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EuropePMC; 2021.
Preprint in English | EuropePMC | ID: ppcovidwho-313366


Background: Blood laboratory tests are the most reliable methods for the diagnosis and assessment of vital organs’ functions and the body’s response to infection. Herein, we compared the results of dynamic blood tests between the survivor and non-survivor group of patients with coronavirus disease 2019 (COVID-19) and aimed to determine the predicted and tricky week for death and surveillance. Methods: : The survivor and non-survivor groups were compared using biochemical blood tests, routine blood tests, and coagulation blood tests over four weeks of investigation. Results: : Blood urea nitrogen, creatinine, high-sensitivity C-reactive protein, total bile acid, neutrophil count, white blood cell count, D-dimer, fibrin and fibrinogen degradation product, and prothrombin time showed significantly higher levels in the non-survivor group than the survivor group. Only pre-albumin, eosinophil count, lymphocyte count, red blood cell count, platelet count, hemoglobin, and prothrombin activity tests were significantly higher in the survivor group than the non-survivor group. Generally, the third week of the non-survivor’s group could be regarded as the predicted week for death based on all tests except for creatinine, pre-albumin, total bile acid, monocyte count, white blood cell count, and prothrombin activity. The tricky week in the non-survivor group was the second week in all tests except for pre-albumin, basophil count, eosinophil count, lymphocyte count, platelet count, D-dimer, and fibrin and fibrinogen degradation product. Conclusions: : Based on our study, specific attention should be given to some weeks with respect to their related tests as predicted or tricky for death or surveillance, respectively.

Zhonghua Wei Zhong Bing Ji Jiu Yi Xue ; 32(10): 1174-1177, 2020 Oct.
Article in Chinese | MEDLINE | ID: covidwho-1067794


OBJECTIVE: To analyze the clinical characteristics and prognosis of coronavirus disease 2019 (COVID-19) patients complicated with pneumothorax. METHODS: The clinical data of 7 COVID-19 patients complicated with pneumothorax admitted to Huanggang Central Hospital from January 3 to March 10, 2020 were retrospectively analyzed. The clinical features, diagnosis and treatment were summarized, and experience in the treatment of COVID-19 was shared. RESULTS: (1) General information: among the 7 patients, 5 were males and 2 were females. Four of them had no underlying disease, and 1 had a history of diabetes and hypertension. One patient had only a history of hypertension. There were 6 cases of right pneumothorax and 1 case of bilateral pneumothorax. The 7 patients had a long hospital stay, all over 4 weeks, mostly complicated with multiple organ dysfunction. (2) Imaging examination: 1 case evolved from the early stage to the advanced stage within 1 week and to the severe stage within 2 weeks. Pneumothorax occurred 4 weeks later, and was absorbed within 2 weeks. The remaining 6 patients presented progressive stage on admission, all of them advanced to severe stage within 1 to 2 weeks, and most of them presented diffused consolidation shadows, striation shadows and fibrosis of both lungs, obvious pleural adhesion, and extremely slow lesion absorption. (3) Treatment: 1 severe patient with pneumothorax 4 weeks after onset was given non-invasive mechanical ventilation. The remaining 6 critically ill patients were treated with endotracheal intubation and mechanical ventilation. Five patients were treated with mechanical ventilation within 3 days after the occurrence of pneumothorax, and 1 patient was treated with mechanical ventilation after 11 days. (4) Outcome: 1 patient without endotracheal intubation was continuously given nasal high-flow oxygen therapy, and the condition was stable. Four of the 6 patients complicated with pneumothorax after endotracheal intubation died, and the other 2 patients successfully removed the drainage tube within 2 weeks of closed thoracic drainage, and their condition gradually stabilized. CONCLUSIONS: COVID-19 complicated with pneumothorax is a dangerous disease with poor prognosis, and should be paid adequate attention.

Betacoronavirus , Coronavirus Infections , Pandemics , Pneumonia, Viral , Pneumothorax , COVID-19 , Coronavirus Infections/complications , Female , Humans , Male , Pneumonia, Viral/complications , Pneumothorax/etiology , Retrospective Studies , SARS-CoV-2
Virulence ; 11(1): 1394-1401, 2020 12.
Article in English | MEDLINE | ID: covidwho-872896


We previously reported that sputum induction was more sensitive than throat swabs for the detection of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in two convalescent coronavirus disease 2019 (COVID-19) patients; however, the value and safety of induced sputum testing require further study. We conducted a prospective multi-center cross-sectional study to compare induced sputum to throat swabs for SARS-CoV-2 detection. Confirmed COVID-19 patients from six hospitals in six cities across China who received one or more negative RT-PCR result for SARS-CoV-2 were enrolled, and paired specimens (induced sputum and throat swabs; 56 cases) were assayed. In three paired samples, both the induced sputum and throat swabs were positive for SARS-CoV-2. The positive rate for induced sputum was significantly higher than for throat swabs both overall (28.6% vs 5.4%, respectively; p < 0.01). Patients were divided according to time span from onset of illness to sample collection into the more-than-30-day (n = 26) and less-than-30-day (n = 30) groups. The positive rate for induced sputum was also significantly higher than for throat swabs in the less-than-30-day group (53.3% vs 10.0%, respectively; p < 0.001). For the more-than-30-day group, all paired samples were negative for SARS-CoV-2. Blood oxygen saturation, respiratory rate, and heart rate remained stable during sputum induction and no staff were infected. Because induced sputum is more reliable and has a lower false-negative rate than throat swabs, we believe induced sputum is more useful for the confirmation of COVID-19 and is safer as a criterion for release from quarantine.

Betacoronavirus/isolation & purification , Clinical Laboratory Techniques/methods , Coronavirus Infections/diagnosis , Pneumonia, Viral/diagnosis , Sputum/virology , Adolescent , Adult , Aged , Aged, 80 and over , Betacoronavirus/genetics , Bronchoalveolar Lavage Fluid/virology , COVID-19 , COVID-19 Testing , China , Cross-Sectional Studies , False Negative Reactions , Female , Humans , Male , Middle Aged , Pandemics , Prospective Studies , Reverse Transcriptase Polymerase Chain Reaction , SARS-CoV-2 , Sensitivity and Specificity , Young Adult