Clinical Characteristics

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Successful recovery of COVID-19 pneumonia in a renal transplant recipient with long-term immunosuppression
Zhu L.;  Xu X.;  Ma K.;  Yang J.;  Guan H.;  Chen S.;  Chen Z.;  Chen G.
American Journal of Transplantation (2020). Date of Publication: 2020

ABSTRACT
The current outbreak of Coronavirus Disease 2019 (COVID-19) has raised great concern worldwide, but its impact on transplant recipients is unknown. We report here the clinical features and therapeutic course of the first reported renal transplant recipient with confirmed COVID-19 pneumonia. This is a 52-year-old man who received kidney transplantation 12 years ago. His overall clinical characteristics (symptoms, laboratory examinations, and chest CT) were similar to those of non-transplanted COVID-19 patients. Following a treatment regimen consisting of reduced immunosuppressant use and low dose methylprednisolone-based therapy, the COVID-19 pneumonia in this long-term immunosuppressive patient was successfully recovered. This effectively treated case has reference value for the future treatment of other transplant patients with COVID-19 pneumonia.


RECORD 2
TITLE
  Transcriptomic characteristics of bronchoalveolar lavage fluid and peripheral blood mononuclear cells in COVID-19 patients
AUTHOR NAMES
  Xiong Y.;  Liu Y.;  Cao L.;  Wang D.;  Guo M.;  Jiang A.;  Guo D.;  Hu W.;  Yang J.;  Tang Z.;  Wu H.;  Lin Y.;  Zhang M.;  Zhang Q.;  Shi M.;  Liu Y.;  Zhou Y.;  Lan K.;  Chen Y.
SOURCE
  Emerging Microbes and Infections (2020) 9:1 (761-770). Date of Publication: 1 Jan 2020
ABSTRACT
  Circulating in China and 158 other countries and areas, the ongoing COVID-19 outbreak has caused devastating mortality and posed a great threat to public health. However, efforts to identify effectively supportive therapeutic drugs and treatments has been hampered by our limited understanding of host immune response for this fatal disease. To characterize the transcriptional signatures of host inflammatory response to SARS-CoV-2 (HCoV-19) infection, we carried out transcriptome sequencing of the RNAs isolated from the bronchoalveolar lavage fluid (BALF) and peripheral blood mononuclear cells (PBMC) specimens of COVID-19 patients. Our results reveal distinct host inflammatory cytokine profiles to SARS-CoV-2 infection in patients, and highlight the association between COVID-19 pathogenesis and excessive cytokine release such as CCL2/MCP-1, CXCL10/IP-10, CCL3/MIP-1A, and CCL4/MIP1B. Furthermore, SARS-CoV-2 induced activation of apoptosis and P53 signalling pathway in lymphocytes may be the cause of patients’ lymphopenia. The transcriptome dataset of COVID-19 patients would be a valuable resource for clinical guidance on anti-inflammatory medication and understanding the molecular mechansims of host response.
FULL TEXT LINK
http://dx.doi.org/10.1080/22221751.2020.1747363

RECORD 3
TITLE
  Clinical features and treatment of COVID-19 patients in northeast Chongqing
AUTHOR NAMES
  Wan S.;  Xiang Y.;  Fang W.;  Zheng Y.;  Li B.;  Hu Y.;  Lang C.;  Huang D.;  Sun Q.;  Xiong Y.;  Huang X.;  Lv J.;  Luo Y.;  Shen L.;  Yang H.;  Huang G.;  Yang R.
SOURCE
  Journal of Medical Virology (2020). Date of Publication: 2020
ABSTRACT
  The outbreak of the novel coronavirus in China (SARS-CoV-2) that began in December 2019 presents a significant and urgent threat to global health. This study was conducted to provide the international community with a deeper understanding of this new infectious disease. Epidemiological, clinical features, laboratory findings, radiological characteristics, treatment, and clinical outcomes of 135 patients in northeast Chongqing were collected and analyzed in this study. A total of 135 hospitalized patients with COVID-19 were enrolled. The median age was 47 years (interquartile range, 36-55), and there was no significant gender difference (53.3% men). The majority of patients had contact with people from the Wuhan area. Forty-three (31.9%) patients had underlying disease, primarily hypertension (13 [9.6%]), diabetes (12 [8.9%]), cardiovascular disease (7 [5.2%]), and malignancy (4 [3.0%]). Common symptoms included fever (120 [88.9%]), cough (102 [76.5%]), and fatigue (44 [32.5%]). Chest computed tomography scans showed bilateral patchy shadows or ground glass opacity in the lungs of all the patients. All patients received antiviral therapy (135 [100%]) (Kaletra and interferon were both used), antibacterial therapy (59 [43.7%]), and corticosteroids (36 [26.7%]). In addition, many patients received traditional Chinese medicine (TCM) (124 [91.8%]). It is suggested that patients should receive Kaletra early and should be treated by a combination of Western and Chinese medicines. Compared to the mild cases, the severe ones had lower lymphocyte counts and higher plasma levels of Pt, APTT, d-dimer, lactate dehydrogenase, PCT, ALB, C-reactive protein, and aspartate aminotransferase. This study demonstrates the clinic features and therapies of 135 COVID-19 patients. Kaletra and TCM played an important role in the treatment of the viral pneumonia. Further studies are required to explore the role of Kaletra and TCM in the treatment of COVID-19.
FULL TEXT LINK
http://dx.doi.org/10.1002/jmv.25783

RECORD 4
TITLE
  Comparison of Hospitalized Patients with Acute Respiratory Distress Syndrome Caused by COVID-19 and H1N1
AUTHOR NAMES
  Tang X.;  Du R.;  Wang R.;  Cao T.;  Guan L.;  Yang C.;  Zhu Q.;  Hu M.;  Li X.;  Li Y.;  Liang L.;  Tong Z.;  Sun B.;  Peng P.;  Shi H.
SOURCE
  Chest (2020). Date of Publication: 26 Mar 2020
ABSTRACT
  BACKGROUND: Since the outbreak of Coronavirus Disease 2019 (COVID-19) in China in December 2019, considerable attention has been focused on its elucidation. However, it is also important for clinicians and epidemiologists to differentiate COVID-19 from other respiratory infectious diseases, such as influenza viruses. RESEARCH QUESTION: The aim of the study was to explore the different clinical presentations between COVID-19 and influenza A (H1N1) pneumonia in patients with acute respiratory distress syndrome (ARDS). STUDY DESIGN: and Methods: This was a retrospective case-control study. We compared two independent cohorts of ARDS patients infected with either COVID-19 (n=73) or H1N1 (n=75). We analyzed and compared their clinical manifestations, imaging characteristics, treatments, and prognosis. RESULTS: The median age of COVID-19 patients was higher than that of H1N1 patients, and there was a higher proportion of males among COVID-19 patients (p<0.05). COVID-19 patients exhibited higher proportions of non-productive coughs, fatigue, and gastrointestinal symptoms than those of H1N1 patients (p<0.05). H1N1 patients had higher sequential organ failure assessment (SOFA) scores than COVID-19 patients (p<0.05). The PaO2/FiO2 of 198.2 mmHg in COVID-19 patients was significantly higher than the PaO2/FiO2 of 107.0 mmHg of H1N1 patients (p<0.001). Ground-glass opacities was more common in COVID-19 patients than in H1N1 patients (p<0.001). There was a greater variety of antiviral therapies administered to COVID-19 patients than to H1N1 patients. The in-hospital mortality of COVID-19 patients was 28.8%, while that of H1N1 patients was 34.7% (p=0.483). SOFA-score adjusted mortality of H1N1 patients was significantly higher than that of COVID-19 patients with the rate ratio was 2.009 (95% CI [1.563, 2.583], p<0.001). INTERPRETATION: There were many differences between COVID-19 and H1N1-induced ARDS patients in clinical presentations. Compared with H1N1, patients with COVID-19 induced ARDS had lower severity of illness scores at presentation and lower SOFA-score adjusted mortality.
FULL TEXT LINK
http://dx.doi.org/10.1016/j.chest.2020.03.032

RECORD 5
TITLE
  Preliminary Results of Initial Testing for Coronavirus (COVID-19) in the Emergency Department
AUTHOR NAMES
  Tolia V.M.;  Chan T.C.;  Castillo E.M.
SOURCE
  The western journal of emergency medicine (2020) 21:3. Date of Publication: 27 Mar 2020
ABSTRACT
  INTRODUCTION: On March 10, 2020, the World Health Organization declared a global pandemic due to widespread infection of the novel coronavirus 2019 (COVID-19). We report the preliminary results of a targeted program of COVID-19 infection testing in the ED in the first 10 days of its initiation at our institution. METHODS: We conducted a review of prospectively collected data on all ED patients who had targeted testing for acute COVID-19 infection at two EDs during the initial 10 days of testing (March 10-19, 2020). During this initial period with limited resources, testing was targeted toward high-risk patients per Centers for Disease Control and Prevention guidelines. Data collected from patients who were tested included demographics, clinical characteristics, and test qualifying criteria. We present the data overall and by test results with descriptive statistics. RESULTS: During the 10-day study period, the combined census of the study EDs was 2157 patient encounters. A total of 283 tests were ordered in the ED. The majority of patients were 18-64 years of age, male, non-Hispanic white, had an Emergency Severity Index score of three, did not have a fever, and were discharged from the ED. A total of 29 (10.2%) tested positive. Symptoms-based criteria most associated with COVID-19 were the most common criteria identified for testing (90.6%). All other criteria were reported in 5.51-43.0% of persons being tested. Having contact with a person under investigation was significantly more common in those who tested positive compared to those who tested negative (63% vs 24.5%, respectively). The majority of patients in both results groups had at least two qualifying criteria for testing (75.2%). CONCLUSION: In this review of prospectively collected data on all ED patients who had targeted testing for acute COVID-19 infection at two EDs in the first 10 days of testing, we found that 10.2% of those tested were identified as positive. The continued monitoring of testing and results will help providers understand how COVID-19 is progressing in the community.
FULL TEXT LINK
http://dx.doi.org/10.5811/westjem.2020.3.47348

RECORD 6
TITLE
  Knowledge, attitudes, and practices towards COVID-19 among Chinese residents during the rapid rise period of the COVID-19 outbreak: a quick online cross-sectional survey
AUTHOR NAMES
  Zhong B.-L.;  Luo W.;  Li H.-M.;  Zhang Q.-Q.;  Liu X.-G.;  Li W.-T.;  Li Y.
SOURCE
  International journal of biological sciences (2020) 16:10 (1745-1752). Date of Publication: 2020
ABSTRACT
  Unprecedented measures have been adopted to control the rapid spread of the ongoing COVID-19 epidemic in China. People’s adherence to control measures is affected by their knowledge, attitudes, and practices (KAP) towards COVID-19. In this study, we investigated Chinese residents’ KAP towards COVID-19 during the rapid rise period of the outbreak. An online sample of Chinese residents was successfully recruited via the authors’ networks with residents and popular media in Hubei, China. A self-developed online KAP questionnaire was completed by the participants. The knowledge questionnaire consisted of 12 questions regarding the clinical characteristics and prevention of COVID-19. Assessments on residents’ attitudes and practices towards COVID-19 included questions on confidence in winning the battle against COVID-19 and wearing masks when going out in recent days. Among the survey completers (n=6910), 65.7% were women, 63.5% held a bachelor degree or above, and 56.2% engaged in mental labor. The overall correct rate of the knowledge questionnaire was 90%. The majority of the respondents (97.1%) had confidence that China can win the battle against COVID-19. Nearly all of the participants (98.0%) wore masks when going out in recent days. In multiple logistic regression analyses, the COVID-19 knowledge score (OR: 0.75-0.90, P<0.001) was significantly associated with a lower likelihood of negative attitudes and preventive practices towards COVID-2019. Most Chinese residents of a relatively high socioeconomic status, in particular women, are knowledgeable about COVID-19, hold optimistic attitudes, and have appropriate practices towards COVID-19. Health education programs aimed at improving COVID-19 knowledge are helpful for Chinese residents to hold optimistic attitudes and maintain appropriate practices. Due to the limited sample representativeness, we must be cautious when generalizing these findings to populations of a low socioeconomic status.
FULL TEXT LINK
http://dx.doi.org/10.7150/ijbs.45221

RECORD 7
TITLE
  Liver injury during highly pathogenic human coronavirus infections
AUTHOR NAMES
  Xu L.;  Liu J.;  Lu M.;  Yang D.;  Zheng X.
SOURCE
  Liver International (2020). Date of Publication: 2020
ABSTRACT
  The severe acute respiratory syndrome coronavirus 2 (SARS-Cov-2), the pathogen of 2019 novel coronavirus disease (COVID-19), has posed a serious threat to global public health. The WHO has declared the outbreak of SARS-CoV-2 infection an international public health emergency. Lung lesions have been considered as the major damage caused by SARS-CoV-2 infection. However, liver injury has also been reported to occur during the course of the disease in severe cases. Similarly, previous studies have shown that liver damage was common in the patients infected by the other two highly pathogenic coronavirus – severe acute respiratory syndrome coronavirus (SARS-CoV) and the Middle East respiratory syndrome coronavirus (MERS-CoV), and associated with the severity of diseases. In this review, the characteristics and mechanism of liver injury caused by SARS-CoV, MERS-CoV as well as SARS-CoV-2 infection were summarized, which may provide help for further studies on the liver injury of COVID-19.
FULL TEXT LINK
http://dx.doi.org/10.1111/liv.14435

RECORD 8
TITLE
  The clinical characteristics of pneumonia patients coinfected with 2019 novel coronavirus and influenza virus in Wuhan, China
AUTHOR NAMES
  Ding Q.;  Lu P.;  Fan Y.;  Xia Y.;  Liu M.
SOURCE
  Journal of Medical Virology (2020). Date of Publication: 2020
ABSTRACT
  The outbreak of 2019 novel coronavirus (COVID-19) infection emerged in Wuhan, China, in December 2019. Since then the novel coronavirus pneumonia disease has been spreading quickly and many countries and territories have been affected, with major outbreaks in China, South Korea, Italy, and Iran. Influenza virus has been known as a common pathogen in winter and it can cause pneumonia. It was found clinically that very few patients were diagnosed with both COVID-19 and influenza virus. A total of 5 of the 115 patients confirmed with COVID-19 were also diagnosed with influenza virus infection, with three cases being influenza A and two cases being influenza B. In this study, we describe the clinical characteristics of those patients who got infected with COVID-19 as well as influenza virus. Common symptoms at onset of illness included fever (five [100%] patients), cough (five [100%] patients), shortness of breath (five [100%] patients), nasal tampon (three [60%] patients), pharyngalgia (three [60%] patients), myalgia (two [40%] patients), fatigue (two [40%] patients), headache (two [40%] patients), and expectoration (two [40%] patients). The laboratory results showed that compared to the normal values, the patients’ lymphocytes were reduced (four [80%] patients), and liver functions alanine aminotransferase and aspartate aminotransferase (two [40%] patients and two [40%] patients) and C-reactive protein (four [80%] patients) were increased when admitted to hospital. They stayed in the hospital for 14, 30, 17, 12, and 19 days (28.4 ± 7.02), respectively. The main complications for the patients were acute respiratory distress syndrome (one [20%] patients), acute liver injury (three [60%] patients), and diarrhea (two [40%] patients). All patients were given antiviral therapy (including oseltamivir), oxygen inhalation, and antibiotics. Three patients were treated with glucocorticoids including two treated with oral glucocorticoids. One of the five patients had transient hemostatic medication for hemoptysis. Fortunately, all patients did not need intensive care unit and were discharged from the hospital without death. In conclusion, those patients with both COVID-19 and influenza virus infection did not appear to show a more severe condition because based on the laboratory findings, imaging studies, and patient prognosis, they showed similar clinical characteristics as those patients with COVID-19 infection only. However, it is worth noting that the symptoms of nasal tampon and pharyngalgia may be more prone to appear for those coinfection patients.
FULL TEXT LINK
http://dx.doi.org/10.1002/jmv.25781

RECORD 9
TITLE
  Clinical features of COVID-19 in elderly patients: A comparison with young and middle-aged patients
AUTHOR NAMES
  Liu K.;  Chen Y.;  Lin R.;  Han K.
SOURCE
  Journal of Infection (2020). Date of Publication: 2020
ABSTRACT
  Background: Due to the general susceptibility of new coronaviruses, the clinical characteristics and outcomes of elderly and young patients may be different. Objective: To analyze the clinical characteristics of elderly patients with 2019 new-type coronavirus pneumonia (COVID-19). Methods: This is a retrospective study of patients with new coronavirus pneumonia (COVID-19) who were hospitalized in Hainan Provincial People’s Hospital from January 15, 2020 to February 18, 2020. Compare the clinical characteristics of elderly with Young and Middle-aged patients. Results: A total of 56 patients were enrolled 18 elderly patients (32.14%), and 38 young and middle-aged patients (67.86%). The most common symptoms in both groups were fever, followed by cough and sputum. Four patients in the elderly group received negative pressure ICU for mechanical ventilation, and five patients in the young and middle-aged group. One patient died in the elderly group (5.56%), and two patients died in the young and middle-aged group (5.26%). The PSI score of the elderly group was higher than that of the young and middle-aged group (P < 0.001). The proportion of patients with PSI grades IV and V was significantly higher in the elderly group than in the young and middle-aged group (P < 0.05). The proportion of multiple lobe involvement in the elderly group was higher than that in the young and middle-aged group (P < 0.001), and there was no difference in single lobe lesions between the two groups. The proportion of lymphocytes in the elderly group was significantly lower than that in the young and middle-aged group (P < 0.001), and the C-reactive protein was significantly higher in the young group (P < 0.001). The Lopinavir and Ritonavir Tablets, Chinese medicine, oxygen therapy, and mechanical ventilation were statistically different in the elderly group and the young and middle-aged group, and the P values were all <0.05. Interpretation: The mortality of elderly patients with COVID-19 is higher than that of young and middle-aged patients, and the proportion of patients with PSI grade IV and V is significantly higher than that of young and middle-aged patients. Elderly patients with COVID-19 are more likely to progress to severe disease.
FULL TEXT LINK
http://dx.doi.org/10.1016/j.jinf.2020.03.005

RECORD 10
TITLE
  Clinical features and obstetric and neonatal outcomes of pregnant patients with COVID-19 in Wuhan, China: a retrospective, single-centre, descriptive study
AUTHOR NAMES
  Yu N.;  Li W.;  Kang Q.;  Xiong Z.;  Wang S.;  Lin X.;  Liu Y.;  Xiao J.;  Liu H.;  Deng D.;  Chen S.;  Zeng W.;  Feng L.;  Wu J.
SOURCE
  The Lancet. Infectious diseases (2020). Date of Publication: 24 Mar 2020
ABSTRACT
  BACKGROUND: In December, 2019, coronavirus disease 2019 (COVID-19) caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) emerged in Wuhan, China. The number of affected pregnant women is increasing, but scarce information is available about the clinical features of COVID-19 in pregnancy. This study aimed to clarify the clinical features and obstetric and neonatal outcomes of pregnant patients with COVID-19. METHODS: In this retrospective, single-centre study, we included all pregnant women with COVID-19 who were admitted to Tongji Hospital in Wuhan, China. Clinical features, treatments, and maternal and fetal outcomes were assessed. FINDINGS: Seven patients, admitted to Tongji Hospital from Jan 1, to Feb 8, 2020, were included in our study. The mean age of the patients was 32 years (range 29-34 years) and the mean gestational age was 39 weeks plus 1 day (range 37 weeks to 41 weeks plus 2 days). Clinical manifestations were fever (six [86%] patients), cough (one [14%] patient), shortness of breath (one [14%] patient), and diarrhoea (one [14%] patient). All the patients had caesarean section within 3 days of clinical presentation with an average gestational age of 39 weeks plus 2 days. The final date of follow-up was Feb 12, 2020. The outcomes of the pregnant women and neonates were good. Three neonates were tested for SARS-CoV-2 and one neonate was infected with SARS-CoV-2 36 h after birth. INTERPRETATION: The maternal, fetal, and neonatal outcomes of patients who were infected in late pregnancy appeared very good, and these outcomes were achieved with intensive, active management that might be the best practice in the absence of more robust data. The clinical characteristics of these patients with COVID-19 during pregnancy were similar to those of non-pregnant adults with COVID-19 that have been reported in the literature. FUNDING: National Natural Science Foundation of China, Hubei Provincial Natural Science Foundation of China.
FULL TEXT LINK
http://dx.doi.org/10.1016/S1473-3099(20)30176-6

RECORD 11
TITLE
  Clinical and coagulation characteristics of 7 patients with critical COVID-2019 pneumonia and acro-ischemia
AUTHOR NAMES
  Zhang Y.;  Cao W.;  Xiao M.;  Li Y.J.;  Yang Y.;  Zhao J.;  Zhou X.;  Jiang W.;  Zhao Y.Q.;  Zhang S.Y.;  Li T.S.
SOURCE
  Zhonghua xue ye xue za zhi = Zhonghua xueyexue zazhi (2020) 41 (E006). Date of Publication: 28 Mar 2020
ABSTRACT
  Objective: To investigate the clinical and coagulation characteristics of the critical Coronavirus disease 2019 (COVID-19) patients with acro-ischemia in the intensive care unit (ICU). Methods: The retrospective study included 7 critical COVID-19 patients with acro-ischemia in a single center in Wuhan, from Feb 4 to Feb 15, 2020. The clinical and laboratory data before and during the ICU stay were analyzed. Results: The median age of 7 patients was 59 years and 4 of them were men. 3 of them were associated with underlying comorbidities. Fever, cough, dyspnea and diarrhea were common clinical symptoms. All patients had acro-ischemia presentations including finger/toe cyanosis, skin bulla and dry gangrene. D-dimer, fibrinogen and fibrinogen degradation product (FDP) were significantly elevated in most patients. Prothrombin time (PT) were prolonged in 4 patients. D-dimer and FDP levels increased progressively when COVID-2019 exacerbated, and 4 patients were diagnosed with definite disseminated intravascular coagulation (DIC). 6 patients received low molecular weight heparin (LMWH) treatment, after which their D-dimer and FDP decreased, but there was no significant improvement in clinical symptoms. 5 patients died finally and the median time from acro-ischemia to death was 12 days. Conclusions: The existence of hypercoagulation status in critical COVID-2019 patients should be monitored closely, and anticoagulation therapy can be considered in selected patients. More clinical data is needed to investigate the role of anticoagulation in COVID-2019 treatment.
FULL TEXT LINK
http://dx.doi.org/10.3760/cma.j.issn.0253-2727.2020.0006

RECORD 12
TITLE
  Clinical Characteristics of 54 medical staff with COVID-19: A retrospective study in a single center in Wuhan, China
AUTHOR NAMES
  Chu J.;  Yang N.;  Wei Y.;  Yue H.;  Zhang F.;  Zhao J.;  He L.;  Sheng G.;  Chen P.;  Li G.;  Wu S.;  Zhang B.;  Zhang S.;  Wang C.;  Miao X.;  Li J.;  Liu W.;  Zhang H.
SOURCE
  Journal of medical virology (2020). Date of Publication: 29 Mar 2020
ABSTRACT
  BACKGROUND: In December 2019, an outbreak of the SARS-Cov-2 infection occurred in Wuhan, and rapidly spread to worldwide, which has attracted many people’s concerns about the patients. However, studies on the infection status of medical personnels is still lacking. METHODS: 54 cases of SARS-Cov-2 infected medical staff from Tongji Hospital between January 7th to February 11th of 2020 were analyzed in this retrospective study. Clinical and epidemiological characteristics were compared between different groups by statistical method. RESULTS: From January 7 to February 11, 2020, 54 medical staff of Tongji Hospital were hospitalized due to COVID-19. Most of them were from other clinical departments (72.2%) rather than emergency department (3.7%) or medical technology departments (18.5%). Among the 54 COVID-19 patients, the distribution of age had a significant difference between non-severe type and severe/critical cases (median age: 47 years vs. 38 years, p=0.0015). However, there was no statistical difference in terms of gender distribution and the first symptoms between theses two groups. Furthermore, we observed that the lesion regions in SARS-Cov-2 infected lungs with severe-/critical-type of medical staff were more likely to exhibit lesions in the right upper lobe (31.7% vs. 0%, P=0.028) and right lung (61% vs. 18.2%, P=0.012). CONCLUSIONS: Based on our findings with medical staff infection data, we suggest training for all hospital staff to prevent infection and preparation of sufficient protection and disinfection materials. This article is protected by copyright. All rights reserved.
FULL TEXT LINK
http://dx.doi.org/10.1002/jmv.25793

RECORD 13
TITLE
  Detectable SARS-CoV-2 Viral RNA in Feces of Three Children during Recovery Period of COVID-19 Pneumonia
AUTHOR NAMES
  Zhang T.;  Cui X.;  Zhao X.;  Wang J.;  Zheng J.;  Zheng G.;  Guo W.;  Cai C.;  He S.;  Xu Y.
SOURCE
  Journal of medical virology (2020). Date of Publication: 29 Mar 2020
ABSTRACT
  Coronavirus Disease 2019 (COVID-19) is a newly emerging infectious disease caused by a novel coronavirus, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). After its first occurrence in Wuhan of China from December 2019, COVID-19 rapidly spread around the world. According to the World Health Organization (WHO) statement on March 13, 2020, there had been over 132,500 confirmed cases globally. Nevertheless, the case reports of children are rare, which result in the lack of evidence for preventing and controlling of children’s infection. Here, we report 3 cases of SARS-CoV-2 infected children diagnosed from February 3 to February 17, 2020 in Tianjin, China. All of these three cases experienced mild illness and recovered soon after treatment, with the nucleic acid of throat swab turning negative within 14, 11, 7 days after diagnosis respectively. However, after been discharged, all the three cases were tested SARS-CoV-2 positive in the stool samples within 10 days, in spite of their remained negative nucleic acid in throat swab specimens. Therefore, it is necessary to be aware of the possibility of fecal-oral transmission of SARS-CoV-2 infection, especially for children cases. This article is protected by copyright. All rights reserved.
FULL TEXT LINK
http://dx.doi.org/10.1002/jmv.25795

