Clinical characteristics of 2019 novel coronavirus infection in China

AbstractBackgroundSince December 2019, acute respiratory disease (ARD) due to 2019 novel coronavirus (2019-nCoV) emerged in Wuhan city and rapidly spread throughout China. We sought to delineate the clinical characteristics of these cases.MethodsWe extracted the data on 1,099 patients with laboratory-confirmed 2019-nCoV ARD from 552 hospitals in 31 provinces/provincial municipalities through January 29th, 2020.ResultsThe median age was 47.0 years, and 41.90% were females. Only 1.18% of patients had a direct contact with wildlife, whereas 31.30% had been to Wuhan and 71.80% had contacted with people from Wuhan. Fever (87.9%) and cough (67.7%) were the most common symptoms. Diarrhea is uncommon. The median incubation period was 3.0 days (range, 0 to 24.0 days). On admission, ground-glass opacity was the typical radiological finding on chest computed tomography (50.00%). Significantly more severe cases were diagnosed by symptoms plus reverse-transcriptase polymerase-chain-reaction without abnormal radiological findings than non-severe cases (23.87% vs. 5.20%, P<0.001). Lymphopenia was observed in 82.1% of patients. 55 patients (5.00%) were admitted to intensive care unit and 15 (1.36%) succumbed. Severe pneumonia was independently associated with either the admission to intensive care unit, mechanical ventilation, or death in multivariate competing-risk model (sub-distribution hazards ratio, 9.80; 95% confidence interval, 4.06 to 23.67).ConclusionsThe 2019-nCoV epidemic spreads rapidly by human-to-human transmission. Normal radiologic findings are present among some patients with 2019-nCoV infection. The disease severity (including oxygen saturation, respiratory rate, blood leukocyte/lymphocyte count and chest X-ray/CT manifestations) predict poor clinical outcomes.

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Clinical Characteristics, Management, and Outcome of the First 19 Patients With Pneumonia Due to the 2019 Novel Coronavirus Disease Treated in an Intensive Care Unit in the Republic of Cyprus

Cureus ◽

10.7759/cureus.15114 ◽

2021 ◽

Author(s):

Antonia Kastoris ◽

Stelios Iordanou ◽

Christos Efseviou ◽

Andry Papastylianou ◽

Elpidoforos S Soteriades ◽

...

Keyword(s):

Intensive Care Unit ◽

Intensive Care ◽

Clinical Characteristics ◽

The Republic ◽

Novel Coronavirus ◽

Republic Of Cyprus

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COVID-19-Related Severe Hypercoagulability in Patients Admitted to Intensive Care Unit for Acute Respiratory Failure

Thrombosis and Haemostasis ◽

10.1055/s-0040-1710018 ◽

2020 ◽

Vol 120 (06) ◽

pp. 998-1000 ◽

Cited By ~ 159

Author(s):

Luca Spiezia ◽

Annalisa Boscolo ◽

Francesco Poletto ◽

Lorenzo Cerruti ◽

Ivo Tiberio ◽

...

Keyword(s):

Intensive Care Unit ◽

Intensive Care ◽

Respiratory Failure ◽

Acute Respiratory Failure ◽

Severe Pneumonia ◽

University Hospital ◽

Common Finding ◽

Novel Coronavirus ◽

Clot Formation Time ◽

D Dimer

AbstractIn late December 2019 an outbreak of a novel coronavirus (SARS-CoV-2) causing severe pneumonia (COVID-19) was reported in Wuhan, Hubei Province, China. A common finding in most COVID-19 patients is high D-dimer levels which are associated with a worse prognosis. We aimed to evaluate coagulation abnormalities via traditional tests and whole blood thromboelastometry profiles in a group of 22 (mean age 67 ± 8 years, M:F 20:2) consecutive patients admitted to the Intensive Care Unit of Padova University Hospital for acute respiratory failure due to COVID-19. Cases showed significantly higher fibrinogen and D-dimer plasma levels versus healthy controls (p < 0.0001 in both comparisons). Interestingly enough, markedly hypercoagulable thromboelastometry profiles were observed in COVID-19 patients, as reflected by shorter Clot Formation Time (CFT) in INTEM (p = 0.0002) and EXTEM (p = 0.01) and higher Maximum Clot Firmness (MCF) in INTEM, EXTEM and FIBTEM (p < 0.001 in all comparisons). In conclusion, COVID-19 patients with acute respiratory failure present a severe hypercoagulability rather than consumptive coagulopathy. Fibrin formation and polymerization may predispose to thrombosis and correlate with a worse outcome.

