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1.
EuropePMC; 2020.
Preprint in English | EuropePMC | ID: ppcovidwho-325035

ABSTRACT

In this study, we ascertained the chest CT data of 60 patients admitted to 3 hospitals in Chongqing with confirmed COVID-19. We conducted anatomical and pathological analyses to elucidate the possible reasons for the distribution, morphology, and characteristics of COVID-19 in chest CT. We also shared a semiquantitative scoring of affected lung segments, which was recommended by our local medical association. This scoring system was applied to quantify the severity of the disease. The most frequent imaging findings of COVID-19 were subpleural ground glass opacities and consolidation;there was a significant difference in semiquantitative scores between the early, progressive, and severe stages of the disease. We conclude that the chest CT findings of COVID-19 showed certain characteristics because of the anatomical features of the human body and pathological changes caused by the virus. Therefore, chest CT is a valuable tool for facilitating the diagnosis of COVID-19 and semiquantitative scoring of affected lung segments may further elucidate diagnosis and assessment of disease severity. This will assist healthcare workers in diagnosing COVID-19 and assessing disease severity, facilitate the selection of appropriate treatment options, which is important for reducing the spread of the virus, saving lives, and controlling the pandemic.

2.
EuropePMC; 2020.
Preprint in English | EuropePMC | ID: ppcovidwho-315695

ABSTRACT

Background: COVID-19 associated with SARS-CoV-2 infection is of outbreak worldwide. This project aimed to provide clinical features, treatment advice and risk factors of patients diagnosed with COVID-19.MethodsIn this study, we analyzed 109 patients with confirmed COVID-19. We compared the relevant data of patients over 60 years old and under 60 years old, analyzed the data of patients with chronic diseases, and clarified the importance of the combination of laboratory examination and CT diagnosis.ResultsMost of patients 59(54.1%) had no fever. 100(91.7%) of patients required supplemental O 2 , and their SpO2 values reached normal after oxygen therapy. 72 (66.1%) patients were over 60 years old, and they were more likely to develop respiratory symptoms. Among all patients, only 14 (12.8%) patients were positive for anti-SARS-CoV-2 antibody, SARS-COV-2 RT-PCR assay and CT diagnosis.Conclusion(1) O 2 supplement therapy plays an important role in the treatment of COVID-19 patients.(2) People over 60 years old or(and) having chronic diseases are risk factors of SARS-CoV-2 infection.(3) Most patients infected with SARS-CoV-2 have no fever symptoms.(4) We recommend that CT positive results be included in the confirmed diagnosis criteria, which is important for the diagnosis of COVID-19.

3.
Mil Med Res ; 8(1): 57, 2021 11 01.
Article in English | MEDLINE | ID: covidwho-1496239

ABSTRACT

BACKGROUND: Mitochondria have been shown to play vital roles during severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection and coronavirus disease 2019 (COVID-19) development. Currently, it is unclear whether mitochondrial DNA (mtDNA) variants, which define mtDNA haplogroups and determine oxidative phosphorylation performance and reactive oxygen species production, are associated with COVID-19 risk. METHODS: A population-based case-control study was conducted to compare the distribution of mtDNA variations defining mtDNA haplogroups between healthy controls (n = 615) and COVID-19 patients (n = 536). COVID-19 patients were diagnosed based on molecular diagnostics of the viral genome by qPCR and chest X-ray or computed tomography scanning. The exclusion criteria for the healthy controls were any history of disease in the month preceding the study assessment. MtDNA variants defining mtDNA haplogroups were identified by PCR-RFLPs and HVS-I sequencing and determined based on mtDNA phylogenetic analysis using Mitomap Phylogeny. Student's t-test was used for continuous variables, and Pearson's chi-squared test or Fisher's exact test was used for categorical variables. To assess the independent effect of each mtDNA variant defining mtDNA haplogroups, multivariate logistic regression analyses were performed to calculate the odds ratios (ORs) and 95% confidence intervals (CIs) with adjustments for possible confounding factors of age, sex, smoking and diseases (including cardiopulmonary diseases, diabetes, obesity and hypertension) as determined through clinical and radiographic examinations. RESULTS: Multivariate logistic regression analyses revealed that the most common investigated mtDNA variations (> 10% in the control population) at C5178a (in NADH dehydrogenase subunit 2 gene, ND2) and A249d (in the displacement loop region, D-loop)/T6392C (in cytochrome c oxidase I gene, CO1)/G10310A (in ND3) were associated with a reduced risk of severe COVID-19 (OR = 0.590, 95% CI 0.428-0.814, P = 0.001; and OR = 0.654, 95% CI 0.457-0.936, P = 0.020, respectively), while A4833G (ND2), A4715G (ND2), T3394C (ND1) and G5417A (ND2)/C16257a (D-loop)/C16261T (D-loop) were related to an increased risk of severe COVID-19 (OR = 2.336, 95% CI 1.179-4.608, P = 0.015; OR = 2.033, 95% CI 1.242-3.322, P = 0.005; OR = 3.040, 95% CI 1.522-6.061, P = 0.002; and OR = 2.890, 95% CI 1.199-6.993, P = 0.018, respectively). CONCLUSIONS: This is the first study to explore the association of mtDNA variants with individual's risk of developing severe COVID-19. Based on the case-control study, we concluded that the common mtDNA variants at C5178a and A249d/T6392C/G10310A might contribute to an individual's resistance to developing severe COVID-19, whereas A4833G, A4715G, T3394C and G5417A/C16257a/C16261T might increase an individual's risk of developing severe COVID-19.


