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1.
Gac Med Mex ; 156(3): 246-248, 2020.
Artículo en Inglés | MEDLINE | ID: covidwho-692409

RESUMEN

Except for pregnant women, the management of critically ill patients with COVID-19 during the pandemic includes the standard procedures that are used for any patient that requires to be attended to at the intensive care unit, as well as limited administration of crystalloid solutions, orotracheal intubation, invasive mechanical ventilation in the event of patient clinical deterioration, and muscle relaxants continuous infusion only if necessary. Non-invasive mechanical ventilation and high-flow oxygen therapy are not recommended due to the generation of aerosol (associated with risk of viral spread among health personnel), and neither is extracorporeal membrane oxygenation or the use of steroids. So far, there is no specific antiviral treatment for patients with COVID-19, and neither are there results of controlled trials supporting the use of any.


Asunto(s)
Infecciones por Coronavirus/terapia , Cuidados Críticos/métodos , Unidades de Cuidados Intensivos , Neumonía Viral/terapia , Infecciones por Coronavirus/fisiopatología , Infecciones por Coronavirus/transmisión , Enfermedad Crítica , Humanos , Transmisión de Enfermedad Infecciosa de Paciente a Profesional/prevención & control , Pandemias , Neumonía Viral/fisiopatología , Neumonía Viral/transmisión
2.
J Infect Dis ; 221(11): 1762-1769, 2020 05 11.
Artículo en Inglés | MEDLINE | ID: covidwho-688308

RESUMEN

BACKGROUND: In December 2019, novel coronavirus (SARS-CoV-2) pneumonia (COVID-19) was reported in Wuhan and has since rapidly spread throughout China. We aimed to clarify the characteristics and clinical significance of peripheral lymphocyte subset alteration in COVID-19. METHODS: The levels of peripheral lymphocyte subsets were measured by flow cytometry in 60 hospitalized COVID-19 patients before and after treatment, and their association with clinical characteristics and treatment efficacy was analyzed. RESULTS: Total lymphocytes, CD4+ T cells, CD8+ T cells, B cells, and natural killer (NK) cells decreased in COVID-19 patients, and severe cases had a lower level than mild cases. The subsets showed a significant association with inflammatory status in COVID-19, especially CD8+ T cells and CD4+/CD8+ ratio. After treatment, 37 patients (67%) showed clinical response, with an increase in CD8+ T cells and B cells. No significant change in any subset was detected in nonresponsive cases. In multivariate analysis, posttreatment decrease in CD8+ T cells and B cells and increase in CD4+/CD8+ ratio were indicated as independent predictors of poor efficacy. CONCLUSIONS: Peripheral lymphocyte subset alteration was associated with clinical characteristics and treatment efficacy of COVID-19. CD8+ T cells tended to be an independent predictor for COVID-19 severity and treatment efficacy.


Asunto(s)
Infecciones por Coronavirus/complicaciones , Infecciones por Coronavirus/fisiopatología , Subgrupos Linfocitarios , Neumonía Viral/complicaciones , Neumonía Viral/fisiopatología , Neumonía/etiología , Neumonía/fisiopatología , Adulto , Anciano , Betacoronavirus/aislamiento & purificación , China , Infecciones por Coronavirus/diagnóstico , Infecciones por Coronavirus/terapia , Femenino , Citometría de Flujo , Humanos , Recuento de Linfocitos , Subgrupos Linfocitarios/inmunología , Masculino , Persona de Mediana Edad , Pandemias , Neumonía/diagnóstico , Neumonía/terapia , Neumonía Viral/diagnóstico , Neumonía Viral/terapia , Pronóstico , Resultado del Tratamiento
3.
Monaldi Arch Chest Dis ; 90(2)2020 Jun 23.
Artículo en Inglés | MEDLINE | ID: covidwho-688266

RESUMEN

There is a need of consensus about the pulmonary rehabilitation (PR) in patients with COVID-19 after discharge from acute care. To facilitate the knowledge of the evidence and its translation into practice, we developed suggestions based on experts' opinion. A steering committee identified areas and questions sent to experts. Other international experts participated to a RAND Delphi method in reaching consensus and proposing further suggestions. Strong agreement in suggestions was defined when the mean agreement was >7 (1 = no agreement and 9 = maximal agreement). Panelists response rate was >95%. Twenty-three questions from 4 areas: Personnel protection equipment, phenotypes, assessments, interventions, were identified and experts answered with 121 suggestions, 119 of which received high level of concordance. The evidence-based suggestions provide the clinicians with current evidence and clinical experts opinion. This framework can be used to facilitate clinical decision making within the context of the individual patient. Further studies will evaluate the clinical usefulness of these suggestions.


