COVID-19 cases from the first local outbreak of SARS-CoV-2 B.1.1.7 variant in China presented more serious clinical features: a prospective, comparative cohort study

Background: The SARS-CoV-2 B.1.1.7 variant which was first identified in the United Kingdom (U.K.) has increased sharply in numbers worldwide and was reported to be more contagious. On January 17, 2021, a COVID-19 clustered outbreak caused by B.1.1.7 variant occurred in a community in Daxing District, Beijing, China. Three weeks prior, another non-variant (lineage B.1.470) COVID-19 outbreak occurred in Shunyi District, Beijing. This study aimed to investigate the clinical features of B.1.1.7 variant infection. Methods: A prospective cohort study was conducted on COVID-19 cases admitted to Ditan hospital since January 2020. Data of 74 COVID-19 cases from two independent COVID-19 outbreaks in Beijing were extracted as study subjects from a Cloud Database established in Ditan hospital, which included 41 Shunyi cases (Shunyi B.1.470 group) and 33 Daxing cases (Daxing B.1.1.7 group) that have been hospitalized since December 25, 2020 and January 17, 2021, respectively. We conducted a comparison of the clinical characteristics, RT-qPCR results and genomic features between the two groups. Findings: Cases from Daxing B.1.1.7 group (15 [45.5%] male; median age, 39 years [range, 30.5, 62.5]) and cases from Shunyi B.1.470 group (25 [61.0%] male; median age, 31 years [range, 27.5, 41.0]) had a statistically significant difference in median age (P =0.014). Seven clinical indicators of Daxing B.1.1.7 group were significantly higher than Shunyi B.1.470 group including patients having fever over 38℃ (14/33 [46.43%] in Daxing B.1.1.7 group vs. 9/41 (21.95%) in Shunyi B.1.470 group [P = 0 .015]), C-reactive protein ([CRP, mg/L], 4.30 [2.45, 12.1] vs. 1.80, [0.85, 4.95], [P = 0.005]), Serum amyloid A ([SAA, mg/L], 21.50 [12.50, 50.70] vs. 12.00 [5.20, 26.95], [P = 0.003]), Creatine Kinase ([CK, U/L]), 110.50 [53.15,152.40] vs. 70.40 [54.35,103.05], [P = 0.040]), D-dimer ([DD, mg/L], 0.31 [0.20, 0.48] vs. 0.24 [0.17,0.31], [P = 0.038]), CD4+ T lymphocyte ([CD4+ T, mg/L], [P = 0.003]) , and Ground-glass opacity (GGO) in lung (15/33 [45.45%] vs. 5/41 [12.20%], [P =0.001]). After adjusting for the age factor, B.1.1.7 variant infection was the risk factor for CRP (P = 0.045, Odds ratio [OR] 2.791, CI [1.025, 0.8610]), SAA (0.011, 5.031, [1.459, 17.354]), CK (0.034, 4.34, [0.05, 0.91]), CD4+ T ( 0.029, 3.31, [1.13, 9.71]), and GGO (0.005, 5.418, [1.656, 17.729]) of patients. The median Ct value of RT-qPCR tests of the N-gene target in the Daxing B.1.1.7 group was significantly lower than the Shunyi B.1.470 group (P=0.036). The phylogenetic analysis showed that only 2 amino acid mutations in spike protein were detected in B.1.470 strains while B.1.1.7 strains had 3 deletions and 7 mutations. Interpretation: Clinical features including a more serious inflammatory response, pneumonia and a possible higher viral load were detected in the cases infected with B.1.1.7 SARS-CoV-2 variant. It could therefore be inferred that the B.1.1.7 variant may have increased pathogenicity.

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Comparison of lipid and non-lipid markers of atherosclerosis in arterial versus venous blood

Annals of Clinical Biochemistry International Journal of Laboratory Medicine ◽

10.1258/000456303321610637 ◽

2003 ◽

Vol 40 (3) ◽

pp. 286-288 ◽

Cited By ~ 2

Author(s):

Bruce Palmer ◽

Linley E Watson ◽

Mark W Riggs ◽

Mark Lawrence ◽

Clinton E Baisden ◽

...

