Clinical features of patients with severe acute respiratory syndrome coronavirus 2 Delta variant infection and abnormal liver function in Guangdong Province, China. TT -? ? ? ? ? ?.

Objective To investigate the clinical features of patients with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) Delta variant infection and abnormal liver function in Guangdong Province, China. Methods The patients with SARS-CoV-2 Delta variant infection who belonged to the same chain of transmission in Guangdong Province (Guangzhou and Foshan) and were admitted to Guangzhou Eighth People's Hospital, Guangzhou Medical University from May 21 to June 18, 2021 were enrolled in this study, and the judgment criteria for liver function were alanine aminotransferase (male/female) > 50/40 U/L, aspartate aminotransferase > 40 U/L, total bilirubin > 26 mumol/L, gamma-glutamyl transpeptidase > 60 U/L, and alkaline phosphatase (ALK) > 125 U/L. Abnormality in any one item of the above criteria was defined as abnormal liver function, and such patients were included in analysis (the patients, aged < 18 years, who had a mild or moderate increase in ALP alone were not included in analysis). Clinical data were compared between the patients with normal liver function and those with abnormal liver function, and the etiology and prognosis of abnormal liver function were analyzed. The Mann-Whitney U test was used for comparison of continuous data between two groups;the chi-square test was used for comparison of categorical data between two groups. Results Among the 166 patients with SARS-CoV-2 Delta variant infection, 32 (19.3%) had abnormal liver function with mild-to-moderate increases in liver function parameters, and compared with the normal liver function group, the abnormal liver function group had a significantly higher proportion of critical patients (chi2=38.689, P < 0.001) and significantly higher age and inflammatory cytokines [C-reactive protein type, serum amyloid A, and interleukin-6 (IL-6)](all P < 0.05). Among the 32 patients with abnormal liver function, 13 patients had abnormal liver function on admission (defined as primary group), while 19 patients had normal liver function on admission but were found to have abnormal liver function by reexamination after treatment (defined as secondary group). For the primary group, the evidence of abnormal liver function was not found for 3 patients (3/13, 23.1%), and the possibility of toxic liver injury directly associated with SARS-CoV-2 infection was considered. Among the 19 patients in the secondary group, 9 (47.4%) had mild/common type and 10 (52.6%) had critical type, and all critical patients had the evidence of liver injury indirectly caused by the significant increases in C-reactive protein type, serum amyloid A, and IL-6 and hypoxemia;the evidence of abnormal liver function was not found for only 1 patient (1/19, 5.3%), and the possibility of toxic liver injury directly associated with SARS-CoV-2 infection was considered. All 32 patients with abnormal liver function had [JP2]significant reductions in liver function parameters after treatment including liver protection. Conclusion As for the patients with SARS-CoV-2 Delta variant infection who belong to the same chain of transmission in Guangdong Province, the critical patients show a significantly higher proportion of patients with abnormal liver function than the patients with other clinical types, and other factors except SARS-CoV-2 infection and indirect injury caused by SARS-CoV-2 infection are the main cause of liver injury.Copyright © 2022 Editorial Board of Jilin University. All rights reserved.

Kawasaki Disease in the Time of COVID-19 and MIS-C - The International Kawasaki Disease Registry.

