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

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.

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

10.21203/rs.3.rs-22978/v1 ◽

2020 ◽

Author(s):

Yu lei ◽

xiaobo huang ◽

silang bamu ◽

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

Abstract Background: Coronavirus 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. Methods: 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. Results: 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). Conclusions: 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.

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Discovery of asymptomatic moyamoya arteriopathy in pediatric syndromic populations: radiographic and clinical progression

Neurosurgical FOCUS ◽

10.3171/2011.10.focus11228 ◽

2011 ◽

Vol 31 (6) ◽

pp. E6 ◽

Cited By ~ 36

Author(s):

Ning Lin ◽

Lissa Baird ◽

McKenzie Koss ◽

Kimberly E. Kopecky ◽

Evelyne Gone ◽

...

Keyword(s):

Radiographic Progression ◽

Clinical Symptoms ◽

Neurofibromatosis Type ◽

Consecutive Series ◽

Clinical Progression ◽

Unaffected Side ◽

Asymptomatic Patients ◽

Routine Surveillance ◽

History Of ◽

The Mean

Object Limited data exist to guide management of incidentally discovered pediatric moyamoya. Best exemplified in the setting of unilateral moyamoya, in which the unaffected side is monitored, this phenomenon also occurs in populations undergoing routine surveillance of the cerebral vasculature for other conditions, such as sickle cell disease (SCD) or neurofibromatosis Type 1 (NF1). The authors present their experience with specific syndromic moyamoya populations to better characterize the natural history of radiographic and clinical progression in patients with asymptomatic moyamoya. Methods The authors performed a retrospective review of the clinical database of the neurosurgery department at Children's Hospital Boston, including both nonoperative referrals and a consecutive series of 418 patients who underwent surgical revascularization for moyamoya disease between 1988 and 2010. Results Within the period of time studied, 83 patients were asymptomatic at the time of radiographic diagnosis of moyamoya, while also having either unilateral moyamoya or moyamoya in association with either SCD or NF1. The mean age at presentation was 9.1 years (range 1–21 years), and there were 49 female (59%) and 34 male (41%) patients. The mean follow-up duration was 5.4 ± 3.8 years (mean ± SD), with 45 patients (54%) demonstrating radiographic progression and 37 (45%) becoming symptomatic within this period. Patients with SCD had the highest incidence of both radiographic (15 patients [75%]) and clinical (13 patients [65%]) progression, followed by NF1 (20 patients [59%] with radiographic progression and 15 patients [44%] with clinical progression) and patients with unilateral moyamoya (10 patients [35%] with radiographic progression and 9 patients [31%] with clinical progression). Conclusions Radiographic progression occurred in the majority of asymptomatic patients and generally heralded subsequent clinical symptoms. These data demonstrate that moyamoya is a progressive disorder, even in asymptomatic populations, and support the rationale of early surgical intervention to minimize morbidity from stroke.

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High incidence of asymptomatic SARS-CoV-2 infection, Chongqing, China

10.1101/2020.03.16.20037259 ◽

2020 ◽

Cited By ~ 4

Author(s):

Yang Tao ◽

Panke Cheng ◽

Wen Chen ◽

Peng Wan ◽

Yaokai Chen ◽

...

Keyword(s):