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Factors Predicting Outcome in Intensive Care Unit-Admitted COVID-19 Patients: Using Clinical, Laboratory, and Radiologic Characteristics

Critical Care Research and Practice ◽

10.1155/2021/9941570 ◽

2021 ◽

Vol 2021 ◽

pp. 1-7

Author(s):

Aminreza Abkhoo ◽

Elaheh Shaker ◽

Mohammad-Mehdi Mehrabinejad ◽

Javid Azadbakht ◽

Nahid Sadighi ◽

...

Keyword(s):

Intensive Care Unit ◽

Intensive Care ◽

Mortality Rate ◽

Pericardial Effusion ◽

Clinical Laboratory ◽

Vital Signs ◽

Ground Glass Opacity ◽

Laboratory Findings ◽

Radiologic Findings ◽

Significant Difference

Purpose. To investigate the factors contributing to mortality in coronavirus disease 2019 (COVID-19) patients admitted in the intensive care unit (ICU) and design a model to predict the mortality rate. Method. We retrospectively evaluated the medical records and CT images of the ICU-admitted COVID-19 patients who had an on-admission chest CT scan. We analyzed the patients’ demographic, clinical, laboratory, and radiologic findings and compared them between survivors and nonsurvivors. Results. Among the 121 enrolled patients (mean age, 62.2 ± 14.0 years; male, 82 (67.8%)), 41 (33.9%) survived, and the rest succumbed to death. The most frequent radiologic findings were ground-glass opacity (GGO) (71.9%) with peripheral (38.8%) and bilateral (98.3%) involvement, with lower lobes (94.2%) predominancy. The most common additional findings were cardiomegaly (63.6%), parenchymal band (47.9%), and crazy-paving pattern (44.4%). Univariable analysis of radiologic findings showed that cardiomegaly p : 0.04 , pleural effusion p : 0.02 , and pericardial effusion p : 0.03 were significantly more prevalent in nonsurvivors. However, the extension of pulmonary involvement was not significantly different between the two subgroups (11.4 ± 4.1 in survivors vs. 11.9 ± 5.1 in nonsurvivors, p : 0.59 ). Among nonradiologic factors, advanced age p : 0.002 , lower O2 saturation p : 0.01 , diastolic blood pressure p : 0.02 , and hypertension p : 0.03 were more commonly found in nonsurvivors. There was no significant difference between survivors and nonsurvivors in terms of laboratory findings. Three following factors remained significant in the backward logistic regression model: O2 saturation (OR: 0.91 (95% CI: 0.84–0.97), p : 0.006 ), pericardial effusion (6.56 (0.17–59.3), p : 0.09 ), and hypertension (4.11 (1.39–12.2), p : 0.01 ). This model had 78.7% sensitivity, 61.1% specificity, 90.0% positive predictive value, and 75.5% accuracy in predicting in-ICU mortality. Conclusion. A combination of underlying diseases, vital signs, and radiologic factors might have prognostic value for mortality rate prediction in ICU-admitted COVID-19 patients.

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Baseline characteristics, level of disease severity and outcomes of patients with COVID-19 admitted to intensive care unit in COVID-19 dedicated Mugda Medical College and Hospital, Dhaka, Bangladesh

International Journal of Community Medicine and Public Health ◽

10.18203/2394-6040.ijcmph20204347 ◽

2020 ◽

Vol 7 (10) ◽

pp. 3837

Author(s):

Irin Hossain ◽

Manzurul H. Khan ◽

Shah G. Tuhin ◽

M. M. Aktaruzzaman ◽

Shafiur Rahman ◽

...

