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List of Articles
RECORD 1
TITLE
COVID-19: what has been learned and to be learned about the novel coronavirus disease
AUTHOR NAMES
Yi Y.; Lagniton P.N.P.; Ye S.; Li E.; Xu R.-H.
SOURCE
International journal of biological sciences (2020) 16:10 (1753-1766). Date of Publication: 2020
ABSTRACT
The outbreak of Coronavirus disease 2019 (COVID-19), caused by severe acute respiratory syndrome (SARS) coronavirus 2 (SARS-CoV-2), has thus far killed over 3,000 people and infected over 80,000 in China and elsewhere in the world, resulting in catastrophe for humans. Similar to its homologous virus, SARS-CoV, which caused SARS in thousands of people in 2003, SARS-CoV-2 might also be transmitted from the bats and causes similar symptoms through a similar mechanism. However, COVID-19 has lower severity and mortality than SARS but is much more transmissive and affects more elderly individuals than youth and more men than women. In response to the rapidly increasing number of publications on the emerging disease, this article attempts to provide a timely and comprehensive review of the swiftly developing research subject. We will cover the basics about the epidemiology, etiology, virology, diagnosis, treatment, prognosis, and prevention of the disease. Although many questions still require answers, we hope that this review helps in the understanding and eradication of the threatening disease.
FULL TEXT LINK
http://dx.doi.org/10.7150/ijbs.45134
RECORD 2
TITLE
Novel Coronavirus Pneumonia (COVID-19) Progression Course in 17 Discharged Patients: Comparison of Clinical and Thin-Section CT Features During Recovery
AUTHOR NAMES
Han X.; Cao Y.; Jiang N.; Chen Y.; Alwalid O.; Zhang X.; Gu J.; Dai M.; Liu J.; Zhu W.; Zheng C.; Shi H.
SOURCE
Clinical infectious diseases : an official publication of the Infectious Diseases Society of America (2020). Date of Publication: 30 Mar 2020
ABSTRACT
BACKGROUND: To retrospectively analyze the evolution of clinical features and thin-section CT imaging of novel coronavirus pneumonia (COVID-19) in 17 discharged patients. METHODS: Serial thin-section CT scans of 17 discharged patients with COVID-19 were obtained during recovery. Longitudinal changes of clinical parameters and CT pattern were documented in all patients during 4 weeks since admission. CT score was used to evaluate the extent of the disease. RESULTS: There was a marked improvement of fever, lymphocytes count, C-reactive protein and erythrocyte sedimentation rate within the first two weeks since admission. However, the mean CT score rapidly increased from the 1st to 3rd week, with a top score of 8.2 obtained in the 2nd week. During the 1st week, the main CT pattern was ground-glass opacities (GGO,76.5%). The frequency of GGO (52.9%) decreased in the 2nd week. Consolidation and mixed patterns (47.0%) were noted in the 2nd week. Thereafter, consolidations generally dissipated into GGO and the frequency of GGO increased in the 3rd week (76.5%) and 4th week (71.4%). Opacities were mainly located in the peripheral (76.5%), subpleural (47.1%) zones of the lungs, and presented as focal (35.3%) or multifocal (29.4%) in the 1st week and became more diffuse in the 2nd (47.1%) and 3rd week (58.8%), then showed reduced extent in 4th week (50%). CONCLUSIONS: The progression course of CT pattern was later than the clinical parameters within the first two weeks since admission; however, there was a synchronized improvement in both clinical and radiologic features in the 4th week.
FULL TEXT LINK
http://dx.doi.org/10.1093/cid/ciaa271
RECORD 3
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 4
TITLE
COVID-19, ECMO, and lymphopenia: a word of caution
AUTHOR NAMES
Henry B.M.
SOURCE
The Lancet Respiratory Medicine (2020) 8:4 (e24). Date of Publication: 1 Apr 2020
FULL TEXT LINK
http://dx.doi.org/10.1016/S2213-2600(20)30119-3
RECORD 5
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 6
TITLE
COVID-19: global consequences for oncology
AUTHOR NAMES
The Lancet Oncology
SOURCE
The Lancet Oncology (2020) 21:4 (467). Date of Publication: 1 Apr 2020
FULL TEXT LINK
http://dx.doi.org/10.1016/S1470-2045(20)30175-3
RECORD 7
TITLE
SARS-CoV-2 and COVID-19: The most important research questions
AUTHOR NAMES
Yuen K.-S.; Ye Z.-W.; Fung S.-Y.; Chan C.-P.; Jin D.-Y.
SOURCE
Cell and Bioscience (2020) 10:1 Article Number: 40. Date of Publication: 16 Mar 2020
ABSTRACT
Coronavirus disease 2019 (COVID-19) caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is an ongoing global health emergency. Here we highlight nine most important research questions concerning virus transmission, asymptomatic and presymptomatic virus shedding, diagnosis, treatment, vaccine development, origin of virus and viral pathogenesis.
FULL TEXT LINK
http://dx.doi.org/10.1186/s13578-020-00404-4
RECORD 8
TITLE
Coronavirus Disease 2019 (COVID-19) Pandemic and Pregnancy
AUTHOR NAMES
Dashraath P.; Jing Lin Jeslyn W.; Mei Xian Karen L.; Li Min L.; Sarah L.; Biswas A.; Arjandas Choolani M.; Mattar C.; Lin S.L.
SOURCE
American journal of obstetrics and gynecology (2020). Date of Publication: 23 Mar 2020
ABSTRACT
The current coronavirus disease 2019 (COVID-19) pneumonia pandemic, caused by the severe acute respiratory syndrome 2 (SARS-CoV-2) virus, is spreading globally at an accelerated rate, with a basic reproduction number (R0) of 2 – 2.5, indicating that 2 – 3 persons will be infected from an index patient. A serious public health emergency, it is particularly deadly in vulnerable populations and communities in which healthcare providers are insufficiently prepared to manage the infection. As of March 16, 2020, there are more than 180,000 confirmed cases of COVID-19 worldwide, with over 7,000 related deaths. The SARS-CoV-2 virus has been isolated from asymptomatic individuals, and affected patients continue to be infectious two weeks after cessation of symptoms. The substantial morbidity and socioeconomic impact have necessitated drastic measures across all continents, including nationwide lockdowns and border closures. Pregnant women and their fetuses represent a high-risk population during infectious disease outbreaks. To date, the outcomes of 55 pregnant women infected with COVID-19 and 46 neonates have been reported in the literature, with no definite evidence of vertical transmission. Physiological and mechanical changes in pregnancy increase susceptibility to infections in general, particularly when the cardiorespiratory system is affected, and encourage rapid progression to respiratory failure in the gravida. Furthermore, the pregnancy bias towards T-helper 2 (Th2) system dominance which protects the fetus, leaves the mother vulnerable to viral infections, which are more effectively contained by the Th1 system. These unique challenges mandate an integrated approach to pregnancies affected by SARS-CoV-2. Here we present a review of COVID-19 in pregnancy, bringing together the various factors integral to the understanding of pathophysiology and susceptibility, diagnostic challenges with real-time reverse transcriptase polymerase chain reaction (RT-PCR) assays, therapeutic controversies, intrauterine transmission and maternal-fetal complications. We discuss the latest options in antiviral therapy and vaccine development, including the novel use of chloroquine in the management of COVID-19. Fetal surveillance, in view of the predisposition to growth restriction and special considerations during labor and delivery are addressed. Additionally, we focus on keeping frontline obstetric care providers safe while continuing to provide essential services. Our clinical service model is built around the principles of workplace segregation, responsible social distancing, containment of cross-infection to healthcare providers, judicious use of personal protective equipment and telemedicine. Our aim is to share a framework which can be adopted by tertiary maternity units managing pregnant women in the flux of a pandemic while maintaining the safety of the patient and healthcare provider at its core.
FULL TEXT LINK
http://dx.doi.org/10.1016/j.ajog.2020.03.021
RECORD 9
TITLE
The effect of control strategies to reduce social mixing on outcomes of the COVID-19 epidemic in Wuhan, China: a modelling study
AUTHOR NAMES
Prem K.; Liu Y.; Russell T.W.; Kucharski A.J.; Eggo R.M.; Davies N.; Jit M.; Klepac P.
SOURCE
The Lancet. Public health (2020). Date of Publication: 25 Mar 2020
ABSTRACT
BACKGROUND: In December, 2019, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), a novel coronavirus, emerged in Wuhan, China. Since then, the city of Wuhan has taken unprecedented measures in response to the outbreak, including extended school and workplace closures. We aimed to estimate the effects of physical distancing measures on the progression of the COVID-19 epidemic, hoping to provide some insights for the rest of the world. METHODS: To examine how changes in population mixing have affected outbreak progression in Wuhan, we used synthetic location-specific contact patterns in Wuhan and adapted these in the presence of school closures, extended workplace closures, and a reduction in mixing in the general community. Using these matrices and the latest estimates of the epidemiological parameters of the Wuhan outbreak, we simulated the ongoing trajectory of an outbreak in Wuhan using an age-structured susceptible-exposed-infected-removed (SEIR) model for several physical distancing measures. We fitted the latest estimates of epidemic parameters from a transmission model to data on local and internationally exported cases from Wuhan in an age-structured epidemic framework and investigated the age distribution of cases. We also simulated lifting of the control measures by allowing people to return to work in a phased-in way and looked at the effects of returning to work at different stages of the underlying outbreak (at the beginning of March or April). FINDINGS: Our projections show that physical distancing measures were most effective if the staggered return to work was at the beginning of April; this reduced the median number of infections by more than 92% (IQR 66-97) and 24% (13-90) in mid-2020 and end-2020, respectively. There are benefits to sustaining these measures until April in terms of delaying and reducing the height of the peak, median epidemic size at end-2020, and affording health-care systems more time to expand and respond. However, the modelled effects of physical distancing measures vary by the duration of infectiousness and the role school children have in the epidemic. INTERPRETATION: Restrictions on activities in Wuhan, if maintained until April, would probably help to delay the epidemic peak. Our projections suggest that premature and sudden lifting of interventions could lead to an earlier secondary peak, which could be flattened by relaxing the interventions gradually. However, there are limitations to our analysis, including large uncertainties around estimates of R0 and the duration of infectiousness. FUNDING: Bill & Melinda Gates Foundation, National Institute for Health Research, Wellcome Trust, and Health Data Research UK.