RECORD 14
TITLE
  Comparison of clinical characteristics of coronavirus disease (COVID-19) and severe acute respiratory syndrome (SARS) as experienced in Taiwan
AUTHOR NAMES
  Su Y.-J.;  Lai Y.-C.
SOURCE
  Travel Medicine and Infectious Disease (2020) Article Number: 101625. Date of Publication: 2020
FULL TEXT LINK
http://dx.doi.org/10.1016/j.tmaid.2020.101625

RECORD 15
TITLE
  Can we contain the COVID-19 outbreak with the same measures as for SARS?
AUTHOR NAMES
  Wilder-Smith A.;  Chiew C.J.;  Lee V.J.
SOURCE
  The Lancet Infectious Diseases (2020). Date of Publication: 2020
ABSTRACT
  The severe acute respiratory syndrome (SARS) outbreak in 2003 resulted in more than 8000 cases and 800 deaths. SARS was eventually contained by means of syndromic surveillance, prompt isolation of patients, strict enforcement of quarantine of all contacts, and in some areas top-down enforcement of community quarantine. By interrupting all human-to-human transmission, SARS was effectively eradicated. By contrast, by Feb 28, 2020, within a matter of 2 months since the beginning of the outbreak of coronavirus disease 2019 (COVID-19), more than 82 000 confirmed cases of COVID-19 have been reported with more than 2800 deaths. Although there are striking similarities between SARS and COVID-19, the differences in the virus characteristics will ultimately determine whether the same measures for SARS will also be successful for COVID-19. COVID-19 differs from SARS in terms of infectious period, transmissibility, clinical severity, and extent of community spread. Even if traditional public health measures are not able to fully contain the outbreak of COVID-19, they will still be effective in reducing peak incidence and global deaths. Exportations to other countries need not result in rapid large-scale outbreaks, if countries have the political will to rapidly implement countermeasures.
FULL TEXT LINK
http://dx.doi.org/10.1016/S1473-3099(20)30129-8

RECORD 16
TITLE
  CT imaging features of patients with different clinical types of coronavirus disease 2019 (COVID-19)
AUTHOR NAMES
  Zhong Q.;  Li Z.;  Shen X.;  Xu K.;  Shen Y.;  Fang Q.;  Chen F.;  Liang T.
SOURCE
  Zhejiang da xue xue bao. Yi xue ban = Journal of Zhejiang University. Medical sciences (2020) 49:1 (0). Date of Publication: 25 May 2020
ABSTRACT
  OBJECTIVE: To analyze the CT findings of patients with different clinical types of coronavirus disease 2019 (COVID-19). METHODS: A total of 67 patients diagnosed as COVID-19 by nucleic acid testing were included and divided into 4 groups according to the clinical staging based on Diagnosis and treatment of novel coronavirus pneumonia (Trial version 6). The CT imaging characteristics were analyzed among patients with different clinical types. RESULTS: Among 67 patients, 3 (4.5%) were mild cases, 35 (52.2%) were ordinary cases, 22 (32.8%) were severe cases, and 7 (10.4%) were critically ill. There were no abnormal CT findings in mild cases. In 35 ordinary cases, there were single lesions in 3 cases (8.6%) and multiple lesions in 33 cases (91.4%), while in severe case 1 case had single lesion (4.5%) and 21 had multiple lesions (95.5%). CT images of ordinary patients were mainly manifested as solid plaque shadow and halo sign (18/35, 51.4%); while fibrous strip shadow with ground glass shadow was more frequent in severe cases (7/22, 31.8%). Consolidation shadow as the main lesion was observed in 7 cases, and all of them were severe or critical ill patients. CONCLUSIONS: CT images in patients with different clinical types of COVID-19 have characteristic manifestations, and solid shadow may predict severe and critical illness.

RECORD 17
TITLE
  Clinical characteristics of fatal and recovered cases of coronavirus disease 2019 (COVID-19) in Wuhan, China: a retrospective study
AUTHOR NAMES
  Deng Y.;  Liu W.;  Liu K.;  Fang Y.-Y.;  Shang J.;  Zhou L.;  Wang K.;  Leng F.;  Wei S.;  Chen L.;  Liu H.-G.
SOURCE
  Chinese medical journal (2020). Date of Publication: 20 Mar 2020
ABSTRACT
  BACKGROUND: The 2019 novel coronavirus (2019-nCoV) has caused the outbreak of the acute respiratory disease in Wuhan, Hubei Province of China since December 2019. This study is performed to analyze the clinical characteristics of patients who succumbed to and who recovered from 2019 novel coronavirus disease (COVID-19). METHODS: Clinical data were collected from two tertiary hospitals in Wuhan. A retrospective investigation was conducted to analyze the clinical characteristics of fatal cases of COVID-19 (death group) and compare them with recovered patients (recovered group). Continuous variables were analyzed using the Mann-Whitney U test. Categorical variables were analyzed by χ test or Fisher’s exact tests as appropriate. RESULTS: Our study enrolled 109 COVID-19 patients who died during hospitalization and 116 recovered patients. The median age of the death group was older than the recovered group (69 [62, 74] years vs. 40 [33, 57] years, Z = 9.738, P < 0.001). More patients in the death group had underlying diseases (72.5% vs. 41.5%, χ = 22.105, P < 0.001). Patients in the death group had a significantly longer time of illness onset to hospitalization (10.0 [6.5, 12.0] days vs. 7.0 [5.0, 10.0] days, Z = 3.216, P = 0.001). On admission, the proportion of patients with symptoms of dyspnea (70.6% vs. 24.7%, χ = 60.905, P < 0.001) and expectoration (32.1% vs.15.7%, χ = 13.250, P < 0.001) was significantly higher. The blood oxygen saturation was significantly lower in the death group (85 [77, 91]% vs. 97 [95, 98]%, Z = 10.625, P < 0.001). The white blood cell (WBC) in death group was higher on admission (7.23 [4.87, 11.17] × 10/L vs. 4.52 [3.62, 5.88] × 10/L, Z = 7.618, P < 0.001). Patients in the death group exhibited significantly lower lymphocyte count (0.63 [0.40, 0.79] × 10/L vs. 1.00 [0.72, 1.27] × 10/L, Z = 8.037, P < 0.001) and lymphocyte/WBC ratio (7.10 [4.45, 12.73]% vs. 23.5 [15.27, 31.25]%, Z = 10.315, P < 0.001) on admission, and the lymphocyte/WBC ratio continue to decrease during hospitalization (7.10 [4.45, 12.73]% vs. 2.91 [1.79, 6.13]%, Z = 5.242, P < 0.001). Alanine transaminase (ALT) (22.00 [15.00, 34.00] U/L vs. 18.70 [13.00, 30.38] U/L, Z = 2.592, P = 0.010), aspartate transaminase (AST) (34.00 [27.00, 47.00] U/L vs. 22.00 [17.65, 31.75] U/L, Z = 7.308, P < 0.001), and creatinine levels (89.00 [72.00, 133.50] μmol/L vs.65.00 [54.60, 78.75] μmol/L, Z = 6.478, P < 0.001) were significantly higher in the death group that those in the recovered group. C-reactive protein (CRP) levels were also significantly higher in the death group on admission (109.25 [35.00, 170.28] mg/L vs.3.22 [1.04, 21.80] mg/L, Z = 10.206, P < 0.001) showed no significant improvement after treatment (109.25 [35.0, 170.28] mg/L vs. 81.60 [27.23, 179.08] mg/L, Z = 1.219, P = 0.233). The patients in the death group had more complications such as acute respiratory distress syndrome (89.9% vs. 7.6%, χ = 148.105, P < 0.001), acute cardiac injury (59.6% vs. 0.8%, χ = 93.222, P < 0.001), acute kidney injury (18.3% vs. 0, χ = 23.257, P < 0.001), shock (11.9% vs. 0, χ = 14.618, P < 0.001), and disseminated intravascular coagulation (DIC) (6.4% vs. 0, χ = 7.655, P = 0.006). CONCLUSIONS: Compared to the recovered group, more patients in the death group exhibited characteristics of advanced age, pre-existing comorbidities, dyspnea, oxygen saturation decrease, increased WBC count, decreased lymphocytes, and elevated CRP levels. More patients in the death groups had complications such as ARDS, acute cardiac injury, acute kidney injury, shock, and DIC.
FULL TEXT LINK
http://dx.doi.org/10.1097/CM9.0000000000000824

RECORD 18
TITLE
  Clinical Characteristics of Covid-19 in China
AUTHOR NAMES
  Rolf J.D.
SOURCE
  The New England journal of medicine (2020) 382. Date of Publication: 27 Mar 2020
FULL TEXT LINK
http://dx.doi.org/10.1056/NEJMc2005203

RECORD 19
TITLE
  Clinical Characteristics of Covid-19 in China. Reply
AUTHOR NAMES
  Guan W.-J.;  Zhong N.-S.
SOURCE
  The New England journal of medicine (2020) 382. Date of Publication: 27 Mar 2020
FULL TEXT LINK
http://dx.doi.org/10.1056/NEJMc2005203

RECORD 20
TITLE
  Clinical Characteristics of Covid-19 in China
AUTHOR NAMES
  Chen A.T.C.;  Coura-Filho G.B.;  Rehder M.H.H.
SOURCE
  The New England journal of medicine (2020) 382. Date of Publication: 27 Mar 2020
FULL TEXT LINK
http://dx.doi.org/10.1056/NEJMc2005203

RECORD 21
TITLE
  SARS-CoV-2: A Storm is Raging
AUTHOR NAMES
  Pedersen S.F.;  Ho Y.-C.
SOURCE
  The Journal of clinical investigation (2020). Date of Publication: 27 Mar 2020
ABSTRACT
  The pandemic coronavirus infectious disease (COVID-19), caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), is rapidly spreading across the globe. In this issue of the JCI, Chen and colleagues compared the clinical and immunologic characteristics between moderate versus severe COVID-19. The authors found that respiratory distress on admission is associated with unfavorable outcomes. Increased cytokine levels (IL-6, IL-10 and TNFα), lymphopenia (in CD4+ and CD8+ T cells), and decreased IFNγ expression in CD4+ T cells are associated with severe COVID-19. Overall, this study characterized the cytokine storm in severe COVID-19 and provides insights into immune therapeutics and vaccine design.
FULL TEXT LINK
http://dx.doi.org/10.1172/JCI137647

RECORD 22
TITLE
  Clinical characteristics of 113 deceased patients with coronavirus disease 2019: retrospective study
AUTHOR NAMES
  Chen T.;  Wu D.;  Chen H.;  Yan W.;  Yang D.;  Chen G.;  Ma K.;  Xu D.;  Yu H.;  Wang H.;  Wang T.;  Guo W.;  Chen J.;  Ding C.;  Zhang X.;  Huang J.;  Han M.;  Li S.;  Luo X.;  Zhao J.;  Ning Q.
SOURCE
  BMJ (Clinical research ed.) (2020) 368 (m1091). Date of Publication: 26 Mar 2020
ABSTRACT
  OBJECTIVE: To delineate the clinical characteristics of patients with coronavirus disease 2019 (covid-19) who died. DESIGN: Retrospective case series. SETTING: Tongji Hospital in Wuhan, China. PARTICIPANTS: Among a cohort of 799 patients, 113 who died and 161 who recovered with a diagnosis of covid-19 were analysed. Data were collected until 28 February 2020. MAIN OUTCOME MEASURES: Clinical characteristics and laboratory findings were obtained from electronic medical records with data collection forms. RESULTS: The median age of deceased patients (68 years) was significantly older than recovered patients (51 years). Male sex was more predominant in deceased patients (83; 73%) than in recovered patients (88; 55%). Chronic hypertension and other cardiovascular comorbidities were more frequent among deceased patients (54 (48%) and 16 (14%)) than recovered patients (39 (24%) and 7 (4%)). Dyspnoea, chest tightness, and disorder of consciousness were more common in deceased patients (70 (62%), 55 (49%), and 25 (22%)) than in recovered patients (50 (31%), 48 (30%), and 1 (1%)). The median time from disease onset to death in deceased patients was 16 (interquartile range 12.0-20.0) days. Leukocytosis was present in 56 (50%) patients who died and 6 (4%) who recovered, and lymphopenia was present in 103 (91%) and 76 (47%) respectively. Concentrations of alanine aminotransferase, aspartate aminotransferase, creatinine, creatine kinase, lactate dehydrogenase, cardiac troponin I, N-terminal pro-brain natriuretic peptide, and D-dimer were markedly higher in deceased patients than in recovered patients. Common complications observed more frequently in deceased patients included acute respiratory distress syndrome (113; 100%), type I respiratory failure (18/35; 51%), sepsis (113; 100%), acute cardiac injury (72/94; 77%), heart failure (41/83; 49%), alkalosis (14/35; 40%), hyperkalaemia (42; 37%), acute kidney injury (28; 25%), and hypoxic encephalopathy (23; 20%). Patients with cardiovascular comorbidity were more likely to develop cardiac complications. Regardless of history of cardiovascular disease, acute cardiac injury and heart failure were more common in deceased patients. CONCLUSION: Severe acute respiratory syndrome coronavirus 2 infection can cause both pulmonary and systemic inflammation, leading to multi-organ dysfunction in patients at high risk. Acute respiratory distress syndrome and respiratory failure, sepsis, acute cardiac injury, and heart failure were the most common critical complications during exacerbation of covid-19.
FULL TEXT LINK
http://dx.doi.org/10.1136/bmj.m1091

RECORD 23
TITLE
  Early antiviral treatment contributes to alleviate the severity and improve the prognosis of patients with novel coronavirus disease (COVID-19)
AUTHOR NAMES
  Wu J.;  Li W.;  Shi X.;  Chen Z.;  Jiang B.;  Liu J.;  Wang D.;  Liu C.;  Meng Y.;  Cui L.;  Yu J.;  Cao H.;  Li L.
SOURCE
  Journal of internal medicine (2020). Date of Publication: 27 Mar 2020
ABSTRACT
  BACKGROUND: At present, the severity of patients infected with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has been a focal point. METHODS: To assess the factors associated with severity and prognosis of patients infected with SARS-CoV-2, we retrospectively investigated the clinical, imaging, and laboratory characteristics of confirmed 280 cases of novel coronavirus disease (COVID-19) from January 20 to February 20, 2020. RESULTS: The median age of patients in the mild group was 37.55 years old, while that in the severe group was 63.04 years old. The proportion of patients over 65 years old in the severe group was significantly higher than that of the mild group (59.04% vs. 10.15%, P < 0.05). 85.54% of severe patients had diabetes or cardiovascular diseases, which was significantly higher than that of the mild group (51.81% vs 7.11%, P = 0.025; 33.73% vs 3.05%, P = 0.042). Patients in the mild group experienced earlier initiation of antiviral treatment (1.19 ± 0.45 vs 2.65 ± 1.06 days in the severe group, P < 0.001). Our study showed that comorbidity, time from illness onset to antiviral, and age >=65 were three major risk factors for COVID-19 progression, while comorbidity and time from illness onset to antiviral were two major risk factors for COVID-19 recovery. CONCLUSIONS: The elderly and patients with underlying diseases are more likely to experience a severe progression of COVID-19. It is recommended that timely antiviral treatment should be initiated to slow the disease progression and improve the prognosis.
FULL TEXT LINK
http://dx.doi.org/10.1111/joim.13063

RECORD 24
TITLE
  Clinical Characteristics of Covid-19 in China
AUTHOR NAMES
  Zavascki A.P.;  Falci D.R.
SOURCE
  The New England journal of medicine (2020) 382. Date of Publication: 27 Mar 2020
FULL TEXT LINK
http://dx.doi.org/10.1056/NEJMc2005203

RECORD 25
TITLE
  Clinical Characteristics of Covid-19 in China
AUTHOR NAMES
  Henry B.M.;  Vikse J.
SOURCE
  The New England journal of medicine (2020) 382. Date of Publication: 27 Mar 2020
FULL TEXT LINK
http://dx.doi.org/10.1056/NEJMc2005203

RECORD 26
TITLE
  Clinical and immunologic features in severe and moderate Coronavirus Disease 2019
AUTHOR NAMES
  Chen G.;  Wu D.;  Guo W.;  Cao Y.;  Huang D.;  Wang H.;  Wang T.;  Zhang X.;  Chen H.;  Yu H.;  Zhang X.;  Zhang M.;  Wu S.;  Song J.;  Chen T.;  Han M.;  Li S.;  Luo X.;  Zhao J.;  Ning Q.
SOURCE
  The Journal of clinical investigation (2020). Date of Publication: 27 Mar 2020
ABSTRACT
  BACKGROUND: Since December 2019, an outbreak of Coronavirus Disease 2019 (COVID-19) caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) emerged in Wuhan, and is now becoming a global threat. We aimed to delineate and compare the immunologic features of severe and moderate COVID-19. METHODS: In this retrospective study, the clinical and immunologic characteristics of 21 patients (17 male and 4 female) with COVID-19 were analyzed. These patients were classified as severe (11 cases) and moderate (10 cases) according to the Guidelines released by the National Health Commission of China. RESULTS: The median age of severe and moderate cases was 61.0 and 52.0 years, respectively. Common clinical manifestations included fever, cough and fatigue. Compared to moderate cases, severe cases more frequently had dyspnea, lymphopenia, and hypoalbuminemia, with higher levels of alanine aminotransferase, lactate dehydrogenase, C-reactive protein, ferritin and D-dimer as well as markedly higher levels of IL-2R, IL-6, IL-10, and TNF-α. Absolute number of T lymphocytes, CD4+T and CD8+T cells decreased in nearly all the patients, and were markedly lower in severe cases (294.0, 177.5 and 89.0 × 106/L) than moderate cases (640.5, 381.5 and 254.0 × 106/L). The expressions of IFN-γ by CD4+T cells tended to be lower in severe cases (14.1%) than moderate cases (22.8%). CONCLUSION: The SARS-CoV-2 infection may affect primarily T lymphocytes particularly CD4+T and CD8+ T cells, resulting in decrease in numbers as well as IFN-γ production. These potential immunological markers may be of importance due to their correlation with disease severity in COVID-19.
FULL TEXT LINK
http://dx.doi.org/10.1172/JCI137244

RECORD 27
TITLE
  Analysis on cluster cases of COVID-19 in Tianjin
AUTHOR NAMES
  Liu Y.F.;  Li J.M.;  Zhou P.H.;  Liu J.;  Dong X.C.;  Lyu J.;  Zhang Y.
SOURCE
  Zhonghua liu xing bing xue za zhi = Zhonghua liuxingbingxue zazhi (2020) 41:5 (654-657). Date of Publication: 26 Mar 2020
ABSTRACT
  Objective: To understand the characteristics of clusters of COVID-19 cases in Tianjin, and provide epidemiological evidence for the prevention and control of COVID-19. Methods: The data of all the cluster cases of COVID-19 in Tianjin reported as 22 February 2020 were collected to analyze the characteristics of different types of the clusters. Results: A total of 115 COVID-19 cases were reported in in 33 clusters in Tianjin. Clusters can be classified as following: 28 familial clusters (71 cases), 1 work place cluster (10 cases), 3 transport vehicle clusters (8 cases) and 1 public place cluster (26 cases). Fourteen familial clusters were caused by the cases from the working place or public place clusters. Numbers of secondary cases of family clusters were 1-7, the median number was 7.The interval from onset to diagnosis for the first case was longer than those of other cases in the familial clusters (Z=-2.406, P= 0.016). The median of incubation period of the public place clusters was 2 days. The intervals from onset to diagnosis were significant different among the family, working place and public place clusters (H=8.843, , P=0.012) , and there were also significant differences in onset time among the secondary cases (H=16.607, P=0.000) . Conclusions: In the surveillance of COVID-19 epidemic, special attention should be paid to the cases from same family, same work place, or other places where clustering are prone to occur, and the epidemiological investigation should be carried out timely to confirm the cluster. To prevent the transmission of COVID-19, the close contacts of the patients should be transferred to an assigned observation place in time for single room isolation. The awareness of COVID-19 prevention is low in some rural areas, reflected by many mass gathering activities and delayed medical care seeking after onset. It is necessary to strengthen the health education and take control measures in early period of epidemic.
FULL TEXT LINK
http://dx.doi.org/10.3760/cma.j.cn112338-20200225-00165

RECORD 28
TITLE
  Epidemiological analysis on 1 052 cases of COVID-19 in epidemic clusters
AUTHOR NAMES
  Gan H.;  Zhang Y.;  Yuan M.;  Wu X.Y.;  Liu Z.R.;  Liu M.;  Wu J.B.;  Xu S.J.;  Gong L.;  Xu H.L.;  Tao F.B.
SOURCE
  Zhonghua liu xing bing xue za zhi = Zhonghua liuxingbingxue zazhi (2020) 41:5 (E027). Date of Publication: 26 Mar 2020
ABSTRACT
  Objective: To understand the epidemiological characteristics of the cases of COVID-19 epidemic clusters, and explore the influence of family factors and social factors such as group activities on the spread of the disease. Methods: The data of cases of COVID-19 epidemic clusters from 19 January, 2020 to 25 February, 2020 were collected from the official platforms of 36 cities in 6 provinces in China. Descriptive statistical methods, χ(2) test and curve fitting were used to analyze the epidemiological characteristics of the clustered cases. Results: By 25 February, 2020, the data of 1 052 cases in 366 epidemic clusters were collected. In these clustered cases, 86.9%(914/1 050) occurred in families. Among the 1 046 cases with gender information, 513 were males (49.0%) and 533 were females (51.0%). The cases were mainly young adults between 18 and 59 years old, accounting for 68.5% (711/1 038). In the 366 epidemic clusters , the clusters in which the first confirmed cases with the history of sojourn in Wuhan or Hubei accounted for 47.0%(172/366). From 19 January to 3 February, 2020, the first confirmed cases with Wuhan or Hubei sojourn history accounted for 66.5%. From 4 to 25 February, the first confirmed cases who had Wuhan or Hubei sojourn history accounted for only 18.2%. The median of interval between the first generation case onset and the second generation case onset was 5 (2-8) days. The median of onset- diagnosis interval of the initial cases was 6 (3-9) days, and the median of onset-diagnosis interval of the secondary cases was 5 (3-8) days. Conclusions: Epidemic clusters of COVID-19 were common in many cities outside Wuhan and Hubei. Close contact in family was one of the main causes for the spread of household transmission of the virus. After 4 February, the epidemic clusters were mainly caused by the first generation or second generation cases in local areas, and the time for diagnosis became shorter.
FULL TEXT LINK
http://dx.doi.org/10.3760/cma.j.cn112338-20200301-00223

RECORD 29
TITLE
  Arbidol combined with LPV/r versus LPV/r alone against Corona Virus Disease 2019: A retrospective cohort study
AUTHOR NAMES
  Deng L.;  Li C.;  Zeng Q.;  Liu X.;  Li X.;  Zhang H.;  Hong Z.;  Xia J.
SOURCE
  Journal of Infection (2020). Date of Publication: 2020
ABSTRACT
  Background: Corona Virus Disease 2019 (COVID-19) due to the 2019 novel coronavirus (SARS-CoV-2) emerged in Wuhan city and rapidly spread throughout China. We aimed to compare arbidol and lopinavir/ritonavir(LPV/r) treatment for patients with COVID-19 with LPV/r only. Methods: In this retrospective cohort study, we included adults (age≥18years) with laboratory-confirmed COVID-19 without Invasive ventilation, diagnosed between Jan 17, 2020, and Feb 13, 2020. Patients, diagnosed after Jan 17, 2020, were given oral arbidol and LPV/r in the combination group and oral LPV/r only in the monotherapy group for 5–21 days. The primary endpoint was a negative conversion rate of coronavirus from the date of COVID-19 diagnosis(day7, day14), and assessed whether the pneumonia was progressing or improving by chest CT (day7). Results: We analyzed 16 patients who received oral arbidol and LPV/r in the combination group and 17 who oral LPV/r only in the monotherapy group, and both initiated after diagnosis. Baseline clinical, laboratory, and chest CT characteristics were similar between groups. The SARS-CoV-2 could not be detected for 12(75%) of 16 patients’ nasopharyngeal specimens in the combination group after seven days, compared with 6 (35%) of 17 in the monotherapy group (p < 0·05). After 14 days, 15 (94%) of 16 and 9 (52·9%) of 17, respectively, SARS-CoV-2 could not be detected (p < 0·05). The chest CT scans were improving for 11(69%) of 16 patients in the combination group after seven days, compared with 5(29%) of 17 in the monotherapy group (p < 0·05). Conclusion: In patients with COVID-19, the apparent favorable clinical response with arbidol and LPV/r supports further LPV/r only.
FULL TEXT LINK
http://dx.doi.org/10.1016/j.jinf.2020.03.002

