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1.
J Med Virol ; 2020 Jul 21.
Article in English | MEDLINE | ID: covidwho-689535

ABSTRACT

BACKGROUND: There's an outbreak of COVID-19 since December 2019, first in Wuhan. It has caused huge medical challenges to Hubei Province with currently more than 67 thousand confirmed cases till March 08, 2020. Identification, there is no clinically effective drug. Isolation and masks are essential to limit human-to-human transmission initially. The nucleic acid test (NAT) of COVID-19 currently was the most reliable established laboratory diagnosis method in clinical. METHODS: From February 8th, 2020 to March 7th, 2020, 4254 cases were collected for analysis at six nucleic acid collection sites in the community medical team of Hubei Provincial Hospital of Traditional Chinese Medicine, which cover almost all groups who need NAT in Wuhan. Distribution of positive rates in different sites by genders, ages or occupations were compared. RESULTS: The positive rates of different sites from high to low were: hospital wards (24.71%) > fever clinics (16.57%) > nursing homes (5.51%) > isolation hotels (5.30%) > rehabilitation stations (1.36%) > close contact sites (0.17%). The confirmed patients in isolation hotels, hospital ward and fever clinical were mainly middle-aged and elderly, and most of them were women. The positive rate in isolation hotels and fever clinics gradually decreased over time. There were no significant differences between genders among those six nucleic acid collection sites (P <0.05). CONCLUSIONS: The hospital wards have the highest positive rate; however, close contact sites have lowest one. Patients who are discharged from hospitals may still have potential risks. Middle-aged and older people remain the focus of epidemic prevention and control. This article is protected by copyright. All rights reserved.

2.
Curr. Urol. ; 2020.
Article in English | ELSEVIER | ID: covidwho-677848

ABSTRACT

Coronavirus disease 2019 (COVID-19) is a new infectious disease that first emerged in December 2019. It has infected more than 4,890,000 people in more than 200 countries. This virus can cause progressive respiratory symptoms and severe diseases such as organ failure and death. The complete genomic sequence of SARS-CoV-2 was determined after the virus's identification, and the sequence analysis showed that SARS-CoV-2 strains are genetically similar to SARS-CoV. Angiotensin converting enzyme II is an entry receptor for SARS-CoV-2, which is highly expressed in the kidney, so some patients had symptoms of kidney damage. Here we reviewed the current progress of COVID-19 and its urogenital manifestations. In this rapidly moving field, this review was comprehensive as of May 30, 2020.

4.
Endocrine ; 2020 Jul 23.
Article in English | MEDLINE | ID: covidwho-670320

ABSTRACT

PURPOSE: This essay aims to propose suggestions on what we can learn from previous investigations to conduct further studies on the potential mechanisms underlying the effect of diabetes mellitus on COVID-19. METHODS: We reviewed some literature on diabetes and other types of coronavirus infection such as Middle East respiratory syndrome (MERS) and severe acute respiratory syndrome (SARS) and made some summaries and comparisons. RESULTS: Diabetes affect the occurrence and progression of COVID-19. CONCLUSIONS: In-depth and comprehensive exploration of the mechanism of diabetes affecting COVID-19 should be carried out.

