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1.
Can J Infect Dis Med Microbiol ; 2020: 7320813, 2020.
Article in English | MEDLINE | ID: covidwho-721224

ABSTRACT

Objective: We aimed to explore the predictive effectiveness of blood biochemical indexes for COVID-19 severity. Method: We retrospectively analyzed the clinical data of COVID-19 patients who were cured and discharged from the Public Health Treatment Center of Changsha from January 30, 2020, to February 19, 2020. According to the clinical classification of the disease, the patients were divided into severe and nonsevere groups. General clinical data and underlying medical conditions were recorded through the electronic medical record (EMR) system. Laboratory examination results of the patients during their hospitalization were collected, including the first results for erythrocyte sedimentation rate (ESR), C-reactive protein (CRP), peripheral blood lymphocyte ratio and count, and peripheral blood white blood cell (WBC) count. Univariate and multivariate logistic regression models were used to analyze the predictive effectiveness of blood biochemical indexes and other related factors for COVID-19 severity. Result: In all, 108 COVID-19 patients (median age: 43.9 years (range: 1-75); male patients: 56 (51.85%)) were enrolled, of whom 24 (22.22%) showed severe disease and 84 (77.78%) showed nonsevere disease, and two in 24 patients with severe disease developed into a critically severe type and died. Fever was the most common onset symptom (67.59%), followed by cough (48.15%) and fatigue (37.04%). Comorbidities were important factors affecting the severity of COVID-19, and among the patients with severe disease, the proportion with comorbidities was 70.83%, and the proportion without comorbidities was 29.17%. The intergroup difference was significant (P < 0.05). In patients with CRP levels (mg/L) of ≤8, >8-≤20, >20-≤40, and >40, the proportions of those with severe and nonsevere disease were 0 to 32, 7 to 19, 6 to 23, and 11 to 10, respectively; the intergroup difference was significant (P < 0.05). Conclusion: The presence or absence of comorbidities and CRP elevation were independent significant predictors of COVID-19 severity, and hypertension was found as the most common comorbidity in patients with severe disease.

2.
Front Cell Infect Microbiol ; 10: 404, 2020.
Article in English | MEDLINE | ID: covidwho-705170

ABSTRACT

Background: The ABO blood group system has been associated with multiple infectious diseases, including hepatitis B, dengue haemorrhagic fever and so on. Coronavirus disease 2019 (COVID-19) is a new respiratory infectious disease and the relationship between COVID-19 and ABO blood group system needs to be explored urgently. Methods: A hospital-based case-control study was conducted at Zhongnan Hospital of Wuhan University from 1 January 2020 to 5 March 2020. A total of 105 COVID-19 cases and 103 controls were included. The blood group frequency was tested with the chi-square statistic, and odds ratios (ORs) with 95% confidence intervals (CIs) were calculated between cases and controls. In addition, according to gender, the studied population was divided into two subgroups, and we assessed the association between cases and controls by gender. Finally, considering lymphopenia as a feature of COVID-19, the relationship between the ABO blood group and the lymphocyte count was determined in case samples. Results: The frequencies of blood types A, B, AB, and O were 42.8, 26.7, 8.57, and 21.9%, respectively, in the case group. Association analysis between the ABO blood group and COVID-19 indicated that there was a statistically significant difference for blood type A (P = 0.04, OR = 1.33, 95% CI = 1.02-1.73) but not for blood types B, AB or O (P = 0.48, OR = 0.90, 95% CI = 0.66-1.23; P = 0.61, OR = 0.88, 95% CI = 0.53-1.46; and P = 0.23, OR = 0.82, 95% CI = 0.58-1.15, respectively). An analysis stratified by gender revealed that the association was highly significant between blood type A in the female subgroup (P = 0.02, OR = 1.56, 95% CI = 1.08-2.27) but not in the male subgroup (P = 0.51, OR = 1.14, 95% CI = 0.78-1.67). The average level of lymphocyte count was the lowest with blood type A in patients, however, compared with other blood types, there was still no significant statistical difference. Conclusions: Our findings provide epidemiological evidence that females with blood type A are susceptible to COVID-19. However, these research results need to be validated in future studies.


