scholarly journals Association between clinical characteristics and laboratory findings with outcome of hospitalized COVID-19 patients, a report from northeast of Iran

Author(s):  
Sahar Sobhani ◽  
Reihaneh Aryan ◽  
Elham Kalantari ◽  
Salman Soltani ◽  
Nafise Malek ◽  
...  

AbstractCoronavirus disease 2019 (COVID-19) was first discovered in December 2019 in China and has rapidly spread worldwide. Clinical characteristics, laboratory findings, and their association with the outcome of patients with COVID-19 can be decisive in management and early diagnosis. Data were obtained retrospectively from medical records of 397 hospitalized COVID-19 patients between February and May 2020 in Imam Reza hospital, northeast of Iran. Clinical and laboratory features were evaluated among survivors and non-survivors. The correlation between variables and duration of hospitalization and admission to the Intensive Care Unit (ICU) was determined. Male sex, age, hospitalization duration, and admission to ICU were significantly related to mortality rate. Headache was a more common feature in patients who survived (p = 0.017). It was also related to a shorter stay in the hospital (p = 0.032) as opposed to patients who experienced chest pain (p = 0.033). Decreased levels of consciousness and dyspnea were statistically more frequent in non-survivors (p = 0.003 and p = 0.011, respectively). Baseline white blood cell count (WBC), erythrocyte sedimentation rate (ESR), and C-reactive protein (CRP) were significantly higher in non-survivors (p < 0.001). Patients with higher WBC and CRP levels were more likely to be admitted to ICU (p = 0.009 and p = 0.001, respectively). Evaluating clinical and laboratory features can help clinicians find ways for risk stratifying patients and even make predictive tools. Chest pain, decreased level of consciousness, dyspnea, and increased CRP and WBC levels seem to be the most potent predictors of severe prognosis.

2021 ◽  
Vol 2021 ◽  
pp. 1-5
Author(s):  
Sahar Sobhani ◽  
Reihaneh Aryan ◽  
Elham Kalantari ◽  
Salman Soltani ◽  
Nafise Malek ◽  
...  

Coronavirus disease 2019 (COVID-19) was first discovered in December 2019 in China and has rapidly spread worldwide. Clinical characteristics, laboratory findings, and their association with the outcome of patients with COVID-19 can be decisive in management and early diagnosis. Data were obtained retrospectively from medical records of 397 hospitalized COVID-19 patients between February and May 2020 in Imam Reza Hospital, northeast Iran. Clinical and laboratory features were evaluated among survivors and nonsurvivors. The correlation between variables and duration of hospitalization and admission to the intensive care unit (ICU) was determined. Male sex, age, hospitalization duration, and admission to ICU were significantly related to mortality rate. Headache was a more common feature in patients who survived ( p = 0.017 ). It was also related to a shorter stay in the hospital ( p = 0.032 ) as opposed to patients who experienced chest pain ( p = 0.033 ). Decreased levels of consciousness and dyspnea were statistically more frequent in nonsurvivors ( p = 0.003 and p = 0.011 , respectively). Baseline white blood cell (WBC) count, erythrocyte sedimentation rate (ESR), and C-reactive protein (CRP) were significantly higher in nonsurvivors ( p < 0.001 ). Patients with higher WBC and CRP levels were more likely to be admitted to ICU ( p = 0.009 and p = 0.001 , respectively). Evaluating clinical and laboratory features can help clinicians find ways for risk stratifying patients and even make predictive tools. Chest pain, decreased level of consciousness, dyspnea, and increased CRP and WBC levels seem to be the most potent predictors of severe prognosis.


2021 ◽  
Vol 47 (1) ◽  
Author(s):  
Isabella Tarissi De Jacobis ◽  
Rosa Vona ◽  
Camilla Cittadini ◽  
Alessandra Marchesi ◽  
Laura Cursi ◽  
...  