RECORD 30
TITLE
  Imaging manifestations and diagnostic value of chest CT of coronavirus disease 2019 (COVID-19) in the Xiaogan area
AUTHOR NAMES
  Wang K.;  Kang S.;  Tian R.;  Zhang X.;  Wang Y.
SOURCE
  Clinical Radiology (2020). Date of Publication: 2020
ABSTRACT
  AIM: To report the epidemiological, clinical, and radiological characteristics of patients with COVID-19 in Xiaogan, Hubei, China. MATERIALS AND METHODS: The complete clinical and imaging data of 114 confirmed COVID-19 patients treated in Xiaogan Hospital were analysed retrospectively. Data were gathered regarding the presence of chest computed tomography (CT) abnormalities; the distribution, morphology, density, location, and stage of abnormal shadows on chest CT; and observing the correlation between the severity of chest infection and lymphocyte ratio and blood oxygen saturation (SPO2) in patients. RESULTS: Chest CT revealed abnormal lung shadows in 110 patients. Regarding lesion distribution, multi-lobe lesions in both lungs were present in most patients (80 cases; 72.7%). Lesions most frequently involved both the peripheral zone and the central zone (62 cases; 56.4%). Regarding lesion morphology, 56 cases (50.1%) demonstrated patchy shadows that were partially fused into large areas. Thirty cases showed ground-glass opacity (27.3%), 30 cases showed the consolidation change (27.3%), and the remaining 50 cases showed both types of changes (45.4%). The progressing stage was the most common stage (54 cases; 49.1%). CT results showed a negative correlation with SPO2 and lymphocyte numbers (p<0.05), with r-values of −0.446 and −0.780, respectively. CONCLUSION: Spiral CT is a sensitive examination method, which can be applied to make an early diagnosis and for evaluation of progression, with a diagnostic sensitivity and accuracy better than that of nucleic acid detection.
FULL TEXT LINK
http://dx.doi.org/10.1016/j.crad.2020.03.004

RECORD 31
TITLE
  Recommended prophylactic and management strategies for severe acute respiratory syndrome coronavirus 2 infection in transplant recipients
AUTHOR NAMES
  Ju C.-R.;  Lian Q.-Y.;  Zhang J.-H.;  Qiu T.;  Cai Z.-T.;  Jiang W.-Y.;  Zhang J.;  Cheng Q.;  Chen G.;  Li N.;  Wang C.-Y.;  He J.-X.
SOURCE
  Chronic Diseases and Translational Medicine (2020). Date of Publication: 2020
ABSTRACT
  Since December 2019, increasing attention has been paid to the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) epidemic in Wuhan, China. SARS-CoV-2 primarily invades the respiratory tract and lungs, leading to pneumonia and other systemic disorders. The effect of SARS-CoV-2 in transplant recipients has raised significant concerns, especially because there is a large population of transplant recipients in China. Based on the current epidemic situation, this study reviewed publications on this virus and coronavirus disease 2019 (COVID-19), analyzed common features of respiratory viral pneumonias, and presented the currently reported clinical characteristics of COVID-19 in transplant recipients to improve strategies regarding the diagnosis and treatment of COVID-19 in this special population.
FULL TEXT LINK
http://dx.doi.org/10.1016/j.cdtm.2020.02.003

RECORD 32
TITLE
  The use of anti-inflammatory drugs in the treatment of people with severe coronavirus disease 2019 (COVID-19): The experience of clinical immunologists from China
AUTHOR NAMES
  Zhang W.;  Zhao Y.;  Zhang F.;  Wang Q.;  Li T.;  Liu Z.;  Wang J.;  Qin Y.;  Zhang X.;  Yan X.;  Zeng X.;  Zhang S.
SOURCE
  Clinical Immunology (2020) 214 Article Number: 108393. Date of Publication: 1 May 2020
ABSTRACT
  The pandemic outbreak of coronavirus disease 2019 (COVID-19) is rapidly spreading all over the world. Reports from China showed that about 20% of patients developed severe disease, resulting in a fatality of 4%. In the past two months, we clinical immunologists participated in multi-rounds of MDT (multidiscipline team) discussion on the anti-inflammation management of critical COVID-19 patients, with our colleagues dispatched from Chinese leading PUMC Hospital to Wuhan to admit and treat the most severe patients. Here, from the perspective of clinical immunologists, we will discuss the clinical and immunological characteristics of severe patients, and summarize the current evidence and share our experience in anti-inflammation treatment, including glucocorticoids, IL-6 antagonist, JAK inhibitors and choloroquine/hydrocholoroquine, of patients with severe COVID-19 that may have an impaired immune system.
FULL TEXT LINK
http://dx.doi.org/10.1016/j.clim.2020.108393

RECORD 33
TITLE
  Epidemiological, clinical characteristics of cases of SARS-CoV-2 infection with abnormal imaging findings
AUTHOR NAMES
  Zhang X.;  Cai H.;  Hu J.;  Lian J.;  Gu J.;  Zhang S.;  Ye C.;  Lu Y.;  Jin C.;  Yu G.;  Jia H.;  Zhang Y.;  Sheng J.;  Li L.;  Yang Y.
SOURCE
  International journal of infectious diseases : IJID : official publication of the International Society for Infectious Diseases (2020). Date of Publication: 20 Mar 2020
ABSTRACT
  PURPOSE: To investigate the epidemiological, clinical characteristics of COVID-19 patients with abnormal imaging findings. METHODS: Patients confirmed with SARS-CoV-2 infection of Zhejiang province from Jan 17 to Feb 8 underwent CT or x-ray were enrolled. Epidemiological, clinical data were analyzed between those with abnormal or normal imaging findings. RESULTS: Excluding 72 patients with normal images, 230 of 573 patients affected more than two lobes. The median radiograph score was 2.0 and there’s negative correlation between the score and oxygenation index (ρ=-0.657,P < 0.001). Patients with abnormal images were older (46.65 ± 13.82), with higher rate of coexisting condition(28.8%), lower rate of exposure history and longer time between onset and confirmation(5d) than non-pneumonia patients(all P < 0.05). Higher rate of fever, cough, expectoration, and headache, lower lymphocytes, albumin, serum sodium levels and higher total bilirubin, creatine kinase, lactate dehydrogenase and C-reactive protein levels and lower oxygenation index were observed in pneumonia patients (all P < 0.05). Muscle ache, shortness of breath, nausea and vomiting, lower lymphocytes levels and higher serum creatinine and radiograph score at admission were predictive factors for severe/critical subtype. CONCLUSION: Patients with abnormal images have more obvious clinical manifestations and laboratory changes. Combing clinical features and radiograph score can effectively predict severe/critical type.
FULL TEXT LINK
http://dx.doi.org/10.1016/j.ijid.2020.03.040

RECORD 34
TITLE
  Clinical Characteristics of Children with Coronavirus Disease 2019 in Hubei, China
AUTHOR NAMES
  Zheng F.;  Liao C.;  Fan Q.-H.;  Chen H.-B.;  Zhao X.-G.;  Xie Z.-G.;  Li X.-L.;  Chen C.-X.;  Lu X.-X.;  Liu Z.-S.;  Lu W.;  Chen C.-B.;  Jiao R.;  Zhang A.-M.;  Wang J.-T.;  Ding X.-W.;  Zeng Y.-G.;  Cheng L.-P.;  Huang Q.-F.;  Wu J.;  Luo X.-C.;  Wang Z.-J.;  Zhong Y.-Y.;  Bai Y.;  Wu X.-Y.;  Jin R.-M.
SOURCE
  Current medical science (2020). Date of Publication: 24 Mar 2020
ABSTRACT
  Since December 2019, COVID-19 has occurred unexpectedly and emerged as a health problem worldwide. Despite the rapidly increasing number of cases in subsequent weeks, the clinical characteristics of pediatric cases are rarely described. A cross-sectional multicenter study was carried out in 10 hospitals across Hubei province. A total of 25 confirmed pediatric cases of COVID-19 were collected. The demographic data, epidemiological history, underlying diseases, clinical manifestations, laboratory and radiological data, treatments, and outcomes were analyzed. Of 25 hospitalized patients with COVID-19, the boy to girl ratio was 1.27:1. The median age was 3 years. COVID-19 cases in children aged ❤ years, 3.6 years, and ≥6-years patients were 10 (40%), 6 (24%), and 9 (36%), respectively. The most common symptoms at onset of illness were fever (13 [52%]), and dry cough (11 [44%]). Chest CT images showed essential normal in 8 cases (33.3%), unilateral involvement of lungs in 5 cases (20.8%), and bilateral involvement in 11 cases (45.8%). Clinical diagnoses included upper respiratory tract infection (n=8), mild pneumonia (n=15), and critical cases (n=2). Two critical cases (8%) were given invasive mechanical ventilation, corticosteroids, and immunoglobulin. The symptoms in 24 (96%) of 25 patients were alleviated and one patient had been discharged. It was concluded that children were susceptible to COVID-19 like adults, while the clinical presentations and outcomes were more favorable in children. However, children less than 3 years old accounted for majority cases and critical cases lied in this age group, which demanded extra attentions during home caring and hospitalization treatment.
FULL TEXT LINK
http://dx.doi.org/10.1007/s11596-020-2172-6

RECORD 35
TITLE
  Clinical observation and management of COVID-19 patients
AUTHOR NAMES
  Li T.;  Lu H.;  Zhang W.
SOURCE
  Emerging microbes & infections (2020) 9:1 (687-690). Date of Publication: 1 Dec 2020
ABSTRACT
  Three leading infectious disease experts in China were invited to share their bedside observations in the management of COVID-19 patients. Professor Taisheng Li was sent to Wuhan to provide frontline medical care. He depicts the clinical course of SARS-CoV-2 infection. Furthermore, he observes the significant abnormality of coagulation function and proposes that the early intravenous immunoglobulin and low molecular weight heparin anticoagulation therapy are very important. Professor Hongzhou Lu, a leader in China to try various anti-viral drugs, expresses concern on the quality of the ongoing clinical trials as most trials are small in scale and repetitive in nature, and emphasizes the importance of the quick publication of clinical trial results. Regarding the traditional Chinese medicine, Professor Lu suggests to develop a creative evaluation system because of the complicated chemical compositions. Professor Wenhong Zhang is responsible for Shanghai’s overall clinical management of the COVID-19 cases. He introduces the team approach to manage COVID-19 patients. For severe or critically ill patients, in addition to the respiratory supportive treatment, timely multiorgan evaluation and treatment is very crucial. The medical decisions and interventions are carefully tailored to the unique characteristics of each patient.
FULL TEXT LINK
http://dx.doi.org/10.1080/22221751.2020.1741327

RECORD 36
TITLE
  Characteristics and Outcomes of 21 Critically Ill Patients with COVID-19 in Washington State
AUTHOR NAMES
  Arentz M.;  Yim E.;  Klaff L.;  Lokhandwala S.;  Riedo F.X.;  Chong M.;  Lee M.
SOURCE
  JAMA – Journal of the American Medical Association (2020). Date of Publication: 2020
FULL TEXT LINK
http://dx.doi.org/10.1001/jama.2020.4326

RECORD 37
TITLE
  Epidemiological, clinical and virological characteristics of 74 cases of coronavirus-infected disease 2019 (COVID-19) with gastrointestinal symptoms
AUTHOR NAMES
  Jin X.;  Lian J.-S.;  Hu J.-H.;  Gao J.;  Zheng L.;  Zhang Y.-M.;  Hao S.-R.;  Jia H.-Y.;  Cai H.;  Zhang X.-L.;  Yu G.-D.;  Xu K.-J.;  Wang X.-Y.;  Gu J.-Q.;  Zhang S.-Y.;  Ye C.-Y.;  Jin C.-L.;  Lu Y.-F.;  Yu X.;  Yu X.-P.;  Huang J.-R.;  Xu K.-L.;  Ni Q.;  Yu C.-B.;  Zhu B.;  Li Y.-T.;  Liu J.;  Zhao H.;  Zhang X.;  Yu L.;  Guo Y.-Z.;  Su J.-W.;  Tao J.-J.;  Lang G.-J.;  Wu X.-X.;  Wu W.-R.;  Qv T.-T.;  Xiang D.-R.;  Yi P.;  Shi D.;  Chen Y.;  Ren Y.;  Qiu Y.-Q.;  Li L.-J.;  Sheng J.;  Yang Y.
SOURCE
  Gut (2020) Article Number: 320926. Date of Publication: 2020
ABSTRACT
  Objective: The SARS-CoV-2-infected disease (COVID-19) outbreak is a major threat to human beings. Previous studies mainly focused on Wuhan and typical symptoms. We analysed 74 confirmed COVID-19 cases with GI symptoms in the Zhejiang province to determine epidemiological, clinical and virological characteristics. Design: COVID-19 hospital patients were admitted in the Zhejiang province from 17 January 2020 to 8 February 2020. Epidemiological, demographic, clinical, laboratory, management and outcome data of patients with GI symptoms were analysed using multivariate analysis for risk of severe/critical type. Bioinformatics were used to analyse features of SARS-CoV-2 from Zhejiang province. Results: Among enrolled 651 patients, 74 (11.4%) presented with at least one GI symptom (nausea, vomiting or diarrhoea), average age of 46.14 years, 4-day incubation period and 10.8% had pre-existing liver disease. Of patients with COVID-19 with GI symptoms, 17 (22.97%) and 23 (31.08%) had severe/critical types and family clustering, respectively, significantly higher than those without GI symptoms, 47 (8.14%) and 118 (20.45%). Of patients with COVID-19 with GI symptoms, 29 (39.19%), 23 (31.08%), 8 (10.81%) and 16 (21.62%) had significantly higher rates of fever >38.5°C, fatigue, shortness of breath and headache, respectively. Low-dose glucocorticoids and antibiotics were administered to 14.86% and 41.89% of patients, respectively. Sputum production and increased lactate dehydrogenase/glucose levels were risk factors for severe/critical type. Bioinformatics showed sequence mutation of SARS-CoV-2 with m6A methylation and changed binding capacity with ACE2. Conclusion: We report COVID-19 cases with GI symptoms with novel features outside Wuhan. Attention to patients with COVID-19 with non-classic symptoms should increase to protect health providers.
FULL TEXT LINK
http://dx.doi.org/10.1136/gutjnl-2020-320926

RECORD 38
TITLE
  The different clinical characteristics of corona virus disease cases between children and their families in China – the character of children with COVID-19
AUTHOR NAMES
  Su L.;  Ma X.;  Yu H.;  Zhang Z.;  Bian P.;  Han Y.;  Sun J.;  Liu Y.;  Yang C.;  Geng J.;  Zhang Z.;  Gai Z.
SOURCE
  Emerging microbes & infections (2020) 9:1 (707-713). Date of Publication: 1 Dec 2020
ABSTRACT
  This study aims to analyze the different clinical characteristics between children and their families infected with severe acute respiratory syndrome coronavirus 2. Clinical data from nine children and their 14 families were collected, including general status, clinical, laboratory test, and imaging characteristics. All the children were detected positive result after their families onset. Three children had fever (22.2%) or cough (11.2%) symptoms and six (66.7%) children had no symptom. Among the 14 adult patients, the major symptoms included fever (57.1%), cough (35.7%), chest tightness/pain (21.4%), fatigue (21.4%) and sore throat (7.1%). Nearly 70% of the patients had normal (71.4%) or decreased (28.6%) white blood cell counts, and 50% (7/14) had lymphocytopenia. There were 10 adults (71.4%) showed abnormal imaging. The main manifestations were pulmonary consolidation (70%), nodular shadow (50%), and ground glass opacity (50%). Five discharged children were admitted again because their stool showed positive result in SARS-CoV-2 PCR. COVID-19 in children is mainly caused by family transmission, and their symptoms are mild and prognosis is better than adult. However, their PCR result in stool showed longer time than their families. Because of the mild or asymptomatic clinical process, it is difficult to recognize early for pediatrician and public health staff.
FULL TEXT LINK
http://dx.doi.org/10.1080/22221751.2020.1744483

RECORD 39
TITLE
  Analysis of Epidemiological and Clinical features in older patients with Corona Virus Disease 2019 (COVID-19) out of Wuhan
AUTHOR NAMES
  Lian J.;  Jin X.;  Hao S.;  Cai H.;  Zhang S.;  Zheng L.;  Jia H.;  Hu J.;  Gao J.;  Zhang Y.;  Zhang X.;  Yu G.;  Wang X.;  Gu J.;  Ye C.;  Jin C.;  Lu Y.;  Yu X.;  Yu X.;  Ren Y.;  Qiu Y.;  Li L.;  Sheng J.;  Yang Y.
SOURCE
  Clinical infectious diseases : an official publication of the Infectious Diseases Society of America (2020). Date of Publication: 25 Mar 2020
ABSTRACT
  BACKGROUND: The outbreak of COVID-19 has become a big threat to China, with high contagious capacity and varied mortality. This study aimed to investigate the epidemiological and clinical characteristics of older patients with COVID-19 out of Wuhan. METHODS: A retrospective study was performed, with collecting data from medical records of confirmed COVID-19 patients in Zhejiang province from Jan 17 to Feb 12, 2020. Epidemiological, clinical and treatment data were analyzed between those older (≥60y) and younger (<60y) patients. RESULTS: Total 788 patients with confirmed COVID-19 were selected, where 136 were older patients with corresponding age of 68.28y±7.314y. There was a significantly higher frequency of women in the older patients compared with the younger patients (57.35% vs 46.47%, P=0.021). The presence of coexisting medical condition was significantly higher in older patients compared with younger patients (55.15% vs 21.93%, P<0.001), including the rate of hypertension, diabetes, heart diseases and COPD. Significantly higher rates of severe (older vs younger groups: 16.18% vs 5.98%, P<0.001)/critical (8.82% vs 0.77%, P<0.001) type, shortness of breath (12.50% vs 3.07%, P<0.001) and high temperature of >39.0℃ (13.97% vs 7.21%, P=0.010) were observed in older patients compared with younger patients. Finally, Higher rates of ICU admission (9.56% vs 1.38%, P<0.001) and methylprednisolone application (28.68% vs 9.36%, P<0.001) were also identified in older patients. CONCLUSIONS: The specific epidemiological and clinical features of older COVID-19 patients included significantly higher female gender, body temperature, co-existing of basic diseases and rate of severe and critical type.
FULL TEXT LINK
http://dx.doi.org/10.1093/cid/ciaa242

RECORD 40
TITLE
  Coronavirus disease 2019: initial chest CT findings
AUTHOR NAMES
  Zhou Z.;  Guo D.;  Li C.;  Fang Z.;  Chen L.;  Yang R.;  Li X.;  Zeng W.
SOURCE
  European radiology (2020). Date of Publication: 24 Mar 2020
ABSTRACT
  OBJECTIVES: To systematically analyze CT findings during the early and progressive stages of natural course of coronavirus disease 2019 and also to explore possible changes in pulmonary parenchymal abnormalities during these two stages. METHODS: We retrospectively reviewed the initial chest CT data of 62 confirmed coronavirus disease 2019 patients (34 men, 28 women; age range 20-91 years old) who did not receive any antiviral treatment between January 21 and February 4, 2020, in Chongqing, China. Patients were assigned to the early-stage group (onset of symptoms within 4 days) or progressive-stage group (onset of symptoms within 4-7 days) for analysis. CT characteristics and the distribution, size, and CT score of pulmonary parenchymal abnormalities were assessed. RESULTS: In our study, the major characteristic of coronavirus disease 2019 was ground-glass opacity (61.3%), followed by ground-glass opacity with consolidation (35.5%), rounded opacities (25.8%), a crazy-paving pattern (25.8%), and an air bronchogram (22.6%). No patient presented cavitation, a reticular pattern, or bronchial wall thickening. The CT scores of the progressive-stage group were significantly greater than those of the early-stage group (p = 0.004). CONCLUSIONS: Multiple ground-glass opacities with consolidations in the periphery of the lungs were the primary CT characteristic of coronavirus disease 2019. CT score can be used to evaluate the severity of the disease. If these typical alterations are found, then the differential diagnosis of coronavirus disease 2019 must be considered. KEY POINTS: • Multiple GGOs with consolidations in the periphery of the lungs were the primary CT characteristic of COVID-19. • The halo sign may be a special CT feature in the early-stage COVID-19 patients. • Significantly increased CT score may indicate the aggravation of COVID-19 in the progressive stage.
FULL TEXT LINK
http://dx.doi.org/10.1007/s00330-020-06816-7

RECORD 41
TITLE
  Epidemiological and Clinical Predictors of COVID-19
AUTHOR NAMES
  Sun Y.;  Koh V.;  Marimuthu K.;  Ng O.T.;  Young B.;  Vasoo S.;  Chan M.;  Lee V.J.M.;  De P.P.;  Barkham T.;  Lin R.T.P.;  Cook A.R.;  Leo Y.S.
SOURCE
  Clinical infectious diseases : an official publication of the Infectious Diseases Society of America (2020). Date of Publication: 25 Mar 2020
ABSTRACT
  BACKGROUND: Rapid identification of COVID-19 cases, which is crucial to outbreak containment efforts, is challenging due to the lack of pathognomonic symptoms and in settings with limited capacity for specialized nucleic acid-based reverse transcription polymerase chain reaction (PCR) testing. METHODS: This retrospective case-control study involves subjects (7 to 98 years) presenting at the designated national outbreak screening centre and tertiary care hospital in Singapore for SARS-CoV-2 testing from January 26 to February 16, 2020. COVID-19 status was confirmed by PCR testing of sputum, nasopharyngeal swabs or throat swabs. Demographic, clinical, laboratory and exposure-risk variables ascertainable at presentation were analyzed to develop an algorithm for estimating the risk of COVID-19. Model development used Akaike’s information criterion in a stepwise fashion to build logistic regression models, which were then translated into prediction scores. Performance was measured using receiver operating characteristics curves, adjusting for over-confidence using leave-out-one cross validation. RESULTS: The study population included 788 subjects, of whom 54 (6.9%) were SARS-CoV-2 positive and 734 (93.1%) were SARS-CoV-2 negative. The median age was 34 years and 407 (51.7%) were female. Using leave-out-one cross validation, all the models incorporating clinical tests (Models 1, 2 and 3) performed well with areas under the receiver operating characteristics curve (AUC) of 0.91, 0.88 and 0.88 respectively. In comparison, Model 4 had an AUC of 0.65. CONCLUSIONS: Rapidly ascertainable clinical and laboratory data could identify individuals at high risk of COVID-19 and enable prioritization of PCR-testing and containment efforts. Basic laboratory test results were crucial to prediction models.
FULL TEXT LINK
http://dx.doi.org/10.1093/cid/ciaa322

RECORD 42
TITLE
  Clinical characteristics and intrauterine vertical transmission potential of COVID-19 infection in nine pregnant women: a retrospective review of medical records
AUTHOR NAMES
  Chen H.;  Guo J.;  Wang C.;  Luo F.;  Yu X.;  Zhang W.;  Li J.;  Zhao D.;  Xu D.;  Gong Q.;  Liao J.;  Yang H.;  Hou W.;  Zhang Y.
SOURCE
  The Lancet (2020) 395:10226 (809-815). Date of Publication: 7 Mar 2020
ABSTRACT
  Background: Previous studies on the pneumonia outbreak caused by the 2019 novel coronavirus disease (COVID-19) were based on information from the general population. Limited data are available for pregnant women with COVID-19 pneumonia. This study aimed to evaluate the clinical characteristics of COVID-19 in pregnancy and the intrauterine vertical transmission potential of COVID-19 infection. Methods: Clinical records, laboratory results, and chest CT scans were retrospectively reviewed for nine pregnant women with laboratory-confirmed COVID-19 pneumonia (ie, with maternal throat swab samples that were positive for severe acute respiratory syndrome coronavirus 2 [SARS-CoV-2]) who were admitted to Zhongnan Hospital of Wuhan University, Wuhan, China, from Jan 20 to Jan 31, 2020. Evidence of intrauterine vertical transmission was assessed by testing for the presence of SARS-CoV-2 in amniotic fluid, cord blood, and neonatal throat swab samples. Breastmilk samples were also collected and tested from patients after the first lactation. Findings: All nine patients had a caesarean section in their third trimester. Seven patients presented with a fever. Other symptoms, including cough (in four of nine patients), myalgia (in three), sore throat (in two), and malaise (in two), were also observed. Fetal distress was monitored in two cases. Five of nine patients had lymphopenia (<1·0 × 10 cells per L). Three patients had increased aminotransferase concentrations. None of the patients developed severe COVID-19 pneumonia or died, as of Feb 4, 2020. Nine livebirths were recorded. No neonatal asphyxia was observed in newborn babies. All nine livebirths had a 1-min Apgar score of 8–9 and a 5-min Apgar score of 9–10. Amniotic fluid, cord blood, neonatal throat swab, and breastmilk samples from six patients were tested for SARS-CoV-2, and all samples tested negative for the virus. Interpretation: The clinical characteristics of COVID-19 pneumonia in pregnant women were similar to those reported for non-pregnant adult patients who developed COVID-19 pneumonia. Findings from this small group of cases suggest that there is currently no evidence for intrauterine infection caused by vertical transmission in women who develop COVID-19 pneumonia in late pregnancy. Funding: Hubei Science and Technology Plan, Wuhan University Medical Development Plan.
FULL TEXT LINK
http://dx.doi.org/10.1016/S0140-6736(20)30360-3