Asunto(s)
Infecciones por Coronavirus/rehabilitación , Modalidades de Fisioterapia , Neumonía Viral/rehabilitación , Insuficiencia Respiratoria/rehabilitación , Terapia Respiratoria/métodos , Atención Ambulatoria , Betacoronavirus , Infecciones por Coronavirus/complicaciones , Infecciones por Coronavirus/fisiopatología , Técnica Delfos , Prueba de Esfuerzo , Humanos , Unidades de Cuidados Intensivos , Italia , Estado Nutricional , Pandemias , Equipo de Protección Personal , Neumonía Viral/complicaciones , Neumonía Viral/fisiopatología , Calidad de Vida , Pruebas de Función Respiratoria , Insuficiencia Respiratoria/etiología , Insuficiencia Respiratoria/fisiopatología , Trastornos por Estrés Postraumático
4.
BMC Infect Dis ; 20(1): 549, 2020 Jul 29.
Artículo en Inglés | MEDLINE | ID: covidwho-684717

RESUMEN

BACKGROUND: We aimed to report the epidemiological and clinical characteristics of hospitalized patients with coronavirus disease-19 (COVID-19) in Zengdu District, Hubei Province, China. METHODS: Clinical data on COVID-19 inpatients in Zengdu Hospital from January 27 to March 11, 2020 were collected; this is a community hospital in an area surrounding Wuhan and supported by volunteer doctors. All hospitalized patients with COVID-19 were included in this study. The epidemiological findings, clinical features, laboratory findings, radiologic manifestations, and clinical outcomes of these patients were analyzed. The patients were followed up for clinical outcomes until March 22, 2020. Severe COVID-19 cases include severe and critical cases diagnosed according to the seventh edition of China's COVID-19 diagnostic guidelines. Severe and critical COVID-19 cases were diagnosed according to the seventh edition of China's COVID-19 diagnostic guidelines. RESULTS: All hospitalized COVID-19 patients, 276 (median age: 51.0 years), were enrolled, including 262 non-severe and 14 severe patients. The proportion of patients aged over 60 years was higher in the severe group (78.6%) than in the non-severe group (18.7%, p < 0.01). Approximately a quarter of the patients (24.6%) had at least one comorbidity, such as hypertension, diabetes, or cancer, and the proportion of patients with comorbidities was higher in the severe group (85.7%) than in the non-severe group (21.4%, p < 0.01). Common symptoms included fever (82.2% [227/276]) and cough (78.0% [218/276]). 38.4% (106/276) of the patients had a fever at the time of admission. Most patients (94.9% [204/276]) were cured and discharged; 3.6% (10/276) deteriorated to a critical condition and were transferred to another hospital. The median COVID-19 treatment duration and hospital stay were 14.0 and 18.0 days, respectively. CONCLUSIONS: Most of the COVID-19 patients in Zengdu had mild disease. Older patients with underlying diseases were at a higher risk of progression to severe disease. The length of hospital-stay and antiviral treatment duration for COVID-19 were slightly longer than those in Wuhan. This work will contribute toward an understanding of COVID-19 characteristics in the areas around the core COVID-19 outbreak region and serve as a reference for decision-making for epidemic prevention and control in similar areas.


Asunto(s)
Betacoronavirus/patogenicidad , Infecciones por Coronavirus/epidemiología , Infecciones por Coronavirus/fisiopatología , Tiempo de Internación/estadística & datos numéricos , Neumonía Viral/epidemiología , Neumonía Viral/fisiopatología , Adolescente , Adulto , Niño , Preescolar , China/epidemiología , Comorbilidad , Infecciones por Coronavirus/diagnóstico , Infecciones por Coronavirus/tratamiento farmacológico , Tos/epidemiología , Femenino , Fiebre/epidemiología , Humanos , Hipertensión/epidemiología , Lactante , Recién Nacido , Masculino , Persona de Mediana Edad , Pandemias , Neumonía Viral/diagnóstico , Estudios Retrospectivos , Resultado del Tratamiento , Adulto Joven
5.
Circulation ; 142(2): 114-128, 2020 07 14.
Artículo en Inglés | MEDLINE | ID: covidwho-684109

