implementing disease control strategy in Myanmar.

6.
Preprint | medRxiv | ID: ppmedrxiv-20165142

ABSTRACT

We propose a variational model for computing the effective reproduction number (ERN) of SARS-CoV-2 from the daily count of incident cases. This computation only requires the knowledge of the serial interval. The ERN estimate is made through the minimization of a functional that includes: (i) the adjustment of the incidence curve using an epidemiological model, (ii) the regularity of the estimation of the ERN and, (iii) the adjustment of the initial value to an initial estimate of R_0 obtained from the initial exponential growth of the epidemic. The model does not assume any statistical distribution for the ERN and, more importantly, does not require truncating the serial interval when its distribution contains negative days. A comparative study has been carried out with the standard EpiEstim method. For a particular choice of the parameters of the variational model and of the serial interval, a good agreement has been obtained between the estimate provided by the variational model and a 7 days shifted estimate obtained by EpiEstim. This backward shift suggests that our estimate is closer to present than that of EpiEstim. We also examine how to forecast the value of the ERN and the number of infected in the short term by two different extrapolation techniques. An implementation of the model is available online at www.ipol.im/ern.

7.
Preprint | medRxiv | ID: ppmedrxiv-20164335

ABSTRACT

While the novel coronavirus continues to spread worldwide, the reported incubation period has varied between studies and is imprecise due to limited data. A literature search with certain selection criteria was conducted on May 30, 2020. In total, sixty-four articles were included, and 854 individual-level data were extracted from 30 studies for pooled analysis. Of these studies, 72% of them reported a median or mean incubation period of 4-7 days, while our estimated median was 4.9 days (95% confidence interval [CI]: 4.6-5.2). However, the inclusion of 81 asymptomatic and presymptomatic patients, as well as 31 cases with incubation periods exceeding 14 days, led to our estimation of 97.5th percentile with 19.2 days (95% CI: 17.4-21.4), beyond the currently suggested 14-day quarantine period. Therefore, we appeal to prolong the quarantine duration, especially for areas that have insufficient testing resources, to protect susceptible populations from being infected.

8.
Preprint | medRxiv | ID: ppmedrxiv-20166298

ABSTRACT

SARS-CoV-2 rapidly spread from a regional outbreak to a global pandemic in just a few months. Global research efforts have focused on developing effective vaccines against SARS-CoV-2 and the disease it causes, COVID-19. However, some of the basic epidemiological parameters, such as the exponential epidemic growth rate and the basic reproductive number, R0, across geographic areas are still not well quantified. Here, we developed and fit a mathematical model to case and death count data collected from the United States and eight European countries during the early epidemic period before broad control measures were implemented. Results show that the early epidemic grew exponentially at rates between 0.19-0.29/day (epidemic doubling times between 2.4-3.6 days). We discuss the current estimates of the mean serial interval, and argue that existing evidence suggests that the interval is between 6-8 days in the absence of active isolation efforts. Using parameters consistent with this range, we estimated the median R0 value to be 5.8 (confidence interval: 4.7-7.3) in the United States and between 3.6 and 6.1 in the eight European countries. This translates to herd immunity thresholds needed to stop transmission to be between 73% and 84%. We further analyze how vaccination schedules depends on R0, the duration of vaccine-induced immunity to SARS-CoV-2, and show that individual-level heterogeneity in vaccine induced immunity can significantly affect vaccination schedules.

9.
Preprint | medRxiv | ID: ppmedrxiv-20166348

ABSTRACT

College campuses in the United States are highly vulnerable to infectious diseases outbreaks, and there is a mounting need to develop strategies that best mitigate their size and duration, particularly as colleges consider reopening their campuses in the midst of the COVID-19 pandemic. Towards addressing this need, we applied a stochastic transmission model to quantify the impact of university-level responses to past outbreaks on their campuses and used it to determine which control interventions are most effective. The model aims to simultaneously overcome three crucial issues: stochastic variation in small populations, missing or unobserved case data, and changes in disease transmission rates post-intervention. We tested the model and assessed various interventions using data from the 2014 and 2016 mumps outbreaks at Ohio State University and Harvard University, respectively. Our results suggest that universities should design more aggressive diagnostic procedures and stricter isolation policies to decrease infectious disease incidence on campus. Our model can be applied to data from other outbreaks in college campuses and similar small-population settings.

