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1.
Journal of Associated Medical Sciences ; 55(3):7-10, 2022.
Article in English | Scopus | ID: covidwho-1876172

ABSTRACT

Background: Sar CoV2, a novel coronavirus was identified as the cause of respiratory abnormality diseases COVID-19. It has no specific symptoms and the transmission occurs via respiratory droplets or contaminated surfaces. Seroprevalence studies of many diseases have been found to be useful to detect people who were exposed to infection and reveal the burden of the disease. Objectives: This study aimed to assess the correlation between Clinical findings and laboratory testing of patients with Sar CoV2 infection as derived by RT PCR detection and to investigate serological antibody of IgM, IgG in serum of Covid19 hospitalized patients. Materials and methods: The study was conducted on 168 patients with positive RT PCR for COVID-19 during June 2021-January 2022 in Khon Kaen Hospital. The nasopharyngeal swabs and blood samples were obtained on the day of admission. Data collection of patient’s clinical symptoms and laboratory testing were recorded for statistical analysis. We performed CBC and anti Sar CoV2 (IgM,IgG) according to standard laboratory methods. Results: The results indicated that seroprevalence of anti Sar CoV2 in COVID-19 patients was approximately 28% (47/168). The laboratory markers of CBC;as WBC, neutrophil, lymphocyte and platelet demonstrated lower significance. No correlation was observed between Ct of RT PCR with clinical signs and symptoms of COVID-19 patients. In case of RBC, Hemoglobin and Hematocrit, there were also no correlation with clinical characteristics of COVID-19 patients. Conclusion: The study observed that WBC count and platelet count was significantly lower for some cases. However, awareness of these parameters is required, because of the large heterogeneity in test performance. From serological tests it was observed that anti Sar CoV2 is not suitable diagnosis of the acute phase of infection. Both tests can be used to help RT PCR for diagnosis of Sar CoV2 infection. © 2022, Faculty of Associated Medical Sciences, Chiang Mai University. All rights reserved.

2.
Viral Immunol ; 35(3): 236-243, 2022 04.
Article in English | MEDLINE | ID: covidwho-1815959

ABSTRACT

To investigate the clinical characteristic of domestic coronavirus disease 2019 (COVID-19) patients after vaccination campaign conducted in China. According to vaccination status and months from first vaccine dose to infection detection, patients were divided into unvaccinated, <3 months, 3-6 months, and >6 months groups. The information of demographic and clinical characteristics, laboratory and thoracic computed tomography (CT) findings, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) nucleic acid and IgM, IgG antibodies was retrospectively collected. Therapeutic approaches, temperature-normalizing and viral shedding times, outcomes were also summarized. SARS-CoV-2 antibody levels were further analyzed based on the other following variables: time from second vaccine dose to infection, vaccine dose, the interval from the first to the second dose, and vaccine brand. Among 208 COVID-19 patients, 13 (6.28%) were unvaccinated. No significant differences in demographic and clinical characteristics, laboratory and CT findings, and SARS-CoV-2 nucleic acid loads were detected between groups (all p > 0.05). In comparison with the unvaccinated group, the median SARS-CoV-2 IgG levels were noticeably increased in those vaccinated groups (0.603 in unvaccinated, 15.925 in <3 months, 14.04 in 3-6 months, and 4.94 in >6 months, respectively, p < 0.05). However, SARS-CoV-2 IgG levels were not altered between groups divided based on the other variables. Vaccination does not affect the clinical characteristics in COVID-19 patients. COVID-19 patients with vaccination have high SARS-CoV-2 IgG levels. Underscore the necessity of rapid implementation of vaccination campaigns can be speculated.


Subject(s)
COVID-19 , Nucleic Acids , Antibodies, Viral , COVID-19/prevention & control , Humans , Immunoglobulin G , Retrospective Studies , SARS-CoV-2
3.
J Infect Dev Ctries ; 16(1): 32-40, 2022 01 31.
Article in English | MEDLINE | ID: covidwho-1706259

ABSTRACT

INTRODUCTION: Coronavirus disease 2019 (COVID-19) has caused an outbreak around the world. Early detection of severe illness is crucial for patients' survival. We analysed initial clinical characteristics of 146 patients with COVID-19 reported in Guizhou province, China to explore risk factors for transforming mild illness to severe. METHODOLOGY: Data of 146 laboratory-confirmed cases were collected and evaluated by the survival analysis of univariate and multivariate Cox proportional hazards model. RESULTS: On initial presentation, patients had fever (51.05%), dry cough (45.45%), headache (16.08%), shortness of breath (7.75%) and gastrointestinal symptoms (13.99%). Among 146 laboratory-confirmed cases, 30 patients (20.55%) had severe illness and needed Intensive Care Unit care for supportive treatment. The remaining patients (116, 79.45%) were non-severe cases. Nineteen (19/146, 13.01%) of 30 patients in the Intensive Care Unit had comorbidities, including hypertension (12, 40.00%), diabetes (5, 16.67%), cardiovascular disease (5, 16.67%) and pulmonary disease (4, 13.33%). For survival analysis, patients who had fever (HR = 3.30, 95% CI = 1.31, 8.29) and comorbidities (HR = 9.76, 95% CI = 4.28, 22.23) at baseline were more likely to be admitted into the Intensive Care Unit. Few variables were not related to the survival time of discharge from baseline to discharge and from Intensive Care Unit care to discharge. CONCLUSIONS: Severe patients with COVID-19 should be paid more attention. On initial symptoms, many patients did not have fever, but those with fever were more likely to be admitted to the Intensive Care Unit. Comorbidities were likewise a risk factor of severe COVID-19.


