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1.
BMC Infect Dis ; 22(1): 498, 2022 May 26.
Article in English | MEDLINE | ID: covidwho-1865281

ABSTRACT

OBJECTIVES: One of the major challenges in treating patients with coronavirus disease 2019 (COVID-19) is predicting the severity of disease. We aimed to develop a new score for predicting progression from mild/moderate to severe COVID-19. METHODS: A total of 239 hospitalized patients with COVID-19 from two medical centers in China between February 6 and April 6, 2020 were retrospectively included. The prognostic abilities of variables, including clinical data and laboratory findings from the electronic medical records of each hospital, were analysed using the Cox proportional hazards model and Kaplan-Meier methods. A prognostic score was developed to predict progression from mild/moderate to severe COVID-19. RESULTS: Among the 239 patients, 216 (90.38%) patients had mild/moderate disease, and 23 (9.62%) progressed to severe disease. After adjusting for multiple confounding factors, pulmonary disease, age > 75, IgM, CD16+/CD56+ NK cells and aspartate aminotransferase were independent predictors of progression to severe COVID-19. Based on these five factors, a new predictive score (the 'PAINT score') was established and showed a high predictive value (C-index = 0.91, 0.902 ± 0.021, p < 0.001). The PAINT score was validated using a nomogram, bootstrap analysis, calibration curves, decision curves and clinical impact curves, all of which confirmed its high predictive value. CONCLUSIONS: The PAINT score for progression from mild/moderate to severe COVID-19 may be helpful in identifying patients at high risk of progression.


Subject(s)
COVID-19 , COVID-19/diagnosis , Humans , Nomograms , Prognosis , Proportional Hazards Models , Retrospective Studies
2.
Sustainability ; 14(9):4898, 2022.
Article in English | ProQuest Central | ID: covidwho-1843194

ABSTRACT

The emergence of various web contents gives customers influence according to characteristics. The characteristics of the content can distinguish the three types of commerce: branded content-type commerce, review content-type commerce, and home shopping content-type commerce. The purpose of this study is to identify the difference between customer engagement and reuse intention according to the three types of content characteristics. To identify the research questions, we conducted experiment and survey for three different commerce types. Randomized participants were exposed to different three web contents. Analysis of variance (ANOVA) was applied to compare three groups on average to analyze the differences between those groups. After testing the manipulation of experiment, structural equation modeling for various antecedents was performed. Interaction had a positive effect on engagement, as we prove within the paper. Content information had a positive impact on engagement, as you can see within the research. The effect of attention on engagement was confirmed as positive. Results of analysis proved our hypotheses;thus, scarcity of time had a positive effect on engagement and scarcity of quantity had a positive effect on engagement, as we prove within the paper. Ubiquity has a positive effect on engagement. System quality positively affects engagement. Ease of use has a positive effect on engagement. Consumer engagement had a positive effect on reuse intention. Finally, there are differences among the three kinds of mobile commerce as a conclusion within the findings.

3.
Journal of Army Medical University ; 44(3):195-202, 2022.
Article in Chinese | CAB Abstracts | ID: covidwho-1841727

ABSTRACT

Objective: To construct an XGBoost prediction model to predict disease severity of COVID-19 based on clinical characteristics dataset of COVID-19 patients.

4.
Inflammation ; 2021 Nov 25.
Article in English | MEDLINE | ID: covidwho-1838368

ABSTRACT

The emergence of severe acute syndrome coronavirus 2 (SARS-CoV-2) in December 2019 has led to the global COVID-19 pandemic. Although the symptoms of most COVID-19 patients are mild or self-curable, most of severe patients have sepsis caused by cytokine storms, which greatly increases the case fatality rate. Moreover, there is no effective drug that can limit the novel coronavirus thus far, so it is more needed to develop antiviral drugs for the SARS-CoV-2. In our research, we employed the techniques of molecular docking to screen 35 flavonoid compounds among which 29 compounds have Z-scores lower than - 6. Then, ( -)-gallocatechin gallate, ( +)-gallocatechin and baicalein were identified to have potent inhibitory activity against SARS-CoV-2 Mpro with IC50 values of 5.774 ± 0.805 µM, 13.14 ± 2.081 µM and 5.158 ± 0.928 µM respectively by FRET assay. Molecular docking results also showed that ( -)-gallocatechin gallate, ( +)-gallocatechin and baicalein can non-covalently bind to Mpro through π-π stacking and hydrogen bonds in the Cys145 catalytic site. We further evaluated the effect of ( -)-gallocatechin gallate and baicalein on cytokine storms using a mouse model of sepsis. ( -)-Gallocatechin gallate and baicalein significantly reduced sepsis of mouse models on weight, murine sepsis score, and survival rate and reduced the inflammatory factor levels, such as TNF-α, IL-1α, IL-4, and IL-10. Overall, ( -)-gallocatechin gallate and baicalein show certain potential of treatment against COVID-19.

