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2.
Aging (Albany NY) ; 122020 Nov 21.
Article in English | MEDLINE | ID: covidwho-946449

ABSTRACT

BACKGROUND: Novel Coronavirus disease 2019 (COVID-19) was first detected in pneumonia patients in Wuhan, China in December 2019. Based on the current understanding, COVID-19 has become a global issue. Presumably, numerous studies have found that SARS-CoV-2 also transpires in kidney tissue with permanent viral loads. However, it is elusive as to whether SARS-CoV-2 can directly damage the kidney or induce acute renal failure. Hence, to comprehensively understand the impact of COVID-19 on kidney damage, we conducted a retrospective series of case studies to assess kidney functions. Additionally, ACE2 distribution in kidney tissue was analyzed through RNAseq data in open-access databases. RESULTS: According to the findings from transcriptome analysis, we revealed higher ACE2 expression levels in females than males. Similar results were more noticeable in the elderly than in young adults. Furthermore, single-cell RNA sequencing data analysis showed high ACE2 expression in kidney tubule and collecting duct principal cells as well as glomerular parietal epithelial cells. On their admission, the patient's serum creatinine and blood urea nitrogen (BUN) were elevated to between 36.13% and 16.80%, respectively. The estimated glomerular filtration rate (EGFR) of < 60 ml/min per 1.73 m2 was reported in 10.92 % of the patients. Notably, at admission, increased BUN time varied linearly following the generalized additive mixed model. Thus, the hourly-increase of BUN in patients was 0.495 (95%CI: 0.263, 0.726). CONCLUSION: Based on clinical findings, it was ascertained that COVID-19 can damage renal function, but it seldom causes acute renal failure. Coronavirus may directly bind to ACE2-positive cells and damage kidney tissue in the analysis of scRNA-seq data in kidney tissue. Therefore, this evidence suggests that kidney tissue act as the SARS-CoV-2 infection site and the findings could provide insight into the pathophysiology of kidney damage. METHODS: We systematically analyzed ACE2 expression profiles in organs based on open-access datasets for healthy individuals. Meanwhile, single-cell sequencing data for kidney samples were collected and analyzed. Assessments on kidney functions were conducted on 119 selected COVID-19 positive patients admitted from 10th February - 18th March 2020, in hospital in Wuhan City, Hubei Province. Consequently, their clinical records and laboratory findings, such as the estimated glomerular filtration rate (eGFR), Blood Urea Nitrogen (BUN), Creatinine, and Comorbidities, were collected.

3.
Respir Res ; 21(1): 314, 2020 Nov 26.
Article in English | MEDLINE | ID: covidwho-945210

ABSTRACT

BACKGROUND: Previous studies have focused on the clinical characteristics of hospitalized patients with the novel 2019 coronavirus disease (COVID-19). Limited data are available for convalescent patients. This study aimed to evaluate the clinical characteristics of discharged COVID-19 patients. METHODS: In this retrospective study, we extracted data for 134 convalescent patients with COVID-19 in Guizhou Provincial Staff Hospital from February 15 to March 31, 2020. Cases were analyzed on the basis of demographic, clinical, and laboratory data as well as radiological features. RESULTS: Of 134 convalescent patients with COVID-19, 19 (14.2%) were severe cases, while 115 (85.8%) were non-severe cases. The median patient age was 33 years (IQR, 21.8 to 46.3), and the cohort included 69 men and 65 women. Compared with non-severe cases, severe patients were older and had more chronic comorbidities, especially hypertension, diabetes, and thyroid disease (P < 0.05). Leukopenia was present in 32.1% of the convalescent patients and lymphocytopenia was present in 6.7%, both of which were more common in severe patients. 48 (35.8%) of discharged patients had elevated levels of alanine aminotransferase, which was more common in adults than in children (40.2% vs 13.6%, P = 0.018). A normal chest CT was found in 61 (45.5%) patients during rehabilitation. Severe patients had more ground-glass opacity, bilateral patchy shadowing, and fibrosis. No significant differences were observed in the positive rate of IgG and/or IgM antibodies between severe and non-severe patients. CONCLUSION: Leukopenia, lymphopenia, ground-glass opacity, and fibrosis are common in discharged severe COVID-19 patients, and liver injury is common in discharged adult patients. We suggest physicians develop follow-up treatment plans based on the different clinical characteristics of convalescent patients.