Keyword(s):

Particle Density ◽

Venous Blood ◽

Hdl Cholesterol ◽

High Sensitivity ◽

Heart Catheterization ◽

Blood Concentrations ◽

Reactive Protein ◽

Amyloid A ◽

Left Heart Catheterization ◽

Significant Difference

Background: Early studies have suggested that there may be differences in the concentration of lipoprotein particles and their associated apolipoproteins in arterial and venous blood and that this gradient might explain a proclivity to develop atherosclerotic lesions. The aim of this study was to use current methods of analysis to determine levels of these components, including particle densities and several common inflammatory markers in arterial and venous blood. Methods: Samples of arterial and venous blood were obtained nearly simultaneously in 26 patients undergoing right and left heart catheterization. Analyses were performed using enzymatic, immunoturbidimetric and ultracentrifugation assays. Results: Data obtained for total cholesterol, triglyceride, HDL-cholesterol, LDL-cholesterol, HDL and LDL particle density, high sensitivity C-reactive protein, serum amyloid-A and apoprotein B-100 concentrations in arterial and venous blood did not demonstrate any significant difference in the means. Conclusion: Arterial and venous blood can be used interchangeably to study the effect of blood concentrations of common soluble surrogate markers of atherosclerosis.

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Clinical Characteristics and outcomes in HBV carriers with COVID-19 in WuHan, China: a retrospective cohort study

10.21203/rs.3.rs-42476/v1 ◽

2020 ◽

Author(s):

Jingjing Lu ◽

Mu Hu ◽

Xia Zhou ◽

Hui Zhu ◽

Feilong Wang ◽

...

Keyword(s):

Cohort Study ◽

Laboratory Test ◽

Clinical Features ◽

Retrospective Cohort Study ◽

Retrospective Cohort ◽

Chest Tightness ◽

Amyloid A ◽

Laboratory Test Results ◽

Glutamyl Transferase ◽

Epidemiological Characteristics

Abstract Background: Coronavirus 2019 (COVID-19) is a novel infectious disease that was first reported in Wuhan, China, but has spread to all parts of the world. At the same time, because China has millions of HBV carriers, HBV infection has become a major public health problem in China. In this study, we aim to describe the clinical features of HBV carriers (AsC) infected with COVID-19 and to assess the factors that may affect the outcome during disease progression.Methods: This retrospective cohort study included 72 patients diagnosed with COVID-19 in Wuhan Jinyintan Hospital. These patients were also diagnosed as HBV carriers. The epidemiological characteristics, demographic features, clinical manifestations, laboratory test, treatment, management and final outcome were collected and analyzed.Results: The median age of 72 patients is 58.5 years old, of which 55.56% (n=40) are male. 20 (30.56%) patients were severe cases and 50 (69.44%) were non-severe cases. Fever is the most common symptom, followed by cough, chest tightness and sputum. Laboratory test results including hematologic, biochemical, infection and coagulation parameters and several indicators, such as Aspartate Aminotransferase (AST), Total Bilirubin (TBil), Direct Bilirubin (DBil), Indirect Bilirubin (IBil), γ-glutamyl Transferase (GGT) showed difference between their admission and discharge. The level of Prealbumin (PA) and Serum Amyloid A (SAA) in the study showed a significant trend from high to low, which has statistical significance.Conclusions: The clinical features of HBV carriers with COVID-19 have obvious systemic symptoms, such as fever, cough, and chest tightness. Compared with liver function data on admission and discharge, SARS-CoV-2 does not directly activate the Hepatitis B virus, and the risk of liver cell damage of HBV carriers with COVID-19 does not increase. Both PA and SAA are sensitive indicators and can be used to evaluate the prognosis and outcome of these patients.

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Epidemiological and clinical characteristics of COVID-19 patients in Nanjing

10.21203/rs.3.rs-18007/v1 ◽

2020 ◽

Author(s):

Wei Chen ◽

Chunmei Hu ◽

Lili Huang ◽

Min Cai ◽

Yongchen Zhang ◽

...

