Clinical features and outcomes of 2019 novel coronavirus-infected patients with high plasma BNP levels

AbstractAimsTo explore clinical features and outcome of 2019 novel coronavirus(2019-nCoV)-infected patients with high BNP levelsMethods and resultsData were collected from patients’ medical records, and we defined high BNP according to the plasma BNP was above > 100 pg/mL. In total,34 patients with corona virus disease 2019(COVID-19)were included in the analysis. Ten patients had high plasma BNP level. The median age for these patients was 60.5 years(interquartile range, 40-80y), and 6/10 (60%) were men. Underlying comorbidities in some patients were coronary heart disease (n=2, 20%), hypertesion (n=3,30%), heart failure (n=1,10%)and diabetes (n=2, 20%). Six (60%) patients had a history of Wuhan exposure. The most common symptoms at illness onset in patients were fever (n=7, 70%), cough (n=3, 30%), headache or fatigue(n=4,40%). These patients had higher aspartate aminotransferase(AST), troponin I, C reactive protein and lower hemoglobin, and platelet count,compared with patients with normal BNP, respectively. Compared with patients with normal BNP, patients with high BNP were more likely to develop severe pneumonia, and receive tracheal cannula, invasive mechanical ventilation, continuous renal replacement therapy, extracorporeal membrane oxygenation, and be admitted to the intensive care unit. One patient with high BNP died during the study.ConclusionHigh BNP is a common condition among patients infected with 2019-nCoV. Patients with high BNP showed poor clinical outcomes

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Clinical features and outcomes of 2019 novel coronavirus–infected patients with cardiac injury

10.1101/2020.03.11.20030957 ◽

2020 ◽

Cited By ~ 4

Author(s):

Youbin Liu ◽

Jinglong Li ◽

Dehui Liu ◽

Huafeng Song ◽

Chunlin Chen ◽

...

Keyword(s):

Clinical Features ◽

Troponin I ◽

Cardiac Injury ◽

C Reactive Protein ◽

Cardiac Biomarker ◽

X Ray ◽

Illness Onset ◽

Reactive Protein ◽

Chest X Ray ◽

Novel Coronavirus

AbstractAimsTo explore the epidemiological and clinical features of 2019 novel coronavirus(2019-nCoV)-infected patients with cardiac injury.Methods and resultsData were collected from patients’ medical records, and we defined cardiac injury according to cardiac biomarker troponin I level > 0.03 μg/L. Among the 291 patients, 15 (5.2%) showed evidence of cardiac injury. Of 15 hospitalized patients with cardiac injury, the median age was 65 years, and 11/15 (73.3%) were men. Underlying cardiovascular diseases in some patients were hypertension (n=7, 46.7%), coronary heart disease (n=3, 20%) and diabetes (n=3, 20%). The most common symptoms at illness onset in patients with cardiac injury were fever (n=11, 73.3%), cough (n=7, 46.7%), headache or fatigue (n=5, 33.3%) and dyspnea (n=4, 26.7%). These patients had higher systolic pressures, white blood cell count, neutrophil count, troponin I, brain natriuretic peptide, D-dimer and lower lymphocyte count, and platelet count, compared with patients without cardiac injury, respectively. Bilateral infiltrates on chest X-ray and elevated C-reactive protein occurred in all patients with cardiac injury. Compared with patients without cardiac injury, patients with cardiac injury were more likely to develop acute respiratory distress syndrome, and receive mechanical ventilation, continuous renal replacement therapy, extracorporeal membrane oxygenation and vasopressor therapy and be admitted to the intensive care unit.ConclusionCardiac injury is a common condition among patients infected with 2019-nCoV. Compared with patients without cardiac injury, the clinical outcomes of patients with cardiac injury are relatively worse.

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A Comparative Study on the Clinical Features of Coronavirus 2019 (COVID-19) Pneumonia With Other Pneumonias

Clinical Infectious Diseases ◽

10.1093/cid/ciaa247 ◽

2020 ◽

Vol 71 (15) ◽

pp. 756-761 ◽

Cited By ~ 95

Author(s):

Dahai Zhao ◽

Feifei Yao ◽

Lijie Wang ◽

Ling Zheng ◽

Yongjun Gao ◽

...

