scholarly journals Clinical and Epidemiological Features of 46 Children <1 Year Old With Coronavirus Disease 2019 in Wuhan, China: A Descriptive Study

2020 ◽  
Vol 222 (8) ◽  
pp. 1293-1297 ◽  
Author(s):  
Xinghua Liu ◽  
Jianqiao Tang ◽  
Rong Xie ◽  
Wei Li ◽  
Jianying Chen ◽  
...  
Keyword(s):  
Medical Information ◽  
Clinical Symptoms ◽  
Invasive Mechanical Ventilation ◽  
Cardiac Injury ◽  
Multiple Organ ◽  
Multiple Organ Dysfunction ◽  
Test Results ◽  
Epidemiological Features ◽  
Moderate Disease ◽  
Laboratory Test Results

Abstract The number of coronavirus disease 2019 (COVID-19) cases has exceeded 10 million. However, little is known about the epidemiology and clinical characteristics of COVID-19 infants. We collected medical information of 46 confirmed patients (&lt;1 year old) and retrospectively analyzed epidemiological history, clinical symptoms, and laboratory test results. The median age was 5 (interquartile range, 2–7) months. Sixteen cases had fever and 27 cases had cough. Moderate disease was present in 40 cases and cardiac injury occurred in 38 cases, following by liver dysfunction in 20 cases and lymphopenia in no cases. Of all infant patients, 2 received invasive mechanical ventilation and 1 died with multiple organ dysfunction syndrome.

scholarly journals Prevalence and Course of SARS-CoV-2 Infection among Immunocompromised Children Hospitalised in the Tertiary Referral Hospital in Poland

2021 ◽  
Vol 10 (19) ◽  
pp. 4556
Author(s):  
Karolina Kuczborska ◽  
Janusz Książyk
Keyword(s):  
Laboratory Test ◽  
Clinical Characteristics ◽  
Chronic Treatment ◽  
Clinical Symptoms ◽  
Referral Hospital ◽  
Test Results ◽  
Tertiary Referral ◽  
Tertiary Referral Hospital ◽  
Laboratory Test Results ◽  
Underlying Diseases

The aim of this retrospective study was the assessment of the prevalence, clinical characteristics, and the comparison of the course of SARS-CoV-2 infection in children with and without immunodeficiency that were admitted to the COVID-19 Subunit of the tertiary referral hospital in Warsaw, Poland. We analysed 313 children hospitalised in the COVID-19 Subunit. The analysis was performed on the total study group and subgroups of children with and without immunodeficiency. In each group, clinical data and laboratory test results were analysed. Of the 68 children with isolated fevers, only seven (11.76%) were diagnosed with COVID-19, whereas among those with the accompanying features of respiratory or gastrointestinal infection, only one (3.23%) and ten (16.95%) patients tested positive, respectively. In both groups, the course of the infection was mainly asymptomatic or mild. The children with immunodeficiencies had lower white blood cell and lymphocyte counts, lower haemoglobin levels, and higher urea levels but did not differ in other biochemical variables. To conclude, the most frequently reported symptoms of COVID-19 indicate that this disease among children is only a small percentage. In both groups, the responses to the infection were comparable in terms of the mild clinical symptoms and the laboratory test results. Therefore, SARS-CoV-2 infection should not alter the chronic treatment of underlying diseases.

scholarly journals Epidemiological and Clinical Features of COVID-19 Patients at National Emergency Hospital Wisma Atlet Kemayoran, Jakarta,Indonesia

2021 ◽  
Author(s):  
Agus Dwi Susanto ◽  
Anna Rozaliyani ◽  
Budi Prasetyo ◽  
Heidy Agustin ◽  
Hario Baskoro ◽  
...  
Keyword(s):  
Clinical Symptoms ◽  
Young Patients ◽  
Patient Characteristics ◽  
Test Results ◽  
Emergency Hospital ◽  
Laboratory Test Results ◽  
Number Of Patients ◽  
Chest X Ray ◽  
The Many ◽  
National Emergency