Subject(s)
COVID-19 , DNA, Mitochondrial , COVID-19/genetics , Case-Control Studies , China , DNA, Mitochondrial/genetics , Humans , Mitochondria/genetics , Phylogeny , Risk Factors
4.
Asian J Psychiatr ; 64: 102801, 2021 Oct.
Article in English | MEDLINE | ID: covidwho-1340519

ABSTRACT

OBJECTIVE: Children of parents with mental illness (COPMI) are vulnerable during the COVID-19 pandemic. The study aimed to assess the psychosocial impacts of the pandemic and identify potential factors influencing their mental health. METHOD: 665 COPMI from six sites including Wuhan in China were enrolled. COPMI's mental health and the impacts of COVID-19 were assessed by an online survey. Univariate and multivariate analyses were performed to examine the association between impact factors and participants' mental health. RESULTS: 16.1 % of participants were in abnormal range of mental health, with interpersonal relationship being the most common problem. 48.6 % of participants reported quite worried about the epidemic. All aspects of adverse effects of COVID-19 were more prevalent among COPMI in Wuhan than in other sites. Concerns about COVID-19 (OR = 1.7, p = 0.02), decreased family income (OR = 2.0, p = 0.02), being physically abused (OR = 2.1, p = 0.04), witnessing family members being physically abused (OR = 2.0, p = 0.03), and needs for promoting family members' mental health (OR = 2.2, p < 0.01) were independent risk factors for participants' mental health. CONCLUSION: The findings raise our awareness of the impacts of COVID-19 pandemic on the wellbeing of COPMI. Multifaceted psychosocial support for COPMI is urgently needed to support them live through the pandemic.


Subject(s)
COVID-19 , Mental Disorders , Child , China/epidemiology , Cross-Sectional Studies , Humans , Mental Disorders/epidemiology , Pandemics , Parents , SARS-CoV-2
5.
Aging (Albany NY) ; 12(22): 22413-22424, 2020 11 24.
Article in English | MEDLINE | ID: covidwho-966953

ABSTRACT

COVID-19 exhibits both variability and rapid progression, particularly in patients with comorbidities such as diabetes, hypertension or cancer. To determine how these underlying disorders exacerbate pneumonia in COVID-19, we evaluated 79 patients with severe COVID-19 and grouped them according to whether or not they had comorbidities. Clinical information, laboratory examinations, immunological function, and treatment outcomes were retrospectively analyzed. Our study revealed that severe COVID-19 patients with comorbidities had higher levels of inflammatory indices, including blood interferon-γ, interleukin (IL)-6 and c-reactive protein levels as well as the erythrocyte sedimentation rate. These were accompanied by lymphopenia, hypokalemia, hypoalbuminemia, a decrease in either CD4+ T cells or lymphocyte count, and coagulation disorders, which were closely related to poor prognosis. Patients with comorbidities also had longer disease remission times (27 ± 6.7 days) than those without comorbidities (20 ± 6.5 days). Cox multivariate analysis indicated that glucocorticoid therapy and IL-6 were independent prognostic factors. Our findings suggest that coexisting comorbidities aggravate COVID-19 through the excessive release of inflammatory factors and that glucocorticoid therapy may be beneficial.