5.
Lancet ; 395(10223): 497-506, 2020 02 15.
Article in English | MEDLINE | ID: covidwho-665705

ABSTRACT

BACKGROUND: A recent cluster of pneumonia cases in Wuhan, China, was caused by a novel betacoronavirus, the 2019 novel coronavirus (2019-nCoV). We report the epidemiological, clinical, laboratory, and radiological characteristics and treatment and clinical outcomes of these patients. METHODS: All patients with suspected 2019-nCoV were admitted to a designated hospital in Wuhan. We prospectively collected and analysed data on patients with laboratory-confirmed 2019-nCoV infection by real-time RT-PCR and next-generation sequencing. Data were obtained with standardised data collection forms shared by WHO and the International Severe Acute Respiratory and Emerging Infection Consortium from electronic medical records. Researchers also directly communicated with patients or their families to ascertain epidemiological and symptom data. Outcomes were also compared between patients who had been admitted to the intensive care unit (ICU) and those who had not. FINDINGS: By Jan 2, 2020, 41 admitted hospital patients had been identified as having laboratory-confirmed 2019-nCoV infection. Most of the infected patients were men (30 [73%] of 41); less than half had underlying diseases (13 [32%]), including diabetes (eight [20%]), hypertension (six [15%]), and cardiovascular disease (six [15%]). Median age was 49·0 years (IQR 41·0-58·0). 27 (66%) of 41 patients had been exposed to Huanan seafood market. One family cluster was found. Common symptoms at onset of illness were fever (40 [98%] of 41 patients), cough (31 [76%]), and myalgia or fatigue (18 [44%]); less common symptoms were sputum production (11 [28%] of 39), headache (three [8%] of 38), haemoptysis (two [5%] of 39), and diarrhoea (one [3%] of 38). Dyspnoea developed in 22 (55%) of 40 patients (median time from illness onset to dyspnoea 8·0 days [IQR 5·0-13·0]). 26 (63%) of 41 patients had lymphopenia. All 41 patients had pneumonia with abnormal findings on chest CT. Complications included acute respiratory distress syndrome (12 [29%]), RNAaemia (six [15%]), acute cardiac injury (five [12%]) and secondary infection (four [10%]). 13 (32%) patients were admitted to an ICU and six (15%) died. Compared with non-ICU patients, ICU patients had higher plasma levels of IL2, IL7, IL10, GSCF, IP10, MCP1, MIP1A, and TNFα. INTERPRETATION: The 2019-nCoV infection caused clusters of severe respiratory illness similar to severe acute respiratory syndrome coronavirus and was associated with ICU admission and high mortality. Major gaps in our knowledge of the origin, epidemiology, duration of human transmission, and clinical spectrum of disease need fulfilment by future studies. FUNDING: Ministry of Science and Technology, Chinese Academy of Medical Sciences, National Natural Science Foundation of China, and Beijing Municipal Science and Technology Commission.


Subject(s)
Coronavirus Infections/diagnosis , Coronavirus Infections/epidemiology , Pneumonia, Viral/diagnosis , Pneumonia, Viral/epidemiology , Adult , Age Distribution , Aged , China/epidemiology , Comorbidity , Coronavirus Infections/complications , Coronavirus Infections/transmission , Cough/epidemiology , Cough/virology , Female , Fever/epidemiology , Fever/virology , Hospitalization/statistics & numerical data , Humans , Intensive Care Units/statistics & numerical data , Male , Middle Aged , Myalgia/epidemiology , Myalgia/virology , Pneumonia, Viral/complications , Pneumonia, Viral/transmission , Prognosis , Radiography, Thoracic , Respiratory Distress Syndrome, Adult/epidemiology , Respiratory Distress Syndrome, Adult/virology , Time Factors , Tomography, X-Ray Computed , Young Adult
6.
J Pediatr ; 2020 Jun 18.
Article in English | MEDLINE | ID: covidwho-662046