Keyword(s):

Ground Glass Opacity ◽

Medical Professional ◽

Central China ◽

Reactive Protein ◽

Family Cluster ◽

Significant Difference ◽

Imported Cases ◽

Severe Group ◽

The Difference ◽

Underlying Diseases

Abstract Background: Since December 2019, the outbreak of COVID-19 has spread quickly and thumped many countries and regions. The epidemic of central China was under the spotlight and attracted much more attentions. However, there are few reports describing COVID-19 patients in the regions outside of Wuhan, which are undergoing the change from sporadic imported cases to community-acquired transmission.Methods: The electronic medical records of 74 laboratory-confirmed patients of COVID-19 were retrospectively reviewed and analyzed. Their epidemiological, demographic, clinical and radiological characteristics were systematically summarized. The difference between severe patients and non-severe patients were also analyzed statistically.Results: The 74 COVID-19 patients were composed of 4 (5.4%) mild patients, 56 (75.7%) common patients, 13 (17.6%) severe patients and 1 (1.4%) critical patient. 43 were male, and 31 were female, with the average age 48.1±17.5. No significant difference of susceptibility was observed between genders, and almost people with all age were susceptible to SARS-CoV-2 infection. Before Jan 26, only imported sporadic cases were observed. However, from that day onward, family cluster infection cases increased dramatically, up to 70.3% (52/74), which were mainly from 15 family. The incubation period spanned from 0 to 19 days, with the median 5, and 81.4% had symptom onset within 7 days. At admission, 31.1% of patients had underlying diseases and the most common underlying diseases were hypertension (13.5%) and diabetes (5.4%). The most common symptoms were fever (90.5%), cough (75.7%), fatigue (36.5%) and chest distress (32.4%). 36.5% and 16.2% of patients had leukopenia and lymphocytopenia. 43.2% of patients had increased C reactive protein (CRP), and 40.5% had higher erythrocyte sedimentation rate (ESR) and 21.6% had higher calcitonin. 74.3% of patients had obvious lesions in both lung lobes and 56.8% of lesions manifested as ground glass opacity. Compared with non-severe group, the severe/critical group were significantly older and had more underlying diseases. After treatment, all patients improved and were discharged. No medical professional infection and death case were reported.Conclusion: The epidemic of COVID-19 in Nanjing were mainly caused by family cluster infection. The entire prevalence and illness were much milder than those of Wuhan. The disease of COVID-19 could be controlled and cured.

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Comparison of Clinical Features Between Patients with Positive and Negative Appendectomy

10.21203/rs.3.rs-46787/v1 ◽

2020 ◽

Author(s):

Guner Cakmak ◽

Kayhan Ozdemir

Keyword(s):

Acute Appendicitis ◽

Clinical Features ◽

Total Bilirubin ◽

Negative Appendectomy ◽

C Reactive Protein ◽

Future Studies ◽

Reactive Protein ◽

Significant Difference ◽

Laboratory Investigations ◽

The Mean

Abstract Objective: The objective of this study was to retrospectively compare clinical features and prognostic values between the patients who were referred to the general surgery clinic of our hospital with the presumed diagnosis of acute appendicitis and underwent positive or negative appendectomy.Methods: Patients were divided into two groups as positive (PA) (n:425) and negative appendectomy (NA) (n:425) and the data obtained were compared between these two groups. Laboratory investigations were performed in all patients, and white blood cell (WBC), mean platelet volume (MPV), neutrophils count (NEU), neutrophils (%) (NEU%), C-reactive protein (CRP) and total bilirubin (TBIL) values were studied. Results: The mean MPV value was found as 7.66 in PA groups and 7.90 in NA group, and the mean MPV value was statistically significantly lower in PA group, compared to NA groups (p=0.034). The mean TBIL value was 0.75 in PA group and 0.90 in NA group, and the mean TBIL value was statistically significantly lower in PA group (p=0.034).There was no statistically significant difference between the two groups in terms of the other studied laboratory parameters (for all p>0.05).Conclusion: The mean MPV and TBIL values can be used as specific biomarkers in predicting positive acute appendicitis. We believe that these results will contribute to the literature and will be guiding for future studies.

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COVIDTrach; a prospective cohort study of mechanically ventilated COVID-19 patients undergoing tracheostomy in the UK

10.1101/2020.10.20.20216085 ◽

2020 ◽

Author(s):

◽

NJI Hamilton ◽

AGM Schilder ◽

T Jacob ◽

G Ambler ◽

...