Subject(s)
COVID-19 , China/epidemiology , Comorbidity , Disease Outbreaks , Humans , Proportional Hazards Models , Retrospective Studies , SARS-CoV-2
4.
Journal of Xi'an Jiaotong University (Medical Sciences) ; 42(6):915-922, 2021.
Article in Chinese | Scopus | ID: covidwho-1662833

ABSTRACT

Objective: To investigate the clinical characteristics, treatment and outcome of elderly patients with COVID-19. Methods: We made a retrospective analysis of the clinical data of elderly patients with COVID-19 admitted by the National Anti-epidemic Medical Team of The First Affiliated Hospital of Xi'an Jiaotong University in Department of the seventh ward of Renmin Hospital of Wuhan University between February 9 and March 15, 2020. We fully extracted the patients' demographics, epidemiological characteristics, clinical manifestations, laboratory examination, imaging performance, treatment and outcomes. Results: In this study we included a total of 30 patients(18 males and 12 females), with an average age of(71.1±14.4) years. Their underlying diseases included cardiovascular and cerebrovascular diseases(23 patients), chronic pulmonary disease(3 patients), digestive disease(2 patients), diabetes mellitus(3 patients), and chronic kidney disease(1 patients). Before admission, 22 patients received oral medication. The initial symptoms were fever and cough. The peak body temperature averaged(38.4±0.6)℃ The mean time from symptom onset to hospitalization was 15.0±7.7 days. The clinical classification was mainly severe type in 26 patients(87%). Laboratory examination revealed lower lymphocyte count(0.7±0.2)×109/L, and higher blood D-D dimer lever(6.9±13)μg/L. Serum lactate dehydrogenase(LDH) significantly increased(310±136)U/L. Serum C-reactive protein(61±52)mg/L and erythrocyte sedimentation rate(ESR)(66±38)mmol/L slightly increased. Imaging performance revealed that diffuse lesions were located in bilateral pulmonary parenchyma(22 patients) and in single pulmonary parenchyma(7 patients). Ground-glass opacity was found in all the patients, and the average number of CT examination during hospitalization was 3.5±1.3. Viral load revealed that nucleic acid in nasopharyngeal swabs of 30 patients was all positive, nucleic acid in the feces of 6 patients was positive, and nucleic acid in nasopharyngeal swab of 1 patient was positive, whose nucleic acid in alveolar lavage fluid was negative. Serum IgG antibody level was(157.5±29.2)AU/mL and IgM antibody level was(69.0±148.7)AU/mL. Complications included ARDS in 5 patients, AKI in 5 patients, cardiac injury in 3 patients, shock in 2 patients, nosocomial infection in 3 patients, coagulation disorder in 3 patients, and gastrointestinal bleeding in 3 patients. Finally, 5 patients received non-invasive mechanical ventilation and 2 patients received invasive mechanical ventilation. Another 2 patients underwent CRRT and 1 patient received CRRT plus ECMO. Of the 3 patients with critical type, 2 died and 1 survived. There were 25 patients who turned from severe type into normal type/light type, and 1 patient finally died(turned from severe type into critical type). In the end, 15 patients were cured and discharged. The average time of viral nucleic acid from positive to negative was 12.4±5.6 and the average time of lesion absorption in computer tomography was 16.9±5.8 days. The total hospital stay was 22.9±8.1 days, and the 28-day mortality rate was 6.7%. Conclusion: COVID-19 in elderly patients is mostly severe and its initial symptoms are still fever and cough. Patients should be immediately hospitalized when symptoms develop. The time of viral nucleic acid transformation and imaging improvement is longer than that of others. The mortality in critically ill patients is higher than that of others. Clinicians should pay more attention to the elderly people. © 2021, Editorial Board of Journal of Xi'an Jiaotong University (Medical Sciences). All right reserved.

5.
Int J Gen Med ; 14: 8039-8046, 2021.
Article in English | MEDLINE | ID: covidwho-1523541

ABSTRACT

PURPOSE: The main objective of this study was to decipher the general epidemiology, clinical characteristic, laboratory finding and chest computed tomography (CT) imaging features of the novel coronavirus disease (COVID-19) patients whose initial detection of severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2)is negative. METHODS: Nearly 100 confirmed cases admitted to The Fifth Affiliated Hospital of Sun Yat-sen University from 18th January to 26th February, 2020, were screened. Clinical records, laboratory results and CT images were reviewed for nine COVID-19 patients with initially negative RT-PCR detection. RESULTS: Fever and cough were common, and one patient merely present gastrointestinal symptoms. Increasing CRP and decreasing ALB were showed in nearly half of the patients among negative detection and return to normal level after real time polymerase chain reaction (RT-PCR) results converted from positive to negative. Left lower lobe was affected nearly in all the patients. A patient received oxygen support timely according his high Mulbsta score. CONCLUSION: Our study elucidated on the clinical features of hospitalized patients with initially negative detection of SARS-CoV nucleic acid. Patient merely with symptoms associated with digestive system should be screened for COVID-19. CT scan and repeated RT-PCR are two powerful diagnostic tools. Mulbsta score assessing in the early stage enhances the confidence of severity evaluation in physician.