RECORD 43
TITLE
  2019 novel coronavirus disease outbreak and molecular genetic characteristics of severe acute respiratory syndrome-coronavirus-2
AUTHOR NAMES
  Jeong Y.S.
SOURCE
  Journal of Bacteriology and Virology (2020) 50:1 (1-8). Date of Publication: 1 Mar 2020
ABSTRACT
  The 2019 novel coronavirus disease (COVID-19) outbreaks that emerged in Wuhan city, Hubei province, have led to a formidable number of confirmed cases that resulted in >5,700 deaths globally, including 143 countries in all 6 continents. The World Health Organization declared a Public Health Emergency of International Concern with a very high level of global risk assessment. Severe acute respiratory syndrome (SARS)-coronavirus-2 (SARS-CoV-2), the agent of COVID-19, has >79% nucleotide sequence homology to SARS-CoV; therefore, both belong to the genus betacoronavirus and subgenus sarbecovirus. The S1 domains of the two appeared to share the cellular receptor ACE2, but revealed a much higher S1-ACE2 binding affinity. As seen in many other human coronaviruses, SARS-CoV-2 also shows respiratory infection, but the basic reproductive number (R0) in transmission and the clinical latency are quite dissimilar from those of SARS-or MERS-CoVs. Many scientists infer that the time point of cross-barrier transfer from bats to mediate animals or to humans should be a rather recent event based on the full-length genome analyses obtained from the very first patients. Copy-choice polymerization, which often leads to a significant genome recombination rate in most coronaviruses, predicts the continued emergence of novel coronaviruses.
FULL TEXT LINK
http://dx.doi.org/10.4167/jbv.2020.50.1.001

RECORD 44
TITLE
  Early epidemiological and clinical characteristics of 28 cases of coronavirus disease in South Korea
AUTHOR NAMES
  Kong I.;  Park Y.;  Woo Y.;  Lee J.;  Cha J.;  Choi J.;  Kim Y.;  Kim J.;  Park S.;  Yum M.;  Kim T.;  Jo J.;  Kim M.;  Lee D.;  Kim J.;  Park S.;  Bahk H.;  Yu J.;  Kwon J.;  Kim H.;  Shin N.;  Lee S.;  In H.;  Jung J.;  Cho S.;  Jeon B.;  Kim D.;  Jin G.;  Kim S.;  Kim S.;  Kim Y.;  Kim E.;  Kim B.I.;  Kim H.;  Lee H.;  Jin Y.;  Kim J.;  Kim H.;  Ryu B.;  Shin S.;  Shin E.;  Lee J.;  Lee S.;  Jang Y.;  Choi E.;  Hyun J.;  Ko D.;  Seo G.;  Kwon S.;  Park E.;  Choi S.;  Hwang S.;  Lee S.;  Kang B.;  Park J.;  Lee D.;  Jo S.;  Choi S.;  Lee J.;  Cho S.;  Park J.;  Kim J.;  Lee E.;  Kim J.;  Kim S.;  Kim U.
SOURCE
  Osong Public Health and Research Perspectives (2020) :1 (8-14). Date of Publication: 2020
ABSTRACT
  Objectives: The first confirmed case of coronavirus disease 2019 (COVID-19) in South Korea was reported in January 2020, with 28 confirmed cases reported as of February 14th, 2020. The epidemiological and clinical characteristics of all 28 cases were analyzed in response to this disease. Methods: The epidemiological characteristics and early clinical features of the 28 patients from Korea with confirmed COVID-19 were analyzed using COVID-19 reporting and surveillance data and the epidemiological investigation reports prepared by the rapid response team. Results: There were 16 patients that entered Korea from foreign countries: Wuhan, China (11 patients), Zhuhai, China, (1 patient), Singapore (2 patients), Japan (1 patient), and Thailand (1 patient). The early symptoms were fever, sore throat, cough or sputum production, chills, and muscle ache. Three patients were asymptomatic, however, 18 developed pneumonia. Of the 28 cases, 16 were index cases imported from abroad, with 10 cases of secondary infection originating in Korea, and the route of transmission still under investigation for 2 patients. The 10 patients with secondary infection were infected from contact with family members or acquaintances of primary patients, and the suspected sites of transmission were mostly at home. Conclusion: COVID-19 in Korea was spread by 16 infected individuals traveling from other countries, leading to second-generation cases. The initial symptoms were mostly minor, but the disease was infectious at this stage, resulting from close contact, particularly at home. Establishing an early detection strategy for COVID-19 is crucial for managing the transmission of the disease.
FULL TEXT LINK
http://dx.doi.org/10.24171/j.phrp.2020.11.1.03

RECORD 45
TITLE
  Epidemiology, causes, clinical manifestation and diagnosis, prevention and control of coronavirus disease (COVID-19) during the early outbreak period: A scoping review
AUTHOR NAMES
  Adhikari S.P.;  Meng S.;  Wu Y.-J.;  Mao Y.-P.;  Ye R.-X.;  Wang Q.-Z.;  Sun C.;  Sylvia S.;  Rozelle S.;  Raat H.;  Zhou H.
SOURCE
  Infectious Diseases of Poverty (2020) 9:1 Article Number: 29. Date of Publication: 17 Mar 2020
ABSTRACT
  Background: The coronavirus disease (COVID-19) has been identified as the cause of an outbreak of respiratory illness in Wuhan, Hubei Province, China beginning in December 2019. As of 31 January 2020, this epidemic had spread to 19 countries with 11 791 confirmed cases, including 213 deaths. The World Health Organization has declared it a Public Health Emergency of International Concern. Methods: A scoping review was conducted following the methodological framework suggested by Arksey and O’Malley. In this scoping review, 65 research articles published before 31 January 2020 were analyzed and discussed to better understand the epidemiology, causes, clinical diagnosis, prevention and control of this virus. The research domains, dates of publication, journal language, authors’ affiliations, and methodological characteristics were included in the analysis. All the findings and statements in this review regarding the outbreak are based on published information as listed in the references. Results: Most of the publications were written using the English language (89.2%). The largest proportion of published articles were related to causes (38.5%) and a majority (67.7%) were published by Chinese scholars. Research articles initially focused on causes, but over time there was an increase of the articles related to prevention and control. Studies thus far have shown that the virus’ origination is in connection to a seafood market in Wuhan, but specific animal associations have not been confirmed. Reported symptoms include fever, cough, fatigue, pneumonia, headache, diarrhea, hemoptysis, and dyspnea. Preventive measures such as masks, hand hygiene practices, avoidance of public contact, case detection, contact tracing, and quarantines have been discussed as ways to reduce transmission. To date, no specific antiviral treatment has proven effective; hence, infected people primarily rely on symptomatic treatment and supportive care. Conclusions: There has been a rapid surge in research in response to the outbreak of COVID-19. During this early period, published research primarily explored the epidemiology, causes, clinical manifestation and diagnosis, as well as prevention and control of the novel coronavirus. Although these studies are relevant to control the current public emergency, more high-quality research is needed to provide valid and reliable ways to manage this kind of public health emergency in both the short- and long-term.
FULL TEXT LINK
http://dx.doi.org/10.1186/s40249-020-00646-x

RECORD 46
TITLE
  A review of the 2019 Novel Coronavirus (COVID-19) based on current evidence
AUTHOR NAMES
  Wang L.-S.;  Wang Y.-R.;  Ye D.-W.;  Liu Q.-Q.
SOURCE
  International journal of antimicrobial agents (2020) (105948). Date of Publication: 19 Mar 2020
ABSTRACT
  The pneumonia caused by novel coronavirus (SARS-CoV-2) in Wuhan, China in December 2019 is a highly contagious disease. The World Health Organization (WHO) has declared the ongoing outbreak as a global public health emergency. Currently, the research on novel coronavirus is still in the primary stage. Based on the current published evidence, we systematically summarizes the epidemiology, clinical characteristics, diagnosis, treatment and prevention of knowledge surrounding COVID-19. This review in the hope of helping the public effectively recognize and deal with the 2019 novel coronavirus (SARS-CoV-2), and providing a reference for future studies.
FULL TEXT LINK
http://dx.doi.org/10.1016/j.ijantimicag.2020.105948

RECORD 47
TITLE
  The evolution of CT characteristics in the patients with COVID-19 pneumonia
AUTHOR NAMES
  Lei P.;  Fan B.;  Yuan Y.
SOURCE
  The Journal of infection (2020). Date of Publication: 19 Mar 2020
FULL TEXT LINK
http://dx.doi.org/10.1016/j.jinf.2020.03.014

RECORD 48
TITLE
  Clinical and biochemical indexes from 2019-nCoV infected patients linked to viral loads and lung injury
AUTHOR NAMES
  Liu Y.;  Yang Y.;  Zhang C.;  Huang F.;  Wang F.;  Yuan J.;  Wang Z.;  Li J.;  Li J.;  Feng C.;  Zhang Z.;  Wang L.;  Peng L.;  Chen L.;  Qin Y.;  Zhao D.;  Tan S.;  Yin L.;  Xu J.;  Zhou C.;  Jiang C.;  Liu L.
SOURCE
  Science China. Life sciences (2020) 63:3 (364-374). Date of Publication: 1 Mar 2020
ABSTRACT
  The outbreak of the 2019-nCoV infection began in December 2019 in Wuhan, Hubei province, and rapidly spread to many provinces in China as well as other countries. Here we report the epidemiological, clinical, laboratory, and radiological characteristics, as well as potential biomarkers for predicting disease severity in 2019-nCoV-infected patients in Shenzhen, China. All 12 cases of the 2019-nCoV-infected patients developed pneumonia and half of them developed acute respiratory distress syndrome (ARDS). The most common laboratory abnormalities were hypoalbuminemia, lymphopenia, decreased percentage of lymphocytes (LYM) and neutrophils (NEU), elevated C-reactive protein (CRP) and lactate dehydrogenase (LDH), and decreased CD8 count. The viral load of 2019-nCoV detected from patient respiratory tracts was positively linked to lung disease severity. ALB, LYM, LYM (%), LDH, NEU (%), and CRP were highly correlated to the acute lung injury. Age, viral load, lung injury score, and blood biochemistry indexes, albumin (ALB), CRP, LDH, LYM (%), LYM, and NEU (%), may be predictors of disease severity. Moreover, the Angiotensin II level in the plasma sample from 2019-nCoV infected patients was markedly elevated and linearly associated to viral load and lung injury. Our results suggest a number of potential diagnosis biomarkers and angiotensin receptor blocker (ARB) drugs for potential repurposing treatment of 2019-nCoV infection.
FULL TEXT LINK
http://dx.doi.org/10.1007/s11427-020-1643-8

RECORD 49
TITLE
  The origin, transmission and clinical therapies on coronavirus disease 2019 (COVID-19) outbreak – an update on the status
AUTHOR NAMES
  Guo Y.-R.;  Cao Q.-D.;  Hong Z.-S.;  Tan Y.-Y.;  Chen S.-D.;  Jin H.-J.;  Tan K.-S.;  Wang D.-Y.;  Yan Y.
SOURCE
  Military Medical Research (2020) 7:1 (11). Date of Publication: 13 Mar 2020
ABSTRACT
  An acute respiratory disease, caused by a novel coronavirus (SARS-CoV-2, previously known as 2019-nCoV), the coronavirus disease 2019 (COVID-19) has spread throughout China and received worldwide attention. On 30 January 2020, World Health Organization (WHO) officially declared the COVID-19 epidemic as a public health emergency of international concern. The emergence of SARS-CoV-2, since the severe acute respiratory syndrome coronavirus (SARS-CoV) in 2002 and Middle East respiratory syndrome coronavirus (MERS-CoV) in 2012, marked the third introduction of a highly pathogenic and large-scale epidemic coronavirus into the human population in the twenty-first century. As of 1 March 2020, a total of 87,137 confirmed cases globally, 79,968 confirmed in China and 7169 outside of China, with 2977 deaths (3.4%) had been reported by WHO. Meanwhile, several independent research groups have identified that SARS-CoV-2 belongs to β-coronavirus, with highly identical genome to bat coronavirus, pointing to bat as the natural host. The novel coronavirus uses the same receptor, angiotensin-converting enzyme 2 (ACE2) as that for SARS-CoV, and mainly spreads through the respiratory tract. Importantly, increasingly evidence showed sustained human-to-human transmission, along with many exported cases across the globe. The clinical symptoms of COVID-19 patients include fever, cough, fatigue and a small population of patients appeared gastrointestinal infection symptoms. The elderly and people with underlying diseases are susceptible to infection and prone to serious outcomes, which may be associated with acute respiratory distress syndrome (ARDS) and cytokine storm. Currently, there are few specific antiviral strategies, but several potent candidates of antivirals and repurposed drugs are under urgent investigation. In this review, we summarized the latest research progress of the epidemiology, pathogenesis, and clinical characteristics of COVID-19, and discussed the current treatment and scientific advancements to combat the epidemic novel coronavirus.
FULL TEXT LINK
http://dx.doi.org/10.1186/s40779-020-00240-0

RECORD 50
TITLE
  Clinical features and dynamics of viral load in imported and non-imported patients with COVID-19
AUTHOR NAMES
  Xu T.;  Chen C.;  Zhu Z.;  Cui M.;  Chen C.;  Dai H.;  Xue Y.
SOURCE
  International journal of infectious diseases : IJID : official publication of the International Society for Infectious Diseases (2020). Date of Publication: 13 Mar 2020
ABSTRACT
  OBJECTIVES: To compare the clinical characteristics and the dynamics of viral load between the imported and non-imported patients with COVID-19. DESIGN AND METHODS: Data from 51 laboratory-confirmed patients were retrospectively analyzed. RESULTS: The incubation period in the tertiary group was longer than that in the imported and secondary groups (both P < 0.05). Fever was the most common symptom at the onset of illness (73.33%, 58.82%, and 68.42%, respectively), and half of the patients had a low-grade temperature (<38.0℃) with a short duration of fever (<7 days). The CT scan showed that most patients had bilateral pneumonia in the three groups (80.00%, 76.47%, and 73.68%, respectively). Ct values detected from the tertiary patients were similar to those from the imported and secondary groups at the time of admission (both P > 0.05). For the tertiary group, the viral load was undetectable for half of the patients (52.63%) on day 7, and all patients on day 14. For 1/3rd of the patients in the imported and secondary groups, the viral load remained positive on day 14 after the admission. CONCLUSIONS: COVID-19 can present as pneumonia with less onset of symptoms, and the infectivity of SARS-CoV2 may gradually decrease in the tertiary patients.
FULL TEXT LINK
http://dx.doi.org/10.1016/j.ijid.2020.03.022

RECORD 51
TITLE
  CT image of novel coronavirus pneumonia: a case report
AUTHOR NAMES
  Zhang X.;  Song W.;  Liu X.;  Lyu L.
SOURCE
  Japanese journal of radiology (2020). Date of Publication: 18 Mar 2020
ABSTRACT
  OBJECTIVE: Knowledge of CT characteristics of COVID-19 pneumonia might be helpful to the early diagnosis and treatment of patients, and to control the spread of infection. METHODS: The chest CT images of the patient were collected to describe the CT manifestations and characteristics, and they were compared with the previous studies. RESULTS: Multiple patchy ground-glass opacities (GGOs) were seen in bilateral lung, mostly in subpleural areas. They progressed within 3 days, and nodular GGOs were also seen together with subpleural patchy GGOs. CONCLUSION: Our case of COVID-19 pneumonia showed multiple subpleural GGOs in bilateral lung, rapid progression, and it also accompanied nodular GGOs on chest CT. These findings were consistent with the previous reports, and they might be useful for early detection and evaluation of severity of COVID-19 pneumonia.
FULL TEXT LINK
http://dx.doi.org/10.1007/s11604-020-00945-1

RECORD 52
TITLE
  Guide to the Forensic Pathology Practice on Death Cases Related to Corona Virus Disease 2019 COVID-19 Trial Draft
AUTHOR NAMES
  Mao D.M.;  Zhou N.;  Zheng D.;  Le J.C.;  Zhao Q.H.;  Luo B.;  Guan D.W.;  Zhou Y.W.;  Hu B.J.;  Cheng J.D.
SOURCE
  Fa yi xue za zhi (2020) 36:1 (6-5). Date of Publication: 25 Feb 2020
ABSTRACT
  Abstract: Autopsy is of great significance to the elucidation of the pathological changes, pathogenesis and cause of death of corona virus disease 2019 (COVID-19) and can provide theoretical basis for more scientific and accurate prevention and control of the outbreak. Based on related laws and regulations, such as Law of the People’s Republic of China on Prevention and Control of Infectious Diseases, the clinical manifestations and epidemiological characteristics of COVID-19, and the related guidelines on the prevention and control of the outbreak, combined with the practical work of forensic pathology examination, the Guide to the Forensic Pathology Practice on Death Cases Related to Corona Virus Disease 2019 (COVID-19) (Trial Draft) has been developed. This guide includes information on the background investigation of the cases, autopsy room requirements, personal prevention and protections, external examinations, autopsy, auxiliary examinations, and so on. This guide can be used as a reference by forensic and pathological examination institutions, as well as examination staff.
FULL TEXT LINK
http://dx.doi.org/10.12116/j.issn.1004-5619.2020.01.003

RECORD 53
TITLE
  Eleven Faces of Coronavirus Disease 2019
AUTHOR NAMES
  Dong X.;  Cao Y.-Y.;  Lu X.-X.;  Zhang J.-J.;  Du H.;  Yan Y.-Q.;  Akdis C.A.;  Gao Y.-D.
SOURCE
  Allergy (2020). Date of Publication: 20 Mar 2020
ABSTRACT
  BACKGROUND AND AIMS: The outbreak of coronavirus disease 2019 (COVID-19) caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection has recently spread worldwide and been declared a pandemic. We aim to describe here the various clinical presentations of this disease by examining eleven cases. METHODS: Electronic medical records of 11 patients with COVID-19 were collected and demographics, clinical manifestations, outcomes, key laboratory results, and radiological images are discussed. RESULTS: The clinical course of the eleven cases demonstrated the complexity of the COVID-19 profile with different clinical presentations. Clinical manifestations range from asymptomatic cases to patients with mild and severe symptoms, with or without pneumonia. Laboratory detection of the viral nucleic acid can yield false-negative results, and serological testing of virus specific IgG and IgM antibodies should be used as an alternative for diagnosis. Patients with common allergic diseases did not develop distinct symptoms and severe courses. Cases with a pre-existing condition of chronic obstructive pulmonary disease or complicated with a secondary bacterial pneumonia were more severe. CONCLUSION: All different clinical characteristics of COVID-19 should be taken into consideration to identify patients that need to be in strict quarantine for the efficient containment of the pandemic.
FULL TEXT LINK
http://dx.doi.org/10.1111/all.14289

RECORD 54
TITLE
  Escalating infection control response to the rapidly evolving epidemiology of the Coronavirus disease 2019 (COVID-19) due to SARS-CoV-2 in Hong Kong
AUTHOR NAMES
  Cheng V.C.C.;  Wong S.-C.;  Chen J.H.K.;  Yip C.C.Y.;  Chuang V.W.M.;  Tsang O.T.Y.;  Sridhar S.;  Chan J.F.W.;  Ho P.-L.;  Yuen K.-Y.
SOURCE
  Infection Control and Hospital Epidemiology (2020). Date of Publication: 2020
ABSTRACT
  Background:To describe the infection control preparedness for Coronavirus Disease (COVID-19) due to SARS-CoV-2 [previously known as 2019-novel coronavirus] in the first 42 days after announcement of a cluster of pneumonia in China, on 31 December 2019 (day 1) in Hong Kong.Methods:A bundle approach of active and enhanced laboratory surveillance, early airborne infection isolation, rapid molecular diagnostic testing, and contact tracing for healthcare workers (HCWs) with unprotected exposure in the hospitals was implemented. Epidemiological characteristics of confirmed cases, environmental and air samples were collected and analyzed.Results:From day 1 to day 42, forty-two (3.3%) of 1275 patients fulfilling active (n=29) and enhanced laboratory surveillance (n=13) confirmed to have SARS-CoV-2 infection. The number of locally acquired case significantly increased from 1 (7.7%) of 13 [day 22 to day 32] to 27 (93.1%) of 29 confirmed case [day 33 to day 42] (p<0.001). Twenty-eight patients (66.6%) came from 8 family clusters. Eleven (2.7%) of 413 HCWs caring these confirmed cases were found to have unprotected exposure requiring quarantine for 14 days. None of them was infected and nosocomial transmission of SARS-CoV-2 was not observed. Environmental surveillance performed in a patient with viral load of 3.3×106 copies/ml (pooled nasopharyngeal/ throat swab) and 5.9×106 copies/ml (saliva) respectively. SARS-CoV-2 revealed in 1 (7.7%) of 13 environmental samples, but not in 8 air samples collected at a distance of 10 cm from patient’s chin with or without wearing a surgical mask.Conclusion:Appropriate hospital infection control measures could prevent nosocomial transmission of SARS-CoV-2.
FULL TEXT LINK
http://dx.doi.org/10.1017/ice.2020.58

RECORD 55
TITLE
  Clinical characteristics and therapeutic procedure for four cases with 2019 novel coronavirus pneumonia receiving combined Chinese and Western medicine treatment
AUTHOR NAMES
  Wang Z.;  Chen X.;  Lu Y.;  Chen F.;  Zhang W.
SOURCE
  Bioscience trends (2020) 14:1 (64-68). Date of Publication: 16 Mar 2020
ABSTRACT
  Pneumonia associated with the 2019 novel coronavirus (2019-nCoV) is continuously and rapidly circulating at present. No effective antiviral treatment has been verified thus far. We report here the clinical characteristics and therapeutic procedure for four patients with mild or severe 2019-nCoV pneumonia admitted to Shanghai Public Health Clinical Center. All the patients were given antiviral treatment including lopinavir/ritonavir (Kaletra®), arbidol, and Shufeng Jiedu Capsule (SFJDC, a traditional Chinese medicine) and other necessary support care. After treatment, three patients gained significant improvement in pneumonia associated symptoms, two of whom were confirmed 2019-nCoV negative and discharged, and one of whom was virus negative at the first test. The remaining patient with severe pneumonia had shown signs of improvement by the cutoff date for data collection. Results obtained in the current study may provide clues for treatment of 2019-nCoV pneumonia. The efficacy of antiviral treatment including lopinavir/ritonavir, arbidol, and SFJDC warrants further verification in future study.
FULL TEXT LINK
http://dx.doi.org/10.5582/bst.2020.01030

RECORD 56
TITLE
  COVID-19: Real-time dissemination of scientific information to fight a public health emergency of international concern
AUTHOR NAMES
  Song P.;  Karako T.
SOURCE
  Bioscience trends (2020) 14:1 (1-2). Date of Publication: 16 Mar 2020
ABSTRACT
  Rapidly sharing scientific information is an effective way to reduce public panic about COVID-19, and doing so is the key to providing real-time guidance to epidemiologists working to contain the outbreak, clinicians managing patients, and modelers helping to understand future developments and the possible effectiveness of various interventions. This issue has rapidly reviewed and published articles describing COVID-19, including the drug treatment options for SARS-CoV-2, its clinical characteristics, and therapies involving a combination of Chinese and Western medicine, the efficacy of chloroquine phosphate in the treatment of COVID-19 associated pneumonia according to clinical studies, and reflections on the system of reserve medical supplies for public health emergencies. As an academic journal, we will continue to quickly and transparently share data with frontline healthcare workers who need to know the epidemiological and clinical features of COVID-19.
FULL TEXT LINK
http://dx.doi.org/10.5582/bst.2020.01056

RECORD 57
TITLE
  Clinical characteristics of refractory COVID-19 pneumonia in Wuhan, China
AUTHOR NAMES
  Mo P.;  Xing Y.;  Xiao Y.;  Deng L.;  Zhao Q.;  Wang H.;  Xiong Y.;  Cheng Z.;  Gao S.;  Liang K.;  Luo M.;  Chen T.;  Song S.;  Ma Z.;  Chen X.;  Zheng R.;  Cao Q.;  Wang F.;  Zhang Y.
SOURCE
  Clinical infectious diseases : an official publication of the Infectious Diseases Society of America (2020). Date of Publication: 16 Mar 2020
ABSTRACT
  BACKGROUND: Since December 2019, novel coronavirus (SARS-CoV-2)-infected pneumonia (COVID-19) occurred in Wuhan, and rapidly spread throughout China. This study aimed to clarify the characteristics of patients with refractory COVID-19. METHODS: In this retrospective single-center study, we included 155 consecutive patients with confirmed COVID-19 in Zhongnan Hospital of Wuhan University from January 1st to February 5th. The cases were divided into general and refractory COVID-19 groups according to the clinical efficacy after hospitalization, and the difference between groups were compared. RESULTS: Compared with general COVID-19 patients (45.2%), refractory patients had an older age, male sex, more underlying comorbidities, lower incidence of fever, higher levels of maximum temperature among fever cases, higher incidence of breath shortness and anorexia, severer disease assessment on admission, high levels of neutrophil, aspartate aminotransferase (AST), lactate dehydrogenase (LDH) and C-reactive protein, lower levels of platelets and albumin, and higher incidence of bilateral pneumonia and pleural effusion (P<0.05). Refractory COVID-19 patients were more likely to receive oxygen, mechanical ventilation, expectorant, and adjunctive treatment including corticosteroid, antiviral drugs and immune enhancer (P<0.05). After adjustment, those with refractory COVID-19 were also more likely to have a male sex and manifestations of anorexia and fever on admission, and receive oxygen, expectorant and adjunctive agents (P<0.05) when considering the factors of disease severity on admission, mechanical ventilation, and ICU transfer. CONCLUSION: Nearly 50% COVID-19 patients could not reach obvious clinical and radiological remission within 10 days after hospitalization. The patients with male sex, anorexia and no fever on admission predicted poor efficacy.
FULL TEXT LINK
http://dx.doi.org/10.1093/cid/ciaa270

