scholarly journals Hypercoagulation and Antithrombotic Treatment in Coronavirus 2019: A New Challenge

2020 ◽  
Vol 120 (06) ◽  
pp. 949-956 ◽  
Author(s):  
Francesco Violi ◽  
Daniele Pastori ◽  
Roberto Cangemi ◽  
Pasquale Pignatelli ◽  
Lorenzo Loffredo
Keyword(s):  
Multiorgan Failure ◽  
Laboratory Data ◽  
Clinical Severity ◽  
The Novel ◽  
Antithrombotic Treatment ◽  
Clotting System ◽  
Thrombotic Risk ◽  
Number Of Patients ◽  
Coronary Ischemia ◽  
Novel Coronavirus

AbstractThe novel coronavirus 2019 (COVID-19) is clinically characterized by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), which is responsible for a high number of patients needing mechanical ventilation or intensive care units treatment and for the elevated mortality risk. A link between COVID-19 and multiorgan failure may be dependent on the fact that most COVID-19 patients are complicated by pneumonia, which is known to be associated with early changes of clotting and platelet activation and artery dysfunction; these changes may implicate in thrombotic-related events such as myocardial infarction and ischemic stroke. Recent data showed that myocardial injury compatible with coronary ischemia may be detectable in SARS-CoV-2 patients and laboratory data exploring clotting system suggest the presence of a hypercoagulation state. Thus, we performed a systematic review of COVID-19 literature reporting measures of clotting activation to assess if changes are detectable in this setting and their relationship with clinical severity. Furthermore, we discussed the biologic plausibility of the thrombotic risk in SARS-CoV-2 and the potential use of an antithrombotic treatment.

scholarly journals Clinical and Laboratory Profiles of 75 Hospitalized Patients with Novel Coronavirus Disease 2019 in Hefei, China

2020 ◽  
Author(s):  
Zonghao Zhao ◽  
Jiajia Xie ◽  
Ming Yin ◽  
Yun Yang ◽  
Hongliang He ◽  
...  
Keyword(s):  
T Cell ◽  
Treatment Effectiveness ◽  
Antiviral Treatment ◽  
Laboratory Data ◽  
Clinical Manifestations ◽  
Nasopharyngeal Swab ◽  
The Novel ◽  
Reactive Protein ◽  
Cell Counts ◽  
Novel Coronavirus

AbstractThe outbreak of the novel coronavirus disease 2019 (COVID-19) infection began in December 2019 in Wuhan, and rapidly spread to many provinces in China. The number of cases has increased markedly in Anhui, but information on the clinical characteristics of patients is limited. We reported 75 patients with COVID-19 in the First Affiliated Hospital of USTC from Jan 21 to Feb 16, 2020, Hefei, Anhui Province, China. COVID-19 infection was confirmed by real-time RT-PCR of respiratory nasopharyngeal swab samples. Epidemiological, clinical and laboratory data were collected and analyzed. Of the 75 patients with COVID-19, 61 (81.33%) had a direct or indirect exposure history to Wuhan. Common symptoms at onset included fever (66 [88.0%] of 75 patients) and dry cough (62 [82.67%]). Of the patients without fever, cough could be the only or primary symptom. The most prominent laboratory abnormalities were lymphopenia, decreased percentage of lymphocytes (LYM%), decreased CD4+ and CD8+ T cell counts, elevated C-reactive protein (CRP) and lactate dehydrogenase (LDH). Patients with elevated interleukin 6 (IL-6) showed significant decreases in the LYM%, CD4+ and CD8+ T cell counts. Besides, the percentage of neutrophils, CRP, LDH and Procalcitonin levels increased significantly. We concluded that COVID-19 could cause different degrees of hematological abnormalities and damage of internal organs. Hematological profiles including LYM, LDH, CRP and IL-6 could be indicators of diseases severity and evaluation of treatment effectiveness. Antiviral treatment requires a comprehensive and supportive approach. Further targeted therapy should be determined based on individual clinical manifestations and laboratory indicators.

scholarly journals The impact of COVID-19 pandemic on the treatment of acute appendicitis in China

2021 ◽  
Author(s):  
ZhiXue Zheng ◽  
Jing Tao Bi ◽  
Ya Qi Liu ◽  
Xuan Cai
Keyword(s):  
Acute Appendicitis ◽  
White Blood Cells ◽  
Onset Time ◽  
The Novel ◽  
C Reactive Protein ◽  
Reactive Protein ◽  
Number Of Patients ◽  
Hospital Visits ◽  
Novel Coronavirus ◽  
The Impact