ABSTRACT

OBJECTIVES: To compare the clinical and laboratory features of severe acute respiratory syndrome 2003 (SARS) and coronavirus disease 2019 (COVID-19) in 2 Chinese pediatric cohorts, given that the causative pathogens and are biologically similar. STUDY DESIGN: This is a cross-sectional study reviewing pediatric patients with SARS (n = 43) and COVID-19 (n = 244) who were admitted to the Princess Margaret Hospital in Hong Kong and Wuhan Children's Hospital in Wuhan, respectively. Demographics, hospital length of stay, and clinical and laboratory features were compared. RESULTS: Overall, 97.7% of patients with SARS and 85.2% of patients with COVID-19 had epidemiologic associations with known cases. Significantly more patients with SARS developed fever, chills, myalgia, malaise, coryza, sore throat, sputum production, nausea, headache, and dizziness than patients with COVID-19. No patients with SARS were asymptomatic at the time of admission, whereas 29.1% and 20.9% of patients with COVID-19 were asymptomatic on admission and throughout their hospital stay, respectively. More patients with SARS required oxygen supplementation than patients with COVID-19 (18.6 vs 4.7%; P = .004). Only 1.6% of patients with COVID-19 and 2.3% of patients with SARS required mechanical ventilation. Leukopenia (37.2% vs 18.6%; P = .008), lymphopenia (95.4% vs 32.6%; P < .01), and thrombocytopenia (41.9% vs 3.8%; P < .001) were significantly more common in patients with SARS than in patients with COVID-19. The duration between positive and negative nasopharyngeal aspirate and the length in hospital stay were similar in patients with COVID-19, regardless of whether they were asymptomatic or symptomatic, suggesting a similar duration of viral shedding. CONCLUSIONS: Children with COVID-19 were less symptomatic and had more favorable hematologic findings than children with SARS.

7.
Data Brief ; (31)20200801.
Article in English | ELSEVIER | ID: covidwho-656394

ABSTRACT

Haematological and immunological data of children with COVID-19 infection is lacking. Between 21st January and 20th March 2020, 244 children who were confirmed to have COVID-19 infection and admitted to the Wuhan Children's Hospital, China were retrospectively reviewed. 193 children were considered as symptomatic, which was defined as having either the presence of clinical symptoms or the presence of CT thorax abnormalities. Their haematological and immunological profiles, including complete blood counts, lymphocyte subsets (T, B and NK cell counts), immunoglobulin (Ig) profiles (IgG, IgA and IgM) and cytokine profiles were analysed and compared between the symptomatic and asymptomatic groups. The median values and the interquartile ranges were calculated. Comparison was made using the Mann–Whitney U test. Children with symptomatic COVID-19 infection had significantly lower haemoglobin levels, but higher absolute lymphocyte and monocyte counts, IgG and IgA levels, as well as interleukin 6 (IL-6), IL-10, tumour necrosis factor alpha and interferon gamma levels. The obtained data will be utilized for further studies in comparing children and adults with COVID-19 infections in other parts of the world and with different severity.

8.
Eur Respir J ; 2020 Jul 16.
Article in English | MEDLINE | ID: covidwho-649672

ABSTRACT

BACKGROUND: Use of existing disease severity scores would greatly contribute to risk stratification and rationally resource allocation in COVID-19 pandemic. However, the performance of these scores in COVID-19 hospitalised patients with pneumonia was still unknown. METHODS: In this single center, retrospective study, all hospitalised patients with COVID-19 pneumonia from Wuhan Jin Yin-tan Hospital who had discharged or died as of February 15, 2020 were enrolled. Performance of PSI, CURB-65, A-DROP, CRB-65, SMART-COP, qSOFA and NEWS2 were validated. Net reclassification improvement (NRI) and integrated discrimination improvement (IDI) were also estimated. RESULTS: Among the 654 patients enrolled, 133 patients died and 521 were discharged. Areas of under curves (AUCs) of A-DROP, CURB-65, PSI, SMART-COP, NEWS2, CRB-65 and qSOFA in the prediction of in-hospital death were 0.87, 0.85, 0.85, 0.84, 0.81, 0.80 and 0.73 respectively. CONCLUSION: ADROP is a reliable tool for risk stratification of death in COVID-19 hospitalised patients on admission.

