scholarly journals Asymptomatic COVID-19 Have Longer Treatment Cycle Than Moderate Type of Confirmed Patients

Author(s):  
Wei Zhang ◽  
Qinying Long ◽  
Yanbiao Huang ◽  
Changju Chen ◽  
Jinhua Wu ◽  
...  

ABSTRACTObjectivesA kind of pneumonia caused by unknown causes that occurred in Wuhan, Hubei, China in December 2019, was reported as a result of novel coronavirus infection on January 7, 2020, and then WHO named it COVID-19. To compare the difference of epidemiology and clinical characteristics between asymptomatic COVID-19 infections and moderate type of confirmed cases.MethodsRetrospective, single-center cohort study of COVID-19 involving 52 infections of both 26 asymptomatic and 26 moderate type of confirmed cases in the recovery stage at Guizhou Provincial Staff Hospital in Guiyang, China, from January 29, to March 31, 2020; final date of follow-up was April 22. This study was registered in Chinese Clinical Trial Registry Center. Documented the asymptomatic COVID-19 infections and moderate type of confirmed cases. Epidemiological, demographic, clinical, laboratory, radiological, and treatment data were collected and analyzed. Epidemiological and clinical characteristics of asymptomatic COVID-19 infections and moderate type of confirmed cases were compared.ResultsThe median treatment cycle of asymptomatic COVID-19 infections was 16 days (interquartile range, 11-20 days) and longer than 13 days (interquartile range, 10-15 days) of moderate type of confirmed cases (p=0.049). The median incubation period of asymptomatic COVID-19 infections was 10 days (interquartile range, 0-21 days), while the control group was 7 days (interquartile range, 1-15 days) (p=0.27). On the initial chest computerized tomography (CT) check, 18 (69.2%, 18/26) asymptomatic COVID-19 infections were no imaging changes, which was of no significance compared with 12 (46.2%, 12/26) patients with moderate type of confirmed patients (p=0.092).ConclusionsIn this single-center study, we found that asymptomatic COVID-19 infections have longer treatment cycle than those moderate type of confirmed cases.Key PointsIn this single-center case series involving 52 infections with asymptomatic and moderate type of COVID-19 cases, asymptomatic COVID-19 infections have longer treatment cycle than those moderate type of confirmed patients.

2020 ◽  
Author(s):  
Wei Zhang ◽  
Youshu Yuan ◽  
Zhengqiao Yang ◽  
Jinxia Fu ◽  
Yun Zhang ◽  
...  

ABSTRACTObjectivesIn December, 2019, a type of novel coronavirus which was designated novel coronavirus 2019 (2019-nCoV) by World Health Organization (WHO) occurred in Wuhan, Hubei, China. The epidemiological and clinical characteristics of those patients under 18 years old in the recovery stage are limited. To compare the difference of epidemiological and clinical characteristics of COVID-19 involving 25 patients under 18 years old in recovery stage between confirmed and asymptomatic infections.MethodsRetrospective, single-center cohort study of COVID-19 involving 25 patients under 18 years old in the recovery stage at Guizhou Provincial Staff Hospital in Guiyang, China, from January 29, to March 31, 2020; final date of follow-up was April 22. Epidemiological, demographic, clinical, laboratory, radiological, and treatment data were collected and analyzed. Epidemiological and clinical characteristics of confirmed COVID-19 infections and asymptomatic infections were compared.ResultsAmong the 25 COVID infections under 18 years old, 16 (64%) were mild or moderate confirmed cases, and 9 (36%) were asymptomatic. The shortest treatment period was 6 days, the longest 26 days, and the average treatment period 14 days. Four cases (44.4%) had visited Wuhan or had a living story in the city. There were 9 (100%) asymptomatic cases were familial cluster outbreak, with an average infection number was 6 cases among all families. The number of asymptomatic COVID-19 infections with leukopenia were significantly more than confirmed cases (p=0.04).ConclusionsLeukopenia mostly occurred in asymptomatic COVID-19 infections under 18 years old compared with the confirmed patients.Key PointIn this single-center case series involving 25 cases under 18 years old with COVID-19 infections, leukopenia mostly occurred in asymptomatic infections.


2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Qing Zhang ◽  
Qian Xu ◽  
Yi-yang Chen ◽  
Li-xin Lou ◽  
Li-he Che ◽  
...  

