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1.
Medicine (Baltimore) ; 99(38): e22345, 2020 Sep 18.
Article in English | MEDLINE | ID: covidwho-787430

ABSTRACT

BACKGROUND: At the end of 2019, peoples normal lives were disrupted by a sudden plague (COVID-19), the huge impact of COVID-19 on society has never been appeared. How to effectively prevent and treat COVID-19 is a concern for all health care workers. Exercise as a green and cheap complementary therapy, which has been proven to improve the immune capacity of the body and prevent infection. The main purpose of this study is to provide a reliable methodological guidance and credible evidence for exercise on COVID-19 therapeutic. METHODS: This protocol is guided by the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Protocols. We will search the following database sources for the Randomized controlled trials: the Cochrane Library, PubMed, EMBASE, Web of Science, Chinese Biomedical Literature Database (CBM), Chinese National Knowledge Infrastructure Database (CNKI), Chinese Science and the Wanfang Database. All randomized controlled trials of exercise therapy for COVID-19 in the above database will be considered for inclusion, and high-quality articles will be screened for data extraction and analysis, to summarize the therapeutic effect of exercise on COVID-19 patients. RESULTS: In this study, we hope to find strong evidence for the treatment of COVID-19 by exercise. CONCLUSION: The conclusion of our study will provide credible evidence to judge whether exercise is an effective intervention on the COVID-19 patients therapeutic, and guide future researches.PROSPERO registration number: CRD42020200883.

2.
Environ Pollut ; 266(Pt 2): 115291, 2020 Nov.
Article in English | MEDLINE | ID: covidwho-764587

ABSTRACT

Due to continuous spread of coronavirus disease 2019 (COVID-19) worldwide, long-term effective prevention and control measures should be adopted for public transport facilities, as they are increasing in popularity and serve as the principal modes for travel of many people. The human infection risk could be extremely high due to length of exposure time window, transmission routes and structural characteristics during travel or work. This can result in the rapid spread of the infection. Based on the transmission characteristics of Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) and the nature of public transport sites, we identified comprehensive countermeasures toward the prevention and control of COVID-19, including the strengthening of personnel management, personal protection, environmental cleaning and disinfection, and health education. Multi-pronged strategies can enhance safety of public transportation. The prevention and control of the disease during the use of public transportation will be particularly important when all countries in the world resume production. The aim of this study is to introduce experience of the prevention and control measures for public transportation in China to promote the global response to COVID-19.


Subject(s)
Coronavirus Infections , Coronavirus , Pandemics , Pneumonia, Viral/epidemiology , Transportation , Betacoronavirus , China , Humans
3.
Eur Radiol ; 2020 Sep 15.
Article in English | MEDLINE | ID: covidwho-757945

ABSTRACT

OBJECTIVE: To determine CT's role in the early detection of COVID-19 infection and serial CT changes in the disease course in patients with COVID-19 pneumonia. METHODS: From January 21 to February 18, 2020, all of the patients who were suspected of novel coronavirus infection and verified by RT-PCR tests were retrospectively enrolled in our study. All of the patients underwent serial RT-PCR tests and serial CT imaging. The temporal relationship between the serial RT-PCR results (negative conversion to positive, positive to negative) and serial CT imaging was investigated, and serial CT changes were evaluated. RESULTS: A total of 155 patients with confirmed COVID-19 pneumonia were evaluated. Chest CT detection time of COVID-19 pneumonia was 2.61 days earlier than RT-PCR test (p = 0.000). The lung CT improvement time was significantly shorter than that of RT-PCR conversion to negative (p = 0.000). Three stages were identified from the onset of the initial symptoms: stage 1 (0-3 days), stage 2 (4-7 days), and stage 3 (8-14 days and later). Ground glass opacity (GGO) was predominant in stage 1, then consolidation and crazy paving signs were dramatically increased in stage 2. In stage 3, fibrotic lesions were rapidly increased. There were significant differences in the main CT features (p = 0.000), number of lobes involved (p = 0.001), and lesion distribution (p = 0.000) among the different stages. CONCLUSION: Chest CT detected COVID-19 pneumonia earlier than the RT-PCR results and can be used to monitor disease course. Combining imaging features with epidemiology history and clinical information could facilitate the early diagnosis of COVID-19 pneumonia. KEY POINTS: • The chest CT detection time of COVID-19 pneumonia was 2.61 days earlier than that of an initial RT-PCR positive result (t = - 7.31, p = 0.000). • The lung CT improvement time was significantly shorter than that of RT-PCR conversion to negative (t = - 4.72, p = 0.000). • At the early stage (0-3 days), the CT features of COVID-19 were predominantly GGO and small-vessel thickening; at stage 2 (4-7 days), GGO evolved to consolidation and crazy paving signs. At stage 3 (8-14 days and later), fibrotic lesions significantly increased, accompanied by consolidation, GGO, and crazy paving signs.

