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1.
Ann Transl Med ; 9(18): 1446, 2021 Sep.
Article in English | MEDLINE | ID: covidwho-1436465

ABSTRACT

BACKGROUND: The rapid spread of coronavirus disease-19 (COVID-19) poses a global health emergency, and cases entering China from Russia are quite diverse. This study explored and compared the clinical characteristics and outcomes of severe and critically ill COVID-19 patients from Russia with and without influenza A infection, treated in a northern Chinese hospital (Russia imported patients). METHODS: A total of 32 severe and critically ill Russia-imported COVID-19 patients treated in the Heilongjiang Imported Severe and Critical COVID-19 Treatment Center from April 6 to May 11, 2020 were included, including 8 cases (group A) with and 24 cases (group B) without influenza A infection. The clinical characteristics of each group were compared, including prolonged hospital stay, duration of oxygen therapy, time from onset to a negative SARS-CoV-2 qRT-PCR RNA (Tneg) result, and duration of bacterial infection. RESULTS: The results showed that blood group, PaO2/FiO2, prothrombin time (PT), prothrombin activity (PTA), computed tomography (CT) score, hospital stay, duration of oxygenation therapy, Tneg, and duration of bacterial infection were statistically different between the two groups (P<0.05). Multivariant regression analysis showed that the Sequential Organ Failure Assessment (SOFA) score, C-reactive protein (CRP), and influenza A infection were factors influencing hospital stay; SOFA score, CRP, and CT score were factors influencing the duration of oxygenation therapy; PaO2/FiO2, platelet count (PLT), and CRP were factors influencing Tneg; and gender, SOFA score, and influenza A infection were factors influencing the duration of bacterial infection. CONCLUSIONS: Influenza A infection is common in Russia-imported COVID-19 patients, which can prolong the hospital stay and duration of bacterial infection. Routinely screening and treating influenza A should be conducted early in such patients.

2.
Rev Cardiovasc Med ; 21(4): 635-641, 2020 12 30.
Article in English | MEDLINE | ID: covidwho-1005370

ABSTRACT

To investigate the right heart function in coronavirus disease 2019 (COVID-19) patients with acute respiratory distress syndrome (ARDS), a retrospective analysis of 49 COVID-19 patients with ARDS was performed. Patients were divided into severe group and critically-severe group according to the severity of illness. Age-matched healthy volunteers were recruited as a control group. The cardiac cavity diameters, tricuspid annular plane systolic excursion (TAPSE), tricuspid valve regurgitation pressure gradient biggest (TRPG), pulmonary arterial systolic pressure (PASP), maximum inferior vena cava diameter (IVCmax) and minimum diameter (IVCmin), and inferior vena cava collapse index (ICV-CI) were measured using echocardiography. We found that the TAPSE was significantly decreased in pneumonia patients compared to healthy subjects (P < 0.0001), and it was significantly lower in critically-severe patients (P = 0.0068). The TAPSE was less than 17 mm in three (8.6%) severe and five (35.7%) critically-severe patients. In addition, the TAPSE was significantly decreased in severe ARDS patients than in mild ARDS patients. The IVCmax and IVCmin were significantly increased in critically-severe patients compared to healthy subjects and severe patients (P < 0.01), whereas the ICV-CI was significantly decreased (P < 0.05). COVID-19 patients had significantly larger right atrium and ventricle than healthy controls (P < 0.01). The left ventricular ejection fraction (LVEF) in critically-severe patients was significantly lower than that in severe patients and healthy controls (P < 0.05). Right ventricular function was impaired in critically-severe COVID-19 patients. The assessment and protection of the right heart function in COVID-19 patients should be strengthened.


