scholarly journals Transmission and clinical characteristics of coronavirus disease 2019 in 104 outside-Wuhan patients, China

2020 ◽  
Author(s):  
Chengfeng Qiu ◽  
Qian Xiao ◽  
Xin Liao ◽  
Ziwei Deng ◽  
Huiwen Liu ◽  
...  
Keyword(s):  
Incubation Period ◽  
Clinical Characteristics ◽  
Clinical Laboratory ◽  
Antiviral Treatment ◽  
Hunan Province ◽  
Main Body ◽  
Medication Therapy ◽  
Traditional Chinese Medicine Therapy ◽  
Contact Investigation ◽  
Imported Cases

AbstractBackgroundCases with coronavirus disease 2019 (COVID-19) emigrated from Wuhan escalated the risk of spreading in other cities. This report focused on the outside-Wuhan patients to assess the transmission and clinical characteristics of this illness.MethodsContact investigation was conducted on each patient who admitted to the assigned hospitals in Hunan Province (geographically adjacent to Wuhan) from Jan 22, 2020 to Feb 12, 2020. Demographic, clinical, laboratory and radiological characteristics, medication therapy and outcomes were collected and analyzed. Patients were confirmed by PCR test.ResultsOf the 104 patients, 48 (46.15%) were imported cases and 56 (53.85%) were indigenous cases; 93 (89.42%) had a definite contact history with infections. Family clusters were the major body of patients. Transmission along the chain of 3 “generations” was observed. Mean age was 43 (rang, 8-84) years (including 3 children) and 49 (47.12%) were male. Most patients had typical symptoms, 5 asymptomatic infections were found and 2 of them infected their relatives. The median incubation period was 6 (rang, 1-32) days, of 8 patients ranged from 18 to 32 days. Just 9 of 16 severe patients required ICU care. Until Feb 12, 2020, 40 (38.46%) discharged and 1 (0.96%) died. For the antiviral treatment, 80 (76.92%) patients received traditional Chinese medicine therapy.ConclusionsFamily but not community transmission occupied the main body of infections in the two centers. Asymptomatic transmission demonstrated here warned us that it may bring more risk to the spread of COVID-19. The incubation period of 8 patients exceeded 14 days.

scholarly journals Association between incubation period and clinical characteristics of patients with COVID-19

2020 ◽  
Vol 48 (9) ◽  
pp. 030006052095683
Author(s):  
Yeyu Cai ◽  
Jiayi Liu ◽  
Haitao Yang ◽  
Mian Wang ◽  
Qingping Guo ◽  
...  
Keyword(s):  
Incubation Period ◽  
Disease Severity ◽  
Symptom Onset ◽  
Clinical Characteristics ◽  
Characteristic Curve ◽  
Severe Disease ◽  
Receiver Operator Characteristic Curve ◽  
Hunan Province ◽  
Laboratory Findings ◽  
Incubation Periods

Purpose To investigate associations between the clinical characteristics and incubation periods of patients infected with coronavirus disease 2019 (COVID-19) in Wuhan, China. Methods Complete clinical and epidemiological data from 149 patients with COVID-19 at a hospital in Hunan Province, China, were collected and retrospectively analyzed. Results Analysis of the distribution and receiver operator characteristic curve of incubation periods showed that 7 days was the optimal cut-off value to assess differences in disease severity between groups. Patients with shorter (≤7 days) incubation periods (n = 79) had more severe disease, longer durations of hospitalization, longer times from symptom onset to discharge, more abnormal laboratory findings, and more severe radiological findings than patients with longer (>7 days) incubation periods. Regression and correlation analyses also showed that a shorter incubation period was associated with longer times from symptom onset to discharge. Conclusion The associations between the incubation periods and clinical characteristics of COVID-19 patients suggest that the incubation period may be a useful marker of disease severity and prognosis.

scholarly journals The differences of clinical characteristics and outcomes between imported and local patients of COVID-19 in Hunan: A two-center retrospective study

2020 ◽  
Author(s):  
Chang Wang ◽  
Lizhi Zhou ◽  
Juan Chen ◽  
Yong Yang ◽  
Tianlong Huang ◽  
...  
Keyword(s):  
Clinical Characteristics ◽  
Gamma Globulin ◽  
Laboratory Data ◽  
Hunan Province ◽  
Local Resident ◽  
Imported Cases ◽  
History Of ◽  
The Difference ◽  
Novel Coronavirus ◽  
Severe Type