10.
Preprint | medRxiv | ID: ppmedrxiv-20166116

ABSTRACT

Background: Coronavirus Disease 2019 (COVID-19) is caused by Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) and spreads through droplet-mediated transmission on contaminated surfaces and in air. Mounting scientific evidence from observational studies suggests that face masks for the general public may reduce the spread of infections. However, results from randomized control trials (RCT) have been presented as inconclusive, and concerns related to the safety and efficacy of non-surgical face masks in non-clinical settings remain. This controversy calls for a meta-analysis which considers non-compliance in RCTs, the time-lag in benefits of universal masking, and possible adverse effects. Methods: We performed a meta-analysis of RCTs of non-surgical face masks in preventing viral respiratory infections in non-hospital and non-household settings at cumulative and maximum follow-up as primary endpoints. The search for RCTs yielded five studies published before May 29th, 2020. We pooled estimates from the studies and performed random-effects meta-analysis and mixed-effects meta-regression across studies, accounting for covariates in compliance vs. non-compliance in treatment. Results: Face masks decreased infections across all studies at maximum follow-up (p=0.0318$, RR=0.608 [0.387 - 0.956]), and particularly in studies without non-compliance bias. We found significant between-study heterogeneity in studies with bias (I^2=71.2%, p=0.0077). We also used adjusted meta-regression to account for heterogeneity. The results support a significant protective effect of masking (p=0.0006, beta=0.0214, SE= 0.0062). No severe adverse effects were detected. Interpretation: The meta-analysis of existing randomized control studies found support for the efficacy of face masks among the general public. Our results show that face masks protect populations from infections and do not pose a significant risk to users. Recommendations and clear communication concerning the benefits of face masks should be provided to limit the number of COVID-19 and other respiratory infections.

11.
Preprint | medRxiv | ID: ppmedrxiv-20143016

ABSTRACT

This study reveals the human mobility from various sources and the luxury nature of social distancing in the U.S. during the COVID-19 pandemic by highlighting the disparities in mobility dynamics from lower-income and upper-income counties. We collect, process, and compute mobility data from four sources: 1) Apple mobility trend reports, 2) Google community mobility reports, 3) mobility data from Descartes Labs, and 4) Twitter mobility calculated via weighted distance. We further design a Responsive Index (RI) based on the time series of mobility change percentages to quantify the general degree of mobility-based responsiveness to COVID-19 at the U.S. county level. We find statistically significant positive correlations in the RI between either two data sources, revealing their general similarity, albeit with varying Pearson r coefficients. Despite the similarity, however, mobility from each source presents unique and even contrasting characteristics, in part demonstrating the multifaceted nature of human mobility. The positive correlation between RI and income at the county level is significant in all mobility datasets, suggesting that counties with higher income tend to react more aggressively in terms of reducing more mobility in response to the COVID-19 pandemic. Most states present a positive difference in RI between their upper-income and lower-income counties, where diverging patterns in time series of mobility changes percentages can be found. To our best knowledge, this is the first study that cross-compares multi-source mobility datasets. The findings shed light on not only the characteristics of multi-source mobility data but also the mobility patterns in tandem with the economic disparity.