Asymptomatic Patient ◽

Medical Center ◽

Age Groups ◽

The Elderly ◽

Hospital Length ◽

Hospital Length Of Stay ◽

Asymptomatic Patients ◽

Imported Cases ◽

History Of ◽

Epidemiological Characteristics

SummaryBackgroundSARS-CoV-2 has been a global pandemic, but the emergence of asymptomatic patients has caused difficulties in the prevention of the epidemic. Therefore, it is significant to understand the epidemiological characteristics of asymptomatic patients with SARS-CoV-2 infection.MethodsIn this single-center, retrospective and observational study, we collected data from 167 patients with SARS-CoV-2 infection treated in Chongqing Public Health Medical Center (Chongqing, China) from January to March 2020. The epidemiological characteristics and variable of these patients were collected and analyzed.Findings82.04% of the SARS-CoV-2 infected patients had a travel history in Wuhan or a history of contact with returnees from Wuhan, showing typical characteristics of imported cases, and the proportion of severe Covid-19 patients was 13.2%, of which 59% were imported from Wuhan. For the patients who was returnees from Wuhan, 18.1% was asymptomatic patients. In different infection periods, compared with the proportion after 1/31/2020, the proportion of asymptomatic patient among SARS-CoV-2 infected patient was higher(19% VS 1.5%). In different age groups, the proportion of asymptomatic patient was the highest(28.6%) in children group under 14, next in elder group over 70 (27.3%). Compared with mild and common Covid-19 patients, the mean latency of asymptomatic was longer (11.25 days VS 8.86 days), but the hospital length of stay was shorter (14.3 days VS 16.96 days).ConclusionThe SARS-CoV-2 prevention needs to focus on the screening of asymptomatic patients in the community with a history of contact with the imported population, especially for children and the elderly population.

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Epidemiological and clinical characteristics of 671 COVID-19 patients in Henan Province, China

International Journal of Epidemiology ◽

10.1093/ije/dyaa081 ◽

2020 ◽

Vol 49 (4) ◽

pp. 1085-1095

Author(s):

Yifei Nie ◽

Jitian Li ◽

Xueyong Huang ◽

Wanshen Guo ◽

Xiaobai Zhang ◽

...

Keyword(s):

Clinical Laboratory ◽

Case Series ◽

Henan Province ◽

X Rays ◽

Illness Onset ◽

Medical Disorders ◽

History Of ◽

The Mean ◽

Wet Market ◽

Mean Time

Abstract Background Despite many reports on the characteristics of coronavirus disease 2019 (COVID-19) in Wuhan, China, relatively little is known about the transmission features of COVID-19 outside Wuhan, especially at the provincial level. Methods We collected epidemiological, demographic, clinical, laboratory, radiological and occupation information, along with contact history, of 671 patients with laboratory-confirmed COVID-19 reported from January 23 to February 5, 2020, in Henan province, China. We described characteristics of these cases, compared the diagnostic accuracy and features of blood testing, computed tomography (CT) scans and X-rays, and analysed SARS-CoV-2 transmission sources and patients’ occupations in Henan province. Results The mean age of patients in this case series was 43 years, 56.2% were male and 22.4% had coexisting medical disorders. The death rate was 0.3%. Fourteen patients did not show any symptoms. Lymphocyte percentage was associated with disease severity (χ2 = 6.71, P = 0.035) but had a large variation in each sample group. The mean time from illness onset to diagnosis was 5.6 days. A total of 330 patients had ever lived in or visited Wuhan, 150 had contact with confirmed cases, 323 had been to a hospital and 119 had been to a wet market. There were 33 patients who did not have a traceable transmission source, with 21.2% of these being farmers and 15.2% being workmen. Conclusions Lymphocyte percentage was a sign of severe COVID-19 in general but was not a good diagnostic index. Longer time from illness onset to diagnosis was associated with higher COVID-19 severity, older age, higher likelihood of having coexisting cardiovascular diseases including hypertension, and being male. Farming was found to be a high-risk occupation in Henan province, China.

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Surgery for ‘asymptomatic’ mild primary hyperparathyroidism improves some clinical symptoms postoperatively

Acta Endocrinologica ◽

10.1530/eje-13-0502 ◽

2013 ◽

Vol 169 (5) ◽

pp. 665-672 ◽

Cited By ~ 14

Author(s):

Claire Blanchard ◽

Muriel Mathonnet ◽

Frédéric Sebag ◽

Cécile Caillard ◽

Antoine Hamy ◽

...