Keyword(s):

Clinical Features ◽

Clinical Symptoms ◽

Severe Pneumonia ◽

Ground Glass Opacity ◽

Chest Ct ◽

Rt Pcr ◽

Bilateral Involvement ◽

Radiological Features ◽

History Of ◽

Novel Coronavirus

Abstract Background A novel coronavirus (COVID-19) has raised world concern since it emerged in Wuhan, China in December 2019. The infection may result in severe pneumonia with clusters of illness onsets. Its impacts on public health make it paramount to clarify the clinical features with other pneumonias. Methods Nineteen COVID-19 and 15 other patients with pneumonia (non-COVID-19) in areas outside of Hubei were involved in this study. Both COVID-19 and non-COVID-19 patients were confirmed to be infected using throat swabs and/or sputa with/without COVID-2019 by real-time RT-PCR. We analyzed the demographic, epidemiological, clinical, and radiological features from those patients, and compared the differences between COVID-19 and non-COVID-19. Results All patients had a history of exposure to confirmed cases of COVID-19 or travel to Hubei before illness. The median (IQR) duration was 8 (6–11) and 5 (4–11) days from exposure to onset in COVID-19 and non-COVID-19 cases, respectively. The clinical symptoms were similar between COVID-19 and non-COVID-19. The most common symptoms were fever and cough. Fifteen (78.95%) COVID-19 but 4 (26.67%) non-COVID-19 patients had bilateral involvement while 17 COVID-19 patients (89.47%) but 1 non-COVID-19 patient (6.67%) had multiple mottling and ground-glass opacity on chest CT images. Compared with non-COVID-19, COVID-19 presents remarkably more abnormal laboratory tests, including AST, ALT, γ-GT, LDH, and α-HBDH. Conclusions The COVID-19 infection has onsets similar to other pneumonias. CT scan may be a reliable test for screening COVID-19 cases. Liver function damage is more frequent in COVID-19 than non-COVID-19 patients. LDH and α-HBDH may be considerable markers for evaluation of COVID-19.

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The Prognostic Value of Myocardial Injury in COVID-19 Patients and Associated Characteristics

10.21203/rs.3.rs-251810/v1 ◽

2021 ◽

Author(s):

jian he ◽

Bicheng Zhang ◽

Quan Zhou ◽

Wenjing Yang ◽

Jing Xu ◽

...

Keyword(s):

Prognostic Value ◽

Myocardial Injury ◽

Troponin I ◽

Invasive Mechanical Ventilation ◽

High Sensitivity ◽

Chronic Obstructive ◽

Obstructive Pulmonary Disease ◽

Reactive Protein ◽

Mortality Incidence ◽

Novel Coronavirus

Abstract Background: Since December 2019, Coronavirus disease 2019 (COVID-19) has emerged as an international pandemic. COVID-19 patients with myocardial injury might need special attention. However, understanding on this aspect remains unclear. This study aimed to illustrate clinical characteristics and the prognostic value of myocardial injury to COVID-19 patients. Methods: This retrospective, single-center study finally included 304 hospitalized COVID-19 cases confirmed by real-time RT-PCR from January 11 to March 25, 2020. Myocardial injury was determined by serum high-sensitivity troponin I (Hs-TnI). The primary endpoint was COVID-19 associated mortality. Results: Of 304 COVID-19 patients (median age, 65 years; 52.6% males), 88 patients (27.3%) died (61 patients with myocardial injury, 27 patients without myocardial injury on admission). COVID-19 patients with myocardial injury had more comorbidities (hypertension, chronic obstructive pulmonary disease, cardiovascular disease, and cerebrovascular disease); lower lymphocyte counts, higher C-reactive protein (CRP, median, 84.9 vs 28.5 mg/L, p<0.001), procalcitonin levels (median, 0.29 vs 0.06 ng/ml, p<0.001), inflammatory and immune response markers; more frequent need for noninvasive ventilation, invasive mechanical ventilation; and was associated with higher mortality incidence (hazard ratio, HR=7.02, 95% confidence interval, CI, 4.45-11.08, p<0.001) than those without myocardial injury. Myocardial injury (HR=4.55, 95% CI, 2.49-8.31, p<0.001), senior age, CRP levels, and novel coronavirus pneumonia (NCP) types on admission were independent predictors to mortality in COVID-19 patients. Conclusions: COVID patients with myocardial injury on admission is associated with more severe clinical presentation and biomarkers. Myocardial injury and higher HsTNI are both strongest independent predictors to COVID related mortality after adjusting confounding factors. In addition, senior age, CRP levels and NCP types are also associated with mortality. Trial registration: Not applicable.