BACKGROUND: Patients with Multisystem Inflammatory Syndrome in Children (MIS-C) and Kawasaki disease (KD) have overlapping clinical features. We compared demographics/clinical presentation, management, and outcomes of patients by evidence of prior SARS-CoV-2 infection. METHODS: The International KD Registry (IKDR) enrolled KD and MIS-C patients from sites from North, Central and South America, Europe, Asia and Middle East. Evidence of prior infection was defined as: Positive (+ve household contact or positive PCR/serology), Possible (suggestive clinical features of MIS-C and/or KD with negative PCR or serology but not both), Negative (negative PCR and serology and no known exposure), and Unknown (incomplete testing and no known exposure). RESULTS: Of 2345 enrolled patients SARS-CoV-2 status was Positive for 1541 (66%) patients, Possible 89 (4%), Negative 404 (17%) and Unknown for 311 (13%) patients. Clinical outcomes varied significantly between the groups, with more patients in the Positive/Possible groups presenting with shock, having admission to Intensive Care, receiving inotropic support, and having longer hospital stays. Regarding cardiac abnormalities, patients in the Positive/Possible groups had a higher prevalence of left ventricular dysfunction, while patients in the Negative and Unknown groups had more severe coronary artery abnormalities. results CONCLUSION: : There appears to be a spectrum of clinical features from MIS-C to KD with a great deal of heterogeneity, and one primary differentiating factor is evidence for prior acute SARS CoV2 infection/exposure. SARS-CoV-2 Positive/Possible patients had more severe presentations and required more intensive management, with a greater likelihood of ventricular dysfunction but less severe coronary artery adverse outcomes, in keeping with MIS-C.

Deaths by COVID-19 in a hospital from a city from Legal Amazon region: what lessons could be learned?

Objective: Describe the epidemiology of COVID-19 deaths within a hospital in the Amazon region in a period of 64 days, which corresponds to the growth curve of the COVID-19 first-wave pandemic in 2020. Method(s): The data were obtained from medical records of 152 deaths registered for adults and elderly hospitalized. The data were also compared with the number of deaths in previous years during the same period studied to assess the impact of the pandemic on this hospital. The study also assesses the impact of intra-hospital transfers, accounting for the number of times patients who died performed transfers between sectors of the hospital. Result(s): During the period analyzed, there was an increase in deaths compared to the previous years. The majority of dead patients were male, aged between 34 and 96 years. The deaths were associated comorbidities such as arterial hypertension, diabetes mellitus, and kidney disease. The SARS-CoV-2 infection was confirmed in 91 cases. Among them, 15 individuals were admitted without conditions related to SARS-CoV-2 infection;they had a three-fold higher number of hospital transfers than those admitted with SARS-CoV-2 infection symptoms. Sixteen patients with SARS-CoV-2 infection developed respiratory symptoms just after hospitalization. The diagnostic exam for SARS-CoV-2 infection was performed on average 4 (+/- 6) days after the onset of symptoms and 6 (+/- 6) days after admission, and the average time from the onset of respiratory symptoms to death was 4 (+/- 6) days. Conclusion(s): These data suggest the high presence of hospital infection by SARS-CoV-2 in the Brazilian Amazon region, which may be related to the number of sectorial transfers, delay in confirming the diagnosis, and lack of management. We report a serious public health problem, as it demonstrates the fragility of healthcare institutions in the hospital environment.Copyright © 2023 Faculdade de Medicina de Ribeirao Preto - U.S.P.. All rights reserved.

Chest CT findings of COVID-19-infected patients, are there differences between pediatric and adult patients? A systematic review

BackgroundPurpose of this study was to deliver a report of chest CT findings of COVID-19-infected pediatric and adult patients and to make an age-based comparison. A systematic search was conducted in accordance with PRISMA guidelines to identify relevant studies in the electronic databases of PubMed, Scopus, ProQuest, ScienceDirect, and Web of Sciences from January 1, 2020 to March 27, 2020 using search terms in the titles and s. Based on our inclusion and exclusion criteria, 762 articles were screened. Finally, 15 eligible articles which had adequate data on chest CT findings of COVID-19-infected patients were enrolled in this systematic review.ResultsIn pediatric patients (15 years old or younger), peripheral distribution was found in 100% of cases, ground glass opacities (GGO) in 55.2%, bilateral involvement in 50%, halo sign in 50%, unilateral involvement in 30%, consolidation in 22.2%, crazy paving pattern in 20%, nodular opacities in 15%, pleural effusion in 4.2%, lymphadenopathy in none, and normal imaging in 20.8% of cases. On the other hand, in adult patients, bilateral involvement was reported in 76.8%, GGO in 68.4%, peripheral distribution in 62.2%, mixed GGO and consolidation in 48.7%, consolidation in 33.7%, crazy paving pattern in 27.7%, mixed central and peripheral distribution in 25.0%, unilateral involvement in 15.2%, nodular opacities in 9.2%, pleural effusion in 5.5%, central distribution of lesions in 5.4%, lymphadenopathy in 2.4%, and normal imaging in 9.8% of cases.ConclusionAccording to the findings of this systematic review, children infected with COVID-19 can present with normal or atypical findings (nodular opacities/unilateral involvement) in chest imaging more frequently than adult patients. Therefore, more caution should be taken to avoid misdiagnosis or missed diagnosis in infected children. Besides, clinical and laboratory findings need to be considered more decision-making for pediatric patients with normal or atypical chest CT scan but high suspicion of COVID-19.

