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1.
Semin Liver Dis ; 42(2): 151-158, 2022 05.
Article in English | MEDLINE | ID: covidwho-1900715

ABSTRACT

With the spread of coronavirus disease 2019 (COVID-19) worldwide, extrapulmonary lesions, including liver dysfunction, have attracted growing attention. The mechanisms underlying liver dysfunction in COVID-19 remain unclear. The reported prevalence of liver dysfunction varies widely across studies. In addition, its impact on clinical outcomes and its recovery after discharge are still controversial. In this review, pathological and laboratory findings were analyzed to reveal the potential mechanisms of COVID-19-induced liver injury from onset to recovery. Four patterns of liver damage were summarized according to the pathological findings, including hypoxemia and shock changes, vascular thrombosis and vascular damage, bile duct damage, and other histological changes. With a strict definition, the prevalence of liver dysfunction was not as high as reported. Meanwhile, liver dysfunction improved during the process of recovery. Nevertheless, the definite liver dysfunction was significantly associated with severe clinical course, which should not be ignored.


Subject(s)
COVID-19 , Liver Diseases , Thrombosis , COVID-19/complications , Humans
2.
EuropePMC; 2020.
Preprint in English | EuropePMC | ID: ppcovidwho-325432

ABSTRACT

Background: Elderly patients with COVID-19 were shown to have a high case-fatality rate. We aimed to explore the risk factors associated with death in patients over 70 years old (yo). Methods: : In this retrospective study, we enrolled patients over 70 yo with COVID-19 between January 20 and February 15, 2020. Epidemiological, demographic, and clinical data were collected. Univariate and multivariate Cox regression methods were used to explore the risk factors. Results: : A total of 147 patients were enrolled. The case-fatality rate was 28.6%. Multivariate Cox proportional hazard regression showed that clinical subtypes including the severe type (HR = 2.983, 95% CI: 1.231–7.226, P = 0.016) and the critical type (HR = 3.267, 95%CI: 1.009–10.576, P = 0.048) were associated with increasing risk of death when compared with the general type. Blood urea nitrogen greater than 9.5 mmol/L (HR = 2.805, 95% CI: 1.141–6.892, P = 0.025) on admission was an independent risk factor for death among laboratory findings. Conclusion: The patients over 70 yo with COVID-19 had a high case-fatality rate. The risk factors including clinical subtypes and blood urea nitrogen greater than 9.5 mmol/L could help physicians to identify elderly patients with poor clinical outcomes at an early stage.

3.
BMC Infect Dis ; 21(1): 821, 2021 Aug 16.
Article in English | MEDLINE | ID: covidwho-1374104

ABSTRACT

BACKGROUND: Elderly patients with COVID-19 were shown to have a high case-fatality rate. We aimed to explore the risk factors associated with death in patients over 70 years old (yr). METHODS: In this retrospective study, we enrolled consecutively hospitalized patients over 70 yr with COVID-19 between January 20 and February 15, 2020 in Renmin Hospital of Wuhan University. Epidemiological, demographic, and clinical data were collected. Clinical subtypes, including mild, moderate, severe, and critical types, were used to evaluate the severity of disease. Patients were classified into two groups: survivor and non-survivor groups. Clinical data were compared between the two groups. Univariable and multivariable Cox regression methods were used to explore the risk factors. RESULTS: A total of 147 patients were enrolled. The case-fatality rate was 28.6%. Multivariable Cox proportional hazard regression showed that clinical subtypes, including the severe type (HR = 2.983, 95% CI: 1.231-7.226, P = 0.016) and the critical type (HR = 3.267, 95%CI: 1.009-10.576, P = 0.048), were associated with increasing risk of death when compared with the general type. Blood urea nitrogen greater than 9.5 mmol/L (HR = 2.805, 95% CI: 1.141-6.892, P = 0.025) on admission was an independent risk factor for death among laboratory findings. CONCLUSION: The patients over 70 yr with COVID-19 had a high case-fatality rate. The risk factors, including clinical subtypes and blood urea nitrogen greater than 9.5 mmol/L, could help physicians to identify elderly patients with poor clinical outcomes at an early stage.