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Clinical Features of Maintenance Hemodialysis Patients with 2019 Novel Coronavirus-Infected Pneumonia in Wuhan, China

Clinical Journal of the American Society of Nephrology ◽

10.2215/cjn.04160320 ◽

2020 ◽

Vol 15 (8) ◽

pp. 1139-1145 ◽

Cited By ~ 21

Author(s):

Jun Wu ◽

Jushuang Li ◽

Geli Zhu ◽

Yanxia Zhang ◽

Zhimin Bi ◽

...

Keyword(s):

Clinical Features ◽

Troponin I ◽

Clinical Laboratory ◽

Cardiac Injury ◽

Hemodialysis Patients ◽

Hospitalized Patients ◽

Maintenance Hemodialysis ◽

Computed Tomographic ◽

Risk Of Death ◽

Novel Coronavirus

Background and objectivesPrevious reports on the outbreak of coronavirus disease 2019 were on the basis of data from the general population. Our study aimed to investigate the clinical features of patients on maintenance hemodialysis.Design, setting, participants, & measurements In this retrospective, single-center study, we included 49 hospitalized patients on maintenance hemodialysis and 52 hospitalized patients without kidney failure (controls) with confirmed coronavirus disease 2019 at Tongren Hospital of Wuhan University from January 30, 2020 to March 10, 2020. Demographic, clinical, laboratory, and radiologic characteristics and treatment and outcomes data were analyzed. The final date of follow-up was March 19, 2020.ResultsThe median age of 101 patients was 62 years (interquartile range, 49–72). All patients were local residents of Wuhan. In terms of common symptoms, there were differences between patients on hemodialysis and controls (fatigue [59% versus 83%], dry cough [49% versus 71%], and fever [47% versus 90%]). Lymphocyte counts were decreased (0.8×109/L [patients on hemodialysis] versus 0.9×109/L [controls], P=0.02). Comparing patients on hemodialysis with controls, creatine kinase–muscle and brain type, myoglobin, hypersensitive troponin I, B-type natriuretic peptide, and procalcitonin were increased, and the percentage of abnormalities in bilateral lung was higher in computed tomographic scan (82% versus 69%, P=0.15) and unilateral lung was lower (10% versus 27%, P=0.03). Common complications including shock, acute respiratory distress syndrome, arrhythmia, and acute cardiac injury in patients on hemodialysis were significantly higher. Compared with controls, more patients on hemodialysis received noninvasive ventilation (25% versus 6%, P=0.008). As of March 19, 2020, three patients on hemodialysis (6%) were transferred to the intensive care unit and received invasive ventilation. Seven patients on hemodialysis (14%) had died.ConclusionsThe main symptoms of coronavirus disease 2019 pneumonia, including fever and cough, were less common in patients on hemodialysis. Patients on hemodialysis with coronavirus disease 2019 were at higher risk of death.

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Clinical cases of eculizumab use as a part of complex therapy in patients with severe COVID-19.