6.
Front Cell Infect Microbiol ; 11: 670823, 2021.
Article in English | MEDLINE | ID: covidwho-1399128

ABSTRACT

Objective: To analyze the epidemiological history, clinical symptoms, laboratory testing parameters of patients with mild and severe COVID-19 infection, and provide a reference for timely judgment of changes in the patients' conditions and the formulation of epidemic prevention and control strategies. Methods: A retrospective study was conducted in this research, a total of 90 patients with COVID-19 infection who received treatment from January 21 to March 31, 2020 in the Ninth People's Hospital of Dongguan City were selected as study subject. We analyzed the clinical characteristics of laboratory-confirmed patients with COVID-19, used the oversampling method (SMOTE) to solve the imbalance of categories, and established Lasso-logistic regression and random forest models. Results: Among the 90 confirmed COVID-19 cases, 79 were mild and 11 were severe. The average age of the patients was 36.1 years old, including 49 males and 41 females. The average age of severe patients is significantly older than that of mild patients (53.2 years old vs 33.7 years old). The average time from illness onset to hospital admission was 4.1 days and the average actual hospital stay was 18.7 days, both of these time actors were longer for severe patients than for mild patients. Forty-eight of the 90 patients (53.3%) had family cluster infections, which was similar among mild and severe patients. Comorbidities of underlying diseases were more common in severe patients, including hypertension, diabetes and other diseases. The most common symptom was cough [45 (50%)], followed by fever [43 (47.8%)], headache [7 (7.8%)], vomiting [3 (3.3%)], diarrhea [3 (3.3%)], and dyspnea [1 (1.1%)]. The laboratory findings of patients also included leukopenia [13(14.4%)] and lymphopenia (17.8%). Severe patients had a low level of creatine kinase (median 40.9) and a high level of D-dimer. The median NLR of severe patients was 2.82, which was higher than that of mild patients. Logistic regression showed that age, phosphocreatine kinase, procalcitonin, the lymphocyte count of the patient on admission, cough, fatigue, and pharynx dryness were independent predictors of COVID-19 severity. The classification of random forest was predicted and the importance of each variable was displayed. The variable importance of random forest indicates that age, D-dimer, NLR (neutrophil to lymphocyte ratio) and other top-ranked variables are risk factors. Conclusion: The clinical symptoms of COVID-19 patients are non-specific and complicated. Age and the time from onset to admission are important factors that determine the severity of the patient's condition. Patients with mild illness should be closely monitored to identify those who may become severe. Variables such as age and creatine phosphate kinase selected by logistic regression can be used as important indicators to assess the disease severity of COVID-19 patients. The importance of variables in the random forest further complements the variable feature information.


Subject(s)
COVID-19 , Lymphopenia , Adult , China/epidemiology , Female , Hospitalization , Humans , Male , Middle Aged , Retrospective Studies , SARS-CoV-2
7.
Eur J Clin Microbiol Infect Dis ; 40(8): 1633-1643, 2021 Aug.
Article in English | MEDLINE | ID: covidwho-1323943

ABSTRACT

This study aims to compare clinical characteristics and severity between adults with respiratory syncytial virus (RSV-p) and influenza-related pneumonia (Flu-p). A total of 127 patients with RSV-p, 693 patients with influenza A-related pneumonia (FluA-p), and 386 patients with influenza B-related pneumonia (FluB-p) were retrospectively reviewed from 2013 through 2019 in five teaching hospitals in China. A multivariate logistic regression model indicated that age ≥ 50 years, cerebrovascular disease, chronic kidney disease, solid malignant tumor, nasal congestion, myalgia, sputum production, respiratory rates ≥ 30 beats/min, lymphocytes < 0.8×109/L, and blood albumin < 35 g/L were predictors that differentiated RSV-p from Flu-p. After adjusting for confounders, a multivariate logistic regression analysis confirmed that, relative to RSV-p, FluA-p (OR 2.313, 95% CI 1.377-3.885, p = 0.002) incurred an increased risk for severe outcomes, including invasive ventilation, ICU admission, and 30-day mortality; FluB-p (OR 1.630, 95% CI 0.958-2.741, p = 0.071) was not associated with increased risk. Some clinical variables were useful for discriminating RSV-p from Flu-p. The severity of RSV-p was less than that of FluA-p, but was comparable to FluB-p.