Subject(s)
ABO Blood-Group System/blood , Coronavirus Infections/blood , Genetic Predisposition to Disease , Lymphopenia/blood , Pneumonia, Viral/blood , Betacoronavirus , Blood Grouping and Crossmatching , Case-Control Studies , Disease Susceptibility/blood , Female , Humans , Lymphocyte Count , Male , Middle Aged , Pandemics , Retrospective Studies , Sex Factors
3.
Disaster Med Public Health Prep ; : 1-3, 2020 Jul 15.
Article in English | MEDLINE | ID: covidwho-646995

ABSTRACT

OBJECTIVES: The novel coronavirus disease 2019 (COVID-19) pandemic has spread to over 213 countries and territories. We sought to describe the clinical features of fatalities in patients with severe COVID-19. METHODS: We conducted an Internet-based retrospective cohort study through retrieving the clinical information of 100 COVID-19 deaths from nonduplicating incidental reports in Chinese provincial and other governmental websites between January 23 and March 10, 2020. RESULTS: Approximately 6 of 10 COVID-19 deaths were males (64.0%). The average age was 70.7 ± 13.5 y, and 84% of patients were elderly (over age 60 y). The mean duration from admission to diagnosis was 2.2 ± 3.8 d (median: 1 d). The mean duration from diagnosis to death was 9.9 ± 7.0 d (median: 9 d). Approximately 3 of 4 cases (76.0%) were complicated by 1 or more chronic diseases, including hypertension (41.0%), diabetes (29.0%) and coronary heart disease (27.0%), respiratory disorders (23.0%), and cerebrovascular disease (12.0%). Fever (46.0%), cough (33.0%), and shortness of breath (9.0%) were the most common first symptoms. Multiple organ failure (67.9%), circulatory failure (20.2%), and respiratory failure (11.9%) are the top 3 direct causes of death. CONCLUSIONS: COVID-19 deaths are mainly elderly and patients with chronic diseases especially cardiovascular disorders and diabetes. Multiple organ failure is the most common direct cause of death.

4.
World J Pediatr ; 16(4): 326-332, 2020 Aug.
Article in English | MEDLINE | ID: covidwho-613534

ABSTRACT

During the COVID-19 epidemic, it is important for ensuring infection prevention and control in the pediatric respiratory clinics. Herein, we introduced the practice of infection prevention and control in pediatric respiratory clinics in China. Triage measures for patients who visit respiratory clinics, quality control for pediatric respiratory clinics and other preventive measures for related examinations and treatment have been introduced in this review article.


Subject(s)
Ambulatory Care/organization & administration , Communicable Disease Control/organization & administration , Coronavirus Infections/prevention & control , Pandemics/prevention & control , Pneumonia, Viral/prevention & control , Practice Guidelines as Topic , Respiratory Tract Diseases/therapy , Adolescent , Ambulatory Care Facilities/organization & administration , Child , Child, Preschool , China/epidemiology , Coronavirus Infections/epidemiology , Female , Humans , Infection Control/organization & administration , Male , Pandemics/statistics & numerical data , Pneumonia, Viral/epidemiology , Respiratory Tract Diseases/diagnosis , Respiratory Tract Diseases/epidemiology
5.
J Allergy Clin Immunol Pract ; 8(8): 2585-2591.e1, 2020 09.
Article in English | MEDLINE | ID: covidwho-609222

ABSTRACT

BACKGROUND: The clinical management of coronavirus disease 2019 (COVID-19) is dependent on understanding the underlying factors that contribute to the disease severity. In the absence of effective antiviral therapies, other host immunomodulatory therapies such as targeting inflammatory response are currently being used without clear evidence of their effectiveness. Because inflammation is an essential component of host antiviral mechanisms, therapies targeting inflammation may adversely affect viral clearance and disease outcome. OBJECTIVE: To understand whether the persistent presence of the virus is a key determinant in the disease severity during COVID-19 and to determine whether the viral reactivation in some patients is associated with infectious viral particles. METHODS: The data for patients were available including the onset of the disease, duration of viral persistence, measurements of inflammatory markers such as IL-6 and C-reactive protein, chest imaging, disease symptoms, and their durations among others. Follow-up tests were performed to determine whether the viral negative status persists after their recovery. RESULTS: Our data show that patients with persistent viral presence (>16 days) have more severe disease outcomes including extensive lung involvement and requirement of respiratory support. Two patients who died of COVID-19 were virus-positive at the time of their death. Four patients demonstrated virus-positive status on the follow-up tests, and these patient samples were sent to viral culture facility where virus culture could not be established. CONCLUSIONS: These data suggest that viral persistence is the key determining factor of the disease severity. Therapies that may impair the viral clearance may impair the host recovery from COVID-19.