12.
Preprint | medRxiv | ID: ppmedrxiv-20160077

ABSTRACT

Introduction Preterm birth is the leading cause of child mortality globally, with many survivors experiencing long-term adverse consequences. Preliminary evidence suggests that preterm births dropped dramatically following implementation of policy measures aimed at mitigating the impact of the COVID-19 pandemic. Methods We undertook a national quasi-experimental difference-in-regression-discontinuity approach to study the impact of the COVID-19 mitigation measures implemented in the Netherlands in a stepwise fashion on 9, 15, and 23 March 2020 on the incidence of preterm birth. We used data from the neonatal dried blood spot screening programme (2010-2020) and cross-validated these against national perinatal registry data. Stratified analyses were conducted according to gestational age subgroups, and sensitivity analyses to assess robustness of the findings. We explored potential effect modification by neighbourhood socio-economic status. Results Data on 1,599,549 singleton newborns were available, including 56,720 post-implementation births. Consistent reductions in preterm birth were seen across various time windows surrounding implementation of the 9 March COVID-19 mitigation measures: +/- 2 months (n=531,823): odds ratio 0.77 (95% confidence interval 0.66-0.91), p=0.002; +/- 3 months (n=796,531): 0.85 (0.73-0.98), p=0.028; +/- 4 months (n=1,066,872): 0.84 (0.73-0.97), p=0.023. Decreases observed following the 15 March measures were of smaller magnitude and not statistically significant. No changes were observed after 23 March. Preterm birth reductions after 9 March were consistent across gestational age strata and robust in sensitivity analyses. They appeared confined to high-socioeconomic status neighbourhoods, but effect modification was not statistically significant. Conclusion In this national quasi-experimental study, initial implementation of COVID-19 mitigation measures was associated with a 15-23% drop in preterm births in the following months, in agreement with preliminary observations in other countries. It is now of pivotal importance that integration of comparable data from across the globe is undertaken to further substantiate these findings and start exploring the underlying mechanisms.

13.
Preprint | medRxiv | ID: ppmedrxiv-20166637

ABSTRACT

The use of face masks is recommended worldwide to reduce the spread of COVID-19. A plethora of facial coverings and respirators, both commercial and homemade, pervade the market, but the true filtration capabilities of many homemade measures against the virus are unclear and continue to be unexplored. In this work, we compare the efficacy of the following masks in keeping out particulate matter below 2.5 microns: N95 respirators, surgical masks, cloth masks, cloth masks with activated carbon air filters, cloth masks with HVAC air filters, lightly starch-enhanced cloth masks, and heavily-starched cloth masks. The experiments utilize an inhalation system and aerosol chamber to simulate a masked individual respiring aerosolized air. COVID-19 disproportionately affects people in low-income communities, who often lack the resources to acquire appropriate personal protective equipment and tend to lack the flexibility to shelter in place due to their public-facing occupations. This work tests low-cost enhancements to homemade masks to assist these communities in making better masks to reduce viral transmission. Experimental results demonstrate that the filtration efficacy of cloth masks with either a light or heavy starch can approach the performance of much costlier masks. This discovery supports the idea of low-cost enhancements to reduce transmission and protect individuals from contracting COVID-19.

14.
Preprint | medRxiv | ID: ppmedrxiv-20166710

ABSTRACT

Background and objective: The outbreak of COVID-19 has become a global health concern. In this study, we evaluate the effectiveness and safety of convalescent plasma therapy in patients with severe and critically ill COVID-19. Methods: Sixteen COVID-19 patients received transfusion of anti-COVID-19 antibody-positive convalescent plasma. The main outcome was time for viral nucleic acid amplification (NAA) test turning negative. Clinical laboratory parameters were measured at the baseline (d0) before plasma transfusion, and day 1 (d1), day 3 (d3) after transfusion as well. Results: Among the 16 patients, 10 of them had a consistently positive result of viral NAA test before convalescent plasma transfusion. Eight patients (8/10) became negative from day 2 to day 8 after transfusion. Severe patients showed a shorter time for NAA test turning negative after transfusion (mean rank 2.17 vs 5.90, P = 0.036). Two critically ill patients transfused plasma with lower antibody level remained a positive result of NAA test. CRP level demonstrated a decline 1 day after convalescent plasma treatment, compared with the baseline (P = 0.017). No adverse events were observed during convalescent plasma transfusion. Conclusions: Viral NAA test of most patients with COVID-19 who received convalescent plasma transfusion turned negative on the 2nd to 8th days after transfusion, and the negative time of severe patients was shorter than that of critically ill patients.