Subject(s)
COVID-19/immunology , Glucocorticoids/therapeutic use , Inflammation Mediators/blood , Inflammation/diagnosis , SARS-CoV-2/immunology , Adult , Aged , Aged, 80 and over , Blood Sedimentation , C-Reactive Protein/analysis , C-Reactive Protein/immunology , CD4 Lymphocyte Count , COVID-19/blood , COVID-19/drug therapy , COVID-19/epidemiology , Comorbidity , Female , Humans , Inflammation/blood , Inflammation/drug therapy , Inflammation/immunology , Interleukin-6/blood , Interleukin-6/immunology , Male , Middle Aged , Pandemics , Prognosis , Retrospective Studies , SARS-CoV-2/isolation & purification , Severity of Illness Index , Treatment Outcome
7.
PLoS One ; 15(9): e0238760, 2020.
Article in English | MEDLINE | ID: covidwho-745057

ABSTRACT

In this study, we ascertained the chest CT data of 60 patients admitted to 3 hospitals in Chongqing with confirmed COVID-19. We conducted anatomical and pathological analyses to elucidate the possible reasons for the distribution, morphology, and characteristics of COVID-19 in chest CT. We also shared a semiquantitative scoring of affected lung segments, which was recommended by our local medical association. This scoring system was applied to quantify the severity of the disease. The most frequent imaging findings of COVID-19 were subpleural ground glass opacities and consolidation; there was a significant difference in semiquantitative scores between the early, progressive, and severe stages of the disease. We conclude that the chest CT findings of COVID-19 showed certain characteristics because of the anatomical features of the human body and pathological changes caused by the virus. Therefore, chest CT is a valuable tool for facilitating the diagnosis of COVID-19 and semiquantitative scoring of affected lung segments may further elucidate diagnosis and assessment of disease severity. This will assist healthcare workers in diagnosing COVID-19 and assessing disease severity, facilitate the selection of appropriate treatment options, which is important for reducing the spread of the virus, saving lives, and controlling the pandemic.


Subject(s)
Coronavirus Infections/diagnostic imaging , Lung/diagnostic imaging , Pneumonia, Viral/diagnostic imaging , Tomography, Spiral Computed/standards , Adolescent , Adult , Aged , COVID-19 , Child , Coronavirus Infections/pathology , Female , Humans , Lung/pathology , Male , Middle Aged , Pandemics , Pneumonia, Viral/pathology , Severity of Illness Index , Tomography, Spiral Computed/methods
9.
Aging (Albany NY) ; 12(16): 15946-15953, 2020 08 24.
Article in English | MEDLINE | ID: covidwho-729799

ABSTRACT

BACKGROUND: Severe acute respiratory syndrome coronavirus 2(SARS-CoV-2) is the virus responsible for the coronavirus disease 2019(COVID-19) pandemic. Despite the extensive studies aiming to understand the pathology of COVID-19, the clinicopathological characteristics and risk factors associated with COVID-19 remain mostly unclear. In this study, we assessed the clinical course and features of COVID-19 patients. FINDINGS: There were 59 patients (54.1%) that had no fever. One-hundred(91.7%) patients required oxygen therapy, which improved percutaneous oxygen saturation (SpO2). Seventy-two (66.1%) patients aged over 60; these patients were more likely to develop respiratory symptoms. Only 13(11.9%) patients were positive for anti-SARS-CoV-2 antibodies, SARS-CoV-2 nucleic acid, and computed tomography (CT) findings. We found significant differences in age, respiratory symptoms, and heart rates between patients with and without underlying conditions. CONCLUSIONS: Our findings suggest that oxygen plays an important role in the treatment of COVID-19 patients and that age and underlying diseases are significant risk factors for COVID-19. Most COVID-19 patients have no fever, and CT provides higher detection rates than antibody- and nucleic acid-based detection methods. METHODS: We analyzed data from 109 confirmed COVID-19 cases. We compared the clinicopathological characteristic of patients stratified according to age and underlying diseases, as well as assessed the detection rates of different diagnostic methods.