FULL TEXT LINK
http://dx.doi.org/10.1016/S2468-2667(20)30073-6
RECORD 10
TITLE
Quantitative Detection and Viral Load Analysis of SARS-CoV-2 in Infected Patients
AUTHOR NAMES
Yu F.; Yan L.; Wang N.; Yang S.; Wang L.; Tang Y.; Gao G.; Wang S.; Ma C.; Xie R.; Wang F.; Tan C.; Zhu L.; Guo Y.; Zhang F.
SOURCE
Clinical infectious diseases : an official publication of the Infectious Diseases Society of America (2020). Date of Publication: 28 Mar 2020
ABSTRACT
BACKGROUND: Coronavirus disease 2019 (COVID-19) has become a public health emergency. The widely used reverse transcription PCR (RT-PCR) method has limitations for clinical diagnosis and treatment. METHODS: A total of 323 samples from 76 COVID-19 confirmed patients were analyzed by droplet digital PCR (ddPCR) and RT-PCR based two target genes (ORF1ab and N). Nasal swabs, throat swabs, sputum, blood, and urine were collected. Clinical and imaging data were obtained for clinical staging. RESULTS: In 95 samples tested positive by both methods, the cycle threshold (Ct) of RT-PCR was highly correlated with the copy numbed of ddPCR (ORF1ab gene, R2 = 0.83; N gene, R2 = 0.87). 4 (4/161) negative and 41 (41/67) single-gene positive samples tested by RT-PCR were positive according to ddPCR with viral load ranging from 11.1 to 123.2 copies/test. Then the viral load of respiratory samples was compared and the average viral load in sputum (17429 ± 6920 copies/test) was found to be significantly higher than in throat swabs (2552 ± 1965 copies/test, p < 0.001) and nasal swabs (651 ± 501 copies/test, p < 0.001). Furthermore, the viral load in the early and progressive stages were significantly higher than that in the recovery stage (46800 ± 17272 vs 1252 ± 1027, p < 0.001) analyzed by sputum samples. CONCLUSIONS: Quantitative monitoring of viral load in lower respiratory tract samples helps to evaluate disease progression, especially in cases of low viral load.
FULL TEXT LINK
http://dx.doi.org/10.1093/cid/ciaa345
RECORD 11
TITLE
Organ-protective Effect of Angiotensin-converting Enzyme 2 and its Effect on the Prognosis of COVID-19
AUTHOR NAMES
Cheng H.; Wang Y.; Wang G.-Q.
SOURCE
Journal of medical virology (2020). Date of Publication: 27 Mar 2020
ABSTRACT
This article reviews the correlation between ACE2 and severe risk factors for COVID-19 and the possible mechanisms. Angiotensin-converting enzyme 2 (ACE2) is a crucial component of the renin-angiotensin system (RAS). The classical RAS ACE-Ang II-AT1R regulatory axis and the ACE2-Ang1-7-MasR counter-regulatory axis play an essential role in maintaining homeostasis in humans. ACE2 is widely distributed in the heart, kidneys, lungs, and testes. ACE2 antagonizes the activation of the classical RAS system and protects against organ damage, protecting against hypertension, diabetes, and cardiovascular disease. Similar to SARS-CoV, SARS-CoV-2 also uses the ACE2 receptor to invade human alveolar epithelial cells. ARDS is a clinical high-mortality disease, and ACE2 has a protective effect on this type of acute lung injury. Current research shows that the poor prognosis of patients with COVID-19 is related to factors such as sex (male), age (higher than 60 years), underlying diseases (hypertension, diabetes, and cardiovascular disease), secondary ARDS, and other relevant factors. Because of these protective effects of ACE2 on chronic underlying diseases and ARDS, the development of spike protein-based vaccine and drugs enhancing ACE2 activity may become one of the most promising approaches for the treatment of COVID-19 in the future. This article is protected by copyright. All rights reserved.
FULL TEXT LINK
http://dx.doi.org/10.1002/jmv.25785
RECORD 12
TITLE
2019 novel coronavirus (Covid-19) pneumonia: Serial computed tomography findings
AUTHOR NAMES
Wei J.; Xu H.; Xiong J.; Shen Q.; Fan B.; Ye C.; Dong W.; Hu F.
SOURCE
Korean Journal of Radiology (2020) 21:4 (494-497). Date of Publication: 1 Apr 2020
ABSTRACT
From December 2019, Coronavirus disease 2019 (COVID-19) pneumonia (formerly known as the 2019 novel Coronavirus [2019-nCoV]) broke out in Wuhan, China. In this study, we present serial CT findings in a 40-year-old female patient with COVID-19 pneumonia who presented with the symptoms of fever, chest tightness, and fatigue. She was diagnosed with COVID-19 infection confirmed by real-time reverse-transcriptase-polymerase chain reaction. CT showed rapidly progressing peripheral consolidations and ground-glass opacities in both lungs. After treatment, the lesions were shown to be almost absorbed leaving the fibrous lesions.
FULL TEXT LINK
http://dx.doi.org/10.3348/kjr.2020.0112
RECORD 13
TITLE
Consensus of Chinese experts on protection of skin and mucous membrane barrier for health-care workers fighting against coronavirus disease 2019
AUTHOR NAMES
Yan Y.; Chen H.; Chen L.; Cheng B.; Diao P.; Dong L.; Gao X.; Gu H.; He L.; Ji C.; Jin H.; Lai W.; Lei T.; Li L.; Li L.; Li R.; Liu D.; Liu W.; Lu Q.; Shi Y.; Song J.; Tao J.; Wang B.; Wang G.; Wu Y.; Xiang L.; Xie J.; Xu J.; Yao Z.; Zhang F.; Zhang J.; Zhong S.; Li H.; Li H.
SOURCE
Dermatologic Therapy (2020). Date of Publication: 2020
ABSTRACT
Health professions preventing and controlling Coronavirus Disease 2019 are prone to skin and mucous membrane injury, which may cause acute and chronic dermatitis, secondary infection and aggravation of underlying skin diseases. This is a consensus of Chinese experts on protective measures and advice on hand-cleaning- and medical-glove-related hand protection, mask- and goggles-related face protection, UV-related protection, eye protection, nasal and oral mucosa protection, outer ear, and hair protection. It is necessary to strictly follow standards of wearing protective equipment and specification of sterilizing and cleaning. Insufficient and excessive protection will have adverse effects on the skin and mucous membrane barrier. At the same time, using moisturizing products is highly recommended to achieve better protection.
FULL TEXT LINK
http://dx.doi.org/10.1111/dth.13310
RECORD 14
TITLE
Risk of COVID-19 for patients with cancer
AUTHOR NAMES
Xia Y.; Jin R.; Zhao J.; Li W.; Shen H.
SOURCE
The Lancet Oncology (2020) 21:4 (e180). Date of Publication: 1 Apr 2020
FULL TEXT LINK
http://dx.doi.org/10.1016/S1470-2045(20)30150-9
RECORD 15
TITLE
Cardiac troponin I in patients with coronavirus disease 2019 (COVID-19): Evidence from a meta-analysis
AUTHOR NAMES
Lippi G.; Lavie C.J.; Sanchis-Gomar F.
SOURCE
Progress in Cardiovascular Diseases (2020). Date of Publication: 2020
FULL TEXT LINK
http://dx.doi.org/10.1016/j.pcad.2020.03.001
RECORD 16
TITLE
Full spectrum of COVID-19 severity still being depicted
AUTHOR NAMES
Xu Z.; Li S.; Tian S.; Li H.; Kong L.-Q.
SOURCE
The Lancet (2020) 395:10228 (947-948). Date of Publication: 21 Mar 2020
FULL TEXT LINK
http://dx.doi.org/10.1016/S0140-6736(20)30308-1
RECORD 17
TITLE
Full spectrum of COVID-19 severity still being depicted – Authors’ reply
AUTHOR NAMES
Gu X.; Cao B.; Wang J.
SOURCE
The Lancet (2020) 395:10228 (948-949). Date of Publication: 21 Mar 2020
FULL TEXT LINK
http://dx.doi.org/10.1016/S0140-6736(20)30371-8
RECORD 18
TITLE
COVID-19 – what should anaethesiologists and intensivists know about it?
AUTHOR NAMES
Wujtewicz M.; Dylczyk-Sommer A.; Aszkiełowicz A.; Zdanowski S.; Piwowarczyk S.; Owczuk R.
SOURCE
Anaesthesiology intensive therapy (2020) 52:1 (34-41). Date of Publication: 2020
ABSTRACT
Over the past three months, the world has faced an unprecedented health hazard. The World Health Organization has announced a pandemic infection with an unknown species of coronavirus called SARS-CoV-2. Spreading mainly through the droplet route, the virus causes mild symptoms in the majority of cases, the most common being: fever (80%), dry cough (56%), fatigue (22%) and muscle pain (7%); less common symptoms include a sore throat, a runny nose, diarrhea, hemoptysis and chills. A life-threatening complication of SARS-CoV-2 infection is an acute respiratory distress syndrome (ARDS), which occurs more often in older adults, those with immune disorders and co-morbidities. Severe forms of the infection, being an indication for treatment in the intensive care unit, comprise acute lung inflammation, ARDS, sepsis and septic shock. The article presents basic information about etiology, pathogenesis and diagnostics (with particular emphasis on the importance of tomocomputer imaging), clinical picture, treatment and prevention of the infection. It goes on to emphasize the specific risks of providing anesthesiology and intensive care services. Due to the fact that effective causal treatment is not yet available and the number of infections and deaths increases day by day, infection prevention and strict adherence to recommendations of infection control organizations remain the basis for fighting the virus.
FULL TEXT LINK
http://dx.doi.org/10.5114/ait.2020.93756
RECORD 19
TITLE
Cardiovascular Implications of Fatal Outcomes of Patients with Coronavirus Disease 2019 (COVID-19)
AUTHOR NAMES
Guo T.; Fan Y.; Chen M.; Wu X.; Zhang L.; He T.; Wang H.; Wan J.; Wang X.; Lu Z.
