scholarly journals Clinical characteristics of 25 death cases with COVID-19: a retrospective review of medical records in a single medical center, Wuhan, China

2020 ◽  
Author(s):  
Xun Li ◽  
Luwen Wang ◽  
Shaonan Yan ◽  
Fan Yang ◽  
Longkui Xiang ◽  
...  
Keyword(s):  
Medical Records ◽  
Clinical Characteristics ◽  
Kidney Diseases ◽  
Heart Diseases ◽  
Organ Damage ◽  
Chronic Obstructive ◽  
Clinical Records ◽  
Underlying Diseases ◽  
Death Cases ◽  
D Dimer

SummaryBackgroundThe pneumonia caused by the 2019 novel coronavirus (SARS-CoV-2) is a highly infectious disease, which was occurred in Wuhan, Hubei Province, China in December 2019. As of February 13, 2020, a total of 59883 cases of COVID-19 in China have been confirmed and 1368 patients have died from the disease. However, the clinical characteristics of the dyed patients were still not clearly clarified. This study aims to summarize the clinical characteristics of death cases with COVID-19 and to identify critically ill patients of COVID-19 early and reduce their mortality.MethodsThe clinical records, laboratory findings and radiologic assessments included chest X-ray or computed tomography were extracted from electronic medical records of 25 died patients with COVID-19 in Renmin Hospital of Wuhan University from Jan 14 to Feb 13, 2020. Two experienced clinicians reviewed and abstracted the data.FindingsThe mean age of the dead was 71.48 ± 12.42 years, the average course of the disease was 10.56 ± 4.42 days, all patients eventually died of respiratory failure. All of those who died had underlying diseases, the most common of which was hypertension (16/25, 64%), followed by diabetes (10/25, 40%), heart diseases (8/25, 32%), kidney diseases (5/25, 20%), cerebral infarction (4/25, 16%), chronic obstructive pulmonary disease (COPD, 2/25, 8%), malignant tumors (2/25, 8%) and acute pancreatitis (1/25, 4%). The most common organ damage outside the lungs was the heart, followed by kidney and liver. In the patients’ last examination before death, white blood cell and neutrophil counts were elevated in 17 patients (17/25, 68%) and 18 patients (18/25, 72%), lymphocyte counts were decreased in 22 patients (22/25, 88%). Most patients’ PCT, CRP and SAA levels were elevated, the percentages were 90.5% (19/21), 85% (19/20) and 100% (21/21) respectively. The levels of the last test of neutrophils (15/16, 93.8%), PCT (11/11, 100%), CRP (11/13, 84.6%), cTnI (8/9, 88.9%), D-Dimer (11/12, 91.6%) and LDH (9/9, 100%) were increased as compared to the first test, while the levels of lymphocytes were decreased (14/16, 87.5%).InterpretationThe age and underlying diseases (hypertension, diabetes, etc.) were the most important risk factors for death of COVID-19 pneumonia. Bacterial infections may play an important role in promoting the death of patients. Malnutrition was common to severe patients. Multiple organ dysfunction can be observed, the most common organ damage was lung, followed by heart, kidney and liver. The rising of neutrophils, SAA, PCT, CRP, cTnI, D-Dimer and LDH levels can be used as indicators of disease progression, as well as the decline of lymphocytes counts.

scholarly journals Clinical characteristics of patients hospitalized with COVID-19 in Spain: results from the SEMI-COVID-19 Network

2020 ◽  
Author(s):  
José Manuel Casas Rojo ◽  
Juan Miguel Antón Santos ◽  
Jesús Millán Núñez-Cortés ◽  
Carlos Lumbreras ◽  
José Manuel Ramos Rincón ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Cohort Study ◽  
Respiratory Distress ◽  
Electronic Medical Records ◽  
Medical Records ◽  
Retrospective Cohort ◽  
Clinical Characteristics ◽  
Close Relationship ◽  
D Dimer ◽  
Overall Mortality

