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1.
Aging (Albany NY) ; 12(12): 11224-11237, 2020 06 17.
Article in English | MEDLINE | ID: covidwho-1251837

ABSTRACT

With the outbreak of coronavirus disease-19 (COVID-19), Changsha faced an increasing burden of treating the Wuhan migrants and their infected patients. This study is a retrospective, single-center case series of the 238 consecutive hospitalized patients with confirmed COVID-19 at the First Hospital of Changsha city, China, from 01/21 to 02/14, 2020; the final date of follow-up was 02/27, 2020. Of 238 patients 43.7% visited Wuhan, 58.4% got in touch with Wuhan people, and 47.5% had contacted with diagnosed patients. 37.8% patients had family members infected. 190 cases had mild / general disease, and 48 cases had severe / critical disease. Compared to mild or general patients, more severe or critical patients visited Wuhan (59.6% vs 40.2%; P=0.02) and contacted with Wuhan people (74.5% vs 55.0%; P=0.02). All patients received antiviral treatment, including Lopinavir / Ritonavir (29.3%), Interferon (14.6%) and their combination (40.6%), Arbidol (6.7%), Xuebijing (7.1%) and Chloroquine phosphate (1.3%). Severe and critical patients received glucocorticoid, Gamma-globulin and oxygen inhalation. Some received mechanic ventilation support. As of 02/27, 161 patients discharged. The median length of hospital stay was 13 days. The 10-, 14-, 20- and 28-day discharge rate was 19.1%, 42.8%, 65.0% and 76.4%, respectively. No hospital-related transmission was observed.


Subject(s)
Antiviral Agents/therapeutic use , Betacoronavirus , Coronavirus Infections/epidemiology , Coronavirus Infections/therapy , Pneumonia, Viral/epidemiology , Pneumonia, Viral/therapy , Respiration, Artificial , Adult , Anti-Inflammatory Agents, Non-Steroidal/therapeutic use , COVID-19 , China/epidemiology , Chloroquine/analogs & derivatives , Chloroquine/therapeutic use , Drug Combinations , Drugs, Chinese Herbal/therapeutic use , Female , Glucocorticoids/therapeutic use , Hospitalization , Humans , Immunologic Factors/therapeutic use , Indoles/therapeutic use , Interferons/therapeutic use , Lopinavir/therapeutic use , Male , Middle Aged , Oxygen/therapeutic use , Pandemics , Retrospective Studies , Ritonavir/therapeutic use , SARS-CoV-2 , gamma-Globulins/therapeutic use
2.
Med Sci Monit ; 27: e926751, 2021 Feb 11.
Article in English | MEDLINE | ID: covidwho-1079820

ABSTRACT

BACKGROUND Coronavirus disease 2019 (COVID-19) is spreading rapidly worldwide, and scientists are trying to find a way to overcome the disease. We explored the risk factors that influence patient outcomes, including treatment regimens, which can provide a reference for further treatment. MATERIAL AND METHODS A retrospective cohort study analysis was performed using data from 97 patients with COVID-19 who visited Wuhan Union Hospital from February 2020 to March 2020. We collected data on demographics, comorbidities, clinical manifestations, laboratory tests, treatment methods, outcomes, and complications. Patients were divided into a recovered group and a deceased group. We compared the differences between the 2 groups and analyzed risk factors influencing the treatment effect. RESULTS Seventy-six patients recovered and 21 died. The average age and body mass index (BMI) of the deceased group were significantly higher than those of the recovered group (69.81±6.80 years vs 60.79±11.28 years, P<0.001 and 24.95±3.14 kg/m² vs 23.09±2.97 kg/m², P=0.014, respectively). The combination of antiviral drugs and supportive therapy appears to be associated with the lowest mortality (P<0.05). Multivariate Cox regression analysis revealed that age, BMI, H-CRP, shock, and acute respiratory distress syndrome (ARDS) were independent risk factors for patients with COVID-19 (P<0.05). CONCLUSIONS Elderly patients and those with a high BMI, as well as patients who experience shock and ARDS, may have a higher risk of death from COVID-19. The combination of antiviral drugs and supportive therapy appears to be associated with lower mortality, although further research is needed.


Subject(s)
COVID-19/drug therapy , COVID-19/mortality , Respiratory Distress Syndrome/mortality , Shock/mortality , Age Factors , Aged , Antiviral Agents/therapeutic use , COVID-19/complications , COVID-19/virology , China/epidemiology , Drug Therapy, Combination/methods , Drugs, Chinese Herbal/therapeutic use , Female , Hospital Mortality , Humans , Kaplan-Meier Estimate , Male , Middle Aged , Prognosis , Respiratory Distress Syndrome/etiology , Respiratory Distress Syndrome/therapy , Retrospective Studies , Risk Factors , SARS-CoV-2/isolation & purification , SARS-CoV-2/pathogenicity , Shock/etiology , Shock/therapy , Treatment Outcome , gamma-Globulins/therapeutic use
3.
BMJ Case Rep ; 13(12)2020 Dec 17.
Article in English | MEDLINE | ID: covidwho-991778

ABSTRACT

The aetiology of febrile exanthems in children is often difficult to distinguish clinically. A diagnosis of Kawasaki disease (KD) should be considered in infants with exanthematous fever. More perplexing is the increasing incidence of an atypical form of KD. Pathogenesis of KD remains unclear even though an aberrant response of the immune system to an unidentified pathogen is often hypothesised. A 30-fold increase in the incidence of KD in Italy during the SARS-CoV-2 pandemic suggests an immune response to a viral trigger. We report an infant clinically diagnosed with high probability as incomplete KD, who presented with reactivation of the BCG injection site even though fever with rash was only less than 3 days duration. Echocardiography confirmed coronary artery abnormalities and prompt treatment with intravenous immunoglobulin facilitated rapid recovery. Physicians should consider a diagnosis of KD if BCG site reactivation is noted in children presenting with febrile exanthema.