Abstract Background Since December 2019 coronavirus disease (COVID-19) emerged in Wuhan and spread rapidly worldwide. Despite the high number of people affected, data on clinical features and prognostic factors in children and adolescents are limited. We propose a retrospective study aimed to evaluate clinical characteristics of children infected with SARS-CoV-2 in Italy. Methods A pediatric population admitted with COVID-19 to Bambino Gesù Children’s Hospital of Rome (Italy) in the period from the end of February to July 2020 has been studied. Medical history, comorbidities, symptoms and laboratory findings were obtained from patients’ electronic medical records. Results In 66 patients (35 males and 31 females) we found that: i) fever and cough were the dominant symptoms, while vomit and convulsions were rare symptoms; and ii) all ages of childhood were susceptible to COVID-19. Furthermore, we found that, compared to females, males with COVID-19, although not significantly, had higher values of inflammatory markers such as C-reactive protein (CRP) and ESR. Conversely, we found that COVID-19 positive females were older than males and required more days of hospitalization. Both males and females COVID-19 positives had procalcitonin values within the normal range and D-Dimer values slightly higher than the normal range. With regard to this latter marker, the value measured in females, although not significant, was higher than that measured in males. Interestingly, the presence of leukopenia was found in both sexes. Conclusions Compared to the adults we found that COVID-19 infection in children is a non-severe inflammatory disease in both males and females. In any case, many detailed studies should be conducted.


2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Anna Maria Cattelan ◽  
Eugenia Di Meco ◽  
Marco Trevenzoli ◽  
Alessia Frater ◽  
Anna Ferrari ◽  
...  

Abstract Background Identifying risk factors for severe novel-coronavirus disease (COVID-19) is useful to ascertain which patients may benefit from advanced supportive care. The study offers a description of COVID-19 patients, admitted to a general ward for a non-critical clinical picture, with the aim to analyse the differences between those transferred to the intensive (ICU) and/or sub-intensive care (SICU) units and those who were not. Methods This observational retrospective study includes all COVID-19 patients admitted to the Infectious Diseases Unit. Clinical, laboratory, radiological and treatment data were collected. The primary outcome was a composite of need of transfer to the ICU and/or SICU during the hospitalization. Patients who did not require to be transferred are defined as Group 1; patients who were transferred to the ICU and/or SICU are defined as Group 2. Demographic, clinical characteristics and laboratory findings at the 1st, 3rd and last measurements were compared between the two groups. Results 303 were included. The median age was 62 years. 69 patients (22.8%) met the primary outcome and were defined as Group 2. The overall fatality rate was 6.8%. Group 2 patients were predominantly male (76.8% vs. 55.1%, p < 0.01), had a higher fatality rate (14.5% vs. 3.8%, p < 0,01), had more hypertension (72.4% vs. 44%, p < 0,01) and diabetes (31.9% vs. 21%, p = 0.04) and were more likely to present dry cough (49.3% vs. 25.2%, p < 0.01). Overall, chest X-ray at admission showed findings suggestive of pneumonia in 63.2%, and Group 2 were more likely to develop pathological findings during the hospitalization (72.7% vs. 17.2%, p = 0.01). At admission, Group 2 presented significantly higher neutrophil count, aspartate-transaminase and C-Reactive-Protein. At the 3rd measurement, Group 2 presented persistently higher neutrophil count, hepatic inflammation markers and C-Reactive-Protein. Group 1 presented a shorter duration from admission to negativization of follow-up swabs (20 vs. 35 days, p < 0.01). Conclusions The presence of comorbidities and the persistent observation of abnormal laboratory findings should be regarded as predisposing factors for clinical worsening.


2020 ◽  
Author(s):  
Wen Luo ◽  
Yihua Lin ◽  
Xiangyang Yao ◽  
Yonghong Shi ◽  
Fang Lu ◽  
...  