10.
Annals of translational medicine ; 8(11):689-689, 2020.
Article | WHO COVID | ID: covidwho-631894

ABSTRACT

Background: Since the first appearance in Wuhan, China in December 2019, the novel coronavirus disease (COVID-19) has posed serious threats to the public health in many Chinese places and overseas It is essential to quantify the transmissibility on real-time basis for designing public health responses Methods: We estimated the time-varying reproduction numbers in China, Hubei province and Wuhan city by using the renewable equation determined by the serial interval (SI) of COVID-19 We compare the average reproduction numbers in different periods of time to explore the effectiveness of the public health control measures against the COVID-19 epidemic Results: We estimated the reproduction numbers at 2 61 (95% CI: 2 47-2 75), 2 76 (95% CI: 2 54-2 95) and 2 71 (95% CI: 2 43-3 01) for China, Hubei province and Wuhan respectively We found that the reproduction number largely dropped after the city lockdown As of February 16, the three reproduction numbers further reduced to 0 98, 1 14 and 1 41 respectively Conclusions: The control of COVID-19 epidemic was effective in substantially reducing the disease transmissibility in terms of the reproduction number in China reduced to 0 98 as of February 16 At the same time, the reproduction number in Wuhan was probably still larger than 1, and thus the enhancement in the public health control was recommended to maintain

11.
Front Med ; 2020 Jul 03.
Article in English | MEDLINE | ID: covidwho-632554

ABSTRACT

The possible effects of angiotensin-converting enzyme inhibitors (ACEIs) or angiotensin II receptor blockers (ARBs) on COVID-19 disease severity have generated considerable debate. We performed a single-center, retrospective analysis of hospitalized adult COVID-19 patients in Wuhan, China, who had definite clinical outcome (dead or discharged) by February 15, 2020. Patients on anti-hypertensive treatment with or without ACEI/ARB were compared on their clinical characteristics and outcomes. The medical records from 702 patients were screened. Among the 101 patients with a history of hypertension and taking at least one anti-hypertensive medication, 40 patients were receiving ACEI/ARB as part of their regimen, and 61 patients were on antihypertensive medication other than ACEI/ARB. We observed no statistically significant differences in percentages of in-hospital mortality (28% vs. 34%, P = 0.46), ICU admission (20% vs. 28%, P = 0.37) or invasive mechanical ventilation (18% vs. 26%, P = 0.31) between patients with or without ACEI/ARB treatment. Further multivariable adjustment of age and gender did not provide evidence for a significant association between ACEI/ARB treatment and severe COVID-19 outcomes. Our findings confirm the lack of an association between chronic receipt of renin-angiotensin system antagonists and severe outcomes of COVID-19. Patients should continue previous anti-hypertensive therapy until further evidence is available.

13.
Virol Sin ; 35(3): 311-320, 2020 Jun.
Article in English | MEDLINE | ID: covidwho-617330

ABSTRACT

The mechanism of how SARS-CoV-2 causes severe multi-organ failure is largely unknown. Acute kidney injury (AKI) is one of the frequent organ damage in severe COVID-19 patients. Previous studies have shown that human renal tubule cells could be the potential host cells targeted by SARS-CoV-2. Traditional cancer cell lines or immortalized cell lines are genetically and phenotypically different from host cells. Animal models are widely used, but often fail to reflect a physiological and pathogenic status because of species tropisms. There is an unmet need for normal human epithelial cells for disease modeling. In this study, we successfully established long term cultures of normal human kidney proximal tubule epithelial cells (KPTECs) in 2D and 3D culture systems using conditional reprogramming (CR) and organoids techniques. These cells had the ability to differentiate and repair DNA damage, and showed no transforming property. Importantly, the CR KPTECs maintained lineage function with expression of specific transporters (SLC34A3 and cubilin). They also expressed angiotensin-converting enzyme 2 (ACE2), a receptor for SARS-CoV and SARS-CoV-2. In contrast, cancer cell line did not express endogenous SLC34A3, cubilin and ACE2. Very interestingly, ACE2 expression was around twofold higher in 3D organoids culture compared to that in 2D CR culture condition. Pseudovirion assays demonstrated that SARS-CoV spike (S) protein was able to enter CR cells with luciferase reporter. This integrated 2D CR and 3D organoid cultures provide a physiological ex vivo model to study kidney functions, innate immune response of kidney cells to viruses, and a novel platform for drug discovery and safety evaluation.