RESUMEN

BACKGROUND: To investigate deep vein thrombosis (DVT) in hospitalized patients with coronavirus disease 2019 (COVID-19), we performed a single institutional study to evaluate its prevalence, risk factors, prognosis, and potential thromboprophylaxis strategies in a large referral and treatment center. METHODS: We studied a total of 143 patients with COVID-19 from January 29, 2020 to February 29, 2020. Demographic and clinical data, laboratory data, including ultrasound scans of the lower extremities, and outcome variables were obtained, and comparisons were made between groups with and without DVT. RESULTS: Of the 143 patients hospitalized with COVID-19 (age 63±14 years, 74 [51.7%] men), 66 patients developed lower extremity DVT (46.1%: 23 [34.8%] with proximal DVT and 43 [65.2%] with distal DVT). Compared with patients who did not have DVT, patients with DVT were older and had a lower oxygenation index, a higher rate of cardiac injury, and worse prognosis, including an increased proportion of deaths (23 [34.8%] versus 9 [11.7%]; P=0.001) and a decreased proportion of patients discharged (32 [48.5%] versus 60 [77.9%]; P<0.001). Multivariant analysis showed an association only between CURB-65 (confusion status, urea, respiratory rate, and blood pressure) score 3 to 5 (odds ratio, 6.122; P=0.031), Padua prediction score ≥4 (odds ratio, 4.016; P=0.04), D-dimer >1.0 µg/mL (odds ratio, 5.818; P<0.014), and DVT in this cohort, respectively. The combination of a CURB-65 score 3 to 5, a Padua prediction score ≥4, and D-dimer >1.0 µg/mL has a sensitivity of 88.52% and a specificity of 61.43% for screening for DVT. In the subgroup of patients with a Padua prediction score ≥4 and whose ultrasound scans were performed >72 hours after admission, DVT was present in 18 (34.0%) patients in the subgroup receiving venous thromboembolism prophylaxis versus 35 (66.0%) patients in the nonprophylaxis group (P=0.010). CONCLUSIONS: The prevalence of DVT is high and is associated with adverse outcomes in hospitalized patients with COVID-19. Prophylaxis for venous thromboembolism may be protective in patients with a Padua protection score ≥4 after admission. Our data seem to suggest that COVID-19 is probably an additional risk factor for DVT in hospitalized patients.


Asunto(s)
Infecciones por Coronavirus/diagnóstico , Neumonía Viral/diagnóstico , Trombosis de la Vena/diagnóstico , Adulto , Anciano , Anticoagulantes/uso terapéutico , Betacoronavirus/aislamiento & purificación , Presión Sanguínea , China/epidemiología , Infecciones por Coronavirus/complicaciones , Infecciones por Coronavirus/mortalidad , Infecciones por Coronavirus/fisiopatología , Femenino , Productos de Degradación de Fibrina-Fibrinógeno/análisis , Humanos , Estimación de Kaplan-Meier , Extremidad Inferior/diagnóstico por imagen , Masculino , Persona de Mediana Edad , Oportunidad Relativa , Pandemias , Neumonía Viral/complicaciones , Neumonía Viral/mortalidad , Neumonía Viral/fisiopatología , Prevalencia , Pronóstico , Frecuencia Respiratoria , Estudios Retrospectivos , Factores de Riesgo , Resultado del Tratamiento , Trombosis de la Vena/complicaciones , Trombosis de la Vena/tratamiento farmacológico , Trombosis de la Vena/epidemiología
7.
J Med Internet Res ; 22(7): e19514, 2020 07 02.
Artículo en Inglés | MEDLINE | ID: covidwho-669450