4.
Emerg Microbes Infect ; 9(1): 1869-1877, 2020 Dec.
Article in English | MEDLINE | ID: covidwho-730432

ABSTRACT

Critically ill patients with coronavirus diseases 2019 (COVID-19) are of grave concern. Those patients usually underwent a stage of excessive inflammation before developing acute respiratory distress syndrome. In this study, we test the hypothesis that short-term, low-to-moderate-dose corticosteroids would benefit patients when used in the early phase of excessive inflammation, namely, the therapeutic window. Among a Shanghai cohort and a validation cohort, we enrolled COVID-19 patients showing marked radiographic progression. Short-term, low-to-moderate-dose corticosteroids were considered for them. After identifying the possible markers for the therapeutic window, we then divided the patients, based on whether they were treated with corticosteroids within the therapeutic window, into the early-start group and control group. We identified that the therapeutic window for corticosteroids was characterized by a marked radiographic progression and lactase dehydrogenase (LDH) less than two times the upper limit of normal (ULN). The Shanghai cohort comprised of 68 patients, including 47 in the early-start group and 21 in the control group. The proportion of patients requiring invasive mechanical ventilation was significantly lower in the early-start group than in the control group (10.6% vs. 33.3%, difference, 22.7%, 95% confidence interval 2.6-44.8%). Among the validation cohort of 51 patients, similar difference of the primary outcome was observed (45.0% vs. 74.2%, P = 0.035). Among COVID-19 patients with marked radiologic progression, short-term, low-to-moderate-dose corticosteroids benefits patients with LDH levels of less than two times the ULN, who may be in the early phase of excessive inflammation.


Subject(s)
Adrenal Cortex Hormones/therapeutic use , Coronavirus Infections/prevention & control , Pandemics/prevention & control , Pneumonia, Viral/prevention & control , Adrenal Cortex Hormones/administration & dosage , Biomarkers , Cohort Studies , Coronavirus Infections/diagnostic imaging , Coronavirus Infections/pathology , Coronavirus Infections/therapy , Disease Progression , Humans , Inflammation/prevention & control , L-Lactate Dehydrogenase/blood , Pneumonia, Viral/diagnostic imaging , Pneumonia, Viral/pathology , Pneumonia, Viral/therapy , Radiography , Reproducibility of Results , Respiration, Artificial , Respiratory Distress Syndrome, Adult/etiology , Treatment Outcome
5.
Acad. J. Second Mil. Med. Univ. ; 6(41): 616-620, 2020.
Article in Chinese | ELSEVIER | ID: covidwho-727546