The emergency hospital is intended to prevent transmission of COVID-19 in the community by isolating patients without symptoms, with mild or moderate symptoms. This study evaluated the clinical characteristics and outcomes of COVID-19 patients who were admitted to this facility. This retrospective study reviewed data of patients treated at the National Emergency Hospital Wisma Atlet Kemayoran in Jakarta, Indonesia, from March 23 to April 30, 2020. Patient characteristics (clinical symptoms, laboratory test results, Chest X-Ray, SARS-CoV-2 immunoserology, and RT-PCR results from nasopharyngeal/ oropharyngeal preparations) were compared between severity groups. There were 413 COVID-19 cases analyzed, of which 190 (46%) were asymptomatic, 93 (22.5%) were mild, and 130 (31.5%) were moderate cases. Most asymptomatic cases were male, with young age, and without comorbidity. Mild cases were dominated by female and young patients, while most moderate cases were male and older patients. The number of patients with comorbidities was higher in mild and moderate cases. The patient’s overall outcome was good and did not differ based on the severity of symptoms. Despite the many challenges, patients with moderate symptoms can be safely treated in the emergency hospital.

scholarly journals Preliminary study to identify severe from moderate cases of COVID-19 using NLR&RDW-SD combination parameter

2020 ◽  
Author(s):  
Changzheng Wang ◽  
Rongrong Deng ◽  
Liyao Gou ◽  
Zhongxiao Fu ◽  
Xiaomei Zhang ◽  
...  
Keyword(s):  
Clinical Symptoms ◽  
Diagnostic Efficiency ◽  
Test Results ◽  
Laboratory Test Results ◽  
Severe Group ◽  
Preliminary Study ◽  
Hematology Parameters ◽  
And Control ◽  
Combined Parameters ◽  
Severe Type

AbstractObjectivesInvestigate the characteristics and rules of hematology changes in patients with COVID-19, and explore the possibility to identify moderate and severe patients using conventional hematology parameters or combined parameters.MethodsThe clinical data of 45 moderate and severe type patients with SARS-CoV-2 infections in Jingzhou Central Hospital from January 23 to February 13, 2020 were collected. The epidemiological indexes, clinical symptoms and laboratory test results of the patients were retrospectively analyzed. Those parameters with significant differences between the two groups were analyzed, and the combination parameters with best diagnostic performance were selected using the LDA method.ResultsOf the 45 patients with COVID-19 (35 moderate and 10 severe cases), 23 were male and 22 female, aged 16-62 years. The most common clinical symptoms were fever (89%) and dry cough (60%). As the disease progressed, WBC, Neu#, NLR, PLR, RDW-CV and RDW-SD parameters in the severe group were significantly higher than that in the moderate group (P<0.05); meanwhile, Lym#, Eos#, HFC%, RBC, HGB and HCT parameters in the severe group were significantly lower than that in the moderate group (P<0.05). For NLR, the AUC, the best cut-off value, the sensitivity and the specificity were 0.890, 13.39, 83.3% and 82.4% respectively, and for PLR, the AUC, the best cut-off, the sensitivity and the specificity were 0.842, 267.03, 83.3% and 74.0% respectively. The combined parameter NLR&RDW-SD had the best diagnostic efficiency (AUC was 0.938) and when the cut-off value was 1.046, the sensitivity and the specificity were 90.0% and 84.7% respectively, followed by the fitting parameter NLR&RDW-CV (AUC = 0.923). When the cut-off value was 0.62, the sensitivity and the specificity for distinguishing severe type from moderate cases of COVID-19 were 90.0% and 82.4% respectively.ConclusionsThe combined parameter NLR&RDW-SD is the best hematology index and can help clinicians to predict the severity of COVID-19 patients, and it can be used as a useful indicator to help prevent and control the epidemic.

scholarly journals Clinical Characteristics of Non-Pneumonia COVID-19 Adults in Shanghai, China

2020 ◽  
Author(s):  
Haiying Ji ◽  
Lijuan Hu ◽  
Tao Li ◽  
Linjing Gong ◽  
Xu Wu ◽  
...  
Keyword(s):  
Incubation Time ◽  
Clinical Characteristics ◽  
Clinical Symptoms ◽  
Diagnostic Classification ◽  
Test Results ◽  
Underlying Condition ◽  
Laboratory Test Results ◽  
Initial Symptoms ◽  
Local Residents ◽  
Taste Disorders