Keyword(s):

Primary Hyperparathyroidism ◽

Clinical Improvement ◽

Clinical Symptoms ◽

Clinical Score ◽

Symptom Improvement ◽

Asymptomatic Group ◽

Postoperative Symptom ◽

International Panel ◽

Asymptomatic Patients ◽

Mild Primary Hyperparathyroidism

Objective and backgroundMost primary hyperparathyroidism (pHPT) patients do not conform to the guidelines for parathyroidectomy established by an international panel of specialists and have a mild pHPT. This group is typically defined as ‘asymptomatic’. The primary aim of this study was to determine symptom improvement in this ‘asymptomatic’ group after parathyroidectomy. Secondly, we aimed to create a preoperative clinical score predicting postoperative symptom resolution.DesignA prospective nonrandomized study included patients with mild pHPT.MethodsA questionnaire (22 items) was given to ‘asymptomatic’ patients preoperatively and at 3, 6, and 12 postoperative months. A logistic regression was performed to create a preoperative clinical score.ResultsOne hundred and sixteen patients were included. Postoperatively, HPT was resolved in 98% of patients. Twelve of 22 nonspecific symptoms were improved at 1 year. Subgroups analysis showed a greater improvement in patients <70 years and those with a serum calcium level ≥2.6 mmol/l preoperatively. A clinical score, based on age and five symptoms, was established to predict the clinical improvement after surgery in mild pHPT patients with a positive predictive value of 81%.ConclusionPatients with asymptomatic pHPT have clinical improvement of their symptoms postoperatively even after 1 year. Younger patients and those with higher preoperative calcium levels show the best improvement.

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The Effect of Organophosphorus Compounds on Serum Pseudocholinesterase Levels in a Group of Industrial Workers

Human & Experimental Toxicology ◽

10.1177/096032719101000406 ◽

1991 ◽

Vol 10 (4) ◽

pp. 275-278 ◽

Cited By ~ 8

Author(s):

Jacob Peedicayil ◽

Kalpana Ernest ◽

Molly Thomas ◽

A.S. Kanagasabapathy ◽

P.M. Stephen

Keyword(s):

Clinical Symptoms ◽

Organophosphorus Compounds ◽

Industrial Workers ◽

Normal Range ◽

High Incidence ◽

Exposed Workers ◽

History Of ◽

The Mean ◽

Symptoms And Signs ◽

Low Serum

This paper presents the findings of a study of serum pseudocholinesterase activity in a group of 36 industrial workers chronically exposed to organophosphorus (OP) compounds. The mean pseudocholinesterase level of the workers was significantly lower than that of 36 other workers without a history of similar exposure. Although there was a high incidence of clinical features suggestive of OP compound toxicity in the exposed workers, no significant correlation between serum pseudocholinesterase levels and clinical symptoms and signs was found. Six exposed workers, found to have low serum pseudocholinesterase levels, were transferred for 6 months to work areas which did not involve OP exposure, whereupon their levels rose significantly back to the normal range.

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A prospective, open label clinical study to evaluate the safety, efficacy and tolerability of azadvir herbal steam inhaler in asymptomatic, mildly symptomatic COVID-19 patients and health care workers posted to covid wards

International Journal of Basic & Clinical Pharmacology ◽

10.18203/2319-2003.ijbcp20211018 ◽

2021 ◽

Vol 10 (4) ◽

pp. 373

Author(s):

Ajitha Pottirayil ◽

Shankar A. S. ◽

Shaji Kannoth ◽

Poorna Prasad ◽

Sharath Kumar B. Jaikar ◽

...

Keyword(s):