ABSTRACT

Objective To summarize the clinical features and imaging findings of six coronavirus disease 2019 (COVID-19) patients, so as to provide evidences for early diagnosis and clinical intervention. Methods Six COVID-19 patients with positive severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) were enrolled from the Seventh People's Hospital of Shanghai University of Traditional Chinese Medicine from Jan. 1 to Feb. 22, 2020. The epidemiological history, clinical manifestations, imaging data and laboratory indicators were retrospectively analyzed. Results All six patients had a clear travel or residence history in Wuhan. Four patients had fever, three had cough, two had upper respiratory tract symptoms such as runny nose and sore throat, and two had systemic symptoms such as headache and muscle ache. Chest computed tomography (CT) showed that all the six patients had abnormal manifestations in bilateral lungs, and the lower lung lesions were more common than the upper lung lesions. The main manifestations were multiple ground-glass opacities, consolidation shadows, crazy paving sign and different degrees of fibrosis in lateral field of bilateral lungs. Chest CT examination later after onset showed lung consolidation and severe fibrosis. Conclusion The imaging of COVID-19 has special characteristics. Combined with the epidemiological history, clinical manifestations and the detection of SARS-CoV-2 nucleic acid, COVID-19 can be effectively diagnosed in the early stage.

6.
Nursing Outlook ; 2020.
Article | WHO COVID | ID: covidwho-726809

ABSTRACT

Objectives To explore the relationship between psychosocial support related factors and the mental health of COVID-19 positive patients Methods This exploratory study of thirty-five COVID-19 positive patients were enrolled between February 1st to March 1st, 2020 Sleep quality, depression, anxiety, and social support were measured and social support related data of participants were collected Psychological intervention was administered and patients were followed two weeks post intervention Linear regression was performed to explore the relationship between psychosocial risk factors and improvement of psychological symptoms Results Thirty-two individuals exhibited sleep, depressive and anxiety symptoms which improved post support intervention At baseline, symptoms were associated with gender, severity of pneumonia, social support Better social support at follow-up and improvement from COVID-19 predicted improvement in their psychological symptoms Conclusions This initial evidence from China may stress the importance of administering psychosocial intervention during the treatment of COVID-19 for better patient outcomes in other countries

7.
Emerg Microbes Infect ; 9(1): 1869-1877, 2020 Dec.
Article in English | MEDLINE | ID: covidwho-713723

ABSTRACT

Critically ill patients with coronavirus diseases 2019 (COVID-19) are of grave concern. Those patients usually underwent a stage of excessive inflammation before developing acute respiratory distress syndrome. In this study, we test the hypothesis that short-term, low-to-moderate-dose corticosteroids would benefit patients when used in the early phase of excessive inflammation, namely, the therapeutic window. Among a Shanghai cohort and a validation cohort, we enrolled COVID-19 patients showing marked radiographic progression. Short-term, low-to-moderate-dose corticosteroids were considered for them. After identifying the possible markers for the therapeutic window, we then divided the patients, based on whether they were treated with corticosteroids within the therapeutic window, into the early-start group and control group. We identified that the therapeutic window for corticosteroids was characterized by a marked radiographic progression and lactase dehydrogenase (LDH) less than two times the upper limit of normal (ULN). The Shanghai cohort comprised of 68 patients, including 47 in the early-start group and 21 in the control group. The proportion of patients requiring invasive mechanical ventilation was significantly lower in the early-start group than in the control group (10.6% vs. 33.3%, difference, 22.7%, 95% confidence interval 2.6-44.8%). Among the validation cohort of 51 patients, similar difference of the primary outcome was observed (45.0% vs. 74.2%, P = 0.035). Among COVID-19 patients with marked radiologic progression, short-term, low-to-moderate-dose corticosteroids benefits patients with LDH levels of less than two times the ULN, who may be in the early phase of excessive inflammation.


Subject(s)
Adrenal Cortex Hormones/therapeutic use , Coronavirus Infections/prevention & control , Pandemics/prevention & control , Pneumonia, Viral/prevention & control , Adrenal Cortex Hormones/administration & dosage , Biomarkers , Cohort Studies , Coronavirus Infections/diagnostic imaging , Coronavirus Infections/pathology , Coronavirus Infections/therapy , Disease Progression , Humans , Inflammation/prevention & control , L-Lactate Dehydrogenase/blood , Pneumonia, Viral/diagnostic imaging , Pneumonia, Viral/pathology , Pneumonia, Viral/therapy , Radiography , Reproducibility of Results , Respiration, Artificial , Respiratory Distress Syndrome, Adult/etiology , Treatment Outcome
8.
Saudi J Gastroenterol ; 26(5): 272-278, 2020.
Article in English | MEDLINE | ID: covidwho-706036