Subject(s)
Betacoronavirus/isolation & purification , Clinical Laboratory Techniques/methods , Coronavirus Infections , Oxygen Inhalation Therapy/methods , Pandemics , Pneumonia, Viral , Age Factors , Aged , Blood Gas Monitoring, Transcutaneous/methods , COVID-19 , COVID-19 Testing , China/epidemiology , Comorbidity , Coronavirus Infections/diagnosis , Coronavirus Infections/epidemiology , Coronavirus Infections/physiopathology , Coronavirus Infections/therapy , Female , Humans , Male , Middle Aged , Pneumonia, Viral/diagnosis , Pneumonia, Viral/epidemiology , Pneumonia, Viral/physiopathology , Pneumonia, Viral/therapy , Retrospective Studies , Risk Assessment , Risk Factors , SARS-CoV-2 , Symptom Assessment/methods
10.
MedComm (2020) ; 1(2): 240-248, 2020 Sep.
Article in English | MEDLINE | ID: covidwho-728113

ABSTRACT

Clinicians have been faced with the challenge of differentiating between severe acute respiratory syndrome associated coronavirus 2 (SARS-CoV-2) infected pneumonia (NCP) and influenza A infected pneumonia (IAP), a seasonal disease that coincided with the outbreak. We aim to develop a machine-learning algorithm based on radiomics to distinguish NCP from IAP by texture analysis based on computed tomography (CT) imaging. Forty-one NCP and 37 IAP patients admitted from January to February 6, 2019 admitted to two hospitals in Wenzhou, China. All patients had undergone chest CT examination and blood routine tests prior to receiving medical treatment. NCP was diagnosed by real-time RT-PCR assays. Eight of 56 radiomic features extracted by LIFEx were selected by least absolute shrinkage and selection operator regression to develop a radiomics score and subsequently constructed into a nomogram to predict NCP with area under the operating characteristics curve of 0.87 (95% confidence interval: 0.77-0.93). The nomogram also showed excellent calibration with Hosmer-Lemeshow test yielding a nonsignificant statistic (P = .904). The novel nomogram may efficiently distinguish between NCP and IAP patients. The nomogram may be incorporated to existing diagnostic algorithm to effectively stratify suspected patients for SARS-CoV-2 pneumonia.

11.
Anesth Analg ; 131(2): 326-334, 2020 08.
Article in English | MEDLINE | ID: covidwho-650425

ABSTRACT

Coronavirus disease 2019 (COVID-19), caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), has spread worldwide. During the ongoing COVID-19 epidemic, most hospitals have postponed elective surgeries. However, some emergency surgeries, especially for trauma patients, are inevitable. For patients with suspected or confirmed COVID-19, a standard protocol addressing preoperative preparation, intraoperative management, and postoperative surveillance should be implemented to avoid nosocomial infection and ensure the safety of patients and the health care workforce. With reference to the guidelines and recommendations issued by the National Health Commission and Chinese Society of Anesthesiology, this article provides recommendations for anesthesia management of trauma and emergency surgery cases during the COVID-19 pandemic.


Subject(s)
Anesthesia , Anesthesiology , Coronavirus Infections , Coronavirus , Pandemics , Pneumonia, Viral , Betacoronavirus , COVID-19 , Humans , SARS-CoV-2
12.
Liver Int ; 40(9): 2160-2163, 2020 09.
Article in English | MEDLINE | ID: covidwho-611716

ABSTRACT

The Corona Virus Disease 2019 (COVID-19) pandemic has attracted increasing worldwide attention. While metabolic-associated fatty liver disease (MAFLD) affects a quarter of world population, its impact on COVID-19 severity has not been characterized. We identified 55 MAFLD patients with COVID-19, who were 1:1 matched by age, sex and obesity status to non-aged severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2)-infected patients without MAFLD. Our results demonstrate that in patients aged less than 60 years with COVID-19, MAFLD is associated with an approximately fourfold increase (adjusted odds ratio 4.07, 95% confidence interval 1.20-13.79, P = .02) in the probability for severe disease, after adjusting for confounders. Healthcare professionals caring for patients with COVID-19 need to be aware that there is a positive association between MAFLD and severe illness with COVID-19.