5.
World J Gastroenterol ; 28(15): 1526-1535, 2022 Apr 21.
Article in English | MEDLINE | ID: covidwho-1818246

ABSTRACT

The coronavirus disease 2019 (COVID-19) pandemic caused by severe acute respiratory syndrome coronavirus-2 has brought serious challenges for the medical field. Patients with COVID-19 usually have respiratory symptoms. However, liver dysfunction is not an uncommon presentation. Additionally, the degree of liver dysfunction is associated with the severity and prognosis of COVID-19. Prevention, diagnosis, and treatment of malnutrition should be routinely recommended in the management of patients with COVID-19, especially in those with liver dysfunction. Recently, a large number of studies have reported that nutrition therapy measures, including natural dietary supplements, vitamins, minerals and trace elements, and probiotics, might have potential hepatoprotective effects against COVID-19-related liver dysfunction via their antioxidant, antiviral, anti-inflammatory, and positive immunomodulatory effects. This review mainly focuses on the possible relationship between COVID-19 and liver dysfunction, nutritional and metabolic characteristics, nutritional status assessment, and nutrition therapy to provide a reference for the nutritionists while making evidence-based nutritional decisions during the COVID-19 pandemic.


Subject(s)
COVID-19 , Liver Diseases , Nutritionists , Humans , Liver Diseases/diagnosis , Liver Diseases/therapy , Pandemics , SARS-CoV-2
6.
World J Crit Care Med ; 11(2): 112-114, 2022 Mar 09.
Article in English | MEDLINE | ID: covidwho-1791994

ABSTRACT

Coronavirus disease 2019 (COVID-19) caused by severe acute respiratory syndrome coronavirus-2 has become a worldwide public health crisis. Studies have demonstrated that diabetes and dyslipidaemia are common comorbidities and could be high-risk factors for severe COVID-19. Vitamin D, a group of fat-soluble compounds responsible for intestinal absorption of calcium, magnesium, and phosphate, has been widely used as a dietary supplement for the prevention and treatment of numerous diseases, including infectious and non-infectious diseases, due to its high cost-effectiveness; safety; tolerability; and anti-thrombotic, anti-inflammatory, antiviral, and immunomodulatory properties. In this letter to the editor, we mainly discuss the potential role of vitamin D in patients with diabetes, dyslipidaemia, and COVID-19.

7.
PLoS Genet ; 18(4): e1010137, 2022 04.
Article in English | MEDLINE | ID: covidwho-1789166

ABSTRACT

Viral infections can alter host transcriptomes by manipulating host splicing machinery. Despite intensive transcriptomic studies on SARS-CoV-2, a systematic analysis of alternative splicing (AS) in severe COVID-19 patients remains largely elusive. Here we integrated proteomic and transcriptomic sequencing data to study AS changes in COVID-19 patients. We discovered that RNA splicing is among the major down-regulated proteomic signatures in COVID-19 patients. The transcriptome analysis showed that SARS-CoV-2 infection induces widespread dysregulation of transcript usage and expression, affecting blood coagulation, neutrophil activation, and cytokine production. Notably, CD74 and LRRFIP1 had increased skipping of an exon in COVID-19 patients that disrupts a functional domain, which correlated with reduced antiviral immunity. Furthermore, the dysregulation of transcripts was strongly correlated with clinical severity of COVID-19, and splice-variants may contribute to unexpected therapeutic activity. In summary, our data highlight that a better understanding of the AS landscape may aid in COVID-19 diagnosis and therapy.