ABSTRACT

Background/Aims: We aimed to evaluate the distribution of abnormal liver-related biomarkers in patients with coronavirus disease (COVID-19) and explore the prognostic value of elevated liver enzymes and abnormal liver synthetic capacity with regards to patient mortality. Patients and Methods: This retrospective observational study included 80 laboratory-confirmed COVID-19 cases. Data were collected from the electronic medical record system by a trained team of physicians. Alanine aminotransferase (ALT), aspartate aminotransferase (AST), total bilirubin (TB), albumin, and prealbumin levels at admission and on day 7 after admission were collected. The primary outcome of the current study was patient mortality. Results: Abnormal ALT, AST, TB, albumin, and prealbumin levels were observed in 11 (13.8%), 15 (18.8%), 5 (6.3%), 22 (27.5%), and 31 (38.8%) patients, respectively. Male gender correlated with elevated ALT and AST levels (p = 0.027 and 0.036, respectively). Higher levels of AST and lower levels of albumin and prealbumin were associated with patient mortality (p = 0.009, 0.002, and 0.003, respectively). Multivariate Cox regression analysis identified patient age (p = 0.013, HR 1.108) and prealbumin levels (p = 0.015, HR 0.986) as independent predictors for patient mortality. However, changes in liver-related biomarkers were not associated with poor outcome in multivariate analysis (p > 0.05). Conclusions: Abnormalities in albumin and prealbumin levels are common among COVID-19 patients and hypoprealbuminemia independently predicts adverse outcome and should be carefully considered in clinical practice. Moreover, changes in liver-related biomarkers is not a salient feature of COVID-19.

9.
Medicine (Baltimore) ; 99(31): e21429, 2020 Jul 31.
Article in English | MEDLINE | ID: covidwho-696106

ABSTRACT

RATIONALE: The COVID-19 cases increased very fast in January and February 2020. The mortality among critically ill patients, especially the elder ones, is relatively high. Considering many patients died of severe inflammation response, it is urgent to develop effective therapeutic strategies for these patients. The human umbilical cord mesenchymal stem cells (hUCMSCs) have shown good capabilities to modulate the immune response and repair the injured tissue. Therefore, investigating the potential of hUCMSCs to the treatment of COVID-19 critically ill patients is necessary. PATIENT CONCERNS: A 65-year-old woman felt fatigued and had a fever with body temperature of 38.2C, coughed up white foaming sputum. After 1 day, she had chest tightness with SPO2 of 81%, and blood pressure of 160/91 mm Hg. DIAGNOSE: According to the guideline for the diagnosis and treatment of 2019 novel coronavirus infected pneumonia (Trial 4th Edition), COVID-19 was diagnosed, based on the real-time RT-PCR test of SARS-CoV-2. INTERVENTIONS: After regular treatment for 12 days, the inflammation symptom of the patient was still very severe and the potential side effects of corticosteroid were observed. Then, allogenic hUCMSCs were given 3 times (5 × 10 cells each time) with a 3-day interval, together with thymosin α1 and antibiotics daily injection. OUTCOMES: After these treatments, most of the laboratory indexes and CT images showed remission of the inflammation symptom. The patient was subsequently transferred out of ICU, and the throat swabs test reported negative 4 days later. LESSONS: These results indicated the clinical outcome and good tolerance of allogenic hUCMSCs transfer.


Subject(s)
Betacoronavirus , Cord Blood Stem Cell Transplantation/methods , Coronavirus Infections/therapy , Mesenchymal Stem Cell Transplantation/methods , Pneumonia, Viral/therapy , Aged , Anti-Bacterial Agents/therapeutic use , Combined Modality Therapy , Coronavirus Infections/drug therapy , Coronavirus Infections/virology , Female , Humans , Pandemics , Pneumonia, Viral/virology , Thymalfasin/therapeutic use , Treatment Outcome
10.
Emerg. Mark. Financ. Trade ; 10(56): 2198-2212, 20200808.
Article in English | ELSEVIER | ID: covidwho-670539

ABSTRACT

In this article, we use an event study approach to empirically study the market performance and response trends of Chinese industries to the COVID-19 pandemic. The study found that transportation, mining, electricity & heating, and environment industries have been adversely impacted by the pandemic. However, manufacturing, information technology, education and health-care industries have been resilient to the pandemic.