Abstract Background The clinical characteristics of patients with confirmed 2019 novel coronavirus disease (COVID-19) in Jilin Province, China were investigated. Methods Clinical, laboratory, radiology, and treatment data of 41 hospitalized patients with confirmed COVID-19 were retrospectively collected. The population was stratified by disease severity as mild, moderate, or severe, based on guidelines of the National Health and Medical Commission of China. Results The 41 hospitalized patients with COVID-19 were studied, and the median age was 45 years (interquartile range [IQR], 31–53; range, 10–87 years) and 18 patients (43.9%) were female. All of the patients had recently visited Wuhan or other places (ie, Beijing, Thailand) or had Wuhan-related exposure. Common symptoms included fever (32[78%]) and cough (29[70.7%]). All patients were without hepatitis B/C virus hepatitis. CRP (C-reactive protein, 11.3 mg/L [interquartile range {IQR}, 2.45–35.2]) was elevated in 22 patients (53.7%), and cardiac troponin I (1.5 ng/mL [IQR, 0.8–5.0]) was elevated in 41 patients (100%). Chest computed tomographic scans showed bilateral ground glass opacity (GGO) or GGO with consolidation in the lungs of 27(65.9%) patients. 31(75.6%) patients had an abnormal electrocardiograph (ECG). Comparing the three groups, the levels of CRP and cardiac troponin I, GGO distribution in bilateral lungs, and electrocardiogram changes were statistically significant (p < 0.05). Cardiac troponin I had a strong positive correlation with CRP (r = 0.704, p = 0.042) and LDH (r = 0.738, p = 0.037). Conclusion Significant differences among the groups suggest that several clinical parameters may serve as biomarkers of COVID-19 severity at hospital admission. Elevated cTnI could be considered as a predictor of severe COVID-19, reflecting the prognosis of patients with severe COVID-19. The results warrant further inspection and confirmation.


2020 ◽  
Author(s):  
Wei Zhang ◽  
Youshu Yuan ◽  
Zhengqiao Yang ◽  
Jinxia Fu ◽  
Yun Zhang ◽  
...  

Abstract Background In December, 2019, a type of novel coronavirus which was designated novel coronavirus 2019 (2019-nCoV) by World Health Organization (WHO) occurred in Wuhan, Hubei, China. The epidemiological and clinical characteristics of those patients under 18 years old in the recovery stage are limited. To compare the difference of epidemiological and clinical characteristics of COVID-19 involving 25 patients under 18 years old in recovery stage between confirmed and asymptomatic infections.Methods Retrospective, single-center cohort study of COVID-19 involving 25 patients under 18 years old in the recovery stage at Guizhou Provincial Staff Hospital in Guiyang, China, from January 29, to March 31, 2020; final date of follow-up was April 22. Epidemiological, demographic, clinical, laboratory, radiological, and treatment data were collected and analyzed. Epidemiological and clinical characteristics of confirmed COVID-19 infections and asymptomatic infections were compared.Results Among the 25 COVID infections under 18 years old, 16 (64%) were mild or moderate confirmed cases, and 9 (36%) were asymptomatic. The shortest treatment period was 6 days, the longest 26 days, and the average treatment period 14 days. Four cases (44.4%) had visited Wuhan or had a living story in the city. There were 9 (100%) asymptomatic cases were familial cluster outbreak, with an average infection number was 6 cases among all families. The number of asymptomatic COVID-19 infections’ Leukopenia were significantly more than confirmed cases (p = 0.04).Conclusions Leukopenia mostly occurred in asymptomatic COVID-19 infections under 18 years old compared with the confirmed patients.


Vaccines ◽  
2021 ◽  
Vol 9 (10) ◽  
pp. 1112
Author(s):  
Zhe Ruan ◽  
Yonglan Tang ◽  
Chunhong Li ◽  
Chao Sun ◽  
Ying Zhu ◽  
...  

In this study, we report the safety of coronavirus disease 2019 (COVID-19) vaccine in patients with myasthenia gravis (MG). Patients who were vaccinated against COVID-19 were included. Demographics, clinical characteristics, medications, and vaccination information were collected. The main observation outcome is the worsening of MG symptoms within 4 weeks following COVID-19 vaccination. A total of 22 patients with MG vaccinated for COVID-19 were included. Ten (45.5%) patients had ocular MG (OMG), and 12 (55.5%) patients had generalized MG (GMG). Six (27.3%) patients were female, and the mean (SD) onset age was 45.4 (11.8) years. Nineteen (86.4%) patients were seropositive for acetylcholine receptors (AChR) antibody. Seven (31.8%) patients underwent thymectomy, and four of them confirmed thymoma pathologically. Twenty-one patients were administrated with inactivated vaccines, and the remaining one was administrated with recombinant subunit vaccine. Twenty (90.9%) patients did not present MG symptom worsening within 4 weeks of COVID-19 vaccination, and two (9.1%) patients reported slight symptom worsening but resolved quickly within a few days. Our findings suggest inactivated COVID-19 vaccines might be safe in MG patients with Myasthenia Gravis Foundation of America (MGFA) classification I to II, supporting the recommendation to promote vaccination for MG patients during the still expanding COVID-19 pandemic.