Subject(s)
COVID-19 , Alternative Splicing/genetics , COVID-19/genetics , COVID-19 Testing , Humans , Proteomics , SARS-CoV-2/genetics , Transcriptome
9.
Front Public Health ; 9: 754199, 2021.
Article in English | MEDLINE | ID: covidwho-1775952

ABSTRACT

Background: Lung cancer is the leading source of cancer-caused disability-adjusted life years. Medical cost burden impacts the well-being of patients through reducing income, cutting daily expenses, curtailing leisure activities, and depleting exhausting savings. The COmprehensive Score for Financial Toxicity (COST) was created and validated by De Souza and colleagues. Our study intends to measure the financial burdens of cancer therapy and investigate the link between financial toxicity and health-related quality of life (HRQoL) in an advanced lung cancer population. Methods: Patients aged ≥ 18 years with confirmed stage III to IV lung cancer were eligible. The COST questionnaire verified by de Souza et al. was used to identify financial toxicity. Multivariable linear regression analysis with log transformation univariate analysis and Pearson correlations were used to perform the analysis. Results: The majority of the patients (90.8%, n = 138/152) had an annual income of $50,000 ($7,775). The cohort's insurance situation was as follows: 64.5% of the cohort had social insurance, 20.4% had commercial insurance, and 22.0% had both. Patients who were younger age (50-59, P < 0.001), employed but on sick leave, and had lower income reported increased levels of financial toxicity (P < 0.05). The risk factors for high financial toxicity: (i) younger age (50-59), (ii) <1 month of savings, and (iii) being employed but on sick leave. Increased financial toxicity is moderately correlated with a decrease in QoL. Conclusion: Poorer psychological status and specific demographics are linked to increased financial toxicity (lower COST). Financial toxicity has a modest relationship with HRQoL and may have a clear link with HRQoL measurements.


Subject(s)
Lung Neoplasms , Adolescent , China , Cost of Illness , Financial Stress , Humans , Lung Neoplasms/psychology , Quality of Life
10.
BMC Infect Dis ; 22(1): 271, 2022 Mar 20.
Article in English | MEDLINE | ID: covidwho-1745483

ABSTRACT

BACKGROUND: During the COVID-19 outbreak in Taiwan between May 11 and June 20, 2021, the observed fatality rate (FR) was 5.3%, higher than the global average at 2.1%. The high number of reported deaths suggests that many patients were not treated promptly or effectively. However, many unexplained deaths were subsequently identified as cases, indicating a few undetected cases, resulting in a higher estimate of FR. Whether the true FR is exceedingly high and what factors determine the detection of cases remain unknown. Estimating the true number of total infected cases (i.e. including undetected cases) can allow an accurate estimation of FR and effective reproduction number ([Formula: see text]). METHODS: We aimed at quantifying the time-varying FR and [Formula: see text] using the estimated true numbers of cases; and, exploring the relationship between the true case number and test and trace data. After adjusting for reporting delays, we developed a model to estimate the number of undetected cases using reported deaths that were and were not previously detected. The daily FR and [Formula: see text] were calculated using the true number of cases. Afterwards, a logistic regression model was used to assess the impact of daily testing and tracing data on the detection ratio of deaths. RESULTS: The estimated true daily case number at the peak of the outbreak on May 22 was 897, which was 24.3% higher than the reported number, but the difference became less than 4% on June 9 and afterwards. After taking account of undetected cases, our estimated mean FR (4.7%) was still high but the daily rate showed a large decrease from 6.5% on May 19 to 2.8% on June 6. [Formula: see text] reached a maximum value of 6.4 on May 11, compared to 6.0 estimated using the reported case number. The decreasing proportion of undetected cases was found to be associated with the increases in the ratio of the number of tests conducted to reported cases, and the proportion of cases that are contact traced before symptom onset. CONCLUSIONS: Increasing testing capacity and contact tracing coverage without delays not only improve parameter estimation by reducing hidden cases but may also reduce fatality rates.