RESUMEN

BACKGROUND: Most patients with coronavirus disease (COVID-19) who show mild symptoms are sent home by physicians to recover. However, the condition of some of these patients becomes severe or critical as the disease progresses. OBJECTIVE: The aim of this study was to evaluate a telemedicine model that was developed to address the challenges of treating patients with progressive COVID-19 who are home-quarantined and shortages in the medical workforce. METHODS: A telemedicine system was developed to continuously monitor the progression of home-quarantined patients with COVID-19. The system was built based on a popular social media smartphone app called WeChat; the app was used to establish two-way communication between a multidisciplinary team consisting of 7 medical workers and 188 home-quarantined individuals (including 74 confirmed patients with COVID-19). The system helped patients self-assess their conditions and update the multidisciplinary team through a telemedicine form stored on a cloud service, based on which the multidisciplinary team made treatment decisions. We evaluated this telemedicine system via a single-center retrospective study conducted at Tongji Hospital in Wuhan, China, in January 2020. RESULTS: Among 188 individuals using the telemedicine system, 114 (60.6%) were not infected with COVID-19 and were dismissed. Of the 74 confirmed patients with COVID-19, 26 (35%) recovered during the study period and voluntarily stopped using the system. The remaining 48/76 confirmed patients with COVID-19 (63%) used the system until the end of the study, including 6 patients whose conditions progressed to severe or critical. These 6 patients were admitted to hospital and were stabilized (one received extracorporeal membrane oxygenation support for 17 days). All 74 patients with COVID-19 eventually recovered. Through a comparison of the monitored symptoms between hospitalized and nonhospitalized patients, we found prolonged persistence and deterioration of fever, dyspnea, lack of strength, and muscle soreness to be diagnostic of need for hospitalization. CONCLUSIONS: By continuously monitoring the changes in several key symptoms, the telemedicine system reduces the risks of delayed hospitalization due to disease progression for patients with COVID-19 quarantined at home. The system uses a set of scales for quarantine management assessment that enables patients to self-assess their conditions. The results are useful for medical staff to identify disease progression and, hence, make appropriate and timely treatment decisions. The system requires few staff to manage a large cohort of patients. In addition, the system can solicit help from recovered but self-quarantined medical workers to alleviate shortages in the medical workforce and free healthy medical workers to fight COVID-19 on the front line. Thus, it optimizes the usage of local medical resources and prevents cross-infections among medical workers and patients.


Asunto(s)
Infecciones por Coronavirus/diagnóstico , Infecciones por Coronavirus/epidemiología , Progresión de la Enfermedad , Vivienda , Monitoreo Fisiológico , Neumonía Viral/diagnóstico , Neumonía Viral/epidemiología , Cuarentena , Telemedicina/métodos , Adulto , Anciano , Betacoronavirus , Infecciones por Coronavirus/fisiopatología , Femenino , Personal de Salud/estadística & datos numéricos , Hospitalización , Humanos , Masculino , Persona de Mediana Edad , Pandemias , Admisión del Paciente , Médicos/estadística & datos numéricos , Neumonía Viral/fisiopatología , Cuarentena/métodos , Estudios Retrospectivos
8.
Subst Abus ; 41(3): 286-291, 2020.
Artículo en Inglés | MEDLINE | ID: covidwho-664707

RESUMEN

The COVID-19 pandemic disproportionately disrupts the daily lives of marginalized populations. Persons with substance use disorders are a particularly vulnerable population because of their unique social and health care needs. They face significant harm from both the pandemic itself and its social and economic consequences, including marginalization in health care and social systems. Hence, we discuss: (1) why persons with substance use disorders are at increased risk for infection with COVID-19 and a severe illness course; (2) anticipated adverse consequences of COVID-19 in persons with substance use disorders; (3) challenges to health care delivery and substance use treatment programs during and after the COVID-19 pandemic; and (4) the potential impact on clinical research in substance use disorders. We offer recommendations for clinical, public health, and social policies to mitigate these challenges and to prevent negative outcomes.


Asunto(s)
Infecciones por Coronavirus/epidemiología , Prestación de Atención de Salud , Neumonía Viral/epidemiología , Trastornos Relacionados con Sustancias/epidemiología , Trastornos Relacionados con Sustancias/terapia , Betacoronavirus , Investigación Biomédica , Infecciones por Coronavirus/fisiopatología , Política de Salud , Accesibilidad a los Servicios de Salud , Humanos , Servicios de Salud Mental , Pandemias , Neumonía Viral/fisiopatología , Política Pública , Riesgo , Índice de Severidad de la Enfermedad , Estrés Psicológico/psicología , Trastornos Relacionados con Sustancias/psicología
10.
Heart Lung Circ ; 29(6): e69-e77, 2020 Jun.
Artículo en Inglés | MEDLINE | ID: covidwho-664510

RESUMEN

The global coronavirus disease (COVID-19) pandemic poses an unprecedented stress on healthcare systems internationally. These Health system-wide demands call for efficient utilisation of resources at this time in a fair, consistent, ethical and efficient manner would improve our ability to treat patients. Excellent co-operation between hospital units (especially intensive care unit [ICU], emergency department [ED] and cardiology) is critical in ensuring optimal patient outcomes. The purpose of this document is to provide practical guidelines for the effective use of interventional cardiology services in Australia and New Zealand. The document will be updated regularly as new evidence and knowledge is gained with time. Goals Considerations.