6.
Sleep Med ; 72: 1-4, 2020 08.
Article in English | MEDLINE | ID: covidwho-342920

ABSTRACT

OBJECTIVE: To evaluate sleep disturbances of Chinese frontline medical workers (FMW) under the outbreak of coronavirus disease 2019 (COVID-19), and make a comparison with non-FMW. METHODS: The medical workers from multiple hospitals in Hubei Province, China, volunteered to participate in this cross-sectional study. An online questionnaire, including Pittsburgh Sleep Quality Index (PSQI), Athens Insomnia Scale (AIS) and Visual Analogue Scale (VAS), was used to evaluate sleep disturbances and mental status. Sleep disturbances were defined as PSQI>6 points or/and AIS>6 points. We compared the scores of PSQI, AIS, anxiety and depression VAS, as well as prevalence of sleep disturbances between FMW and non-FMW. RESULTS: A total of 1306 subjects (801 FMW and 505 non-FMW) were enrolled. Compared to non-FMW, FMW had significantly higher scores of PSQI (9.3 ± 3.8 vs 7.5 ± 3.7; P < 0.001; Cohen's d = 0.47), AIS (6.9 ± 4.3 vs 5.3 ± 3.8; P < 0.001; Cohen's d = 0.38), anxiety (4.9 ± 2.7 vs 4.3 ± 2.6; P < 0.001; Cohen's d = 0.22) and depression (4.1 ± 2.5 vs 3.6 ± 2.4; P = 0.001; Cohen's d = 0.21), as well as higher prevalence of sleep disturbances according to PSQI > 6 points (78.4% vs 61.0%; relative risk [RR] = 1.29; P < 0.001) and AIS > 6 points (51.7% vs 35.6%; RR = 1.45; P < 0.001). CONCLUSION: FMW have higher prevalence of sleep disturbances and worse sleep quality than non-FMW. Further interventions should be administrated for FMW, aiming to maintain their healthy condition and guarantee their professional performance in the battle against COVID-19.


Subject(s)
Anxiety/epidemiology , Coronavirus Infections/epidemiology , Depression/epidemiology , Health Personnel/statistics & numerical data , Pneumonia, Viral/epidemiology , Sleep Initiation and Maintenance Disorders/epidemiology , Adult , Anxiety/psychology , Betacoronavirus , Case-Control Studies , China/epidemiology , Cross-Sectional Studies , Depression/psychology , Disease Outbreaks , Female , Health Personnel/psychology , Humans , Male , Pandemics , Prevalence , Sex Factors , Sleep Initiation and Maintenance Disorders/physiopathology , Sleep Initiation and Maintenance Disorders/psychology , Sleep Wake Disorders/epidemiology , Sleep Wake Disorders/physiopathology , Visual Analog Scale
7.
Zhongguo Zhong Yao Za Zhi ; 45(7): 1531-1535, 2020 Apr.
Article in Chinese | MEDLINE | ID: covidwho-324713

ABSTRACT

It is an essential task to discuss the death cases for clinicians. During the emergent public events, the report and analysis of death cases is of far-reaching significance. The epidemic of coronavirus disease 2019(COVID-19) has brought huge losses to China, and the medical system has been sustaining tremendous pressure. The best weapon to defeat the epidemic is medical data and related scientific research, of which the systematic analysis and efficient use of death cases is a key step. Based on the incomplete record of death case report, the lack of humanistic perspective and patient report, every department and institution is facing great challenge in terms of data management. Given that the relevant systems need to be improved, and that the integration of standardized reports and clinical research is not mature,as well as other problems, we put forward several methodological suggestions: ① Establish national medical and health data center and improve relevant laws and regulations. ② Increase investment in medical data management and start data collection and analysis as early as possible during the epidemic. ③ Refine the content of death case report and promote the standardization of report. ④ Pay close attention to the report of death cases, review, summary and analysis. More importantly, we should continue to build and improve platforms and programs related to disease control, carry out epidemic-associated scientific research, enhance the managing efficiency of public health data, elevate the anti-risk capability of our medical system, and promote the steady progress of the health China strategy.