RECORD 58
TITLE
  Management strategies for patients with gynecological malignancies during the outbreak of COVID19
AUTHOR NAMES
  Zhang J.;  Peng P.;  Li X.;  Zha Y.F.;  Zhang G.N.;  Zhang Y.;  Xiang Y.
SOURCE
  Zhonghua fu chan ke za zhi (2020) 55 (E011). Date of Publication: 16 Mar 2020
ABSTRACT
  Objective: To explore the management strategies for patients with gynecological malignant tumors during the outbreak and transmission of COVID19. Methods: We retrospectively analyzed the clinical characteristics, treatment, and disease outcomes of three patients with gynecological malignancies associated with COVID19 in Renmin Hospital of Wuhan University in January 2020, and proposed management strategies for patients with gynecological tumors under risk of COVID19. Results: Three patients were treated COVID19 based on the national diagnosis and treatment protocol as well as research progress. Meanwhile, these patients were appropriately adjusted the treatment plan in accordance with the clinical guidelines for gynecological tumors. Pneumonia was cured in 2 patients, and one patient died of COVID-19. Conclusions: Patients with gynecological malignant tumors are high-risk groups prone to COVID-19 infection, and gynecological oncologists need to carry out education, prevention, control and treatment according to specific conditions. While actively preventing and controlling COVID-19, the diagnosis and treatment of gynecological malignant tumors should be carried out in an orderly and safe manner.
FULL TEXT LINK
http://dx.doi.org/10.3760/cma.j.cn112141-20200302-00168

RECORD 59
TITLE
  Prevalence of comorbidities in the novel Wuhan coronavirus (COVID-19) infection: a systematic review and meta-analysis
AUTHOR NAMES
  Yang J.;  Zheng Y.;  Gou X.;  Pu K.;  Chen Z.;  Guo Q.;  Ji R.;  Wang H.;  Wang Y.;  Zhou Y.
SOURCE
  International journal of infectious diseases : IJID : official publication of the International Society for Infectious Diseases (2020). Date of Publication: 12 Mar 2020
ABSTRACT
  BACKGROUND: An outbreak of Novel Coronavirus (COVID -19) in Wuhan, China, the epidemic is more widespread than initially estimated, with cases now confirmed in multiple countries. AIMS: The aim of the meta-analysis was to assess the prevalence of comorbidities in the COVID-19 infection patients and the risk of underlying diseases in severe patients compared to non-severe patients. METHODS: A literature search was conducted using the databases PubMed, EMBASE, and Web of sciences until February 25, 2020. Risk ratio (OR) and 95% confidence intervals (CIs) were pooled using random-effects models. RESULTS: Eight studies were included in the meta- analysis, including 46248 infected patients. The result showed the most prevalent clinical symptom was fever ( 91 ± 3, 95% CI 86-97% ), followed by cough (67 ± 7, 95% CI 59-76%), fatigue ( 51 ± 0, 95% CI 34-68% ) and dyspnea ( 30 ± 4, 95% CI 21-40%). The most prevalent comorbidity were hypertension (17 ± 7, 95% CI 14-22%) and diabetes ( 8 ± 6, 95% CI 6-11% ), followed by cardiovascular diseases ( 5 ± 4, 95% CI 4-7% ) and respiratory system disease( 2 ± 0, 95% CI 1-3% ). Compared with the Non-severe patient, the pooled odds ratio of hypertension, respiratory system disease, cardiovascular disease in severe patients were (OR 2.36, 95% CI: 1.46-3.83), (OR 2.46, 95% CI: 1.76-3.44) and (OR 3.42, 95% CI: 1.88-6.22)respectively. CONCLUSION: We assessed the prevalence of comorbidities in the COVID-19 infection patients and found underlying disease, including hypertension, respiratory system disease and cardiovascular, may be a risk factor for severe patients compared with Non-severe patients.
FULL TEXT LINK
http://dx.doi.org/10.1016/j.ijid.2020.03.017

RECORD 60
TITLE
  Patients of COVID-19 may benefit from sustained lopinavir-combined regimen and the increase of eosinophil may predict the outcome of COVID-19 progression
AUTHOR NAMES
  Liu F.;  Xu A.;  Zhang Y.;  Xuan W.;  Yan T.;  Pan K.;  Yu W.;  Zhang J.
SOURCE
  International journal of infectious diseases : IJID : official publication of the International Society for Infectious Diseases (2020). Date of Publication: 12 Mar 2020
ABSTRACT
  OBJECTIVES: To explore the epidemiological information, clinical characteristics, therapeutic outcomes and temporal progression of laboratory findings in 2019-coronavirus disease (COVID-19) patients exposed to lopinavir. METHODS: We collected data from ten COVID-19 patients admitted between January 22, 2020 and February 11, 2020 at Xixi hospital in Hangzhou, China. RESULTS: Of ten patients, secondary, tertiary and quartus patients emerged, the incubation period was 3-7 days. Mainly initial symptoms were cough and low fever (37.3-38.0 ℃). An asymptomatic case presented normal radiography, the others existed ground glass opacities. All cases (three transferred, seven discharged) exposed to lopinavir on initial hospitalization. Three patients stopped lopinavir using because of adverse effect, two of them deteriorated, one hospitalized longer than others who with sustained lopinavir using. Levels of potassium, albumin, lymphocyte were low, but increased persistently after treatment. Eosinophil values were low on initial hospitalization, then all returned to normal before discharge. Viral load of SARS-CoV-2, radiography and eosinophil improved continuously in 3-14, 6-8 and 7-9 days, respectively. CONCLUSIONS: Increasing eosinophils may be an indicator of COVID-19 improvement. The COVID-19 patients may benefit from sustained lopinavir using. More researches on a larger scale are needed to verify these points.
FULL TEXT LINK
http://dx.doi.org/10.1016/j.ijid.2020.03.013

RECORD 61
TITLE
  Coronavirus Disease 2019 (COVID-19): A Systematic Review of Imaging Findings in 919 Patients
AUTHOR NAMES
  Salehi S.;  Abedi A.;  Balakrishnan S.;  Gholamrezanezhad A.
SOURCE
  AJR. American journal of roentgenology (2020) (1-7). Date of Publication: 14 Mar 2020
ABSTRACT
  OBJECTIVE. Available information on CT features of the 2019 novel coronavirus disease (COVID-19) is scattered in different publications, and a cohesive literature review has yet to be compiled. MATERIALS AND METHODS. This article includes a systematic literature search of PubMed, Embase (Elsevier), Google Scholar, and the World Health Organization database. RESULTS. Known features of COVID-19 on initial CT include bilateral multilobar ground-glass opacification (GGO) with a peripheral or posterior distribution, mainly in the lower lobes and less frequently within the right middle lobe. Atypical initial imaging presentation of consolidative opacities superimposed on GGO may be found in a smaller number of cases, mainly in the elderly population. Septal thickening, bronchiectasis, pleural thickening, and subpleural involvement are some of the less common findings, mainly in the later stages of the disease. Pleural effusion, pericardial effusion, lymphadenopathy, cavitation, CT halo sign, and pneumothorax are uncommon but may be seen with disease progression. Follow-up CT in the intermediate stage of disease shows an increase in the number and size of GGOs and progressive transformation of GGO into multifocal consolidative opacities, septal thickening, and development of a crazy paving pattern, with the greatest severity of CT findings visible around day 10 after the symptom onset. Acute respiratory distress syndrome is the most common indication for transferring patients with COVID-19 to the ICU and the major cause of death in this patient population. Imaging patterns corresponding to clinical improvement usually occur after week 2 of the disease and include gradual resolution of consolidative opacities and decrease in the number of lesions and involved lobes. CONCLUSION. This systematic review of current literature on COVID-19 provides insight into the initial and follow-up CT characteristics of the disease.
FULL TEXT LINK
http://dx.doi.org/10.2214/AJR.20.23034

RECORD 62
TITLE
  Incubation period and other epidemiological characteristics of 2019 novel coronavirus infections with right truncation: A statistical analysis of publicly available case data
AUTHOR NAMES
  Linton N.M.;  Kobayashi T.;  Yang Y.;  Hayashi K.;  Akhmetzhanov A.R.;  Jung S.-M.;  Yuan B.;  Kinoshita R.;  Nishiura H.
SOURCE
  Journal of Clinical Medicine (2020) 9:2 Article Number: 538. Date of Publication: 1 Feb 2020
ABSTRACT
  The geographic spread of 2019 novel coronavirus (COVID-19) infections from the epicenter of Wuhan, China, has provided an opportunity to study the natural history of the recently emerged virus. Using publicly available event-date data from the ongoing epidemic, the present study investigated the incubation period and other time intervals that govern the epidemiological dynamics of COVID-19 infections. Our results show that the incubation period falls within the range of 2–14 days with 95% confidence and has a mean of around 5 days when approximated using the best-fit lognormal distribution. The mean time from illness onset to hospital admission (for treatment and/or isolation) was estimated at 3–4 days without truncation and at 5–9 days when right truncated. Based on the 95th percentile estimate of the incubation period, we recommend that the length of quarantine should be at least 14 days. The median time delay of 13 days from illness onset to death (17 days with right truncation) should be considered when estimating the COVID-19 case fatality risk.
FULL TEXT LINK
http://dx.doi.org/10.3390/jcm9020538

RECORD 63
TITLE
  Management strategies of neonatal jaundice during the coronavirus disease 2019 outbreak
AUTHOR NAMES
  Ma X.-L.;  Chen Z.;  Zhu J.-J.;  Shen X.-X.;  Wu M.-Y.;  Shi L.-P.;  Du L.-Z.;  Fu J.-F.;  Shu Q.
SOURCE
  World Journal of Pediatrics (2020). Date of Publication: 2020
ABSTRACT
  The outbreak of coronavirus disease 2019 (COVID-19; formally known as 2019-nCoV) has become a most challenging health emergency. Owing to rigorous quarantine and control measures taken in China, routine neonatal health surveillance and follow-up have become challenging. Without follow-up surveillance, some rapid and progressive newborn diseases, such as bilirubin encephalopathy, may be ignored. The characteristics of onset age of kernicterus suggest that monitoring of bilirubin level at home provides a useful way to alert hospital visits and to prevent the development of extremely hyperbilirubinemia. Therefore, we developed an online follow-up program for convenient monitoring of bilirubin level of newborns that is based on our practical experiences. The aim is to make our management strategies of neonatal jaundice tailored to the infection prevention and control during the COVID-19 epidemic.
FULL TEXT LINK
http://dx.doi.org/10.1007/s12519-020-00347-3

RECORD 64
TITLE
  Clinical characteristics of novel coronavirus disease 2019 (COVID-19) in newborns, infants and children
AUTHOR NAMES
  Hong H.;  Wang Y.;  Chung H.-T.;  Chen C.-J.
SOURCE
  Pediatrics and Neonatology (2020). Date of Publication: 2020
FULL TEXT LINK
http://dx.doi.org/10.1016/j.pedneo.2020.03.001

RECORD 65
TITLE
  Clinical characteristics of severe acute respiratory syndrome coronavirus 2 reactivation
AUTHOR NAMES
  Ye G.;  Pan Z.;  Pan Y.;  Deng Q.;  Chen L.;  Li J.;  Li Y.;  Wang X.
SOURCE
  Journal of Infection (2020). Date of Publication: 2020
ABSTRACT
  Objectives: Previous studies on the pneumonia outbreak caused by the 2019 novel coronavirus disease (COVID-19) were based on information from the general population. However, limited data was available for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) reactivation. This study aimed to evaluate the clinical characteristics of the SARS-CoV-2 reactivation. Methods: Clinical records, laboratory results, and chest CT scans were retrospectively reviewed for 55 patients with laboratory-confirmed COVID-19 pneumonia (i.e., with throat swab samples that were positive for SARS-CoV-2) who were admitted to Zhongnan Hospital of Wuhan University, Wuhan, China, from Jan. 8 to Feb. 10, 2020. Results: All 55 patients had a history of epidemiological exposure to COVID-19, and 5 (9%) patients who discharged from hospital presented with SARS-CoV-2 reactivation. Among the 5 reactivated patients, other symptoms were also observed, including fever, cough, sore throat, and fatigue. One of the 5 patients had progressive lymphopenia (from 1.3 to 0.56 × 109 cells per L) and progressive neutrophilia (from 4.5 to 18.28 × 109 cells per L). All 5 reactivated patients presented normal aminotransferase levels. Throat swab samples from the 5 reactivated patients were tested for SARS-CoV-2, indicating all positive for the virus. Conclusions: Findings from this small group of cases suggested that there was currently evidence for reactivation of SARS-CoV-2 and there might be no specific clinical characteristics to distinguish them.
FULL TEXT LINK
http://dx.doi.org/10.1016/j.jinf.2020.03.001

RECORD 66
TITLE
  Dynamic changes of chest CT imaging in patients with corona virus disease-19 (COVID-19)
AUTHOR NAMES
  Wang J.;  Liu J.;  Wang Y.;  Liu W.;  Chen X.;  Sun C.;  Shen X.;  Wang Q.;  Wu Y.;  Liang W.;  Ruan L.
SOURCE
  Zhejiang da xue xue bao. Yi xue ban = Journal of Zhejiang University. Medical sciences (2020) 49:1 (0). Date of Publication: 24 Feb 2020
ABSTRACT
  OBJECTIVE: To analyze the dynamic changes of chest CT images of patients with corona virus disease-19 (COVID-19). METHODS: Fifty-two cases of COVID-19 were admitted in the First Affiliated Hospital of Zhejiang University School of Medicine. The consecutive chest CT scans were followed up for all patients with an average of 4 scans performed per patient during the hospitalization. The shortest interval between each scan was 2 days and the longest was 7 days. The shape, number and distribution of lung shadows, as well as the characteristics of the lesions on the CT images were reviewed. RESULTS: The obvious shadows infiltrating the lungs were shown on CT images in 50 cases, for other 2 cases there was no abnormal changes in the lungs during the first CT examination. Ground-glass opacities (GGO) were found in 48 cases (92.3%), and 19 cases (36.5%) had patchy consolidation and sub-consolidation, which were accompanied with air bronchi sign in 17 cases (32.7%). Forty one cases (78.8%) showed a thickened leaflet interval, 4 cases (7.6%) had a small number of fibrous stripes. During hospitalization, GGO lesions in COVID-19 patients gradually became rare, the fibrous strip shadows increased and it became the most common imaging manifestation. The lesions rapidly progressed in 39 cases (75.0%) within 6-9 days after admission. On days 10-14 of admission, the lesions distinctly resolved in 40 cases (76.9%). CONCLUSIONS: The chest CT images of patients with COVID-19 have certain characteristics with dynamic changes, which are of value for monitoring disease progress and clinical treatment.

RECORD 67
TITLE
  Clinical progression of patients with COVID-19 in Shanghai, China
AUTHOR NAMES
  Chen J.;  Qi T.;  Liu L.;  Ling Y.;  Qian Z.;  Li T.;  Li F.;  Xu Q.;  Zhang Y.;  Xu S.;  Song Z.;  Zeng Y.;  Shen Y.;  Shi Y.;  Zhu T.;  Lu H.
SOURCE
  The Journal of infection (2020). Date of Publication: 11 Mar 2020
ABSTRACT
  BACKGROUND: Studies on the 2019 novel coronavirus disease (COVID-19) have generally been limited to the description of the epidemiology and initial clinical characteristics. We investigated the temporal progression in patients with COVID-19. METHODS: In this retrospective, single-center study, we included confirmed cases of COVID-19 from Jan 20 to Feb 6, 2020 in Shanghai. Final date of follow-up was February 25, 2020. RESULTS: Of the 249 patients enrolled, the median age was 51 years old, and 126 (50.6%) were male. The duration from onset of symptoms to hospitalization was 4(2-7) days in symptomatic patients. Fever was occurred in 235(94.3%) patients. A total of 215 (86.3%) patients had been discharged after 16(12-20) days hospitalization. The estimated median duration of fever in all the patients with fever was 10 days (95 confidential intervals [CIs]: 8-11 days) after onset of symptoms. Patients who were transferred to intensive care units (ICU) had significantly longer duration of fever as compared to those not in ICU (31 days v.s. 9 days after onset of symptoms, respectively, P<0.0001). Radiological aggravation of initial image was observed in 163 (65.7%) patients on day 7 after onset of symptoms. 154(94.5%) of these patients showed radiological improvement on day 14. The median duration to negative reverse-transcriptase PCR tests of upper respiratory tract samples was 11 days (95 CIs: 10-12 days). Viral clearance was more likely to be delayed in patients in ICU than those not in ICU (P<0.0001). In multivariate logistical analysis, age (Odds ratio [OR]=1.06) and CD4 T cell count (OR=0.55 per 100 cells/ul increase) were independently associated with ICU admission. CONCLUSIONS: The majority of COVID-19 cases are mild. The clinical progression pattern suggests that early control of viral replication and application of host-directed therapy in later stage is essential to improve the prognosis of CVOID-19.
FULL TEXT LINK
http://dx.doi.org/10.1016/j.jinf.2020.03.004

RECORD 68
TITLE
  Epidemiologic and Clinical Characteristics of 91 Hospitalized Patients with COVID-19 in Zhejiang, China: A retrospective, multi-centre case series
AUTHOR NAMES
  Qian G.-Q.;  Yang N.-B.;  Ding F.;  Ma A.H.Y.;  Wang Z.-Y.;  Shen Y.-F.;  Shi C.-W.;  Lian X.;  Chu J.-G.;  Chen L.;  Wang Z.-Y.;  Ren D.-W.;  Li G.-X.;  Chen X.-Q.;  Shen H.-J.;  Chen X.-M.
SOURCE
  QJM : monthly journal of the Association of Physicians (2020). Date of Publication: 17 Mar 2020
ABSTRACT
  BACKGROUND: Recent studies have focused initial clinical and Epidemiologic characteristics on the COVID-19, mainly revealing situation in Wuhan, Hubei. AIM: To reveal more data on the epidemiologic and clinical characteristics of COVID-19 patients outside of Wuhan, in Zhejiang, China. DESIGN: Retrospective case series. METHODS: 88 cases of laboratory-confirmed and 3 cases of clinical-confirmed COVID-19 were admitted to five hospitals in Zhejiang province, China. Data were collected from 20 January 2020 to 11 February 2020. RESULTS: Of all 91 patients, 88 (96.70%) were laboratory-confirmed COVID-19 with throat swab samples that tested positive for SARS-Cov-2 while 3 (3.30%) were clinical-diagnosed COVID-19 cases. The median age of the patients was 50 (36.5-57) years, and female accounted for 59.34%. In this sample 40 (43.96%) patients had contracted the diseases from local cases, 31 (34.07%) patients had been to Wuhan/Hubei, 8 (8.79%) cases had contacted with people from Wuhan, 11 (12.09%) cases were confirmed aircraft transmission. In particular within the city of Ningbo, 60.52% cases can be traced back to an event held in a temple. The most common symptoms were fever (71.43%), cough (60.44%) and fatigue (43.96%). The median of incubation period was 6 (IQR, 3-8) days and the median time from first visit to a doctor to confirmed diagnosis was 1 (1-2) days. According to the Chest computed tomography scans, 67.03% cases had bilateral pneumonia. CONCLUSIONS: Social activity cluster, family cluster and travel by airplane were how COVID-19 patients get transmitted and could be rapidly diagnosed COVID-19 in Zhejiang.
FULL TEXT LINK
http://dx.doi.org/10.1093/qjmed/hcaa089

RECORD 69
TITLE
  Safety and efficacy of different anesthetic regimens for parturients with COVID-19 undergoing Cesarean delivery: a case series of 17 patients
AUTHOR NAMES
  Chen R.;  Zhang Y.;  Huang L.;  Cheng B.-H.;  Xia Z.-Y.;  Meng Q.-T.
SOURCE
  Canadian Journal of Anesthesia (2020). Date of Publication: 2020
ABSTRACT
  Purpose: To assess the management and safety of epidural or general anesthesia for Cesarean delivery in parturients with coronavirus disease (COVID-19) and their newborns, and to evaluate the standardized procedures for protecting medical staff. Methods: We retrospectively reviewed the cases of parturients diagnosed with severe acute respiratory syndrome coronavirus (SARS-CoV-2) infection disease (COVID-19). Their epidemiologic history, chest computed tomography scans, laboratory measurements, and SARS-CoV-2 nucleic acid positivity were evaluated. We also recorded the patients’ demographic and clinical characteristics, anesthesia and surgery-related data, maternal and neonatal complications, as well as the health status of the involved medical staff. Results: The clinical characteristics of 17 pregnant women infected with SARS-CoV-2 were similar to those previously reported in non-pregnant adult patients. All of the 17 patients underwent Cesarean delivery with anesthesia performed according to standardized anesthesia/surgery procedures. Fourteen of the patients underwent continuous epidural anesthesia with 12 experiencing significant intraoperative hypotension. Three patients received general anesthesia with tracheal intubation because emergency surgery was needed. Three of the parturients are still recovering from their Cesarean delivery and are receiving in-hospital treatment for COVID-19. Three neonates were born prematurely. There were no deaths or serious neonatal asphyxia events. All neonatal SARS-CoV-2 nucleic acid tests were negative. No medical staff were infected throughout the patient care period. Conclusions: Both epidural and general anesthesia were safely used for Cesarean delivery in the parturients with COVID-19. Nevertheless, the incidence of hypotension during epidural anesthesia appeared excessive. Proper patient transfer, medical staff access procedures, and effective biosafety precautions are important to protect medical staff from COVID-19.
FULL TEXT LINK
http://dx.doi.org/10.1007/s12630-020-01630-7

RECORD 70
TITLE
  Clinical course and risk factors for mortality of adult inpatients with COVID-19 in Wuhan, China: a retrospective cohort study
AUTHOR NAMES
  Zhou F.;  Yu T.;  Du R.;  Fan G.;  Liu Y.;  Liu Z.;  Xiang J.;  Wang Y.;  Song B.;  Gu X.;  Guan L.;  Wei Y.;  Li H.;  Wu X.;  Xu J.;  Tu S.;  Zhang Y.;  Chen H.;  Cao B.
SOURCE
  The Lancet (2020). Date of Publication: 2020
ABSTRACT
  Background: Since December, 2019, Wuhan, China, has experienced an outbreak of coronavirus disease 2019 (COVID-19), caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Epidemiological and clinical characteristics of patients with COVID-19 have been reported but risk factors for mortality and a detailed clinical course of illness, including viral shedding, have not been well described. Methods: In this retrospective, multicentre cohort study, we included all adult inpatients (≥18 years old) with laboratory-confirmed COVID-19 from Jinyintan Hospital and Wuhan Pulmonary Hospital (Wuhan, China) who had been discharged or had died by Jan 31, 2020. Demographic, clinical, treatment, and laboratory data, including serial samples for viral RNA detection, were extracted from electronic medical records and compared between survivors and non-survivors. We used univariable and multivariable logistic regression methods to explore the risk factors associated with in-hospital death. Findings: 191 patients (135 from Jinyintan Hospital and 56 from Wuhan Pulmonary Hospital) were included in this study, of whom 137 were discharged and 54 died in hospital. 91 (48%) patients had a comorbidity, with hypertension being the most common (58 [30%] patients), followed by diabetes (36 [19%] patients) and coronary heart disease (15 [8%] patients). Multivariable regression showed increasing odds of in-hospital death associated with older age (odds ratio 1·10, 95% CI 1·03–1·17, per year increase; p=0·0043), higher Sequential Organ Failure Assessment (SOFA) score (5·65, 2·61–12·23; p<0·0001), and d-dimer greater than 1 μg/mL (18·42, 2·64–128·55; p=0·0033) on admission. Median duration of viral shedding was 20·0 days (IQR 17·0–24·0) in survivors, but SARS-CoV-2 was detectable until death in non-survivors. The longest observed duration of viral shedding in survivors was 37 days. Interpretation: The potential risk factors of older age, high SOFA score, and d-dimer greater than 1 μg/mL could help clinicians to identify patients with poor prognosis at an early stage. Prolonged viral shedding provides the rationale for a strategy of isolation of infected patients and optimal antiviral interventions in the future. Funding: Chinese Academy of Medical Sciences Innovation Fund for Medical Sciences; National Science Grant for Distinguished Young Scholars; National Key Research and Development Program of China; The Beijing Science and Technology Project; and Major Projects of National Science and Technology on New Drug Creation and Development.
FULL TEXT LINK
http://dx.doi.org/10.1016/S0140-6736(20)30566-3

RECORD 71
TITLE
  Anesthetic Management of Patients With Suspected or Confirmed 2019 Novel Coronavirus Infection During Emergency Procedures
AUTHOR NAMES
  Zhao S.;  Ling K.;  Yan H.;  Zhong L.;  Peng X.;  Yao S.;  Huang J.;  Chen X.
SOURCE
  Journal of Cardiothoracic and Vascular Anesthesia (2020). Date of Publication: 2020
ABSTRACT
  Objectives: The aim of the present study was to prevent cross-infection in the operating room during emergency procedures for patients with confirmed or suspected 2019 novel coronavirus (2019-nCoV) by following anesthesia management protocols, and to document clinical- and anesthesia-related characteristics of these patients. Design: This was a retrospective, multicenter clinical study. Setting: This study used a multicenter dataset from 4 hospitals in Wuhan, China. Participants: Patients and health care providers with confirmed or suspected 2019-nCoV from January 23 to 31, 2020, at the Wuhan Union Hospital, the Wuhan Children’s Hospital, The Central Hospital of Wuhan, and the Wuhan Fourth Hospital in Wuhan, China. Interventions: Anesthetic management and infection control guidelines for emergency procedures for patients with suspected 2019-nCoV were drafted and applied in 4 hospitals in Wuhan. Measurements and Main Results: Cross-infection in the operating rooms of the 4 hospitals was effectively reduced by implementing the new measures and procedures. The majority of patients with laboratory-confirmed 2019-nCoV infection or suspected infection were female (23 [62%] of 37), and the mean age was 41.0 years old (standard deviation 19.6; range 4-78). 10 (27%) patients had chronic medical illnesses, including 4 (11%) with diabetes, 8 (22%) with hypertension, and 8 (22%) with digestive system disease. Twenty-five (68%) patients presented with lymphopenia, and 23 (62%) patients exhibited multiple mottling and ground-glass opacity on computed tomography scanning. Conclusions: The present study indicates that COVID 19–specific guidelines for emergency procedures for patients with confirmed or suspected 2019-nCoV may effectively prevent cross-infection in the operating room. Most patients with confirmed or suspected COVID 19 presented with fever and dry cough and demonstrated bilateral multiple mottling and ground-glass opacity on chest computed tomography scans.
FULL TEXT LINK
http://dx.doi.org/10.1053/j.jvca.2020.02.039

