scholarly journals Epidemiological and clinical characteristics of discharged patients infected with SARS-CoV-2 on the Qinghai plateau

2020 ◽  
Author(s):  
Aiqi Xi ◽  
Ma Zhuo ◽  
Jingtao Dai ◽  
Yuehe Ding ◽  
Xiuzhen Ma ◽  
...  
Keyword(s):  
Clinical Characteristics ◽  
Invasive Mechanical Ventilation ◽  
Tibet Plateau ◽  
Severe Illness ◽  
Qinghai Province ◽  
Protein Levels ◽  
Reactive Protein ◽  
Non Invasive ◽  
Discharged Patients ◽  
Qinghai Tibet Plateau

AbstractSince the outbreak of coronavirus disease 2019 (COVID-19), caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) was first reported in Wuhan, a series of confirmed cases of COVID-19 were found on the Qinghai-Tibet plateau. We aimed to describe the epidemiological, clinical characteristics, and outcomes of all confirmed cases in Qinghai, a province at high altitude. With efficient measures to stop the spread of coronavirus, no new cases were found in Qinghai Province for 60 consecutive days between Feb 6 and April 6, 2020. Of all 18 patients with confirmed SARS-CoV-2 infection, 15 patients comprising 4 transmission clusters were identified. Three patients were infected by direct contact without travel history to Wuhan. Seven patients were asymptomatic on admission. Of 18 patients, 10 patients showed bilateral pneumonia and 2 patients showed no abnormalities. Three patients with comorbidities such as hypertension, liver diseases or diabetes developed severe illness. High C-reactive protein levels and elevations of both ALT and AST were observed in 3 severely ill patients on admission. All 18 patients were eventually discharged, including the 3 severe patients who recovered after treatment with non-invasive mechanical ventilation, convalescent plasma and other therapies. Our findings confirmed human-to-human transmission of SARS-CoV-2 in clusters. The strategies of early diagnosis, early isolation, and early treatment are important to prevent the spread of COVID-19 and improve the cure rate. Patients with comorbidities are more likely to develop severe illness and could benefit from convalescent plasma transfusion.

scholarly journals Clinical characteristics of Chilean patients with rheumatic diseases and COVID-19: data from the Covid-19 Global Rheumatology Alliance physician-reported registry

2021 ◽  
Author(s):  
Oriela Martínez ◽  
Francisca Valenzuela ◽  
Sebastián Ibáñez
Keyword(s):  
Rheumatoid Arthritis ◽  
Mechanical Ventilation ◽  
Mortality Rate ◽  
Rheumatic Disease ◽  
Rheumatic Diseases ◽  
Clinical Characteristics ◽  
Invasive Mechanical Ventilation ◽  
List Type ◽  
Non Invasive ◽  
Rheumatic Patients

AbstractObjectiveThe coronavirus disease 2019 (COVID-19) pandemic, caused by the severe acute respiratory syndrome coronavirus 2 (SARS-Cov-2), has registered more than 234 million confirmed cases and more than 4.7 million deaths throughout the world until October 2, 2021. During the last few months, a significant number of reports of COVID-19 in patients with rheumatic diseases have been published. In this study the objective is to report the clinical characteristics of Chilean patients with rheumatic diseases and COVID-19 reported in the “Global Rheumatology Alliance” (GRA) physician registration platform.MethodsChilean patients with rheumatic diseases and COVID-19 were included in the Covid-19 GRA physician-reported registry.Results54 patients were included. The most common primary rheumatic disease was rheumatoid arthritis (RA) with 28 cases (51.9%). 30 patients (55.6%) used corticosteroids, of which 20 (66.7%) used a dose of 10 mg or less. 33 patients (61.1%) only used conventional DMARDs, 4 (7.4%) only biological, and 6 (11.1%) the combination. A total of 35 patients (64.8%) had to be hospitalized. 2 patients (3.7%) died. 26 patients of the 35 hospitalized (74.2%) required some type of ventilatory support, of which 5 (19.2%) required non-invasive and 8 (30.8%) invasive mechanical ventilation or extracorporeal membrane oxygenation (ECMO).DiscussionMost of included Chilean rheumatic patients were hospitalized, with a low mortality rate but with a high percentage of patients requiring at least non-invasive mechanical ventilation.Key Points-The most common primary rheumatic disease was rheumatoid arthritis (RA) followed by lupus (LES)-Most of the included Chilean rheumatic patients were hospitalized, with a high percentage of patients requiring at least non-invasive mechanical ventilation, but with a low mortality rate.-Worsening of arthralgias or activation of the rheumatic disease was not reported.