Asunto(s)
Betacoronavirus , Consenso , Infecciones por Coronavirus , Cuidados Críticos , Unidades de Cuidados Intensivos , Pandemias , Neumonía Viral , Australia/epidemiología , Cardiología/normas , Infecciones por Coronavirus/epidemiología , Infecciones por Coronavirus/fisiopatología , Infecciones por Coronavirus/terapia , Humanos , Nueva Zelanda/epidemiología , Neumonía Viral/epidemiología , Neumonía Viral/fisiopatología , Neumonía Viral/terapia , Guías de Práctica Clínica como Asunto
14.
BMJ Open ; 10(7): e038004, 2020 07 22.
Artículo en Inglés | MEDLINE | ID: covidwho-662507

RESUMEN

INTRODUCTION: An outbreak of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) occurred in Wuhan, China starting in December 2019. Yet the clinical features and long-term outcomes of neonates with SARS-CoV-2 exposure are lacking. The purpose of this study is to describe the clinical course and prognosis of the neonates exposed to SARS-CoV-2. METHODS AND ANALYSIS: This is a multicentre observational study conducted at the designated children and maternal and child hospitals in the mainland of China. Neonates exposed to SARS-CoV-2 infection will be recruited. The data to be collected via case report forms include demographic details, clinical features, laboratory and imaging results, as well as outcomes. Primary outcomes are the mortality of neonates with COVID-19 and SARS-CoV-2 infection of neonates born to mothers with COVID-19. Secondary outcomes are the birth weight, premature delivery and neurological development of neonates exposed to SARS-CoV-2. The neurological development is assessed by the Chinese standardised Denver Developmental Screening Test at the corrected age of 6 months. ETHICS AND DISSEMINATION: This study has been approved by the Children's Hospital of Fudan University ethics committee (No. (2020)31). The study findings will be disseminated in peer-reviewed journals and presented at national and international conferences in order to improve the understanding of the clinical course among neonates exposed to SARS-CoV-2 and to provide evidence-based treatment and prevention strategies for this group. TRIAL REGISTRATION NUMBER: NCT04279899.


Asunto(s)
Desarrollo Infantil , Infecciones por Coronavirus/epidemiología , Trastornos del Neurodesarrollo/epidemiología , Neumonía Viral/epidemiología , Complicaciones Infecciosas del Embarazo/epidemiología , Nacimiento Prematuro/epidemiología , Betacoronavirus , China/epidemiología , Infecciones por Coronavirus/mortalidad , Infecciones por Coronavirus/fisiopatología , Femenino , Maternidades , Hospitales Pediátricos , Humanos , Lactante , Recién Nacido , Pandemias , Neumonía Viral/mortalidad , Neumonía Viral/fisiopatología , Embarazo , Estudios Prospectivos , Índice de Severidad de la Enfermedad
15.
BMJ Open ; 10(7): e038555, 2020 07 22.
Artículo en Inglés | MEDLINE | ID: covidwho-662505

RESUMEN

INTRODUCTION: There is an outbreak of COVID-19 worldwide. As there is no effective therapy or vaccine yet, rigorous implementation of traditional public health measures such as isolation and quarantine remains the most effective tool to control the outbreak. When an asymptomatic individual with COVID-19 exposure is being quarantined, it is necessary to perform temperature and symptom surveillance. As such surveillance is intermittent in nature and highly dependent on self-discipline, it has limited effectiveness. Advances in biosensor technologies made it possible to continuously monitor physiological parameters using wearable biosensors with a variety of form factors. OBJECTIVE: To explore the potential of using wearable biosensors to continuously monitor multidimensional physiological parameters for early detection of COVID-19 clinical progression. METHOD: This randomised controlled open-labelled trial will involve 200-1000 asymptomatic subjects with close COVID-19 contact under mandatory quarantine at designated facilities in Hong Kong. Subjects will be randomised to receive a remote monitoring strategy (intervention group) or standard strategy (control group) in a 1:1 ratio during the 14 day-quarantine period. In addition to fever and symptom surveillance in the control group, subjects in the intervention group will wear wearable biosensors on their arms to continuously monitor skin temperature, respiratory rate, blood pressure, pulse rate, blood oxygen saturation and daily activities. These physiological parameters will be transferred in real time to a smartphone application called Biovitals Sentinel. These data will then be processed using a cloud-based multivariate physiology analytics engine called Biovitals to detect subtle physiological changes. The results will be displayed on a web-based dashboard for clinicians' review. The primary outcome is the time to diagnosis of COVID-19. ETHICS AND DISSEMINATION: Ethical approval has been obtained from institutional review boards at the study sites. Results will be published in peer-reviewed journals.