Subject(s)
COVID-19/mortality , Aged , Aged, 80 and over , COVID-19/ethnology , China/epidemiology , Female , Hospital Mortality , Humans , Male , Prognosis , Retrospective Studies , Risk Factors , SARS-CoV-2
4.
BMC Infect Dis ; 21(1): 821, 2021 Aug 16.
Article in English | MEDLINE | ID: covidwho-1357021

ABSTRACT

BACKGROUND: Elderly patients with COVID-19 were shown to have a high case-fatality rate. We aimed to explore the risk factors associated with death in patients over 70 years old (yr). METHODS: In this retrospective study, we enrolled consecutively hospitalized patients over 70 yr with COVID-19 between January 20 and February 15, 2020 in Renmin Hospital of Wuhan University. Epidemiological, demographic, and clinical data were collected. Clinical subtypes, including mild, moderate, severe, and critical types, were used to evaluate the severity of disease. Patients were classified into two groups: survivor and non-survivor groups. Clinical data were compared between the two groups. Univariable and multivariable Cox regression methods were used to explore the risk factors. RESULTS: A total of 147 patients were enrolled. The case-fatality rate was 28.6%. Multivariable Cox proportional hazard regression showed that clinical subtypes, including the severe type (HR = 2.983, 95% CI: 1.231-7.226, P = 0.016) and the critical type (HR = 3.267, 95%CI: 1.009-10.576, P = 0.048), were associated with increasing risk of death when compared with the general type. Blood urea nitrogen greater than 9.5 mmol/L (HR = 2.805, 95% CI: 1.141-6.892, P = 0.025) on admission was an independent risk factor for death among laboratory findings. CONCLUSION: The patients over 70 yr with COVID-19 had a high case-fatality rate. The risk factors, including clinical subtypes and blood urea nitrogen greater than 9.5 mmol/L, could help physicians to identify elderly patients with poor clinical outcomes at an early stage.


Subject(s)
COVID-19/mortality , Aged , Aged, 80 and over , COVID-19/ethnology , China/epidemiology , Female , Hospital Mortality , Humans , Male , Prognosis , Retrospective Studies , Risk Factors , SARS-CoV-2
5.
Ann Surg ; 272(6): e321-e328, 2020 12.
Article in English | MEDLINE | ID: covidwho-873174

ABSTRACT

OBJECTIVE: To describe the epidemiologic features and clinical courses of gastrointestinal cancer patients with pre/asymptomatic COVID-19 and to explore evidence of SARS-CoV-2 in the surgically resected specimens. SUMMARY BACKGROUND DATA: The advisory of postponing or canceling elective surgeries escalated a worldwide debate regarding the safety and feasibility of performing elective surgical procedures during this pandemic. Limited data are available on gastrointestinal cancer patients with pre/asymptomatic COVID-19 undergoing surgery. METHODS: Clinical data were retrospectively collected and analyzed. Surgically resected specimens of the cases with confirmed COVID-19 were obtained to detect the expression of ACE2 and the presence of SARS-CoV-2. RESULTS: A total of 52 patients (male, 34) with a median age 62.5 years were enrolled. All the patients presented no respiratory symptoms or abnormalities on chest computed tomography before surgery. Six patients (11.5%) experienced symptom onset and were confirmed to be COVID-19. All were identified to be preoperatively pre/asymptomatic, as 5 were with SARS-CoV-2 presenting in cytoplasm of enterocytes or macrophages from the colorectal tissues and 1 had symptom onset immediately after surgery. The case fatality rate in patients with COVID-19 was 16.7%, much higher than those without COVID-19 (2.2%). CONCLUSIONS: Gastrointestinal cancer patients with pre/asymptomatic COVID-19 were at high risk of postoperative onset and death. At current pandemic, elective surgery should be postponed or canceled. It highlights the need for investigating the full clinical spectrum and natural history of this infection. The early colorectal tropism of SARS-CoV-2 may have major implications on prevention, diagnosis, and treatment of COVID-19.


Subject(s)
Asymptomatic Infections , COVID-19 , Gastrointestinal Neoplasms/surgery , Gastrointestinal Neoplasms/virology , SARS-CoV-2/isolation & purification , Aged , Asymptomatic Infections/epidemiology , COVID-19/complications , COVID-19/diagnosis , COVID-19/epidemiology , Elective Surgical Procedures , Female , Gastrointestinal Neoplasms/complications , Gastrointestinal Neoplasms/epidemiology , Humans , Male , Middle Aged , Postoperative Complications/epidemiology , Postoperative Complications/virology , Retrospective Studies
6.
SSRN; 2020.
Preprint | SSRN | ID: ppcovidwho-583

ABSTRACT

Background: COVID-19 is an emerging infectious disease that first reported in China and has spread worldwide. We aimed to explore the clinical variables associa

8.
JAMA ; 2020.
Article | WHO COVID | ID: covidwho-884

ABSTRACT

Previous studies suggest that COVID-19 is more likely to infect older adult men, particularly those with chronic comorbidities.2-4 Few infections in children have been reported. We identified all infected infants in China and described demographic, epidemiologic, and clinical features.

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