Your browser doesn't support javascript.
Show: 20 | 50 | 100
Results 1 - 20 de 40
Filter
1.
Data ; 5(3):68-68, 2020.
Article | WHO COVID | ID: covidwho-693531

ABSTRACT

The COVID-19 viral disease surfaced at the end of 2019 and quickly spread across the globe To rapidly respond to this pandemic and offer data support for various communities (e g , decision-makers in health departments and governments, researchers in academia, public citizens), the National Science Foundation (NSF) spatiotemporal innovation center constructed a spatiotemporal platform with various task forces including international researchers and implementation strategies Compared to similar platforms that only offer viral and health data, this platform views virus-related environmental data collection (EDC) an important component for the geospatial analysis of the pandemic The EDC contains environmental factors either proven or with potential to influence the spread of COVID-19 and virulence or influence the impact of the pandemic on human health (e g , temperature, humidity, precipitation, air quality index and pollutants, nighttime light (NTL)) In this platform/framework, environmental data are processed and organized across multiple spatiotemporal scales for a variety of applications (e g , global mapping of daily temperature, humidity, precipitation, correlation of the pandemic to the mean values of climate and weather factors by city) This paper introduces the raw input data, construction and metadata of reprocessed data, and data storage, as well as the sharing and quality control methodologies of the COVID-19 related environmental data collection

2.
Chin. J. Radiol. ; 7(54): 683-687, 20200710.
Article in Chinese | ELSEVIER | ID: covidwho-677736

ABSTRACT

Objective: To explore the diagnostic value of chest CT imaging in differential diagnosis between common-type COVID-19 and mycoplasma pneumonia (MP). Methods: From the January to February 2020, the clinical and imaging data of COVID-19 patients (diagnosed in the Affiliated Hospital of Jining Medical University, the Fourth People's Hospital of Jining and the Second People's Hospital of Jining) and MP patients (diagnosed in the Affiliated Hospital of Jining Medical University) were retrospectively collected and analyzed. Forty-three patients with common-type COVID-19 (28 males, 15 females, 43±14 years old) and 50 patients with MP (19 males, 31 females, 37±14 years old) were enrolled as COVID-19 group and MP group, respectively. The clinical manifestations, laboratory results and chest CT findings of these two groups were analyzed and compared. Results: (1) Clinical manifestations: there were more patients with muscle ache and asthenia in COVID-19 group than in MP group (χ ²=5.110, 4.834, P<0.05). No significant difference was found in fever and cough between two groups (χ ²=0.378, 0.097, P>0.05). (2) Laboratory examination: the procalcitonin level of cases in COVID-19 group was significantly lower than that in MP group (χ ²=12.263, P=0.001). No significant difference was found in leukocyte count, lymphocyte count, C-reactive protein level and erythrocyte sedimentation rate (Z=-1.117, χ ²=2.410, 0.787, 0.800, all P>0.05) between two groups. (3) Chest CT findings bilateral lung involvement was found more in COVID-19 group than in MP group (χ ²=30.012, P<0.001); while the one lobe of ipilateral lung involvement was less in COVID-19 group than in MP group (χ ²=19.927, P<0.001); there was no significant difference in multiple lobes of ipilateral lung involvment between the two groups (χ ²=1.366, P>0.05). Ground glass, paving stone sign and air bronchus sign were found significantly more in COVID-19 group than in MP group (χ ²=30.171, 19.119, 9.790, all P<0.05); while the pulmonary consolidation, central lobular nodule and centripetal thickening of bronchus wall were found significantly less in COVID-19 group than in MP group (χ ²=25.450, 33.532, 48.553, all P<0.001). Conclusions: The clinical manifestations and laboratory examination have limited value in the differential diagnosis of common-type COVID-19 and MP, while chest CT imaging might be more valuable in the early differential diagnosis of these two diseases.