Abstract Background: Since December 2019, coronavirus disease 2019 (COVID-19) rapidly spread throughout the whole world , data have been needed on the clinical characteristics of the affected patients.Objectives: A total of 579 adult COVID-19 cases were enrolled in Shanghai from Jan 20 to Apr 15, 2020, in which 95 cases (16.41%) showed non-pneumonia on CT when confirmed. The characteristics of non-pneumonia cases have not been clearly described previously, and this might provide guidance to prevent and treatment of COVID-19.Method: We retrospectively collected the patient clinical dataset including demography, epidemiology, clinical manifestation, laboratory test results, diagnostic classification, treatment and clinical outcomes.Results: The average age of 95 COVID-19 cases was 31.45 ± 12.89 years old and 95.79% of them were less than 60 years old. They had mild clinical symptoms and/or laboratory abnormalities. 20 of the 95 cases occurred mild pneumonia during hospitalization, accompanied with lower lymphocyte counts, in which 60% cases were complicated with underlying condition and 15% cases were over 60 years old. All cases were cured. 16 of the 95 cases were local residents with clear epidemiological history and long incubation time, and mainly discovered as fever and respiratory symptoms. Other 79 cases were overseas imported, some had initial symptoms of diarrhea, smell or taste disorders and so on. They were mainly found at port of entry.Conclusions: Non-pneumonia COVID-19 predominantly occurred among young adults with mild clinical symptoms and possible long incubation time. The patients with underlying condition or at older age more likely developed mild pneumonia after diagnosis. Thereby, it is very important to pay attention to these patients and make reasonable diagnostic classification towards better prevention and treatment of COVID-19.

scholarly journals Prognostic Analysis of Elderly Patients with Multiple Organ Dysfunction Syndrome Undergoing Invasive Mechanical Ventilation

2020 ◽  
Vol 2020 ◽  
pp. 1-7
Author(s):  
Kun Xiao ◽  
Bin Liu ◽  
Wei Guan ◽  
Peng Yan ◽  
Licheng Song ◽  
...  
Keyword(s):  
Mechanical Ventilation ◽  
Organ Dysfunction ◽  
Multiple Organ Dysfunction Syndrome ◽  
Invasive Mechanical Ventilation ◽  
The Elderly ◽  
Multiple Organ ◽  
Apache Ii ◽  
Multiple Organ Dysfunction ◽  
Saps Ii ◽  
Apache Iii

Objective. To prospectively investigate early prognostic assessments of patients with Multiple Organ Dysfunction Syndrome in the Elderly (MODSE) who were receiving invasive mechanical ventilation (IMV). Methods. The clinical data of 351 patients were enrolled prospectively between January 2013 and January 2018. The Acute Physiology and Chronic Health Evaluation II (APACHE II), APACHE III, Simplified Acute Physiology Score (SAPS II), and Multiple Organ Dysfunction Score (MODS) were calculated. According to the outcome of 28-day, the patients were divided into survivors and nonsurvivors. Additionally, based on whether weaning could be implemented, all patients were divided into a successful-weaning group and a failure-to-wean group. Results. According to the prognosis, the areas under the receiver operating characteristic curve of the APACHE II, APACHE III, SAPS II, and MODS scoring systems were 0.837, 0.833, 0.784, and 0.860, respectively. MODS exhibited the highest sensitivity, whereas APACHE II showed the highest specificity, and successful weaning was conducive to ameliorating patients’ prognosis. Multivariate logistic regression analyses revealed that underlying lung disease, plasma albumin, serum creatinine level, number of failing organs, and IMV duration were related to prognosis of weaning, with odds ratios (ORs) of 1.447, 0.820, 1.603, 2.374, and 3.105, respectively. Conclusions. The APACHE II, APACHE III, SAPS II, and MODS systems could perform excellent prognostic assessment for patients with Multiple Organ Dysfunction Syndrome in the elderly. Underlying lung disease, plasma albumin, serum creatinine, number of failing organs, and IMV duration were independent prognostic factors of weaning in MODSE patients with invasive mechanical ventilation.

scholarly journals A Case Report on Korean Medical Treatment of a Patient with Abnormal Liver Function Induced by Rovazet