Subject(s)
Coronavirus Infections/complications , Fatty Liver/complications , Pneumonia, Viral/complications , Adult , Betacoronavirus , COVID-19 , China/epidemiology , Cohort Studies , Coronavirus Infections/epidemiology , Female , Humans , Male , Middle Aged , Pandemics , Pneumonia, Viral/epidemiology , SARS-CoV-2
14.
Blood Purif ; 50(1): 57-64, 2021.
Article in English | MEDLINE | ID: covidwho-580103

ABSTRACT

BACKGROUND: With an estimated basic reproductive number of 3.77, the Coronavirus Disease 2019 (COVID-19) continues to spread. It is urgent to exert adequate efforts for the management of dialysis patients, caregivers, and healthcare personnel (HCP). This study aimed at reporting practical workflow, identification of high-risk or suspected cases of CO-VID-19, and subsequent response measures. METHODS: At the time of the COVID-19 outbreak, precautions and practice protocols were applied in our dialysis units (DUs). This single-center study retrospectively reviewed all high-risk/suspected cases from January 23, 2020, to February 10, 2020. Epidemiological, clinical feature, and detailed data on all cases were recorded. RESULTS: Practical workflow for the clinical management of dialysis patients, caregivers, and HCP was initiated. A total of 6 high-risk/suspected cases were identified. Female gender, older age, presence of cardiovascular disease, diabetes, anuresis, immunocompromised status, hypoalbuminemia, and underweight were noticeable features in these cases. Direct evidence of infection or epidemiological risk was detected in five cases. Close monitoring for temperature and oxygen saturation during hemodialysis sessions may be reasonable. No confirmed COVID-19 cases were reported in our DU, but certain cases showed rapid deterioration due to other critically severe condition needing hospitalization. Portable dialysis machines are of great need to ensure dialysis care provision. CONCLUSIONS: Our study described a practical workflow for patient-centered management during COVID-19 outbreak. Potential risk factors and underlying clinical patterns were reported. Further studies regarding the efficacy of infection control precautions and practice protocols tailored for dialysis settings are warranted.


Subject(s)
COVID-19/prevention & control , Infection Control/methods , Kidney Failure, Chronic/therapy , Renal Dialysis , Aged , COVID-19/complications , COVID-19/diagnosis , Disease Outbreaks , Female , Humans , Kidney Failure, Chronic/complications , Male , Middle Aged , Renal Dialysis/methods , Retrospective Studies
16.
EMBO Mol Med ; 12(7): e12421, 2020 07 07.
Article in English | MEDLINE | ID: covidwho-306055

ABSTRACT

Progression to severe disease is a difficult problem in treating coronavirus disease 2019 (COVID-19). The purpose of this study is to explore changes in markers of severe disease in COVID-19 patients. Sixty-nine severe COVID-19 patients were included. Patients with severe disease showed significant lymphocytopenia. Elevated level of lactate dehydrogenase (LDH), C-reactive protein (CRP), ferritin, and D-dimer was found in most severe cases. Baseline interleukin-6 (IL-6) was found to be associated with COVID-19 severity. Indeed, the significant increase of baseline IL-6 was positively correlated with the maximal body temperature during hospitalization and with the increased baseline of CRP, LDH, ferritin, and D-dimer. High baseline IL-6 was also associated with more progressed chest computed tomography (CT) findings. Significant decrease in IL-6 and improved CT assessment was found in patients during recovery, while IL-6 was further increased in exacerbated patients. Collectively, our results suggest that the dynamic change in IL-6 can be used as a marker for disease monitoring in patients with severe COVID-19.


Subject(s)
Coronavirus Infections/pathology , Interleukin-6/analysis , Pneumonia, Viral/pathology , Adult , Aged , Aged, 80 and over , Antiviral Agents/therapeutic use , Betacoronavirus/isolation & purification , Biomarkers/analysis , C-Reactive Protein/analysis , COVID-19 , Coronavirus Infections/drug therapy , Coronavirus Infections/virology , Female , Humans , Lymphopenia/etiology , Male , Middle Aged , Pandemics , Pneumonia, Viral/drug therapy , Pneumonia, Viral/virology , SARS-CoV-2 , Severity of Illness Index , Tomography, X-Ray Computed
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