4.
J Dig Dis ; 2020 Jul 26.
Article in English | MEDLINE | ID: covidwho-670044

ABSTRACT

OBJECTIVE: Abnormal liver function has been noticed as common extra pulmonary organ damage of the coronavirus disease 2019 (COVID-19). Severe patients had a higher probability and progression of liver injury compared with non-severe patients. We aimed to investigate the prognostic value of liver injury in COVID-19 patients. METHODS: We retrospectively included 502 patients with laboratory-confirmed SARS CoV-2 infection. Clinical features and survival of patients with and without liver injury were compared. Cox proportional hazard ratio models were used to find the variables that have an effect on survival. RESULTS: Among enrolled 502 patients, 301 patients had abnormal liver function with increased neutrophil count, C-reactive protein (CRP), creatinine, troponin (TnI), D-dimer, lactose dehydrogenase (LDH) and creatine kinase (CK). Compared to patients with normal liver functions, those with abnormal liver functions had higher mortality rate (28.9% vs 9.0%, P<0.001), higher ratio of male patients (65.1% vs 40.8%, P<0.001) and higher chance of SIRS development (53.5% vs 41.3%, P=0.007). Among patients with abnormal liver functions, liver damage grade 2 patients (both ALT/AST and ALP/GGT abnormal) had higher ratio of male patients, neutrophil count, PCT, D-dimer and mortality rate. Multivariate Cox regression analyses suggested that grade of liver damage (HR:1.377, 95%CI:1.000-1.896, P=0.049) was an independent predictor of death. CONCLUSIONS: COVID-19 patients with abnormal liver functions have a higher mortality. Liver damage is an independent prognostic factor of COVID-19. This article is protected by copyright. All rights reserved.

6.
CMAJ ; 192(27): E734-E744, 2020 07 06.
Article in English | MEDLINE | ID: covidwho-661875

ABSTRACT

BACKGROUND: Antiviral medications are being given empirically to some patients with coronavirus disease 2019 (COVID-19). To support the development of a COVID-19 management guideline, we conducted a systematic review that addressed the benefits and harms of 7 antiviral treatments for COVID-19. METHODS: We searched MEDLINE, Embase, Cochrane Central Register of Controlled Trials (CENTRAL), PubMed and 3 Chinese databases (CNKI, WANFANG and SinoMed) through Apr. 19, medRxiv and Chinaxiv through Apr. 27, and Chongqing VIP through Apr. 30, 2020. We included studies of ribavirin, chloroquine, hydroxychloroquine, umifenovir (arbidol), favipravir, interferon and lopinavir/ritonavir. If direct evidence from COVID-19 studies was not available, we included indirect evidence from studies of severe acute respiratory syndrome (SARS) and Middle East respiratory syndrome (MERS) for efficacy outcomes and other acute respiratory viral infections for safety outcomes. RESULTS: In patients with nonsevere COVID-19 illness, the death rate was extremely low, precluding an important effect on mortality. We found only very low-quality evidence with little or no suggestion of benefit for most treatments and outcomes in both nonsevere and severe COVID-19. An exception was treatment with lopinavir/ritonavir, for which we found low-quality evidence for a decrease in length of stay in the intensive care unit (risk difference 5 d shorter, 95% confidence interval [CI] 0 to 9 d) and hospital stay (risk difference 1 d shorter, 95% CI 0 to 2 d). For safety outcomes, evidence was of low or very low quality, with the exception of treatment with lopinavir/ritonavir for which moderate-quality evidence suggested likely increases in diarrhea, nausea and vomiting. INTERPRETATION: To date, persuasive evidence of important benefit in COVID-19 does not exist for any antiviral treatments, although for each treatment evidence has not excluded important benefit. Additional randomized controlled trials involving patients with COVID-19 will be needed before such treatments can be administered with confidence.


Subject(s)
Antiviral Agents , Betacoronavirus/drug effects , Coronavirus Infections/drug therapy , Influenza, Human/drug therapy , Lopinavir/pharmacology , Pneumonia, Viral/drug therapy , Amides , Antiviral Agents/pharmacology , Chloroquine , Evidence-Based Medicine , Humans , Hydroxychloroquine , Indoles , Observational Studies as Topic , Pandemics , Pyrazines , Ribavirin , Ritonavir
7.
Journal of Ophthalmology ; 2020.
Article | WHO COVID | ID: covidwho-655569

ABSTRACT

The novel coronavirus pneumonia COVID-19 is caused by the novel coronavirus SARS-CoV-2, which is highly contagious, has a long incubation period, and can be detected in patients' tears and conjunctival secretions In this study, we describe our experience regarding the necessary protective measures that need to be taken during ophthalmic examination and treatment The authors reviewed the clinical work arrangements during the epidemic situation at the Eye Hospital of Wenzhou Medical University in China and analyzed the prevention and control measures that were applied during the laser corneal refractive surgery process The comprehensive protection protocol, which was established throughout the entire process, included both horizontal (medical staff-patient, medical staff-medical staff, and patient-patient) and vertical (preoperative, intraoperative, and postoperative transmission assessment) approach and was mainly focused on strengthening the protection against potential aerosol transmission that may occur during intraocular pressure measurements and laser ablation The described and proposed protocol, along with the further guidelines followed by the medical personnel, proved to be efficacious and contributed significantly to the control of the COVID-19 outbreak and the protection of both the patients and the medical staff [ABSTRACT FROM AUTHOR] Copyright of Journal of Ophthalmology is the property of Hindawi Limited and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission However, users may print, download, or email articles for individual use This abstract may be abridged No warranty is given about the accuracy of the copy Users should refer to the original published version of the material for the full abstract (Copyright applies to all Abstracts )