Abstract Objective This research aims to analyze the impact of the novel coronavirus pandemic on the hospital visits of patients with acute appendicitis. Methods The retrospective analysis was designed to look at the treatment of acute appendicitis in the Department of General Surgery in Beijing Jishuitan Hospital before and during the COVID-19 pandemic (2019–2020). Data was analyzed by the numbers of patients, sex, age, onset time, fever or not, laboratory examination, imaging test, and treatment. And we analyzed the differences between the “pre-COVID group” and “during-COVID group”. Results Compared with the year 2019, the number of acute appendicitis patients has diminished substantially during the COVID-19 pandemic (2020), but the number elevated with the control of the pandemic. Even if we did not find the differences of the treatment before and during the pandemic (P = 0.932), the onset time to emergency was significantly longer (P < 0.001), and more patients had showed fever (P < 0.001) during the COVID-19 pandemic. And the total number of white blood cells and C reactive protein level were significantly higher in 2020 than those in 2019 (P = 0.006, 0.003). And the same result was found in patients with appendiceal fecalith (P = 0.047). Conclusion During the pandemic of the new coronavirus pneumonia, the number of patients with acute appendix treatment dropped significantly, mainly because it took longer than before, and the condition was more severe. It can be seen that the new coronary pneumonia has a great impact on the patients’ medical treatment behavior, and the active prevention and treatment of the new coronavirus pneumonia is currently an important and urgent issue.

scholarly journals Novel Coronavirus Infection (COVID-19) in Humans: A Scoping Review and Meta-Analysis

2020 ◽  
Vol 9 (4) ◽  
pp. 941 ◽  
Author(s):  
Israel Júnior Borges do Nascimento ◽  
Nensi Cacic ◽  
Hebatullah Mohamed Abdulazeem ◽  
Thilo Caspar von Groote ◽  
Umesh Jayarajah ◽  
...  
Keyword(s):  
Scoping Review ◽  
Clinical Symptoms ◽  
Meta Analysis ◽  
Laboratory Data ◽  
Gastrointestinal Symptoms ◽  
Common Disease ◽  
Imaging Data ◽  
Laboratory Findings ◽  
Number Of Patients ◽  
Novel Coronavirus

A growing body of literature on the 2019 novel coronavirus (SARS-CoV-2) is becoming available, but a synthesis of available data has not been conducted. We performed a scoping review of currently available clinical, epidemiological, laboratory, and chest imaging data related to the SARS-CoV-2 infection. We searched MEDLINE, Cochrane CENTRAL, EMBASE, Scopus and LILACS from 01 January 2019 to 24 February 2020. Study selection, data extraction and risk of bias assessment were performed by two independent reviewers. Qualitative synthesis and meta-analysis were conducted using the clinical and laboratory data, and random-effects models were applied to estimate pooled results. A total of 61 studies were included (59,254 patients). The most common disease-related symptoms were fever (82%, 95% confidence interval (CI) 56%–99%; n = 4410), cough (61%, 95% CI 39%–81%; n = 3985), muscle aches and/or fatigue (36%, 95% CI 18%–55%; n = 3778), dyspnea (26%, 95% CI 12%–41%; n = 3700), headache in 12% (95% CI 4%–23%, n = 3598 patients), sore throat in 10% (95% CI 5%–17%, n = 1387) and gastrointestinal symptoms in 9% (95% CI 3%–17%, n = 1744). Laboratory findings were described in a lower number of patients and revealed lymphopenia (0.93 × 109/L, 95% CI 0.83–1.03 × 109/L, n = 464) and abnormal C-reactive protein (33.72 mg/dL, 95% CI 21.54–45.91 mg/dL; n = 1637). Radiological findings varied, but mostly described ground-glass opacities and consolidation. Data on treatment options were limited. All-cause mortality was 0.3% (95% CI 0.0%–1.0%; n = 53,631). Epidemiological studies showed that mortality was higher in males and elderly patients. The majority of reported clinical symptoms and laboratory findings related to SARS-CoV-2 infection are non-specific. Clinical suspicion, accompanied by a relevant epidemiological history, should be followed by early imaging and virological assay.