Keyword(s):

Intensive Care Unit ◽

Intensive Care ◽

Critically Ill ◽

Critically Ill Patients ◽

Clinical Characteristics ◽

Icu Patients ◽

Ventilator Support ◽

Medical College ◽

Central Oxygen ◽

Novel Coronavirus

Background: Novel coronavirus disease is associated with highly intensive care unit (ICU) mortality. With the dramatic increase of confirmed cases as well as death toll in Bangladesh, timely and effective management of severely and critically ill patients appears to be particularly important. This includes streamlining workflows for rapid diagnosis and isolation, clinical management, and infection prevention. The main objective of this study was identification of the demographic, clinical characteristics, severity and outcome of patients admitted into ICU. Methods: We aimed to describe the demographic and clinical characteristics, severity of disease, management patterns and outcomes of critically ill patients with coronavirus disease 2019 admitted to ICU in a Bangladeshi setting and for this purpose a retro-prospective study of conveniently selected 63 ICU admitted patients with COVID-19 was conducted from May 1 to June 30, 2020. Data were obtained from patient charts and the hospitals’ records using a structured questionnaire. Results: Most of the ICU patients were older male (30, 65.3%) and most of them were 70 or above years of age group (17, 37.0%). ICU patients more likely suffered from comorbidities like hypertension (938, 60.3%); diabetes (36, 57.1%); chronic kidney disease (21, 33.3%). In most cases treatment in ICU included the administration of antibiotics (100.0%) (Meropenem, 20, 31.7%). Forty-Eight patients died (discharge mortality, 76.2%), and fourteen patients were discharged alive from the ICU with a rate of 22.2%. One patient transferred (Palliative discharge, 1.6%) to other facilities for palliative care purpose.Conclusions: Our findings also highlight the importance of planning for mass critical care along with central oxygen supply system as the need for ICU care and ventilator support to treat patients with COVID-19 grows rapidly in Bangladesh.

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A Timely Call to Arms: COVID-19, the Circadian Clock, and Critical Care

Journal of Biological Rhythms ◽

10.1177/0748730421992587 ◽

2021 ◽

Vol 36 (1) ◽

pp. 55-70

Author(s):

Jeffrey Haspel ◽

Minjee Kim ◽

Phyllis Zee ◽

Tanja Schwarzmeier ◽

Sara Montagnese ◽

...

Keyword(s):

Intensive Care Unit ◽

Human Physiology ◽

Critical Care ◽

Intensive Care ◽

Severe Acute Respiratory Syndrome ◽

Circadian Clock ◽

Clinical Course ◽

Disease Expression ◽

Severe Manifestation ◽

Novel Coronavirus

We currently find ourselves in the midst of a global coronavirus disease 2019 (COVID-19) pandemic, caused by the highly infectious novel coronavirus, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Here, we discuss aspects of SARS-CoV-2 biology and pathology and how these might interact with the circadian clock of the host. We further focus on the severe manifestation of the illness, leading to hospitalization in an intensive care unit. The most common severe complications of COVID-19 relate to clock-regulated human physiology. We speculate on how the pandemic might be used to gain insights on the circadian clock but, more importantly, on how knowledge of the circadian clock might be used to mitigate the disease expression and the clinical course of COVID-19.

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Clinical characteristics of non-convulsive status epilepticus diagnosed by simplified continuous electroencephalogram monitoring at an emergency intensive care unit

Acute Medicine & Surgery ◽

10.1002/ams2.221 ◽

2016 ◽

Vol 4 (1) ◽

pp. 31-37 ◽

Cited By ~ 6

Author(s):

Satoshi Egawa ◽

Toru Hifumi ◽

Kenya Kawakita ◽

Arisa Manabe ◽

Ryuta Nakashima ◽

...

Keyword(s):

Intensive Care Unit ◽

Intensive Care ◽

Status Epilepticus ◽

Clinical Characteristics ◽

Convulsive Status Epilepticus

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Patients Admitted for Variant Alpha COVID-19 Have Poorer Outcomes than Those Infected with the Old Strain

Journal of Clinical Medicine ◽

10.3390/jcm10163550 ◽

2021 ◽

Vol 10 (16) ◽

pp. 3550

Author(s):

Matteo Vassallo ◽

Sabrina Manni ◽

Camille Klotz ◽

Roxane Fabre ◽

Paola Pini ◽

...

