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1.
Diabetes Research and Clinical Practice ; 2020.
Artigo | COVIDWHO | ID: covidwho-622036

RESUMO

Aims To investigate the clinical characteristics, laboratory findings and high- resolution CT (HRCT) features and to explore the risk factors for in-hospital death and complications of coronavirus disease 2019 (COVID-19) patients with diabetes Methods From Dec 31, 2019, to Apr 5, 2020, a total of 132 laboratory-confirmed COVID-19 patients with diabetes from two hospitals were retrospectively included in our study Clinical, laboratory and chest CT data were analyzed and compared between the two groups with an admission glucose level of ≤11mmol/L (group 1) and >11mmol/L (group 2) Logistic regression analyses were used to identify the risk factors associated with in-hospital death and complications Results Of 132 patients, 15 died in hospital and 113 were discharged Patients in group 2 were more likely to require intensive care unit care (21 4% vs 9 2%), to develop acute respiratory distress syndrome (ARDS) (23 2% vs 9 25%) and acute cardiac injury (12 5% vs 1 3%), and had a higher death rate (19 6% vs 5 3%) than group 1 In the multivariable analysis, patients with admission glucose of >11 mmol/l had an increased risk of death (OR: 7 629, 95%CI: 1 391-37 984) and in-hospital complications (OR: 3 232, 95%CI: 1 393-7 498) Admission d-dimer of ≥1 5 μg/mL (OR: 6 645, 95%CI: 1 212-36 444) and HRCT score of ≥10 (OR: 7 792, 95%CI: 2 195-28 958) were associated with increased odds of in-hospital death and complications, respectively Conclusions In COVID-19 patients with diabetes, poorly-controlled blood glucose (>11mmol/L) may be associated with poor outcomes Admission hyperglycemia, elevated d-dimer and high HRCT score are potential risk factors for adverse outcomes and death

4.
Transpl Infect Dis ; : e13335, 2020 May 21.
Artigo em Inglês | MEDLINE | ID: covidwho-327200
6.
Clin Infect Dis ; 2020 Mar 30.
Artigo em Inglês | MEDLINE | ID: covidwho-19637

RESUMO

BACKGROUND: To retrospectively analyze the evolution of clinical features and thin-section CT imaging of novel coronavirus pneumonia (COVID-19) in 17 discharged patients. METHODS: Serial thin-section CT scans of 17 discharged patients with COVID-19 were obtained during recovery. Longitudinal changes of clinical parameters and CT pattern were documented in all patients during 4 weeks since admission. CT score was used to evaluate the extent of the disease. RESULTS: There was a marked improvement of fever, lymphocytes count, C-reactive protein and erythrocyte sedimentation rate within the first two weeks since admission. However, the mean CT score rapidly increased from the 1st to 3rd week, with a top score of 8.2 obtained in the 2nd week. During the 1st week, the main CT pattern was ground-glass opacities (GGO,76.5%). The frequency of GGO (52.9%) decreased in the 2nd week. Consolidation and mixed patterns (47.0%) were noted in the 2nd week. Thereafter, consolidations generally dissipated into GGO and the frequency of GGO increased in the 3rd week (76.5%) and 4th week (71.4%). Opacities were mainly located in the peripheral (76.5%), subpleural (47.1%) zones of the lungs, and presented as focal (35.3%) or multifocal (29.4%) in the 1st week and became more diffuse in the 2nd (47.1%) and 3rd week (58.8%), then showed reduced extent in 4th week (50%). CONCLUSIONS: The progression course of CT pattern was later than the clinical parameters within the first two weeks since admission; however, there was a synchronized improvement in both clinical and radiologic features in the 4th week.

