Clinical characteristics of 134 convalescent patients with COVID-19 in Guizhou, China (preprint)

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.

Ontology-based systematic classification and analysis of coronaviruses, hosts, and host-coronavirus interactions towards deep understanding of COVID-19 (preprint)

Given the existing COVID-19 pandemic worldwide, it is critical to systematically study the interactions between hosts and coronaviruses including SARS-Cov, MERS-Cov, and SARS-CoV-2 (cause of COVID-19). We first created four host-pathogen interaction (HPI)-Outcome postulates, and generated a HPI-Outcome model as the basis for understanding host-coronavirus interactions (HCI) and their relations with the disease outcomes. We hypothesized that ontology can be used as an integrative platform to classify and analyze HCI and disease outcomes. Accordingly, we annotated and categorized different coronaviruses, hosts, and phenotypes using ontologies and identified their relations. Various COVID-19 phenotypes are hypothesized to be caused by the backend HCI mechanisms. To further identify the causal HCI-outcome relations, we collected 35 experimentally-verified HCI protein-protein interactions (PPIs), and applied literature mining to identify additional host PPIs in response to coronavirus infections. The results were formulated in a logical ontology representation for integrative HCI-outcome understanding. Using known PPIs as baits, we also developed and applied a domain-inferred prediction method to predict new PPIs and identified their pathological targets on multiple organs. Overall, our proposed ontology-based integrative framework combined with computational predictions can be used to support fundamental understanding of the intricate interactions between human patients and coronaviruses (including SARS-CoV-2) and their association with various disease outcomes.

Clinical features of 35 COVID-19 patients with hospitalization for more than 20 days (preprint)

Background: As we know, some patients with Coronavirus disease 2019 (COVID-19) may stay longer in the hospital, but whether the different hospitalization days are associated with different clinical features is not clear yet. Methods: This study is a single-centered, observational and retrospective case series.97 patients with COVID-19 were divided into two groups:patients with hospitalization for more than 20 days (Group1,n=35)and those with hospitalization for less than 20 days (Group2,n=62).Data were collected Results Acute Respiratory Distress Syndrome(ARDS) and Hospital acquired pneumonia (HAP)were more common in Group1 than in Group2 . There were more patients administered quadruple antiviral therapy in Group1 than in Group2 . In group1, 14.3% patients’ specimens showed positive again after they were discharged from the hospital.Compared with Group2,Group1 had higher percentages of oxygenation index<300mmHg leucopenia and lymphopenia. In Group1, 19 patients were treated with chloroquine phosphate,whose nucleic acid tests were negative soon,but 5 patents who hadn’t used the medicine had positive testing again . Conclusions: COVID-19 patients with longer hospitalization are more severe and need more quadruple antiviral therapy ;For patients who don't use chloroquine phosphate, the nucleic acid tests are more likely to return to positive again even if they have no symptoms at that time .

Therapeutic Effects and Molecular Network Mechanism of Chinese herbs for Coronavirus Disease-19 (preprint)

Background: The coronavirus disease-19 (COVID-19) outbreak on December 2019.The present study was aimed to explore the therapeutic effects and the network pharmacology mechanism of Chinese herbs in COVID-19 patients.Methods: In this retrospective study, demographic, clinical signs, radiography, and laboratory of 78 patients were analysis from patients' medical records. Network pharmacology was applied to characterize the action mechanism of herbs decoction. Results: Of all patients were imported cases with familial aggregation. Survival analysis showed that the proportion of cough (χ2 =3.864, P=0.049) and fever (χ2 =5.549, P=0.018) in TCM group declined faster than control group. There was a significant radiographic lesions remission difference between groups (χ2 =7.666, P=0.006). After adjusted by baseline data, the changes of Lymphocytes, ALT and LDH were greater in TCM group (P=0.023, 0.005, 0.015, respectively). A total of 1852 ingredients in 13 herbs were obtained, among which, the ingredients-target network included 168 compounds and 189 targets, 38 GO terms and 63 pathways were found in enrichment analysis. Conclusion: The therapeutic effect of Chinese herbs was amelioration of cough and fever, facilitated the absorption of inflammatory infiltrates seen in the lungs, and increased the number of lymphocytes, protection of liver function via the mechanism of inhibition of coronavirus attack organs and immune cells directly. Molecular mechanisms need to be further validate in vitro and vivo.

The unexplained increasing of Erythrocyte Sedimentation Rate in a case recovered from COVID-19 (preprint)

Background A novel coronavirus virus pneumonia (named COVID-19) broke out in Wuhan, China on December 2019, and spread around of the word [1, 2]. As of March 4th, 2020, 93090 confirmed cases and 2984 deaths have been reported in more than 80 countries and territories. It has triggered global public health security [2, 3]. However, the features and prognosis of COVID-19 are incompletely understood [2].Case presentation We here report that the erythrocyte sedimentation rate (ESR) increased in a confirmed COVID patient, the high level of ESR sustained for long time even patient recovered from COVID-19, while all results related to tumor, tuberculosis, rheumatic diseases, anemia, et al. cannot explain the abnormal ESR presented in this case.Conclusion Although the increased ESR cannot be explained by all existing evidences, which possibly links the abnormal pathologic change in some COVID-19 patients and negative prognosis, and provides the clue to dissect the mechanism of illness progressing in COVID-19 and its prognosis.