RECORD 72
TITLE
  Clinical Characteristics of Coronavirus Disease 2019 in China
AUTHOR NAMES
  Guan W.-J.;  Ni Z.-Y.;  Hu Y.;  Liang W.-H.;  Ou C.-Q.;  He J.-X.;  Liu L.;  Shan H.;  Lei C.-L.;  Hui D.S.C.;  Du B.;  Li L.-J.;  Zeng G.;  Yuen K.-Y.;  Chen R.-C.;  Tang C.-L.;  Wang T.;  Chen P.-Y.;  Xiang J.;  Li S.-Y.;  Wang J.-L.;  Liang Z.-J.;  Peng Y.-X.;  Wei L.;  Liu Y.;  Hu Y.-H.;  Peng P.;  Wang J.-M.;  Liu J.-Y.;  Chen Z.;  Li G.;  Zheng Z.-J.;  Qiu S.-Q.;  Luo J.;  Ye C.-J.;  Zhu S.-Y.;  Zhong N.-S.
SOURCE
  The New England journal of medicine (2020). Date of Publication: 28 Feb 2020
ABSTRACT
  BACKGROUND: Since December 2019, when coronavirus disease 2019 (Covid-19) emerged in Wuhan city and rapidly spread throughout China, data have been needed on the clinical characteristics of the affected patients. METHODS: We extracted data regarding 1099 patients with laboratory-confirmed Covid-19 from 552 hospitals in 30 provinces, autonomous regions, and municipalities in China through January 29, 2020. The primary composite end point was admission to an intensive care unit (ICU), the use of mechanical ventilation, or death. RESULTS: The median age of the patients was 47 years; 41.9% of the patients were female. The primary composite end point occurred in 67 patients (6.1%), including 5.0% who were admitted to the ICU, 2.3% who underwent invasive mechanical ventilation, and 1.4% who died. Only 1.9% of the patients had a history of direct contact with wildlife. Among nonresidents of Wuhan, 72.3% had contact with residents of Wuhan, including 31.3% who had visited the city. The most common symptoms were fever (43.8% on admission and 88.7% during hospitalization) and cough (67.8%). Diarrhea was uncommon (3.8%). The median incubation period was 4 days (interquartile range, 2 to 7). On admission, ground-glass opacity was the most common radiologic finding on chest computed tomography (CT) (56.4%). No radiographic or CT abnormality was found in 157 of 877 patients (17.9%) with nonsevere disease and in 5 of 173 patients (2.9%) with severe disease. Lymphocytopenia was present in 83.2% of the patients on admission. CONCLUSIONS: During the first 2 months of the current outbreak, Covid-19 spread rapidly throughout China and caused varying degrees of illness. Patients often presented without fever, and many did not have abnormal radiologic findings. (Funded by the National Health Commission of China and others.).
FULL TEXT LINK
http://dx.doi.org/10.1056/NEJMoa2002032

RECORD 73
TITLE
  Risk Factors Associated with Acute Respiratory Distress Syndrome and Death in Patients with Coronavirus Disease 2019 Pneumonia in Wuhan, China
AUTHOR NAMES
  Wu C.;  Chen X.;  Cai Y.;  Xia J.;  Zhou X.;  Xu S.;  Huang H.;  Zhang L.;  Zhou X.;  Du C.;  Zhang Y.;  Song J.;  Wang S.;  Chao Y.;  Yang Z.;  Xu J.;  Zhou X.;  Chen D.;  Xiong W.;  Xu L.;  Zhou F.;  Jiang J.;  Bai C.;  Zheng J.;  Song Y.
SOURCE
  JAMA Internal Medicine (2020). Date of Publication: 2020
ABSTRACT
  Importance: Coronavirus disease 2019 (COVID-19) is an emerging infectious disease that was first reported in Wuhan, China, and has subsequently spread worldwide. Risk factors for the clinical outcomes of COVID-19 pneumonia have not yet been well delineated. Objective: To describe the clinical characteristics and outcomes in patients with COVID-19 pneumonia who developed acute respiratory distress syndrome (ARDS) or died. Design, Setting, and Participants: Retrospective cohort study of 201 patients with confirmed COVID-19 pneumonia admitted to Wuhan Jinyintan Hospital in China between December 25, 2019, and January 26, 2020. The final date of follow-up was February 13, 2020. Exposures: Confirmed COVID-19 pneumonia. Main Outcomes and Measures: The development of ARDS and death. Epidemiological, demographic, clinical, laboratory, management, treatment, and outcome data were also collected and analyzed. Results: Of 201 patients, the median age was 51 years (interquartile range, 43-60 years), and 128 (63.7%) patients were men. Eighty-four patients (41.8%) developed ARDS, and of those 84 patients, 44 (52.4%) died. In those who developed ARDS, compared with those who did not, more patients presented with dyspnea (50 of 84 [59.5%] patients and 30 of 117 [25.6%] patients, respectively [difference, 33.9%; 95% CI, 19.7%-48.1%]) and had comorbidities such as hypertension (23 of 84 [27.4%] patients and 16 of 117 [13.7%] patients, respectively [difference, 13.7%; 95% CI, 1.3%-26.1%]) and diabetes (16 of 84 [19.0%] patients and 6 of 117 [5.1%] patients, respectively [difference, 13.9%; 95% CI, 3.6%-24.2%]). In bivariate Cox regression analysis, risk factors associated with the development of ARDS and progression from ARDS to death included older age (hazard ratio [HR], 3.26; 95% CI 2.08-5.11; and HR, 6.17; 95% CI, 3.26-11.67, respectively), neutrophilia (HR, 1.14; 95% CI, 1.09-1.19; and HR, 1.08; 95% CI, 1.01-1.17, respectively), and organ and coagulation dysfunction (eg, higher lactate dehydrogenase [HR, 1.61; 95% CI, 1.44-1.79; and HR, 1.30; 95% CI, 1.11-1.52, respectively] and D-dimer [HR, 1.03; 95% CI, 1.01-1.04; and HR, 1.02; 95% CI, 1.01-1.04, respectively]). High fever (≥39 °C) was associated with higher likelihood of ARDS development (HR, 1.77; 95% CI, 1.11-2.84) and lower likelihood of death (HR, 0.41; 95% CI, 0.21-0.82). Among patients with ARDS, treatment with methylprednisolone decreased the risk of death (HR, 0.38; 95% CI, 0.20-0.72). Conclusions and Relevance: Older age was associated with greater risk of development of ARDS and death likely owing to less rigorous immune response. Although high fever was associated with the development of ARDS, it was also associated with better outcomes among patients with ARDS. Moreover, treatment with methylprednisolone may be beneficial for patients who develop ARDS.
FULL TEXT LINK
http://dx.doi.org/10.1001/jamainternmed.2020.0994

RECORD 74
TITLE
  Epidemiological characteristics of confirmed COVID-19 cases in Tianjin
AUTHOR NAMES
  Dong X.C.;  Li J.M.;  Bai J.Y.;  Liu Z.Q.;  Zhou P.H.;  Gao L.;  Li X.Y.;  Zhang Y.
SOURCE
  Zhonghua liu xing bing xue za zhi = Zhonghua liuxingbingxue zazhi (2020) 41:5 (638-642). Date of Publication: 13 Mar 2020
ABSTRACT
  Objective: To investigate the clinical and epidemiological characteristics of 135 confirmed cases of COVID-19 in Tianjin. Methods: The clinical and epidemiological data of 135 cases of COVID-19 in Tianjin were collected, and the data were analyzed with descriptive method. The factors influencing the severity of the illness were analyzed. Results: Among the 135 COVID-19 cases, 72 were males and 63 were females, the age of the cases was (48.62±16.83) years, and the case fatality rate was 2.22%. Local transmission caused 74.81% of the cases. A total of 33 clusters occurred, involving 85.92% of all COVID-19 cases. The median of the incubation period of COVID-19 was 6.50 days, the average generation interval was 5 days, and the household secondary transmission rate was 20.46%. Fever was the main symptom (78.63%), followed by cough (56.48%). Multivariate regression analysis indicated that age (OR=1.038, 95%CI: 1.010-1.167) and the number of chronic underlying diseases (OR=1.709, 95%CI: 1.052-2.777) were the risk factors of severe illness. Conclusions: Fever was the main symptom at the early phase of COVID-19 in Tianjin, and the local cluster cases accounted for high proportion in confirmed COVID-19 cases reported in Tianjin. Severe illness was prone to occur in people with old age and multi underlying diseases. Strict isolation of close contacts and intensive care of high-risk groups are the main measures to reduce the morbidity and case fatality of COVID-19.
FULL TEXT LINK
http://dx.doi.org/10.3760/cma.j.cn112338-20200221-00146

RECORD 75
TITLE
  Epidemiological investigation on a cluster epidemic of COVID-19 in a collective workplace in Tianjin
AUTHOR NAMES
  Zhang Y.;  Su X.;  Chen W.;  Fei C.N.;  Guo L.R.;  Wu X.L.;  Zhou N.;  Guo Y.T.;  Dong X.C.;  Zhao Y.;  Wang H.W.;  Pan Y.;  Zuo L.J.
SOURCE
  Zhonghua liu xing bing xue za zhi = Zhonghua liuxingbingxue zazhi (2020) 41:5 (649-653). Date of Publication: 12 Mar 2020
ABSTRACT
  Objective: To investigate and analysis the epidemiological characteristics of a cluster epidemic of COIVD-19 in a collective workplace in Tianjin, evduate the prevention and control measures based on limited evidence and experience in early period of COVID-19 epidemic. Methods: Descriptive research method was used to describe the distribution and other epidemiological characteristics of the cluster cases of COVID-19. Results: Since the onset of the first index case on January 15, ten confirmed COVID-19 cases had occurred in the workplace, and the epidemic had spread from the workplace to 4 families, infecting 7 family members. The median age of 17 cases was 55 (19-79) years. All the 10 employee cases were males, and in 7 family cases, 3 were males and 4 were females. Of the employee cases, 8 worked in CW workshop and 2 worked in administrative office building. The median exposure-onset interval of all the cases was 4 (0-12) days, and the median exposure-onset interval was 4.5 days in the employee cases and 4 days in the family cases. The median onset-medical care seeking interval was 4 days in the non-isolated cases, 2.5 days in the cases with home isolation after onset, and 0.5 day in the cases with home isolation before onset. Conclusion: The clustering of COVID-19 cases was observed in this workplace in Tianjin, which affected 4 families. In the early stage of the epidemic, accurate and rapid blocking and control measures can completely prevent the large-scale spread of COVID-19.
FULL TEXT LINK
http://dx.doi.org/10.3760/cma.j.cn112338-20200219-00121

RECORD 76
TITLE
  Coronavirus Disease 2019 (COVID-19): Emerging and Future Challenges for Dental and Oral Medicine
AUTHOR NAMES
  Meng L.;  Hua F.;  Bian Z.
SOURCE
  Journal of dental research (2020) (22034520914246). Date of Publication: 12 Mar 2020
ABSTRACT
  The epidemic of coronavirus disease 2019 (COVID-19), originating in Wuhan, China, has become a major public health challenge for not only China but also countries around the world. The World Health Organization announced that the outbreaks of the novel coronavirus have constituted a public health emergency of international concern. As of February 26, 2020, COVID-19 has been recognized in 34 countries, with a total of 80,239 laboratory-confirmed cases and 2,700 deaths. Infection control measures are necessary to prevent the virus from further spreading and to help control the epidemic situation. Due to the characteristics of dental settings, the risk of cross infection can be high between patients and dental practitioners. For dental practices and hospitals in areas that are (potentially) affected with COVID-19, strict and effective infection control protocols are urgently needed. This article, based on our experience and relevant guidelines and research, introduces essential knowledge about COVID-19 and nosocomial infection in dental settings and provides recommended management protocols for dental practitioners and students in (potentially) affected areas.
FULL TEXT LINK
http://dx.doi.org/10.1177/0022034520914246

RECORD 77
TITLE
  Genomic analysis of a 2019-nCoV strain in the first COVID-19 patient found in Hangzhou, Zhejiang, China
AUTHOR NAMES
  Yu H.;  Wang X.C.;  Li J.;  Qian X.;  Yu X.F.;  Sun Z.;  Chen J.F.;  Kao Q.J.;  Wang H.Q.;  Pan J.C.
SOURCE
  Zhonghua yu fang yi xue za zhi [Chinese journal of preventive medicine] (2020) 54 (E026). Date of Publication: 15 Mar 2020
ABSTRACT
  Objective: To understand the viral genomic characteristics of a 2019-nCoV strain in the first COVID-19 patient found in Hangzhou, China. Methods: Viral RNA was extracted in throat swab and sputum sample of the patient and was performed real-time reverse transcription PCR detection and obtained viral genome by high-throughput sequencing method. Phylogenetic analysis was conducted using 29 2019-nCoV genomes and 30 β-coronavirus genomes deposited in NCBI GenBank. Fifteen genomes from Wuhan were grouped by mutation sites and others were identified by Wuhan’s or specific mutation sites. Results: A 29 833 bp length genome of the first 2019-nCoV strain in Hangzhou was obtained, covering full length of the coding regions of coronavirus. Phylogenetic analysis showed that the genome was closest to the genome of a bat SARS-like coronavirus strain RaTG13 with an identity of 96.11% (28 666/29 826). Among the genes between two genomes, E genes were highly conserved (99.56%), while S genes had lowest identity (92.87%), suggesting that S gene was of a faster evolutionary rate. The genome sequence similarities among 29 strains from China (Hangzhou, Wuhan, and Shenzhen), Japan, USA, and Finland, were all more than 99.9%; however, some single nucleotide polymorphisms were identified in some strains. Conclusion: The genome of Hangzhou 2019-nCoV strain was very close to the genomes of strains from other cities in China and overseas collected at early epidemic phase. The 2019-nCoV genome sequencing method used in this paper provides an useful tool for monitoring variation of viral genes.
FULL TEXT LINK
http://dx.doi.org/10.3760/cma.j.cn112150-20200217-00128

RECORD 78
TITLE
  Impact of complicated myocardial injury on the clinical outcome of severe or critically ill COVID-19 patients
AUTHOR NAMES
  He X.W.;  Lai J.S.;  Cheng J.;  Wang M.W.;  Liu Y.J.;  Xiao Z.C.;  Xu C.;  Li S.S.;  Zeng H.S.
SOURCE
  Zhonghua xin xue guan bing za zhi (2020) 48 (E011). Date of Publication: 15 Mar 2020
ABSTRACT
  Objective: To analyze the clinical characteristics of the severe or critically ill patients with novel coronavirus pneumonia (COVID-19), and evaluate the impact of complicated myocardial injury on the prognosis of these patients. Methods: A retrospective study was conducted in 54 patients who admitted to Tongji hospital from February 3, 2020 to February 24, 2020 and met the criteria of severe or critical conditions of COVID-19. The clinical characteristics and hospital mortality rate were analyzed and compared between the patients with or without myocardial injury, which was defined with 3 times higher serum cardiac troponin value. Results: The median age of the 54 patients was 68 (59.8, 74.3) years. Among all the patients, 24 (44.4%) patients were complicated with hypertension, 13 (24.1%) with diabetes, 8 (14.8%) with coronary heart disease, and 3 (5.6%) with previous cerebral infarction. During hospitalization, 24 (44.4%) of the patients were complicated with myocardial injury and 26 (48.1%) patients died in hospital. In-hospital mortality was significantly higher in patients with myocardial injury than in patients without myocardial injury (14 (60.9%) vs. 8 (25.8%), P=0.013). Moreover, the levels of C-reactive protein (153.6 (80.3, 240.7) ng/L vs. 49.8 (15.9, 101.9) ng/L) and N-terminal pro-B-type natriuretic peptide (852.0 (400.0, 2 315.3) ng/L vs. 197.0 (115.3, 631.0) ng/L) were significantly higher than patients without myocardial injury (all P<0.01). Conclusions: Prevalence of myocardial injury is high among severe or critically ill COVID-19 patients. Severe or critically ill COVID-19 patients with myocardial injury face a significantly higher risk of in-hospital mortality. The study suggests that it is important to monitor and manage the myocardial injury during hospitalization for severe or critically ill COVID-19 patients.
FULL TEXT LINK
http://dx.doi.org/10.3760/cma.j.cn112148-20200228-00137

RECORD 79
TITLE
  Clinical characteristics of 24 asymptomatic infections with COVID-19 screened among close contacts in Nanjing, China
AUTHOR NAMES
  Hu Z.;  Song C.;  Xu C.;  Jin G.;  Chen Y.;  Xu X.;  Ma H.;  Chen W.;  Lin Y.;  Zheng Y.;  Wang J.;  Hu Z.;  Yi Y.;  Shen H.
SOURCE
  Science China. Life sciences (2020). Date of Publication: 4 Mar 2020
ABSTRACT
  Previous studies have showed clinical characteristics of patients with the 2019 novel coronavirus disease (COVID-19) and the evidence of person-to-person transmission. Limited data are available for asymptomatic infections. This study aims to present the clinical characteristics of 24 cases with asymptomatic infection screened from close contacts and to show the transmission potential of asymptomatic COVID-19 virus carriers. Epidemiological investigations were conducted among all close contacts of COVID-19 patients (or suspected patients) in Nanjing, Jiangsu Province, China, from Jan 28 to Feb 9, 2020, both in clinic and in community. Asymptomatic carriers were laboratory-confirmed positive for the COVID-19 virus by testing the nucleic acid of the pharyngeal swab samples. Their clinical records, laboratory assessments, and chest CT scans were reviewed. As a result, none of the 24 asymptomatic cases presented any obvious symptoms while nucleic acid screening. Five cases (20.8%) developed symptoms (fever, cough, fatigue, etc.) during hospitalization. Twelve (50.0%) cases showed typical CT images of ground-glass chest and 5 (20.8%) presented stripe shadowing in the lungs. The remaining 7 (29.2%) cases showed normal CT image and had no symptoms during hospitalization. These 7 cases were younger (median age: 14.0 years; P=0.012) than the rest. None of the 24 cases developed severe COVID-19 pneumonia or died. The median communicable period, defined as the interval from the first day of positive nucleic acid tests to the first day of continuous negative tests, was 9.5 days (up to 21 days among the 24 asymptomatic cases). Through epidemiological investigation, we observed a typical asymptomatic transmission to the cohabiting family members, which even caused severe COVID-19 pneumonia. Overall, the asymptomatic carriers identified from close contacts were prone to be mildly ill during hospitalization. However, the communicable period could be up to three weeks and the communicated patients could develop severe illness. These results highlighted the importance of close contact tracing and longitudinally surveillance via virus nucleic acid tests. Further isolation recommendation and continuous nucleic acid tests may also be recommended to the patients discharged.
FULL TEXT LINK
http://dx.doi.org/10.1007/s11427-020-1661-4

RECORD 80
TITLE
  Clinical characteristics and influencing factors of patients with novel coronavirus pneumonia combined with liver injury in Shaanxi region
AUTHOR NAMES
  Yao N.;  Wang S.N.;  Lian J.Q.;  Sun Y.T.;  Zhang G.F.;  Kang W.Z.;  Kang W.
SOURCE
  Zhonghua gan zang bing za zhi = Zhonghua ganzangbing zazhi = Chinese journal of hepatology (2020) 28 (E003). Date of Publication: 10 Mar 2020
ABSTRACT
  Objective: To understand the clinical characteristics, change of liver function, influencing factors and prognosis in hospitalized patients with coronavirus disease-19 (COVID-19) combined with liver injury. Methods: The general conditions, biochemical indicators of liver, blood clotting mechanism, routine blood test, UGT1A1 * 28 gene polymorphism and other data of 40 cases with COVID-19 admitted to the isolation ward of Tangdu Hospital were retrospectively analyzed. The clinical characteristics, influencing factors and prognosis of liver injury in patients with liver injury group and those with normal liver function group were compared. The mean of two samples in univariate analysis was compared by t-test and analysis of variance. The counting data was measured by χ(2) tests. The non-normal distribution measurement data were described by the median, and the non-parametric test was used. Statistically significant influencing factors were used as the independent variables in univariate analysis. Multiple logistic regression analysis was used to analyze the main influencing factors of liver injury. Results: Of the 40 cases, 25 were male (62.5%) and 15 were female (37.5%), aged 22 to 83 (53.87 ± 15.84) years. Liver injury was occurred in 22 cases (55%) during the course of the disease. Alanine aminotransferase (ALT) and aspartate aminotransferase (AST) level was initially increased (4.4 to 3.5 times of the normal value) along with decrease of albumin in the second week, and the difference was statistically significant (P < 0.001). Ten cases (43.5%) had highest abnormal total blood bilirubin (54.1 μmol/ L). There was no correlation between the increase in transaminase and the increase in total blood bilirubin (R = -0.006, P = 0.972). Three cases had prothrombin activity (PTA) of ≤ 50%, 10 cases had elevated FDP, and 13 cases had elevated D-dimer, all of whom were severe or critically ill. Liver function injury was more likely to occur in patients who used many types of drugs and large amounts of hormones (P = 0.002, P = 0.031), and there was no correlation with the TA6TA7 mutation in the UGT1A1 * 28 gene locus. Multiple regression analysis showed that the occurrence of liver injury was only related to critical illness. The liver function of all patients had recovered within one week after conventional liver protection treatment. Conclusion: COVID-19 combined with liver function injury may be due to the slight elevation of transaminase, mostly around the second week of the disease course. Severe patients have a higher proportion of liver injury, and critical type is an independent risk factor for liver injury.
FULL TEXT LINK
http://dx.doi.org/10.3760/cma.j.cn501113-20200226-00070

RECORD 81
TITLE
  Comparison of epidemic characteristics between SARS in2003 and COVID-19 in 2020 in Guangzhou
AUTHOR NAMES
  Li X.Q.;  Cai W.F.;  Huang L.F.;  Chen C.;  Liu Y.F.;  Zhang Z.B.;  Yuan J.;  Li T.G.;  Wang M.
SOURCE
  Zhonghua liu xing bing xue za zhi = Zhonghua liuxingbingxue zazhi (2020) 41:5 (634-637). Date of Publication: 11 Mar 2020
ABSTRACT
  Objective: By analyzing the epidemic characteristics and related indicators of SARS (2003) and COVID-19(2020), to explore the reasons for the similarities and differences of the two epidemics, so as to provide reference for epidemic prevention and control. Methods: The general situation, clinical classification, activity history, contact history, family members’ contact and incidence of the two infectious diseases in Guangzhou were collected and used to analyze the time characteristics, occupational characteristics, age characteristics and other key indicators of the two diseases, including the number of cases, composition ratio (%), mean, median, crude mortality, etc. Results: A total of 1 072 cases of SARS (2003) were included in the study. 353 of which were severe cases with the incidence of 30.13%. 43 cases of death were reported with a mortality rate of 4.01%. The average age was 46 years old, and 26.31% of the cases were medical staff. The interval time between first report to continuous zero reports was 129 days. As to COVID-19 (2020), a total of 346 cases were included. 58 of which were severe cases with the incidence of 16.67%. One case of death was reported with a mortality rate of 0.29%. The average age was 38 years old, and no hospital infection among medical staff was reported. The interval time between first report to continuous zero reports was 35 days. Conclusions: The prevention and control strategies for COVID-19 (2010) are more effective compared to that of SARS (2003), and the emergency response procedures are worth to be evaluated and summarized.
FULL TEXT LINK
http://dx.doi.org/10.3760/cma.j.cn112338-20200228-00209

RECORD 82
TITLE
  2019 novel coronavirus patients’ clinical characteristics, discharge rate and fatality rate of meta-analysis
AUTHOR NAMES
  Li L.-Q.;  Huang T.;  Wang Y.-Q.;  Wang Z.-P.;  Liang Y.;  Huang T.-B.;  Zhang H.-Y.;  Sun W.-M.;  Wang Y.-P.
SOURCE
  Journal of medical virology (2020). Date of Publication: 12 Mar 2020
ABSTRACT
  BACKGROUND: To study the clinical data, discharge rate, and fatality rate of COVID-19 patients for clinical help. METHODS: The clinical data of COVID-19 patients from December 2019 to February 2020 were retrieved from four databases. We statistically analyzed the clinical symptoms and laboratory results of COVID-19 patients and explained the discharge rate, fatality rate with a single-arm meta-analysis. RESULTS: The available data of 1994 patients in 10 literatures were included in our study. The main clinical symptoms of COVID-19 patients were fever (88.5%), cough (68.6%), myalgia or fatigue (35.8%), expectoration (28.2%), dyspnea (21.9%). Minor symptoms include headache or dizziness: (12.1%) diarrhea (4.8%), nausea, and vomiting (3.9%). The results of laboratory results showed that the lymphocytopenia (64.5%), increase of CRP (44.3%), increase of LDH (28.3%), and leukocytopenia (29.4%) were more common. CONCLUSIONS: The results of single-arm meta-analysis showed that: the male took a larger percentage in the gender distribution of COVID-19 patients 60%[95%CI (0.54,0.65)], the discharge rate of COVID-19 patients was 42%[95%CI (0.29,0.55)], and the fatality rate was 7%[95%CI (0.04,0.10)]. This article is protected by copyright. All rights reserved.
FULL TEXT LINK
http://dx.doi.org/10.1002/jmv.25757