Subject(s)
COVID-19 , Basic Reproduction Number , COVID-19/epidemiology , Humans , Taiwan/epidemiology
11.
EuropePMC; 2022.
Preprint in English | EuropePMC | ID: ppcovidwho-330238

ABSTRACT

At the end of 2019, the COVID-19 emerged in Wuhan, China. It has since put global public health institutions on high alert. People reduced their traveling, and production has stopped nationwide during the epidemic. This paper explores the effect of these COVID-19-derived changes on the air quality in China. Air quality data of 367 cities around China were included. The daily air pollutants concentration (AQI,CO, O 3 , NO 2 , SO 2 , PM10, and PM2.5) were collected. We compared the air quality changes between three periods (23.1.2019-23.3.2019, 22.11.2019-22.1.2020, and 23.1.2020–23.3.2020). To compare, we calculated the daily average number of cities with pollution, and the trend in air quality index change. Furthermore, Air quality in the top 50 cities with confirmed cases and Wuhan was analyzed. During the period between 23.1.2020 and 23.3.2020, the number of cities with excellent air quality was significantly higher than that in another two periods. The concentrations of PM2.5, PM10, NO 2 , SO 2 , CO, and O 3 decreased significantly during the COVID-19 epidemic. The most significant decreases were in PM10 and NO 2 . The number of cities with good air quality in the later period was significantly higher than that a year before. The air quality has improved significantly during the COVID-19 outbreak, The reason for this change may be human activities such as reduced transportation and production stoppage.

12.
Signal Transduct Target Ther ; 7(1): 57, 2022 02 23.
Article in English | MEDLINE | ID: covidwho-1702971

ABSTRACT

The coronavirus disease 2019 (COVID-19) is a highly transmissible disease caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) that poses a major threat to global public health. Although COVID-19 primarily affects the respiratory system, causing severe pneumonia and acute respiratory distress syndrome in severe cases, it can also result in multiple extrapulmonary complications. The pathogenesis of extrapulmonary damage in patients with COVID-19 is probably multifactorial, involving both the direct effects of SARS-CoV-2 and the indirect mechanisms associated with the host inflammatory response. Recognition of features and pathogenesis of extrapulmonary complications has clinical implications for identifying disease progression and designing therapeutic strategies. This review provides an overview of the extrapulmonary complications of COVID-19 from immunological and pathophysiologic perspectives and focuses on the pathogenesis and potential therapeutic targets for the management of COVID-19.


Subject(s)
Acute Kidney Injury/complications , COVID-19/complications , Cytokine Release Syndrome/complications , Disseminated Intravascular Coagulation/complications , Lymphopenia/complications , Myocarditis/complications , Pulmonary Embolism/complications , Acute Kidney Injury/drug therapy , Acute Kidney Injury/immunology , Acute Kidney Injury/virology , Anticoagulants/therapeutic use , Antiviral Agents/therapeutic use , COVID-19/drug therapy , COVID-19/immunology , COVID-19/virology , Clinical Trials as Topic , Cytokine Release Syndrome/drug therapy , Cytokine Release Syndrome/immunology , Cytokine Release Syndrome/virology , Disseminated Intravascular Coagulation/drug therapy , Disseminated Intravascular Coagulation/immunology , Disseminated Intravascular Coagulation/virology , Endothelial Cells/drug effects , Endothelial Cells/immunology , Endothelial Cells/virology , Humans , Immunity, Innate/drug effects , Immunologic Factors/therapeutic use , Lymphopenia/drug therapy , Lymphopenia/immunology , Lymphopenia/virology , Myocarditis/drug therapy , Myocarditis/immunology , Myocarditis/virology , Pulmonary Embolism/drug therapy , Pulmonary Embolism/immunology , Pulmonary Embolism/virology , Renin-Angiotensin System/drug effects , Renin-Angiotensin System/immunology , SARS-CoV-2/drug effects , SARS-CoV-2/growth & development , SARS-CoV-2/pathogenicity
13.
EuropePMC; 2021.
Preprint in English | EuropePMC | ID: ppcovidwho-324241