Abstract Objective: We sought to investigate the clinical characteristics of patients with novel coronavirus pneumonia in Xiamen, which is a city in Fujian Province, China. Methods: From January 20, 2020, to March 4, 2020, the clinical characteristics of all patients confirmed with novel coronavirus pneumonia admitted to the First Affiliated Hospital of Xiamen University, which was the only designated hospital for cases of novel coronavirus pneumonia in Xiamen, were analyzed. Results: A total of 35 cases of novel coronavirus pneumonia were confirmed. Patients were divided into the general-ward admission group and the intensive-care-unit (ICU) admission group. The most commonly observed symptoms were fever (80%), cough (51%), expectoration (28%), and fatigue (23%). Compared with patients in the general-ward group, patients in the ICU group had a higher maximum body temperature, a longer duration of fever after admission, and more symptoms of systemic pain. Considering the laboratory findings, patients in the ICU group exhibited lower peripheral blood lymphocyte ratios and lymphocyte counts but higher C-reactive protein and lactate dehydrogenase levels. All patients were discharged without death, and no patients required invasive ventilation, continuous renal replacement therapy, or extracorporeal membrane oxygenation. Conclusion: Relative to patients with novel coronavirus pneumonia in Wuhan, the cases in Xiamen were less severe.


2020 ◽  
Vol 148 ◽  
Author(s):  
Puyu Shi ◽  
Guoxia Ren ◽  
Jun Yang ◽  
Zhiqiang Li ◽  
Shujiao Deng ◽  
...  

Abstract The mortality of coronavirus disease 2019 (COVID-19) differs between countries and regions. This study aimed to clarify the clinical characteristics of imported and second-generation cases in Shaanxi. This study included 134 COVID-19 cases in Shaanxi outside Wuhan. Clinical data were compared between severe and non-severe cases. We further profiled the dynamic laboratory findings of some patients. In total, 34.3% of the 134 patients were severe cases, 11.2% had complications. As of 7 March 2020, 91.8% patients were discharged and one patient (0.7%) died. Age, lymphocyte count, C-reactive protein, erythrocyte sedimentation rate, direct bilirubin, lactate dehydrogenase and hydroxybutyrate dehydrogenase showed difference between severe and no-severe cases (all P < 0.05). Baseline lymphocyte count was higher in survived patients than in non-survivor case, and it increased as the condition improved, but declined sharply when death occurred. The interleukin-6 (IL-6) level displayed a downtrend in survivors, but rose very high in the death case. Pulmonary fibrosis was found on later chest computed tomography images in 51.5% of the pneumonia cases. Imported and second-generation cases outside Wuhan had a better prognosis than initial cases in Wuhan. Lymphocyte count and IL-6 level could be used for evaluating prognosis. Pulmonary fibrosis as the sequelae of COVID-19 should be taken into account.


2020 ◽  
Vol 5 (3) ◽  
pp. 279-284 ◽  
Author(s):  
Yanan Li ◽  
Man Li ◽  
Mengdie Wang ◽  
Yifan Zhou ◽  
Jiang Chang ◽  
...  

Background and purposeCOVID-19 is an infectious disease caused by Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2). Apart from respiratory complications, acute cerebrovascular disease (CVD) has been observed in some patients with COVID-19. Therefore, we described the clinical characteristics, laboratory features, treatment and outcomes of CVD complicating SARS-CoV-2 infection.Materials and methodsDemographic and clinical characteristics, laboratory findings, treatments and clinical outcomes were collected and analysed. Clinical characteristics and laboratory findings of patients with COVID-19 with or without new-onset CVD were compared.ResultsOf 219 patients with COVID-19, 10 (4.6%) developed acute ischaemic stroke and 1 (0.5%) had intracerebral haemorrhage. COVID-19 with new onset of CVD were significantly older (75.7±10.8 years vs 52.1±15.3 years, p<0.001), more likely to present with severe COVID-19 (81.8% vs 39.9%, p<0.01) and were more likely to have cardiovascular risk factors, including hypertension, diabetes and medical history of CVD (all p<0.05). In addition, they were more likely to have increased inflammatory response and hypercoagulable state as reflected in C reactive protein (51.1 (1.3–127.9) vs 12.1 (0.1–212.0) mg/L, p<0.05) and D-dimer (6.9 (0.3–20.0) vs 0.5 (0.1–20.0) mg/L, p<0.001). Of 10 patients with ischemic stroke; 6 received antiplatelet treatment with aspirin or clopidogrel; and 3 of them died. The other four patients received anticoagulant treatment with enoxaparin and 2 of them died. As of 24 March 2020, six patients with CVD died (54.5%).ConclusionAcute CVD is not uncommon in COVID-19. Our findings suggest that older patients with risk factors are more likely to develop CVD. The development of CVD is an important negative prognostic factor which requires further study to identify optimal management strategy to combat the COVID-19 outbreak.