ABSTRACTBackgroundSpain has been one of the countries most affected by the COVID-19 pandemic.ObjectiveTo create a registry of patients with COVID-19 hospitalized in Spain in order to improve our knowledge of the clinical, diagnostic, therapeutic, and prognostic aspects of this disease.MethodsA multicentre retrospective cohort study, including consecutive patients hospitalized with confirmed COVID-19 throughout Spain. Epidemiological and clinical data, additional tests at admission and at seven days, treatments administered, and progress at 30 days of hospitalization were collected from electronic medical records.ResultsUp to April 30th 2020, 6,424 patients from 109 hospitals were included. Their median age was 69.1 years (range: 18-102 years) and 56.9% were male. Prevalences of hypertension, dyslipidemia, and diabetes mellitus were 50.2%, 39.7%, and 18.7%, respectively. The most frequent symptoms were fever (86.2%) and cough (76.5%). High values of ferritin (72.4%), lactate dehydrogenase (70.2%), and D-dimer (61.5%), as well as lymphopenia (52.6%), were frequent. The most used antiviral drugs were hydroxychloroquine (85.7%) and lopinavir/ritonavir (62.4%). 31.5% developed respiratory distress. Overall mortality rate was 21.1%, with a marked increase with age (50-59 years: 4.2%, 60-69 years: 9.1%, 70-79 years: 21.4%, 80-89 years: 42.5%, ≥ 90 years: 51.1%).ConclusionsThe SEMI-COVID-19 Network provides data on the clinical characteristics of patients with COVID-19 hospitalized in Spain. Patients with COVID-19 hospitalized in Spain are mostly severe cases, as one in three patients developed respiratory distress and one in five patients died. These findings confirm a close relationship between advanced age and mortality.

scholarly journals Clinical Characteristics and Risk Factors for Myocardial Injury and Arrhythmia in COVID-19 patients

2020 ◽  
Author(s):  
Hong Gang Ren ◽  
Xingyi Guo ◽  
Lei Tu ◽  
Qinyong Hu ◽  
Kevin Blighe ◽  
...  
Keyword(s):  
Risk Factors ◽  
Clinical Characteristics ◽  
Myocardial Injury ◽  
Heart Diseases ◽  
Chronic Obstructive ◽  
Cross Sectional ◽  
Obstructive Pulmonary Disease ◽  
Increased Risk ◽  
History Of ◽  
Cross Sectional Design

ABSTRACTBackgroundPatients with COVID-19 can develop myocardial injury and arrhythmia during the course of their illness. However, the underlying risk factors for the development of cardiovascular related manifestations are unclear.MethodsUsing a register-based multi-center cross-sectional design, we analyzed 80 patients with myocardial injury and 401 controls, as well as 71 patients with arrhythmia and 409 controls, all admitted with COVID-19. Putative risk factors for myocardial injury and arrhythmia were evaluated with logistic regression with adjustment for potential confounders.ResultsCOVID-19 patients with myocardial injury had fatigue (66.2%) and dyspnea (63.7%), while those with arrhythmia had dyspnea (71.8%). Patients with myocardial injury and arrhythmia had a significant mortality of 92.5% and 94.4%, respectively. A history of chronic obstructive pulmonary disease (COPD) or heart diseases was associated with an increased risk of myocardial injury (odds ratio [OR] = 1.94, 95% confidence interval [CI]: 1.01-3.71; OR = 7.43, 95% CI: 3.99-13.83) and arrhythmia (OR = 1.94, 95% CI: 1.00-3.75; OR = 13.16, 95% CI: 6.75-25.68). In addition, we found that gamma glutamyltranspeptidase (GGT) >50U/L (OR = 2.14, 95% CI: 1.37-3.32; OR = 1.85, 95% CI: 1.19-2.85), serum creatinine >111μmol/L (OR = 8.96, 95% CI: 4.4-18.23; OR = 3.71, 95% CI: 2.01-6.85), serum sodium <136 mmol/L (OR = 4.68, 95% CI: 2.46-8.91; OR = 2.06; 95% CI: 1.06-4.00) were all associated with increased risk of myocardial injury and arrhythmia, respectively.ConclusionOur reported clinical characteristics and identified risk factors are important for clinical study of COVID-19 patients developing myocardial injury and arrhythmia.