SOURCE
JAMA Cardiology (2020). Date of Publication: 2020
ABSTRACT
Importance: Increasing numbers of confirmed cases and mortality rates of coronavirus disease 2019 (COVID-19) are occurring in several countries and continents. Information regarding the impact of cardiovascular complication on fatal outcome is scarce. Objective: To evaluate the association of underlying cardiovascular disease (CVD) and myocardial injury with fatal outcomes in patients with COVID-19. Design, Setting, and Participants: This retrospective single-center case series analyzed patients with COVID-19 at the Seventh Hospital of Wuhan City, China, from January 23, 2020, to February 23, 2020. Analysis began February 25, 2020. Main Outcomes and Measures: Demographic data, laboratory findings, comorbidities, and treatments were collected and analyzed in patients with and without elevation of troponin T (TnT) levels. Result: Among 187 patients with confirmed COVID-19, 144 patients (77%) were discharged and 43 patients (23%) died. The mean (SD) age was 58.50 (14.66) years. Overall, 66 (35.3%) had underlying CVD including hypertension, coronary heart disease, and cardiomyopathy, and 52 (27.8%) exhibited myocardial injury as indicated by elevated TnT levels. The mortality during hospitalization was 7.62% (8 of 105) for patients without underlying CVD and normal TnT levels, 13.33% (4 of 30) for those with underlying CVD and normal TnT levels, 37.50% (6 of 16) for those without underlying CVD but elevated TnT levels, and 69.44% (25 of 36) for those with underlying CVD and elevated TnTs. Patients with underlying CVD were more likely to exhibit elevation of TnT levels compared with the patients without CVD (36 [54.5%] vs 16 [13.2%]). Plasma TnT levels demonstrated a high and significantly positive linear correlation with plasma high-sensitivity C-reactive protein levels (β = 0.530, P <.001) and N-terminal pro-brain natriuretic peptide (NT-proBNP) levels (β = 0.613, P <.001). Plasma TnT and NT-proBNP levels during hospitalization (median [interquartile range (IQR)], 0.307 [0.094-0.600]; 1902.00 [728.35-8100.00]) and impending death (median [IQR], 0.141 [0.058-0.860]; 5375 [1179.50-25695.25]) increased significantly compared with admission values (median [IQR], 0.0355 [0.015-0.102]; 796.90 [401.93-1742.25]) in patients who died (P =.001; P <.001), while no significant dynamic changes of TnT (median [IQR], 0.010 [0.007-0.019]; 0.013 [0.007-0.022]; 0.011 [0.007-0.016]) and NT-proBNP (median [IQR], 352.20 [174.70-636.70]; 433.80 [155.80-1272.60]; 145.40 [63.4-526.50]) was observed in survivors (P =.96; P =.16). During hospitalization, patients with elevated TnT levels had more frequent malignant arrhythmias, and the use of glucocorticoid therapy (37 [71.2%] vs 69 [51.1%]) and mechanical ventilation (41 [59.6%] vs 14 [10.4%]) were higher compared with patients with normal TnT levels. The mortality rates of patients with and without use of angiotensin-converting enzyme inhibitors/angiotensin receptor blockers was 36.8% (7 of 19) and 25.6% (43 of 168). Conclusions and Relevance: Myocardial injury is significantly associated with fatal outcome of COVID-19, while the prognosis of patients with underlying CVD but without myocardial injury is relatively favorable. Myocardial injury is associated with cardiac dysfunction and arrhythmias. Inflammation may be a potential mechanism for myocardial injury. Aggressive treatment may be considered for patients at high risk of myocardial injury..
FULL TEXT LINK
http://dx.doi.org/10.1001/jamacardio.2020.1017
RECORD 20
TITLE
Safe Delivery for COVID-19 Infected Pregnancies
AUTHOR NAMES
Qi H.; Luo X.; Zheng Y.; Zhang H.; Li J.; Zou L.; Feng L.; Chen D.; Shi Y.; Tong C.; Baker P.N.
SOURCE
BJOG : an international journal of obstetrics and gynaecology (2020). Date of Publication: 26 Mar 2020
ABSTRACT
Since December 2019, a new coronavirus (COVID-19) infection has rapidly become prevalent in central China1 . On the basis of knowledge obtained from a previous coronavirus outbreak2 , pregnant women are believed to be susceptible to this virus. Once a maternal infection of COVID-19 is suspected or confirmed, childbirth becomes complicated and challenging. Efficient obstetric treatment is required, and is key to optimizing the prognosis for both mother and child. Care should be taken in determination of the timing of delivery, assessment of the indications for caesarean section, preparation of the delivery room to prevent infection, choice of the type of anesthesia, and newborn management.
FULL TEXT LINK
http://dx.doi.org/10.1111/1471-0528.16231
RECORD 21
TITLE
Anticoagulant treatment is associated with decreased mortality in severe coronavirus disease 2019 patients with coagulopathy
AUTHOR NAMES
Tang N.; Bai H.; Chen X.; Gong J.; Li D.; Sun Z.
SOURCE
Journal of thrombosis and haemostasis : JTH (2020). Date of Publication: 27 Mar 2020
ABSTRACT
BACKGROUND: A relatively high mortality of severe coronavirus disease 2019 (COVID-19) is worrying, the application of heparin in COVID-19 has been recommended by some expert consensus due to the risk of disseminated intravascular coagulation and venous thromboembolism. However, its efficacy remains to be validated. METHODS: Coagulation results, medications and outcomes of consecutive patients being classified as severe COVID-19 in Tongji hospital were retrospectively analysed. The 28-day mortality between heparin users and nonusers were compared, also in different risk of coagulopaphy which was stratified by the sepsis-induced coagulopathy (SIC) score or D-dimer result. RESULTS: There were 449 patients with severe COVID-19 enrolled into the study, 99 of them received heparin (mainly with low molecular weight heparin, LMWH) for 7 days or longer. The D-dimer, prothrombin time and age were positively, and platelet count was negatively, correlated with 28-day mortality in multivariate analysis. No difference on 28-day mortality was found between heparin users and nonusers (30.3% vs 29.7%, P=0.910). But the 28-day mortality of heparin users were lower than nonusers In patients with SIC score ≥4 (40.0% vs 64.2%, P=0.029), or D-dimer > 6 fold of upper limit of normal (32.8% vs 52.4%, P=0.017). CONCLUSIONS: Anticoagulant therapy mainly with LMWH appears to be associated with better prognosis in severe COVID-19 patients meeting SIC criteria or with markedly elevated D-dimer.
FULL TEXT LINK
http://dx.doi.org/10.1111/jth.14817
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
COVID-19: Melatonin as a potential adjuvant treatment
AUTHOR NAMES
Zhang R.; Wang X.; Ni L.; Di X.; Ma B.; Niu S.; Liu C.; Reiter R.J.
SOURCE
Life sciences (2020) (117583). Date of Publication: 23 Mar 2020
ABSTRACT
This article summarizes the likely benefits of melatonin in the attenuation of COVID-19 based on its putative pathogenesis. The recent outbreak of COVID-19 has become a pandemic with tens of thousands of infected patients. Based on clinical features, pathology, the pathogenesis of acute respiratory disorder induced by either highly homogenous coronaviruses or other pathogens, the evidence suggests that excessive inflammation, oxidation, and an exaggerated immune response very likely contribute to COVID-19 pathology. This leads to a cytokine storm and subsequent progression to acute lung injury (ALI)/acute respiratory distress syndrome (ARDS) and often death. Melatonin, a well-known anti-inflammatory and anti-oxidative molecule, is protective against ALI/ARDS caused by viral and other pathogens. Melatonin is effective in critical care patients by reducing vessel permeability, anxiety, sedation use, and improving sleeping quality, which might also be beneficial for better clinical outcomes for COVID-19 patients. Notably, melatonin has a high safety profile. There is significant data showing that melatonin limits virus-related diseases and would also likely be beneficial in COVID-19 patients. Additional experiments and clinical studies are required to confirm this speculation.
FULL TEXT LINK
http://dx.doi.org/10.1016/j.lfs.2020.117583
RECORD 25
TITLE
Early epidemiological analysis of the coronavirus disease 2019 outbreak based on crowdsourced data: a population-level observational study
AUTHOR NAMES
Sun K.; Chen J.; Viboud C.
SOURCE
The Lancet Digital Health (2020) 2:4 (e201-e208). Date of Publication: 1 Apr 2020
ABSTRACT
Background: As the outbreak of coronavirus disease 2019 (COVID-19) progresses, epidemiological data are needed to guide situational awareness and intervention strategies. Here we describe efforts to compile and disseminate epidemiological information on COVID-19 from news media and social networks. Methods: In this population-level observational study, we searched DXY.cn, a health-care-oriented social network that is currently streaming news reports on COVID-19 from local and national Chinese health agencies. We compiled a list of individual patients with COVID-19 and daily province-level case counts between Jan 13 and Jan 31, 2020, in China. We also compiled a list of internationally exported cases of COVID-19 from global news media sources (Kyodo News, The Straits Times, and CNN), national governments, and health authorities. We assessed trends in the epidemiology of COVID-19 and studied the outbreak progression across China, assessing delays between symptom onset, seeking care at a hospital or clinic, and reporting, before and after Jan 18, 2020, as awareness of the outbreak increased. All data were made publicly available in real time. Findings: We collected data for 507 patients with COVID-19 reported between Jan 13 and Jan 31, 2020, including 364 from mainland China and 143 from outside of China. 281 (55%) patients were male and the median age was 46 years (IQR 35–60). Few patients (13 [3%]) were younger than 15 years and the age profile of Chinese patients adjusted for baseline demographics confirmed a deficit of infections among children. Across the analysed period, delays between symptom onset and seeking care at a hospital or clinic were longer in Hubei province than in other provinces in mainland China and internationally. In mainland China, these delays decreased from 5 days before Jan 18, 2020, to 2 days thereafter until Jan 31, 2020 (p=0·0009). Although our sample captures only 507 (5·2%) of 9826 patients with COVID-19 reported by official sources during the analysed period, our data align with an official report published by Chinese authorities on Jan 28, 2020. Interpretation: News reports and social media can help reconstruct the progression of an outbreak and provide detailed patient-level data in the context of a health emergency. The availability of a central physician-oriented social network facilitated the compilation of publicly available COVID-19 data in China. As the outbreak progresses, social media and news reports will probably capture a diminishing fraction of COVID-19 cases globally due to reporting fatigue and overwhelmed health-care systems. In the early stages of an outbreak, availability of public datasets is important to encourage analytical efforts by independent teams and provide robust evidence to guide interventions. Funding: Fogarty International Center, US National Institutes of Health.
FULL TEXT LINK
http://dx.doi.org/10.1016/S2589-7500(20)30026-1
RECORD 26
TITLE
The outbreak of Coronavirus Disease 2019 (COVID-19)—An emerging global health threat
AUTHOR NAMES
Arshad Ali S.; Baloch M.; Ahmed N.; Arshad Ali A.; Iqbal A.