Asunto(s)
Inteligencia Artificial , Infecciones por Coronavirus/diagnóstico , Aplicaciones Móviles , Neumonía Viral/diagnóstico , Cuarentena , Teléfono Inteligente , Dispositivos Electrónicos Vestibles , Betacoronavirus , Monitoreo de Gas Sanguíneo Transcutáneo , Técnicas de Laboratorio Clínico , Nube Computacional , Infecciones por Coronavirus/fisiopatología , Diagnóstico Precoz , Frecuencia Cardíaca , Hong Kong , Humanos , Pandemias , Neumonía Viral/fisiopatología , Frecuencia Respiratoria , Temperatura Cutánea , Telemedicina
18.
Isr Med Assoc J ; 7(22): 335-337, 2020 Jul.
Artículo en Inglés | MEDLINE | ID: covidwho-658811

RESUMEN

BACKGROUND: There is a high prevalence of olfaction changes, especially in the early presentation, in COVID-19 patients. The mechanisms through which the virus leads to anosmia/hyposmia is still not fully understood. However, olfaction changes could be used as an indication for testing or quarantine. Screening for infections and other diseases by recognizing volatile organic compounds (VOCs) has been previously conducted. Hence, if the coronavirus infection also results in VOCs excretion, physicians could "smell" the virus by using electronic noses. We conducted a literature review on olfaction changes and the COVID-19. Our results suggest that these changes could be used an indication for early testing, even as an isolated symptom. We propose that the electronic nose be used as a future screening tool, especially in agglomeration spaces such as airports, for screening for the COVID-19 infection.


Asunto(s)
Técnicas de Laboratorio Clínico/métodos , Infecciones por Coronavirus/diagnóstico , Trastornos del Olfato/virología , Neumonía Viral/diagnóstico , Animales , Infecciones por Coronavirus/fisiopatología , Humanos , Tamizaje Masivo/métodos , Pandemias , Neumonía Viral/fisiopatología , Prevalencia , Olfato/fisiología
20.
Ther Adv Respir Dis ; 14: 1753466620942129, 2020.
Artículo en Inglés | MEDLINE | ID: covidwho-656093

RESUMEN

BACKGROUND: In December of 2019, coronavirus disease 2019 (Covid-19) was reported in Wuhan, China, and has now rapidly swept around the world. Much research has been carried out since the outbreak, but few studies have focused on the dysfunction of the adaptive immunity. METHODS: In this retrospective and multi-center study, 373 patients with laboratory-confirmed COVID-19 from Shanghai Public Health Clinical Center and Affiliated Hospital of Putian University were recruited. Demographic, clinical, radiological features, and laboratory data were recorded and analyzed at admission and at discharge. Results of immunological tests were followed up until the patients were discharged. RESULTS: Of the 373 patients with COVID-19 pneumonia, 322 were in the non-severe group and 51 were in the severe group. Number of T cells, CD4+ and CD8+ T cells, and total lymphocytes declined remarkably upon admission and elevated when the patients were discharged. At admission, counts of total lymphocytes, T cells, CD4+ and CD8+ T cells, and levels of C3 and C4 in the severe group were lower than those in the non-severe group, whereas the neutrophil to lymphocyte ratio (NLR) was higher in the severe group. Counts of T cells, CD4+ and CD8+ T cells, and total lymphocytes were negatively correlated with lactate dehydrogenase and C-reactive protein. CONCLUSION: COVID-19 might target adaptive immunity and cause a decrease in lymphocytes, especially T cells and subsets. Physicians should pay close attention to the adaptive immunity of patients upon admission. Monitoring NLR, T lymphocytes, and subsets would help physicians with the proper diagnosis and treatment of COVID-19.The reviews of this paper are available via the supplemental material section.


Asunto(s)
Inmunidad Adaptativa/inmunología , Infecciones por Coronavirus/epidemiología , Neumonía Viral/epidemiología , Linfocitos T/inmunología , Adulto , Anciano , Anciano de 80 o más Años , China/epidemiología , Técnicas de Laboratorio Clínico , Infecciones por Coronavirus/diagnóstico , Infecciones por Coronavirus/inmunología , Infecciones por Coronavirus/fisiopatología , Femenino , Humanos , Masculino , Persona de Mediana Edad , Neutrófilos/inmunología , Pandemias , Neumonía Viral/inmunología , Neumonía Viral/fisiopatología , Estudios Retrospectivos , Índice de Severidad de la Enfermedad
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