Abstract Background: The clinical characteristics and outcomes of the 2019 novel coronavirus (COVID-19) pneumonia are different in Hubei compared to other regions in China. But there are few comparative studies on the differences between imported and local patients which may provide information of the different courses of the virus after transmission. Methods: We investigated 169 cases of COVID-19 pneumonia in two centers in Hunan Province, and divided them into two groups according to epidemiological history, "imported patients" refers to patient with a clear history of travel in Wuhan within 14 days before onset, and " local patients” refers to local resident without a recent history of travel in Wuhan, aiming to analyze the difference in clinical characteristics and outcomes between the two groups. All the epidemiological, clinical, imaging, and laboratory data were analyzed and contrasted. Results: The incidence of fever on admission in imported patients was significantly higher than local patients. There was a significantly higher proportion of abnormal pulmonary signs, hypokalemia, hyponatremia, prolonged PT, elevated D-dimer and elevated blood glucose in imported patients. Compared with local patients, the proportion using antibiotics, glucocorticoids and gamma globulin were significantly higher in imported patients. The moderate type was more common in local patients, and the severe type were more frequent in imported patients. In addition, the median duration of viral clearance was longer in imported patients. Conclusions: In summary, we found that imported cases were more likely to develop into severe cases, compared with local patients and required more powerful treatments.Trial registration: Registered 21st March 2020, and this study has been approved by the Medical Ethics Committee (Approved Number. 2020017).

scholarly journals Epidemiological and clinical characteristics of a familial cluster of COVID-19

2020 ◽  
Vol 148 ◽  
Author(s):  
Yong Sun ◽  
Lin Tian ◽  
Xiaomei Du ◽  
Hua Wang ◽  
Yueshan Li ◽  
...  
Keyword(s):  
Severe Acute Respiratory Syndrome ◽  
Family Member ◽  
Incubation Period ◽  
Clinical Characteristics ◽  
Clinical Laboratory ◽  
Epidemiological Investigation ◽  
Radiological Findings ◽  
Wuhan City ◽  
Familial Cluster ◽  
Family Cluster

Abstract We report a family cluster of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection involving five patients in a family cluster in Dazhou, China, including the epidemiological, clinical, laboratory and radiological findings. Three-generation transmission was observed. Through epidemiological investigation, we observed asymptomatic transmission to a cohabiting family member, as well as person-to-person transmission of SARS-CoV-2 outside Wuhan city. The asymptomatic transmission demonstrated here provides evidence that there could be a greater risk of Coronavirus Disease 2019 (COVID-19) spread. This cluster also demonstrated that COVID-19 is transmissible during the incubation period of an asymptomatic person. Early isolation and treatment, stressing prevention of cluster outbreaks, could help prevent further spread of the epidemic.

scholarly journals The differences of clinical characteristics and outcomes between imported and local patients of COVID-19 in Hunan: a two-center retrospective study

2020 ◽  
Vol 21 (1) ◽  
Author(s):  
Chang Wang ◽  
Lizhi Zhou ◽  
Juan Chen ◽  
Yong Yang ◽  
Tianlong Huang ◽  
...  
Keyword(s):  
Clinical Characteristics ◽  
Gamma Globulin ◽  
Laboratory Data ◽  
Hunan Province ◽  
Local Resident ◽  
Imported Cases ◽  
History Of ◽  
The Difference ◽  
Novel Coronavirus ◽  
Severe Type

Abstract Background The clinical characteristics and outcomes of the 2019 novel coronavirus (COVID-19) pneumonia are different in Hubei compared to other regions in China. But there are few comparative studies on the differences between imported and local patients which may provide information of the different courses of the virus after transmission. Methods We investigated 169 cases of COVID-19 pneumonia in two centers in Hunan Province, and divided them into two groups according to epidemiological history, "imported patients" refers to patient with a clear history of travel in Wuhan within 14 days before onset, and " local patients” refers to local resident without a recent history of travel in Wuhan, aiming to analyze the difference in clinical characteristics and outcomes between the two groups. All the epidemiological, clinical, imaging, and laboratory data were analyzed and contrasted. Results The incidence of fever on admission in imported patients was significantly higher than local patients. There was a significantly higher proportion of abnormal pulmonary signs, hypokalemia, hyponatremia, prolonged PT, elevated D-dimer and elevated blood glucose in imported patients. Compared with local patients, the proportion using antibiotics, glucocorticoids and gamma globulin were significantly higher in imported patients. The moderate type was more common in local patients, and the severe type were more frequent in imported patients. In addition, the median duration of viral clearance was longer in imported patients. Conclusions In summary, we found that imported cases were more likely to develop into severe cases, compared with local patients and required more powerful treatments. Trial registration Registered 21st March 2020, and this study has been approved by the Medical Ethics Committee (Approved Number. 2020017).