SARS-CoV-2 Vaccine Effectiveness against Omicron Variant in Infection-Naive Population, Australia, 2022.

SARS-CoV-2 transmission in Western Australia, Australia, was negligible until a wave of Omicron variant infections emerged in February 2022, when >90% of adults had been vaccinated. This unique pandemic enabled assessment of SARS-CoV-2 vaccine effectiveness (VE) without potential interference from background immunity from prior infection. We matched 188,950 persons who had a positive PCR test result during February-May 2022 to negative controls by age, week of test, and other possible confounders. Overall, 3-dose VE was 42.0% against infection and 81.7% against hospitalization or death. A primary series of 2 viral-vectored vaccines followed by an mRNA booster provided significantly longer protection against infection >60 days after vaccination than a 3-dose series of mRNA vaccine. In a population free from non-vaccine-derived background immunity, vaccines against the ancestral spike protein were ≈80% effective for preventing serious outcomes from infection with the SARS-CoV-2 Omicron variant.

Consensus of Chinese experts on pre-examination and triage in outpatient departments of dermatology at the stage of prevention and control of 2019 novel coronavirus infection.

The 2019 novel coronavirus infection has brought big challenges to prevention and control of the national epidemic in China. During the fight against the epidemic, how to properly carry out pre-examination and triage for patients with skin lesions and fever has been a practical problem encountered in dermatology hospitals of all grades and in general hospitals with a large number of dermatological outpatient visits. The Chinese Society of Dermatology organized experts to formulate the principles and procedures for pre-examination and triage in outpatient departments of dermatology at the stage of prevention and control of the 2019 novel coronavirus infection epidemic, so as to guide the current fight against the epidemic.Copyright © 2020 by the Chinese Medical Association.

Consensus of Chinese experts on protection of skin and mucous membrane barrier for health professions fighting against coronavirus disease 2019.

Health professions preventing and controlling coronavirus disease 2019 are prone to skin and mucous membrane injuries, which may cause acute and chronic dermatitis, secondary infections and aggravation of underlying skin diseases. This is a consensus of Chinese experts on measures and advice on hand cleaning- and medical glove-related hand protection, mask-and goggles-related face protection, ultraviolet-related protection, as well as eye, nasal and oral mucosa, outer ear and hair protection. It is necessary to strictly follow standards on wearing protective equipment and specifications on sterilizing and cleaning. Both insufficient and excessive protection will adversely affect the skin and mucous membrane barrier. At the same time, using moisturizing products is highly recommended to achieve better protection.Copyright © 2020 by the Chinese Medical Association.

Clinical features of 153 patients with COVID-19 in Chongqing municipality.