Subject(s)
Betacoronavirus/metabolism , Cell Culture Techniques/methods , Coronavirus Infections/virology , Coronavirus/metabolism , Epithelial Cells/virology , Kidney/virology , Pneumonia, Viral/virology , Animals , Betacoronavirus/pathogenicity , Cell Line , Coronavirus/pathogenicity , DNA Damage , Disease Models, Animal , Humans , Organoids , Pandemics , Peptidyl-Dipeptidase A/metabolism , Receptors, Cell Surface/metabolism , SARS Virus/metabolism , SARS Virus/pathogenicity , Sodium-Phosphate Cotransporter Proteins, Type IIc/metabolism , Spike Glycoprotein, Coronavirus/metabolism
14.
Geospat Health ; 15(1)2020 06 15.
Article in English | MEDLINE | ID: covidwho-614121

ABSTRACT

The cluster of pneumonia cases linked to coronavirus disease 2019 (Covid-19), first reported in China in late December 2019 raised global concern, particularly as the cumulative number of cases reported between 10 January and 5 March 2020 reached 80,711. In order to better understand the spread of this new virus, we characterized the spatial patterns of Covid-19 cumulative cases using ArcGIS v.10.4.1 based on spatial autocorrelation and cluster analysis using Global Moran's I (Moran, 1950), Local Moran's I and Getis-Ord General G (Ord and Getis, 2001). Up to 5 March 2020, Hubei Province, the origin of the Covid-19 epidemic, had reported 67,592 Covid-19 cases, while the confirmed cases in the surrounding provinces Guangdong, Henan, Zhejiang and Hunan were 1351, 1272, 1215 and 1018, respectively. The top five regions with respect to incidence were the following provinces: Hubei (11.423/10,000), Zhejiang (0.212/10,000), Jiangxi (0.201/10,000), Beijing (0.196/10,000) and Chongqing (0.186/10,000). Global Moran's I analysis results showed that the incidence of Covid-19 is not negatively correlated in space (p=0.407413>0.05) and the High-Low cluster analysis demonstrated that there were no high-value incidence clusters (p=0.076098>0.05), while Local Moran's I analysis indicated that Hubei is the only province with High-Low aggregation (p<0.0001).

15.
J Pediatr ; 2020 Jun 18.
Article in English | MEDLINE | ID: covidwho-611396

ABSTRACT

OBJECTIVES: To compare the clinical and laboratory features of severe acute respiratory syndrome 2003 (SARS) and coronavirus disease 2019 (COVID-19) in 2 Chinese pediatric cohorts, given that the causative pathogens and are biologically similar. STUDY DESIGN: This is a cross-sectional study reviewing pediatric patients with SARS (n = 43) and COVID-19 (n = 244) who were admitted to the Princess Margaret Hospital in Hong Kong and Wuhan Children's Hospital in Wuhan, respectively. Demographics, hospital length of stay, and clinical and laboratory features were compared. RESULTS: Overall, 97.7% of patients with SARS and 85.2% of patients with COVID-19 had epidemiologic associations with known cases. Significantly more patients with SARS developed fever, chills, myalgia, malaise, coryza, sore throat, sputum production, nausea, headache, and dizziness than patients with COVID-19. No patients with SARS were asymptomatic at the time of admission, whereas 29.1% and 20.9% of patients with COVID-19 were asymptomatic on admission and throughout their hospital stay, respectively. More patients with SARS required oxygen supplementation than patients with COVID-19 (18.6 vs 4.7%; P = .004). Only 1.6% of patients with COVID-19 and 2.3% of patients with SARS required mechanical ventilation. Leukopenia (37.2% vs 18.6%; P = .008), lymphopenia (95.4% vs 32.6%; P < .01), and thrombocytopenia (41.9% vs 3.8%; P < .001) were significantly more common in patients with SARS than in patients with COVID-19. The duration between positive and negative nasopharyngeal aspirate and the length in hospital stay were similar in patients with COVID-19, regardless of whether they were asymptomatic or symptomatic, suggesting a similar duration of viral shedding. CONCLUSIONS: Children with COVID-19 were less symptomatic and had more favorable hematologic findings than children with SARS.

