scholarly journals COVID-19 versus non-COVID-19 pneumonia: A retrospective cohort study in Chengdu, China

Author(s):  
Xiao-Jin Li ◽  
Bing-Xing Shuai ◽  
Zhong-Wei Zhang ◽  
Yan Kang

Background and ObjectiveSince the outbreak of coronavirus disease 2019 (COVID-19) in December 2019 in Wuhan, Hubei Province, China, it has spread throughout the world and become a global public health emergency. It is important to distinguish COVID-19 from other viral pneumonias to properly screen and diagnose patients, reduce nosocomial infections, and complement the inadequacy of nucleic acid testing. In this study, we retrospectively analysed the clinical data of COVID-19 versus non-COVID-19 patients treated at our hospital between January 17 and February 27, 2020 to summarize our clinical experience in the differential diagnosis of COVID-19.MethodsIn this retrospective cohort study, 23 confirmed COVID-19 patients were consecutively enrolled from January 17 to February 27, 2020, and 29 confirmed non-COVID-19 patients were enrolled in the West China Hospital of Sichuan University. We collected baseline data, epidemiological data, clinical characteristics, imaging findings, viral nucleic acid test results, and survival data. SPSS v22.0 was used for the statistical analysis. Outcomes were followed-up until March 25.ResultsA total of 52 patients were included in this study, including 23 COVID-19 patients and 29 non-COVID-19 patients. No significant between-group differences were observed for age, sex, primary signs or symptoms, cellular immunity, or platelet count. Significant between-group differences were observed in clinical characteristics such as dry cough, contact with individuals from Wuhan, some underlying diseases, nucleated cell count, chest imaging findings, viral nucleic acid test results, 28-day mortality, and 28-day survival.ConclusionEpidemiological data, clinical symptoms, nucleic acid test results for COVID-19 and chest CT manifestation may help distinguish COVID-19 from non-COVID-19 cases, prevent imported cases and nosocomial infections.

2020 ◽  
Author(s):  
Meng Xu ◽  
Xun Liu ◽  
Chuhong Su ◽  
Yuping Zeng ◽  
Jinqian Zhang ◽  
...  

AbstractBackgroundCoronavirus disease 2019 (COVID-19) has become a global health problem. We aim to investigate the changes in the results of viral nucleic acid tests on pharyngeal swabs and feces of patients with COVID-19 and CT imaging of lungs as the disease progresses.MethodsSeven patients with COVID-19 in the third affiliated hospital of Sun Yat-sen University Yuedong Hospital were retrospectively enrolled with clinical features, including imaging staging, and performance characteristics of viral nucleic acid test results of pharyngeal swabs and feces. The dynamic changes of these features were observed during hospitalization, and therapeutic effect and prognosis of patients were evaluated.ResultsThe results of seven cases with COVID-19 were positive for viral nucleic acid tests on pharyngeal swabs early after the onset of symptoms, and then turned negative; while the results of viral nucleic acid tests on feces were persistently positive in the mid-term clinical treatment and recovery period. And the viral nucleic acid test results were capricious in three cases. Pulmonary CT imaging showed characteristic changes in early, advanced and recovery phases.ConclusionThe application of viral nucleic acid detection and pulmonary CT imaging can be used for screening of suspected cases. Fecal nucleic acid test should be recommended as the reference of discharge standard, in order to minimize the risk of transmission from digestive tract.


2020 ◽  
Vol 221 (12) ◽  
pp. 1940-1947 ◽  
Author(s):  
Yanfeng Pan ◽  
Xue Yu ◽  
Xinwei Du ◽  
Qingqing Li ◽  
Xianyang Li ◽  
...  

Abstract Background We retrospectively analyzed 26 persistently asymptomatic severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) carriers. Methods Epidemiological and clinical characteristics from the 26 asymptomatic patients with positive results for SARS-CoV-2 ribonucleic acid testing were obtained. Results Twenty-two patients (84.6%) correlated with clustering occurrence. The median period from contact to diagnosis and the last positive nucleic acid test was 19 (8–24 days) and 21.5 days (10–36 days), respectively. The median period from diagnosis to negative nucleic acid test was significantly different between patients with normal or atypical chest computed tomography (CT) findings (n = 16, 61.5%; 7.5 days [2–20 days]) and patients with typical ground-glass or patchy opacities on CT (n = 10, 38.5%; 12.5 days [8–22 days]; P < .01). Seven patients (70.0%) with initial positive nucleic acid test results had a negative result simultaneously with improved CT findings. Obvious improvement in CT findings was observed in 3 patients (30.0%) despite positive nucleic acid test results. Conclusions In asymptomatic patients, changes in biochemical and inflammatory variables are small and changes on chest CT can occur. It is worth noting that the long existence of SARS-CoV-2 in some asymptomatic patients and false-negative results need to be considered in SARS-CoV-2 nucleic acid test.