scholarly journals The differences of clinical characteristics and outcomes between imported and local patients of COVID-19 in Hunan: A two-center retrospective study

2020 ◽  
Author(s):  
Chang Wang ◽  
Lizhi Zhou ◽  
Juan Chen ◽  
Yong Yang ◽  
Tianlong Huang ◽  
...  
Keyword(s):  
Clinical Characteristics ◽  
Gamma Globulin ◽  
Laboratory Data ◽  
Hunan Province ◽  
Local Resident ◽  
Imported Cases ◽  
History Of ◽  
The Difference ◽  
Novel Coronavirus ◽  
Severe Type

Abstract Background: The clinical characteristics and outcomes of the 2019 novel coronavirus (COVID-19) pneumonia are different in Hubei compared to other regions in China. But there are few comparative studies on the differences between imported and local patients which may provide information of the different courses of the virus after transmission. Methods: We investigated 169 cases of COVID-19 pneumonia in two centers in Hunan Province, and divided them into two groups according to epidemiological history, "imported patients" refers to patient with a clear history of travel in Wuhan within 14 days before onset, and " local patients” refers to local resident without a recent history of travel in Wuhan, aiming to analyze the difference in clinical characteristics and outcomes between the two groups. All the epidemiological, clinical, imaging, and laboratory data were analyzed and contrasted. Results: The incidence of fever on admission in imported patients was significantly higher than local patients. There was a significantly higher proportion of abnormal pulmonary signs, hypokalemia, hyponatremia, prolonged PT, elevated D-dimer and elevated blood glucose in imported patients. Compared with local patients, the proportion using antibiotics, glucocorticoids and gamma globulin were significantly higher in imported patients. The moderate type was more common in local patients, and the severe type were more frequent in imported patients. In addition, the median duration of viral clearance was longer in imported patients. Conclusions: In summary, we found that imported cases were more likely to develop into severe cases, compared with local patients and required more powerful treatments.Trial registration: Registered 21st March 2020, and this study has been approved by the Medical Ethics Committee (Approved Number. 2020017).

scholarly journals Subcritical Transmission in the Early Stage of COVID-19 in Korea

2021 ◽  
Vol 18 (3) ◽  
pp. 1265
Author(s):  
Yong Sul Won ◽  
Jong-Hoon Kim ◽  
Chi Young Ahn ◽  
Hyojung Lee
Keyword(s):  
Incubation Period ◽  
Early Stage ◽  
Probability Distributions ◽  
Likelihood Estimation ◽  
Contact Tracing ◽  
Statistical Characterization ◽  
Serial Interval ◽  
Imported Cases ◽  
The Mean ◽  
Reporting Delays

While the coronavirus disease 2019 (COVID-19) outbreak has been ongoing in Korea since January 2020, there were limited transmissions during the early stages of the outbreak. In the present study, we aimed to provide a statistical characterization of COVID-19 transmissions that led to this small outbreak. We collated the individual data of the first 28 confirmed cases reported from 20 January to 10 February 2020. We estimated key epidemiological parameters such as reporting delay (i.e., time from symptom onset to confirmation), incubation period, and serial interval by fitting probability distributions to the data based on the maximum likelihood estimation. We also estimated the basic reproduction number (R0) using the renewal equation, which allows for the transmissibility to differ between imported and locally transmitted cases. There were 16 imported and 12 locally transmitted cases, and secondary transmissions per case were higher for the imported cases than the locally transmitted cases (nine vs. three cases). The mean reporting delays were estimated to be 6.76 days (95% CI: 4.53, 9.28) and 2.57 days (95% CI: 1.57, 4.23) for imported and locally transmitted cases, respectively. The mean incubation period was estimated to be 5.53 days (95% CI: 3.98, 8.09) and was shorter than the mean serial interval of 6.45 days (95% CI: 4.32, 9.65). The R0 was estimated to be 0.40 (95% CI: 0.16, 0.99), accounting for the local and imported cases. The fewer secondary cases and shorter reporting delays for the locally transmitted cases suggest that contact tracing of imported cases was effective at reducing further transmissions, which helped to keep R0 below one and the overall transmissions small.

scholarly journals Clinical features of imported cases of coronavirus disease 2019 in Tibetan patients in the Plateau area