16.
Chin Med J (Engl) ; 133(12): 1390-1396, 2020 Jun 20.
Article in English | MEDLINE | ID: covidwho-608052

ABSTRACT

BACKGROUND: Critical patients with the coronavirus disease 2019 (COVID-19), even those whose nucleic acid test results had turned negative and those receiving maximal medical support, have been noted to progress to irreversible fatal respiratory failure. Lung transplantation (LT) as the sole therapy for end-stage pulmonary fibrosis related to acute respiratory distress syndrome has been considered as the ultimate rescue therapy for these patients. METHODS: From February 10 to March 10, 2020, three male patients were urgently assessed and listed for transplantation. After conducting a full ethical review and after obtaining assent from the family of the patients, we performed three LT procedures for COVID-19 patients with illness durations of more than one month and extremely high sequential organ failure assessment scores. RESULTS: Two of the three recipients survived post-LT and started participating in a rehabilitation program. Pearls of the LT team collaboration and perioperative logistics were summarized and continually improved. The pathological results of the explanted lungs were concordant with the critical clinical manifestation, and provided insight towards better understanding of the disease. Government health affair systems, virology detection tools, and modern communication technology all play key roles towards the survival of the patients and their rehabilitation. CONCLUSIONS: LT can be performed in end-stage patients with respiratory failure due to COVID-19-related pulmonary fibrosis. If confirmed positive-turned-negative virology status without organ dysfunction that could contraindicate LT, LT provided the final option for these patients to avoid certain death, with proper protection of transplant surgeons and medical staffs. By ensuring instant seamless care for both patients and medical teams, the goal of reducing the mortality rate and salvaging the lives of patients with COVID-19 can be attained.


Subject(s)
Betacoronavirus , Coronavirus Infections/complications , Lung Transplantation/methods , Pneumonia, Viral/complications , Pulmonary Fibrosis/surgery , Respiratory Distress Syndrome, Adult/surgery , Aged , Coronavirus Infections/mortality , Extracorporeal Membrane Oxygenation , Humans , Male , Middle Aged , Pandemics , Pneumonia, Viral/mortality , Pulmonary Fibrosis/mortality , Respiratory Distress Syndrome, Adult/mortality
17.
Pediatr Pulmonol ; 2020 Jun 16.
Article in English | MEDLINE | ID: covidwho-599420

ABSTRACT

OBJECTIVE: Information regarding the association of immune-related factors with pneumonia in children with coronavirus disease 2019 (COVID-19) is scarce. This study aims to summarize the immune-related factors and their association with pneumonia in children with COVID-19. METHODS: Children with COVID-19 at Wuhan Children's Hospital from 28 January to 12 March 2020 were enrolled. Pneumonia due to causes other than COVID-19 were excluded. The clinical and laboratory information including routine blood tests, blood biochemistry, lymphocyte subsets, immunoglobulins, cytokines, and inflammatory factors were analyzed retrospectively in 127 patients. Normal ranges and mean values of laboratory markers were applied as parameters for logistic regression analyses of their association with pneumonia. RESULTS: In nonintensive care unit patients, 48.8% and 22.4% of patients had increased levels of procalcitonin and hypersensitive C-reactive protein (hs-CRP) respectively. A total 12.6% and 18.1% of patients had decreased levels of immunoglobulin A (IgA) and interleukin 10 (IL-10), respectively. Approximately 65.8% of patients had pneumonia. These patients had decreased levels of globulin (odds ratio [OR], 3.13; 95% confidence interval [CI] 1.41-6.93; P = .005), IgA (OR, 4.00; 95% CI, 1.13-14.18; P = .032), and increased levels of hs-CRP (OR, 3.14; 95% CI, 1.34-7.36; P = .008), procalcitonin (OR, 3.83; 95% CI, 2.03-7.24; P < .001), IL-10 (OR, 7.0; 95% CI, 1.59-30.80; P = .010), and CD4+ CD25+ T lymphocyte less than 5.0% (OR, 1.93; 95% CI, 1.04-3.61; P = 0.038). CONCLUSION: Decreased IgA and CD4+ CD25+ T lymphocyte percentage, and increased hs-CRP, procalcitonin, and IL-10 were associated with pneumonia, suggesting that the immune-related factors may participate in the pathogenesis of pneumonia in children with COVID-19.