RECORD 83
TITLE
  Clinical and CT features in pediatric patients with COVID-19 infection: Different points from adults
AUTHOR NAMES
  Xia W.;  Shao J.;  Guo Y.;  Peng X.;  Li Z.;  Hu D.
SOURCE
  Pediatric Pulmonology (2020). Date of Publication: 2020
ABSTRACT
  Purpose: To discuss the different characteristics of clinical, laboratory, and chest computed tomography (CT) in pediatric patients from adults with 2019 novel coronavirus (COVID-19) infection. Methods: The clinical, laboratory, and chest CT features of 20 pediatric inpatients with COVID-19 infection confirmed by pharyngeal swab COVID-19 nucleic acid test were retrospectively analyzed during 23 January and 8 February 2020. The clinical and laboratory information was obtained from inpatient records. All the patients were undergone chest CT in our hospital. Results: Thirteen pediatric patients (13/20, 65%) had an identified history of close contact with COVID-19 diagnosed family members. Fever (12/20, 60%) and cough (13/20, 65%) were the most common symptoms. For laboratory findings, procalcitonin elevation (16/20, 80%) should be pay attention to, which is not common in adults. Coinfection (8/20, 40%) is common in pediatric patients. A total of 6 patients presented with unilateral pulmonary lesions (6/20, 30%), 10 with bilateral pulmonary lesions (10/20, 50%), and 4 cases showed no abnormality on chest CT (4/20, 20%). Consolidation with surrounding halo sign was observed in 10 patients (10/20, 50%), ground-glass opacities were observed in 12 patients (12/20, 60%), fine mesh shadow was observed in 4 patients (4/20, 20%), and tiny nodules were observed in 3 patients (3/20, 15%). Conclusion: Procalcitonin elevation and consolidation with surrounding halo signs were common in pediatric patients which were different from adults. It is suggested that underlying coinfection may be more common in pediatrics, and the consolidation with surrounding halo sign which is considered as a typical sign in pediatric patients.
FULL TEXT LINK
http://dx.doi.org/10.1002/ppul.24718

RECORD 84
TITLE
  Epidemiological investigation of a family clustering of COVID-19
AUTHOR NAMES
  Guan Q.;  Liu M.;  Zhuang Y.J.;  Yuan Y.;  Wang S.S.;  Li J.;  Chen Z.;  Yang X.L.;  Tang Z.R.;  Jia H.J.;  Ma J.Y.;  Wang X.X.;  Li J.;  Zhuang Y.;  He Y.
SOURCE
  Zhonghua liu xing bing xue za zhi = Zhonghua liuxingbingxue zazhi (2020) 41 (629-633). Date of Publication: 9 Mar 2020
ABSTRACT
  Objective: To investigate the epidemiological characteristics of a family clustering of COVID-19. Methods: Field epidemiological survey was conducted. Result: Case 1 of the long-term residents from Hubei province was the source of infection of this family clustering. There were 6 cases (from case 2 to case 7) infected in the whole incubation period. The incubation period was more than 14 days for 3 of the second-generation cases. Routes of transmission include respiratory droplets (from case 1 transmitted to case 6, from case 1 to her family members) and closecontact (from case 1 to other cases in her family). All the age groups were generally susceptible, while elderly were easier to progress to critically ill. Besides respiratory symptoms, there were also gastrointestinal symptoms, of which diarrhea was the most common one. Conclusion: Family clustering had been an important part for COVID-19 cases.
FULL TEXT LINK
http://dx.doi.org/10.3760/cma.j.cn112338-20200223-00152

RECORD 85
TITLE
  The Incubation Period of Coronavirus Disease 2019 (COVID-19) From Publicly Reported Confirmed Cases: Estimation and Application
AUTHOR NAMES
  Lauer S.A.;  Grantz K.H.;  Bi Q.;  Jones F.K.;  Zheng Q.;  Meredith H.R.;  Azman A.S.;  Reich N.G.;  Lessler J.
SOURCE
  Annals of internal medicine (2020). Date of Publication: 10 Mar 2020
ABSTRACT
  Background: A novel human coronavirus, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), was identified in China in December 2019. There is limited support for many of its key epidemiologic features, including the incubation period for clinical disease (coronavirus disease 2019 [COVID-19]), which has important implications for surveillance and control activities. Objective: To estimate the length of the incubation period of COVID-19 and describe its public health implications. Design: Pooled analysis of confirmed COVID-19 cases reported between 4 January 2020 and 24 February 2020. Setting: News reports and press releases from 50 provinces, regions, and countries outside Wuhan, Hubei province, China. Participants: Persons with confirmed SARS-CoV-2 infection outside Hubei province, China. Measurements: Patient demographic characteristics and dates and times of possible exposure, symptom onset, fever onset, and hospitalization. Results: There were 181 confirmed cases with identifiable exposure and symptom onset windows to estimate the incubation period of COVID-19. The median incubation period was estimated to be 5.1 days (95% CI, 4.5 to 5.8 days), and 97.5% of those who develop symptoms will do so within 11.5 days (CI, 8.2 to 15.6 days) of infection. These estimates imply that, under conservative assumptions, 101 out of every 10 000 cases (99th percentile, 482) will develop symptoms after 14 days of active monitoring or quarantine. Limitation: Publicly reported cases may overrepresent severe cases, the incubation period for which may differ from that of mild cases. Conclusion: This work provides additional evidence for a median incubation period for COVID-19 of approximately 5 days, similar to SARS. Our results support current proposals for the length of quarantine or active monitoring of persons potentially exposed to SARS-CoV-2, although longer monitoring periods might be justified in extreme cases. Primary Funding Source: U.S. Centers for Disease Control and Prevention, National Institute of Allergy and Infectious Diseases, National Institute of General Medical Sciences, and Alexander von Humboldt Foundation.
FULL TEXT LINK
http://dx.doi.org/10.7326/M20-0504

RECORD 86
TITLE
  Erratum: Department of Error (The Lancet (2020) 395(10226) (809–815), (S0140673620303603), (10.1016/S0140-6736(20)30360-3))
SOURCE
  The Lancet (2020) 395:10229 (1038). Date of Publication: 28 Mar 2020
ABSTRACT
  Chen H, Guo J, Wang C, et al. Clinical characteristics and intrauterine vertical transmission potential of COVID-19 infection in nine pregnant women: a retrospective review of medical records. Lancet 2020; 395: 809–15—In table 1 of this Article, the AST value for patient 4 was 76 U/L. And in the figure the chest CT images and descriptions for patient 6 and patient 7 were out of order: the CT images and figure legend have been updated accordingly. These corrections have been made to the online version as of March 23, 2020.
FULL TEXT LINK
http://dx.doi.org/10.1016/S0140-6736(20)30606-1

RECORD 87
TITLE
  The preliminary analysis on the characteristics of the cluster for the Corona Virus Disease
AUTHOR NAMES
  Yang H.Y.;  Xu J.;  Li Y.;  Liang X.;  Jin Y.F.;  Chen S.Y.;  Zhang R.G.;  Zhang W.D.;  Duan G.C.
SOURCE
  Zhonghua liu xing bing xue za zhi = Zhonghua liuxingbingxue zazhi (2020) 41 (623-628). Date of Publication: 8 Mar 2020
ABSTRACT
  Since December 2019, Corona Virus Disease (COVID-19), a new emerging infection disease occurred in Wuhan, has spread in 27 countries and regions. The clusters of many cases were reported with the epidemic progresses. We collected currently available information for 377 COVID-19 clusters (1 719 cases), excluded the hospital clusters and Hubei cases, during the period from January 1, 2020 to February 20, 2020. There were 297 family clusters (79%), case median 4; 39 clusters of dining (10%), case median 5; 23 clusters of shopping malls or supermarkets (6%), case median 13; 12 clusters of work units (3%), case median 6, and 6 clusters of transportation. We selected 325 cases to estimate the incubation period and found its range is 1 to 20 days, median was 7 days, and mode was 4 days. The analysis of the epidemic situation in a department store in China indicates that there is a possibility of patients as the source of infection during the incubation period of the epidemic. From February 5, 2020 to February 21, 2020, 634 persons were infected in the Diamond Princess Liner. All persons are susceptible to SARS-CoV-2. The older, patients during the incubation period and the worse environment may be the cause of the cases rising. The progress of the two typical outbreaks clearly demonstrates the spread of the early cases in Wuhan. Whatever happens, screening and isolating close contacts remains essential except for clinical treatment during the epidemic. Especially for the healthy people in the epidemic area, isolation is the key.
FULL TEXT LINK
http://dx.doi.org/10.3760/cma.j.cn112338-20200223-00153

RECORD 88
TITLE
  Screening and management of asymptomatic infection of corona virus disease 2019 (COVID-19)
AUTHOR NAMES
  Hu Z.B.;  Ci C.
SOURCE
  Zhonghua yu fang yi xue za zhi [Chinese journal of preventive medicine] (2020) 54 (E025). Date of Publication: 8 Mar 2020
ABSTRACT
  To date, the controlling of outbreak of corona virus disease 2019 (COVID-19) has entered into a critical period in China. Recently, work resumption and public place is planning to open outside of Hubei, suggesting an uncertain and complex development of the epidemic in the next stage. Few days ago, we conducted a study on the epidemiological and clinical characteristics of asymptomatic infections of COVID-19, and found them might be the infection source. We believe that the findings are critical for developing public health intervention strategies for controlling COVID-19 infection in the future. Screening among the high-risk population and improving the sensitivity of measurement may contribute to the detection and management of asymptomatic infection.
FULL TEXT LINK
http://dx.doi.org/10.3760/cma.j.cn112150-20200229-00220

RECORD 89
TITLE
  Clinical characteristics and imaging manifestations of the 2019 novel coronavirus disease (COVID-19):A multi-center study in Wenzhou city, Zhejiang, China
AUTHOR NAMES
  Yang W.;  Cao Q.;  Qin L.;  Wang X.;  Cheng Z.;  Pan A.;  Dai J.;  Sun Q.;  Zhao F.;  Qu J.;  Yan F.
SOURCE
  Journal of Infection (2020) 80:4 (388-393). Date of Publication: 1 Apr 2020
ABSTRACT
  Background: Little is known about COVID-19 outside Hubei. The aim of this paper was to describe the clinical characteristics and imaging manifestations of hospitalized patients with confirmed COVID-19 infection in Wenzhou, Zhejiang, China. Methods: In this retrospective cohort study, 149 RT-PCR confirmed positive patients were consecutively enrolled from January 17th to February 10th, 2020 in three tertiary hospitals of Wenzhou. Outcomes were followed up until Feb 15th, 2020. Findings: A total of 85 patients had Hubei travel/residence history, while another 49 had contact with people from Hubei and 15 had no traceable exposure history to Hubei. Fever, cough and expectoration were the most common symptoms, 14 patients had decreased oxygen saturation, 33 had leukopenia, 53 had lymphopenia, and 82 had elevated C-reactive protein. On chest computed tomography (CT), lung segments 6 and 10 were mostly involved. A total of 287 segments presented ground glass opacity, 637 presented mixed opacity and 170 presented consolidation. Lesions were more localized in the peripheral lung with a patchy form. No significant difference was found between patients with or without Hubei exposure history. Seventeen patients had normal CT on admission of these, 12 had negative findings even10 days later. Interpretation: Most patients presented with a mild infection in our study. The imaging pattern of multifocal peripheral ground glass or mixed opacity with predominance in the lower lung is highly suspicious of COVID-19 in the first week of disease onset. Nevetheless, some patients can present with a normal chest finding despite testing positive for COVID-19. Funding: We did not receive any fundings.
FULL TEXT LINK
http://dx.doi.org/10.1016/j.jinf.2020.02.016

RECORD 90
TITLE
  Comparison of heart failure and 2019 novel coronavirus pneumonia in chest CT features and clinical characteristics
AUTHOR NAMES
  Zhu Z.W.;  Tang J.J.;  Chai X.P.;  Fang Z.F.;  Liu Q.M.;  Hu X.Q.;  Xu D.Y.;  Tang L.;  Tai S.;  Wu Y.Z.;  Zhou S.H.
SOURCE
  Zhonghua xin xue guan bing za zhi (2020) 48 (E007). Date of Publication: 4 Mar 2020
ABSTRACT
  Objective: To identify the characteristics including clinical features and pulmonary computed tomography (CT) features of heart failure and novel coronavirus pneumonia(COVID-19). Methods: This study was a retrospective study. A total of 7 patients with Heart failure and 12 patients with COVID-19 in the Second Xiangya Hospital of Central South University between December 1, 2019 and February 15, 2020 were enrolled. The baseline clinical and imaging features of the two groups were statistically analyzed. Results: There was no significant difference in age and sex between the two groups, but the incidence of epidemiological contact history, fever or respiratory symptoms in the COVID-19 group was significantly higher than that in the heart failure group (12/12 vs. 2/7, P=0.001; 12/12 vs. 4/7, P<0.001). While the proportion of cardiovascular diseases and impaired cardiac function was significantly less than that of the heart failure group(2/12 vs.7/7, P<0.001; 0/12 vs.7/7, P<0.001). For imaging features, both groups had ground-glass opacity and thickening of interlobular septum, but the ratio of central and gradient distribution was higher in patients with heart failure than that in patients with COVID-19 (4/7 vs. 1/12, P=0.04). In heart failure group, the ratio of the expansion of small pulmonary veins was also higher (3/7 vs. 0, P=0.013), and the lung lesions can be significantly improved after effective anti-heart failure treatment. Besides, there are more disease with rounded morphology in COVID-19 (9/12 vs. 2/7, P=0.048) . Conclusions: More patients with COVID-19 have epidemiological history and fever or respiratory symptoms. There are significant differences in chest CT features, such as enlargement of pulmonary veins, lesions distribution and morphology between heart failure and COVID-19.
FULL TEXT LINK
http://dx.doi.org/10.3760/cma.j.cn112148-20200218-00093

RECORD 91
TITLE
  Relation Between Chest CT Findings and Clinical Conditions of Coronavirus Disease (COVID-19) Pneumonia: A Multicenter Study
AUTHOR NAMES
  Zhao W.;  Zhong Z.;  Xie X.;  Yu Q.;  Liu J.
SOURCE
  AJR. American journal of roentgenology (2020) (1-6). Date of Publication: 3 Mar 2020
ABSTRACT
  OBJECTIVE. The increasing number of cases of confirmed coronavirus disease (COVID-19) in China is striking. The purpose of this study was to investigate the relation between chest CT findings and the clinical conditions of COVID-19 pneumonia. MATERIALS AND METHODS. Data on 101 cases of COVID-19 pneumonia were retrospectively collected from four institutions in Hunan, China. Basic clinical characteristics and detailed imaging features were evaluated and compared between two groups on the basis of clinical status: nonemergency (mild or common disease) and emergency (severe or fatal disease). RESULTS. Patients 21-50 years old accounted for most (70.2%) of the cohort, and five (5.0%) patients had disease associated with a family outbreak. Most patients (78.2%) had fever as the onset symptom. Most patients with COVID-19 pneumonia had typical imaging features, such as ground-glass opacities (GGO) (87 [86.1%]) or mixed GGO and consolidation (65 [64.4%]), vascular enlargement in the lesion (72 [71.3%]), and traction bronchiectasis (53 [52.5%]). Lesions present on CT images were more likely to have a peripheral distribution (88 [87.1%]) and bilateral involvement (83 [82.2%]) and be lower lung predominant (55 [54.5%]) and multifocal (55 [54.5%]). Patients in the emergency group were older than those in the non-emergency group. Architectural distortion, traction bronchiectasis, and CT involvement score aided in evaluation of the severity and extent of the disease. CONCLUSION. Patients with confirmed COVID-19 pneumonia have typical imaging features that can be helpful in early screening of highly suspected cases and in evaluation of the severity and extent of disease. Most patients with COVID-19 pneumonia have GGO or mixed GGO and consolidation and vascular enlargement in the lesion. Lesions are more likely to have peripheral distribution and bilateral involvement and be lower lung predominant and multifocal. CT involvement score can help in evaluation of the severity and extent of the disease.
FULL TEXT LINK
http://dx.doi.org/10.2214/AJR.20.22976

RECORD 92
TITLE
  Characteristics of and Important Lessons from the Coronavirus Disease 2019 (COVID-19) Outbreak in China: Summary of a Report of 72314 Cases from the Chinese Center for Disease Control and Prevention
AUTHOR NAMES
  Wu Z.;  McGoogan J.M.
SOURCE
  JAMA – Journal of the American Medical Association (2020). Date of Publication: 2020
FULL TEXT LINK
http://dx.doi.org/10.1001/jama.2020.2648

RECORD 93
TITLE
  Investigation and analysis on characteristics of a cluster of COVID-19 associated with exposure in a department store in Tianjin
AUTHOR NAMES
  Wu W.S.;  Li Y.G.;  Wei Z.F.;  Zhou P.H.;  Lyu L.K.;  Zhang G.P.;  Zhao Y.;  He H.Y.;  Li X.Y.;  Gao L.;  Zhang X.M.;  Liu H.;  Zhou N.;  Guo Y.;  Zhang X.M.;  Zhang D.;  Liu J.;  Zhang Y.
SOURCE
  Zhonghua liu xing bing xue za zhi = Zhonghua liuxingbingxue zazhi (2020) 41:4 (489-493). Date of Publication: 5 Mar 2020
ABSTRACT
  Objective: To describe the epidemiological characteristics of a cluster of COVID-19 cases reported in Baodi district of Tianjin as of 18 February, 2020, which might be associated with the exposure in a local department store, and provide suggestions for prevention and control strategy development. Methods: The basic characteristics, time and area distributions, clinical manifestations, epidemiological history and transmission mode of the COVID-19 cases associated with the department store exposure were analyzed. Results: A total of 40 COVID-19 cases were associated with the department store exposure, accounting for 75.47% of the total confirmed cases (53 cases) reported in Baodi district. The cases were mainly at the age of 60 years or older (35.00%) and farmers (40.00%). The main clinical manifestations included fever (95.00%), cough (35.00%), and diarrhea (15.00%). The proportion of confirmed severe cases was 32.50%. The incidence curve showed that the incidence peak occurred on 31 January, 2020. Among the 40 cases, 6(15.00%) were department store employees, 19(47.50%) were customers and 15(37.50%) were close contacts (secondary cases). The first case occurred on 21 January, 2020, this case was a department store employee who had a purchasing history at whole sale markets in other provinces and cities before the onset, and 3 employees were still on duty after symptom onsets. The median of the incubation period of customer cases was 6 days, and the median of the interval between onset and medical treatment of customer cases was 7 days. Conclusion: This was a cluster epidemic of COVID-19, which might be associated with the exposure in the department store. By now, the current prevention and control measures have achieved satisfied effects.
FULL TEXT LINK
http://dx.doi.org/10.3760/cma.j.cn112338-20200221-00139

RECORD 94
TITLE
  Characteristics, causes, diagnosis and treatment of coagulation dysfunction in patients with COVID-19
AUTHOR NAMES
  Mei H.;  Hu Y.
SOURCE
  Zhonghua xue ye xue za zhi = Zhonghua xueyexue zazhi (2020) 41 (E002). Date of Publication: 5 Mar 2020
FULL TEXT LINK
http://dx.doi.org/10.3760/cma.j.issn.0253-2727.2020.0002

RECORD 95
TITLE
  Clinical and computed tomographic imaging features of novel coronavirus pneumonia caused by SARS-CoV-2
AUTHOR NAMES
  Xu Y.-H.;  Dong J.-H.;  An W.-M.;  Lv X.-Y.;  Yin X.-P.;  Zhang J.-Z.;  Dong L.;  Ma X.;  Zhang H.-J.;  Gao B.-L.
SOURCE
  Journal of Infection (2020) 80:4 (394-400). Date of Publication: 1 Apr 2020
ABSTRACT
  Purpose: To investigate the clinical and imaging characteristics of computed tomography (CT) in novel coronavirus pneumonia (NCP) caused by SARS-CoV-2. Materials and methods: A retrospective analysis was performed on the imaging findings of patients confirmed with COVID-19 pneumonia who had chest CT scanning and treatment after disease onset. The clinical and imaging data were analyzed. Results: Fifty patients were enrolled, including mild type in nine, common in 28, severe in 10 and critically severe in the rest three. Mild patients (29 years) were significantly (P<0.03) younger than either common (44.5 years) or severe (54.7) and critically severe (65.7 years) patients, and common patients were also significantly (P<0.03) younger than severe and critically severe patients. Mild patients had low to moderate fever (<39.1 °C), 49 (98%) patients had normal or slightly reduced leukocyte count, 14 (28%) had decreased counts of lymphocytes, and 26 (52%) patients had increased C-reactive protein. Nine mild patients were negative in CT imaging. For all the other types of NCP, the lesion was in the right upper lobe in 30 cases, right middle lobe in 22, right lower lobe in 39, left upper lobe in 33 and left lower lobe in 36. The lesion was primarily located in the peripheral area under the pleura with possible extension towards the pulmonary hilum. Symmetrical lesions were seen in 26 cases and asymmetrical in 15. The density of lesion was mostly uneven with ground glass opacity as the primary presentation accompanied by partial consolidation and fibrosis. Conclusion: CT imaging presentations of NCP are mostly patchy ground glass opacities in the peripheral areas under the pleura with partial consolidation which will be absorbed with formation of fibrotic stripes if improved. CT scanning provides important bases for early diagnosis and treatment of NCP.
FULL TEXT LINK
http://dx.doi.org/10.1016/j.jinf.2020.02.017

RECORD 96
TITLE
  Clinical characteristics and outcomes of 112 cardiovascular disease patients infected by 2019-nCoV
AUTHOR NAMES
  Peng Y.D.;  Meng K.;  Guan H.Q.;  Leng L.;  Zhu R.R.;  Wang B.Y.;  He M.A.;  Cheng L.X.;  Huang K.;  Zeng Q.T.
SOURCE
  Zhonghua xin xue guan bing za zhi (2020) 48 (E004). Date of Publication: 2 Mar 2020
ABSTRACT
  Objective: To explore the clinical characteristics and prognosis of the new coronavirus 2019-nCoV patients combined with cardiovascular disease (CVD). Methods: A retrospective analysis was performed on 112 COVID-19 patients with CVD admitted to the western district of Union Hospital in Wuhan, from January 20, 2020 to February 15, 2020. They were divided into critical group (ICU, n=16) and general group (n=96) according to the severity of the disease and patients were followed up to the clinical endpoint. The observation indicators included total blood count, C-reactive protein (CRP), arterial blood gas analysis, myocardial injury markers, coagulation function, liver and kidney function, electrolyte, procalcitonin (PCT), B-type natriuretic peptide (BNP), blood lipid, pulmonary CT and pathogen detection. Results: Compared with the general group, the lymphocyte count (0.74×10(9) (0.34×10(9), 0.94×10(9))/L vs. 0.99×10(9) (0.71×10(9), 1.29×10(9))/L, P=0.03) was extremely lower in the critical group, CRP (106.98 (81.57, 135.76) mg/L vs. 34.34 (9.55,76.54) mg/L, P<0.001) and PCT (0.20 (0.15,0.48) μg/L vs. 0.11 (0.06,0.20)μg/L, P<0.001) were significantly higher in the critical group. The BMI of the critical group was significantly higher than that of the general group (25.5 (23.0, 27.5) kg/m(2) vs. 22.0 (20.0, 24.0) kg/m(2), P=0.003). Patients were further divided into non-survivor group (17, 15.18%) group and survivor group (95, 84.82%). Among the non-survivors, there were 88.24% (15/17) patients with BMI> 25 kg/m(2), which was significantly higher than that of survivors (18.95% (18/95), P<0.001). Compared with the survived patients, oxygenation index (130 (102, 415) vs. 434 (410, 444), P<0.001) was significantly lower and lactic acid (1.70 (1.30, 3.00) mmol/L vs. 1.20 (1.10, 1.60) mmol/L, P<0.001) was significantly higher in the non-survivors. There was no significant difference in the proportion of ACEI/ARB medication between the critical group and the general group or between non-survivors and survivors (all P>0.05). Conclusion: COVID-19 patients combined with CVD are associated with a higher risk of mortality. Critical patients are characterized with lower lymphocyte counts. Higher BMI are more often seen in critical patients and non-survivor. ACEI/ARB use does not affect the morbidity and mortality of COVID-19 combined with CVD. Aggravating causes of death include fulminant inflammation, lactic acid accumulation and thrombotic events.
FULL TEXT LINK
http://dx.doi.org/10.3760/cma.j.cn112148-20200220-00105