2020 ◽  
Author(s):  
Yu Lei ◽  
Xiaobo Huang ◽  
Bamu SiLang ◽  
YunPing Lan ◽  
Jianli Lu ◽  
...  
Keyword(s):  
Clinical Laboratory ◽  
Clinical Symptoms ◽  
Asymptomatic Group ◽  
Asymptomatic Patients ◽  
Abnormal Chest ◽  
Plateau Area ◽  
Imported Cases ◽  
High Altitude Area ◽  
History Of ◽  
The Mean

AbstractCoronavirus disease 2019 (COVID-19), caused by SARS-CoV-2, has rapidly spread throughout China, but the clinical characteristics of Tibetan patients living in the Qinghai-Tibetan plateau are unknown. We aimed to investigate the epidemiological, clinical, laboratory and radiological characteristics of these patients. We included 67 Tibetan patients with confirmed SARS-CoV-2 infection. The patients were divided into two groups based on the presence of clinical symptoms at admission, with 31 and 36 patients in the symptomatic and asymptomatic groups, respectively. The epidemiological, clinical, laboratory and radiological characteristics were extracted and analysed. No patient had a history of exposure to COVID-19 patients from Wuhan or had travelled to Wuhan. The mean age of Tibetan patients was 39.3 years and 59% of the patients were male. Seven patients presented with fever on admission and lymphocytopenia was present in 20 patients. 47 patients had abnormal chest CTs at admission instead of stating that 20 were unchanged. Lactate dehydrogenase levels were increased in 31 patients. Seven patients progressed to severe COVID-19; however, after treatment, their condition was stable. No patients died. Of the 36 asymptomatic patients, the mean age was younger than the symptomatic group (34.4±17.3vs 44.9±18.1 years, P=0.02). Lymphocyte count and prealbumin levels were higher in the asymptomatic group than the group with clinical symptoms (1.6±0.5 vs 1.3±0.6 and 241.8±68.2 vs 191.9±60.3, respectively; P<0.05). Imported cases of COVID-19 in Tibetan patients were generally mild in this high-altitude area. Absence of fever or radiologic abnormalities on initial presentation were common.

scholarly journals First-in-Woman Safety, Tolerability, and Pharmacokinetics of Orally Administered GS-441524: A Broad-Spectrum Antiviral Treatment for COVID-19

2021 ◽  
Author(s):  
Victoria Yan
Keyword(s):  
Severe Acute Respiratory Syndrome ◽  
Broad Spectrum ◽  
Half Life ◽  
Maximum Concentration ◽  
Viral Infections ◽  
Clinical Laboratory ◽  
Antiviral Treatment ◽  
Oral Solution ◽  
Healthy Human

GS-441524 is a nucleoside analogue with broad-spectrum antiviral activity against RNA viruses, including severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), severe acute respiratory syndrome coronavirus (SARS-CoV), Middle East respiratory syndrome coronavirus (MERS-CoV), and feline coronavirus (FCoV). GS-441524 is the main circulating metabolite following intravenous administration of remdesivir (Veklury®), with a plasma half-life of approximately 24 hours. The safety, tolerability, and pharmacokinetics of GS-441524 was evaluated in a healthy human volunteer (N=1) when administered directly as an oral solution (750 mg) once daily for 7 days (Part 1) and 3 times daily for 3 days (Part 2). In Part 1 of the study, the effect of food on the absorption of GS-441524 was also evaluated. GS-441524 appeared rapidly in plasma, with an average time of maximum concentration of 0.5 hours during once-per-day dosing and exhibited an initial half-life phase of approximately 3.3 hours in the fasted state. Negligible accumulation was observed during part 1 of the multiday study. In Part 2 of the study, GS-441524 was administered 3 times daily, every 3 hours. A 2-4-fold accumulation of GS-441524 was observed approximately 3 hours after the third dose was administered, with a time of maximum concentration of 9 hours and a maximum concentration of 12.01 µM, exceeding the concentration reported to eradicate SARS-CoV-2 in vitro. For the duration of the study, GS-441524 was well-tolerated. There were no treatment-related adverse events and no clinically significant findings in clinical laboratory, vital signs, or electrocardiography. Taken together, these results demonstrate the safety and viability of orally administered GS-441524 for the treatment of COVID-19 and emerging viral infections.

scholarly journals Clinical Characteristics and Outcomes of Diabetic COVID-19 patients in Kuwait