18.
World J Pediatr ; 16(3): 260-266, 2020 06.
Article in English | MEDLINE | ID: covidwho-544107

ABSTRACT

BACKGROUND: The clinical characteristics and outcome of COVID-19 in children are different from those in adults. We aimed to describe the characteristics of infants under 1 year of age (excluding newborns) with COVID-19. METHODS: We retrospectively retrieved data of 36 infants with SARS-CoV-2 infection in Wuhan Children's Hospital from January 26 to March 22, 2020. Clinical features, chest imaging findings, laboratory tests results, treatments and clinical outcomes were analyzed. RESULTS: The mean age of the infected infants was 6.43 months, with a range of 2-12 months. 61.11% of the patients were males and 38.89% females. 86.11% of the infants were infected due to family clustering. Cough (77.78%) and fever (47.22%) were the most common clinical manifestations. Chest CT scan revealed 61.11% bilateral pneumonia and 36.11% unilateral pneumonia. 47.22% of the infants developed complications. Increased leucocytes, neutrophils, lymphocytes, and thrombocytes were observed in 11.11, 8.33, 36.11 and 44.44% of infants, respectively. Decreased leucocytes, neutrophils, thrombocyte and hemoglobin were observed in 8.33, 19.44, 2.78 and 36.11% of infants, respectively. Increased C-reactive protein, procalcitonin, lactate dehydrogenase, alanine aminotransferase, creatine kinase and D-dimer were observed in 19.44, 67.74, 47.22, 19.44, 22.22 and 20.69% of infants, respectively. Only one infant had a high level of creatinine. Co-infections with other respiratory pathogens were observed in 62.86% of infants. CD3 (20.69%), CD4 (68.97%), CD19 (31.03%) and Th/Ts (44.83%) were elevated; CD8 (6.9%) and CD16+CD56 (48.28%) was reduced. IL-4 (7.69%), IL-6 (19.23%), IL-10 (50%), TNF-α (11.54%) and IFN-γ (19.23%) were elevated. Up to March 22, 97.22% of infants recovered, while a critical ill infant died. When the infant's condition deteriorates rapidly, lymphocytopenia was discovered. Meanwhile, C-reactive protein, D-dimer, alanine aminotransferase, creatine kinase, creatinine, IL-6 and IL-10 increased significantly. CONCLUSIONS: In the cohort, we discovered that lymphocytosis, elevated CD4 and IL-10, and co-infections were common in infants with COVID-19, which were different from adults with COVID-19. Most infants with COVID-19 have mild clinical symptoms and good prognosis.