ABSTRACT

Severe acute syndrome coronavirus 2(SARS-CoV-2) caused the global pandemic of COVID-19 since December 2019. Although most of COVID-19’s patients are mild or common, most of the severe patients have sepsis caused by the cytokine storm, which greatly increases the case fatality rate. Moreover, there is no effective drug that can resist the novel coronavirus so far, so it’s urgent to develop antiviral drug for the SARS-CoV-2. In our research, we screened 29 compounds with a score lower than -6 from 35 flavonoid compounds by molecular docking. (-)-Gallocatechin gallate, (+)-Gallocatechin and Baicalein were identified to have potent inhibit activity with IC 50 5.774±0.805μM, 13.14±2.081μM and 5.158±0.928μM by FRET assay. Subsequently, we conducted molecular docking experiments, which showed that (-)-Gallocatechin gallate, (+)-Gallocatechin and Baicalein were non-covalently bound to M pro through π-π stacking and hydrogen bonds in the Cys145 catalytic site. We further evaluated the effect of (-)-Gallocatechin gallate and Baicalein on cytokine storm use a mouse model of sepsis. (-)-Gallocatechin gallate and Baicalein significant reduced sepsis severity based on weight, murine sepsis score and survival rate and reduced the inflammatory factors level such as TNF-α, IL-1α, IL-4 and IL-10. Overall, (-)-Gallocatechin gallate and Baicalein may be potential drugs for symptomatic treatment of COVID-19.

14.
EuropePMC; 2021.
Preprint in English | EuropePMC | ID: ppcovidwho-323658

ABSTRACT

Background: The coronavirus pneumonia is still spreading around the world. Much progress has been made in vaccine development, and vaccination will become an inevitable trend in the fight against this pandemic. However, the public acceptance of COVID-19 vaccination still remains uncertain. Methods: By calculating the sample size of random sampling, anonymous questionnaire was used in Wen Juan Xing survey platform. Multinomial logistic regression analyses were performed to identify the key sociodemographic, cognitive, and attitude associations with samples of healthcare workers and nonhealth care workers. Findings: A total of 2580 respondents have completed the questionnaire, including 1,329 healthcare workers and 1,251 nonhealthcare workers. This study showed that 76.98% of healthcare workers accepted the COVID-19 vaccine, 18.28% workers were hesitant, and 4.74% workers were resistant. Among the nonhealthcare workers, 56.19% workers received the COVID-19 vaccine, 37.57% workers were hesitant, and 6.24% workers were resistant. Among the healthcare workers, compared with vaccine recipients, vaccine-hesitant individuals were more likely to be female (AOR = 1.52, 95% CI: 1.12–2.07);vaccine-resistant individuals were more likely to live in the suburbs (AOR = 2.81, 95% CI: 1.44–3.99) with an income of 10,000 RMB or greater (AOR = 2.00, 95% CI: 1.03–3.90). Among the nonhealthcare workers, vaccine-hesitant individuals were more likely to be female (AOR = 1.66, 95% CI: 1.31–2.11);vaccine-resistant individuals were also more likely to be female (AOR =1.87, 95% CI: 1.16–3.02) and older than 65 years (AOR = 4.96, 95% CI: 1.40–7.62). There are great differences between healthcare workers and nonhealthcare workers in their cognition and attitude towards vaccines. Interpretation: Our study shows that healthcare workers are more willing to be vaccinated than nonhealthcare workers. Current vaccine safety issues continue to be a major factor affecting public acceptance, and to expand vaccine coverage in response to the COVID-19 pandemic, appropriate vaccination strategies and immunization programs are essential, especially for nonhealthcare workers.Funding: Medical and Technology Project of Zhejiang ProvinceDeclaration of Interest: None to declare. Ethical Approval: This study is a nation-wide cross-sectional study in China;the ethics committee ofAffiliated Hospital of Hangzhou Normal University approved all the procedures performed.

15.
EuropePMC; 2021.
Preprint in English | EuropePMC | ID: ppcovidwho-323654

ABSTRACT

Objectives: One of the major challenges in treating patients with coronavirus disease 2019 (COVID-19) is predicting the severity of disease. Natural killer (NK) cells are innate lymphocytes that respond to viral infection and might relate to COVID-19 disease severity. Therefore, we aimed to develop a new predictive score for progression from mild/moderate to severe COVID-19 based on NK cells information. Method: In total, 239 hospitalized patients with COVID-19 from two medical center in China were retrospectively included. The prognostic effects of variables, including clinical data and laboratory findings from the electronic medical records of each hospital, were analyzed using Cox proportional hazards model and Kaplan-Meier methods. A prognostic score was developed to predict progression from mild/moderate to severe COVID-19. Results: : Among the 239 patients, 216 (90.38%) patients had mild/moderate disease and 23 (9.62%) progressed to severe disease. After adjusting multiple confounding factors, pulmonary disease, age >75, IgM, CD16 + /CD56 + NK cells and aspartate aminotransferase were independently predictors of progression to severe COVID-19. Based on these five factors, a new predictive score (the ‘PAINT score’) was established and showed a high predictive value (C-index = 0.91, 0.902 ± 0.021, p<0.001). The PAINT score was validated using nomogram, bootstrap internal validations, calibration curves, decision curves and clinical impact curve, all of which confirmed its high predictive value. Conclusions: : The PAINT score for progression from mild/moderate to severe COVID-19 based on NK cell information may be helpful to identify patients at high risk of progression. Trial registration: None