9.
J Infect Public Health ; 2020 Jul 17.
Article in English | MEDLINE | ID: covidwho-652014

ABSTRACT

BACKGROUND: The COVID-19 outbreak in late December 2019 has quickly emerged into pandemic in 2020. We aimed to describe the epidemiology and clinical characteristics of hospitalized COVID-19 patients, and to investigate the potential risk factors for COVID-19 severity. METHOD: 1663 hospitalized patients with laboratory-confirmed diagnosed COVID-19 from Tongji Hospital between January 14, 2020, and February 28, 2020 were included in the present study. Demographic information, exposure history, medical history, comorbidities, signs and symptoms, chest computed tomography (CT) scanning, severity of COVID-19 and laboratory findings on admission were collected from electronic medical records. Multivariable logistic regression was used to explore the association between potential risk factors with COVID-19 severity. RESULTS: In the present study, the majority (79%) of 1663 COVID-19 patients were aged over 50 years old. A total of 2.8% were medical staff, and an exposure history of Huanan seafood market was document in 0.7%, and 7.4% were family infection. Fever (85.8%), cough (36.0%), fatigue (23.6%) and chest tightness (11.9%) were the most common symptoms in COVID-19 patients. As of February 28, 2020, of the 1663 patients included in this study, 26.0% were discharged, 10.2% were died, and 63.8% remained hospitalized. More than 1/3 of the patients had at least one comorbidity. Most (99.8%) patients had abnormal results Chest CT, and the most common manifestations of chest CT were local patchy shadowing (70.7%) and ground-glass opacity (44.8%). On admission, lymphocytopenia was present in 51.1% of the patients, mononucleosis in 26.6%, and erythrocytopenia in 61.3%. Most of the patients had increased levels of C-reactive protein (80.4%) and D-dimer (64.4%). Compared with non-severe patients, severe patients had more obvious abnormal laboratory results related to inflammation, coagulation disorders, liver and kidney damage (all P < 0.05). Older age (OR = 2.37, 95% CI: 1.47-3.83), leukocytosis (OR = 2.37, 95% CI: 1.47-3.83), and increased creatine kinase (OR = 2.37, 95% CI: 1.47-3.83) on admission were significantly associated with COVID-19 severity. CONCLUSION: Timely medical treatment and clear diagnosis after the onset might be beneficial to control the condition of COVID-19. Severe patients were more likely to be to be elder, and tended to have higher proportion of comorbidities and more prominent laboratory abnormalities. Older age, leukocytosis, and increased creatine kinase might help clinicians to identify severe patients with COVID-19.

10.
Eur J Nucl Med Mol Imaging ; 2020 Jul 14.
Article in English | MEDLINE | ID: covidwho-647136

ABSTRACT

BACKGROUND: The novel coronavirus disease 2019 (COVID-19) is an emerging worldwide threat to public health. While chest computed tomography (CT) plays an indispensable role in its diagnosis, the quantification and localization of lesions cannot be accurately assessed manually. We employed deep learning-based software to aid in detection, localization and quantification of COVID-19 pneumonia. METHODS: A total of 2460 RT-PCR tested SARS-CoV-2-positive patients (1250 men and 1210 women; mean age, 57.7 ± 14.0 years (age range, 11-93 years) were retrospectively identified from Huoshenshan Hospital in Wuhan from February 11 to March 16, 2020. Basic clinical characteristics were reviewed. The uAI Intelligent Assistant Analysis System was used to assess the CT scans. RESULTS: CT scans of 2215 patients (90%) showed multiple lesions of which 36 (1%) and 50 patients (2%) had left and right lung infections, respectively (> 50% of each affected lung's volume), while 27 (1%) had total lung infection (> 50% of the total volume of both lungs). Overall, 298 (12%), 778 (32%) and 1300 (53%) patients exhibited pure ground glass opacities (GGOs), GGOs with sub-solid lesions and GGOs with both sub-solid and solid lesions, respectively. Moreover, 2305 (94%) and 71 (3%) patients presented primarily with GGOs and sub-solid lesions, respectively. Elderly patients (≥ 60 years) were more likely to exhibit sub-solid lesions. The generalized linear mixed model showed that the dorsal segment of the right lower lobe was the favoured site of COVID-19 pneumonia. CONCLUSION: Chest CT combined with analysis by the uAI Intelligent Assistant Analysis System can accurately evaluate pneumonia in COVID-19 patients.