scholarly journals Epidemiological and Clinical Characteristics of 17 Hospitalized Patients with 2019 Novel Coronavirus Infections Outside Wuhan, China

2020 ◽  
Author(s):  
Jie Li ◽  
Shilin Li ◽  
Yurui Cai ◽  
Qin Liu ◽  
Xue Li ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Clinical Characteristics ◽  
National Standards ◽  
C Reactive Protein ◽  
Protein Levels ◽  
Reactive Protein ◽  
Computed Tomography Images ◽  
Younger Age ◽  
Novel Coronavirus ◽  
Epidemiologic Characteristics

SUMMARYAn increasing number of cases of novel coronavirus pneumonia (NCP) infected with 2019-nCoV have been identified in Wuhan and other cities in China, since December 2019. We analyzed data on the 17 confirmed cases in Dazhou to provide the epidemiologic characteristics of NCP outside Wuhan. Among them, 12 patients were still quarantined in the hospital, 5 patients were discharged NCP patients according to the national standards. Compared with non-discharged NCP patients, the discharged NCP patients had younger ages. Moreover, discharged NCP patients had higher heart rate, lymphocytes levels and monocytes levels than non-discharged NCP patients on admission to the hospital. Notably, all of 17 patients had abnormal increased C-reactive protein levels, and 16 patients had abnormal computed tomography images. This study provided some information that younger age, higher lymphocytes levels and monocytes levels at the diagnoses of 2019-nCoV may contributed to faster recovery and better therapeutic outcome.

Bronchiolitis

2020 ◽  
pp. 27-42
Author(s):  
Crawford Fulton ◽  
Kentigern Thorburn
Keyword(s):  
Relative Effectiveness ◽  
Invasive Mechanical Ventilation ◽  
Management Strategies ◽  
High Flow ◽  
Severe Illness ◽  
Review Of The Literature ◽  
Non Invasive ◽  
Critical Care Admission ◽  
Paediatric Critical Care

Bronchiolitis is one of the commonest reasons for paediatric critical care admission in infants. This chapter explores the epidemiology of bronchiolitis, risk factors for severe illness, and various management strategies. In particular, this chapter explores the assessment of a deteriorating child with bronchiolitis and escalation strategies, including high-flow nasal cannula oxygen and non-invasive respiratory support progressing to invasive mechanical ventilation. This chapter includes a review of the literature related to supportive therapies such as nebulized saline, bronchodilators, and saturation targets. Indications for intubation, various intensive care strategies, and their relative effectiveness are also discussed. The role of respiratory extracorporeal membrane oxygenation in bronchiolitis is also explored.

scholarly journals Report on the 19th international symposium on geo-disaster reduction/high-level academic forum on disaster mitigation and integrated risk defense on the Plateau, 12–15 July 2021, Xining, China

2021 ◽  
Vol 8 (1) ◽  
Author(s):  
Fenggui Liu ◽  
Guolong Zhu ◽  
Fawu Wang
Keyword(s):  
International Symposium ◽  
Disaster Mitigation ◽  
Tibet Plateau ◽  
Research Progress ◽  
Disaster Reduction ◽  
Qinghai Province ◽  
Integrated Risk ◽  
Joint Event ◽  
High Level ◽  
Qinghai Tibet Plateau

