scholarly journals Clinical features, diagnostics, and outcomes of patients presenting with acute respiratory illness: a comparison of patients with and without COVID-19

2020 ◽  
Author(s):  
Sachin J. Shah ◽  
Peter N. Barish ◽  
Priya A. Prasad ◽  
Amy Kistler ◽  
Norma Neff ◽  
...  
Keyword(s):  
San Francisco ◽  
Clinical Features ◽  
Cardiac Injury ◽  
Vital Signs ◽  
Case Series ◽  
Signs And Symptoms ◽  
Respiratory Illness ◽  
Acute Respiratory Illness ◽  
Respiratory Illnesses ◽  
Laboratory Results

AbstractBackgroundEmerging data on the clinical presentation, diagnostics, and outcomes of patients with COVID-19 have largely been presented as case series. Few studies have compared these clinical features and outcomes of COVID-19 to other acute respiratory illnesses.MethodsWe examined all patients presenting to an emergency department in San Francisco, California between February 3 and March 31, 2020 with an acute respiratory illness who were tested for SARS-CoV-2. We determined COVID-19 status by PCR and metagenomic next generation sequencing (mNGS). We compared demographics, comorbidities, symptoms, vital signs, and laboratory results including viral diagnostics using PCR and mNGS. Among those hospitalized, we determined differences in treatment (antibiotics, antivirals, respiratory support) and outcomes (ICU admission, ICU interventions, acute respiratory distress syndrome, cardiac injury).FindingsIn a cohort of 316 patients, 33 (10%) tested positive for SARS-CoV-2; 31 patients, all without COVID-19, tested positive for another respiratory virus (16%). Among patients with additional viral testing, no co-infections with SARS-CoV-2 were identified by PCR or mNGS. Patients with COVID-19 reported longer symptoms duration (median 7 vs. 3 days) and were more likely to report fever (82% vs. 44%) fatigue (85% vs. 50%) and myalgias (61% vs 27%); p<0.001 for all comparisons. Lymphopenia (55% vs 34%, p=0.018) and bilateral opacities on initial chest radiograph (55% vs. 24%, p=0.001) were more common in patients with COVID-19. Patients with COVID-19 were more often hospitalized (79% vs. 56%, p=0.014). Of 186 hospitalized patients, patients with COVID-19 had longer hospitalizations (median 10.7d vs. 4.7d, p<0.001) and were more likely to develop ARDS (23% vs. 3%, p<0.001). Most comorbidities, home medications, signs and symptoms, vital signs, laboratory results, treatment, and outcomes did not differ by COVID-19 status.InterpretationWhile we found differences in clinical features of COVID-19 compared to other acute respiratory illnesses, there was significant overlap in presentation and comorbidities. Patients with COVID-19 were more likely to be admitted to the hospital, have longer hospitalizations and develop ARDS, and were unlikely to have co-existent viral infections. These findings enhance understanding of the clinical characteristics of COVID-19 in comparison to other acute respiratory illnesses.

scholarly journals Study of clinical parameters, diagnostics and outcome in patients with acute respiratory illness in a tertiary care centre during COVID-19 pandemic

2021 ◽  
Vol 8 (4) ◽  
pp. 530
Author(s):  
Sunil Mahavar ◽  
Princy Tyagi ◽  
Abhishek Agrawal ◽  
Subrata Banerjee ◽  
Raman Sharma ◽  
...  
Keyword(s):  
Hematological Parameters ◽  
Tertiary Care ◽  
Cardiac Injury ◽  
Vital Signs ◽  
Respiratory Illness ◽  
Acute Respiratory Illness ◽  
Elderly Age ◽  
Tertiary Care Centre ◽  
Group A ◽  
Group B

Background: We retrospectively analyzed and compared 98 patients admitted in Intensive care unit (ICU) with symptoms of acute respiratory illness (ARI) during the era of COVID-19 pandemic.Methods: We examined patients presenting in emergency department of SMS Medical College, Jaipur between 3rd and 20th May, 2020 with symptoms of ARI who were tested for SARS-CoV-2. Among those hospitalized, we compared symptoms, vital signs, comorbidities, biochemical and hematological parameters including viral diagnostics. We determined differences in outcomes (ICU admission, interventions, acute respiratory distress syndrome and cardiac injury).Results: In a cohort of 98 patients with symptoms of ARI, 9 (9.183%) tested positive for SARS-CoV-2. Patients were divided into group A and B based on SARS CoV2 RNA testing. Among patients with additional viral testing, no co-infections with SARS-CoV-2 were identified by PCR. FDP and d-dimer was positive in 44.44% patients in group A and 68.53% in group B. 11.11% mortality was observed in group A and 14.606% in group B. The most common complication of ARI observed in both groups was coagulopathy 33.33% in group A and 42.696% in group B.Conclusions: Presence of comorbidities, lymphopenia, elderly age and elevated NLR, TLC, PLR and LDH have been associated with increased morbidity and mortality. Tuberculosis was most common coinfection seen in patients presenting with ARI. ARI due to non-COVID-19 illness was more severe than due to COVID-19 and was accompanied by multiple respiratory and systemic symptoms and was associated with hospitalization. 