11.
Front. Public Health ; (8)20200529.
Article in English | ELSEVIER | ID: covidwho-613109

ABSTRACT

Background: Frontline health professionals are a COVID-19-susceptible population during the outbreak of COVID-19, but prophylactic drugs against SARS-CoV-2 infection are to be explored. Method: Frontline health professionals diagnosed with COVID-19 before February 9, 2020 in Tongji Hospital, Wuhan, China and the same amount of controls in the uninfected group were included in this study. Clinical and laboratory data were collected with standardized forms. Results: A total of 164 subjects were included in this study, 82 cases in the infected group and 82 controls in the uninfected group, with a median age of 37 years, including 63 males and 101 females. Nineteen (23.2%) patients in the infected group were administered oral arbidol, and 48 (58.5%) in the uninfected group (OR = 0.214, 95% CI 0.109–0.420). The cumulative uninfected rate of health professionals in the arbidol group was significantly higher than that of individuals in the non-arbidol group (log-rank test, χ 2= 98.74; P < 0.001). Forty-eight patients (58.5%) in the infection group were hospitalized, with a median age of 39 (31–49) years, of whom 7 (14.6%) were prophylactically administered arbidol. Thirty-four patients (41.5%) with mild symptoms were treated outside the hospital, among which the median age was 34 (30–39) years, and twelve patients (35.3%) took prophylactic oral arbidol. The hospitalization rate was significantly associated with age (P = 0.024) and oral arbidol administration (OR = 0.313, 95% CI 0.108–0.909). In the age-matched case-control study, the hospitalization rate was not significantly associated with arbidol administration (P = 0.091). Conclusion: Prophylactic oral arbidol was associated with a lower incidence of SARS-CoV-2 infection but not hospitalization rate in health professionals, providing a basis for the selection of prophylactic drugs for high-risk populations.