Subject(s)
Influenza A virus , Influenza, Human/complications , Pneumonia, Viral/virology , Respiratory Syncytial Virus Infections/complications , Respiratory Syncytial Viruses , China/epidemiology , Female , Humans , Influenza, Human/virology , Logistic Models , Male , Middle Aged , Multivariate Analysis , Pneumonia, Viral/epidemiology , Retrospective Studies , Risk Factors
8.
Front Public Health ; 9: 649178, 2021.
Article in English | MEDLINE | ID: covidwho-1247944

ABSTRACT

Background: During the COVID-19 pandemic, many patients admitted to hospital for treatment have recovered and been discharged; however, in some instances, these same patients are re-admitted due to a second fever or a positive COVID-19 PCR test result. To ascertain whether it is necessary to treat these patients in hospitals, especially in asymptomatic cases, we summarize and analyze the clinical and treatment characteristics of patients re-admitted to hospital with a second COVID-19 infection. Methods: Of the 141 COVID-19 cases admitted to the Wenzhou Central Hospital between January 17, 2020, to March 5, 2020, which were followed until March 30, 2020, 12 patients were re-admitted with a second COVID-19 infection. Data was collected and analyzed from their clinical records, lab indexes, commuted tomography (CT), and treatment strategies. Results: Most of the 141 patients had positive outcomes from treatment, with only 12 (8.5%) being re-admitted. In this sub-group: one (8.3%) had a fever, a high white blood cell count (WBC), and progressive CT changes; and one (8.3%) had increased transaminase. The PCR tests of these two patients returned negative results. Another 10 patients were admitted due to a positive PCR test result, seven of which were clinically asymptomatic. Compared to the CT imaging following their initial discharge, the CT imaging of all patients was significantly improved, and none required additional oxygen or mechanical ventilation during their second course of treatment. Conclusions: The prognoses of the re-admitted patients were good with no serious cases. We conclude that home treatment with concentrated medical observation is a safe and feasible course of treatment if the patient returns a positive PCR test result but does not display serious clinical symptoms. During medical observation, patients with underlying conditions should remain a primary focus, but most do not need to be re-admitted to the hospital.


Subject(s)
COVID-19 , Patient Readmission , China/epidemiology , Humans , Pandemics , SARS-CoV-2
9.
J Epidemiol ; 31(8): 487-494, 2021 08 05.
Article in English | MEDLINE | ID: covidwho-1247748

ABSTRACT

BACKGROUND: Notifications of novel coronavirus infections increased in early 2020 in Japan. We described characteristics of novel coronavirus infection cases and analyzed risk factors for severe outcomes. METHODS: Cases were persons with laboratory-confirmed novel coronavirus infection reported under national surveillance between January and March 2020. Clinical characteristics were described, and risk factors of (1) intensive care unit [ICU] admission and (2) invasive ventilation/death were analyzed using Poisson regression. RESULTS: Among the 516 cases analyzed, median age was 60 years (range: 1-97 years) and 285 (55%) were male. Common symptoms/signs were fever (375/475, 79%), cough (353/465, 76%), and pneumonia (245/387, 63%). Ten (2%) cases died. Of the 348 cases with data, 50 (14%) required invasive ventilation. Adjusted for each other, male gender and 1-year increase in age were associated with ICU admission (risk ratio [RR] 4.18; 95% confidence interval [CI], 1.69-10.32 and RR 1.05; 95% CI, 1.03-1.08, respectively) and invasive ventilation/death (RR 2.79; 95% CI, 1.49-5.21 and RR 1.06; 95% CI, 1.04-1.08, respectively). Diabetes, dyslipidemia, hyperuricemia, and lung diseases were also associated with severe outcomes. Of the 80 cases asymptomatic at hospitalization, 40 developed symptoms and five of them >70 years of age required invasive ventilation. CONCLUSIONS: The early stage of the novel coronavirus epidemic in Japan disproportionately affected the elderly. Older age, male gender, and underlying conditions were associated with severe outcomes. Notably, some elderly case-patients who were asymptomatic at diagnosis and promptly hospitalized still went on to develop severe disease, indicating the importance of careful monitoring of certain populations.


Subject(s)
COVID-19/mortality , COVID-19/therapy , Hospitalization/statistics & numerical data , Intensive Care Units , Respiration, Artificial/statistics & numerical data , Adolescent , Adult , Aged , Aged, 80 and over , COVID-19/epidemiology , Child , Child, Preschool , Female , Humans , Infant , Japan/epidemiology , Male , Middle Aged , Risk Factors , SARS-CoV-2/isolation & purification , Severity of Illness Index , Treatment Outcome , Young Adult
10.
Epidemiol Infect ; 148: e218, 2020 09 21.
Article in English | MEDLINE | ID: covidwho-779905

ABSTRACT

'Recurrence' of coronavirus disease 2019 (COVID-19) has triggered numerous discussions of scholars at home and abroad. A total of 44 recurrent cases of COVID-19 and 32 control cases admitted from 11 February to 29 March 2020 to Guanggu Campus of Tongji Hospital affiliated to Tongji Medical College Huazhong University of Science and Technology were enrolled in this study. All the 44 recurrent cases were classified as mild to moderate when the patients were admitted for the second time. The gender and mean age in both cases (recurrent and control) were similar. At least one concomitant disease was observed in 52.27% recurrent cases and 34.38% control cases. The most prevalent comorbidity among them was hypertension. Fever and cough being the most prevalent clinical symptoms in both cases. On comparing both the cases, recurrent cases had markedly elevated concentrations of alanine aminotransferase (ALT) (P = 0.020) and aspartate aminotransferase (AST) (P = 0.007). Moreover, subgroup analysis showed mild to moderate abnormal concentrations of ALT and AST in recurrent cases. The elevated concentrations of ALT and AST may be recognised as predictive markers for the risk of 'recurrence' of COVID-19, which may provide insights into the prevention and control of COVID-19 in the future.