15.
Preprint | medRxiv | ID: ppmedrxiv-20166371

ABSTRACT

Background: COVID 19 has changed the practice of surgery vividly all over the world. Pediatric surgery is not an exception. Prioritization protocols allowing us to provide emergency surgical care to the children in need while controlling the pandemic spread. The aim of this study is to share our experiences with the outcome of children with COVID 19 who had a co existing surgical emergency. Methods: This is a retrospective observational study. We reviewed the epidemiological, clinical, and laboratory data of all patients admitted in our surgery department through the emergency department and later diagnosed to have COVID 19 by RT PCR. The study duration was 3 months (April 2020 to June 2020). A nasopharyngeal swab was taken from all patients irrespective of symptoms to detect SARS CoV 2 by RT PCR with the purpose of detecting asymptomatic patients and patients with atypical symptoms. Emergency surgical services were provided immediately without delay and patients with positive test results were isolated according to the hospital protocol. We divided the test positive patients into 4 age groups for the convenience of data analysis. Data were retrieved from hospital records and analyzed using SPSS (version 25) software. Ethical permission was taken from the hospital ethical review board. Results: Total patients were 32. Seven (21.9%) of them were neonates. Twenty four (75%) patients were male. The predominant diagnosis was acute abdomen followed by infantile hypertrophic pyloric stenosis (IHPS), myelomeningocele, and intussusception. Only two patients had mild respiratory symptoms (dry cough). Fever was present in 13 (40.6%) patients. Fourteen (43.8%) patients required surgical treatment. The mean duration of hospital stay was 5.5 days. One neonate with ARM died in the postoperative ward due to cardiac arrest. No patient had hypoxemia or organ failure. Seven health care workers (5.51%) including doctors & nurses got infected with SARS Co V2 during this period. Conclusion: Our study has revealed a milder course of COVID 19 in children with minimal infectivity even when present in association with emergency surgical conditions. This might encourage a gradual restart to mitigate the impact of COVID 19 on children surgery. Keywords: COVID 19, COVID 19 in children, Children Surgery, Surgical emergency, Surgery in COVID 19 positive patients.

16.
Preprint | medRxiv | ID: ppmedrxiv-20167320

ABSTRACT

Bronchoalveolar lavage samples (n=34) collected in February, 2020 prior to the wide availability of molecular testing for SARS-CoV-2 were retrospectively assayed for presence of viral RNA. None of these patients qualified for SARS-CoV-2 testing based on Centers for Disease Control criteria at the time. None of the samples tested positive for SARS-CoV-2, suggesting that the virus was not yet widespread in Minnesota at the time these samples were obtained.

17.
Preprint | medRxiv | ID: ppmedrxiv-20166256

ABSTRACT

Abstract Background: We evaluated clinical characteristics and the clinical utility of VITROS SARS-CoV-2 antibody tests according to COVID-19 severity in patients in Japan. Methods: We analyzed 255 serum specimens from 130 COVID-19 patients and examined clinical records and laboratory data. Presence of total (IgA, IgM, and IgG) and specific IgG antibody for the spike 1 antigen of SARS-CoV2 was determined using VITROS Anti-SARS-CoV-2 antibody tests. Findings: Overall, 98 (75.4%) and 32 (24.6%) patients had mild and severe COVID-19, respectively. On admission, 76 (58.5%) and 45 (34.6%) patients were positive for total and IgG antibody assays. Among 91 patients at discharge, 90 (98.9%) and 81 (89.0%) patients were positive for total and IgG antibody, respectively. Clinical background and laboratory findings on admission, but not the prevalence or concentration of total or IgG antibody, were associated with disease prognosis. Total and IgG antibody intensity were significantly higher in severe cases than in mild cases in serum collected after 11 days from onset, but not within 10 days. Conclusion: VITROS Anti-SARS-CoV-2 Total and IgG assays will be useful as supporting diagnostic and surveillance tools and for evaluation of humoral immune response to COVID-19. Clinical background and laboratory findings are preferable predictors of disease prognosis.

18.
Preprint | medRxiv | ID: ppmedrxiv-20167056

ABSTRACT

Non-pharmaceutical interventions to control COVID-19 spread have been implemented in several countries with different intensity, timing, and impact on transmission. As a result, post-lockdown COVID-19 dynamics are heterogenous and difficult to interpret. Here we describe a set of contact surveys performed in four Chinese cities (Wuhan, Shanghai, Shenzhen, and Changsha) during the pre-pandemic, lockdown, and post-lockdown period to quantify the transmission impact of relaxing interventions via changes in age-specific contact patterns. We estimate that the mean number of contacts increased 5%-17% since the end of the lockdown but are still 3-7 times lower than their pre-pandemic levels. We find that post-lockdown contact patterns in China are still sufficiently low to keep SARS-CoV-2 transmission under control. We also find that the impact of school interventions depends non-linearly on the share of other activities being resumed. When most community activities are halted, school closure leads to a 77% decrease in the reproductive number; in contrast, when social mixing outside of schools is at pre-pandemic level, school closure leads to a 5% reduction in transmission. Moving forward, to control COVID-19 spread without resorting to a lockdown, it will be key to dose relaxation in social mixing in the community and strengthen targeted interventions.