11.
Emerg. Mark. Financ. Trade ; 10(56): 2332-2349, 20200808.
Article in English | ELSEVIER | ID: covidwho-670538

ABSTRACT

The novel coronavirus (COVID-19) outbreak has become a global pandemic and has greatly impacted the world economy. This article adopts the financial data of Listed companies in China and uses the synthetic index compilation method to compile an accounting index that captures the period before and after the COVID-19 outbreak. This index is based on big data portrait analysis and measures the impact of the COVID-19 on various Chinese industries. The study found that except for the basic industry, which was less affected by the epidemic, the rest of the industries were significantly affected by the epidemic. Besides, the costs of various industries have increased by varying degrees. The aviation, tourism and other service industries have been greatly impacted. New infrastructure, Chinese patent medicine and Internet industries have achieved great development.

14.
Arch Gerontol Geriatr ; 91: 104185, 2020 Jul 15.
Article in English | MEDLINE | ID: covidwho-644807

ABSTRACT

OBJECTIVES: Much of the previous research on COVID-19 was based on all population. But substantial numbers of severe episodes occur in older patients. There is a lack of data about COVID-19 in older adults. The aims of this study were to analyze the clinical characteristics of older adult patients with COVID-19. METHODS: Retrospective study of older patients hospitalized with COVID-19 from February 1 st to March 31 st, 2020 was conducted in the Sino-French New City Branch of Tongjing Hospital in Wuhan, China. According to the degree of severity of COVID-19 during hospitalization, 312 older patients were divided into non-severe and severe cases. RESULTS: the mean age of the patients was 69.2 ± 7.3 years, and 47.4 % of patients had exposure history. 77.2 % of patients had a co-morbidity, with hypertension being the most common (57.1 %), followed by diabetes (38.8 %) and cardiovascular disease (29.8 %). Multivariable regression showed increasing odds of severe COVID-19 associated with age(OR 1.59, 95 %CI 1.13-2.08), SOFA score(OR 5.89, 95 %CI 3.48-7.96), APACHEⅡ score(OR 3.13, 95 %CI 1.85-5.62), platelet count<125 × 109/L(OR 2.36, 95 %CI 1.03-4.14), d-dimer (OR 4.37, 95 %CI 2.58-7.16), creatinine>133 µmol/L(OR 1.85, 95 %CI 1.12-3.04), interleukin-6(OR 4.32, 95 %CI 2.07-7.13), and lung consolidation(OR 1.94, 95 %CI 1.45-4.27) on admission. The most common complication was acute respiratory distress syndrome (35.6 %), followed by acute cardiac injury (33.0 %) and coagulation disorders (30.8 %). 91.7 % of patients were prescribed antiviral therapy, followed by immune globulin (52.9 %) and systemic glucocorticoids (43.6 %). 21.8 % of patients received invasive ventilation, 1.92 % for extracorporeal membrane oxygenation. The overall mortality was 6.73 %, and mortality of severe patients was 17.1 %, which was higher than non-severe patients (0.962 %). CONCLUSIONS: Older patients with COVID-19 had much more co-morbidity, complications and mortality. More attention should be paid to older patients with COVID-19.

15.
Clin. Transl. Radiat. Oncol. ; (24): 88-91, 20200901.
Article in English | ELSEVIER | ID: covidwho-645139

ABSTRACT

After the outbreak of COVID-19, medical institutions in China and even around the world are facing unprecedented challenges. In order to minimize the adverse impact of this unexpected epidemic on patients who need radiotherapy, the expert group of our radiotherapy center immediately formulated comprehensive emergency plans and prevention and control measures, partitioned the work area, launched online staff training, and optimized the radiotherapy process after the outbreak, which provided a strong guarantee for the safe and orderly operation of our radiotherapy center and kept the infection rate to an extremely low level. We hope our experience could provide reference and suggestions for other medical institutions.