2020 ◽  
Author(s):  
Manoj Kumar Reddy Somagutta ◽  
Maria Kezia Lourdes Pormento ◽  
Pousette Hamid ◽  
Alaa Hamdan ◽  
Muhammad Adnan Khan ◽  
...  

Abstract This study aims to assess anakinra's safety and efficacy for treating severe coronavirus disease in 2019 (COVID-19). PubMed, Google Scholar, Cochrane Library, Embase, Scopus, medRxiv, and bioRxiv were searched. Three retrospective studies and five case series involving 3,274 adult patients with severe COVID-19 were included, 621 treated with anakinra (whether administered alone or in combination with other drugs) and 1,565 in the control group arm. All-cause mortality of severe COVID-19 patients among the anakinra group was 20% (16/81), which was lower than that in the control group (65%; 39/60). The difference was statistically significant [hazard ratio (HR) = 0.13, 95% confidence interval (CI) 0.06–0.29, I2= 0%]. The mechanical ventilation requirement with OR 0.57 (0.11-2.84, I2=87%) was not significantly better compared to the control group. For the safety of anakinra, we evaluated thromboembolism risk and liver enzyme elevation. Thromboembolism risk with OR: 1.48 (0.55- 3.99, I2=0%) and elevation in liver transaminases with OR 0.67 (0.11-3.93, I2=66%) were not statistically significant over the control group. However, these non-significant differences between the anakinra and control groups may have been the result of baseline characteristics of the intervention group, and further studies are essential in evaluating anakinra's safety profile.


2020 ◽  
Author(s):  
Chang Wang ◽  
Lizhi Zhou ◽  
Juan Chen ◽  
Yong Yang ◽  
Tianlong Huang ◽  
...  

Abstract Background: The clinical characteristics and outcomes of the 2019 novel coronavirus (COVID-19) pneumonia are different in Hubei compared to other regions in China. But there are few comparative studies on the differences between imported and local patients which may provide information of the different courses of the virus after transmission. Methods: We investigated 169 cases of COVID-19 pneumonia in two centers in Hunan Province, and divided them into two groups according to epidemiological history, "imported patients" refers to patient with a clear history of travel in Wuhan within 14 days before onset, and " local patients” refers to local resident without a recent history of travel in Wuhan, aiming to analyze the difference in clinical characteristics and outcomes between the two groups. All the epidemiological, clinical, imaging, and laboratory data were analyzed and contrasted. Results: The incidence of fever on admission in imported patients was significantly higher than local patients. There was a significantly higher proportion of abnormal pulmonary signs, hypokalemia, hyponatremia, prolonged PT, elevated D-dimer and elevated blood glucose in imported patients. Compared with local patients, the proportion using antibiotics, glucocorticoids and gamma globulin were significantly higher in imported patients. The moderate type was more common in local patients, and the severe type were more frequent in imported patients. In addition, the median duration of viral clearance was longer in imported patients. Conclusions: In summary, we found that imported cases were more likely to develop into severe cases, compared with local patients and required more powerful treatments.Trial registration: Registered 21st March 2020, and this study has been approved by the Medical Ethics Committee (Approved Number. 2020017).


2021 ◽  
Vol 7 (5) ◽  
pp. 4324-4331
Author(s):  
Lei Dai ◽  
Yongyong Wang ◽  
Mingwu Chen