16.
EuropePMC; 2021.
Preprint in English | EuropePMC | ID: ppcovidwho-323526

ABSTRACT

In this work we looked into a dataset of 114 thousands of suspicious messages collected from the most popular closed messaging platform in Taiwan between January and July, 2020. We proposed an hybrid algorithm that could efficiently cluster a large number of text messages according their topics and narratives. That is, we obtained groups of messages that are within a limited content alterations within each other. By employing the algorithm to the dataset, we were able to look at the content alterations and the temporal dynamics of each particular rumor over time. With qualitative case studies of three COVID-19 related rumors, we have found that key authoritative figures were often misquoted in false information. It was an effective measure to increase the popularity of one false information. In addition, fact-check was not effective in stopping misinformation from getting attention. In fact, the popularity of one false information was often more influenced by major societal events and effective content alterations.

17.
EuropePMC; 2020.
Preprint in English | EuropePMC | ID: ppcovidwho-309031

ABSTRACT

Novel coronavirus pneumonia (NCP) has been widely spread in China and several other countries. Early finding of this pneumonia from huge numbers of suspects gives clinicians a big challenge. The aim of the study was to develop a rapid screening model for early predicting NCP in a Zhejiang population, as well as its utility in other areas. A total of 880 participants who were initially suspected of NCP from Jan 17 to Feb 19 were included. Potential predictors were selected via stepwise logistic regression analysis. The model was established based on epidemiological features, clinical manifestations, white blood cell count, and pulmonary imaging changes, with the area under receiver operating characteristic (AUROC) curve of 0.920 (95% confidence interval : 0.902-0.938;AUROC=0.915, and its standard deviation of 0.028, as evaluated in 5-fold cross-validation). At a value of whether the predicted score >4.0, the model could detect NCP with a specificity of 98.3%;at a cut-off value of < -0.5, the model could rule out NCP with a sensitivity of 97.9%. The study demonstrated that the rapid screening model was a helpful and cost-effective tool for early predicting NCP and had great clinical significance given the high activity of NCP.

18.
EuropePMC; 2020.
Preprint in English | EuropePMC | ID: ppcovidwho-308225

ABSTRACT

Background: Coronavirus disease 2019 (COVID-19) is a systemic disease caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. The purpose of the present study was to investigate the association between lung injury and cytokine profile in COVID-19 pneumonia. Methods: This retrospective study was conducted in COVID-19 patients. Demographic characteristics, symptoms, signs, underlying diseases, and laboratory data were collected. The patients were divided into COVID-19 with pneumonia and without pneumonia. CT severity score and PaO 2 /FiO 2 ratio and were used to assess lung injury. Results: 106 patients with 12 COVID-19 without pneumonia and 94 COVID-19 with pneumonia were included. Compared with COVID-19 without pneumonia, COVID-19 with pneumonia had significant higher serum interleukin (IL)-2R, IL-6, and tumor necrosis factor (TNF)-α. Correlation analysis showed that CT severity score and PaO 2 /FiO 2 were significantly correlated with age, presence of any coexisting disorder, lymphocyte count, procalcitonin, IL-2R, and IL-6. In multivariate analysis, log IL6 was only independent explanatory variables for CT severity score (β=0.397, p<0.001) and PaO 2 /FiO 2 (β=-0.434, p=0.003). Conclusions: Elevation of circulating cytokines was significantly associated with presence of pneumonia in COVID-19 and the severity of lung injury in COVID-19 pneumonia. Circulating IL-6 independently predicted the severity of lung injury in COVID-19 pneumonia.