7.
Eur J Radiol ; 126: 108941, 2020 May.
Artigo em Inglês | MEDLINE | ID: covidwho-8282

RESUMO

PURPOSE: To report CT features of coronavirus disease-2019 (COVID-19) in patients with various disease severity. METHODS: The CT manifestations and clinical data of 73 patients with COVID-19 were retrospectively collected in 6 hospitals from Jan 21 to Feb 3, 2020. We analyzed the initial and follow-up CT features of patients with disease severity, according to the Guidelines for the Diagnosis and Treatment of New Coronavirus Pneumonia. RESULTS: Six patients (8%) were diagnosed as mild type pneumonia; these patients had no obvious abnormal CT findings or manifested mild changes of lung infection. All 43 patients (59 %) with common type presented unique or multiple ground-glass opacities (GGO) in the periphery of the lungs, with or without interlobular septal thickening. In the 21 patients (29 %) with severe type, extensive GGO and pulmonary consolidation were found in 16 cases (16/21, 76 %) and 5 cases (24 %), respectively. An extensive "white lung", with atelectasis and pleural effusion were found in critical type patients (3, 4%). On the resolutive phase of the disease, CT abnormalities showed complete resolution, or demonstrated residual linear opacities. CONCLUSIONS: Different CT features are seen according to disease severity, which can help COVID-19 stratification.


Assuntos
Betacoronavirus , Infecções por Coronavirus/diagnóstico por imagem , Pneumonia Viral/diagnóstico por imagem , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Criança , Pré-Escolar , Progressão da Doença , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Pandemias , Derrame Pleural , Atelectasia Pulmonar/diagnóstico por imagem , Estudos Retrospectivos , Índice de Gravidade de Doença , Tomografia Computadorizada por Raios X , Adulto Jovem
8.
Lancet Infect Dis ; 20(4): 425-434, 2020 04.
Artigo em Inglês | MEDLINE | ID: covidwho-1769

RESUMO

BACKGROUND: A cluster of patients with coronavirus disease 2019 (COVID-19) pneumonia caused by infection with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) were successively reported in Wuhan, China. We aimed to describe the CT findings across different timepoints throughout the disease course. METHODS: Patients with COVID-19 pneumonia (confirmed by next-generation sequencing or RT-PCR) who were admitted to one of two hospitals in Wuhan and who underwent serial chest CT scans were retrospectively enrolled. Patients were grouped on the basis of the interval between symptom onset and the first CT scan: group 1 (subclinical patients; scans done before symptom onset), group 2 (scans done ≤1 week after symptom onset), group 3 (>1 week to 2 weeks), and group 4 (>2 weeks to 3 weeks). Imaging features and their distribution were analysed and compared across the four groups. FINDINGS: 81 patients admitted to hospital between Dec 20, 2019, and Jan 23, 2020, were retrospectively enrolled. The cohort included 42 (52%) men and 39 (48%) women, and the mean age was 49·5 years (SD 11·0). The mean number of involved lung segments was 10·5 (SD 6·4) overall, 2·8 (3·3) in group 1, 11·1 (5·4) in group 2, 13·0 (5·7) in group 3, and 12·1 (5·9) in group 4. The predominant pattern of abnormality observed was bilateral (64 [79%] patients), peripheral (44 [54%]), ill-defined (66 [81%]), and ground-glass opacification (53 [65%]), mainly involving the right lower lobes (225 [27%] of 849 affected segments). In group 1 (n=15), the predominant pattern was unilateral (nine [60%]) and multifocal (eight [53%]) ground-glass opacities (14 [93%]). Lesions quickly evolved to bilateral (19 [90%]), diffuse (11 [52%]) ground-glass opacity predominance (17 [81%]) in group 2 (n=21). Thereafter, the prevalence of ground-glass opacities continued to decrease (17 [57%] of 30 patients in group 3, and five [33%] of 15 in group 4), and consolidation and mixed patterns became more frequent (12 [40%] in group 3, eight [53%] in group 4). INTERPRETATION: COVID-19 pneumonia manifests with chest CT imaging abnormalities, even in asymptomatic patients, with rapid evolution from focal unilateral to diffuse bilateral ground-glass opacities that progressed to or co-existed with consolidations within 1-3 weeks. Combining assessment of imaging features with clinical and laboratory findings could facilitate early diagnosis of COVID-19 pneumonia. FUNDING: None.


Assuntos
Betacoronavirus/fisiologia , Infecções por Coronavirus/patologia , Pneumonia Viral/patologia , Adulto , Idoso , China , Infecções por Coronavirus/sangue , Infecções por Coronavirus/complicações , Infecções por Coronavirus/virologia , Feminino , Humanos , Pulmão/patologia , Masculino , Pessoa de Meia-Idade , Pandemias , Pneumonia Viral/sangue , Pneumonia Viral/complicações , Pneumonia Viral/virologia , Tomografia Computadorizada por Raios X
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