12.
Chin Med J (Engl) ; 133(11): 1261-1267, 2020 Jun 05.
Article in English | MEDLINE | ID: covidwho-547754

ABSTRACT

BACKGROUND: The 2019 novel coronavirus has caused the outbreak of the acute respiratory disease in Wuhan, Hubei Province of China since December 2019. This study was performed to analyze the clinical characteristics of patients who succumbed to and who recovered from 2019 novel coronavirus disease (COVID-19). METHODS: Clinical data were collected from two tertiary hospitals in Wuhan. A retrospective investigation was conducted to analyze the clinical characteristics of fatal cases of COVID-19 (death group) and we compare them with recovered patients (recovered group). Continuous variables were analyzed using the Mann-Whitney U test. Categorical variables were analyzed by χ test or Fisher exact test as appropriate. RESULTS: Our study enrolled 109 COVID-19 patients who died during hospitalization and 116 recovered patients. The median age of the death group was older than the recovered group (69 [62, 74] vs. 40 [33, 57] years, Z = 9.738, P < 0.001). More patients in the death group had underlying diseases (72.5% vs. 41.4%, χ = 22.105, P < 0.001). Patients in the death group had a significantly longer time of illness onset to hospitalization (10.0 [6.5, 12.0] vs. 7.0 [5.0, 10.0] days, Z = 3.216, P = 0.001). On admission, the proportions of patients with symptoms of dyspnea (70.6% vs. 19.0%, χ = 60.905, P < 0.001) and expectoration (32.1% vs. 12.1%, χ = 13.250, P < 0.001) were significantly higher in the death group. The blood oxygen saturation was significantly lower in the death group (85 [77, 91]% vs. 97 [95, 98]%, Z = 10.625, P < 0.001). The white blood cell (WBC) in death group was significantly higher on admission (7.23 [4.87, 11.17] vs. 4.52 [3.62, 5.88] ×10/L, Z = 7.618, P < 0.001). Patients in the death group exhibited significantly lower lymphocyte count (0.63 [0.40, 0.79] vs. 1.00 [0.72, 1.27] ×10/L, Z = 8.037, P < 0.001) and lymphocyte percentage (7.10 [4.45, 12.73]% vs. 23.50 [15.27, 31.25]%, Z = 10.315, P < 0.001) on admission, and the lymphocyte percentage continued to decrease during hospitalization (7.10 [4.45, 12.73]% vs. 2.91 [1.79, 6.13]%, Z = 5.242, P < 0.001). Alanine transaminase (22.00 [15.00, 34.00] vs. 18.70 [13.00, 30.38] U/L, Z = 2.592, P = 0.010), aspartate transaminase (34.00 [27.00, 47.00] vs. 22.00 [17.65, 31.75] U/L, Z = 7.308, P < 0.001), and creatinine levels (89.00 [72.00, 133.50] vs. 65.00 [54.60, 78.75] µmol/L, Z = 6.478, P < 0.001) were significantly higher in the death group than those in the recovered group. C-reactive protein (CRP) levels were also significantly higher in the death group on admission (109.25 [35.00, 170.28] vs. 3.22 [1.04, 21.80] mg/L, Z = 10.206, P < 0.001) and showed no significant improvement after treatment (109.25 [35.00, 170.28] vs. 81.60 [27.23, 179.08] mg/L, Z = 1.219, P = 0.233). The patients in the death group had more complications such as acute respiratory distress syndrome (ARDS) (89.9% vs. 8.6%, χ = 148.105, P < 0.001), acute cardiac injury (59.6% vs. 0.9%, χ = 93.222, P < 0.001), acute kidney injury (18.3% vs. 0%, χ = 23.257, P < 0.001), shock (11.9% vs. 0%, χ = 14.618, P < 0.001), and disseminated intravascular coagulation (DIC) (6.4% vs. 0%, χ = 7.655, P = 0.006). CONCLUSIONS: Compared to the recovered group, more patients in the death group exhibited characteristics of advanced age, pre-existing comorbidities, dyspnea, oxygen saturation decrease, increased WBC count, decreased lymphocytes, and elevated CRP levels. More patients in the death group had complications such as ARDS, acute cardiac injury, acute kidney injury, shock, and DIC.


Subject(s)
Betacoronavirus , Coronavirus Infections/complications , Pneumonia, Viral/complications , Adult , Aged , Aged, 80 and over , C-Reactive Protein/analysis , Coronavirus Infections/mortality , Female , Humans , Male , Middle Aged , Oxygen/blood , Pandemics , Pneumonia, Viral/mortality , Retrospective Studies
13.
Hypertens Res ; 43(8): 824-831, 2020 08.
Article in English | MEDLINE | ID: covidwho-459258

ABSTRACT

This study aims to explore the effect of hypertension on disease progression and prognosis in patients with coronavirus disease 2019 (COVID-19). A total of 310 patients diagnosed with COVID-19 were studied. A comparison was made between two groups of patients, those with hypertension and those without hypertension. Their demographic data, clinical manifestations, laboratory indicators, and treatment methods were collected and analyzed. A total of 310 patients, including 113 patients with hypertension and 197 patients without hypertension, were included in the analysis. Compared with patients without hypertension, patients with hypertension were older, were more likely to have diabetes and cerebrovascular disease, and were more likely to be transferred to the intensive care unit. The neutrophil count and lactate dehydrogenase, fibrinogen, and D-dimer levels in hypertensive patients were significantly higher than those in nonhypertensive patients (P < 0.05). However, multivariate analysis (adjusted for age and sex) failed to show that hypertension was an independent risk factor for COVID-19 mortality or severity. COVID-19 patients with hypertension were more likely than patients without hypertension to have severe pneumonia, excessive inflammatory reactions, organ and tissue damage, and deterioration of the disease. Patients with hypertension should be given additional attention to prevent worsening of their condition.


Subject(s)
Coronavirus Infections/complications , Hypertension/complications , Pneumonia, Viral/complications , Adult , Aged , Betacoronavirus , China/epidemiology , Coronavirus Infections/epidemiology , Coronavirus Infections/therapy , Female , Humans , Male , Middle Aged , Pandemics , Pneumonia, Viral/epidemiology , Pneumonia, Viral/therapy , Retrospective Studies
14.
Heart ; 106(15): 1142-1147, 2020 Aug.
Article in English | MEDLINE | ID: covidwho-426977

