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EuropePMC; 2020.
Preprint in English | EuropePMC | ID: ppcovidwho-325059

ABSTRACT

Background: To explore the effects of short-term low- to moderate- dose glucocorticoids on the immune-inflammatory indicators and 28-d prognoses of patients with regular or severe coronavirus disease 2019 (COVID-19). Methods: : The clinical data and laboratorial examination results of 66 patients with regular or severe type of COVID-19 that treated in Henan Provincial People’s Hospital and Nanyang Central Hospital between January 20 and February 14, 2020 were retrospectively analyzed. Here, 36 patients that had been treated with glucocorticoids were categorized in the glucocorticoids group (GC group), while the other 30 patients that had not been treated with glucocorticoids were categorized in the control group. Results: : The immune-inflammatory indicators and prognoses of the patients in the two groups were compared. The sex, age, clinical types, and complications were not significantly different between the two groups (all P> 0.05). After hospitalization, 33.3% and 6.7% of the patients in the GC group and control group were with chest distress, respectively, and the difference was statistically significant ( P= 0.019). The duration of fever was also significantly different between the two groups (6.91 ± 4.41 vs. 9.21 ± 4.46 days, P= 0.036), but the blood examination results within 24 h after hospitalization were not significantly different between the two groups (all P> 0.05). The C-reactive protein (CRP) and Interleukin-6 (IL-6) levels were lower in the GC group than control group on day 7 ( P= 0.012, P= 0.035) but were not significantly different between the two groups on day 14. The CRP and IL-6 levels were significantly reduced after glucocorticoids treatment on day 3, 5 and 7 (all P< 0.05) in GC group. The median time of hospital stay, and 28-d prognoses were not significantly different between the two groups ( P= 0.080, P> 0.999). Conclusions: Glucocorticoids could decrease the levels of inflammatory indicators, but did not significantly influence other immune-related indicators and 28-d prognoses.

3.
J Allergy Clin Immunol Pract ; 9(7): 2645-2655.e14, 2021 07.
Article in English | MEDLINE | ID: covidwho-1118526

ABSTRACT

BACKGROUND: Chronic respiratory diseases (CRD) are common among patients with coronavirus disease 2019 (COVID-19). OBJECTIVES: We sought to determine the association between CRD (including disease overlap) and the clinical outcomes of COVID-19. METHODS: Data of diagnoses, comorbidities, medications, laboratory results, and clinical outcomes were extracted from the national COVID-19 reporting system. CRD was diagnosed based on International Classification of Diseases-10 codes. The primary endpoint was the composite outcome of needing invasive ventilation, admission to intensive care unit, or death within 30 days after hospitalization. The secondary endpoint was death within 30 days after hospitalization. RESULTS: We included 39,420 laboratory-confirmed patients from the electronic medical records as of May 6, 2020. Any CRD and CRD overlap was present in 2.8% and 0.2% of patients, respectively. Chronic obstructive pulmonary disease (COPD) was most common (56.6%), followed by bronchiectasis (27.9%) and asthma (21.7%). COPD-bronchiectasis overlap was the most common combination (50.7%), followed by COPD-asthma (36.2%) and asthma-bronchiectasis overlap (15.9%). After adjustment for age, sex, and other systemic comorbidities, patients with COPD (odds ratio [OR]: 1.71, 95% confidence interval [CI]: 1.44-2.03) and asthma (OR: 1.45, 95% CI: 1.05-1.98), but not bronchiectasis, were more likely to reach to the composite endpoint compared with those without at day 30 after hospitalization. Patients with CRD were not associated with a greater likelihood of dying from COVID-19 compared with those without. Patients with CRD overlap did not have a greater risk of reaching the composite endpoint compared with those without. CONCLUSION: CRD was associated with the risk of reaching the composite endpoint, but not death, of COVID-19.


Subject(s)
Asthma , COVID-19 , Pulmonary Disease, Chronic Obstructive , Asthma/epidemiology , Comorbidity , Hospitalization , Humans , Pulmonary Disease, Chronic Obstructive/epidemiology , Retrospective Studies , Risk Factors , SARS-CoV-2
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