Subject(s)
COVID-19/complications , Heart Ventricles/physiopathology , Pandemics , Ventricular Dysfunction, Right/etiology , Ventricular Function, Right/physiology , COVID-19/epidemiology , Echocardiography, Doppler , Female , Follow-Up Studies , Heart Ventricles/diagnostic imaging , Humans , Male , Middle Aged , Retrospective Studies , Ventricular Dysfunction, Right/diagnosis , Ventricular Dysfunction, Right/physiopathology
3.
Bosn J Basic Med Sci ; 21(2): 235-241, 2021 Apr 01.
Article in English | MEDLINE | ID: covidwho-745645

ABSTRACT

Peripheral blood lymphocyte count is shown to be decreased in patients with COVID-19 in the early stage of the disease. The degree of lymphocyte count reduction is related to COVID-19 severity and could be used as an indicator to reflect the disease severity. Our aim was to investigate the value of lymphocyte count in determining COVID-19 severity and estimating the time for SARS-CoV-2 nucleic acid test results to turn negative. We retrospectively analyzed clinical data of 201 patients with severe and critical COVID-19. The patients were admitted to the West Campus of Union Hospital of Tongji Medical College of Huazhong University of Science and Technology. The data included age, gender, chronic disease, lymphocyte count, and SARS-CoV-2 nucleic acid test results. The age of patients in critically ill group was higher than in severely ill group (p = 0.019). The lymphocyte count of critically ill patients was lower than of severely ill patients. The cutoff value of lymphocyte count to distinguish between the critically ill and the severely ill was 0.735 × 109/L (p = 0.001). The cutoff value of lymphocyte count for SARS-CoV-2 nucleic acid test results turning negative in severely and critically ill patients with chronic diseases (hypertension, diabetes, and coronary heart disease) was 0.835 × 109/L (p = 0.017). The cutoff value of lymphocyte count for SARS-CoV-2 nucleic acid test results turning negative in severely and critically ill male patients was 0.835 × 109/L (p < 0.0001). Lymphocyte count could be an effective indicator to predict COVID-19 severity. It may also be useful in determining the time for nucleic acid test results to turn negative in COVID-19 patients with underlying chronic diseases or male COVID-19 patients with severe and critical conditions.


Subject(s)
COVID-19 Nucleic Acid Testing , COVID-19/immunology , Lymphocyte Count , SARS-CoV-2 , Aged , COVID-19/diagnosis , COVID-19/virology , Female , Humans , Male , Middle Aged , Retrospective Studies , Severity of Illness Index
4.
World J Clin Cases ; 8(14): 2950-2958, 2020 Jul 26.
Article in English | MEDLINE | ID: covidwho-692833

ABSTRACT

BACKGROUND: A large number of pneumonia cases due to coronavirus disease 2019 (COVID-19) have been first reported in China. Meanwhile, the virus is sweeping all around the world and has infected millions of people. Fever and pulmonary symptoms have been noticed as major and early signs of infection, whereas gastrointestinal symptoms were also observed in a significant portion of patients. The clinical investigation of disease onset was underestimated, especially due to the neglection of cases presenting with gastrointestinal symptoms. AIM: To characterize the clinical features of coronavirus-infected patients with gastrointestinal symptoms as initial symptoms. METHODS: This is a retrospective, single-center case series of the general consecutive hospitalized patients with confirmed COVID-19 at Wuhan Union Hospital from February 2, 2020 to February 13, 2020. According to their initial symptoms, these patients were classified into two groups. Patients in group one presented with pulmonary symptoms (PS) as initial symptoms, and group two presented with gastrointestinal symptoms (GS). Epidemiological, demographic, clinical, laboratory, and treatment data were collected for analysis. RESULTS: Among the 50 patients recruited, no patient has been admitted to intensive care units, and no patient died during the study. The duration of hospitalization was longer in the GS group than in the PS group (12.13 ± 2.44 vs 10.00 ± 2.13, P < 0.01). All of the 50 patients exhibited decreased lymphocytes. However, lymphocytes in the GS group were significantly lower compared to those in the PS group (0.94 ± 0.06 vs 1.04 ± 0.15, P < 0.01). Procalcitonin and hs-CRP were both significantly higher in the GS group than in the PS group. Accordingly, the duration of viral shedding was significantly longer in the GS group compared to the PS group (10.22 ± 1.93 vs 8.15 ± 1.87, P < 0.01). CONCLUSION: COVID-19 patients presenting with gastrointestinal symptoms as initial symptoms need more days of viral shedding and hospitalization than the patients presenting with pulmonary symptoms.

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