AbstractThe joint event of 19th International Symposium on Geo-disaster Reduction (19ISGdR) and High-Level Academic Forum on Disaster Mitigation and Integrated Risk Defense on the Plateau was held on 11–15 July in Xining, Qinghai Province, China, focusing on the theme of “Geological disaster and integrated risk defense”. This event consisted of keynote lectures, invited lectures, and Youth forum, which provided a platform for scientists, industrial professionals and young scholars to share their research progress and exchange novel ideas on geo-disaster reduction in a hybrid way of offline and online. A post-symposium field trip for three days was also conducted in the joint area between Qinghai-Tibet plateau and Loess plateau.

scholarly journals Clinical and Epidemiological Characteristics of the First Month of the Covid-19 Pandemic in Chile

2020 ◽  
Author(s):  
Macarena R Vial ◽  
Anne Peters ◽  
Inia Perez ◽  
Maria Spencer ◽  
Mario Barbe ◽  
...  
Keyword(s):  
Latin America ◽  
Hospital Mortality ◽  
Clinical Characteristics ◽  
Clinical Course ◽  
Laboratory Data ◽  
Molecular Testing ◽  
Protein Levels ◽  
Reactive Protein ◽  
Single Center Study ◽  
Epidemiological Characteristics

Introduction: Understanding the clinical course and outcomes of patients with Covid-19 in underrepresented populations like Latin America is paramount. In this study, we report the clinical characteristics of Covid-19 in Chile, with a focus on subjects requiring hospitalization during the initial phases of the SARS-CoV-2 pandemic. Methods: This is a single center study including all consecutive patients diagnosed with Covid-19 during the first month of the pandemic. Demographics, clinical characteristics and laboratory data were collected within 24 hours of admission. The primary outcome was a composite of ICU admission or all-cause, in-hospital mortality. Results: During the first month of the pandemic, 381 patients were confirmed as positive for SARS- CoV-2 by molecular testing; 88 (23.1%) of them eventually required hospitalization. Median age of the cohort was 39 years (IQR 31-49). Overall mortality was 0.7% and 18 (3.7%) out of the 88 subjects who required hospitalization either died and/or required ICU. Increased body mass index (BMI), C-reactive protein levels (CRP) and the SaTO2/FiO2 index on admission were independently associated with a higher risk of ICU care or death. Discussion: The lower mortality observed in our prospective cohort during the first month of SARS-Cov-2 pandemic was lower than previously reported. This finding could be due to a lower threshold for admission, a healthcare system not yet overburdened and a younger population, among other factors. BMI, CRP on admission were strong predictors for ICU care or all-cause, in- hospital mortality. Our data provide important information regarding the clinical course of Covid- 19 in Latin America.

scholarly journals Clinical Characteristics and Outcomes of Non-ICU Hospitalization for COVID-19 in a Nonepicenter, Centrally Monitored Healthcare System

2020 ◽  
Vol 16 (1) ◽  
pp. 7-14 ◽  
Author(s):  
David M Nemer ◽  
Bryan R Wilner ◽  
Alicia Burkle ◽  
Jose Aguilera ◽  
Joseph Adewumi ◽  
...  
Keyword(s):  
Health Care ◽  
Lactate Dehydrogenase ◽  
Health Care System ◽  
Clinical Characteristics ◽  
Multivariable Analysis ◽  
Severe Illness ◽  
C Reactive Protein ◽  
Oxygen Requirement ◽  
Reactive Protein ◽  
Care System