Objective: To analyze the clinical features of patients with COVID-19 in Chongqing Municipality. Method(s): The clinical data, laboratory tests and chest imaging findings of 153 patients COVID-19 admitted in Chongqing Public Health Medical Center from January 26 to February 5, 2020 were retrospectively reviewed. According to the relevant diagnostic criteria, patients were divided into non-severe group (n=132) and severe group (n=21). The correlation between serum index changes and disease severity was analyzed. Result(s): The proportion of patients with underlying diabetes or chronic respiratory diseases in severe group was significantly higher than that in non-severe group (chi2=11.04 and 6.94, P<0.05). The proportion of symptom-free patients in non-severe group was significantly higher than that in severe group (chi2=4.09, P<0.05). The symptoms of fever, fatigue and muscle soreness in the severe group were more common than those in the non-severe group (chi2=4.40, 14.42 and 22.67, P<0.05). Among the concomitant symptoms, the proportion of cough and shortness of breath in the severe group was higher than that in the non-severe group (chi2=8.46 and 4.80, P<0.05). C-reactive protein and D-Dimer levels were higher in the severe group than those in the non-severe group (Z=-4.39 and -1.96, P<0.05), and the number of CD3+ T lymphocyte cells, CD4+ T lymphocyte cells and CD8+ T lymphocyte cells in the severe group was lower than that in the non-severe group (Z=27.25, 20.60 and 17.36, P<0.05). Compared with the non-severe group, both lungs and the right lung lower lobe were more susceptible to be involved(chi2=9.7123.61, P<0.05). Conclusion(s): There are significant differences in underlying diseases, clinical symptoms, imaging manifestations and laboratory findings between severe and non-severe patients with COVID-19.Copyright © 2020 by the Chinese Medical Association.

US National Institutes of Health Prioritization of SARS-CoV-2 Variants.

Since late 2020, SARS-CoV-2 variants have regularly emerged with competitive and phenotypic differences from previously circulating strains, sometimes with the potential to escape from immunity produced by prior exposure and infection. The Early Detection group is one of the constituent groups of the US National Institutes of Health National Institute of Allergy and Infectious Diseases SARS-CoV-2 Assessment of Viral Evolution program. The group uses bioinformatic methods to monitor the emergence, spread, and potential phenotypic properties of emerging and circulating strains to identify the most relevant variants for experimental groups within the program to phenotypically characterize. Since April 2021, the group has prioritized variants monthly. Prioritization successes include rapidly identifying most major variants of SARS-CoV-2 and providing experimental groups within the National Institutes of Health program easy access to regularly updated information on the recent evolution and epidemiology of SARS-CoV-2 that can be used to guide phenotypic investigations.

A Case of COVID-19-Induced Immune Thrombocytopenia (ITP) in an Adult Female: An Under-Recognized Emerging Phenomenon.

Coronavirus disease 2019 (COVID-19) follows a mild course in majority of cases, but some patients may develop non-pulmonary yet life-threatening complications. A Pandora's box had been opened when multisystem hyper-inflammatory syndromes and autoimmune diseases that had been described previously in children and young adults, that are associated with COVID-19, have now emerged in adults. They need to be recognized as important sequelae of severe COVID-19 disease. Immune thrombocytopenia (ITP) or thrombocytopenic purpura is an autoantibody and T-cell-mediated autoimmune disorder characterized by isolated thrombocytopenia, which can be triggered by different infections. First-line treatment of severe ITP includes platelet transfusions in life-threatening cases, followed by corticosteroids and intravenous immunoglobulins (IVIG). Since the beginning of the pandemic, more and more cases of COVID-19-associated ITP have been reported. We report a case of acquired ITP in a young woman that could only be attributed to her COVID-19 infection and was refractory to platelet transfusion, requiring further treatments. The aim of this report is to review some of the etiologies and purposed molecular mechanisms of the autoimmune nature of the disease and to focus on diagnosis and treatment. We will review the current literature surrounding this non-pulmonary manifestation of COVID-19 and current treatment options for this uncommon presentation of ITP.

Human-to-Animal Transmission of SARS-CoV-2, South Korea, 2021.