Author(s):  
Antoni Sisó-Almirall ◽  
Belchin Kostov ◽  
Minerva Mas-Heredia ◽  
Sergi Vilanova-Rotllan ◽  
Ethel Sequeira-Aymar ◽  
...  

ABSTRACTBackgroundIn addition to the lack of COVID-19 diagnostic tests for the whole Spanish population, the current strategy is to identify the disease early to limit contagion in the community.AimTo determine clinical factors of a poor prognosis in patients with COVID-19 infection.Design and SettingDescriptive, observational, retrospective study in three primary healthcare centres with an assigned population of 100,000.MethodExamination of the medical records of patients with COVID-19 infections confirmed by polymerase chain reaction.ResultsWe included 322 patients (mean age 56.7 years, 50% female, 115 (35.7%) aged ≥ 65 years). The best predictors of ICU admission or death were greater age, male sex (OR=2.99; 95%CI=1.55 to 6.01), fever (OR=2.18; 95%CI=1.06 to 4.80), dyspnoea(OR=2.22; 95%CI=1.14 to 4.24), low oxygen saturation (OR=2.94; 95%CI=1.34 to 6.42), auscultatory alterations (OR=2.21; 95%CI=1.00 to 5.29), heart disease (OR=4.37; 95%CI=1.68 to 11.13), autoimmune disease (OR=4.03; 95%CI=1.41 to 11.10), diabetes (OR=4.00; 95%CI=1.89 to 8.36), hypertension (OR=3.92; 95%CI=2.07 to 7.53), bilateral pulmonary infiltrates (OR=3.56; 95%CI=1.70 to 7.96), elevated lactate-dehydrogenase (OR=3.02; 95%CI=1.30 to 7.68), elevated C-reactive protein (OR=2.94; 95%CI=1.47 to 5.97), elevated D-dimer (OR=2.66; 95%CI=1.15 to 6.51) and low platelet count (OR=2.41; 95%CI=1.12 to 5.14). Myalgia or artralgia (OR=0.28; 95%CI=0.10 to 0.66), dysgeusia (OR=0.28; 95%CI=0.05 to 0.92) and anosmia (OR=0.23; 95%CI=0.04 to 0.75) were protective factors.ConclusionDetermining the clinical, biological and radiological characteristics of patients with suspected COVID-19 infection will be key to early treatment and isolation and the tracing of contacts.


2020 ◽  
Author(s):  
Elisabetta Straface ◽  
Isabella Tarissi De Jacobis ◽  
Rosa Vona ◽  
Camilla Cittadini ◽  
Alessandra Marchesi ◽  
...  

Abstract Background: Since December 2019 coronavirus disease (COVID-19) emerged in Wuhan and spread rapidly worldwide. Despite the high number of people affected, data on clinical features and prognostic factors in children and adolescents are limited. We propose a retrospective study aimed to evaluate clinical characteristics of children infected with SARS-CoV-2 in Italy, taking into account gender differences. Methods: A pediatric population admitted with COVID-19 to Bambino Gesù Children's Hospital of Rome (Italy) in the period from the end of February to May 2020 has been studied taking into account sex differences. Medical history, comorbidities, symptoms and laboratory findings were obtained from patients' electronic medical records. Results: In 41 patients (21 males and 20 females) we found that: i) fever and cough were the dominant symptoms, while gastrointestinal symptoms were rare; and ii) all ages of childhood were susceptible to COVID-19. Moreover, we found that females with COVID-19, although not significantly, were older than males and required more days of hospitalization (p = 0.01). Conversely, males had, although not significantly, higher values of C reactive protein and erythrocyte sedimentation rate than females. Conclusions: Based on the data listed above, sex differences were detected in an Italian pediatric COVID-19 positive population. Compared to the adults we found that COVID-19 infection in children is a non-severe inflammatory disease in both males and females. In any case, many detailed studies should be conducted.