scholarly journals Severity of respiratory signs and symptoms and virus profiles in Japanese children with acute respiratory illness

2013 ◽  
Vol 57 (12) ◽  
pp. 811-821 ◽  
Author(s):  
Yumiko Miyaji ◽  
Miho Kobayashi ◽  
Kazuko Sugai ◽  
Hiroyuki Tsukagoshi ◽  
Shoichi Niwa ◽  
...  
Keyword(s):  
Signs And Symptoms ◽  
Respiratory Illness ◽  
Acute Respiratory Illness ◽  
Japanese Children ◽  
Respiratory Signs And Symptoms

Clinical features of patients with acute respiratory illness and rhinovirus in their bronchoalveolar lavages

2001 ◽  
Vol 21 (1) ◽  
pp. 9-16 ◽  
Author(s):  
Elsa Malcolm ◽  
Eurico Arruda ◽  
Frederick G. Hayden ◽  
Laurent Kaiser
Keyword(s):  
Clinical Features ◽  
Respiratory Illness ◽  
Acute Respiratory Illness

scholarly journals Association of clinical characteristics of patients presenting with influenza like illness or severe acute respiratory illness with development of acute respiratory distress syndrome

2017 ◽  
Vol 87 (1) ◽  
Author(s):  
Muhammad Ijaz ◽  
Muhammad Jaffar Khan ◽  
Jawad Khan ◽  
. Usama
Keyword(s):  
Acute Respiratory Distress Syndrome ◽  
Respiratory Distress Syndrome ◽  
Respiratory Distress ◽  
Odds Ratio ◽  
Distress Syndrome ◽  
Signs And Symptoms ◽  
Respiratory Illness ◽  
Acute Respiratory Illness ◽  
Influenza Like Illness ◽  
Severe Acute Respiratory Illness

<p>Clinical judgement and suspicion of influenza based on signs and symptoms of influenza-like illness and severe acute respiratory illness are critical for better patient outcome. Whether clinical characteristics of patients are associated with the development of acute respiratory distress syndrome and PCR positivity of samples was the aim of this study. We included all patients (n=37) presenting with influenza like illness (ILI) or severe acute respiratory illness (SARI) to a tertiary care hospital in northwest Pakistan during December 2015 until the end of January 2016. Each patient was assessed for signs and symptoms, clinical features, treatment, complications and outcome of ILI and SARI. Throat or nasopharyngeal swabs were obtained from 36 patient and analyzed for the presence of Influenza virus by quantitative PCR.<strong><em> </em></strong>Patients presenting with ILI or SARI were febrile (p&lt;0.001, one sample <em>t-</em>test), significantly tachypneic (p&lt;0.001) and had critically lower oxygen saturation (p&lt;0.001). Nasal congestion at presentation (p=0.006, chi-square test for association) and infiltrates on chest radiographs (p=0.025) were significantly associated with acute respiratory distress syndrome. Likelihood of the occurrence of ARDS was significantly increased with decrease in oxygen saturation (Odds ratio; 0.75, 95% CI; 0.46, 1.21, p=0.048) and marginally significantly increased in lower age (Odds ratio; 0.82, 95% CI; 0.58, 1.15, p=0.055) and higher white cell count (Odds ratio; 1.001, 95% CI; 0.99, 1.002, p=0.054). The presence of Influenza type A/H1N1pdm09 strains was confirmed in 7/11 patients. However no significant difference was observed in the clinical features and complications of PCR positive and negative patients. Clinical signs and symptoms of influenza-like illness or severe acute respiratory illness significantly predict the development of complications irrespective of the positivity or negativity of laboratory qPCR reports.</p>

scholarly journals Viruses associated with acute respiratory infections 1961–71

1974 ◽  
Vol 72 (3) ◽  
pp. 425-432 ◽  
Author(s):  
P. G. Higgins
Keyword(s):  
Sore Throat ◽  
School Children ◽  
Respiratory Infections ◽  
Respiratory Illness ◽  
Laboratory Diagnosis ◽  
Acute Respiratory Infections ◽  
Acute Respiratory Illness ◽  
Pathogenic Organism ◽  
Respiratory Illnesses ◽  
Influenza Like Illness

SUMMARYInfluenza-like illness, cold and sore throat was the diagnosis given in over 80% of 5177 acute respiratory illnesses in patients swabbed over a 10-year-period. A pathogenic organism was isolated twice as frequently from patients with a sore throat or an influenza-like illness as from those diagnosed as suffering from croup or laryngitis and bronchitis. A laboratory diagnosis was commoner in school children than in older or younger persons.Most of the organisms isolated were found in association with all types of acute respiratory illness but, with increasing age of the patient, one particular agent or group of agents was more likely to be of aetiological significance.