Keyword(s):

Mechanical Ventilation ◽

Cohort Study ◽

Prospective Cohort Study ◽

Prospective Cohort ◽

Clinical Indicators ◽

Mechanically Ventilated ◽

Reactive Protein ◽

Link Type ◽

Multivariable Regression ◽

The Uk

AbstractPurposeCOVIDTrach is a UK multi-centre prospective cohort study project evaluating the outcomes of tracheostomy in patients with COVID-19 receiving mechanical ventilation. It also examines the incidence of SARS-CoV-2 infection among healthcare workers involved in the procedure.MethodAn invitation to participate was sent to all UK NHS departments involved in tracheostomy in COVID-19 patients. Data was entered prospectively and clinical outcomes updated via an online database (REDCap). Clinical variables were compared with outcomes using multivariable regression analysis, with logistic regression used to develop a prediction model for mortality. Participants recorded whether any operators tested positive for SARS-CoV-2 within two weeks of the procedure.ResultsThe cohort comprised 1605 tracheostomy cases from 126 UK hospitals. The median time from intubation to tracheostomy was 15 days (IQR 11, 21). 285 (18%) patients died following the procedure. 1229 (93%) of the survivors had been successfully weaned from mechanical ventilation at censoring and 1049 (81%) had been discharged from hospital. Age, inspired oxygen concentration, PEEP setting, pyrexia, number of days of ventilation before tracheostomy, C-reactive protein and the use of anticoagulation and inotropic support independently predicted mortality. Six reports were received of operators testing positive for SARS-CoV-2 within two weeks of the procedure.ConclusionsTracheostomy appears to be safe in mechanically ventilated patients with COVID-19 and to operators performing the procedure and we identified clinical indicators that are predictive of mortality.FundingThe COVIDTrach project is supported by the Wellcome Trust UCL COVID-19 Rapid Response Award and the National Institute for Health Research.Trial registrationThe study is registered with ClinicalTrials.Gov (NCT04572438).

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Abstract 124: HDL Particles and HDL Functions

Arteriosclerosis Thrombosis and Vascular Biology ◽

10.1161/atvb.35.suppl_1.124 ◽

2015 ◽

Vol 35 (suppl_1) ◽

Author(s):

Bela F Asztalos ◽

Katalin V Horvath ◽

Allison Goldfine ◽

Ernst J Schaefer

Keyword(s):

Cholesterol Efflux ◽

Cvd Risk ◽

Inflammatory Index ◽

Reactive Protein ◽

Amyloid A ◽

Markers Of Inflammation ◽

Significant Difference ◽

Low Hdl ◽

Highly Correlated

Introduction: The role of HDL in CVD risk is not fully understood. Hypothesis: We tested the hypothesis that HDL functions are significantly associated with HDL subpopulation profile. Methods: Lipoproteins, including apoA-I-containing HDL particles, cell-cholesterol efflux (Global, ABCA1- and SRB1-mediated) and HDL Inflammatory Index were measured in a total of 289 subjects. These included 60 CHD patients, 109 subjects with either abnormal lipids (high triglycerides/low HDL or elevated β-sitosterol) or increased levels of the inflammatory markers C-reactive protein (CRP), serum amyloid A (SAA), fibrinogen, or myeloperoxidase (MPO), as well as 120 controls. Results: Global efflux was highly correlated with ABCA1-mediated efflux (r=0.921). Cholesterol efflux via the ABCA1 pathway was significantly correlated with small prebeta-1 HDL particles (r=0.762). CHD patients had significantly higher preβ-1 level than controls; however, per-particle prebeta-1 HDL effluxed 41% less cholesterol in CHD patients as compared to controls, resulting in no significant difference in overall efflux capacity between cases and controls. Cholesterol efflux via the SRB1 pathway was significantly correlated with large α-1 (r=0.784) and α-2 (r=0.460) HDL particles. These two large HDL particles effluxed about 82% of cell cholesterol via the SRB1 pathway. There was no significant difference in SRB1-mediated cholesterol efflux between CHD cases and controls. The HDL Inflammatory Index (HII) was significantly higher (unfavorable) in CHD cases than in controls and was significantly (inversely) associated with α-2 HDL particles (r=454). Increased levels of β-sitosterol significantly altered the HDL subpopulation profile and increased HII. Moreover, HII was not correlated with the concentrations of CRP, SAA, fibrinogen and MPO. Conclusion: HDL subpopulation profile is a major determinant of HDL’s overall cholesterol-efflux capacity. Efflux capacity of preβ-1 particles are compromised in CHD patients by yet unknown factor(s). HDL Inflammatory Index correlates with HDL subpopulation profile, but not with markers of inflammation in plasma.