2020 ◽  
Author(s):  
Rui Zhang ◽  
Jie Zhang ◽  
Weining Chen ◽  
Xiaolin Li ◽  
Jiebing Chen

Abstract Background: The coronavirus disease 2019 (COVID-19) pandemic has spread worldwide. As of October 27th, 2020, the number of worldwide laboratory-confirmed cases had reached 43,340,710, with 1,157,496 deaths. We sought to analyze the clinical characteristics, laboratory findings and therapy for a set of COVID-19 cases.Methods: For this retrospective study, we extracted data for 134 patients with laboratory-confirmed COVID-19 at our hospital from January 16th to April 24th, 2020. Cases were confirmed by real-time RT-PCR and abnormal radiologic findings. Outcomes were followed up until May 1st, 2020.Results: An outcome of death or severe COVID-19 was more likely to occur with coinfection and severe underlying diseases. Age above 60 years old, male sex and symptoms such as fever, cough, chest tightness, headaches and fatigue were also related to severe COVID-19 and an outcome of death. In addition, high temperature, high blood leukocyte and neutrophil counts, C-reactive protein and D-dimer levels, and alanine aminotransferase, aspartate aminotransferase, α-hydroxybutyrate dehydrogenase, lactate dehydrogenase and creatine kinase activities were related to severe COVID-19 and an outcome of death, as was a low lymphocyte count. The administration of gamma globulin appeared to be helpful for reducing mortality in patients with severe COVID-19; however, as the P value was greater than 0.05 (P=0.180), studies of the same conditions with larger samples are needed.Conclusion: Multiple factors are related to severe COVID-19 and an outcome of death. The administration of gamma globulin seemed to be helpful for reducing mortality in severe cases. More related studies are needed in the future.Clinical trial registrationNot applicable


2020 ◽  
Author(s):  
Zheying Tao ◽  
Mingyu Liu ◽  
Jingyi Wu ◽  
Jing Xu ◽  
Wei Chen ◽  
...  

Abstract Background and objective:Anaemia commonly aggravates the severity of respiratory diseases, whereas thus far, no study has elucidated the impact of anaemiaonCorona Virus Disease 2019(COVID-19). The aim of this study was to evaluate the clinical characteristics of patients with anaemia, and to further explore the relationship between anaemiaand the severity of COVID-19.METHODS:In this single-center, retrospective, observational study, a total of 222 patients were recruited, including 79 patients with anaemia and 143 patients without anaemia. Clinical characteristics, laboratory findings, disease progression and prognosis were collected and analyzed. Risk factors associated with the severe illness in COVID-19were established by univariable and multivariable logistic regression models.Result:In our cohort, compared to patients without anaemia, patients with anaemia were more likely to experience one or more comorbidities and severe COVID-19 illness, as well as higher mortality. More patients demonstrated elevated levels of C-reactive protein (CRP), procalcitonin(PCT) and creatinine in anaemia group. Levels of erythrocyte sedimentation rate(ESR), D-dimer, myoglobin, T-pro brain natriuretic peptide(T-pro-BNP) and urea nitrogen(BUN)in patients with anaemia were significantly higher than those without. In addition,the proportion of patients with dyspnoea,elevated CRP and PCT was positively associated with the severity of anaemia. The Odd Ratio (OR) of anaemia related to the severe condition of COVID-19 was 5.07 (95% CI:1.82-14.18, P=0.002) and 3.47 (95% CI:1.02-11.75, P=0.046) after adjustment for baseline date and laboratory indices, respectively.Conclusion:Anaemia is an independent risk factor associated with the severe illness of COVID-19, and healthcare professionals should be more sensitive to the haemoglobin levels of COVID-19 patients on admission. To avoid rapid deterioration, more intensive care should be given to patients with anaemia.Trial registration: Ethics committee of Wuhan University People's Hospital (wdry2020-k064)


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