Тромбоз, гемостаз и реология ◽

10.25555/thr.2021.3.0987 ◽

2021 ◽

Author(s):

Р.А. Майер ◽

Б.А. Бакиров ◽

А.А. Набиева ◽

Д.А. Кудлай

Keyword(s):

Virus Disease ◽

Membrane Attack Complex ◽

Lung Ventilation ◽

Blood Analysis ◽

The Novel ◽

Reactive Protein ◽

Corona Virus ◽

Complex Therapy ◽

Novel Coronavirus ◽

Clinical Cases

Введение. В последние 2 года серьезной проблемой для всего мирового сообщества стало распространение новой коронавирусной (CoV) инфекции COVID-19 (COrona VIrus Disease-2019). Ввиду сложившихся событий в лечении COVID-19 активно стали применяться новые молекулы и уже зарегистрированные лекарственные препараты, доказавшие свою эффективность при других заболеваниях. Цель исследования: оценить эффективность применения препарата экулизумаб у пациентов с тяжелой формой течения COVID-19. Материалы и методы. Проанализированы 3 клинических случая применения препарата экулизумаб в составе комплексной терапии у пациентов с тяжелой формой течения COVID-19. Для оценки эффективности лечения проводился мониторинг основных клинико-лабораторных показателей, а также показателей, характеризующих воспалительный процесс при коронавирусной инфекции: общий анализ крови, биохимический анализ крови, проанализированы уровни таких показателей как ферритин, С-реактивный белок, интерлейкин-6, лактатдегидрогеназа и мембраноатакующий комплекс. Результаты. На фоне проводимой терапии выявлено снижение концентрации основных маркеров воспаления относительно исходных значений. Заключение. Комплексная терапия, включающая экулизумаб, облегчает течение заболевания, позволяет сократить длительность пребывания пациентов в отделении реанимации и интенсивной терапии, укорачивает срок их пребывания на искусственной вентиляции легких, тем самым снижая процент летальности. Background. In the past two years, the incidence of the novel coronavirus (CoV) infection COVID-19 (COrona Virus Disease-2019) has been a serious problem for the global community. Considering these circumstances, new molecules and already registered drugs that have proven their effectiveness in other diseases, began to be actively used in COVID-19 treatment. Objectives: to assess the effi cacy of eculizumab in patients with severe COVID-19. Patients/Methods. Three clinical cases of eculizumab use as a part of complex therapy in patients with severe COVID-19 have been analyzed. To assess the treatment efficacy, the main clinical and laboratory parameters and indicators of inflammatory process in coronavirus infection were monitored (clinical blood analysis, biochemical blood test, levels of ferritin, C-reactive protein, interleukin-6, lactate dehydrogenase and membrane attack complex). Results. Under the therapy we found the reduction of concentration of the main inflammation markers relative to the initial values. Conclusions. Complex therapy with eculizumab facilitates the course of the disease, reduces the stay duration of patients in the intensive care unit, shortens the period of artificial lung ventilation, thereby reducing the mortality rate.

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Troponin I, a risk factor indicating more severe pneumonia among patients with novel coronavirus infected pneumonia

Clinical Infection in Practice ◽

10.1016/j.clinpr.2020.100037 ◽

2020 ◽

Vol 7-8 ◽

pp. 100037

Author(s):

Dong Liu ◽

Qingyuan Yang ◽

Wei Chen ◽

Hong Chen ◽

Yun Feng ◽

...

Keyword(s):

Risk Factor ◽

Troponin I ◽

Severe Pneumonia ◽

Novel Coronavirus

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Incubation Period and Other Epidemiological Characteristics of 2019 Novel Coronavirus Infections with Right Truncation: A Statistical Analysis of Publicly Available Case Data

Journal of Clinical Medicine ◽

10.3390/jcm9020538 ◽

2020 ◽

Vol 9 (2) ◽

pp. 538 ◽

Cited By ~ 436

Author(s):

Natalie Linton ◽

Tetsuro Kobayashi ◽

Yichi Yang ◽

Katsuma Hayashi ◽

Andrei Akhmetzhanov ◽

...