ABSTRACT

BACKGROUND: Coronavirus disease 2019 (COVID-19) has produced a significant health burden worldwide, especially in patients with cardiovascular comorbidities. The aim of this systematic review and meta-analysis was to assess the impact of underlying cardiovascular comorbidities and acute cardiac injury on in-hospital mortality risk. METHODS: PubMed, Embase and Web of Science were searched for publications that reported the relationship of underlying cardiovascular disease (CVD), hypertension and myocardial injury with in-hospital fatal outcomes in patients with COVID-19. The ORs were extracted and pooled. Subgroup and sensitivity analyses were performed to explore the potential sources of heterogeneity. RESULTS: A total of 10 studies were enrolled in this meta-analysis, including eight studies for CVD, seven for hypertension and eight for acute cardiac injury. The presence of CVD and hypertension was associated with higher odds of in-hospital mortality (unadjusted OR 4.85, 95% CI 3.07 to 7.70; I2=29%; unadjusted OR 3.67, 95% CI 2.31 to 5.83; I2=57%, respectively). Acute cardiac injury was also associated with a higher unadjusted odds of 21.15 (95% CI 10.19 to 43.94; I2=71%). CONCLUSION: COVID-19 patients with underlying cardiovascular comorbidities, including CVD and hypertension, may face a greater risk of fatal outcomes. Acute cardiac injury may act as a marker of mortality risk. Given the unadjusted results of our meta-analysis, future research are warranted.

15.
Cell ; 182(1): 59-72.e15, 2020 07 09.
Article in English | MEDLINE | ID: covidwho-401448

ABSTRACT

Early detection and effective treatment of severe COVID-19 patients remain major challenges. Here, we performed proteomic and metabolomic profiling of sera from 46 COVID-19 and 53 control individuals. We then trained a machine learning model using proteomic and metabolomic measurements from a training cohort of 18 non-severe and 13 severe patients. The model was validated using 10 independent patients, 7 of which were correctly classified. Targeted proteomics and metabolomics assays were employed to further validate this molecular classifier in a second test cohort of 19 COVID-19 patients, leading to 16 correct assignments. We identified molecular changes in the sera of COVID-19 patients compared to other groups implicating dysregulation of macrophage, platelet degranulation, complement system pathways, and massive metabolic suppression. This study revealed characteristic protein and metabolite changes in the sera of severe COVID-19 patients, which might be used in selection of potential blood biomarkers for severity evaluation.


Subject(s)
Coronavirus Infections/blood , Metabolomics , Pneumonia, Viral/blood , Proteomics , Adult , Amino Acids/metabolism , Biomarkers/blood , Cluster Analysis , Coronavirus Infections/physiopathology , Female , Humans , Lipid Metabolism , Machine Learning , Macrophages/pathology , Male , Middle Aged , Pandemics , Pneumonia, Viral/physiopathology , Severity of Illness Index
16.
Am J Prev Med ; 59(2): 168-175, 2020 08.
Article in English | MEDLINE | ID: covidwho-381906

ABSTRACT

INTRODUCTION: COVID-19 has become a serious global pandemic. This study investigates the clinical characteristics and the risk factors for COVID-19 mortality and establishes a novel scoring system to predict mortality risk in patients with COVID-19. METHODS: A cohort of 1,663 hospitalized patients with COVID-19 in Wuhan, China, of whom 212 died and 1,252 recovered, were included in this study. Demographic, clinical, and laboratory data on admission were collected from electronic medical records between January 14, 2020 and February 28, 2020. Clinical outcomes were collected until March 26, 2020. Multivariable logistic regression was used to explore the association between potential risk factors and COVID-19 mortality. The receiver operating characteristic curve was used to predict COVID-19 mortality risk. All analyses were conducted in April 2020. RESULTS: Multivariable regression showed that increased odds of COVID-19 mortality was associated with older age (OR=2.15, 95% CI=1.35, 3.43), male sex (OR=1.97, 95% CI=1.29, 2.99), history of diabetes (OR=2.34, 95% CI=1.45, 3.76), lymphopenia (OR=1.59, 95% CI=1.03, 2.46), and increased procalcitonin (OR=3.91, 95% CI=2.22, 6.91, per SD increase) on admission. Spline regression analysis indicated that the correlation between procalcitonin levels and COVID-19 mortality was nonlinear (p=0.0004 for nonlinearity). The area under the receiver operating curve of the COVID-19 mortality risk was 0.765 (95% CI=0.725, 0.805). CONCLUSIONS: The independent risk factors for COVID-19 mortality included older age, male sex, history of diabetes, lymphopenia, and increased procalcitonin, which could help clinicians to identify patients with poor prognosis at an earlier stage. The COVID-19 mortality risk score model may assist clinicians in reducing COVID-19-related mortality by implementing better strategies for more effective use of limited medical resources.