Lung cancer (LC) is a common malignant tumor with high morbidity and mortality. The development of new molecular markers and the early diagnosis of LC and the exploration of emerging targeted therapies are of great significance. Therefore, this study systematically evaluates the correlation between peripheral serum MIC-1 levels and LC. Search PubMed, Web of Science, Medline and other databases, the search time is from the establishment of the database to July 2021. The LC group included LC patients, the Non-cancer group included patients with benign lung diseases (BLD), and the control group included healthy people. The serum MIC-1 levels of LC group and control group, LC group and Non-cancer group were compared respectively, and the correlation between serum MIC-1 and clinical characteristics of LC patients was evaluated and analyzed, and the ROC curve of MIC-1 in prediction of LC. Finally, 5 articles were included, including 1179 patients with LC, 109 patients with BLD, and 1020 healthy people. Meta-analysis results: the level of MIC-1 in LC group was overtop that in healthy group, and the difference was obvious [SMD=1.97, 95%CI (1.35, 2.59), PC0.00001]. The level of MIC-1 in LC group was overtop that in Non-cancer group, and the difference was obvious [SMD=382.97,95%CI (313.74, 452.19), PC0.00001]. The descriptive evaluation analyzes the correlation between MIC-1 and the clinical characteristics of LC group, and the results show that MIC-1 has a certain correlation with the stage of LC group. The AUC of serum MIC-1 in the identification of LC group and the control group was greater than 0.5. The AUC value of MIC-1 in the diagnosis of LC was 0.851-0.906, and the best sensitivity range was 63.50%-99.00%. The best specificity is in the range of 70.4%-95.80%. The Meta-analysis indicated that the serum MIC-1 level in LC group is overtop that in BLD and healthy people, and has a obvious correlation with LC stage staging; and the ROC curve shows that it has important significance in the diagnosis and prognosis of LC.


Author(s):  
Yubing Wang ◽  
Zhongwei Hu ◽  
Jie Luo ◽  
Fuchun Zhang ◽  
Lianjiao Huang ◽  
...  

Abstract Objective To present the clinical characteristics and dynamic changes in laboratory parameters of the COVID-19 in Guangzhou, and explore the probable early warning indicators of disease progressing. Method We enrolled all the patients diagnosed as COVID-19 in the Guangzhou No. 8 People’s Hospital. The patients’ demographic, and epidemiologic data were collected, including chief complaints, lab results and imaging examination. Results The characteristics of the patients in Guangzhou are different from that in Wuhan. They were younger in age, female dominated, not commonly combined with other disease. 75% of patients suffered fever on admission, followed by cough occurring in 62% patients. By comparing the mild/normal and severe/critical patients, male, aged, combined with hypertension, abnormal in blood routine result, raised creatine kinase, glutamic oxaloacetic transaminase, lactate dehydrogenase, CRP, procalcitonin, D-dimer, fibrinogen, APTT, and positive in proteinuria can be candidate of early warning indicators to severe disease. Conclusion The patients in outside epidemic areas showed different characteristics from that in Wuhan. The abnormal laboratory parameters were markedly changed in 4 weeks after admission, and also shown different between the mild and severe patients. The highest specificity and sensitivity potential early warning indicators of severe disease need more evidence to confirm.


2021 ◽  
Vol 2021 ◽  
pp. 1-8
Author(s):  
Huan Liu ◽  
Jun Jin ◽  
Qiao Chen ◽  
Zhongmin Li

Background. The incidence of thyroid nodules increases in the general population. Similarly, we have also seen a dramatic increase in the number of thyroid surgeries. However, the mortality rate of thyroid cancer remained stable or even decreased. The purpose of our study was to investigate whether thyroid cancer affects the malignant risk of the contralateral TI-RADS 3 and 4 nodules. Methods. We conducted a retrospective cohort study in our institution for all thyroid procedures due to nodules from December 2018 to December 2019. All eligible patients were divided into the experimental group (bilateral nodules) and the control group (unilateral nodules) to assess whether the proportion of malignant nodules was different between the two groups. Multivariate logistic regression analysis was used to control potential confounding factors to investigate whether their differences were statistically significant. Results. A total of 330 patients underwent thyroid surgery, of whom 137 were eligible, including 84 in the experimental group and 53 in the control group. The proportion of malignant nodules was significantly different between the experimental group and the control group (29.8% versus 58.5%, unadjusted OR 0.30, 95% CI: 0.17–0.82, p = 0.001 ). However, after controlling for potential confounding factors, including age ( p = 0.004 ), gender ( p = 0.775 ), and TI-RADS classification ( p ≤ 0.001 ), we found that the difference was not significant (adjusted OR 1.08, 95% CI: 0.39–3.01, p = 0.886 ). Conclusion. There is no evidence that thyroid cancer affects the malignant risk of the contralateral TI-RADS 3 and 4 nodules. This study has been registered with the Chinese Clinical Trial Registry (clinical trial registration number: ChiCTR2000038611, registration time: September 26, 2020).


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