16.
J Psychiatr Res ; 129: 198-205, 2020 10.
Article in English | MEDLINE | ID: covidwho-643783

ABSTRACT

OBJECTIVE: An outbreak of coronavirus disease 2019 (COVID-19) is a public health emergency of international concern and poses a big challenge to medical staff and general public. The aim is to investigate psychological impact of COVID-19 epidemic on medical staff in different working posts in China, and to explore the correlation between psychological disorder and the exposure to COVID-19. METHODS: A multicenter WeChat-based online survey was conducted among medical staff in China between 26 February and 3 March 2020. Medical staff deployed to Hubei province from other provinces and medical staffs in different posts outside Hubei were selected to represent diverse exposure intensities to the threat of COVID-19. Anxiety, depression, sleep quality, stress and resilience were evaluated using scales including GAD-7, PHQ-9, PSQI, PSS-14, and CD-RISC-10. Latent class analysis was performed to identify potential staff requiring psychological support. RESULTS: A total of 274 respondents were included, who serving at 4 posts as follows, staff backing Hubei province, isolation wards outside Hubei, fever clinic and infectious disease department, and other departments outside Hubei. The total scores of anxiety, depression, sleep quality and stress were statistically different among groups, meanwhile an increasing tendency of anxiety, depression and sleep quality scores with increasing risk of exposure to COVID-19 was found (p < 0.05). Subsequent post-hoc analysis indicated that the staff backing Hubei had higher scores of anxiety, depression, sleep quality and perceived stress (adjusted p < 0.05). The combined prevalence of anxiety, depression and insomnia of staff backing Hubei reached as high as 38%. Four-class latent class analysis showed 3 categories of population (69.4%) may need psychological support. CONCLUSIONS: High prevalence of anxiety, depression and insomnia exist in medical staff related to COVID-19. The higher the probability and intensity of exposure to COVID-19 patients, the greater the risk that medical staff will suffer from mental disorders, suggesting continuous and proper psychiatric intervention are needed.

18.
Eur J Clin Microbiol Infect Dis ; 2020 Jul 01.
Article in English | MEDLINE | ID: covidwho-622381

ABSTRACT

This study compared the laboratory indexes in 40 non-severe COVID-19 patients with those in 57 healthy controls. In the peripheral blood system of non-severe symptom COVID-19 patients, lymphocytes, eosinophils, basophils, total procollagen type 1 amino-terminal propeptide, osteocalcin N-terminal, thyroid-stimulating hormone, growth hormone, and insulin-like growth factor-binding protein 3 significantly decreased, and total protein, albumin, alanine transaminase, alkaline phosphatase, γ-glutamyl transferase, activated partial thromboplastin time, prothrombin time, fibrinogen, D-dimer, fibrinogen degradation products, human epididymal protein 4, serum ferritin, and C-reactive protein were elevated. SARS-CoV-2 infection can affect hematopoiesis, hemostasis, coagulation, fibrinolysis, bone metabolism, thyroid, parathyroid glands, the liver, and the reproductive system.