Diagnostic and prognostic value of peripheral blood leucocyte ratios in sick cats

2021 ◽  
Author(s):  
Theodora K. Tsouloufi ◽  
Petros S. Frezoulis ◽  
Nectarios Soubasis ◽  
Maria Kritsepi-Konstantinou ◽  
Ioannis L. Oikonomidis
Keyword(s):  
Medical Records ◽  
Kidney Diseases ◽  
Gastrointestinal Diseases ◽  
Peripheral Blood Leucocyte ◽  
Chronic Kidney Diseases ◽  
Prognostic Performance ◽  
Prognostic Utility ◽  
Complete Blood Counts ◽  
Underlying Diseases ◽  
Advia 120

Abstract The objective of this study was to assess the diagnostic and prognostic utility of feline neutrophil-to-lymphocyte (NLR) and lymphocyte-to-monocyte ratios (LMR) in a variety of underlying diseases. Five-year medical records from cats presenting to the internal medicine unit of a veterinary teaching hospital were retrospectively reviewed. Cats were considered for inclusion based on complete medical records. ADVIA 120 was used for the complete blood counts; the NLR and LMR were calculated by dividing the absolute numbers of the respective leucocytes. Two hundred and nineteen sick and 20 healthy cats were included in the study. The median NLR and LMR were significantly (P < 0.05) elevated and decreased, respectively, in cats with infectious, neoplastic and chronic kidney diseases compared to controls. Additionally, cats with neoplasia had significantly higher median NLR compared to cats with urinary tract and gastrointestinal diseases. Non-survivors had significantly higher NLR and lower LMR compared to survivors. Both ratios had suboptimal prognostic performance for the outcome of sick cats (NLR sensitivity: 37.9%, specificity: 86.4%; LMR sensitivity: 69.0%, specificity: 61.0%). Many different disease categories were associated with increased NLR and decreased LMR compared to controls, but the overall prognostic performance of the two leucocyte ratios was suboptimal.

scholarly journals Role of chaperone-mediated autophagy in the pathophysiology including pulmonary disorders

2021 ◽  
Vol 41 (1) ◽  
Author(s):  
Yusuke Hosaka ◽  
Jun Araya ◽  
Yu Fujita ◽  
Kazuyoshi Kuwano
Keyword(s):  
Molecular Mechanisms ◽  
Kidney Diseases ◽  
Heart Diseases ◽  
Treatment Modalities ◽  
Chronic Obstructive ◽  
Limiting Factor ◽  
Target Proteins ◽  
Multiple Organs ◽  
Chaperone Mediated Autophagy

AbstractAutophagy is a highly conserved mechanism of delivering cytoplasmic components for lysosomal degradation. Among the three major autophagic pathways, chaperone-mediated autophagy (CMA) is primarily characterized by its selective nature of protein degradation, which is mediated by heat shock cognate 71 kDa protein (HSC70: also known as HSPA8) recognition of the KFERQ peptide motif in target proteins. Lysosome-associated membrane protein type 2A (LAMP2A) is responsible for substrate binding and internalization to lysosomes, and thus, the lysosomal expression level of LAMP2A is a rate-limiting factor for CMA. Recent advances have uncovered not only physiological but also pathological role of CMA in multiple organs, including neurodegenerative disorders, kidney diseases, liver diseases, heart diseases, and cancers through the accumulation of unwanted proteins or increased degradation of target proteins with concomitant metabolic alterations resulting from CMA malfunction. With respect to pulmonary disorders, the involvement of CMA has been demonstrated in lung cancer and chronic obstructive pulmonary disease (COPD) pathogenesis through regulating apoptosis. Further understanding of CMA machinery may shed light on the molecular mechanisms of refractory disorders and lead to novel treatment modalities through CMA modulation.