BACKGROUND: The clinical characteristics and outcomes associated with non–intensive care unit (non-ICU) hospitalizations for coronavirus disease 2019 (COVID-19) outside disease epicenters remain poorly characterized. METHODS: Systematic analysis of all non-ICU patient hospitalizations for COVID-19 completing discharge between March 13 and May 1, 2020, in a large US health care system utilizing off-site central monitoring. Variables of interest were examined in relation to a composite event rate of death, ICU transfer, or increased oxygen requirement to high-flow nasal cannula, noninvasive ventilation, or mechanical ventilation. RESULTS: Among 350 patients (age, 64 ± 16 years; 55% male), most (73%) required 3 L/min or less of supplemental oxygen during admission. Telemetry was widely utilized (79%) yet arrhythmias were uncommon (14%) and were predominantly (90%) among patients with abnormal troponin levels or known cardiovascular disease. Ventricular tachycardia was rare (5%), nonsustained, and not associated with hydroxychloroquine/azithromycin treatment. Adverse events occurred in 62 patients (18%), including 22 deaths (6%), 48 ICU transfers (14%), and 49 patients with increased oxygen requirement (14%) and were independently associated with elevated C-reactive protein (odds ratio, 1.09 per 1 mg/dL; 95% CI, 1.01-1.18; P = .04) and lactate dehydrogenase (OR, 1.006 per 1U/L; 95% CI, 1.001-1.012; P = .03) in multivariable analysis. CONCLUSION: Among non–critically ill patients hospitalized within a nonepicenter health care system, overall survival was 94% with the development of more severe illness or death independently associated with higher levels of C-reactive protein and lactate dehydrogenase on admission. Clinical decompensation was largely respiratory-related, while serious cardiac arrhythmias were rare, which suggests that telemetry can be prioritized for high-risk patients.

Tannin-degrading bacteria with cellulase activity isolated from the cecum of the Qinghai-Tibet plateau zokor (Myospalax baileyi)

2015 ◽  
Vol 61 (1) ◽  
pp. 21-27 ◽  
Author(s):  
Anatoly Bobrov ◽  
Vasiliy D. Kravchenko ◽  
Günter C. Müller
Keyword(s):  
Cellulase Activity ◽  
Tibet Plateau ◽  
Bacterial Strains ◽  
Negative Effects ◽  
Hydrolyzable Tannin ◽  
16S Rdna Gene ◽  
Qinghai Province ◽  
Degrading Bacteria ◽  
Qinghai Tibet Plateau ◽  
Plateau Zokor

Tannins, which are polyphenols present in various plants, have anti-nutritional activity; however, their negative effects are mitigated by the presence of tannin-degrading microorganisms in the gastrointestinal tract of animals. This has never been investigated in the plateau zokor (Myospalax baileyi) – the predominant small herbivore in the alpine meadow ecosystem of Qinghai Province, China – which consumes tannin-rich herbaceous plants. Tannase activity in the feces of the plateau zokor increased from June to August corresponding to the increase in hydrolyzable tannin concentrations in plants during this period, and three tannin-degrading facultative anaerobic strains (designated as E1, E2, and E3) were isolated from the cecum of these animals. Sequencing of the 16S rDNA gene identified isolates of strain E1 as belonging to the genusEnterococcus, and E2 and E3 to the genusBacillus. All of the bacteria had cellulose-degrading capacity. This study provides the first evidence of symbiotic bacterial strains that degrade tannic acid and cellulose in the cecum of plateau zokor.

scholarly journals Emergy-Based Evaluation of Changes in Agrochemical Residues on the Qinghai–Tibet Plateau, China

2019 ◽  
Vol 11 (13) ◽  
pp. 3652 ◽  
Author(s):  
Xiuhong Wang ◽  
Yili Zhang
Keyword(s):  
Intensity Factor ◽  
Structure Factor ◽  
Synthesis Method ◽  
Tibet Plateau ◽  
Annual Growth Rate ◽  
Qinghai Province ◽  
Productivity Factor ◽  
Tibet Autonomous Region ◽  
Agricultural Materials ◽  
Qinghai Tibet Plateau