Subject(s)
Alanine Transaminase/blood , Aspartate Aminotransferases/blood , Coronavirus Infections/enzymology , Pneumonia, Viral/enzymology , COVID-19 , Case-Control Studies , Cough , Female , Fever , Humans , Male , Middle Aged , Pandemics , Recurrence , Retrospective Studies , Risk Factors
11.
J Med Internet Res ; 22(8): e20108, 2020 08 13.
Article in English | MEDLINE | ID: covidwho-713742

ABSTRACT

BACKGROUND: The number of deaths worldwide caused by coronavirus disease (COVID-19) is increasing rapidly. Information about the clinical characteristics of patients with COVID-19 who were not admitted to hospital is limited. Some risk factors of mortality associated with COVID-19 are controversial (eg, smoking). Moreover, the impact of city closure on mortality and admission rates is unknown. OBJECTIVE: The aim of this study was to explore the risk factors of mortality associated with COVID-19 infection among a sample of patients in Wuhan whose conditions were reported on social media. METHODS: We enrolled 599 patients with COVID-19 from 67 hospitals in Wuhan in the study; 117 of the participants (19.5%) were not admitted to hospital. The demographic, epidemiological, clinical, and radiological features of the patients were extracted from their social media posts and coded. Telephone follow-up was conducted 1 month later (between March 15 and 23, 2020) to check the clinical outcomes of the patients and acquire other relevant information. RESULTS: The median age of patients with COVID-19 who died (72 years, IQR 66.5-82.0) was significantly higher than that of patients who recovered (61 years, IQR 53-69, P<.001). We found that lack of admission to hospital (odds ratio [OR] 5.82, 95% CI 3.36-10.1; P<.001), older age (OR 1.08, 95% CI 1.06-1.1; P<.001), diffuse distribution (OR 11.09, 95% CI 0.93-132.9; P=.058), and hypoxemia (odds ratio 2.94, 95% CI 1.32-6.6; P=.009) were associated with increasing odds of death. Smoking was not significantly associated with mortality risk (OR 0.9, 95% CI 0.44-1.85; P=.78). CONCLUSIONS: Older age, diffuse distribution, and hypoxemia are factors that can help clinicians identify patients with COVID-19 who have poor prognosis. Our study suggests that aggregated data from social media can also be comprehensive, immediate, and informative in disease prognosis.


Subject(s)
Betacoronavirus , Coronavirus Infections , Pandemics , Pneumonia, Viral , Adolescent , Adult , Aged , Aged, 80 and over , COVID-19 , Child , Child, Preschool , China , Female , Hospitalization , Humans , Infant , Infant, Newborn , Male , Middle Aged , Odds Ratio , Prognosis , Retrospective Studies , Risk Factors , SARS-CoV-2 , Social Media , Young Adult
12.
BMC Infect Dis ; 20(1): 567, 2020 Aug 03.
Article in English | MEDLINE | ID: covidwho-692264

ABSTRACT

BACKGROUND: To assess the dynamic changes in clinical and CT characteristics of COVID-19 patients with different epidemiology histories. METHODS: Fifty-three discharged COVID-19 patients were enrolled at Beijing YouAn Hospital, Capital Medical University, between January 21 and March 10, 2020. Spearman correlation analysis was performed between CT scores and laboratory indicators. Patients were divided into the Wuhan group (lived in or with travel to Wuhan, numbering 30 cases) and non-Wuhan group (close contacts or unknown exposure, totaling 23 cases). The CT and laboratory findings were compared between and within groups during the clinical process. RESULTS: Fever (88.7%), cough (64.2%), fatigue (34%), and abnormal laboratory indicators, including lymphopenia, reduced albumin, albumin/globulin (A/G), and elevated C-reactive protein (CRP), were mainly observed. Subpleural ground-glass opacities (86.8%) were usually detected at admission. The CT scores were highly correlated with lymphocytes, CRP, albumin, and A/G at initial and follow-ups (all p < 0.05). Four days after admission, most patients (66.7% Wuhan, 47.8% non-Wuhan) showed progression, and the CT scores of Wuhan significantly increased (p = 0.015). Eight days after admission, the vast majority of patients (69.2% Wuhan, 100% non-Wuhan, p = 0.006) presented improvement, and the CT scores of non-Wuhan were significantly lower than Wuhan (p = 0.006). Pneumonia was completely absorbed in most patients 2-4 weeks after discharge. CONCLUSIONS: CT plays a crucial role in the early diagnosis and monitoring of changes in COVID-19. Lymphocytes, CRP, albumin, and A/G are expected to predict disease severity and prognosis. Viral pathogenicity in non-endemic areas may be weaker than core-infected areas. In most patients, lung lesions can disappear around 4 weeks after discharge.