Keyword(s):

Incubation Period ◽

Case Fatality ◽

Illness Onset ◽

Event Date ◽

History Of ◽

Novel Coronavirus ◽

Case Fatality Risk ◽

Right Truncation ◽

Epidemiological Characteristics ◽

Mean Time

The geographic spread of 2019 novel coronavirus (COVID-19) infections from the epicenter of Wuhan, China, has provided an opportunity to study the natural history of the recently emerged virus. Using publicly available event-date data from the ongoing epidemic, the present study investigated the incubation period and other time intervals that govern the epidemiological dynamics of COVID-19 infections. Our results show that the incubation period falls within the range of 2–14 days with 95% confidence and has a mean of around 5 days when approximated using the best-fit lognormal distribution. The mean time from illness onset to hospital admission (for treatment and/or isolation) was estimated at 3–4 days without truncation and at 5–9 days when right truncated. Based on the 95th percentile estimate of the incubation period, we recommend that the length of quarantine should be at least 14 days. The median time delay of 13 days from illness onset to death (17 days with right truncation) should be considered when estimating the COVID-19 case fatality risk.

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Subacute Thyroiditis in COVID-19 Patients

European Thyroid Journal ◽

10.1159/000511707 ◽

2020 ◽

pp. 1-3

Author(s):

Saeed Sohrabpour ◽

Farrokh Heidari ◽

Ebrahim Karimi ◽

Reza Ansari ◽

Ardavan Tajdini ◽

...

Keyword(s):

Respiratory Illness ◽

Subacute Thyroiditis ◽

Imaging Data ◽

Endocrine Glands ◽

C Reactive Protein ◽

Reactive Protein ◽

History Of ◽

De Quervain ◽

Novel Coronavirus ◽

De Quervain Thyroiditis

Introduction: Since December 2019, novel coronavirus (COVID-19) infection has been identified as the cause of an outbreak of respiratory illness in Wuhan, China. The classic presentation of COVID-19 infection was described as fever, myalgia, cough, and fatigue. Whether coronavirus can directly attack the endocrine glands is unclear. Objective: Post-viral subacute thyroiditis (SAT, de Quervain thyroiditis) has been reported following other viral infection. A limited number of SAT after COVID-19 infection have been reported up to now. Methods: Here, we reported 6 patients with SAT and positive COVID-19 serology tests. Demographic, clinical, biochemical, and imaging data were presented. Results: In this study, 6 patients (4 women and 2 men) with clinician manifestations and physical examination in favor of SAT were described. Cervical ultrasonography showed bilateral hypoechoic areas in the thyroid gland which was suggestive of SAT. Elevated C-reactive protein, erythrocyte sedimentation rate, free thyroxine, free tri-iodothyronine, and undetectable thyrotropin were found in laboratory evaluations. Both IgM and IgG were positive for COVID-19 infection, but the PCR tests were negative in all patients. Patients had history of working in a COVID center and/or family member hospitalized due to COVID-19 pneumonia. Patients were followed up for 1 month and were treated effectively with steroids. Conclusion: This report may help physicians to identify lesser-known manifestations and complications of COVID-19. Early diagnosis of COVID-19 infection results in the prevention of further transmission.

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Prognosis of patients with COVID-19 admitted to a tertiary center in Chile: A cohort study

Medwave ◽

10.5867/medwave.2020.10.8066 ◽

2020 ◽

Vol 20 (10) ◽

pp. e8066-e8066

Author(s):

Miguel Araujo ◽

Paola Ossandón ◽

Ana María Abarca ◽

Ana María Menjiba ◽

Ana María Muñoz

Keyword(s):