Study of changes in agrochemical residues on the Qinghai–Tibet Plateau is necessary for the agricultural green development of the fragile plateau and its downstream regions. The total agrochemical residue (TR) caused by main agrochemical inputs was estimated in the study area of Qinghai province and the Tibet Autonomous Region over 1995–2017 by using the emergy synthesis method. The total agrochemical residue was decomposed into the intensity factor, the structure factor, the productivity factor, and the labour factor by using the Logarithmic Mean Divisia Index (LMDI) decomposition method. The change in TR could be divided into four time periods, i.e., a rapidly increasing period during 1995–1998, a stable period during 1999–2004, a slowly increasing period during 2005–2011, and a fluctuant period during 2012–2017. The study area had a mean TR intensity in area (TRA) of 3.31 × 1014 sej/ha, which was only 38.21% of that in China; however, the annual growth rate of TRA in the study area was 2.93%, higher than the rate of 1.91% in China over 1995–2017. The study area had a mean TR intensity in production (TRP) of 4.06 × 1010 sej/CNY (Chinese Yuan), which was 71.05% of that in China; however, the annual decreasing rate of TRP in the study area was 0.95%, lower than the rate of 1.98% in China over 1995–2017. All the LMDI decomposed factors contributed to the TR increase during 1995–1998; the intensity factor, the structure factor, and the labour factor contributed to the TR decrease during 1999–2004; the structure factor and the productivity factor contributed to the TR increase during 2005–2011; and only the productivity factor contributed to the TR increase during 2012–2017. Compared with the whole country, the study area has more potential to reduce TR by improving agrochemical use efficiency, strengthening the recovery of plastic film residue, increasing organic agricultural materials, raising the efficiency of agricultural production, and accelerating the transfer of rural labours to secondary and tertiary industries.

scholarly journals Clinical characteristics and outcomes of 85 intensive care patients with Covid-19 in South London: A single centre observational study

2020 ◽  
pp. 175114372097154
Author(s):  
Alexander Isted ◽  
Angus J McDonnell ◽  
Eben Jones ◽  
Tomas Grundy ◽  
Swarna Jeyabraba ◽  
...  
Keyword(s):  
Intensive Care ◽  
Observational Study ◽  
Clinical Characteristics ◽  
Invasive Mechanical Ventilation ◽  
Kidney Injury ◽  
Binary Logistic Regression ◽  
Patient Characteristics ◽  
Icu Admission ◽  
Reactive Protein ◽  
Global Pandemic

Background In March 2020, Covid-19 secondary to Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) was declared a global pandemic. Methods This retrospective observational study included patients with Covid-19, managed in a single intensive care unit (ICU). We collected data on patient characteristics, laboratory and radiological findings and ICU management. Data are reported as median (interquartile range). Binary logistic regression modelling was used to identify variables at ICU admission associated with mortality. Results 85 patients (age 57.3 years [49.4–64.2], 75.3% male) were followed up for 34 days (26–40). The commonest comorbidities were hypertension (51.8%), obesity (48.7%), and type 2 diabetes (31.8%). Covid-19 presented with shortness of breath (89.4%), fever (82.4%), and cough (81.2%), first noted 8 days (6–10) prior to ICU admission. PaO2/FiO2-ratios at ICU admission were 8.28 kPa (7.04–11.7). Bilateral infiltrates on chest X-ray, lymphopenia, and raised C-reactive protein and ferritin were typical. 81.2% received invasive mechanical ventilation (IMV). Acute kidney injury occurred in 62.4% with renal replacement therapy required in 20.0%. By the end of the follow-up period, 44.7% had died, 30.6% had been discharged from hospital, 14.1% had been discharged from ICU but remained in hospital and 10.6% remained in ICU. ICU length of stay was 14 days (9–23). Age was the only variable at admission which was associated with mortality. PaO2/FiO2-ratio, driving pressure and peak ferritin and neutrophil count over the first 72-hours of IMV all correlated with mortality. Conclusions We report the clinical characteristics, ICU practices and outcomes of a South London cohort with Covid-19, and have identified factors which correlate with mortality. By sharing our insight, we hope to further understanding of this novel disease.

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