4.
BMC Infect Dis ; 20(1): 647, 2020 Sep 03.
Article in English | MEDLINE | ID: covidwho-744977

ABSTRACT

BACKGROUND: The family cluster is one of most important modes of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) transmission throughout China, and more details are needed about how family clusters cause the spread of coronavirus disease 2019 (COVID-19). CASE PRESENTATION: We retrospectively reviewed 7 confirmed cases from one family cluster. Both clinical features and laboratory examination results were described. Patient 1 had been in close contact with someone who was later confirmed to have COVID-19 in Wuhan City before he returned back to his hometown. He had dinner with 6 other members in his family. All the persons developed COVID-19 successively except for one older woman who neither had dinner with them nor shared a sleeping room with her husband. Six patients had mild or moderate COVID-19 but one older man with underlying diseases progressed into the severe type. After general and symptomatic treatments, all the patients recovered. CONCLUSIONS: In a family cluster, having dinner together may be an important mode for the transmission of SARS-CoV-2. In this setting, most cases are mild with a favorable prognosis, while elderly patients with underlying diseases may progress into the severe type. For someone who has close contact with a confirmed case, 14-day isolation is necessary to contain virus transmission.


Subject(s)
Betacoronavirus/isolation & purification , Coronavirus Infections/physiopathology , Coronavirus Infections/transmission , Family Health , Pneumonia, Viral/physiopathology , Pneumonia, Viral/transmission , Adolescent , Adult , Aged , Betacoronavirus/pathogenicity , Child , China/epidemiology , Coronavirus Infections/epidemiology , Coronavirus Infections/virology , Female , Humans , Male , Pandemics , Pneumonia, Viral/epidemiology , Pneumonia, Viral/virology , Retrospective Studies
5.
Int J Antimicrob Agents ; 56(2): 105974, 2020 Aug.
Article in English | MEDLINE | ID: covidwho-637982

ABSTRACT

Here we report a case of a laboratory-confirmed 2019 novel coronavirus (2019-nCoV)-infected patient with COVID-19 (coronavirus disease 2019) who developed respiratory failure and shock accompanied by persistent diarrhoea despite conventional therapeutic interventions. The patient avoided mechanical ventilation and showed an immediate clinical and radiological improvement following treatment with intensive plasma exchange (PE) followed by intravenous immunoglobulin (IVIG). Successful therapeutic strategies in this case suggest that timely initiation of PE treatment followed by IVIG in critically ill patients with COVID-19 may prevent the disease from worsening and help to reduce the requirement for mechanical ventilation and intensive supportive care. Moreover, it may improve poor clinical outcomes of these patients.


Subject(s)
Betacoronavirus/isolation & purification , Coronavirus Infections/therapy , Critical Illness/therapy , Immunoglobulins, Intravenous/administration & dosage , Plasma Exchange , Pneumonia, Viral/therapy , Coronavirus Infections/virology , Critical Care , Humans , Pandemics , Pneumonia, Viral/virology , Respiration, Artificial , Severity of Illness Index , Treatment Outcome
6.
Environ Microbiol ; 22(8): 3588-3592, 2020 08.
Article in English | MEDLINE | ID: covidwho-635804

ABSTRACT

We reported 20 cases of discharged COVID-19 patients whose RT-PCR test results showed 're-positive'. After finding 're-positive', these patients were admitted to hospital for the second time and were followed up until the end of May 2020. We recorded detailed treatment and follow-up process, and collected relevant data. The possible causes and potential clinical significance of this phenomenon are discussed.


Subject(s)
Betacoronavirus/isolation & purification , Coronavirus Infections/therapy , Pneumonia, Viral/therapy , Adolescent , Adult , Aged, 80 and over , Betacoronavirus/genetics , Child , Child, Preschool , China , Comorbidity , Coronavirus Infections/diagnosis , Coronavirus Infections/etiology , Diabetes Complications/epidemiology , Female , Follow-Up Studies , Humans , Hypertension/complications , Hypertension/epidemiology , Male , Middle Aged , Oropharynx/virology , Pandemics , Patient Discharge/standards , Patient Readmission , Pneumonia, Viral/diagnosis , Pneumonia, Viral/etiology , RNA, Viral/analysis , RNA, Viral/isolation & purification , Reagent Kits, Diagnostic , Real-Time Polymerase Chain Reaction , Recurrence , Reverse Transcriptase Polymerase Chain Reaction , Young Adult
7.
J Med Virol ; 92(9): 1383-1385, 2020 Sep.
Article in English | MEDLINE | ID: covidwho-623625
8.
Complement Ther Med ; 52: 102473, 2020 Aug.
Article in English | MEDLINE | ID: covidwho-591555