SOURCE
Journal of Infection and Public Health (2020). Date of Publication: 2020
ABSTRACT
The outbreak of Coronavirus Disease 2019 (COVID-19) causing novel coronavirus-infected pneumonia (NCIP), has affected the lives of 71,429 people globally. Originating in China, the disease has a rapid progression to other countries. Research suggests remarkable genomic resemblance of 2019-nCoV with Severe Acute Respiratory Syndrome (SARS) which has a history of a pandemic in 2002. With evidence of nosocomial spread, a number of diligent measures are being employed to constrain its propagation. Hence, the Public Health Emergency of International Concern (PHEIC) has been established by the World Health Organization (WHO) with strategic objectives for public health to curtail its impact on global health and economy.
FULL TEXT LINK
http://dx.doi.org/10.1016/j.jiph.2020.02.033
RECORD 27
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 28
TITLE
The Progression of Computed Tomographic (CT) Images in Patients with Coronavirus Disease (COVID-19) Pneumonia: The CT progression of COVID-19 pneumonia
AUTHOR NAMES
Lei D.P.
SOURCE
The Journal of infection (2020). Date of Publication: 20 Mar 2020
FULL TEXT LINK
http://dx.doi.org/10.1016/j.jinf.2020.03.020
RECORD 29
TITLE
Mediastinal Emphysema, Giant Bulla, and Pneumothorax Developed during the Course of COVID-19 Pneumonia
AUTHOR NAMES
Sun R.; Liu H.; Wang X.
SOURCE
Korean journal of radiology (2020). Date of Publication: 20 Mar 2020
ABSTRACT
The coronavirus disease 2019 (COVID-19) pneumonia is a recent outbreak in mainland China and has rapidly spread to multiple countries worldwide. Pulmonary parenchymal opacities are often observed during chest radiography. Currently, few cases have reported the complications of severe COVID-19 pneumonia. We report a case where serial follow-up chest computed tomography revealed progression of pulmonary lesions into confluent bilateral consolidation with lower lung predominance, thereby confirming COVID-19 pneumonia. Furthermore, complications such as mediastinal emphysema, giant bulla, and pneumothorax were also observed during the course of the disease.
FULL TEXT LINK
http://dx.doi.org/10.3348/kjr.2020.0180
RECORD 30
TITLE
Treatment of 5 Critically Ill Patients with COVID-19 with Convalescent Plasma
AUTHOR NAMES
Shen C.; Wang Z.; Zhao F.; Yang Y.; Li J.; Yuan J.; Wang F.; Li D.; Yang M.; Xing L.; Wei J.; Xiao H.; Yang Y.; Qu J.; Qing L.; Chen L.; Xu Z.; Peng L.; Li Y.; Zheng H.; Chen F.; Huang K.; Jiang Y.; Liu D.; Zhang Z.; Liu Y.; Liu L.
SOURCE
JAMA – Journal of the American Medical Association (2020). Date of Publication: 2020
ABSTRACT
Importance: Coronavirus disease 2019 (COVID-19) is a pandemic with no specific therapeutic agents and substantial mortality. It is critical to find new treatments. Objective: To determine whether convalescent plasma transfusion may be beneficial in the treatment of critically ill patients with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. Design, Setting, and Participants: Case series of 5 critically ill patients with laboratory-confirmed COVID-19 and acute respiratory distress syndrome (ARDS) who met the following criteria: severe pneumonia with rapid progression and continuously high viral load despite antiviral treatment; Pao2/Fio2 <300; and mechanical ventilation. All 5 were treated with convalescent plasma transfusion. The study was conducted at the infectious disease department, Shenzhen Third People’s Hospital in Shenzhen, China, from January 20, 2020, to March 25, 2020; final date of follow-up was March 25, 2020. Clinical outcomes were compared before and after convalescent plasma transfusion. Exposures: Patients received transfusion with convalescent plasma with a SARS-CoV-2-specific antibody (IgG) binding titer greater than 1:1000 (end point dilution titer, by enzyme-linked immunosorbent assay [ELISA]) and a neutralization titer greater than 40 (end point dilution titer) that had been obtained from 5 patients who recovered from COVID-19. Convalescent plasma was administered between 10 and 22 days after admission. Main Outcomes and Measures: Changes of body temperature, Sequential Organ Failure Assessment (SOFA) score (range 0-24, with higher scores indicating more severe illness), Pao2/Fio2, viral load, serum antibody titer, routine blood biochemical index, ARDS, and ventilatory and extracorporeal membrane oxygenation (ECMO) supports before and after convalescent plasma transfusion. Results: All 5 patients (age range, 36-65 years; 2 women) were receiving mechanical ventilation at the time of treatment and all had received antiviral agents and methylprednisolone. Following plasma transfusion, body temperature normalized within 3 days in 4 of 5 patients, the SOFA score decreased, and Pao2/Fio2 increased within 12 days (range, 172-276 before and 284-366 after). Viral loads also decreased and became negative within 12 days after the transfusion, and SARS-CoV-2-specific ELISA and neutralizing antibody titers increased following the transfusion (range, 40-60 before and 80-320 on day 7). ARDS resolved in 4 patients at 12 days after transfusion, and 3 patients were weaned from mechanical ventilation within 2 weeks of treatment. Of the 5 patients, 3 have been discharged from the hospital (length of stay: 53, 51, and 55 days), and 2 are in stable condition at 37 days after transfusion. Conclusions and Relevance: In this preliminary uncontrolled case series of 5 critically ill patients with COVID-19 and ARDS, administration of convalescent plasma containing neutralizing antibody was followed by improvement in their clinical status. The limited sample size and study design preclude a definitive statement about the potential effectiveness of this treatment, and these observations require evaluation in clinical trials..
FULL TEXT LINK
http://dx.doi.org/10.1001/jama.2020.4783
RECORD 31
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 32
TITLE
Platelet-to-lymphocyte ratio is associated with prognosis in patients with coronavirus disease-19
AUTHOR NAMES
Qu R.; Ling Y.; Zhang Y.-H.-Z.; Wei L.-Y.; Chen X.; Li X.-M.; Liu X.-Y.; Liu H.-M.; Guo Z.; Ren H.; Wang Q.
SOURCE
Journal of Medical Virology (2020). Date of Publication: 2020
ABSTRACT
Abstract: Since December 2019, novel coronavirus infected pneumonia emerged in Wuhan city and rapidly spread throughout China. In severe novel coronavirus pneumonia cases, the number of platelets, their dynamic changes during the treatment, platelet-to-lymphocyte ratio (PLR) were a concern. We sought to describe the platelet feature of these cases. Single-center case series of the 30 hospitalized patients with confirmed coronavirus disease (COVID)-19 in Huizhou municipal central hospital from January 2020 to February 2020 were retrospectively analyzed. Demographic, clinical, blood routine results, other laboratory results, and treatment data were collected and analyzed. Outcomes of severe patients and nonsevere patients were compared. Univariate analysis showed that: age, platelet peaks, and PLR at peak platelet were the influencing factors in severe patients, multivariate analysis showed that the PLR value at peak platelet during treatment was an independent influencing factor in severe patients. The average hospitalization day of patients with platelet peaks during treatment was longer than those without platelet peaks (P <.05). The average age of patients with platelet peaks during treatment was older than those without platelet peaks (P <.05). The patients with significantly elevated platelets during treatment had longer average hospitalization days. And the higher PLR of patients during treatment had longer average hospitalization days. Single-center case series of the 30 hospitalized patients with confirmed COVID-19 in Huizhou Municipal Central Hospital, presumed that the number of platelets and their dynamic changes during the treatment may have a suggestion on the severity and prognosis of the disease. The patient with markedly elevated platelets and longer average hospitalization days may be related to the cytokine storm. The PLR of patients means the degree of cytokine storm, which might provide a new indicator in the monitoring in patients with COVID-19.
FULL TEXT LINK
http://dx.doi.org/10.1002/jmv.25767
RECORD 33
TITLE
Host susceptibility to severe COVID-19 and establishment of a host risk score: findings of 487 cases outside Wuhan
AUTHOR NAMES
Shi Y.; Yu X.; Zhao H.; Wang H.; Zhao R.; Sheng J.
SOURCE
Critical care (London, England) (2020) 24:1 (108). Date of Publication: 18 Mar 2020
FULL TEXT LINK
http://dx.doi.org/10.1186/s13054-020-2833-7
RECORD 34
TITLE
Chemotherapy strategy for colorectal cancer under the outbreak of corona virus disease 2019
AUTHOR NAMES
Li Y.H.; Shen L.; Li J.
SOURCE
Zhonghua wei chang wai ke za zhi = Chinese journal of gastrointestinal surgery (2020) 23:3 (217-219). Date of Publication: 25 Mar 2020
ABSTRACT
The outbreak of corona virus disease 2019 (COVID-19) makes the medical treatment of colorectal cancers difficult. Cancer patients are more susceptible to infection and tumor history is defined as an important factor of poor prognosis, which challenges both doctors and patients. For metastatic colorectal cancer (CRC) patients, maintenance therapy is the optimal choice. The patients with tumor progression or poor biological behavior should receive or continue combination chemotherapy. Adjuvant chemotherapy should reduce the intensity of treatment and shorten the therapy time. Fever patients during chemotherapy need to receive differential diagnosis and screening according to national standards. Patients with stable diseases and good general conditions may delay imaging examination. Clinicians should make individual clinical decisions based on the specifics of each patient during epidemic situation.
FULL TEXT LINK
http://dx.doi.org/10.3760/cma.j.cn.441530-20200225-00089
RECORD 35
TITLE
Rapid Progression to Acute Respiratory Distress Syndrome: Review of Current Understanding of Critical Illness from COVID-19 Infection
AUTHOR NAMES
Goh K.J.; Choong M.C.; Cheong E.H.; Kalimuddin S.; Duu Wen S.; Phua G.C.; Chan K.S.; Haja Mohideen S.
SOURCE
Annals of the Academy of Medicine, Singapore (2020) 49:1 (1-9). Date of Publication: 1 Jan 2020
ABSTRACT
The coronavirus disease 2019 (COVID-19) outbreak that started in Wuhan, Hubei province, China in December 2019 has now extended across the globe with >100,000 cases and 3,000 deaths reported in 93 countries as of 7 March 2020. We report a case of COVID-19 infection in a 64-year-old man who developed rapidly worsening respiratory failure and acute respiratory distress syndrome (ARDS) that required intubation. As the clinical spectrum of COVID-19 ranges widely from mild illness to ARDS with a high risk of mortality, there is a need for more research to identify early markers of disease severity. Current evidence suggests that patients with advanced age, pre-existing comorbidities or dyspnoea should be closely monitored, especially at 1-2 weeks after symptom onset. It remains to be seen if laboratory findings such as lymphopenia or elevated lactate dehydrogenase may serve as early surrogates for critical illness or markers of disease recovery. Management of ARDS in COVID-19 remains supportive while we await results of drug trials. More studies are needed to understand the incidence and outcomes of ARDS and critical illness from COVID-19, which will be important for critical care management and resource planning.