Appendectomy for Vague Symptoms and Equivocal Physical Findings on Physical Exam and Computed Tomography

2021 ◽  
pp. 000313482110505
Author(s):  
Meaghan Flatley ◽  
Kyle K. Sokol ◽  
Eric M. Balent ◽  
Sara B. Placek ◽  
Joshua S. Ritenour ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Abdominal Pain ◽  
Acute Appendicitis ◽  
Laparoscopic Appendectomy ◽  
Diagnostic Laparoscopy ◽  
Treatment Algorithm ◽  
Case Series ◽  
Signs And Symptoms ◽  
Imaging Characteristics ◽  
Laboratory Results

Background: Appendicitis is a common condition affecting 7-8% of the general population. With the improvement of noninvasive imaging, the diagnostic approach and treatment algorithm for patients with clear signs and symptoms suggestive of acute appendicitis are well agreed-upon. However, patients without pathognomonic signs and symptoms, but with equivocal imaging pose a diagnostic dilemma. These patients may still have acute appendicitis and could potentially benefit from laparoscopic appendectomy. This may be especially true in the subset of patients with appendicoliths. Methods: Our case series exams a group of patients with atypical symptoms who eventually underwent appendectomy and were followed after surgery for at least a month. This case series consists of eight patients with abdominal pain accompanied by a variety of other signs and symptoms in addition to laboratory results and imagining characteristics which were nondiagnostic. These patients had initial Alvarado scores ranging from 0-6. Results: All of these patients were subsequently taken to the operating room for diagnostic laparoscopy and laparoscopic appendectomy. Of these patients, six were known to have appendicoliths based on computed tomography obtained during initial diagnostic workup. Conclusions: All patients underwent a diagnostic laparoscopy and appendectomy. Four had appendicitis and four also had resolution of their symptoms. There exist atypical presentations of appendiceal disease. Patients with abdominal pain/tenderness, even without diagnostic laboratory results or imaging characteristics, may benefit from laparoscopic appendectomy.

scholarly journals Respiratory Viral Testing and Influenza Antiviral Prescriptions During Hospitalization for Acute Respiratory Illnesses

2016 ◽  
Vol 3 (1) ◽  
Author(s):  
Melissa A. Rolfes ◽  
Kimberly M. Yousey-Hindes ◽  
James I. Meek ◽  
Alicia M. Fry ◽  
Sandra S. Chaves
Keyword(s):  
Rate Ratio ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Respiratory Illness ◽  
Care Hospital ◽  
Acute Respiratory Illness ◽  
Respiratory Illnesses ◽  
Testing Rate ◽  
Viral Testing

Abstract We examined respiratory viral testing and influenza antiviral prescriptions at a US tertiary care hospital. During the 2010–11 to 2012–13 influenza seasons, antiviral prescriptions among acute respiratory illness (ARI) hospitalizations were associated with viral testing (rate ratio = 15.0), and empiric prescriptions were rare (&lt;1% of ARI hospitalizations).

scholarly journals Comparison of the cardiovascular presentations, complications and outcomes following different coronaviruses’ infection: A systematic review

2021 ◽  
Vol 13 (2) ◽  
pp. 92-101
Author(s):  
Mohammad Mostafa Ansari Ramandi ◽  
Hossein Yarmohammadi ◽  
Somayeh Beikmohammadi ◽  
Behzad Hassan Hosseiny Fahimi ◽  
Farbod Hatami ◽  
...  
Keyword(s):  
Systematic Review ◽  
Case Studies ◽  
Systematic Reviews ◽  
Case Reports ◽  
Cardiac Injury ◽  
Laboratory Data ◽  
Case Series ◽  
Signs And Symptoms ◽  
Mesh Terms ◽  
Thrombotic Complications

Manifestations caused by coronavirus family have presented it in many ways during the previous years. The aim of this systematic review was to gather all possible cardiovascular manifestations of the coronavirus family in the literature. Adhering to Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, we searched PubMed, Scopus, Web of Science, Cochrane and ProQuest which were updated on May 1, 2020 for the last time. Regarding to the novelty and speed of publications on COVID-19, we searched Google Scholar and also references of included studies and review articles in the systematic search results were searched manually. The searched keywords were the combination of the following MeSH terms: "COVID-19", "SARS", "MERS" and "cardiovascular presentation". The systematic review was registered with ID CRD42020180736 in International Prospective Register of Systematic Reviews (PROSPERO). After screening, 28 original articles and ten case studies (five case reports and five case series) were included. Most of the studies were focused on COVID-19 (20 original articles and four case studies) while the only studies about Middle East Respiratory Syndrome (MERS) were a case report and a case series. Almost all the cardiovascular presentations and complications including acute cardiac injury, arrhythmias and the thrombotic complications were more prevalent in COVID-19 than severe acute respiratory syndrome (SARS) and MERS. The cardiac injury was the most common cardiovascular presentation and complication in COVID-19 whereas thrombotic complications were commonly reported in SARS. The cardiac injury was the predictor of disease severity and mortality in both COVID-19 and SARS.Coronavirus 2019 may present with cardiovascular manifestations and complications in signs and symptoms, laboratory data and other paraclinical findings. Also, cardiovascular complications in the course of COVID-19 may result in worse outcomes.

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