Subject(s)
Cause of Death , Communicable Diseases, Emerging/epidemiology , Coronavirus Infections/mortality , Disease Outbreaks/statistics & numerical data , Pandemics/statistics & numerical data , Pneumonia, Viral/mortality , Adult , Age Factors , Aged , China/epidemiology , Clinical Laboratory Techniques/methods , Cohort Studies , Coronavirus Infections/diagnosis , Databases, Factual , Female , Hospitalization/statistics & numerical data , Humans , Logistic Models , Male , Middle Aged , Multivariate Analysis , Pneumonia, Viral/diagnosis , ROC Curve , Retrospective Studies , Risk Assessment , Sex Factors , Survival Analysis
17.
Eur Respir J ; 2020 May 19.
Article in English | MEDLINE | ID: covidwho-324353

ABSTRACT

BACKGROUND: Timely diagnosis of SARS-CoV-2 infection is a prerequisite for treatment and prevention. The serology characteristics and complement diagnosis value of the antibody test to RNA test need to be demonstrated. METHOD: Serial sera of 80 patients with PCR-confirmed COVID-19 were collected at the First Affiliated Hospital of Zhejiang University, China. Total antibody (Ab), IgM and IgG antibodies against SARS-CoV-2 were detected, and the antibody dynamics during the infection were described. RESULTS: The seroconversion rates for Ab, IgM and IgG were 98.8%, 93.8% and 93.8%, respectively. The first detectible serology marker was Ab, followed by IgM and IgG, with a median seroconversion time of 15, 18 and 20 days post exposure (d.p.e) or 9, 10 and 12 days post onset (d.p.o), respectively. The antibody levels increased rapidly beginning at 6 d.p.o. and were accompanied by a decline in viral load. For patients in the early stage of illness (0-7 d.p.o), Ab showed the highest sensitivity (64.1%) compared to IgM and IgG (33.3% for both, p<0.001). The sensitivities of Ab, IgM and IgG increased to 100%, 96.7% and 93.3% 2 weeks later, respectively. When the same antibody type was detected, no significant difference was observed between enzyme-linked immunosorbent assays and other forms of immunoassays. CONCLUSIONS: A typical acute antibody response is induced during SARS-CoV-2 infection. Serology testing provides an important complement to RNA testing in the later stages of illness for pathogenic specific diagnosis and helpful information to evaluate the adapted immunity status of patients.

18.
Remote Sens. ; 10(12)20200501.
Article in English | ELSEVIER | ID: covidwho-276466

ABSTRACT

The sudden outbreak of the COVID-19 pandemic has brought drastic changes to people's daily lives, work, and the surrounding environment. Investigations into these changes are very important for decision makers to implement policies on economic loss assessments and stimulation packages, city reopening, resilience of the environment, and arrangement of medical resources. In order to analyze the impact of COVID-19 on people's lives, activities, and the natural environment, this paper investigates the spatial and temporal characteristics of Nighttime Light (NTL) radiance and Air Quality Index (AQI) before and during the pandemic in mainland China. The monthly mean NTL radiance, and daily and monthly mean AQI are calculated over mainland China and compared before and during the pandemic. Our results show that the monthly average NTL brightness is much lower during the quarantine period than before. This study categorizes NTL into three classes: residential area, transportation, and public facilities and commercial centers, with NTL radiance ranges of 5-20, 20-40 and greater than 40 (nWcm -2. sr -1), respectively. We found that the Number of Pixels (NOP) with NTL detection increased in the residential area and decreased in the commercial centers for most of the provinces after the shutdown, while transportation and public facilities generally stayed the same. More specifically, we examined these factors in Wuhan, where the first confirmed cases were reported, and where the earliest quarantine measures were taken. Observations and analysis of pixels associated with commercial centers were observed to have lower NTL radiance values, indicating a dimming behavior, while residential area pixels recorded increased levels of brightness after the beginning of the lockdown. The study also discovered a significant decreasing trend in the daily average AQI for mainland China from January to March 2020, with cleaner air in most provinces during February and March, compared to January 2020. In conclusion, the outbreak and spread of COVID-19 has had a crucial impact on people's daily lives and activity ranges through the increased implementation of lockdown and quarantine policies. On the other hand, the air quality of mainland China has improved with the reduction in non-essential industries and motor vehicle usage. This evidence demonstrates that the Chinese government has executed very stringent quarantine policies to deal with the pandemic. The decisive response to control the spread of COVID-19 provides a reference for other parts of the world.