RECORD 36
TITLE
Systematic review of COVID-19 in children show milder cases and a better prognosis than adults
AUTHOR NAMES
Ludvigsson J.F.
SOURCE
Acta paediatrica (Oslo, Norway : 1992) (2020). Date of Publication: 23 Mar 2020
ABSTRACT
AIM: The coronavirus disease 2019 (COVID-19) pandemic has affected hundreds of thousands of people. Data on symptoms and prognoses in children are rare. METHODS: A systematic literature review was carried out to identify papers on COVID-19, which is caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), using the Medline and EMBASE databases between 1 January and 18 March 2020. RESULTS: The search identified 45 relevant scientific papers and letters. The review showed that children have so far accounted for 1-5% of diagnosed COVID-19 cases, they often have milder disease than adults and deaths have been extremely rare. Diagnostic findings have been similar to adults, with fever and respiratory symptoms being prevalent, but fewer children seem to have developed severe pneumonia. Elevated inflammatory markers were less common in children and lymphocytopenia seemed rare. Newborn infants have developed symptomatic COVID-19, but evidence of vertical intrauterine transmission was scarce. Suggested treatment included providing oxygen, inhalations, nutritional support and maintaining fluids and electrolyte balances. CONCLUSIONS: COVID-19 has occurred in children, but they seemed to have a milder disease course and better prognoses than adults. Deaths were extremely rare.
FULL TEXT LINK
http://dx.doi.org/10.1111/apa.15270
RECORD 37
TITLE
Laboratory abnormalities in patients with COVID-2019 infection
AUTHOR NAMES
Lippi G.; Plebani M.
SOURCE
Clinical Chemistry and Laboratory Medicine (2020). Date of Publication: 2020
FULL TEXT LINK
http://dx.doi.org/10.1515/cclm-2020-0198
RECORD 38
TITLE
Coronavirus Disease (COVID-19): Spectrum of CT Findings and Temporal Progression of the Disease
AUTHOR NAMES
Li M.; Lei P.; Zeng B.; Li Z.; Yu P.; Fan B.; Wang C.; Li Z.; Zhou J.; Hu S.; Liu H.
SOURCE
Academic Radiology (2020). Date of Publication: 2020
ABSTRACT
Coronavirus disease is an emerging infection caused by a novel coronavirus that is moving rapidly. High resolution computed tomography (CT) allows objective evaluation of the lung lesions, thus enabling us to better understand the pathogenesis of the disease. With serial CT examinations, the occurrence, development, and prognosis of the disease can be better understood. The imaging can be sorted into four phases: early phase, progressive phase, severe phase, and dissipative phase. The CT appearance of each phase and temporal progression of the imaging findings are demonstrated.
FULL TEXT LINK
http://dx.doi.org/10.1016/j.acra.2020.03.003
RECORD 39
TITLE
Clinical and CT imaging features of the COVID-19 pneumonia: Focus on pregnant women and children
AUTHOR NAMES
Liu H.; Liu F.; Li J.; Zhang T.; Wang D.; Lan W.
SOURCE
Journal of Infection (2020). Date of Publication: 2020
ABSTRACT
Background: The ongoing outbreak of COVID-19 pneumonia is globally concerning. We aimed to investigate the clinical and CT features in the pregnant women and children with this disease, which have not been well reported. Methods: Clinical and CT data of 59 patients with COVID-19 from January 27 to February 14, 2020 were retrospectively reviewed, including 14 laboratory-confirmed non-pregnant adults, 16 laboratory-confirmed and 25 clinically-diagnosed pregnant women, and 4 laboratory-confirmed children. The clinical and CT features were analyzed and compared. Findings: Compared with the non-pregnant adults group (n = 14), initial normal body temperature (9 [56%] and 16 [64%]), leukocytosis (8 [50%] and 9 [36%]) and elevated neutrophil ratio (14 [88%] and 20 [80%]), and lymphopenia (9 [56%] and 16 [64%]) were more common in the laboratory-confirmed (n = 16) and clinically-diagnosed (n = 25) pregnant groups. Totally 614 lesions were detected with predominantly peripheral and bilateral distributions in 54 (98%) and 37 (67%) patients, respectively. Pure ground-glass opacity (GGO) was the predominant presence in 94/131 (72%) lesions for the non-pregnant adults. Mixed consolidation and complete consolidation were more common in the laboratory-confirmed (70/161 [43%]) and clinically-diagnosed (153/322 [48%]) pregnant groups than 37/131 (28%) in the non-pregnant adults (P = 0·007, P < 0·001). GGO with reticulation was less common in 9/161 (6%) and 16/322 (5%) lesions for the two pregnant groups than 24/131 (18%) for the non-pregnant adults (P = 0·001, P < 0·001). The pulmonary involvement in children with COVID-19 was mild with a focal GGO or consolidation. Twenty-three patients underwent follow-up CT, revealing progression in 9/13 (69%) at 3 days whereas improvement in 8/10 (80%) at 6–9 days after initial CT scans. Interpretation: Atypical clinical findings of pregnant women with COVID-19 could increase the difficulty in initial identification. Consolidation was more common in the pregnant groups. The clinically-diagnosed cases were vulnerable to more pulmonary involvement. CT was the modality of choice for early detection, severity assessment, and timely therapeutic effects evaluation for the cases with epidemic and clinical features of COVID-19 with or without laboratory confirmation. The exposure history and clinical symptoms were more helpful for screening in children versus chest CT.
FULL TEXT LINK
http://dx.doi.org/10.1016/j.jinf.2020.03.007
RECORD 40
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 41
TITLE
Temporal Changes of CT Findings in 90 Patients with COVID-19 Pneumonia: A Longitudinal Study
AUTHOR NAMES
Wang Y.; Dong C.; Hu Y.; Li C.; Ren Q.; Zhang X.; Shi H.; Zhou M.
SOURCE
Radiology (2020) (200843). Date of Publication: 19 Mar 2020
ABSTRACT
Background CT may play a central role in the diagnosis and management of COVID-19 pneumonia. Purpose To perform a longitudinal study to analyze the serial CT findings over time in patients with COVID-19 pneumonia. Materials and Methods During January 16 to February 17, 2020, 90 patients (male:female, 33:57; mean age, 45 years) with COVID-19 pneumonia were prospectively enrolled and followed up until they were discharged or died, or until the end of the study. A total of 366 CT scans were acquired and reviewed by 2 groups of radiologists for the patterns and distribution of lung abnormalities, total CT scores and number of zones involved. Those features were analyzed for temporal change. Results CT scores and number of zones involved progressed rapidly, peaked during illness days 6-11 (median: 5 and 5), and followed by persistence of high levels. The predominant pattern of abnormalities after symptom onset was ground-glass opacity (35/78 [45%] to 49/79 [62%] in different periods). The percentage of mixed pattern peaked (30/78 [38%]) on illness days 12-17, and became the second most predominant pattern thereafter. Pure ground-glass opacity was the most prevalent sub-type of ground-glass opacity after symptom onset (20/50 [40%] to 20/28 [71%]). The percentage of ground-glass opacity with irregular linear opacity peaked on illness days 6-11 (14/50 [28%)]) and became the second most prevalent subtype thereafter. The distribution of lesions was predominantly bilateral and subpleural. 66/70 (94%) patients discharged had residual disease on final CT scans (median CT scores and zones involved: 4 and 4), with ground-glass opacity (42/70 [60%]) and pure ground-glass opacity (31/42 [74%]) the most common pattern and subtype. Conclusion The extent of lung abnormalities on CT peaked during illness days 6-11. The temporal changes of the diverse CT manifestations followed a specific pattern, which might indicate the progression and recovery of the illness.
FULL TEXT LINK
http://dx.doi.org/10.1148/radiol.2020200843
RECORD 42
TITLE
COVID-19: a recommendation to examine the effect of hydroxychloroquine in preventing infection and progression
AUTHOR NAMES
Zhou D.; Dai S.-M.; Tong Q.
SOURCE
The Journal of antimicrobial chemotherapy (2020). Date of Publication: 20 Mar 2020
ABSTRACT
A novel coronavirus disease (COVID-19), caused by infection with SARS-CoV-2, has swept across 31 provinces in China and over 40 countries worldwide. The transition from first symptoms to acute respiratory distress syndrome (ARDS) is highly likely to be due to uncontrolled cytokine release. There is an urgent need to identify safe and effective drugs for treatment. Chloroquine (CQ) exhibits a promising inhibitory effect. However, the clinical use of CQ can cause severe side effects. We propose that hydroxychloroquine (HCQ), which exhibits an antiviral effect highly similar to that of CQ, could serve as a better therapeutic approach. HCQ is likely to attenuate the severe progression of COVID-19, inhibiting the cytokine storm by suppressing T cell activation. It has a safer clinical profile and is suitable for those who are pregnant. It is cheaper and more readily available in China. We herein strongly urge that clinical trials are performed to assess the preventive effects of HCQ in both disease infection and progression.
FULL TEXT LINK
http://dx.doi.org/10.1093/jac/dkaa114
RECORD 43
TITLE
Chest CT manifestations of new coronavirus disease 2019 (COVID-19): a pictorial review
AUTHOR NAMES
Ye Z.; Zhang Y.; Wang Y.; Huang Z.; Song B.
SOURCE
European radiology (2020). Date of Publication: 19 Mar 2020
ABSTRACT
Coronavirus disease 2019 (COVID-19) outbreak, first reported in Wuhan, China, has rapidly swept around the world just within a month, causing global public health emergency. In diagnosis, chest computed tomography (CT) manifestations can supplement parts of limitations of real-time reverse transcription polymerase chain reaction (RT-PCR) assay. Based on a comprehensive literature review and the experience in the frontline, we aim to review the typical and relatively atypical CT manifestations with representative COVID-19 cases at our hospital, and hope to strengthen the recognition of these features with radiologists and help them make a quick and accurate diagnosis.Key Points • Ground glass opacities, consolidation, reticular pattern, and crazy paving pattern are typical CT manifestations of COVID-19. • Emerging atypical CT manifestations, including airway changes, pleural changes, fibrosis, nodules, etc., were demonstrated in COVID-19 patients. • CT manifestations may associate with the progression and prognosis of COVID-19.
FULL TEXT LINK
http://dx.doi.org/10.1007/s00330-020-06801-0
RECORD 44
TITLE
Hypothesis for potential pathogenesis of SARS-CoV-2 infection-a review of immune changes in patients with viral pneumonia
AUTHOR NAMES
Lin L.; Lu L.; Cao W.; Li T.