scholarly journals Clinical characteristics of children infected with SARS-CoV-2 in Italy

2021 ◽  
Vol 47 (1) ◽  
Author(s):  
Isabella Tarissi De Jacobis ◽  
Rosa Vona ◽  
Camilla Cittadini ◽  
Alessandra Marchesi ◽  
Laura Cursi ◽  
...  
Keyword(s):  
Electronic Medical Records ◽  
Medical Records ◽  
Clinical Characteristics ◽  
Pediatric Population ◽  
C Reactive Protein ◽  
Normal Range ◽  
Laboratory Findings ◽  
Reactive Protein ◽  
Males And Females ◽  
D Dimer

Abstract Background Since December 2019 coronavirus disease (COVID-19) emerged in Wuhan and spread rapidly worldwide. Despite the high number of people affected, data on clinical features and prognostic factors in children and adolescents are limited. We propose a retrospective study aimed to evaluate clinical characteristics of children infected with SARS-CoV-2 in Italy. Methods A pediatric population admitted with COVID-19 to Bambino Gesù Children’s Hospital of Rome (Italy) in the period from the end of February to July 2020 has been studied. Medical history, comorbidities, symptoms and laboratory findings were obtained from patients’ electronic medical records. Results In 66 patients (35 males and 31 females) we found that: i) fever and cough were the dominant symptoms, while vomit and convulsions were rare symptoms; and ii) all ages of childhood were susceptible to COVID-19. Furthermore, we found that, compared to females, males with COVID-19, although not significantly, had higher values of inflammatory markers such as C-reactive protein (CRP) and ESR. Conversely, we found that COVID-19 positive females were older than males and required more days of hospitalization. Both males and females COVID-19 positives had procalcitonin values within the normal range and D-Dimer values slightly higher than the normal range. With regard to this latter marker, the value measured in females, although not significant, was higher than that measured in males. Interestingly, the presence of leukopenia was found in both sexes. Conclusions Compared to the adults we found that COVID-19 infection in children is a non-severe inflammatory disease in both males and females. In any case, many detailed studies should be conducted.

Prevalence, Biochemical and Clinical Characteristics of Resistant Hypertension

2018 ◽  
Vol 69 (10) ◽  
pp. 2845-2849
Author(s):  
Daniela Gurgus ◽  
Elena Ardeleanu ◽  
Carmen Gadau ◽  
Roxana Folescu ◽  
Ioan Tilea ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Cardiovascular Disease ◽  
Resistant Hypertension ◽  
Clinical Characteristics ◽  
Salt Intake ◽  
Target Organ Damage ◽  
Multivariate Logistic Regression Analysis ◽  
Organ Damage ◽  
Left Ventricular ◽  
High Salt Intake

The objectives of the present study were to evaluate the prevalence of resistant hypertension (RH) in primary care setting and to analyse its biochemical and clinical characteristics. After 3 months of treatment and evaluation, 721 (14.01%) of 5,146 patients with hypertension did not reach target office blood pressure of [ 140/90 mmHg. After exclusion of �white-coat effect� with ambulatory blood pressure, of secondary and pseudo- resistant hypertension, prevalence of RH was 6.74%. Lifestyle factors associated with RH were physical inactivity, obesity, high salt intake, smoking and excessive alcohol ingestion. Compared to controlled hypertension, RH patients presented higher incidence of family history of cardiovascular disease (38.90% vs 25.94%), diabetes mellitus (34.87% vs 19.01%), impaired fasting glucose (21.91% vs 19.07%), target organ damage (29.1% vs 15.95%), and cardiovascular disease (27.09% vs 17.06%). Dyslipidaemia (52.90% vs 42.03%), fasting plasma glucose (116.10�38.9 vs 107.80�37.2), HbA1c (6.41�1.42 vs 5.96�0.94), serum creatinine (1.09�0.27 vs 1.03�0.24) and microalbuminuria (21.90% vs 10.95%) were significantly higher in RH. Predictors of RH, determined by a multivariate logistic regression analysis were left ventricular hypertrophy (OD 2.14, 95% CI 1.32-3.69), renal impairment expressed as eGFR [ 60 ml/min/1.73m2 (OD 1.62, 95% CI 1.21-2.21) and the presence of cardiovascular disease (OD 1.48, 95% CI 1.02-2.16).