2020 ◽  
Author(s):  
Abdullah Alshukry ◽  
Mohammad Bu Abbas ◽  
Yaseen Ali ◽  
Barrak Alahmad ◽  
Abdullah A. Al-Shammari ◽  
...  
Keyword(s):  
Clinical Characteristics ◽  
Clinical Laboratory ◽  
Fasting Blood Glucose ◽  
List Type ◽  
Laboratory Findings ◽  
Reactive Protein ◽  
Patients With Diabetes ◽  
Laboratory Investigations ◽  
Insight Into ◽  
Variable Clinical Presentation

AbstractBackgroundCOVID-19 has a highly variable clinical presentation, ranging from asymptomatic to severe respiratory symptoms and death. Diabetes seems to be one of the main comorbidities contributing to a worse COVID-19 outcome.ObjectiveIn here we analyze the clinical characteristics and outcomes of diabetic COVID-19 patients.MethodsIn this single-center, retrospective study of 417 consecutive COVID-19 patients, we analyze and compare disease severity, outcome, associated complications, and clinical laboratory findings between diabetic and non-diabetic COVID-19 patients.ResultsCOVID-19 patients with diabetes had more severe outcomes and higher mortality than non-diabetic COVID-19 patients. Diabetic COVID-19 patients had significantly higher prevalence of comorbidities, such as hypertension. Laboratory investigations also highlighted notably higher levels of C-reactive protein in diabetic COVID019 patients and lower estimated glomerular filtration rate. They also showed a higher incidence of complications.ConclusionDiabetes could be a major contributor to worsening outcomes in COVID-19 patients. Understanding the pathophysiology underlining these findings could provide insight into better management and improved outcome of such cases.Highlights of the StudyA significantly higher proportion of Diabetic COVID-19 patients required admission to the ICU.Higher fasting blood glucose was associated with higher risk of COVID-19 associated mortality.Diabetic COVID-19 patients had significantly higher incidence of complications including sepsis, ARDS, cardiac failure and renal failure.

scholarly journals CLINICAL CHARACTERISTICS OF 28 PATIENTS WITH DIABETES AND COVID-19 IN WUHAN, CHINA

2020 ◽  
Vol 26 (6) ◽  
pp. 668-674 ◽  
Author(s):  
Feng Wang ◽  
Yan Yang ◽  
Kun Dong ◽  
Yongli Yan ◽  
Shujun Zhang ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Brain Natriuretic Peptide ◽  
Natriuretic Peptide ◽  
Clinical Characteristics ◽  
Troponin I ◽  
Clinical Laboratory ◽  
Invasive Mechanical Ventilation ◽  
Icu Patients ◽  
Patients With Diabetes

Objective: Previous studies on coronavirus disease 2019 (COVID-19) were based on information from the general population. We aimed to further clarify the clinical characteristics of diabetes with COVID-19. Methods: Twenty-eight patients with diabetes and COVID-19 were enrolled from January 29, 2020, to February 10, 2020, with a final follow-up on February 22, 2020. Epidemiologic, demographic, clinical, laboratory, treatment, and outcome data were analyzed. Results: The average age of the 28 patients was 68.6 ± 9.0 years. Most (75%) patients were male. Only 39.3% of the patients had a clear exposure of COVID-19. Fever (92.9%), dry cough (82.1%), and fatigue (64.3%) were the most common symptoms, followed by dyspnea (57.1%), anorexia (57.1%), diarrhea (42.9%), expectoration (25.0%), and nausea (21.4%). Fourteen patients were admitted to the intensive care unit (ICU). The hemoglobin A1c level was similar between ICU and non-ICU patients. ICU patients had a higher respiratory rate, higher levels of random blood glucose, aspartate transaminase, bilirubin, creatine, N-terminal prohormone of brain natriuretic peptide, troponin I, D-dimers, procalcitonin, C-reactive protein, ferritin, interleukin (IL)-2R, IL-6, and IL-8 than non-ICU patients. Eleven of 14 ICU patients received noninvasive ventilation and 7 patients received invasive mechanical ventilation. Twelve patients died in the ICU group and no patients died in the non-ICU group. Conclusion: ICU cases showed higher rates of organ failure and mortality than non-ICU cases. The poor outcomes of patients with diabetes and COVID-19 indicated that more supervision is required in these patients. Abbreviations: COVID-19 = coronavirus disease 2019; ICU = intensive care unit; MERS-CoV = middle East respiratory syndrome-related coronavirus; 2019- nCoV = 2019 novel coronavirus; NT-proBNP = N-terminal prohormone of brain natriuretic peptide; SARS-CoV = severe acute respiratory syndrome-related coronavirus

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