Clinical Symptoms ◽

Standard Of Care ◽

P Value ◽

Rt Pcr ◽

Immune Markers ◽

Open Label ◽

Asymptomatic Group ◽

Asymptomatic Patients ◽

Study Results ◽

D Dimer

Background: COVID-19 patients experience cytokine storm which cause pulmonary and extra-pulmonary complications even with currently available of standard of care. Additional antiviral and immune boosters are the need of hour to treat COVID-19 and to prevent post covid complications.Methods: In this study we enrolled 40 asymptomatic to mild COVID-19 patients to receive azadvir herbal steam inhaler along with standard of care. We evaluated the benefits of azadvir herbal steam inhaler by assessing RT-PCR conversion, clinical outcomes and improvement in immune markers (LDH, CRP, D-DIMER).Results: At the end of the study the immune markers improved significantly in study patients. In mild symptomatic cases IL-6 was 23.2 pg/ml on day 0 and 21.8 pg/ml on day 14. Reduction in IL-6 in mild symptomatic patients was statistically highly significant (p=0.0056). Mean IL-6 in asymptomatic patients was 22.3 pg/ml on day 0 and 21.1 pg/ml on day 14. Reduction in IL-6 in asymptomatic patients was statistically highly significant (p=0.0035). Mean D-dimer was showing decreasing trend from day 0 to day 14 in mild symptomatic patients. In asymptomatic patients D dimer was 0.8 µg/ml on day 0 and 0.6 µg/ml on day 14. D-dimer decreased significantly from day 0 to day 14 (p value =0.0013). Mean LDH values on day 0 in mild symptomatic patients was 319.4 U/l and 219.3 on day 14. The reduction in LDH values in mild symptomatic patients is statistically significant (p value <0.0122). In asymptomatic patients mean LDH values on day 0 was 237 U/l and 194 U/l on day 14. The reduction in LDH values in asymptomatic group was statistically significant. Mean CRP values in mild symptomatic patients on day 0 was 12.2 mg/l and 3.8 mg/l on day 14. There was significant reduction in CRP values in mild symptomatic group which was statistically significant (p value =0.0546). Mean CRP values in asymptomatic patients on day 0 was 4.9 mg/l and 2.8 mg/l on day 14. There was significant reduction in mean CRP in asymptomatic patients which was statistically significant (p value =0.0446). In the present study all 40 patients (100%) cleared the virus and became negative for RT PCR test within 6 days. None of the patients progressed to severe COVID-19 and none of the patients succumbed to the disease.Conclusions: Azadvir accelerated recovery of COVID-19 patients by RT-PCR conversion, early improvement in clinical symptoms and immune markers in this study. This study results clearly indicates that azadvir has antiviral, immune booster activity and has definitive role in the management of asymptomatic to mild COVID-19 patients along with standard of care (CTRI no. CTRI/2020/06/026181).

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Clinical characteristics of COVID-19 in children compared with adults in Shandong, China

10.21203/rs.3.rs-17119/v1 ◽

2020 ◽

Author(s):

Wenjun Du ◽

Jinhong Yu ◽

Hui Wang ◽

Xiaoguo Zhang ◽

Shouwei Zhang ◽

...

Keyword(s):

Clinical Laboratory ◽

Health Workers ◽

Clinical Symptoms ◽

Clinical Signs ◽

Clinical Manifestations ◽

Case Series ◽

Signs And Symptoms ◽

Asymptomatic Patients ◽

Positive Indicators ◽

Clinical Signs And Symptoms

Abstract Aims & Background: The COVID-19 outbreak spread in China and is a threat to the world. We reported on the epidemiological, clinical, laboratory, and radiological characteristics of children cases to help health workers better understand and provide timely diagnosis and treatment.Methods: Retrospectively, two research centers’ case series of 67 consecutive hospitalized cases including 14 children cases with COVID-19 between 23 Jan 2020 to 15 Feb 2020 from Jinan and Rizhao were enrolled in this study. Epidemiological, clinical, laboratory, and radiological characteristics of children and adults were analyzed and compared.Results: Most cases in children were mild(21.4%) and conventional cases(78.6%), with mild clinical signs and symptoms, and all cases were of family clusters. Fever (35.7%) and dry cough(21.4%) were described as clinical manifestations in children cases. Dry cough and phlegm were not the most common symptoms in children compared with adults(p=0.03). In the early stages of the disease, lymphocyte counts did not significantly decline but neutrophils counts did in children compared with adults(p=0.00).There was an elevated level of LDH(p=0.01) and a lower level of CRP(p=0.00)and IL-6(p=0.01) in children compared with adults. There were 8 (57.1%)asymptomatic cases and 6 (42.9%)symptomatic cases among the 14 children cases. The age of asymptomatic patients was younger than that of symptomatic patients(p=0.03). Even among asymptomatic patients, 5(62.5%)cases had pneumonia including 3 (60%) cases with bilateral pneumonia, which was not different compared with that of asymptomatic cases(p=0.58, p=0.74).Conclusions: The clinical symptoms of children are mild, and the positive indicators of laboratory tests are rare, which may easily cause clinical misdiagnoses.