Keyword(s):

Intensive Care Unit ◽

Inflammatory Markers ◽

Clinical Characteristics ◽

Clinical Presentation ◽

Severe Pneumonia ◽

Demographic Parameters ◽

Background Characteristics ◽

Risk Of Death ◽

Mean Delay ◽

Diabetes And Obesity

Objectives: The variant alpha COVID-19 rapidly spread across Europe in early 2021. While this variant’s increased infectivity has been proven, little is known of its clinical presentation and outcomes compared to the old strain. Methods: We identified patients admitted to the Cannes General Hospital for variant alpha-related COVID-19 infection from January to April 2021. Their main demographic parameters, inflammatory markers and clinical characteristics were recorded. Patients admitted from October to December 2020 for 20E (EU1) COVID-19 were selected as controls. Differences between groups were analyzed. Results: We included 157 patients (mean age 73 years; 58% men; mean delay of symptoms 6.9 days). Comorbidities were present in 92% (mainly hypertension, diabetes and obesity or overweight). The prevalence of comorbidities did not differ between groups. In 28% of cases, patients either died or required transfer to the Intensive Care Unit (ICU). The cause of death or of transfer to the ICU was presumably associated with severe pneumonia. Variant alpha COVID-19 had 3.8-fold higher risk of death or transfer to the ICU compared to the old strain. Discussion: Patients infected with variant alpha COVID-19, despite similar background characteristics, had a higher risk of unfavorable outcomes than those infected with the old strain, suggesting increased virulence related to this variant.

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Effect of Respiratory Rehabilitation for a Patient with Severe Pneumonia and Intensive Care Unit Acquired Weakness (ICU-AW) Due to COVID-19

Rigakuryoho Kagaku ◽

10.1589/rika.36.747 ◽

2021 ◽

Vol 36 (5) ◽

pp. 747-752

Author(s):

Shunsuke NAOI ◽

Shunsuke NAKAZATO ◽

Junya KAMESAKO ◽

Shusuke SEKINE ◽

Hitoshi IMAIZUMI

Keyword(s):

Intensive Care Unit ◽

Intensive Care ◽

Severe Pneumonia ◽

Respiratory Rehabilitation

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Increase in Pediatric Intensive Care Unit Hospitalizations Due to Toxic Ingestions during the COVID-19 Pandemic

Journal of Pediatric Intensive Care ◽

10.1055/s-0041-1727249 ◽

2021 ◽

Author(s):

Jennifer L. van Helmond ◽

Brittany Fitts ◽

Jigar C. Chauhan

Keyword(s):

Intensive Care Unit ◽

Intensive Care ◽

Pediatric Intensive Care Unit ◽

Home Environment ◽

Clinical Characteristics ◽

Pediatric Intensive Care ◽

Cross Sectional Study ◽

Mitigation Measures ◽

Sectional Study ◽

Cross Sectional

AbstractThe coronavirus disease 2019 (COVID-19) pandemic and related community mitigation measures had a significant psychosocial impact. We suspected that more patients were admitted to our pediatric intensive care unit (PICU) for toxic ingestions since the start of the pandemic. We therefore investigated if PICU admissions related to toxic ingestions were higher in 2020 as a result of COVID-19 compared with previous years. We completed a cross-sectional study at a tertiary children's hospital comparing admissions to our PICU between April 2020 and October 2020, during which COVID-19 and community mitigation measures were in place, to those during the same 7-month period in the previous 3 years. Total PICU admissions, admissions for all toxic ingestions (intentional ingestions and accidental ingestions), and demographic and clinical characteristics of patients were compared. Total PICU admissions in 2020 during COVID-19 pandemic months were lower compared with the same months in the preceding 3 years (−16%, p< 0.001), however, admissions for toxic ingestions were higher during COVID-19 (+64%, p< 0.001). When separated by type, intentional (+55%, p = 0.012) and accidental ingestions (+94%, p = 0.021) were higher during COVID-19. COVID-19 with community mitigation measures has led to an increase in PICU admissions for intentional and accidental ingestions, indicating an increase in severity of toxic ingestions in children associated with the pandemic. Mental health of adolescents, and safety of infants and toddlers in their home environment, should be targeted with specific interventions in the ongoing COVID-19 pandemic.

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