To investigate SARS-CoV-2 transmission from humans to animals in Seoul, South Korea, we submitted samples from companion animals owned by persons with confirmed COVID-19. Real-time PCR indicated higher SARS-CoV-2 viral infection rates for dogs and cats than previously reported from the United States and Europe. Host-specific adaptations could introduce mutant SARS-CoV-2 to humans.

Research progress on clinical application of convalescent plasma from COVID-19 patients.

COVID-19 is an acute respiratory infectious disease caused by 2019-nCoV, which has become a major global public health event and a serious threat to human health. So far, specific antiviral drugs, safe and effective vaccines for 2019-nCoV are still under development, so there is an urgent need to find alternative strategies for the treatment of COVID-19. Convalescent plasma(CP) contains high titer neutralizing antibodies from patients recovering from infectious diseases, which has been used in the treatment of major infectious diseases such as severe acute respiratory syndrome (SARS) and Middle East respiratory syndrome (MERS), and achieved satisfactory clinical results. Therefore, CP from COVID-19 patient is a meaningful choice for the treatment of severe or life-threatening COVID-19 patients, but its potential risks need to be studied. This review focuses on the clinical mechanism, collection points, clinical application and potential benefits and risks of clinical treatment of CP from COVID-19 patients, which will provide reference for the clinical application of CP from COVID-19 patients.Copyright © 2021 Chinese Medical Association

Research progress on clinical application of convalescent plasma from COVID-19 patients.

COVID-19 is an acute respiratory infectious disease caused by 2019-nCoV, which has become a major global public health event and a serious threat to human health. So far, specific antiviral drugs, safe and effective vaccines for 2019-nCoV are still under development, so there is an urgent need to find alternative strategies for the treatment of COVID-19. Convalescent plasma(CP) contains high titer neutralizing antibodies from patients recovering from infectious diseases, which has been used in the treatment of major infectious diseases such as severe acute respiratory syndrome (SARS) and Middle East respiratory syndrome (MERS), and achieved satisfactory clinical results. Therefore, CP from COVID-19 patient is a meaningful choice for the treatment of severe or life-threatening COVID-19 patients, but its potential risks need to be studied. This review focuses on the clinical mechanism, collection points, clinical application and potential benefits and risks of clinical treatment of CP from COVID-19 patients, which will provide reference for the clinical application of CP from COVID-19 patients.Copyright © 2021 Chinese Medical Association

Research progress on clinical application of convalescent plasma from COVID-19 patients.

COVID-19 is an acute respiratory infectious disease caused by 2019-nCoV, which has become a major global public health event and a serious threat to human health. So far, specific antiviral drugs, safe and effective vaccines for 2019-nCoV are still under development, so there is an urgent need to find alternative strategies for the treatment of COVID-19. Convalescent plasma(CP) contains high titer neutralizing antibodies from patients recovering from infectious diseases, which has been used in the treatment of major infectious diseases such as severe acute respiratory syndrome (SARS) and Middle East respiratory syndrome (MERS), and achieved satisfactory clinical results. Therefore, CP from COVID-19 patient is a meaningful choice for the treatment of severe or life-threatening COVID-19 patients, but its potential risks need to be studied. This review focuses on the clinical mechanism, collection points, clinical application and potential benefits and risks of clinical treatment of CP from COVID-19 patients, which will provide reference for the clinical application of CP from COVID-19 patients.Copyright © 2021 Chinese Medical Association

Multisystem inflammatory syndrome in children related with 2019 Novel Coronavirus infection.

Multisystem inflammatory syndrome in children (MIS-C) reported in the United States and European countries is a disease with multi-organ involved symptoms related with 2019 Novel Coronavirus infection, which has never been reported in China. Although its symptoms are similar to Kawasaki disease, MIS-C has characteristics of higher frequency in older children and adolescents, gastrointestinal symptoms, haemodynamic instability, myocarditis and elevated inflammatory markers. Most of the children need intensive care. The pathogenesis and long-term prognosis of the disease need further study.Copyright © 2020 by the Chinese Medical Association.