The Mitochondrion-targeted Antioxidants in Kidney Disease

2020 ◽  
Vol 27 ◽  
Author(s):  
Xinrui Li ◽  
Liang Ma ◽  
Ping Fu
Keyword(s):  
Reactive Oxygen Species ◽  
Cell Death ◽  
Clinical Characteristics ◽  
Kidney Diseases ◽  
Oxygen Species ◽  
Mitochondrial Targeting ◽  
Mitochondria Dysfunction ◽  
Cellular Reactive Oxygen Species ◽  
Novel Strategy ◽  
The Relationship

: Mitochondria are potent source of cellular reactive oxygen species (ROS) and are vulnerable to oxidative damage. Mitochondria dysfunction could result in adenosine triphosphate (ATP) decrease and cell death. The kidney is an ATPconsuming organ, and the relationship between mitochondrial dysfunction and renal disease has been long noted. Mitochondrial targeting is a novel strategy for kidney diseases. At present, there are several ways to target mitochondria such as the addition of a triphenylphosphonium cation, mitochondria-targeted peptides, and nanocarrier. There are also a variety of choices for the payload, such as nitroxides, quinone derivates, vitamins and so on. This review summarized chemical and also clinical characteristics of various mitochondria-targeted antioxidants and focused on their application and perspectives in kidney diseases.

scholarly journals Clinical characteristics of inpatients with coronavirus disease 2019 (COVID-19) in Sichuan province

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Wen Wang ◽  
Lei Chen ◽  
Qiao He ◽  
Mingqi Wang ◽  
Mei Liu ◽  
...  
Keyword(s):  
Mechanical Ventilation ◽  
Clinical Features ◽  
Medical Records ◽  
Clinical Characteristics ◽  
Sichuan Province ◽  
Chest Ct ◽  
Shortness Of Breath ◽  
Course Of Disease ◽  
West China ◽  
Radiologic Abnormality

Abstract Background The outbreak of COVID-19 has resulted in serious concerns in China and abroad. To investigate clinical features of confirmed and suspected patients with COVID-19 in west China, and to examine differences between severe versus non-severe patients. Methods Patients admitted for COVID-19 between January 21 and February 11 from fifteen hospitals in Sichuan Province, China were included. Experienced clinicians trained with methods abstracted data from medical records using pre-defined, pilot-tested forms. Clinical characteristics between severe and non-severe patients were compared. Results Of the 169 patients included, 147 were laboratory-confirmed, 22 were suspected. For confirmed cases, the most common symptoms from onset to admission were cough (70·7%), fever (70·5%) and sputum (33·3%), and the most common chest CT patterns were patchy or stripes shadowing (78·0%); throughout the course of disease, 19·0% had no fever, and 12·4% had no radiologic abnormality; twelve (8·2%) received mechanical ventilation, four (2·7%) were transferred to ICU, and no death occurred. Compared to non-severe cases, severe ones were more likely to have underlying comorbidities (62·5% vs 26·2%, P = 0·001), to present with cough (92·0% vs 66·4%, P = 0·02), sputum (60·0% vs 27·9%, P = 0·004) and shortness of breath (40·0% vs 8·2%, P <  0·0001), and to have more frequent lymphopenia (79·2% vs 43·7%, P = 0·003) and eosinopenia (84·2% vs 57·0%, P = 0·046). Conclusions The symptoms of patients in west China were relatively mild, and an appreciable proportion of infected cases had no fever, warranting special attention.

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