19.
Clin Infect Pract ; 7: 100037, 2020 Oct.
Article in English | MEDLINE | ID: covidwho-628667

ABSTRACT

Background: In December 2019, a novel communicable disease, novel coronavirus infected pneumonia (NCIP) caused by Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) broke out. We aimed to analyze the characteristics and severity of patients with myocardial damage in NCIP. Methods: We enrolled 215 adult patients with NCIP from January 2020 to February 2020. Outcomes were followed up until March 1st, 2020. Results: 28.37% of the total patients showed increased level of TnI (> 0.040 ng/ml). Patients were older and had more cardiovascular complications in increased TnI group. Higher CRP, NT-proBNP, lower immune CD3, CD4 and CD8 cell account and more involved lobes detected by CT scan in the lung were observed in increased TnI group. Patients with elevated TnI had higher CURB-65 scores and were more likely given glucocorticoid therapy and mechanical ventilation than patients in normal TnI group. Conclusions: Markers of cardiomyocyte injury were elevated not least in elderly males with pre-existing cardiovascular disease. Patients with elevated TnI presented more severe situation, leading to multiple organ dysfunctions, which appeared as a pivotal feature of patients with NCIP that requires attention by clinicians in order to provide necessary treatment as soon as possible and improve patients' outcomes.

20.
Am J Respir Crit Care Med ; 201(11): 1380-1388, 2020 06 01.
Article in English | MEDLINE | ID: covidwho-436947

ABSTRACT

Rationale: The coronavirus disease (COVID-19) pandemic is now a global health concern.Objectives: We compared the clinical characteristics, laboratory examinations, computed tomography images, and treatments of patients with COVID-19 from three different cities in China.Methods: A total of 476 patients were recruited from January 1, 2020, to February 15, 2020, at three hospitals in Wuhan, Shanghai, and Anhui. The patients were divided into four groups according to age and into three groups (moderate, severe, and critical) according to the fifth edition of the Guidelines on the Diagnosis and Treatment of COVID-19 issued by the National Health Commission of China.Measurements and Main Results: The incidence of comorbidities was higher in the severe (46.3%) and critical (67.1%) groups than in the moderate group (37.8%). More patients were taking angiotensin-converting enzyme inhibitors/angiotensin II receptor blockers in the moderate group than in the severe and critical groups. More patients had multiple lung lobe involvement and pleural effusion in the critical group than in the moderate group. More patients received antiviral agents within the first 4 days in the moderate group than in the severe group, and more patients received antibiotics and corticosteroids in the critical and severe groups. Patients >75 years old had a significantly lower survival rate than younger patients.Conclusions: Multiple organ dysfunction and impaired immune function were the typical characteristics of patients with severe or critical illness. There was a significant difference in the use of angiotensin-converting enzyme inhibitors/angiotensin II receptor blockers among patients with different severities of disease. Involvement of multiple lung lobes and pleural effusion were associated with the severity of COVID-19. Advanced age (≥75 yr) was a risk factor for mortality.


Subject(s)
Coronavirus Infections/physiopathology , Pneumonia, Viral/physiopathology , Adult , Age Factors , Aged , Angiotensin Receptor Antagonists/therapeutic use , Angiotensin-Converting Enzyme Inhibitors/therapeutic use , Betacoronavirus , China/epidemiology , Comorbidity , Coronavirus Infections/mortality , Critical Illness , Female , Hospital Mortality , Humans , Incidence , Lung/pathology , Male , Middle Aged , Multiple Organ Failure/virology , Pandemics , Pleural Effusion/virology , Pneumonia, Viral/mortality , Tomography, X-Ray Computed
SELECTION OF CITATIONS
SEARCH DETAIL