2021 ◽  
Vol 42 (5) ◽  
pp. 846-852
Author(s):  
Hee-kyung Kang ◽  
Im-hak Cho ◽  
Chan Lee ◽  
Gi-yoon Heo ◽  
Min-hwa Kim ◽  
...  
Keyword(s):  
Liver Function ◽  
Clinical Case ◽  
Acupuncture Treatment ◽  
Clinical Symptoms ◽  
Abnormal Liver Function ◽  
Lipid Lowering ◽  
Test Results ◽  
Laboratory Test Results ◽  
Lipid Lowering Agent ◽  
Intradermal Acupuncture

Objective: This study evaluated a clinical case of a patient with Rovazet-induced abnormal liver function treated with intradermal acupuncture.Method: A 59-year-old woman with abnormal liver function induced by Rovazet ceased taking the drug and instead received intradermal acupuncture treatment. After 15 days, clinical symptoms and laboratory test results were evaluated.Results: Aspartate aminotransferase and alanine aminotransferase levels decreased, and clinical symptoms such as nausea and fatigue improved after treatment with intradermal acupuncture and cessation of the Rovazet.Conclusion: This study meaningfully examined a clinical case of a patient with abnormal liver function induced by a lipid-lowering agent, which is uncommon in Korea. Unfortunately, the lack of clear evidence and the use of only one case are limitations of the study.

A case of myositis with immunological background associated with statin use

Open Medicine ◽  
2014 ◽  
Vol 9 (5) ◽  
pp. 619-624 ◽  
Author(s):  
Dragana Protić ◽  
Snežana Baltić ◽  
Nada Stupar ◽  
Slavica Pavlov-Dolijanović ◽  
Snežana Mugoša ◽  
...  
Keyword(s):  
Clinical Symptoms ◽  
Test Results ◽  
Atorvastatin Treatment ◽  
The Past ◽  
Immune Mediated ◽  
Laboratory Test Results ◽  
Antisynthetase Antibodies ◽  
Symptoms And Signs ◽  
Therapy Methotrexate

AbstractStatins might cause and/or aggravate the immune-mediated myositis in patients on long-term, stable treatment. We provide a case of polymyositis with an immunological background and gastrointestinal and urinary manifestations in patient on long-term, stable atorvastatin treatment for the past six years. The diagnose of polymyositis was established based on clinical symptoms and signs, electromyography and laboratory test results (elevated aspartate aminotransferase 279 U/L, reference range 0–40 U/L; alanine aminotransferase 198 U/L, 0–33 U/L; lactate dehydrogenase 2200 U/L, 103-227 U/L; creatine kinase 7820 U/L, 15–84 U/L; and positive antinuclear antibodies test, titer of 1:160, with suspect antisynthetase antibodies). Polymyositis was probably related to atorvastatin treatment (Naranjo score, 5). Other probable causes of the myositis were rejected. Coricosteroid therapy, methotrexate and supplementation with vitamin D did not improve the condition. The patient remained bedridden and died two months after the hospital discharge due to the acute myocardial infarction.

scholarly journals Patient with H syndrome, cardiogenic shock, multiorgan infiltration, and digital ischemia

2021 ◽  
Vol 19 (1) ◽  
Author(s):  
Laura Ventura-Espejo ◽  
Inés Gracia-Darder ◽  
Silvia Escribá-Bori ◽  
Eva Regina Amador-González ◽  
Ana Martín-Santiago ◽  
...  
Keyword(s):  
Cardiogenic Shock ◽  
Clinical Symptoms ◽  
Heart Function ◽  
Systolic Dysfunction ◽  
Severe Disease ◽  
Invasive Mechanical Ventilation ◽  
Multiple Organ ◽  
Antibody Detection ◽  
Digital Ischemia ◽  
Liver And Kidney