ABSTRACT

OBJECTIVE: Presentation of a case illustrating the benefits of traditional Chinese medicine (TCM) for treatment of Coronavirus disease 2019 (COVID-19) in critically ill patients. CLINICAL FEATURES AND OUTCOME: A 58-year-old woman presented with cough, fever, dizziness, chest tightness, polypnea and poor appetite. She was admitted to Guizhou Provincial People's hospital, and diagnosed with critically ill type of COVID-19 in February 2020. According to the patient's symptoms and signs, the TCM syndrome differentiation was qi deficiency, dampness-stasis and toxin accumulation. Then she received the combined therapy of a modified Chinese herbal formula and Western medicine. During a twelve-day period of treatment, her respiratory distress and appetite quickly improved. Abnormal laboratory indicators were resumed in time and lung lesions in CT scan largely absorbed. No side effects associated with this Chinese herbal formula were found. Before discharge, two consecutive nasopharyngeal swabs were shown to be negative for severe acute respiratory coronavirus 2 (SARS-CoV-2). CONCLUSIONS: Our case report suggests that collaborative treatments with traditional Chinese medicine prove beneficial in the management of COVID-19 in critically ill patients. In order to give optimal care for this COVID-19 crisis for the whole world, Chinese medicine practitioners and Western medical doctors should work together in frontline.


Subject(s)
Anti-Bacterial Agents/therapeutic use , Anti-Inflammatory Agents/therapeutic use , Antiviral Agents/therapeutic use , Coronavirus Infections/drug therapy , Drugs, Chinese Herbal/therapeutic use , Medicine, Chinese Traditional , Pneumonia, Viral/drug therapy , Betacoronavirus , Coronavirus Infections/physiopathology , Coronavirus Infections/therapy , Critical Illness , Drug Combinations , Female , Humans , Indoles/therapeutic use , Lopinavir/therapeutic use , Methylprednisolone/therapeutic use , Middle Aged , Moxifloxacin/therapeutic use , Noninvasive Ventilation , Oxygen Inhalation Therapy , Pandemics , Pneumonia, Viral/physiopathology , Pneumonia, Viral/therapy , Qi , Ritonavir/therapeutic use
10.
J Infect Dis ; 221(11): 1775-1781, 2020 05 11.
Article in English | MEDLINE | ID: covidwho-381706

ABSTRACT

BACKGROUND: Previous studies on the pneumonia outbreak caused by the 2019 novel coronavirus disease (COVID-19) were mainly based on information from adult populations. Limited data are available for children with COVID-19, especially for infected infants. METHODS: We report a 55-day-old case with COVID-19 confirmed in China and describe the identification, diagnosis, clinical course, and treatment of the patient, including the disease progression from day 7 to day 11 of illness. RESULTS: This case highlights that children with COVID-19 can also present with multiple organ damage and rapid disease changes. CONCLUSIONS: When managing such infant patients with COVID-19, frequent and careful clinical monitoring is essential.


Subject(s)
Coronavirus Infections/complications , Coronavirus Infections/diagnosis , Heart Injuries/etiology , Liver/injuries , Pneumonia, Viral/complications , Pneumonia, Viral/diagnosis , Pneumonia/etiology , Betacoronavirus , China , Coronavirus Infections/pathology , Coronavirus Infections/therapy , Disease Progression , Female , Humans , Infant , Pandemics , Pneumonia, Viral/pathology , Pneumonia, Viral/therapy , Treatment Outcome
11.
J Med Virol ; 92(9): 1383-1385, 2020 Sep.
Article in English | MEDLINE | ID: covidwho-66307
12.
Int J Antimicrob Agents ; 56(2): 105974, 2020 Aug.
Article in English | MEDLINE | ID: covidwho-46284

ABSTRACT

Here we report a case of a laboratory-confirmed 2019 novel coronavirus (2019-nCoV)-infected patient with COVID-19 (coronavirus disease 2019) who developed respiratory failure and shock accompanied by persistent diarrhoea despite conventional therapeutic interventions. The patient avoided mechanical ventilation and showed an immediate clinical and radiological improvement following treatment with intensive plasma exchange (PE) followed by intravenous immunoglobulin (IVIG). Successful therapeutic strategies in this case suggest that timely initiation of PE treatment followed by IVIG in critically ill patients with COVID-19 may prevent the disease from worsening and help to reduce the requirement for mechanical ventilation and intensive supportive care. Moreover, it may improve poor clinical outcomes of these patients.


Subject(s)
Betacoronavirus/isolation & purification , Coronavirus Infections/therapy , Critical Illness/therapy , Immunoglobulins, Intravenous/administration & dosage , Plasma Exchange , Pneumonia, Viral/therapy , Coronavirus Infections/virology , Critical Care , Humans , Pandemics , Pneumonia, Viral/virology , Respiration, Artificial , Severity of Illness Index , Treatment Outcome
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