Subject(s)
Betacoronavirus , C-Reactive Protein/analysis , Coronavirus Infections/diagnostic imaging , Cough/epidemiology , Fever/epidemiology , Lymphopenia/diagnosis , Pneumonia, Viral/diagnostic imaging , Serum Albumin, Human/analysis , Serum Globulins/analysis , Adult , Aged , COVID-19 , Coronavirus Infections/virology , Cough/virology , Disease Progression , Female , Fever/virology , Follow-Up Studies , Humans , Male , Middle Aged , Pandemics , Patient Discharge , Pneumonia, Viral/virology , Prognosis , Retrospective Studies , SARS-CoV-2 , Tomography, X-Ray Computed , Travel
13.
Zhonghua Bing Li Xue Za Zhi ; 49(5): 418-423, 2020 May 08.
Article in Chinese | MEDLINE | ID: covidwho-589596

ABSTRACT

Objective: To investigate the clinical characteristics and placental pathology of 2019-nCoV infection in pregnancy,and to evaluate intrauterine vertical transmission potential of 2019-nCoV infection. Methods: The placentas delivered from pregnant women with confirmed 2019-nCoV infection which were received in the Department of Pathology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology by February 4, 2020 were retrospectively studied. Their clinical material including placental tissue and lung CT, and laboratory results were collected, meanwhile, nucleic acid detection of 2019-nCoV of the placentas were performed by RT-PCR. Results: Three placentas delivered from pregnant women with confirmed 2019-nCoV infection, who were all in their third trimester with emergency caesarean section. All of the three patients presented with fever (one before caesarean and two in postpartum), and had no significant leukopenia and lymphopenia. Neonatal throat swabs from three newborns were tested for 2019-nCoV, and all samples were negative for the nucleic acid of 2019-nCoV. One premature infant was transferred to Department of Neonatology due to low birth weight. By the end of February 25, 2020, none of the three patients developed severe 2019-nCoV pneumonia or died(two patients had been cured and discharged, while another one had been transferred to a square cabin hospital for isolation treatment). There were various degrees of fibrin deposition inside and around the villi with local syncytial nodule increases in all three placentas. One case of placenta showed the concomitant morphology of chorionic hemangioma and another one with massive placental infarction. No pathological change of villitis and chorioamnionitis was observed in our observation of three cases. All samples from three placentas were negative for the nucleic acid of 2019-nCoV. Conclusions: The clinical characteristics of pregnant women with 2019-nCoV infection in late pregnancy are similar to those of non-pregnant patients, and no severe adverse pregnancy outcome is found in the 3 cases of our observation. Pathological study suggests that there are no morphological changes related to infection in the three placentas. Currently no evidence for intrauterine vertical transmission of 2019-nCoV is found in the three women infected by 2019-nCoV in their late pregnancy.


Subject(s)
Coronavirus Infections , Coronavirus , Pandemics , Placenta , Pneumonia, Viral , Pregnancy Complications, Infectious , Adult , Betacoronavirus , COVID-19 , Cesarean Section , Coronavirus Infections/pathology , Female , Humans , Infant, Newborn , Infectious Disease Transmission, Vertical , Placenta/pathology , Placenta/virology , Pneumonia, Viral/pathology , Pregnancy , Pregnancy Complications, Infectious/pathology , Retrospective Studies , SARS-CoV-2
14.
Front Med (Lausanne) ; 7: 210, 2020.
Article in English | MEDLINE | ID: covidwho-456897