Abstract Background H syndrome (HS) is a rare autoinflammatory disease caused by a mutation in the solute carrier family 29, member 3 (SCL29A3) gene. It has a variable clinical presentation and little phenotype-genotype correlation. The pathognomonic sign of HS is cutaneous hyperpigmentation located mainly in the inner thighs and often accompanied by other systemic manifestations. Improvement after tocilizumab treatment has been reported in a few patients with HS. We report the first patient with HS who presented cardiogenic shock, multiorgan infiltration, and digital ischemia. Case presentation 8-year-old boy born to consanguineous parents of Moroccan origin who was admitted to the intensive care unit during the Coronavirus Disease-2019 (COVID-19) pandemic with tachypnoea, tachycardia, and oliguria. Echocardiography showed dilated cardiomyopathy and severe systolic dysfunction compatible with cardiogenic shock. Additionally, he presented with multiple organ dysfunction syndrome. SARS-CoV-2 polymerase chain reaction (PCR) and antibody detection by chromatographic immunoassay were negative. A previously ordered gene panel for pre-existing sensorineural hearing loss showed a pathological mutation in the SCL29A3 gene compatible with H syndrome. Computed tomography scan revealed extensive alveolar infiltrates in the lungs and multiple poor defined hypodense lesions in liver, spleen, and kidneys; adenopathy; and cardiomegaly with left ventricle subendocardial nodules. Invasive mechanical ventilation, broad antibiotic and antifungal coverage showed no significant response. Therefore, Tocilizumab as compassionate use together with pulsed intravenous methylprednisolone was initiated. Improvement was impressive leading to normalization of inflammation markers, liver and kidney function, and stabilising heart function. Two weeks later, he was discharged and has been clinically well since then on two weekly administration of Tocilizumab. Conclusions We report the most severe disease course produced by HS described so far in the literature. Our patient’s manifestations included uncommon, new complications such as acute heart failure with severe systolic dysfunction, multi-organ cell infiltrate, and digital ischemia. Most of the clinical symptoms of our patient could have been explained by SARS-CoV-2, demonstrating the importance of a detailed differential diagnosis to ensure optimal treatment. Although the mechanism of autoinflammation of HS remains uncertain, the good response of our patient to Tocilizumab makes a case for the important role of IL-6 in this syndrome and for considering Tocilizumab as a first-line treatment, at least in severely affected patients.

scholarly journals Multiple Organ Dysfunction Reduces In-Hospital Survival in COVID-19 Patients

2020 ◽  
Vol 5 (09) ◽  
pp. 389-394
Author(s):  
Najiba Abdulrazzaq ◽  
Kashif Bin Naeem ◽  
Abdalla Alhajiri ◽  
Ayman Chkhis ◽  
Vinod Choondal ◽  
...  
Keyword(s):  
Acute Kidney Injury ◽  
Organ Dysfunction ◽  
Distress Syndrome ◽  
Cardiac Injury ◽  
Kidney Injury ◽  
Organ Damage ◽  
Multiple Organ ◽  
Multiple Organ Dysfunction ◽  
Hospital Survival ◽  
Multiple Organs

Background: Although primarily a respiratory illness, COVID-19 involves multiple organs when the disease is severe or critical. Hence, we conducted this study to evaluate the incidence of multiple organ dysfunction in COVID-19 patients and its implications on survival. Methods: A retrospective analysis of laboratory-confirmed COVID-19 patients presenting to our center in Dubai, UAE between April 2020 and July 2020. Data was collected from the electronic medical records and analyzed to evaluate multiple organ damage observed during hospital admission. Findings: Five-hundred patients were studied. Overall mean age was 49.5 years (range 13-94), 76% males, 33% diabetics, 31% hypertensives. 97/500 (19.4%) had evidence of single organ damage; 37/500 (7.4%) had two organ damage; and 105/500 (21%) had more than two organ damage. Acute respiratory distress syndrome was the most prevalent organ damage,153/500 (30.6%); followed by acute cardiac injury, 120/500 (24%); acute kidney injury 107/500 (21.4%); acute liver injury 96/500 (19.2%); septic shock 93/500 (18.6%); disseminated intravascular coagulation 27/500 (5.4%), and heart failure 17/500 (3.4%). We found that in-hospital survival reduced as the number of organs involved increased; only 20% patients survived who had more than 2 organ damage. Also, the chances of survival reduced considerably once other organs were involved in addition to the acute respiratory distress syndrome (91.6% survival in ARDS alone vs. 28.6% survival in ARDS with acute kidney injury vs. 10.4% survival in ARDS with shock/acute cardiac injury/acute kidney injury). Conclusion: Multiple organ dysfunction is common in COVID-19 as 21% had evidence of more than two organ damage in our study. The survival in COVID-19 reduces significantly once multiple organs are involved. Early monitoring and recognition of multiple organ dysfunction is necessary to prevent adverse outcomes and improve survival.

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