scholarly journals SARS-CoV-2 Infection as a Cause of Acute Pancreatitis in a Child—A Case Report

2021 ◽  
Vol 13 (4) ◽  
pp. 552-557
Author(s):  
Natalia Kopiczko ◽  
Kamila Kwiatek-Średzińska ◽  
Mirosława Uścinowicz ◽  
Monika Kowalczuk-Krystoń ◽  
Dariusz Marek Lebensztejn
Keyword(s):  
Acute Pancreatitis ◽  
Abdominal Pain ◽  
Case Report ◽  
The Novel ◽  
Gastrointestinal Manifestations ◽  
Number Of Patients ◽  
Growing Body ◽  
Novel Coronavirus ◽  
Mild Acute Pancreatitis ◽  
First Time

The novel coronavirus disease (COVID-19) was detected for the first time in China in December 2019. Soon after it was declared a pandemic. Main symptoms include fever, dyspnea, cough, muscle pain, headache, anosmia and ageusia, however a growing body of evidence shows that other organs can be affected. Gastrointestinal manifestations have been observed in a considerable number of patients and include abdominal pain, diarrhea and vomiting. The involvement of liver as well as pancreas has been also described, however there are only a few cases of acute pancreatitis reported in patients with COVID-19. Therefore, we present a case of 6-year-old child with mild acute pancreatitis and COVID-19 pneumonia.

scholarly journals Evaluation of the clinical characteristics of suspected or confirmed cases of COVID-19 during home care with isolation: A new retrospective analysis based on O2O

2020 ◽  
Author(s):  
Hui Xu ◽  
Sufang Huang ◽  
Shangkun Liu ◽  
Juan Deng ◽  
Bo Jiao ◽  
...  
Keyword(s):  
Medical Staff ◽  
Muscle Soreness ◽  
Laboratory Data ◽  
Hospitalized Patients ◽  
The Body ◽  
The Novel ◽  
Observation Scale ◽  
Medical Observation ◽  
New Treatment ◽  
Novel Coronavirus

SummaryBackgroundThe recent outbreak of the novel coronavirus in December 2019 (COVID-19) has activated top-level response nationwide. We developed a new treatment model based on the online-to-offline (O2O) model for the home isolated patients, because in the early stages the medical staff were insufficient to cope with so many patients.MethodsIn this single-centered, retrospective study, we enrolled 48 confirmed/suspected COVID-19 patients who underwent home isolation in Wuhan between January 6 and January 31, 2020. By WeChat and online document editing all patients were treated with medical observation scale. The clinical indications such as Fever, Muscle soreness, Dyspnea and Lack of strength were collected with this system led by medical staff in management, medicine, nursing, rehabilitation and psychology.FindingsThe mean age of 48 patients was 39·08±13·88 years, 35(72·9%) were women. Compared with non-hospitalized patients, inpatients were older(≥70years, 2·4% vs 33·3%, P<0·04). All inpatients had fever, 50% inpatients had coughs and showed infiltration in both lungs at the time of diagnosis. 33·3% inpatients exhibited negative changes in their CT results at initial diagnosis. The body temperature of non-hospitalized patients with mild symptoms returned to normal by day 4-5. While dyspnea peaked on day 6 for non-hospitalized patients with mild symptoms, it persisted in hospitalized patients and exacerbated over time. The lack of strength and muscle soreness were both back to normal by day 4 for non-hospitalized patients.InterpretationMonitoring the trends of symptoms is more important for identifying severe cases. Excessive laboratory data and physical examination are not necessary for the evaluation of patients with mild symptoms. The system we developed is the first to convert the subjective symptoms of patients into objective scores. This type of O2O, subjective-to-objective strategy may be used in regions with similar highly infectious diseases to minimize the possibility of infection among medical staff.

scholarly journals A meta-analysis of the impact of COVID-19 on liver dysfunction

2020 ◽  
Vol 25 (1) ◽  
Author(s):  
Zeng-hong Wu ◽  
Dong‑liang Yang
Keyword(s):  
Liver Dysfunction ◽  
Meta Analysis ◽  
Elevated Serum ◽  
Clinical Severity ◽  
The Novel ◽  
Significant Difference ◽  
Novel Coronavirus ◽  
The Impact ◽  
Review Manager ◽  
Different Levels