SOURCE
Emerging microbes & infections (2020) 9:1 (727-732). Date of Publication: 1 Dec 2020
ABSTRACT
Coronavirus disease 2019 (COVID-19) is an infectious disease caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) with droplets and contact as the main means of transmission. Since the first case appeared in Wuhan, China, in December 2019, the outbreak has gradually spread nationwide. Up to now, according to official data released by the Chinese health commission, the number of newly diagnosed patients has been declining, and the epidemic is gradually being controlled. Although most patients have mild symptoms and good prognosis after infection, some patients developed severe and die from multiple organ complications. The pathogenesis of SARS-CoV-2 infection in humans remains unclear. Immune function is a strong defense against invasive pathogens and there is currently no specific antiviral drug against the virus. This article reviews the immunological changes of coronaviruses like SARS, MERS and other viral pneumonia similar to SARS-CoV-2. Combined with the published literature, the potential pathogenesis of COVID-19 is inferred, and the treatment recommendations for giving high-doses intravenous immunoglobulin and low-molecular-weight heparin anticoagulant therapy to severe type patients are proposed.
FULL TEXT LINK
http://dx.doi.org/10.1080/22221751.2020.1746199
RECORD 45
TITLE
Potential scenarios for the progression of a COVID-19 epidemic in the European Union and the European Economic Area, March 2020
AUTHOR NAMES
Johnson H.C.; Gossner C.M.; Colzani E.; Kinsman J.; Alexakis L.; Beauté J.; Würz A.; Tsolova S.; Bundle N.; Ekdahl K.
SOURCE
Euro surveillance : bulletin Europeen sur les maladies transmissibles = European communicable disease bulletin (2020) 25:9. Date of Publication: 1 Mar 2020
ABSTRACT
Two months after the emergence of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), the possibility of established and widespread community transmission in the European Union and European Economic Area (EU/EEA) is becoming more likely. We provide scenarios for use in preparedness for a possible widespread epidemic. The EU/EEA is moving towards the ‘limited sustained transmission’ phase. We propose actions to prepare for potential mitigation phases and coordinate efforts to protect the health of citizens.
FULL TEXT LINK
http://dx.doi.org/10.2807/1560-7917.ES.2020.25.9.2000202
RECORD 46
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 47
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 48
TITLE
A 55-Day-Old Female Infant infected with COVID 19: presenting with pneumonia, liver injury, and heart damage
AUTHOR NAMES
Cui Y.; Tian M.; Huang D.; Wang X.; Huang Y.; Fan L.; Wang L.; Chen Y.; Liu W.; Zhang K.; Wu Y.; Yang Z.; Tao J.; Feng J.; Liu K.; Ye X.; Wang R.; Zhang X.; Zha Y.
SOURCE
The Journal of infectious diseases (2020). Date of Publication: 17 Mar 2020
ABSTRACT
Previous studies on the pneumonia outbreak caused by the 2019 novel coronavirus disease (COVID-19) were mainly based on information from adult populations. Limited data are available for children with COVID-19, especially for infected infants. We report a 55-day-old case with COVID-19 confirmed in China and describe the identification, diagnosis, clinical course, and treatment of the patient, including the disease progression from day 7 to day 11 of illness. This case highlights that children with COVID-19 can also present with multiple organ damage and rapid disease changes. When managing such patients, frequent and careful clinical monitoring is essential.
FULL TEXT LINK
http://dx.doi.org/10.1093/infdis/jiaa113
RECORD 49
TITLE
Pregnancy and Perinatal Outcomes of Women With Coronavirus Disease (COVID-19) Pneumonia: A Preliminary Analysis
AUTHOR NAMES
Liu D.; Li L.; Wu X.; Zheng D.; Wang J.; Yang L.; Zheng C.
SOURCE
AJR. American journal of roentgenology (2020) (1-6). Date of Publication: 18 Mar 2020
ABSTRACT
OBJECTIVE. The purpose of this study was to describe the clinical manifestations and CT features of coronavirus disease (COVID-19) pneumonia in 15 pregnant women and to provide some initial evidence that can be used for guiding treatment of pregnant women with COVID-19 pneumonia. MATERIALS AND METHODS. We reviewed the clinical data and CT examinations of 15 consecutive pregnant women with COVID-19 pneumonia in our hospital from January 20, 2020, to February 10, 2020. A semiquantitative CT scoring system was used to estimate pulmonary involvement and the time course of changes on chest CT. Symptoms and laboratory results were analyzed, treatment experiences were summarized, and clinical outcomes were tracked. RESULTS. Eleven patients had successful delivery (10 cesarean deliveries and one vaginal delivery) during the study period, and four patients were still pregnant (three in the second trimester and one in the third trimester) at the end of the study period. No cases of neonatal asphyxia, neonatal death, stillbirth, or abortion were reported. The most common early finding on chest CT was ground-glass opacity (GGO). With disease progression, crazy paving pattern and consolidations were seen on CT. The abnormalities showed absorptive changes at the end of the study period for all patients. The most common onset symptoms of COVID-19 pneumonia in pregnant women were fever (13/15 patients) and cough (9/15 patients). The most common abnormal laboratory finding was lymphocytopenia (12/15 patients). CT images obtained before and after delivery showed no signs of pneumonia aggravation after delivery. The four patients who were still pregnant at the end of the study period were not treated with antiviral drugs but had achieved good recovery. CONCLUSION. Pregnancy and childbirth did not aggravate the course of symptoms or CT features of COVID-19 pneumonia. All the cases of COVID-19 pneumonia in the pregnant women in our study were the mild type. All the women in this study-some of whom did not receive antiviral drugs-achieved good recovery from COVID-19 pneumonia.
FULL TEXT LINK
http://dx.doi.org/10.2214/AJR.20.23072
RECORD 50
TITLE
A commentary on “World Health Organization declares global emergency: A review of the 2019 novel Coronavirus (COVID-19)”
AUTHOR NAMES
Shah S.G.S.; Farrow A.
SOURCE
International Journal of Surgery (2020) 76 (128-129). Date of Publication: 1 Apr 2020
FULL TEXT LINK
http://dx.doi.org/10.1016/j.ijsu.2020.03.001
RECORD 51
TITLE
Clinical Management of Lung Cancer Patients during the Outbreak of 2019 Novel Coronavirus Disease (COVID-19)
AUTHOR NAMES
Xu Y.; Liu H.; Hu K.; Wang M.
SOURCE
Zhongguo fei ai za zhi = Chinese journal of lung cancer (2020) 23. Date of Publication: 20 Feb 2020
ABSTRACT
Since late December 2019, an outbreak of 2019 novel coronavirus diseases (COVID-19) in Wuhan, China has spread quickly nationwide. With the spread of COVID-19, the routine clinical diagnosis and treatment for lung cancer patients has been disturbed. Due to the systemic immunosuppressive of lung cancer patients caused by the malignancy and anticancer treatments, lung cancer patients are more susceptible to infection than healthy individuals. Furthermore, patients with cancer had poorer prognosis from infection. Lung cancer patients should be the priority group for COVID-19 prevention. The protection provisions and control measures aiming to protect lung cancer patients from COVID-19 have been increasingly concerned. During the COVID-19 outbreak period, it should be carefully differentiated for fever and respiratory symptoms for lung cancer patients receiving anti-tumor treatment, in order to evaluate the risk of COVID-19. Moreover, it is necessary to carry out meticulous and individualized clinical management for lung cancer patients to effectively protect the patients from COVID-19.
FULL TEXT LINK
http://dx.doi.org/10.3779/j.issn.1009-3419.2020.03.02
RECORD 52
TITLE
Management of corona virus disease-19 (COVID-19): the Zhejiang experience
AUTHOR NAMES
Xu K.; Cai H.; Shen Y.; Ni Q.; Chen Y.; Hu S.; Li J.; Wang H.; Yu L.; Huang H.; Qiu Y.; Wei G.; Fang Q.; Zhou J.; Sheng J.; Liang T.; Li L.
SOURCE
Zhejiang da xue xue bao. Yi xue ban = Journal of Zhejiang University. Medical sciences (2020) 49:1 (0). Date of Publication: 21 Feb 2020
ABSTRACT
The current epidemic situation of corona virus disease-19 (COVID-19) still remained severe. As the National Clinical Research Center for Infectious Diseases, the First Affiliated Hospital of Zhejiang University School of Medicine is the primary medical care center for COVID-19 inZhejiang Province. Based on the present expert consensus carried out by National Health Commission and National Administration of Traditional Chinese Medicine, our team summarized and established an effective treatment strategy centered on “Four-Anti and Two-Balance” for clinical practice. The “Four-Anti and Two-Balance”strategy included antivirus, anti-shock, anti-hyoxemia, anti-secondary infection, and maintaining of water, electrolyte and acid base balance and microecological balance. Meanwhile, integrated multidisciplinarypersonalized treatment was recommended to improve therapeutic effect. The importance of early viralogical detection, dynamic monitoring of inflammatory indexes and chest radiograph was emphasized in clinical decision-making. Sputum was observed with the highest positive rate of RT-PCR results. Viral nucleic acids could be detected in10% patients’blood samples at acute periodand 50% of patients had positive RT-PCR results in their feces. We also isolated alive viral strains from feces, indicating potential infectiousness of feces.Dynamic cytokine detection was necessary to timely identifyingcytokine storms and application of artificial liver blood purification system. The “Four-Anti and Two-Balance”strategyeffectively increased cure rate and reduced mortality. Early antiviral treatment could alleviate disease severity and prevent illness progression, and we found lopinavir/ritonavir combined with abidol showed antiviraleffects in COVID-19. Shock and hypoxemia were usually caused by cytokine storms. The artificial liver blood purification system could rapidly remove inflammatory mediators and block cytokine storm.Moreover, it also favoredthe balance of fluid, electrolyte and acid-base and thus improved treatment efficacy in critical illness. For cases of severe illness, early and also short periods of moderate glucocorticoid was supported. Patients with oxygenation index below 200 mmHg should be transferred to intensive medical center. Conservative oxygen therapy was preferred and noninvasive ventilation was not recommended. Patients with mechanical ventilation should be strictly supervised with cluster ventilator-associated pneumonia prevention strategies. Antimicrobial prophylaxis should be prescribed rationally and was not recommended except for patients with long course of disease, repeated fever and elevated procalcitonin (PCT), meanwhile secondary fungal infection should be concerned.Some patients with COVID-19 showed intestinal microbialdysbiosis with decreasedprobiotics such as Lactobacillus and Bifidobacterium. Nutritional and gastrointestinal function should be assessed for all patients.Nutritional support and application of prebiotics or probiotics were suggested to regulate the balance of intestinal microbiota and reduce the risk of secondary infection due to bacterial translocation. Anxiety and fear were common in patients with COVID-19. Therefore, we established dynamic assessment and warning for psychological crisis. We also integrated Chinese medicine in treatment to promote disease rehabilitation through classification methods of traditional Chinese medicine. We optimized nursing process for severe patients to promote their rehabilitation. It remained unclear about viral clearance pattern after the SARS-CoV-2 infection. Therefore, two weeks’ quarantine for discharged patients was required and a regular following up was also needed.The Zhejiang experience above and suggestions have been implemented in our center and achieved good results. However, since COVID-19 was a newly emerging disease, more work was warranted to improve strategies of prevention, diagnosis and treatment for COVID-19.