Mechanical Ventilation ◽

Cohort Study ◽

Intensive Care ◽

Invasive Mechanical Ventilation ◽

Case Fatality ◽

Logistic Regression Models ◽

Reactive Protein ◽

Tertiary Center ◽

History Of ◽

Blood Gas Parameters

Introduction Since the beginning of the COVID-19 pandemic, extensive research has been done on the prognosis of patients with SARS-CoV-2 associated with age, biodemographic conditions, comorbidities, social factors, clinical parameters, inflammatory blood markers, coagulation, biochemical and blood gas parameters, among others. Few studies have addressed this problem in Latin America, so it is of interest to know how the disease plays out in this region. Objective The purpose of our study is to evaluate the course of COVID-19 in patients admitted to a tertiary center in Chile and to assess factors measured close to hospital admission that may be associated with death and the need for invasive mechanical ventilation. Methods We did a retrospective cohort study at Indisa Clinic in Santiago, Chile. We included all patients aged 15 years and older hospitalized between March 11 and July 25, 2020. Hospital mortality and severity of the cases were analyzed, and logistic regression models were applied to identify predictors of outcome variables. Results The sample included 785 subjects. The mean age was 59 years, 59% were men, and 61.3% had comorbidities. Forty five per cent required intensive care, and 24% invasive mechanical ventilation. The overall hospital fatality rate was 18.7%. In intensive care patients, the case fatality was 32.1%, and in those who received invasive mechanical ventilation, it was 59.4%. Independent risk factors for death included age (odds ratio 1.09; 95% confidence interval: 1.07 to 1.12), diabetes (1.68; 1.06 to 2.67), chronic lung disease (2.80; 1.48 to 5.28), increased C-reactive protein, creatinine, and ferritin. No association with sex, public health insurance, history of heart disease, oxygen saturation upon admission, or D-dimer was found. Similar factors were predictors of invasive mechanical ventilation. Discussion The prognosis and predictive factors in this cohort of patients hospitalized in Chile for COVID-19 were comparable to those reported in similar studies from higher-income countries. Male sex was not associated with a poor prognosis in this group of patients.

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Clinical characteristics of survivors and non-survivors, medical and non-medical staff members with 2019-nCoV pneumonia in Wuhan, China: a descriptive study

10.21203/rs.3.rs-20714/v1 ◽

2020 ◽

Author(s):

Jiaxun Hu ◽

You Lv ◽

Ying Xu ◽

Yushan Miao ◽

Wei Wang ◽

...

Keyword(s):

Medical Staff ◽

Clinical Characteristics ◽

Severe Pneumonia ◽

Study Data ◽

Disease Classification ◽

Staff Members ◽

Treatment Measures ◽

History Of ◽

Medical Compliance ◽

Novel Coronavirus

Abstract Objectives: In December 2019，the 2019 novel coronavirus ( 2019-nCoV ) emerged in Wuhan, China, leading to a cluster of severe pneumonia cases. Medical staff members on the front line were also infected. We compared the epidemiology, clinical characteristics, and treatment measures of survivors and non-survivors and the different clinical outcomes of medical staff members and non-medical members of the community infected with 2019-nCoV. Methods: We included 81 patients with adult 2019-nCoV in Hankou Hospital from mid-January to mid-February 2020 in this single-center retrospective study. Data were compared between survivors and non-survivors and between medical staff members and non-medical individuals. Results: All 38 medical staff members were infected by patients while working. Only 2 (2.5%) non-medical individuals had a clear history of exposure to 2019-nCoV patients. The median age was 49 years (interquartile range [IQR], 35-59; range, 23-89 years), and 42 (51.9%) were women. We found that the median age,comorbidity, and some laboratory outcomes(lymphocyte count, urea nitrogen, aspartate aminotransferase, lactate dehydrogenase, etc.)differed significantly between survivors and non-survivors. There were also significant differences in the time from onset to admission, disease classification, comorbidity, and prognosis between medical staff members and non-medical individuals. All medical staff members were cured, while 13 (30.2%) non-medical individuals died. Conclusions: Older males with comorbidities are more likely to be affected by 2019-nCoV. Significant changes in some laboratory markers may indicate a poor prognosis. Medical staff members may have had better prognoses due to fewer comorbidities and better medical compliance. Key words: 2019-nCoV; Clinical characteristics; Mortality; comorbidity; Survivors; Non-survivors; Medical Staff

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