19.
EuropePMC; 2020.
Preprint in English | EuropePMC | ID: ppcovidwho-307614

ABSTRACT

Background: To explore the significance of neutrophil-to-lymphocyte ratio (NLR), lactate dehydrogenase (LDH), D-dimer and CT score in evaluating the severity and prognosis of coronavirus disease – 2019 (COVID-19) in two centers of Hubei, China. Methods: : A total of 432 patients with laboratory confirmed COVID-19 were retrospectively enrolled and divided into non-severe and severe groups. The baseline data, laboratory findings, chest computed tomography (CT) results evaluating by CT score on admission, and clinical outcomes were collected and compared. The logistic regression was used to assess the independent relationship between the baseline level of four indicators (NLR, LDH, D-dimer, CT score) on admission and the severity of COVID-19, respectively. Results: : Among 432 patients, 125 (28.94%) cases were divided into severe group, the remaining (n = 307, 71.06%) were in non-severe group. In multivariate logistic regression, the high level of NLR, LDH were independent predictor in the early classification of patients with COVID-19 (OR = 2.163;95%CI = 1.162–4.026;p =  0.015 for NLR > 3.82;OR = 2.298;95%CI = 1.327–3.979;p =  0.003 for LDH > 246U/L). Furthermore, combining NLR > 3.82 and LDH > 246U/L could increase the sensitivity of diagnosis in severe patients (NLR > 3.82 [50.40%] vs. Combined diagnosis [72.80%];p  = 0.0007;LDH > 246 [59.2%] vs. Combined diagnosis [72.80%];p <  0.0001). Conclusions: : The high levels of NLR and LDH in serum have potential value in the early identification of severe patients with COVID-19. The combination of LDH and NLR can improve the sensitivity of diagnosis. Importance : COVID-19 has been a global pandemic. The mortality rate is range from 3.5-6.0%. In order to predict the risk factors of severity of COVID-19. we explore the significance of neutrophil-to-lymphocyte ratio (NLR), lactate dehydrogenase (LDH), D-dimer and CT score in evaluating the severity and prognosis of coronavirus disease – 2019 (COVID-19) in two centers of Hubei, China. We found that the high levels of NLR and LDH in serum have potential value in the early identification of severe patients with COVID-19. The combination of LDH and NLR can improve the sensitivity of diagnosis.

20.
EuropePMC; 2020.
Preprint in English | EuropePMC | ID: ppcovidwho-325321

ABSTRACT

Background: Coronavirus Disease 2019 (COVID-19) has become a global pandemic and caused over one hundred thousand death. Chloroquine (CQ) and hydroxychloroquine (HCQ) were recommended for off-label use in the treatment of COVID-19 in some countries despite their unclear benefit. However, the toxicity of these agents has been ignored, so the investigation of their safety in the treatment of COVID-19 is crucial for providing a reference for the rational use. Methods: The medical records obtained from the information management system of Guangzhou Eighth People’s Hospital were reviewed to extract data about patients who received chloroquine phosphate tablets for COVID-19 treatment from January 20th to March 5th, 2020. The data were assessed to determine the correlation of adverse reaction with chloroquine phosphate based on Chinese CFDA standards as well as the severity of adverse events based on American CTCAE5.0 standard, and evaluate the safety of this medication. Results: A total of 42 patients (23 males and 19 females, average 42.19±14.29 years old) with COVID-19 were treated with low-dose chloroquine phosphate (oral, 500 mg, once per day). Totally 18 patients(42.86%)experienced 20 adverse events. The mean duration of CQ administration was 6.57 days (SD, 3.16 days;range: 1 day to 16 days) and 52.4% received CQ for 7 to 9 days. The adverse events occurred within 6–8 days of treatment. For the 20 adverse events, 19 were not higher than grade 2 and only one was grade 3 because of the severely limited self-care ability in one patient. The most common adverse events were related to the digestive, circulatory, hepatic, and nervous systems. Conclusion: Oral chloroquine phosphate tablets resulted in a high incidence of adverse reactions. In the clinical trial of chloroquine phosphate for COVID-19 treatment, it should be used under pharmaceutical care;timely evaluation of the drug safety during the treatment process is necessary and a randomized controlled clinical trial should be conducted.

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