ABSTRACT

Objective: This study aimed to identify additional characteristics and features of coronavirus disease (COVID-19) by assessing the clinical courses among COVID-19 patients in a region outside Hubei province. Methods: We analyzed retrospective data regarding general characteristics, epidemiologic history, underlying chronic diseases, clinical symptoms and complications, chest computed tomography findings, biochemical monitoring, disease severity, treatments, and outcomes among 37 adult patients with COVID-19. According to the duration from symptom onset to release from quarantine, the patients were divided into the ≤20 and >20-day groups, and the similarities and differences between them were compared. Results: Among the 37 patients, five had mild disease, 30 had moderate disease, one had severe disease, and one was critically ill. All of the patients were released from quarantine, and no mortality was observed. The average duration from symptom onset to release from quarantine was 20.2 ± 6.6 days. The average duration from symptom onset to hospitalization was 4.1 ± 3.7 days, and the patients were hospitalized for an average of 16.1 ± 6.2 days. The average age was 44.3 ± 1.67 years, and 78.4% of cases were caused by exposure to a patient with confirmed disease or the workplace of a patient with confirmed disease. The main symptoms were cough (67.6%), fever (62.2%), shortness of breath (32.4%), fatigue (24.3%), sore throat (21.6%), vomiting, and diarrhea (21.6%). White blood cell count was decreased in 27.0% of patients, and lymphocyte count was decreased in 62.2% of the patients, among whom 43.5% patients had counts of ≤0.6 × 109/L. On admission, 86.5% of patients showed pneumonia in chest CT scans, including some asymptomatic patients, while 68.8% of patients showed bilateral infiltration. In the >20-day group, the average age was 49.9 ± 1.38 years, and the average duration from symptom onset to hospitalization was 5.5 ± 3.9 days. Compared with the ≤20-day group, patients in the >20-day group were older and the duration was longer (P < 0.05). All of the seven asymptomatic patients belonged to the ≤20-day group. When the 37 patients were released from quarantine, the white blood cell count of 16.2% of the patients was <4.0 × 109/L, the lymphocyte count of 59.5% of the patients was <1.1 × 109/L, and the absolute counts of white blood cells and lymphocytes were 5.02 ± 1.34 × 109/L and 1.03 ± 0.34 × 109/L, respectively, compared with those recorded on admission (P > 0.05). Conclusion: The majority of COVID-19 cases in the study area were mild and moderate, with good clinical outcomes. There were some special characteristics in the clinical course. The reasons for differences in the duration from symptom onset to release from quarantine were complex. There was no significant change in the number of granulocytes at the time of release from quarantine compared to that at the time of admission.

15.
Virulence ; 11(1): 482-485, 2020 12.
Article in English | MEDLINE | ID: covidwho-343283

ABSTRACT

Since its outbreak in Wuhan, Hubei Province China, 2019-coronavirus infected disease (COVID-19) had been widely spread all over the world, the control of which calls for a better understanding of its epidemiology and clinical characteristics. We included 12 confirmed cases of COVID-19 in First Affiliated Hospital of Jilin University from 23 January 2020 to 11 February 2020, which were retrospectively analyzed for epidemiological, demographic, clinical, laboratory, and radiological features. All the patients were confirmed by nucleic acid detection, the average age of whom was 45.25 years (range, 23-79 years). Most patients had a history of Wuhan traveling or had contact with Wuhan travelers or infected cases. Obvious family cluster was observed. Clinical manifestations included fever (12/12), fatigue (10/12), cough (6/12), sore throat (4/12), headache (3/12), and diarrhea (2/12). Only three out of eight patients had pneumonia manifestation on radiography. Most patients had a normal white blood cell (WBC) count and normal or reduced lymphocyte (LY) count. Pneumonia changes were observed in all the four patients who underwent a chest CT scan. Only one elderly patient developed severe pneumonia, while all the rest were mild disease and had a self-limiting course.


Subject(s)
Coronavirus Infections/epidemiology , Coronavirus Infections/pathology , Pneumonia, Viral/epidemiology , Pneumonia, Viral/pathology , Adult , Aged , Betacoronavirus/isolation & purification , COVID-19 , China/epidemiology , Coronavirus Infections/diagnostic imaging , Coronavirus Infections/virology , Cough/etiology , Diarrhea/etiology , Fatigue/etiology , Female , Fever/etiology , Headache/etiology , Humans , Leukocyte Count , Male , Middle Aged , Pandemics , Pharyngitis/etiology , Pneumonia, Viral/diagnostic imaging , Pneumonia, Viral/virology , Retrospective Studies , SARS-CoV-2 , Tomography, X-Ray Computed , Young Adult
16.
Korean J Radiol ; 21(6): 746-755, 2020 06.
Article in English | MEDLINE | ID: covidwho-262130

ABSTRACT

OBJECTIVE: To identify predictors of pulmonary fibrosis development by combining follow-up thin-section CT findings and clinical features in patients discharged after treatment for COVID-19. MATERIALS AND METHODS: This retrospective study involved 32 confirmed COVID-19 patients who were divided into two groups according to the evidence of fibrosis on their latest follow-up CT imaging. Clinical data and CT imaging features of all the patients in different stages were collected and analyzed for comparison. RESULTS: The latest follow-up CT imaging showed fibrosis in 14 patients (male, 12; female, 2) and no fibrosis in 18 patients (male, 10; female, 8). Compared with the non-fibrosis group, the fibrosis group was older (median age: 54.0 years vs. 37.0 years, p = 0.008), and the median levels of C-reactive protein (53.4 mg/L vs. 10.0 mg/L, p = 0.002) and interleukin-6 (79.7 pg/L vs. 11.2 pg/L, p = 0.04) were also higher. The fibrosis group had a longer-term of hospitalization (19.5 days vs. 10.0 days, p = 0.001), pulsed steroid therapy (11.0 days vs. 5.0 days, p < 0.001), and antiviral therapy (12.0 days vs. 6.5 days, p = 0.012). More patients on the worst-state CT scan had an irregular interface (59.4% vs. 34.4%, p = 0.045) and a parenchymal band (71.9% vs. 28.1%, p < 0.001). On initial CT imaging, the irregular interface (57.1%) and parenchymal band (50.0%) were more common in the fibrosis group. On the worst-state CT imaging, interstitial thickening (78.6%), air bronchogram (57.1%), irregular interface (85.7%), coarse reticular pattern (28.6%), parenchymal band (92.9%), and pleural effusion (42.9%) were more common in the fibrosis group. CONCLUSION: Fibrosis was more likely to develop in patients with severe clinical conditions, especially in patients with high inflammatory indicators. Interstitial thickening, irregular interface, coarse reticular pattern, and parenchymal band manifested in the process of the disease may be predictors of pulmonary fibrosis. Irregular interface and parenchymal band could predict the formation of pulmonary fibrosis early.