Subject(s)
Coronavirus Infections/diagnosis , Pneumonia, Viral/diagnosis , China , Coronavirus Infections/therapy , Female , Humans , Infant , Male , Pandemics , Pneumonia, Viral/therapy , Retrospective Studies , Treatment Outcome
19.
Aging (Albany NY) ; 12(11): 10059-10069, 2020 06 01.
Article in English | MEDLINE | ID: covidwho-459080

ABSTRACT

AIM: To evaluate the clinical value of abnormal laboratory results of multiple organs in patients with coronavirus disease 2019 (COVID-2019) and to help clinicians perform correct treatment. RESULTS: Elevated neutrophil-to-LYM ratio (NLR), D-dimer(D-D), interleukin (IL)-6, IL-10, IL-2, interferon-Y, and age were significantly associated with the severity of illness. However, significant and sustained decreases were observed in the LYM subset (p<0.05). D-D, T cell counts, and cytokine levels in severe COVID-19 patients who survived the disease gradually recovered at later time points to levels that were comparable to those of mild cases. Second, D-D increased from 0.5 to 8, and the risk ratio increased from 2.75 to 55, eventually leading to disseminated intravascular coagulation. Moreover, the acute renal function damage occurred earlier than abnormal heart and liver functions (p<0.05). CONCLUSIONS: The degrees of lymphopenia and proinflammatory cytokine storm were higher in severe COVID-19 patients than in mild cases. The degree was associated with the disease severity. Advanced age, NLR, D-D, and cytokine levels may serve as useful prognostic factors for the early identification of severe COVID-19 cases. METHODS: Peripheral blood samples were collected from 93 confirmed COVID-19 patients. The samples were examined for lymphocyte (LYM) subsets by flow cytometry and cytokine profiles by specific immunoassays. The receiver operating characteristic curve was applied to determine the best diagnostic thresholds for laboratory results, and principal component analysis was used to screen the major risk factors. The prognostic values were assessed using the Kaplan-Meier curve and univariate and multivariate COX regression models.


Subject(s)
Betacoronavirus/physiology , Coronavirus Infections/blood , Cytokines/blood , Host-Pathogen Interactions , Pneumonia, Viral/blood , Adult , Aged , China/epidemiology , Coronavirus Infections/diagnosis , Coronavirus Infections/epidemiology , Coronavirus Infections/immunology , Female , Humans , Male , Middle Aged , Pandemics , Pneumonia, Viral/diagnosis , Pneumonia, Viral/epidemiology , Pneumonia, Viral/immunology , Prognosis , Retrospective Studies
20.
Clin Rheumatol ; 39(7): 2031-2037, 2020 Jul.
Article in English | MEDLINE | ID: covidwho-361392

ABSTRACT

Coronavirus disease 2019 (COVID-19) pneumonia, firstly reported in Wuhan, Hubei province, China, has rapidly spread around the world with high mortality rate among critically ill patients. The use of corticosteroids in COVID-19 remains a major controversy. Available evidences are inconclusive. According to WHO guidance, corticosteroids are not recommended to be used unless for another reason. Chinese Thoracic Society (CTS) proposes an expert consensus statement that suggests taking a prudent attitude of corticosteroid usage. In our clinical practice, we do not use corticosteroids routinely; only low-to-moderate doses of corticosteroids were given to several severely ill patients prudently. In this paper, we will present two confirmed severe COVID-19 cases admitted to isolation wards in Optical Valley Campus of Tongji hospital, Tongji Medical College, Huazhong University of Science and Technology. We will discuss questions related to corticosteroids usages.


Subject(s)
Coronavirus Infections , Glucocorticoids/administration & dosage , Pandemics , Pneumonia, Viral , Tomography, X-Ray Computed/methods , Adult , Aged , Antiviral Agents/administration & dosage , Betacoronavirus/isolation & purification , Clinical Decision-Making , Coronavirus Infections/complications , Coronavirus Infections/diagnosis , Coronavirus Infections/physiopathology , Coronavirus Infections/therapy , Humans , Lung/diagnostic imaging , Male , Oxygen Inhalation Therapy/methods , Pneumonia, Viral/complications , Pneumonia, Viral/diagnosis , Pneumonia, Viral/etiology , Pneumonia, Viral/physiopathology , Pneumonia, Viral/therapy , Severity of Illness Index , Treatment Outcome
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