Author(s):  
Ying Su ◽  
Ling-Shuang Zhu ◽  
Yong Gao ◽  
Yuncheng Li ◽  
Zhanlu Xiong ◽  
...  

AbstractBackgroundWith coronavirus disease 2019 (Covid-19) ravaging the global, concern has been aroused whether discharged Covid-19 patients with reappeared positive nucleic acid test results are infected again.ObjectiveTo analyze the clinical characteristics of discharged Covid-19 patients with reappeared positive nucleic acid test results and to track clinical outcomes of them.MethodsWe extracted clinical data on 938 Covid-19 patients from Wuhan Union Hospital (West Branch), and we obtained information about residual symptoms and nucleic acid tests after discharge through follow-up study. We evaluated the relationship of clinical characteristics and reappeared positive results. Each patient had at least 44 days of follow-up.ResultsOf 938 discharged patients, a total of 58 (6.2%) had reappeared positive nucleic acid test results and 880 remain negative. Among patients over the age of 50, the factors we found to be associated with re-positive results were coronary artery disease (14.1%, vs. 5.5% among those without coronary artery disease; odds ratio, 2.81; 95% confidence interval [CI], 1.28 to 6.15), and hypertension (9.5%, vs. 4.9% among those without hypertension; odds ratio, 2.05; 95% CI, 1.10 to 3.82). As of May 11, 2020, 54 (93.1%) re-positive patients turned negative again while two patients remained positive, and two patients was lost to the second follow-up.ConclusionCoexisting diseases including coronary artery disease and hypertension were substantial risk factors for re-positive outcomes among patients over 50. And most re-positive patients tended to return negative eventually.


Transfusion ◽  
2014 ◽  
Vol 55 (2) ◽  
pp. 395-404 ◽  
Author(s):  
Lunan Wang ◽  
Le Chang ◽  
Yunzheng Xie ◽  
Chengyin Huang ◽  
Lei Xu ◽  
...  

2020 ◽  
Author(s):  
Mei Han ◽  
Jingbo Zou ◽  
Wenguang Tian ◽  
Xiaoyu Wei ◽  
Yang Zhou ◽  
...  

Abstract Background: The outbreak of the novel coronavirus in China (COVID-19) represents a significant and urgent threat to global health. We report here five cases of COVID-19 infection patients in our clinical practices who are medically stable and presumed to successfully “cleared” the virus after antiviral treatments. Case presentation: The clinical evaluation depends on the viral nucleic acid test in respiratory specimens by real-time PCR reverse transcription (RT-PCR) assays according to the authorized guidance. We found that the stool samples of these cured patients remain positive in RT-PCR assay while the virus is undetectable in respiratory specimens. RT-PCR molecular diagnostic assay was designed to specifically detect the presence of viral RNA. Thus, the positive result in the fecal specimens implies the existence of viable virions with the patients. Conclusions: This highlights the importance to look closely at the assessment standard of medical treatment, as well as the need for reevaluation of the criteria for the initial screening, prevention, and care of patients with this emerging infection.


Medicine ◽  
2021 ◽  
Vol 100 (48) ◽  
pp. e27933
Author(s):  
Yanru Cui ◽  
Jilin Wang ◽  
Gaofeng Wang ◽  
Xiuguo Xie ◽  
Lizhen Tian

2020 ◽  
Author(s):  
Han Zhang ◽  
Lian Lu ◽  
Wei Hu ◽  
Jian Zhang ◽  
Wei Zhu ◽  
...  