Abstract Background The novel coronavirus disease 2019 (COVID-19), which is caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is leading to a worldwide pandemic. Except representative manifestation of pneumonia and acute respiratory symptoms, COVID-19 patients have also shown different levels of liver injury or liver dysfunction. The aim of our study was to explore the probable clinical severity and mortality of COVID-19 patients and their liver dysfunction. Method A combination of computer and manual retrieval was used to search in Medline through PubMed, EMBASE and Web of Science. Review Manager 5.3 software was used to examine the heterogeneity among the studies and to calculate the combined effect value (OR, 95CI). Subgroup analysis, sensitivity analysis, and publication bias test were also performed. Results We found a significant connection between liver dysfunction and mortality of COVID-19 patients with a pooled OR of 1.98 (95% CI 1.39–2.82; P = 0.0002). There was a significant association between AST and severity of COVID-19 with a pooled OR of 4.48 (95% CI 3.24–7.21; P < 0.001), and a pooled WMD of 3.35 (95% CI, 2.07 to 4.64; P < 0.001). In addition, there was a significant difference between TBIL and severity of COVID-19, with a pooled OR of 1.91 (95% CI 1.40–2.60; P < 0.001), and with a pooled WMD of 1.18 (95% CI, 0.78 to 1.58; P < 0.001). Conclusion The mortality and severity of COVID-19 patients are significantly associated with liver dysfunction. The non-survivors and severe COVID-19 patients have elevated serum AST levels than the survivors and non-severe COVID-19 patients. The results of this study form a basis for better clinical liver management of patients with COVID-19.

scholarly journals Changes in Provision of Psychotherapy in the Early Weeks of the COVID-19 Lockdown in Austria

2020 ◽  
Vol 17 (11) ◽  
pp. 3815 ◽  
Author(s):  
Thomas Probst ◽  
Peter Stippl ◽  
Christoph Pieh
Keyword(s):  
Mental Health ◽  
Health Care ◽  
Mental Health Care ◽  
Online Survey ◽  
Personal Contact ◽  
The Novel ◽  
Central Measure ◽  
Number Of Patients ◽  
Novel Coronavirus

Reducing personal contacts is a central measure against the spreading of the novel coronavirus disease (COVID-19). This troubles mental health, but also mental health care as treatments usually take place in personal contact and switching to remote treatments might be necessary in times of COVID-19. The present study investigated the question how the provision of psychotherapy changed in the early weeks of the COVID-19 lockdown in Austria and whether there were differences between the four therapeutic orientations eligible in Austria (psychodynamic, humanistic, systemic, behavioral). Psychotherapists (N = 1547) completed an online survey. They entered their number of patients treated on average per week (in personal contact, via telephone, via Internet) in the early weeks of the COVID-19 lockdown in Austria as well as (retrospectively) in the months before. The number of patients treated on average per week in personal contact decreased (on average 81%; p < 0.001), whereas the number of patients treated on average per week via telephone and via Internet increased (on average 979% and 1561%; both p < 0.001). Yet, the decrease of psychotherapies through personal contact was not compensated for by increases of remote psychotherapies (p < 0.001). No differences between the four therapeutic orientations emerged. Results imply an undersupply of psychotherapy in the COVID-19 lockdown and that further changes are necessary to cover the increased need for timely psychotherapy in times of COVID-19.

scholarly journals “Door to Treatment” Outcomes of Cancer Patients during the COVID-19 Pandemic

Chemotherapy ◽  
2020 ◽  
pp. 1-6
Author(s):  
Naziye Ak ◽  
Sezai Vatansever
Keyword(s):  
Cancer Patients ◽  
Treatment Time ◽  
Index Case ◽  
Neoadjuvant Treatment ◽  
The Novel ◽  
Newly Diagnosed ◽  
Intravenous Treatment ◽  
Number Of Patients ◽  
Significant Difference ◽  
Novel Coronavirus