RECORD 53
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 54
TITLE
Prevalence and impact of cardiovascular metabolic diseases on COVID-19 in China
AUTHOR NAMES
Li B.; Yang J.; Zhao F.; Zhi L.; Wang X.; Liu L.; Bi Z.; Zhao Y.
SOURCE
Clinical Research in Cardiology (2020). Date of Publication: 2020
ABSTRACT
Background: Studies have reminded that cardiovascular metabolic comorbidities made patients more susceptible to suffer 2019 novel corona virus (2019-nCoV) disease (COVID-19), and exacerbated the infection. The aim of this analysis is to determine the association of cardiovascular metabolic diseases with the development of COVID-19. Methods: A meta-analysis of eligible studies that summarized the prevalence of cardiovascular metabolic diseases in COVID-19 and compared the incidences of the comorbidities in ICU/severe and non-ICU/severe patients was performed. Embase and PubMed were searched for relevant studies. Results: A total of six studies with 1527 patients were included in this analysis. The proportions of hypertension, cardia-cerebrovascular disease and diabetes in patients with COVID-19 were 17.1%, 16.4% and 9.7%, respectively. The incidences of hypertension, cardia-cerebrovascular diseases and diabetes were about twofolds, threefolds and twofolds, respectively, higher in ICU/severe cases than in their non-ICU/severe counterparts. At least 8.0% patients with COVID-19 suffered the acute cardiac injury. The incidence of acute cardiac injury was about 13 folds higher in ICU/severe patients compared with the non-ICU/severe patients. Conclusion: Patients with previous cardiovascular metabolic diseases may face a greater risk of developing into the severe condition and the comorbidities can also greatly affect the prognosis of the COVID-19. On the other hand, COVID-19 can, in turn, aggravate the damage to the heart.
FULL TEXT LINK
http://dx.doi.org/10.1007/s00392-020-01626-9
RECORD 55
TITLE
2019-novel Coronavirus severe adult respiratory distress syndrome in two cases in Italy: An uncommon radiological presentation
AUTHOR NAMES
Albarello F.; Pianura E.; Di Stefano F.; Cristofaro M.; Petrone A.; Marchioni L.; Palazzolo C.; Schininà V.; Nicastri E.; Petrosillo N.; Campioni P.; Eskild P.; Zumla A.; Ippolito G.; Abbonizio M.A.; Agrati C.; Amadei G.; Amendola A.; Antonini M.; Barbaro R.; Bartolini B.; Benigni M.; Bevilacqua N.; Bordi L.; Bordoni V.; Branca M.; Capobianchi M.R.; Caporale C.; Caravella I.; Carletti F.; Castilletti C.; Chiappini R.; Ciaralli C.; Colavita F.; Corpolongo A.; Curiale S.; D’Abramo A.; Dantimi C.; Angelis A.D.; Angelis G.D.; Lorenzo R.D.; Stefano F.D.; Ferraro F.; Fiorentini L.; Frustaci A.; Gallì P.; Garotto G.; Giancola M.L.; Giansante F.; Giombini E.; Greci M.C.; Lalle E.; Lanini S.; Lapa D.; Lepore L.; Lucia A.; Lufrani F.; Macchione M.; Marani A.; Mariano A.; Marini M.C.; Maritti M.; Matusali G.; Meschi S.; Montaldo F.M.C.; Murachelli S.; Noto R.; Pallini E.; Passeri V.; Pelliccioni F.; Petrecchia A.; Pisciotta M.; Pittalis S.; Proietti C.; Puro V.; Rinonapoli G.; Rueca M.; Sacchi A.; Sanasi F.; Santagata C.; Scarcia S.; Scognamiglio P.; Scorzolini L.; Stazi G.; Vaia F.; Vairo F.; Valli M.B.
SOURCE
International Journal of Infectious Diseases (2020) 93 (192-197). Date of Publication: 1 Apr 2020
ABSTRACT
Introduction: Several recent case reports have described common early chest imaging findings of lung pathology caused by 2019 novel Coronavirus (SARS-COV2) which appear to be similar to those seen previously in SARS-CoV and MERS-CoV infected patients. Objective: We present some remarkable imaging findings of the first two patients identified in Italy with COVID-19 infection travelling from Wuhan, China. The follow-up with chest X-Rays and CT scans was also included, showing a progressive adult respiratory distress syndrome (ARDS). Results: Moderate to severe progression of the lung infiltrates, with increasing percentage of high-density infiltrates sustained by a bilateral and multi-segmental extension of lung opacities, were seen. During the follow-up, apart from pleural effusions, a tubular and enlarged appearance of pulmonary vessels with a sudden caliber reduction was seen, mainly found in the dichotomic tracts, where the center of a new insurgent pulmonary lesion was seen. It could be an early alert radiological sign to predict initial lung deterioration. Another uncommon element was the presence of mediastinal lymphadenopathy with short-axis oval nodes. Conclusions: Although only two patients have been studied, these findings are consistent with the radiological pattern described in literature. Finally, the pulmonary vessels enlargement in areas where new lung infiltrates develop in the follow-up CT scan, could describe an early predictor radiological sign of lung impairment.
FULL TEXT LINK
http://dx.doi.org/10.1016/j.ijid.2020.02.043
RECORD 56
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 57
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 58
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 59
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 60
TITLE
Elevated exhaustion levels and reduced functional diversity of T cells in peripheral blood may predict severe progression in COVID-19 patients
AUTHOR NAMES
Zheng H.-Y.; Zhang M.; Yang C.-X.; Zhang N.; Wang X.-C.; Yang X.-P.; Dong X.-Q.; Zheng Y.-T.
SOURCE
Cellular and Molecular Immunology (2020). Date of Publication: 2020
FULL TEXT LINK
http://dx.doi.org/10.1038/s41423-020-0401-3
RECORD 61
TITLE
Procalcitonin in patients with severe coronavirus disease 2019 (COVID-19): A meta-analysis
AUTHOR NAMES
Lippi G.; Plebani M.
SOURCE
Clinica Chimica Acta (2020) 505 (190-191). Date of Publication: 1 Jun 2020
FULL TEXT LINK
http://dx.doi.org/10.1016/j.cca.2020.03.004
RECORD 62
TITLE
Potential factors influencing repeated SARS outbreaks in China
AUTHOR NAMES
Sun Z.; Thilakavathy K.; Kumar S.S.; He G.; Liu S.V.
SOURCE
International Journal of Environmental Research and Public Health (2020) 17:5 Article Number: 1633. Date of Publication: 1 Mar 2020
ABSTRACT
Within last 17 years two widespread epidemics of severe acute respiratory syndrome (SARS) occurred in China, which were caused by related coronaviruses (CoVs): SARS-CoV and SARS-CoV-2. Although the origin(s) of these viruses are still unknown and their occurrences in nature are mysterious, some general patterns of their pathogenesis and epidemics are noticeable. Both viruses utilize the same receptor—angiotensin-converting enzyme 2 (ACE2)—for invading human bodies. Both epidemics occurred in cold dry winter seasons celebrated with major holidays, and started in regions where dietary consumption of wildlife is a fashion. Thus, if bats were the natural hosts of SARS-CoVs, cold temperature and low humidity in these times might provide conducive environmental conditions for prolonged viral survival in these regions concentrated with bats. The widespread existence of these bat-carried or-released viruses might have an easier time in breaking through human defenses when harsh winter makes human bodies more vulnerable. Once succeeding in making some initial human infections, spreading of the disease was made convenient with increased social gathering and holiday travel. These natural and social factors influenced the general progression and trajectory of the SARS epidemiology. However, some unique factors might also contribute to the origination of SARS in Wuhan. These factors are discussed in different scenarios in order to promote more research for achieving final validation.
FULL TEXT LINK
http://dx.doi.org/10.3390/ijerph17051633
RECORD 63
TITLE
The effect of travel restrictions on the spread of the 2019 novel coronavirus (COVID-19) outbreak
AUTHOR NAMES
Chinazzi M.; Davis J.T.; Ajelli M.; Gioannini C.; Litvinova M.; Merler S.; Pastore Y Piontti A.; Mu K.; Rossi L.; Sun K.; Viboud C.; Xiong X.; Yu H.; Halloran M.E.; Longini I.M.; Vespignani A.
SOURCE
Science (New York, N.Y.) (2020). Date of Publication: 6 Mar 2020
ABSTRACT
Motivated by the rapid spread of COVID-19 in Mainland China, we use a global metapopulation disease transmission model to project the impact of travel limitations on the national and international spread of the epidemic. The model is calibrated based on internationally reported cases, and shows that at the start of the travel ban from Wuhan on 23 January 2020, most Chinese cities had already received many infected travelers. The travel quarantine of Wuhan delayed the overall epidemic progression by only 3 to 5 days in Mainland China, but has a more marked effect at the international scale, where case importations were reduced by nearly 80% until mid February. Modeling results also indicate that sustained 90% travel restrictions to and from Mainland China only modestly affect the epidemic trajectory unless combined with a 50% or higher reduction of transmission in the community.
FULL TEXT LINK
http://dx.doi.org/10.1126/science.aba9757
RECORD 64
TITLE
CT Features of Coronavirus Disease 2019 (COVID-19) Pneumonia in 62 Patients in Wuhan, China
AUTHOR NAMES
Zhou S.; Wang Y.; Zhu T.; Xia L.