Abstract In order to identify the clinical characteristics of patients with Corona Virus Disease 2019 (COVID-19) and find out the characteristic effects of 2019 New Coronavirus (SARS-CoV-2) infection on changes in clinical and laboratory data, we analyzed the medical records of 80 suspected cases who admitted in the national designated hospital due to the relevant clinical manifestations of SARS-CoV-2 infection from January 22 to February 13, 2020. 62 (77.5%) confirmed cases and 18 (22.5%) negative cases were confirmed by SARS-CoV-2 nucleic acid test. Epidemiological investigation and statistical analysis were carried out on the clinical and laboratory data of all suspected cases of COVID-19, the specific indicators were found, and the clinical characteristics of COVID-19 were described. Compared with the patients with negative nucleic acid test, the patients with positive nucleic acid test showed shorter time of onset of symptoms, higher plasma CO2 level, lower eosinophil ratio, lower platelet count and hematocrit, lower serum sodium level, higher serum creatinine, higher blood urea and plasma albumin levels (all P<0.05). Our results might provide some suggestions in diagnosis, clinical treatment and prevention for COVID-19.


2020 ◽  
Author(s):  
Jiangrong Liao ◽  
Yueyan Lou ◽  
Shuoyan Lu ◽  
Xueyun Xian ◽  
Xiulin Wu ◽  
...  

Abstract Background: To describe the clinical characteristics and the time of nucleic acid turning negative in patients with common type Corona Virus Disease 2019(COVID-19) pneumonia and analyze the treatment time and prognostic factors.Methods: It’s a retrospective analysis of 72 cases of common type COVID-19 pneumonia diagnosed by nucleic acid test and Computed tomography (CT).Results: The average time of nucleic acid test turning negative is 17.37±9.29 days, and the average treatment time was 23.74±8.06 days. There was no influence of Blood leukocyte count, Neutrophil count, lymphocyte count, C-reactive protein (CRP), glutamic-pyruvic transaminase (ALT), glutamic oxalacetic transaminase (AST), creatinine, D-dimer on the prognosis of the patients, whether univariate or multivariate logistic regression analysis. By χ2 test of the drugs and prognosis, we found that oseltamivir may have an impact on the prognosis of patients (P<0.05), while other drugs have no significant impact on the prognosis of patients. Through the correlation analysis, we found that age, the admission temperature, leukocyte count, neutrophil count, CRP were positively correlated with the treatment time of the patients (both P<0.05). Leukocyte count and neutrophil count were positively correlated with the time of nucleic acid test turning negative (both P<0.05).Conclusions: Age, the admission temperature, leukocyte count, neutrophil count, CRP were positively correlated with the treatment time of the patients. Leukocyte count and neutrophil count were positively correlated with the time of nucleic acid test turning negative. Oseltamivir may have an impact on the prognosis of patients, but the detailed role needs further study.


2020 ◽  
Author(s):  
Han Zhang ◽  
Lian Lu ◽  
Wei Hu ◽  
Jian Zhang ◽  
Wei Zhu ◽  
...  

Abstract Objectives In order to identify the clinical characteristics of patients with Corona Virus Disease 2019 (COVID-19) and find out the characteristic effects of 2019 New Coronavirus (SARS-CoV-2) infection on changes in clinical and laboratory data. Patients and methods From January 22 to February 13, 2020, we enrolled consecutive patients with acute respiratory tract symptoms admitted to a hospital (Ezhou, Hubei, China). For different data types t-test, the variables associated with the diagnosis of COVID-19 were compared by chi-square test and u-test, the statistically significant variables (P-value<0.05) were selected into the final logistic regression model. Results 62 (77.5%) confirmed cases and 18 (22.5%) negative cases were confirmed by SARS-CoV-2 nucleic acid test. Epidemiological investigation and statistical analysis were carried out on the clinical and laboratory data of all suspected cases of COVID-19, the specific indicators were found, and the clinical characteristics of COVID-19 were described. Compared with the patients with negative nucleic acid test, the patients with positive nucleic acid test showed shorter time of onset of symptoms, higher plasma CO2 level, lower eosinophil ratio, lower platelet count and hematocrit, lower serum sodium level, higher serum creatinine, higher blood urea and plasma albumin levels (all P<0.05). Conclusions we argue that the SARS-CoV-2 infection can cause multiple organ damage to the heart, liver, kidney and bone marrow other than lung injury.


2020 ◽  
Author(s):  
Yun Yu ◽  
Di Zhang ◽  
Guoxi Chen ◽  
Xing Lan ◽  
Min Hou ◽  
...  

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