<b><i>Background:</i></b> The novel coronavirus disease 2019 has become a worldwide threat. We aimed to explore reflections of these unexpected changes to newly diagnosed cancer patients. <b><i>Method:</i></b> We searched the 2 months after the index case of our country. The first admission day and the first day of intravenous treatment of newly diagnosed patients were recorded. <b><i>Results:</i></b> In the 60 days measured during the pandemic, the total number of patients on polyclinics was 159/weekdays, and the total applied chemotherapy cycles were 276/week. For comparison, the total numbers in the previous year were 267/weekday and 363/week for polyclinic and applied chemotherapy cycles, respectively. The total number of newly admitted patients in 2020 was 283. For comparison, the number of new patients in the same 60-day period in 2019 was 495. Patients who were admitted for adjuvant treatment required a median of 8 days for the first course, those who were admitted for neoadjuvant treatment required 12 days, and metastatic patients required 14 days; there were no significant differences between treatment types (<i>p</i> = 0.233). However, the median treatment time was 11.5 and 17 days, in 2020 and in 2019, respectively. A significant difference was observed between the 2 groups (<i>p</i> &#x3c; 0.001). <b><i>Conclusion:</i></b> The effective shift of workers and accurate regulations have not resulted in apparent delays in patient care. While a decrease in the number of patients has detected, faster healthcare service was introduced to newly diagnosed patients. The reason for the decrease in the number of patients should be investigated with new studies.

scholarly journals The role of haematological parameters in patients with COVID-19 and influenza virus infection

2020 ◽  
Vol 148 ◽  
Author(s):  
Sumeyye Kazancioglu ◽  
Aliye Bastug ◽  
Bahadir Orkun Ozbay ◽  
Nizamettin Kemirtlek ◽  
Hurrem Bodur
Keyword(s):  
Laboratory Data ◽  
Influenza Virus Infection ◽  
Haematological Parameters ◽  
Severe Illness ◽  
Healthy Controls ◽  
The Novel ◽  
Lymphocyte Ratio ◽  
End Of Treatment ◽  
Novel Coronavirus

Abstract SARS-CoV-2, the causative agent of coronavirus disease 19 (COVID-19), was identified in Wuhan, China. Since then, the novel coronavirus started to be compared to influenza. The haematological parameters and inflammatory indexes are associated with severe illness in COVID-19 patients. In this study, the laboratory data of 120 COVID-19 patients, 100 influenza patients and 61 healthy controls were evaluated. Lower lymphocytes, eosinophils, basophils, platelets and higher delta neutrophil index (DNI), neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR) were found in COVID-19 and influenza groups compared to healthy controls. The eosinophils, lymphocytes and PLR made the highest contribution to differentiate COVID-19 patients from healthy controls (area under the curves (AUCs): 0.819, 0.817 and 0.716, respectively; P-value is <0.0001 for all). The NLR, the optimal cut-off value was 3.58, which resulted in a sensitivity of 30.8 and a specificity of 100 (AUC: 0.677, P < 0.0001). Higher leucocytes, neutrophils, DNI, NLR, PLR and lower lymphocytes, red blood cells, haemoglobin, haematocrit levels were found in severe patients at the end of treatment. Nonsevere patients showed an upward trend for lymphocytes, eosinophils and platelets, and a downward trend for neutrophils, DNI, NLR and PLR. However, there was an increasing trend for eosinophils, platelets and PLR in severe patients. In conclusion, NLR and PLR can be used as biomarkers to distinguish COVID-19 patients from healthy people and to predict the severity of COVID-19. The increasing value of PLR during follow-up may be more useful compared to NLR to predict the disease severity.

Current Status on Treatments and Clinical Trials for COVID-19 (Preprint)

2020 ◽  
Author(s):  
Guosheng Yin ◽  
Chenyang Zhang ◽  
Huaqing Jin
Keyword(s):  
Clinical Trials ◽  
Phase Ii ◽  
Developmental Process ◽  
Current Situation ◽  
Current Status ◽  
The Novel ◽  
Fast Speed ◽  
Death Toll ◽  
Number Of Patients ◽  
Novel Coronavirus

UNSTRUCTURED With the worldwide rapidly growing number of patients infected with the novel coronavirus (COVID-19), the death toll has also been climbing up at a fast speed. There is an urgent need to search for cures for COVID-19 patients. A large number of clinical trials have been launched to test some existing or new antiviral therapeutics and vaccines. In contrast to starting from the scratch, many trials are initiated directly in phase II or III with the hope to expedite the developmental process. We summarize the information on the registered trials for the top ten COVID-19 drugs, and give an overview on the current situation and trend of treatments and clinical trials. In particular, we review those trials that have already been finished and discuss lessons that can be learned from them.

Sign in / Sign up

Export Citation Format

Share Document