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Accuracy of C-reactive protein, procalcitonin, serum amyloid A and neopterin for low-dose CT-scan confirmed pneumonia in elderly patients: A prospective cohort study

PLoS ONE ◽

10.1371/journal.pone.0239606 ◽

2020 ◽

Vol 15 (9) ◽

pp. e0239606

Author(s):

Virginie Prendki ◽

Astrid Malézieux-Picard ◽

Leire Azurmendi ◽

Jean-Charles Sanchez ◽

Nicolas Vuilleumier ◽

...

Keyword(s):

Cohort Study ◽

Elderly Patients ◽

Ct Scan ◽

Prospective Cohort Study ◽

Prospective Cohort ◽

Serum Amyloid A ◽

Low Dose ◽

C Reactive Protein ◽

Reactive Protein ◽

Amyloid A

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Clinical Features and Surgical Treatment of Synchronous Multiple Primary Lung Adenocarcinomas With Different EGFR Mutations

10.21203/rs.3.rs-508833/v1 ◽

2021 ◽

Author(s):

Rirong Qu ◽

Fan Ye ◽

Shaojie Hu ◽

Wei Ping ◽

Yixin Cai ◽

...

Keyword(s):

Clinical Features ◽

Mutation Rate ◽

Surgical Outcomes ◽

Ground Glass Opacity ◽

Egfr Mutations ◽

Driver Gene ◽

Invasive Adenocarcinoma ◽

Significant Difference ◽

Multiple Primary ◽

Lung Adenocarcinomas

Abstract Purpose: We aimed to explore clinical features and surgical outcomes of synchronous multiple primary lung adenocarcinomas (SMPLA) with different EGFR mutations to aid in the diagnosis and treatment of SMPLA.Methods: Medical records of patients with different EGFR mutations who have been diagnosed as SMPLA and underwent surgical resection from March 2015 to December 2019 were retrospectively analyzed. Clinical characteristics, surgical outcomes, recurrence-free survival (RFS) and overall survival (OS) were investigated.Results: A total of 70 patients ( 68.6% female and 77.1% non-somkers) were included. Total of 161 lesions in all patients, 84.4% were ground-glass opacity (GGO) lesions. EGFR mutations were detected in 108 lesions, most of which were L858R (35.4%) and 19Del (20.5%). The mutation rate of mixed GGO is significantly higher than that of pure GGO and solid nodules (SN); the mutation rate of invasive adenocarcinoma is significantly higher than that of other histology subtypes; the mutation rate of lesions >20 mm was significantly higher than that of ≤20 mm. However, there is no significant difference in the mutation rate of specific driver gene between different radiological features, pathological characteristics and sizes. After a median follow-up time of 29 months, the 3-year OS and RFS were 94.4% and 86.0%, respectively.Conclusions: A high discordance of EGFR mutations were identified between tumors in patients with SMPLA. Synchronous multiple lung adenocarcinomas with predominantly multiple GGO should be considered as SMPLA, and surgery may be aggressively performed for these patients due to a good prognosis.

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Analysis of Lung Ground-glass Nodules From the Perspective of Inflammation-to-cancer Transition Based on Il-6 Level and Clinical Features

10.21203/rs.3.rs-751180/v1 ◽

2021 ◽

Author(s):

Changxing Shen ◽

Qing Xia ◽

Zhuang Li ◽

Jing Wen ◽

Hong Zhai ◽

...