Subject(s)
Betacoronavirus , Coronavirus Infections , Pandemics , Pneumonia, Viral , Humans
8.
Zhongguo Zhong Yao Za Zhi ; 45(7): 1526-1530, 2020 Apr.
Article in Chinese | MEDLINE | ID: covidwho-324709

ABSTRACT

The analysis and utilization of clinical scientific research data is an effective means to promote the progress of diagnosis and treatment, and a key step in the development of medical sciences. During the epidemic of coronavirus disease 2019(COVID-19), how to transform the limited diagnostic data into clinical research resources has attracted much attention. Based on the low efficiency of data collection and extraction, the inconsistency of data analysis, the irregularity of data report and the high timeliness of data update during the epidemic, this paper briefly analyzed the background and reasons of data application under the current situation, and then discusses the problems and feasible solutions of clinical data applications under the epidemic situation and, more importantly, for future medical clinical research methods. We put forward several methodological suggestions: ① gradually improve the medical big data model and establish the national medical health data center; ② improve the scientific research literacy of medical staff and popularize the basic skills and knowledge of GCP; ③ promote a scientific, networked and shared data collection and management mode; ④ use the mixed research method and collective analysis to improve the efficiency of clinical data analysis; ⑤ pay attention to narration of the medical feelings and emphasize the humanistic data of clinical medicine. It is expected to promote the standardized and reasonable use of clinical scientific research data, the rigorous integration of expert opinions, and ultimately the development of big data for national health care.


Subject(s)
Betacoronavirus , Coronavirus Infections , Pandemics , Pneumonia, Viral , Coronavirus Infections/epidemiology , Humans , Pneumonia, Viral/epidemiology
10.
Indian pediatrics ; 2020.
Article | WHO COVID | ID: covidwho-38558

ABSTRACT

OBJECTIVE: The purpose of this study was to investigate chest computed tomography (CT) findings in children with coronavirus disease-19 (COVID-19) pneumonia in our hospital METHODS: This study included 22 pediatric patients with confirmed COVID-19 from January to March 2020 The chest CT images and clinical data were reviewed RESULTS: The most prevalent presenting symptoms were fever (64%) and cough (59%), and a mildly elevated mean (SD) C-reactive protein (CRP) level of 11 22(11 06) and erythrocyte sedimentation rate of 18 8 (15 17) were detected The major CT abnormalities observed were mixed ground-glass opacity and consolidation lesions (36%), consolidations (32%), and ground-glass opacities (14%) Peripheral distribution (45%) of lung lesions was predominant Most of the lesions were multilobar (68%), with an average of three lung segments involved CONCLUSION: Children with COVID-19 had relatively milder symptoms and less severe lung inflammation than adults Chest CT plays an important role in the management of children with COVID-19 pneumonia

11.
Clin Res Cardiol ; 109(5): 531-538, 2020 May.
Article in English | MEDLINE | ID: covidwho-7790

ABSTRACT

BACKGROUND: Studies have reminded that cardiovascular metabolic comorbidities made patients more susceptible to suffer 2019 novel corona virus (2019-nCoV) disease (COVID-19), and exacerbated the infection. The aim of this analysis is to determine the association of cardiovascular metabolic diseases with the development of COVID-19. METHODS: A meta-analysis of eligible studies that summarized the prevalence of cardiovascular metabolic diseases in COVID-19 and compared the incidences of the comorbidities in ICU/severe and non-ICU/severe patients was performed. Embase and PubMed were searched for relevant studies. RESULTS: A total of six studies with 1527 patients were included in this analysis. The proportions of hypertension, cardia-cerebrovascular disease and diabetes in patients with COVID-19 were 17.1%, 16.4% and 9.7%, respectively. The incidences of hypertension, cardia-cerebrovascular diseases and diabetes were about twofolds, threefolds and twofolds, respectively, higher in ICU/severe cases than in their non-ICU/severe counterparts. At least 8.0% patients with COVID-19 suffered the acute cardiac injury. The incidence of acute cardiac injury was about 13 folds higher in ICU/severe patients compared with the non-ICU/severe patients. CONCLUSION: Patients with previous cardiovascular metabolic diseases may face a greater risk of developing into the severe condition and the comorbidities can also greatly affect the prognosis of the COVID-19. On the other hand, COVID-19 can, in turn, aggravate the damage to the heart.


Subject(s)
Betacoronavirus , Cardiovascular Diseases/complications , Coronavirus Infections , Metabolic Syndrome/complications , Pandemics , Pneumonia, Viral , Cardiovascular Diseases/epidemiology , China , Coronavirus Infections/complications , Coronavirus Infections/epidemiology , Humans , Metabolic Syndrome/epidemiology , Pneumonia, Viral/complications , Pneumonia, Viral/epidemiology , Prevalence
12.
J Infect ; 80(6): 671-693, 2020 06.
Article in English | MEDLINE | ID: covidwho-3479
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