19.
Emerg Microbes Infect ; 9(1): 1537-1545, 2020 Dec.
Article in English | MEDLINE | ID: covidwho-611841

ABSTRACT

Background: Novel coronavirus pneumonia (COVID-19) is prevalent around the world. We aimed to describe epidemiological features and clinical course in Shanghai. Methods: We retrospectively analysed 325 cases admitted at Shanghai Public Health Clinical Center, between January 20 and February 29, 2020. Results: 47.4% (154/325) had visited Wuhan within 2 weeks of illness onset. 57.2% occurred in 67 clusters; 40% were situated within 53 family clusters. 83.7% developed fever during the disease course. Median times from onset to first medical care, hospitalization and negative detection of nucleic acid by nasopharyngeal swab were 1, 4 and 8 days. Patients with mild disease using glucocorticoid tended to have longer viral shedding in blood and feces. At admission, 69.8% presented with lymphopenia and 38.8% had elevated D-dimers. Pneumonia was identified in 97.5% (314/322) of cases by chest CT scan. Severe-critical patients were 8% with a median time from onset to critical disease of 10.5 days. Half required oxygen therapy and 7.1% high-flow nasal oxygen. The case fatality rate was 0.92% with median time from onset to death of 16 days. Conclusion: COVID-19 cases in Shanghai were imported. Rapid identification, and effective control measures helped to contain the outbreak and prevent community transmission.


Subject(s)
Coronavirus Infections/epidemiology , Pneumonia, Viral/epidemiology , Adolescent , Adult , Aged , Aged, 80 and over , China/epidemiology , Coronavirus Infections/complications , Coronavirus Infections/diagnosis , Coronavirus Infections/therapy , Female , Follow-Up Studies , Health Status Indicators , Humans , Male , Middle Aged , Pandemics , Pneumonia, Viral/complications , Pneumonia, Viral/diagnosis , Pneumonia, Viral/therapy , Retrospective Studies , Time Factors , Treatment Outcome , Virus Shedding , Young Adult
20.
Annals of translational medicine ; 8(9):593-593, 2020.
Article | WHO COVID | ID: covidwho-612192

ABSTRACT

Background: The third fatal coronavirus is the novel coronavirus (SARS-CoV-2) that causes novel coronavirus pneumonia (COVID-19) which first broke out in December 2019 Patients will develop rapidly if there is no any intervention, so the risk identification of severe patients is critical The aim of this study was to investigate the characteristics and rules of hematology changes in patients with COVID-19, and to explore the possibility differentiating moderate and severe patients using conventional hematology parameters or combined parameters Methods: The clinical data of 45 moderate and severe type patients with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infections in Jingzhou Central Hospital from January 23 to February 13, 2020 were collected The epidemiological indexes, clinical symptoms, and laboratory test results of the patients were retrospectively analyzed Those parameters with significant differences between moderate and severe cases were analyzed, and the combination parameters with the best diagnostic performance were selected using the linear discriminant analysis (LDA) method Results: Of the 45 patients with the novel 2019 corona virus (COVID-19) (35 moderate and 10 severe cases), 23 were male and 22 were female, with ages ranging from 16 to 62 years The most common clinical symptoms were fever (89%) and dry cough (60%) As the disease progressed, white blood cell count (WBC), neutrophil count, neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), red blood cell distribution width-coefficient of variation (RDW-CV), and red cell volume distribution width-standard deviation (RDW-SD) parameters in the severe group were significantly higher than those in the moderate group (P<0 05);meanwhile, lymphocyte count (Lym#), eosinophil count (Eos#), high fluorescent cell percentage (HFC%), red blood cell count (RBC), hemoglobin (HGB), and hematocrit (HCT) parameters in the severe group were significantly lower than those in the moderate group (P<0 05) For NLR parameter, it's area under the curve (AUC), cutoff, sensitivity and specificity were 0 890, 13 39, 83 3% and 82 4% respectively;meanwhile, for PLR parameter, it's AUC, cutoff, sensitivity and specificity were 0 842, 267 03, 83 3% and 74 0% respectively The combined parameters of NLR and RDW-SD had the best diagnostic efficiency (AUC =0 938), and when the cutoff value was 1 046, the sensitivity and the specificity were 90 0% and 84 7% respectively, followed by the combined parameter NLR&RDW-CV (AUC =0 923) When the cut-off value was 0 62, the sensitivity and the specificity for distinguishing severe type from moderate cases of COVID-19 were 90 0% and 82 4% respectively Conclusions: The combined NLR and RDW-SD parameter is the best hematology index It may help clinicians to predict the severity of COVID-19 patients and can be used as a useful indicator to help prevent and control the epidemic

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