Keyword(s):

Malignant Transformation ◽

Tumor Markers ◽

Clinical Features ◽

Sleep Disturbances ◽

Ground Glass Opacity ◽

T Cell Subsets ◽

Ground Glass ◽

Coronary Stent Implantation ◽

Significant Difference ◽

Ground Glass Nodules

Abstract Objective：To explore the potential impact of interleukin-6 (IL-6) in promoting the development and progression of lung ground-glass nodules (GGN) based on multiple clinical features using multi-dimensional analysis (MDA). Methods: Sample collected from data taken from patients with lung GGN who received treatment in Shanghai Tenth People's Hospital, between September 2018 and September 2020. Sample data were grouped according to GGN diameter as well as IL-6 levels and screened according to the solitary GGN (d<0.8cm) after more than one year of follow-up observation. Differences in associated complications, peripheral superoxide dismutase (SOD), IgE and T cell subsets, tumor markers, and CT malignant signs were compared between the two sample groups. Results：A total of 145 patients was included in the study. From the results, the diameter of GGN was ≥5mm in 95 patients and <5mm in 50 patients. There were significant differences in peripheral IL-6 levels between the two groups (p<0.05). Whereas the IL-6 level was elevated in 53 patients, the levels were normal in 92 patients. There was a corresponding significant increase in complications such as anxiety, sleep disturbances, feeling of fatigue, and history of coronary stent implantation in the group of GGN patients with elevated levels of IL-6, when compared to the group with the normal IL-6 levels (p<0.05). Peripheral SOD and IgE levels were observed to be significantly higher in the group with elevated IL-6 levels than seen in the group with normal IL-6 levels (p<0.05). In addition, there was also a significant difference in T helper (Th) and T suppressor (Ts) cell levels between the two groups (p<0.05). Levels of tumor markers such as NSE and CY21-1 were also found to be elevated in the group with elevated IL-6 levels than in the group with normal IL-6 levels (p<0.05). Finally, the group with elevated Il-6 levels was observed to have a higher proportion of patients with vascular convergence sign (VCS) and mixed ground-glass opacity (mGGO) as compared to the sample with normal IL-6 levels (p<0.05). Conclusion: Chronic inflammation is an important factor in the malignant transformation of GGN. IL-6 plays a significant role in promoting the formation of early lung cancer through multiple pathways, including mediating imbalance of the human mitochondrial antioxidant system and reactive elevation of IgE, inhibiting the anti-tumor immune function of T cells, and promoting tumor tissue angiogenesis. The probability of malignant transformation is even higher in lung GGN accompanied with IL-6 elevation.

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Epidemiologic and clinical characteristics of 3334 cases with pre-diagnosis coronavirus disease - 2019 (COVID-19) in Turkey

10.22541/au.161219182.26365222/v1 ◽

2021 ◽

Author(s):

Nur Simsek Yurt ◽

Metin Ocak ◽

Yusuf Can Yurt

Keyword(s):

Mortality Rate ◽

Clinical Features ◽

Age Groups ◽

Rt Pcr ◽

Laboratory Findings ◽

Reactive Protein ◽

Significant Difference ◽

Patient Groups ◽

Post Hoc

Introduction: As COVID-19 disease has rapidly spread across the world, its impact has grown with increasing number of cases and mortality rate in Turkey. Aim: The aim of this study is to examine epidemiologic and clinical features of the patients that admitted to the hospital with the pre-diagnosis of coronavirus disease-2019 (COVID-19) in Turkey. Method: In this retrospective study, epidemiologic and clinical features, laboratory findings, radiologic features, therapeutic approaches and survival conditions of the patients with the pre-diagnosis of COVID-19 from March 11th to June 30th, 2020. The all data of the cases were compared in 4 groups: 1st group for the confirmed cases reverse transcriptase polymerase chain reaction (RT-PCR) +, chest computed tomography (CT) +, 2nd group for the clinically diagnosed cases (RT-PCR- CT +), 3rd group for the mild and asymptomatic cases (RT-PCR + CT-), 4th group for the suspected cases (RT-PCR - CT -). Post-hoc analysis was performed to evaluate the differences among the groups. Results: In total, 3334 patients with the pre-diagnosis of COVID-19 admitted to the emergency department. Based on the post-hoc analyses, significant differences were found among the four groups in terms of their test results of leucocytes, hemoglobin, platelets, neutrophils, urea and C-reactive protein (CRP) (p<0.001). Furthermore, the factors of age groups, hospitalization, intensive care follow-up and mortality rate of the four groups showed a significant difference among the groups (p=0.001). Conclusion: Mean of leucocytes, neutrophile and platelet values of the patients with tested positive for the RT-PCR was found lower compared to the ones with tested negative for the RT-PCR. Mean of CRP values was found higher in patients with lung involvement compared to other patient groups.

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