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High incidence of asymptomatic SARS-CoV-2 infection, Chongqing, China

10.21203/rs.3.rs-25603/v1 ◽

2020 ◽

Cited By ~ 2

Author(s):

Yang Tao ◽

Panke Cheng ◽

Wen Chen ◽

Peng Wan ◽

Yaokai Chen ◽

...

Keyword(s):

Asymptomatic Patient ◽

Medical Center ◽

Age Groups ◽

The Elderly ◽

Hospital Length ◽

Hospital Length Of Stay ◽

Asymptomatic Patients ◽

Imported Cases ◽

History Of ◽

Epidemiological Characteristics

Abstract Background SARS-CoV-2 has been a global pandemic, but the emergence of asymptomatic patients has caused difficulties in the prevention of the epidemic. Therefore, it is significant to understand the epidemiological characteristics of asymptomatic patients with SARS-CoV-2 infection. Methods In this single-center, retrospective and observational study, we collected data from 167 patients with SARS-CoV-2 infection treated in Chongqing Public Health Medical Center (Chongqing, China) from January to March 2020. The epidemiological characteristics and variable of these patients were collected and analyzed. Findings 82.04% of the SARS-CoV-2 infected patients had a travel history in Wuhan or a history of contact with returnees from Wuhan, showing typical characteristics of imported cases, and the proportion of severe Covid-19 patients was 13.2%, of which 59% were imported from Wuhan. For the patients who was returnees from Wuhan, 18.1% was asymptomatic patients. In different infection periods, compared with the proportion after 1/31/2020, the proportion of asymptomatic patient among SARS-CoV-2 infected patient was higher(19% VS 1.5%). In different age groups, the proportion of asymptomatic patient was the highest(28.6%) in children group under 14, next in elder group over 70 (27.3%). Compared with mild and common Covid-19 patients, the mean latency of asymptomatic was longer (11.25 days VS 8.86 days), but the hospital length of stay was shorter (14.3 days VS 16.96 days). Conclusion The SARS-CoV-2 prevention needs to focus on the screening of asymptomatic patients in the community with a history of contact with the imported population, especially for children and the elderly population.

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Clinical Characteristics, Dynamic Profile of Radiology and Laboratory Findings in Coronavirus Disease 2019

10.21203/rs.3.rs-25659/v1 ◽

2020 ◽

Author(s):

ailing liu ◽

Jing Zhang ◽

Wei Qiao ◽

Wei Zang ◽

Yingying Zhang ◽

...

Keyword(s):

Clinical Laboratory ◽

Laboratory Data ◽

Oxygenation Index ◽

Laboratory Findings ◽

Single Centre Study ◽

History Of ◽

Group A ◽

The Mean ◽

Group B ◽

Dynamic Profile

Abstract Background Since December 2019, when coronavirus disease 2019 (Covid-19) emerged in Wuhan city and rapidly spread throughout China, more and more data from different area and different stages of disease have been needed.Methods In this retrospective, single-centre study, we included all 38 confirmed cases of Covid-19 in Weihai from Jan 24 to Feb 24, 2020. Patients were divided into group A by normal Oxygenation Index (OI), group B by abnormal OI (less than 400 mmHg).The dynamic changes in clinical laboratory parameters were tracked from day 1 to day 32 after the onset of the disease at 4-day intervals. Cases were analyzed for clinical, radiological features and laboratory data. Outcomes were followed up until Feb 24, 2020.Results 38 patients with Covid-19 were included in this study, 68.42% patients were family clustered, and 97.37% patients had a history of exposure. The mean days between exposure and onset were about 5 days. Most patients were men, mean age was 43 years, 52.6% patients had chronic diseases. Most patients had fever or cough, about a third of patients had expectoration or fatigue, and 5 (13.16%) patients had shortness of breath.

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