Subject(s)
Exanthema/etiology , Mucocutaneous Lymph Node Syndrome/complications , Mucocutaneous Lymph Node Syndrome/diagnosis , BCG Vaccine/administration & dosage , Fever , Humans , Immunologic Factors/therapeutic use , Infant , Male , Mucocutaneous Lymph Node Syndrome/drug therapy , Vaccination/adverse effects , gamma-Globulins/therapeutic use
4.
Pan Afr Med J ; 37: 47, 2020.
Article in English | MEDLINE | ID: covidwho-946276

ABSTRACT

SARS-CoV-2 has created a global public health emergency with significant mortality and morbidity for people living with HIV (PLWH). Preliminary data reveals persons with immune-compromised status are at risk of developing adverse clinical outcomes from SARS-CoV-2. We aimed to characterise clinical outcomes of HIV patients co-infected with SARS-CoV-2 infection in Nasarawa State, North Central Nigeria. We followed four (4) hospitalised HIV patients that tested positive to SARS-CoV-2 in Nasarawa State and characterised their laboratory findings and clinical outcomes. The consent of the cases was sought and they agreed that their clinical data be published. Real-time reverse transcriptase polymerase chain reaction (RT-PCR) tests for SARS-CoV-2 nucleic acid were performed using nasopharyngeal swabs (novel coronavirus PCR fluorescence diagnostic kit, BioGerm medical biotechnology) at the Nigeria Centre for Disease Control (NCDC) in Abuja, Nigeria. Our study reveals mild clinical outcome among HIV patients with SARS-CoV-2 co-infection. There is need for a syndemic framework to be used to conceptualise SARS-CoV-2 impact among HIV patients and an urgent need to strengthen healthcare programmes within Nigeria.


Subject(s)
Anti-Retroviral Agents/therapeutic use , Betacoronavirus , Coinfection/drug therapy , Coronavirus Infections/drug therapy , HIV Infections/drug therapy , Pneumonia, Viral/drug therapy , Severe Acute Respiratory Syndrome , Sex Workers , Antiviral Agents/therapeutic use , COVID-19 , COVID-19 Testing , COVID-19 Vaccines , Clinical Laboratory Techniques/methods , Coronavirus Infections/diagnosis , Female , Glucocorticoids/therapeutic use , Humans , Methylprednisolone/therapeutic use , Nigeria , Norfloxacin/therapeutic use , Pandemics , Pneumonia, Viral/diagnosis , Real-Time Polymerase Chain Reaction , SARS-CoV-2 , gamma-Globulins/therapeutic use
5.
J Int Med Res ; 48(10): 300060520964009, 2020 Oct.
Article in English | MEDLINE | ID: covidwho-890029

ABSTRACT

BACKGROUND: The causative virus of coronavirus disease 2019 (COVID-19) may cause severe fatal pneumonia. The clinical presentation includes asymptomatic infection, severe pneumonia, and acute respiratory failure. Data pertaining to acute renal injury due to COVID-19 in patients who have undergone renal transplantation are scarce. We herein report two cases of COVID-19 along with acute kidney injury following kidney transplantation.Case presentation: Two patients with COVID-19 underwent renal transplantation and were subsequently diagnosed with acute kidney injury. The first patient presented with progressive respiratory symptoms and acute renal injury. He was treated with diuretics and suspension of immunosuppressive therapy; however, the patient died. The second patient presented with respiratory tract symptoms, hypoxemia, and progressive deterioration of renal function followed by improvement. Her mycophenolate mofetil was stopped after admission, and tacrolimus was discontinued 10 days later. Moxifloxacin and methylprednisolone were continued in combination with albumin and gamma globulin infusion. A diuretic was administered, and prednisone was gradually reduced along with tacrolimus. The patient exhibited a satisfactory clinical recovery. CONCLUSION: Patients who develop COVID-19 after kidney transplantation are at risk of acute kidney injury, and their prednisone, immunosuppressant, and gamma globulin treatment must be adjusted according to their condition.


Subject(s)
Acute Kidney Injury/pathology , Coronavirus Infections/pathology , Kidney Transplantation/adverse effects , Kidney/pathology , Pneumonia, Viral/pathology , Acute Kidney Injury/virology , Adult , Betacoronavirus , COVID-19 , Drug Administration Schedule , Female , Humans , Immunosuppressive Agents/administration & dosage , Immunosuppressive Agents/therapeutic use , Kidney/virology , Male , Middle Aged , Pandemics , Prednisone/administration & dosage , Prednisone/therapeutic use , SARS-CoV-2 , Transplant Recipients , gamma-Globulins/administration & dosage , gamma-Globulins/therapeutic use
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