19.
Zhejiang Da Xue Xue Bao Yi Xue Ban ; 49(2): 191-197, 2020 May 25.
Article in Chinese | MEDLINE | ID: covidwho-234346

ABSTRACT

OBJECTIVE: To analyze the dynamic changes of chest CT images of patients with coronavirus disease 2019 (COVID-19). METHODS: Fifty-two cases of COVID-19 were admitted in the First Affiliated Hospital of Zhejiang University School of Medicine. The consecutive chest CT scans were followed up for all patients with an average of 4 scans performed per patient during the hospitalization. The shortest interval between each scan was 2 days and the longest was 7 days. The shape, number and distribution of lung shadows, as well as the characteristics of the lesions on the CT images were reviewed. RESULTS: The obvious shadows infiltrating the lungs were shown on CT images in 50 cases, for other 2 cases there was no abnormal changes in the lungs during the first CT examination. Ground-glass opacities (GGO) were found in 48 cases (92.3%), and 19 cases (36.5%) had patchy consolidation and sub-consolidation, which were accompanied with air bronchi sign in 17 cases (32.7%). Forty one cases (78.8%) showed a thickened leaflet interval, 4 cases (7.6%) had a small number of fibrous stripes. During hospitalization, GGO lesions in COVID-19 patients gradually became rare,the fibrous strip shadows increased and it became the most common imaging manifestation. The lesions rapidly progressed in 39 cases (75.0%) within 6-9 days after admission. On days 10-14 of admission, the lesions distinctly resolved in 40 cases (76.9%). CONCLUSIONS: The chest CT images of patients with COVID-19 have certain characteristics with dynamic changes, which are of value for monitoring disease progress and clinical treatment.


Subject(s)
Coronavirus Infections , Pandemics , Pneumonia, Viral , Tomography, X-Ray Computed , Betacoronavirus/isolation & purification , China , Coronavirus Infections/diagnostic imaging , Coronavirus Infections/pathology , Disease Progression , Humans , Pneumonia, Viral/diagnostic imaging , Pneumonia, Viral/pathology
20.
J Am Soc Nephrol ; 31(6): 1157-1165, 2020 06.
Article in English | MEDLINE | ID: covidwho-154772

ABSTRACT

BACKGROUND: Some patients with COVID-19 pneumonia also present with kidney injury, and autopsy findings of patients who died from the illness sometimes show renal damage. However, little is known about the clinical characteristics of kidney-related complications, including hematuria, proteinuria, and AKI. METHODS: In this retrospective, single-center study in China, we analyzed data from electronic medical records of 333 hospitalized patients with COVID-19 pneumonia, including information about clinical, laboratory, radiologic, and other characteristics, as well as information about renal outcomes. RESULTS: We found that 251 of the 333 patients (75.4%) had abnormal urine dipstick tests or AKI. Of 198 patients with renal involvement for the median duration of 12 days, 118 (59.6%) experienced remission of pneumonia during this period, and 111 of 162 (68.5%) patients experienced remission of proteinuria. Among 35 patients who developed AKI (with AKI identified by criteria expanded somewhat beyond the 2012 Kidney Disease: Improving Global Outcomes definition), 16 (45.7%) experienced complete recovery of kidney function. We suspect that most AKI cases were intrinsic AKI. Patients with renal involvement had higher overall mortality compared with those without renal involvement (28 of 251 [11.2%] versus one of 82 [1.2%], respectively). Stepwise multivariate binary logistic regression analyses showed that severity of pneumonia was the risk factor most commonly associated with lower odds of proteinuric or hematuric remission and recovery from AKI. CONCLUSIONS: Renal abnormalities occurred in the majority of patients with COVID-19 pneumonia. Although proteinuria, hematuria, and AKI often resolved in such patients within 3 weeks after the onset of symptoms, renal complications in COVID-19 were associated with higher mortality.


Subject(s)
Acute Kidney Injury/etiology , Betacoronavirus , Coronavirus Infections/complications , Hematuria/etiology , Pneumonia, Viral/complications , Proteinuria/etiology , Adult , Aged , Coronavirus Infections/mortality , Female , Humans , Logistic Models , Male , Middle Aged , Pandemics , Pneumonia, Viral/mortality , Prognosis , Retrospective Studies
SELECTION OF CITATIONS
SEARCH DETAIL