SOURCE
AJR. American journal of roentgenology (2020) (1-8). Date of Publication: 5 Mar 2020
ABSTRACT
OBJECTIVE. The purpose of this study was to investigate 62 subjects in Wuhan, China, with laboratory-confirmed coronavirus disease (COVID-19) pneumonia and describe the CT features of this epidemic disease. MATERIALS AND METHODS. A retrospective study of 62 consecutive patients with laboratory-confirmed COVID-19 pneumonia was performed. CT images and clinical data were reviewed. Two thoracic radiologists evaluated the distribution and CT signs of the lesions and also scored the extent of involvement of the CT signs. The Mann-Whitney U test was used to compare lesion distribution and CT scores. The chi-square test was used to compare the CT signs of early-phase versus advanced-phase COVID-19 pneumonia. RESULTS. A total of 62 patients (39 men and 23 women; mean [± SD] age, 52.8 ± 12.2 years; range, 30-77 years) with COVID-19 pneumonia were evaluated. Twenty-four of 30 patients who underwent routine blood tests (80.0%) had a decreased lymphocyte count. Of 27 patients who had their erythrocyte sedimentation rate and high-sensitivity C-reactive protein level assessed, 18 (66.7%) had an increased erythrocyte sedimentation rate, and all 27 (100.0%) had an elevated high-sensitivity C-reactive protein level. Multiple lesions were seen on the initial CT scan of 52 of 62 patients (83.9%). Forty-eight of 62 patients (77.4%) had predominantly peripheral distribution of lesions. The mean CT score for the upper zone (3.0 ± 3.4) was significantly lower than that for the middle (4.5 ± 3.8) and lower (4.5 ± 3.7) zones (p = 0.022 and p = 0.020, respectively), and there was no significant difference in the mean CT score of the middle and lower zones (p = 1.00). The mean CT score for the anterior area (4.4 ± 4.1) was significantly lower than that for the posterior area (7.7 ± 6.3) (p = 0.003). CT findings for the patients were as follows: 25 patients (40.3%) had ground-glass opacities (GGO), 21 (33.9%), consolidation; 39 (62.9%), GGO plus a reticular pattern; 34 (54.8%), vacuolar sign; 28 (45.2%), microvascular dilation sign; 35 (56.5%), fibrotic streaks; 21 (33.9%), a subpleural line; and 33 (53.2%), a subpleural transparent line. With regard to bronchial changes seen on CT, 45 patients (72.6%) had air bronchogram, and 11 (17.7%) had bronchus distortion. In terms of pleural changes, CT showed that 30 patients (48.4%) had pleural thickening, 35 (56.5%) had pleural retraction sign, and six (9.7%) had pleural effusion. Compared with early-phase disease (≤ 7 days after the onset of symptoms), advanced-phase disease (8-14 days after the onset of symptoms) was characterized by significantly increased frequencies of GGO plus a reticular pattern, vacuolar sign, fibrotic streaks, a subpleural line, a subpleural transparent line, air bronchogram, bronchus distortion, and pleural effusion; however, GGO significantly decreased in advanced-phase disease. CONCLUSION. CT examination of patients with COVID-19 pneumonia showed a mixed and diverse pattern with both lung parenchyma and the interstitium involved. Identification of GGO and a single lesion on the initial CT scan suggested early-phase disease. CT signs of aggravation and repair coexisted in advanced-phase disease. Lesions presented with a characteristic multifocal distribution in the middle and lower lung regions and in the posterior lung area. A decreased lymphocyte count and an increased high-sensitivity C-reactive protein level were the most common laboratory findings.
FULL TEXT LINK
http://dx.doi.org/10.2214/AJR.20.22975
RECORD 65
TITLE
Clinical and High-Resolution CT Features of the COVID-19 Infection: Comparison of the Initial and Follow-up Changes
AUTHOR NAMES
Xiong Y.; Sun D.; Liu Y.; Fan Y.; Zhao L.; Li X.; Zhu W.
SOURCE
Investigative radiology (2020). Date of Publication: 3 Mar 2020
ABSTRACT
OBJECTIVES: In late December, 2019, an outbreak of coronavirus disease (COVID-19) in Wuhan, China was caused by a novel coronavirus, newly named severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). We aimed to quantify severity of COVID-19 infection on High-Resolution CT and to determine its relationship with clinical parameters. MATERIALS AND METHODS: From Jan 11, 2020, to Feb 5, 2020, the clinical, laboratory and HRCT features of 42 patients (26-75 years, 25 males) with COVID-19 were analyzed. The initial and follow-up CT obtained a mean of 4.5 days and 11.6 days from the illness onset were retrospectively assessed for the severity and progression of pneumonia. Correlations among clinical parameters, initial CT features and progression of opacifications were evaluated with Spearman correlation and linear regression analysis. RESULTS: Thirty-five (83%) patients exhibited a progressive process according to CT features during the early stage from onset. Follow-up CT findings showed progressive opacifications, consolidation, interstitial thickening, fibrous strips and air bronchograms, compared to initial CT (all p<0.05). Before regular treatments, there was a moderate correlation between the days from onset and sum score of opacifications (R=0.68, p<0.01). The C-reactive protein, erythrocyte sedimentation rate and lactate dehydrogenase showed significantly positive correlation with the severity of pneumonia assessed on initial CT (R range 0.36-0.75, p<0.05). The highest temperature and the severity of opacifications assessed on initial CT were significantly related to the progression of opacifications on follow-up CT (p=0.001-0.04). CONCLUSIONS: Patients with the COVID-19 infection usually presented with typical ground-grass opacities and other CT features, which showed significant correlations with some clinical and laboratory measurements. Follow-up CT images often demonstrated progressions during the early stage from illness onset.
FULL TEXT LINK
http://dx.doi.org/10.1097/RLI.0000000000000674
RECORD 66
TITLE
Analysis of the pregnancy outcomes in pregnant women with COVID-19 in Hubei Province
AUTHOR NAMES
Zhang L.; Jiang Y.; Wei M.; Cheng B.H.; Zhou X.C.; Li J.; Tian J.H.; Dong L.; Hu R.H.
SOURCE
Zhonghua fu chan ke za zhi (2020) 55 (E009). Date of Publication: 7 Mar 2020
ABSTRACT
Objective: To study the effect of COVID-19 on pregnancy outcomes and neonatal prognosis in Hubei Province. Methods: A retrospective comparison of the pregnancy outcomes was done between 16 women with COVID-19 and 45 women without COVID-19. Also, the results of laboratory tests, imaging examinations, and the 2019-nCoV nucleic acid test were performed in 10 cases of neonatal deliverd from women with COVID-19. Results: (1) Of the 16 pregnant women with COVID-19, 15 cases were ordinary type and 1 case was severe type. No one has progressed to critical pneumonia. The delivery method of the two groups was cesarean section, and the gestational age were (38.7±1.4) and (37.9±1.6) weeks, there was no significant difference between the two groups (P> 0.05). Also, there wee no significant differences in the intraoperative blood loss and birth weight of the newborn between the two groups (all P>0.05). (2) Ten cases of neonates delivered from pregnant women with COVID-19 were collected. The 2019-nCoV nucleic acid test were all negative. There were no significant differences in fetal distress, meconium-stained amniotic fluid, preterm birth, and neonatal asphyxia between the two groups (all P>0.05). (3) In the treatment of uterine contraction fatigue, carbetocin or carboprost tromethamine was used more in cesarean section for pregnant women with COVID-19 (1.3±0.6), compared with Non-COVID-19 group (0.5±0.7), the difference was statistically significant (P=0.001). Conclusions: If there is an indication for obstetric surgery or critical illness of COVID-19 in pregnant women, timely termination of pregnancy will not increase the risk of premature birth and asphyxia of the newborn, but it is beneficial to the treatment and rehabilitation of maternal pneumonia. Preventive use of long-acting uterotonic agents could reduce the incidence of postpartum hemorrhage during surgery. 2019-nCoV infection has not been found in neonates deliverd from pregnant women with COVID-19.
FULL TEXT LINK
http://dx.doi.org/10.3760/cma.j.cn112141-20200218-00111
RECORD 67
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 68
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 69
TITLE
The Clinical and Chest CT Features Associated with Severe and Critical COVID-19 Pneumonia
AUTHOR NAMES
Li K.; Wu J.; Wu F.; Guo D.; Chen L.; Fang Z.; Li C.
SOURCE
Investigative radiology (2020). Date of Publication: 29 Feb 2020
ABSTRACT
OBJECTIVE: To investigate the clinical and CT features associated with severe and critical Corona Virus Disease 2019 (COVID-19) pneumonia. MATERIALS AND METHODS: Eighty-three patients with COVID-19 pneumonia including 25 severe/critical cases and 58 ordinary cases were enrolled. The chest CT images and clinical data of them were reviewed and compared. The risk factors associated with disease severity were analyzed. RESULTS: Compared with the ordinary patients, the severe/critical patients had older ages, higher incidence of comorbidities, cough, expectoration, chest pain and dyspnea. The incidences of consolidation, linear opacities, crazy-paving pattern and bronchial wall thickening in severe/critical patients were significantly higher than those of the ordinary patients. Besides, severe/critical patients showed higher incidences of lymph node enlargement, pericardial effusion and pleural effusion than the ordinary patients. The CT scores of severe/critical patients were significantly higher than those of the ordinary patients (P < 0.001). Receiver operating characteristic (ROC) curve showed that the sensitivity and specificity of CT Score were 80.0% and 82.8% respectively for the discrimination of the two types. The clinical factors of age > 50 years old, comorbidities, dyspnea, chest pain, cough, expectoration, decreased lymphocytes and increased inflammation indicators were risk factors for severe/critical COVID-19 pneumonia. CT findings of consolidation, linear opacities, crazy-paving pattern, bronchial wall thickening, high CT scores and extrapulmonary lesions were features of severe/critical COVID-19 pneumonia. CONCLUSIONS: There are significant differences in clinical symptoms, laboratory examinations and CT manifestations between the ordinary patients and the severe/critical patients. Many factors are related to the severity of the disease, which can help clinicians to judge the severity of the patient and evaluate the prognosis.
FULL TEXT LINK
http://dx.doi.org/10.1097/RLI.0000000000000672
RECORD 70
TITLE
Outbreak of novel coronavirus (COVID-19): What is the role of radiologists?
AUTHOR NAMES
Kim H.
SOURCE
European Radiology (2020). Date of Publication: 2020
ABSTRACT
• Novel coronavirus (COVID-19)-infected pneumonia usually manifests as bilateral ground-glass opacities in the lung periphery on chest CT scans. • Role of radiologists includes not only early detection of lung abnormality, but also suggestion of disease severity, potential progression to acute respiratory distress syndrome, and possible bacterial co-infection in hospitalized patients.
FULL TEXT LINK
http://dx.doi.org/10.1007/s00330-020-06748-2
Covid19 Literature Reviews 