RECORD 97
TITLE
  Imaging and clinical features of patients with 2019 novel coronavirus SARS-CoV-2
AUTHOR NAMES
  Xu X.;  Yu C.;  Qu J.;  Zhang L.;  Jiang S.;  Huang D.;  Chen B.;  Zhang Z.;  Guan W.;  Ling Z.;  Jiang R.;  Hu T.;  Ding Y.;  Lin L.;  Gan Q.;  Luo L.;  Tang X.;  Liu J.
SOURCE
  European Journal of Nuclear Medicine and Molecular Imaging (2020) 47:5 (1275-1280). Date of Publication: 1 May 2020
ABSTRACT
  Background: The pneumonia caused by the 2019 novel coronavirus (SARS-CoV-2, also called 2019-nCoV) recently break out in Wuhan, China, and was named as COVID-19. With the spread of the disease, similar cases have also been confirmed in other regions of China. We aimed to report the imaging and clinical characteristics of these patients infected with SARS-CoV-2 in Guangzhou, China. Methods: All patients with laboratory-identified SARS-CoV-2 infection by real-time polymerase chain reaction (PCR) were collected between January 23, 2020, and February 4, 2020, in a designated hospital (Guangzhou Eighth People’s Hospital). This analysis included 90 patients (39 men and 51 women; median age, 50 years (age range, 18–86 years). All the included SARS-CoV-2-infected patients underwent non-contrast enhanced chest computed tomography (CT). We analyzed the clinical characteristics of the patients, as well as the distribution characteristics, pattern, morphology, and accompanying manifestations of lung lesions. In addition, after 1–6 days (mean 3.5 days), follow-up chest CT images were evaluated to assess radiological evolution. Findings: The majority of infected patients had a history of exposure in Wuhan or to infected patients and mostly presented with fever and cough. More than half of the patients presented bilateral, multifocal lung lesions, with peripheral distribution, and 53 (59%) patients had more than two lobes involved. Of all included patients, COVID-19 pneumonia presented with ground glass opacities in 65 (72%), consolidation in 12 (13%), crazy paving pattern in 11 (12%), interlobular thickening in 33 (37%), adjacent pleura thickening in 50 (56%), and linear opacities combined in 55 (61%). Pleural effusion, pericardial effusion, and lymphadenopathy were uncommon findings. In addition, baseline chest CT did not show any abnormalities in 21 patients (23%), but 3 patients presented bilateral ground glass opacities on the second CT after 3–4 days. Conclusion: SARS-CoV-2 infection can be confirmed based on the patient’s history, clinical manifestations, imaging characteristics, and laboratory tests. Chest CT examination plays an important role in the initial diagnosis of the novel coronavirus pneumonia. Multiple patchy ground glass opacities in bilateral multiple lobular with periphery distribution are typical chest CT imaging features of the COVID-19 pneumonia.
FULL TEXT LINK
http://dx.doi.org/10.1007/s00259-020-04735-9

RECORD 98
TITLE
  Characteristics of COVID-19 infection in Beijing
AUTHOR NAMES
  Tian S.;  Hu N.;  Lou J.;  Chen K.;  Kang X.;  Xiang Z.;  Chen H.;  Wang D.;  Liu N.;  Liu D.;  Chen G.;  Zhang Y.;  Li D.;  Li J.;  Lian H.;  Niu S.;  Zhang L.;  Zhang J.
SOURCE
  Journal of Infection (2020) 80:4 (401-406). Date of Publication: 1 Apr 2020
ABSTRACT
  Background: Since the first case of a novel coronavirus (COVID-19) infection pneumonia was detected in Wuhan, China, a series of confirmed cases of the COVID-19 were found in Beijing. We analyzed the data of 262 confirmed cases to determine the clinical and epidemiological characteristics of COVID-19 in Beijing. Methods: We collected patients who were transferred by Beijing Emergency Medical Service to the designated hospitals. The information on demographic, epidemiological, clinical, laboratory test for the COVID-19 virus, diagnostic classification, cluster case and outcome were obtained. Furthermore we compared the characteristics between severe and common confirmed cases which including mild cases, no-pneumonia cases and asymptomatic cases, and we also compared the features between COVID-19 and 2003 SARS. Findings: By Feb 10, 2020, 262 patients were transferred from the hospitals across Beijing to the designated hospitals for special treatment of the COVID-19 infected by Beijing emergency medical service. Among of 262 patients, 46 (17.6%) were severe cases, 216 (82.4%) were common cases, which including 192 (73.3%) mild cases, 11(4.2%) non-pneumonia cases and 13 (5.0%) asymptomatic cases respectively. The median age of patients was 47.5 years old and 48.5% were male. 192 (73.3%) patients were residents of Beijing, 50 (26.0%) of which had been to Wuhan, 116 (60.4%) had close contact with confirmed cases, 21 (10.9%) had no contact history. The most common symptoms at the onset of illness were fever (82.1%), cough (45.8%), fatigue (26.3%), dyspnea (6.9%) and headache (6.5%). The median incubation period was 6.7 days, the interval time from between illness onset and seeing a doctor was 4.5 days. As of Feb 10, 17.2% patients have discharged and 81.7% patients remain in hospital in our study, the fatality of COVID-19 infection in Beijing was 0.9%. Interpretation: On the basis of this study, we provided the ratio of the COVID-19 infection on the severe cases to the mild, asymptomatic and non-pneumonia cases in Beijing. Population was generally susceptible, and with a relatively low fatality rate. The measures to prevent transmission was very successful at early stage, the next steps on the COVID-19 infection should be focused on early isolation of patients and quarantine for close contacts in families and communities in Beijing. Funding: Beijing Municipal Science and Technology Commission and Ministry of Science and Technology.
FULL TEXT LINK
http://dx.doi.org/10.1016/j.jinf.2020.02.018

RECORD 99
TITLE
  Clinical Characteristics of Imported Cases of COVID-19 in Jiangsu Province: A Multicenter Descriptive Study
AUTHOR NAMES
  Wu J.;  Liu J.;  Zhao X.;  Liu C.;  Wang W.;  Wang D.;  Xu W.;  Zhang C.;  Yu J.;  Jiang B.;  Cao H.;  Li L.
SOURCE
  Clinical infectious diseases : an official publication of the Infectious Diseases Society of America (2020). Date of Publication: 29 Feb 2020
ABSTRACT
  BACKGROUND: We aimed to report the clinical characteristics of imported coronavirus disease-19 (COVID-19) in Jiangsu Province. METHODS: We retrospectively investigated the clinical, imaging, and laboratory characteristics of confirmed cases of COVID-19 with WHO interim guidance in three Grade ⅢA hospitals of Jiangsu from Jan 22 to Feb 14, 2020. Real time RT-PCR was used to detect the new coronavirus in respiratory samples. RESULTS: Of the 80 patients infected with COVID-19, 41 patients were female, with a median age of 46.1 years. Except for 3 severe patients, the rest of the 77 patients exhibited mild or moderate symptoms. 9 patients were unconfirmed until a third-time nucleic acid test. 38 cases had a history of chronic diseases. The main clinical manifestations of the patients were fever and cough, which accounted for 63 cases (78.75%) and 51 cases (-63.75%) respectively. Only 3 patients (3.75%) showed liver dysfunction. Imaging examination showed that 55 patients (-68.75%) showed abnormal, 25 cases (31.25%) had no abnormal density shadow in the parenchyma of both lungs. Up to now, 21 cases were discharged from the hospital, and no patient died. The average length of stay for discharged patients was 8 days. CONCLUSIONS: Compared with the cases in Wuhan, the cases in Jiangsu exhibited mild or moderate symptoms and no obvious gender susceptivity. The proportion of patients having liver dysfunction and abnormal CT imaging was relatively lower than that of Wuhan. Notably, infected patients may be falsely excluded based on two consecutively negative respiratory pathogenic nucleic acid test results.
FULL TEXT LINK
http://dx.doi.org/10.1093/cid/ciaa199

RECORD 100
TITLE
  Characteristics of peripheral blood leukocyte differential counts in patients with COVID-19
AUTHOR NAMES
  Li Y.X.;  Wu W.;  Yang T.;  Zhou W.;  Fu Y.M.;  Feng Q.M.;  Ye J.M.
SOURCE
  Zhonghua nei ke za zhi (2020) 59 (E003). Date of Publication: 1 Mar 2020
ABSTRACT
  To investigate the early changes of peripheral blood leukocyte differential counts in patients with COVID-19. Ten patients with COVID-19 and 30 patients with other viral pneumonia (non-COVID-19) admitted to Shanghai Jiao Tong University Affiliated Sixth People’s Hospital and Jinshan Branch Hospital from January 22 to February 17, 2020 were enrolled in this study. The differential counts of white blood cells were analyzed. Patients in COVID-19 group showed relatively lower absolute white blood cell (WBC) count 4.95(3.90,6.03)×10(9)/L, lymphocyte absolute count 1.20(0.98,1.50)×10(9)/L and eosinophil absolute count 0.01(0.01,0.01)×10(9)/L. Leukopenia developed in two patients(2/10), lymphocytopenia also in two patients(2/10). Seven over ten patients presented with eosinophil cytopenia. In non-COVID-19 group, absolute WBC count was 8.20 (6.78,9.03) ×10(9)/L (P<0.001), lymphocyte absolute count 1.75(1.20,2.53)×10(9)/L(P=0.036), eosinophil absolute count 0.02(0.01,0.03)×10(9)/L(P=0.05). Lymphocytopenia occurred in (16.7%) patients, eosinophil cytopenia in 16.7% patients too. In conclusion, leukopenia, lymphocytopenia and eosinophil cytopenia are more common in COVID-19 patients than those in non- COVID-19 patients.

RECORD 101
TITLE
  Analysis of factors associated with disease outcomes in hospitalized patients with 2019 novel coronavirus disease
AUTHOR NAMES
  Liu W.;  Tao Z.-W.;  Lei W.;  Ming-Li Y.;  Kui L.;  Ling Z.;  Shuang W.;  Yan D.;  Jing L.;  Liu H.-G.;  Ming Y.;  Yi H.
SOURCE
  Chinese medical journal (2020). Date of Publication: 28 Feb 2020
ABSTRACT
  BACKGROUND: Since early December 2019, the 2019 novel coronavirus disease (COVID-19) has caused pneumonia epidemic in Wuhan, Hubei province of China. This study aims to investigate the factors affecting the progression of pneumonia in COVID-19 patients. Associated results will be used to evaluate the prognosis and to find the optimal treatment regimens for COVID-19 pneumonia. METHODS: Patients tested positive for the COVID-19 based on nucleic acid detection were included in this study. Patients were admitted to 3 tertiary hospitals in Wuhan between December 30, 2019, and January 15, 2020. Individual data, laboratory indices, imaging characteristics, and clinical data were collected, and statistical analysis was performed. Based on clinical typing results, the patients were divided into a progression group or an improvement/stabilization group. Continuous variables were analyzed using independent samples t-test or Mann-Whitney U test. Categorical variables were analyzed using Chi-squared test or Fisher exact test. Logistic regression analysis was performed to explore the risk factors for disease progression. RESULTS: Seventy-eight patients with COVID-19-induced pneumonia met the inclusion criteria and were included in this study. Efficacy evaluation at 2 weeks after hospitalization indicated that 11 patients (14.1%) had deteriorated, and 67 patients (85.9%) had improved/stabilized. The patients in the progression group were significantly older than those in the disease improvement/stabilization group (66 [51, 70] vs. 37 [32, 41] years, U = 4.932, P = 0.001). The progression group had a significantly higher proportion of patients with a history of smoking than the improvement/stabilization group (27.3% vs. 3.0%, χ = 9.291, P = 0.018). For all the 78 patients, fever was the most common initial symptom, and the maximum body temperature at admission was significantly higher in the progression group than in the improvement/stabilization group (38.2 [37.8, 38.6] vs. 37.5 [37.0, 38.4]°C, U = 2.057, P = 0.027). Moreover, the proportion of patients with respiratory failure (54.5% vs. 20.9%, χ = 5.611, P = 0.028) and respiratory rate (34 [18, 48] vs. 24 [16, 60] breaths/min, U = 4.030, P = 0.004) were significantly higher in the progression group than in the improvement/stabilization group. C-reactive protein was significantly elevated in the progression group compared to the improvement/stabilization group (38.9 [14.3, 64.8] vs. 10.6 [1.9, 33.1] mg/L, U = 1.315, P = 0.024). Albumin was significantly lower in the progression group than in the improvement/stabilization group (36.62 ± 6.60 vs. 41.27 ± 4.55 g/L, U = 2.843, P = 0.006). Patients in the progression group were more likely to receive high-level respiratory support than in the improvement/stabilization group (χ = 16.01, P = 0.001). Multivariate logistic analysis indicated that age (odds ratio [OR], 8.546; 95% confidence interval [CI]: 1.628-44.864; P = 0.011), history of smoking (OR, 14.285; 95% CI: 1.577-25.000; P = 0.018), maximum body temperature at admission (OR, 8.999; 95% CI: 1.036-78.147, P = 0.046), respiratory failure (OR, 8.772, 95% CI: 1.942-40.000; P = 0.016), albumin (OR, 7.353, 95% CI: 1.098-50.000; P = 0.003), and C-reactive protein (OR, 10.530; 95% CI: 1.224-34.701, P = 0.028) were risk factors for disease progression. CONCLUSIONS: Several factors that led to the progression of COVID-19 pneumonia were identified, including age, history of smoking, maximum body temperature on admission, respiratory failure, albumin, C-reactive protein. These results can be used to further enhance the ability of management of COVID-19 pneumonia.
FULL TEXT LINK
http://dx.doi.org/10.1097/CM9.0000000000000775

RECORD 102
TITLE
  Clinical characteristics of 140 patients infected with SARS-CoV-2 in Wuhan, China
AUTHOR NAMES
  Zhang J.-J.;  Dong X.;  Cao Y.-Y.;  Yuan Y.-D.;  Yang Y.-B.;  Yan Y.-Q.;  Akdis C.A.;  Gao Y.-D.
SOURCE
  Allergy: European Journal of Allergy and Clinical Immunology (2020). Date of Publication: 2020
ABSTRACT
  Background: Coronavirus disease 2019 (COVID-19) caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection has been widely spread. We aim to investigate the clinical characteristic and allergy status of patients infected with SARS-CoV-2. Methods: Electronic medical records including demographics, clinical manifestation, comorbidities, laboratory data, and radiological materials of 140 hospitalized COVID-19 patients, with confirmed result of SARS-CoV-2 viral infection, were extracted and analyzed. Results: An approximately 1:1 ratio of male (50.7%) and female COVID-19 patients was found, with an overall median age of 57.0 years. All patients were community-acquired cases. Fever (91.7%), cough (75.0%), fatigue (75.0%), and gastrointestinal symptoms (39.6%) were the most common clinical manifestations, whereas hypertension (30.0%) and diabetes mellitus (12.1%) were the most common comorbidities. Drug hypersensitivity (11.4%) and urticaria (1.4%) were self-reported by several patients. Asthma or other allergic diseases were not reported by any of the patients. Chronic obstructive pulmonary disease (COPD, 1.4%) patients and current smokers (1.4%) were rare. Bilateral ground-glass or patchy opacity (89.6%) was the most common sign of radiological finding. Lymphopenia (75.4%) and eosinopenia (52.9%) were observed in most patients. Blood eosinophil counts correlate positively with lymphocyte counts in severe (r =.486, P <.001) and nonsevere (r =.469, P <.001) patients after hospital admission. Significantly higher levels of D-dimer, C-reactive protein, and procalcitonin were associated with severe patients compared to nonsevere patients (all P <.001). Conclusion: Detailed clinical investigation of 140 hospitalized COVID-19 cases suggests eosinopenia together with lymphopenia may be a potential indicator for diagnosis. Allergic diseases, asthma, and COPD are not risk factors for SARS-CoV-2 infection. Older age, high number of comorbidities, and more prominent laboratory abnormalities were associated with severe patients.
FULL TEXT LINK
http://dx.doi.org/10.1111/all.14238

RECORD 103
TITLE
  Clinical characteristics of laboratory confirmed positive cases of SARS-CoV-2 infection in Wuhan, China: A retrospective single center analysis
AUTHOR NAMES
  Huang Y.;  Tu M.;  Wang S.;  Chen S.;  Zhou W.;  Chen D.;  Zhou L.;  Wang M.;  Zhao Y.;  Zeng W.;  Huang Q.;  Xu H.;  Liu Z.;  Guo L.
SOURCE
  Travel Medicine and Infectious Disease (2020) Article Number: 101606. Date of Publication: 2020
FULL TEXT LINK
http://dx.doi.org/10.1016/j.tmaid.2020.101606

RECORD 104
TITLE
  The treatment proposal for the patients with breast diseases in the central epidemic area of 2019 coronavirus disease
AUTHOR NAMES
  Zhao L.;  Zhang L.;  Liu J.W.;  Yang Z.F.;  Shen W.Z.;  Li X.R.
SOURCE
  Zhonghua wai ke za zhi [Chinese journal of surgery] (2020) 58 (E005). Date of Publication: 25 Feb 2020
ABSTRACT
  Currently, the epidemic of 2019 coronavirus disease (COVID-19) is still ongoing. The characteristics including high contagiousness, herd susceptibility and clinical phenotype diversity, made a serious influence on people’s daily life and rountine therapy for other diseases. Breast dieases are clinical common diseases. In the central epidemic area of COVID-19, Hubei province, especially Wuhan, the clinical specialists of breast diseases should consider all of the following factors comprehensively: the prevention of COVID-19, the diagnosis and treatment of breast diseases and the accessibility of medical resources. Besides, we should select the appropriate therapy and optimize treatment process so as to prevent the propagation and cross infection of COVID-19 as well as manage the breast diseases without delay. Therefore, we carried out some management proposals of the patients with breast diseases in the central epidemic area during the epidemic of COVID-19 on the basis of conventional treatment guidelines and clinical experiences. The suggestions and corrections from colleagues will be welcomed.
FULL TEXT LINK
http://dx.doi.org/10.3760/cma.j.cn112139-20200221-00116

RECORD 105
TITLE
  Characteristics of and public health responses to the coronavirus disease 2019 outbreak in China
AUTHOR NAMES
  Deng S.-Q.;  Peng H.-J.
SOURCE
  Journal of Clinical Medicine (2020) 9:2 Article Number: 575. Date of Publication: 1 Feb 2020
ABSTRACT
  In December 2019, cases of unidentified pneumonia with a history of exposure in the Huanan Seafood Market were reported in Wuhan, Hubei Province. A novel coronavirus, SARS-CoV-2, was identified to be accountable for this disease. Human-to-human transmission is confirmed, and this disease (named COVID-19 by World Health Organization (WHO)) spread rapidly around the country and the world. As of 18 February 2020, the number of confirmed cases had reached 75,199 with 2009 fatalities. The COVID-19 resulted in a much lower case-fatality rate (about 2.67%) among the confirmed cases, compared with Severe Acute Respiratory Syndrome (SARS) and Middle East Respiratory Syndrome (MERS). Among the symptom composition of the 45 fatality cases collected from the released official reports, the top four are fever, cough, short of breath, and chest tightness/pain. The major comorbidities of the fatality cases include hypertension, diabetes, coronary heart disease, cerebral infarction, and chronic bronchitis. The source of the virus and the pathogenesis of this disease are still unconfirmed. No specific therapeutic drug has been found. The Chinese Government has initiated a level-1 public health response to prevent the spread of the disease. Meanwhile, it is also crucial to speed up the development of vaccines and drugs for treatment, which will enable us to defeat COVID-19 as soon as possible.
FULL TEXT LINK
http://dx.doi.org/10.3390/jcm9020575

RECORD 106
TITLE
  Analysis of the first cluster of cases in a family of novel coronavirus pneumonia in Gansu Province
AUTHOR NAMES
  Bai S.L.;  Wang J.Y.;  Zhou Y.Q.;  Yu D.S.;  Gao X.M.;  Li L.L.;  Yang F.
SOURCE
  Zhonghua yu fang yi xue za zhi [Chinese journal of preventive medicine] (2020) 54 (E005). Date of Publication: 17 Feb 2020
ABSTRACT
  The epidemiological history and clinical characteristics of 7 cases of COVID-19 and 1 case of close contact in the first family aggregation epidemic of COVID-19 in Gansu Province were analyzed. The first patient A developed on January 22, 2020, with a history of residence in Wuhan, and confirmed severe cases of NCP on January 24, 2020; patient B, on January 23, 2020, diagnosed on January 31, severe cases; patient C, asymptomatic, diagnosed on January 27; patient D, asymptomatic, diagnosed on January 27; patient E, on January 24, diagnosed on January 28; patient F, asymptomatic, diagnosed on January 31; Patient G was asymptomatic and was diagnosed on January 31. In close contact, H was asymptomatic, PCR test was negative and asymptomatic, and he was discharged early. Among the 7 patients, 1 case died of (B) aggravation, and the other patients’ condition was effectively controlled after active treatment. Except for the discharged cases, 5 cases were positive for COVID-19 specific IgM antibody and 1 case was negative. In this clustering outbreak, 4 patients remained asymptomatic, but PCR and IgM antibodies were positive, indicating that asymptomatic patients may be the key point to control the epidemic. Specific IgM antibody screening for patients whose pharyngeal swab nucleic acid test is negative but with ground glass-like lung lesions is very important for early detection and early isolation.
FULL TEXT LINK
http://dx.doi.org/10.3760/cma.j.issn.0253-9624.2020.0005

RECORD 107
TITLE
  The epidemiological characteristics of an outbreak of 2019 novel coronavirus diseases (COVID-19) in China
SOURCE
  Zhonghua liu xing bing xue za zhi = Zhonghua liuxingbingxue zazhi (2020) 41:2 (145-151). Date of Publication: 17 Feb 2020
ABSTRACT
  Objective: An outbreak of 2019 novel coronavirus diseases (COVID-19) in Wuhan, China has spread quickly nationwide. Here, we report results of a descriptive, exploratory analysis of all cases diagnosed as of February 11, 2020. Methods: All COVID-19 cases reported through February 11, 2020 were extracted from China’s Infectious Disease Information System. Analyses included: 1) summary of patient characteristics; 2) examination of age distributions and sex ratios; 3) calculation of case fatality and mortality rates; 4) geo-temporal analysis of viral spread; 5) epidemiological curve construction; and 6) subgroup analysis. Results: A total of 72 314 patient records-44 672 (61.8%) confirmed cases, 16 186 (22.4%) suspected cases, 10567 (14.6%) clinical diagnosed cases (Hubei only), and 889 asymptomatic cases (1.2%)-contributed data for the analysis. Among confirmed cases, most were aged 30-79 years (86.6%), diagnosed in Hubei (74.7%), and considered mild (80.9%). A total of 1 023 deaths occurred among confirmed cases for an overall case-fatality rate of 2.3%. The COVID-19 spread outward from Hubei sometime after December 2019 and by February 11, 2020, 1 386 counties across all 31 provinces were affected. The epidemic curve of onset of symptoms peaked in January 23-26, then began to decline leading up to February 11. A total of 1 716 health workers have become infected and 5 have died (0.3%). Conclusions: The COVID-19 epidemic has spread very quickly. It only took 30 days to expand from Hubei to the rest of Mainland China. With many people returning from a long holiday, China needs to prepare for the possible rebound of the epidemic.
FULL TEXT LINK
http://dx.doi.org/10.3760/cma.j.issn.0254-6450.2020.02.003

RECORD 108
TITLE
  Preliminary study of the relationship between novel coronavirus pneumonia and liver function damage: a multicenter study
AUTHOR NAMES
  Liu C.;  Jiang Z.C.;  Shao C.X.;  Zhang H.G.;  Yue H.M.;  Chen Z.H.;  Ma B.Y.;  Liu W.Y.;  Huang H.H.;  Yang J.;  Wang Y.;  Liu H.Y.;  Xu D.;  Wang J.T.;  Yang J.Y.;  Pan H.Q.;  Zou S.Q.;  Li F.J.;  Lei J.Q.;  Li X.;  He Q.;  Gu Y.;  Qi X.L.
SOURCE
  Zhonghua gan zang bing za zhi = Zhonghua ganzangbing zazhi = Chinese journal of hepatology (2020) 28:2 (148-152). Date of Publication: 20 Feb 2020
ABSTRACT
  Objective: To analyze the clinical characteristics of cases of novel coronavirus pneumonia and a preliminary study to explore the relationship between different clinical classification and liver damage. Methods: Consecutively confirmed novel coronavirus infection cases admitted to seven designated hospitals during January 23, 2020 to February 8, 2020 were included. Clinical classification (mild, moderate, severe, and critical) was carried out according to the diagnosis and treatment program of novel coronavirus pneumonia (Trial Fifth Edition) issued by the National Health Commission. The research data were analyzed using SPSS19.0 statistical software. Quantitative data were expressed as median (interquartile range), and qualitative data were expressed as frequency and rate. Results: 32 confirmed cases that met the inclusion criteria were included. 28 cases were of mild or moderate type (87.50%), and four cases (12.50%) of severe or critical type. Four cases (12.5%) were combined with one underlying disease (bronchial asthma, coronary heart disease, malignant tumor, chronic kidney disease), and one case (3.13%) was simultaneously combined with high blood pressure and malignant tumor. The results of laboratory examination showed that the alanine aminotransferase (ALT), aspartate aminotransferase (AST), albumin (ALB), and total bilirubin (TBil) for entire cohort were 26.98 (16.88 ~ 46.09) U/L and 24.75 (18.71 ~ 31.79) U/L, 39.00 (36.20 ~ 44.20) g/L and 16.40 (11.34- ~ 21.15) mmol/L, respectively. ALT, AST, ALB and TBil of the mild or moderate subgroups were 22.75 (16.31- ~ 37.25) U/L, 23.63 (18.71 ~ 26.50) U/L, 39.70 (36.50 ~ 46.10) g/L, and 15.95 (11.34 ~ 20.83) mmol/L, respectively. ALT, AST, ALB and TBil of the severe or critical subgroups were 60.25 (40.88 ~ 68.90) U/L, 37.00 (20.88 ~ 64.45) U/L, 35.75 (28.68 ~ 42.00) g/L, and 20.50 (11.28 ~ 25.00) mmol/L, respectively. Conclusion: The results of this multicenter retrospective study suggests that novel coronavirus pneumonia combined with liver damage is more likely to be caused by adverse drug reactions and systemic inflammation in severe patients receiving medical treatment. Therefore, liver function monitoring and evaluation should be strengthened during the treatment of such patients.
FULL TEXT LINK
http://dx.doi.org/10.3760/cma.j.issn.1007-3418.2020.02.003