Recommendations for clinical management of children and adolescents with chronic heart failure during the epidemic period of novel coronavirus pneumonia.

The outbreak of 2019 novel coronavirus pneumonia(COVID-19) in Wuhan, Hubei, China in December 2019 has spread to all parts of the country. Epidemiology showed that the population is generally susceptible to the virus, and the number of infected children and adolescents has been increasing. Children and adolescents with chronic heart failure have poor physical fitness, and there are great challenges to the diagnosis and treatment for these patients with 2019 novel coronavirus(2019-nCoV) infection. Based on the clinical characteristics of COVID-19 in children and the key points of management of chronic heart failure in children and adolescents, we suggested the clinical management recommendations for 2019-nCoV infection in children and adolescents with chronic heart failure.Copyright © 2020 by the Chinese Medical Association.

The application of nano-biosensors in the detection of 2019-nCoV.

The pandemic of 2019 novel coronavirus (2019-nCoV) infection since 2020 caused Coronavirus Disease 2019 (COVID-19) leads the serious threaten to global public health. It is urgent to diagnose COVID-19, guide epidemiological measures, control the infection rates, research/develop the antiviral treatment and promote the vaccine research. The application of nano-material based biosensors (the nano-biosensors) has achieved the high-performance detection of a variety of biomarkers due to their small device size, label free detection, high sensitivity, good specificity, short detection time, and has been considered as great potential to become a point-of-care testing tool for detecting 2019-nCoV. Therefore, by summarizing the working principle and classification of nano-biosensors, and focusing on the research progress of nano-biosensors in the detection of 2019-nCoV reported in the recent years, our review provides the challenges and future development prospects of the nano-biosensor in clinical laboratory.Copyright © 2022 Chin J Lab Med. All rights reserved.

Clinical features of 153 patients with COVID-19 in Chongqing municipality.

Objective: To analyze the clinical features of patients with COVID-19 in Chongqing Municipality. Method(s): The clinical data, laboratory tests and chest imaging findings of 153 patients COVID-19 admitted in Chongqing Public Health Medical Center from January 26 to February 5, 2020 were retrospectively reviewed. According to the relevant diagnostic criteria, patients were divided into non-severe group (n=132) and severe group (n=21). The correlation between serum index changes and disease severity was analyzed. Result(s): The proportion of patients with underlying diabetes or chronic respiratory diseases in severe group was significantly higher than that in non-severe group (chi2=11.04 and 6.94, P<0.05). The proportion of symptom-free patients in non-severe group was significantly higher than that in severe group (chi2=4.09, P<0.05). The symptoms of fever, fatigue and muscle soreness in the severe group were more common than those in the non-severe group (chi2=4.40, 14.42 and 22.67, P<0.05). Among the concomitant symptoms, the proportion of cough and shortness of breath in the severe group was higher than that in the non-severe group (chi2=8.46 and 4.80, P<0.05). C-reactive protein and D-Dimer levels were higher in the severe group than those in the non-severe group (Z=-4.39 and -1.96, P<0.05), and the number of CD3+ T lymphocyte cells, CD4+ T lymphocyte cells and CD8+ T lymphocyte cells in the severe group was lower than that in the non-severe group (Z=27.25, 20.60 and 17.36, P<0.05). Compared with the non-severe group, both lungs and the right lung lower lobe were more susceptible to be involved(chi2=9.7123.61, P<0.05). Conclusion(s): There are significant differences in underlying diseases, clinical symptoms, imaging manifestations and laboratory findings between severe and non-severe patients with COVID-19.Copyright © 2020 by the Chinese Medical Association.

Drug therapy in hospitalized patients with very severe symptoms following COVID-19

Implication for health policy/practice/research/medical education: To treat COVID-19, the first choice should be antiviral drugs and sometimes a small dose of anti-inflammatory drugs to reduce inflammation. In this regard, chloroquine has both features including antiviral activity and anti-inflammatory effect.Copyright © 2020 The Author(s);.