Subject(s)
Coronavirus Infections/diagnostic imaging , Pneumonia, Viral/diagnostic imaging , Pulmonary Fibrosis/diagnostic imaging , Pulmonary Fibrosis/virology , Adult , Aged , Betacoronavirus/isolation & purification , COVID-19 , Coronavirus Infections/epidemiology , Coronavirus Infections/pathology , Female , Humans , Male , Microtomy/methods , Middle Aged , Pandemics , Patient Discharge , Pleural Effusion/pathology , Pleural Effusion/virology , Pneumonia, Viral/epidemiology , Pneumonia, Viral/pathology , Predictive Value of Tests , Pulmonary Fibrosis/pathology , Retrospective Studies , SARS-CoV-2 , Tomography, X-Ray Computed/methods
17.
Chinese Journal of Emergency Medicine ; (12): E019-E019, 2020.
Article in Chinese | WPRIM (Western Pacific), WPRIM (Western Pacific) | ID: covidwho-5927

ABSTRACT

Objective@#To explore the regularity and characteristics of the transmission of Novel Coronavirus Pneumonia(NCP) in crowd, for provide a reference for pre-hospital first aid to identify and screen NCP and close contact, at the same time to improve protection awareness and reduce infection rates.@*Method@#Retrospective analysis about the cases of familial aggregation transferred by Beijing Emergency Medical Center between January 20 and February 10, 2020,collect relevant information,including basic information,contact history,symptoms and signs, clinical outcome, etc.@*Results@#The mean incubation period of familial cluster cases was 5.6d,mean time from onset of symptoms to first visit was 1.8d;Among the 5 family cluster cases, 4 had fever,mean body temperature 38ºC, the Sp02 averaged 96%; Among the 5 family cluster cases, 4 had cough, 2 had fatigue, and 1 had dyspnea.@*Conclusion@#People are susceptible to infection to NCP,it spreads easily between close contacts, effective isolation is the focus of prevention and control among family members, it is also one of the difficulties of prevention and control.

18.
Chinese Journal of Infectious Diseases ; (12): E006-E006, 2020.
Article in Chinese | WPRIM (Western Pacific), WPRIM (Western Pacific) | ID: covidwho-2054

ABSTRACT

Objective@#To analysis the clinical characteristics and experiences in diagnosis and treatment of the patients with novel coronavirus pneumonia (NCP).@*Methods@#Clinical data of 28 patients with NCP in Nanning Fourth People's Hospital from January 22 to February 5 in 2020 were collected. The clinical manifestations, epidemiological history, laboratory tests, imaging examinations and treatments of patients were analyzed retrospectively.@*Results@#The 28 patients with confirmed viral pneumonia included 11 males and 17 females, ranging from 11 to 68 years. They all had history of epidemiological exposure and were all positive for 2019-nCoV nucleic acid in throat swabs. There were one mild case, 25 ordinary cases and two severe cases. There were four groups of family clusters. The illness onset ranged from 1 to 12 days after exposure, and the time from the symptom onset to the positive result of the nucleic acid test was 0 to 13 days. The clinical symptoms were mainly fever and cough, which progressed rapidly in a short period of time. Since the onset of illness, the peak values of axillary temperature of the 28 patients were 36.6~39.5 ℃, while five patients had no fever throughout the course of the disease with the peak temperature of ≤37 ℃. There were two patients presented with decreased white blood cell counts, five patients with elevated C reactive protein, six patients with abnormal alanine aminotransferase, three patients with abnormal aspartate aminotransferase,10 patients with elevated creatine kinase, three patients with elevated creatine kinase isoenzyme, four patients with elevated lactate dehydrogenase, and all with normal procalcitonin levels. The chest computed tomography examinations showed that the common features were ground glass shadows (21 cases), blurred edges (18 cases), speckles and patchy shadows (17 cases), thickening and disorder of some lung textures (7 cases), and visible band shadows (7 cases). Pulmonary lesions often progressed rapidly. One 11-year-old child was treated with alpha-interferon alone, and 27 patients were treated with alpha-interferon inhalation plus lopinavir/ritonavir with 4 withdrawal due to adverse reactions. Up to February 12, nine patients had been discharged from the hospital, who were ordinary cases, without death cases.@*Conclusions@#The NCP patients mostly present with fever and cough. Pulmonary lesions often progress rapidly. Respiratory pathogen testing should be conducted as early as possible and repeatedly. Disisolation should be cautious for suspected people who are negative for 2019-nCoV nucleic acid in pharynx swabs.

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