The first wave of the COVID-19 pandemic in Southern Hungary: Epidemiology, symptoms and signs

Imaging ◽

10.1556/1647.2021.00014 ◽

2021 ◽

Author(s):

Péter Palásti ◽

Ádám Visnyovszki ◽

Sándor Csizmadia ◽

Mária Matúz ◽

Zsanett Szabó ◽

...

Keyword(s):

Clinical Status ◽

The Elderly ◽

Altered Mental Status ◽

Chest Ct ◽

Future Research ◽

Epidemic Curve ◽

Number Of Patients ◽

History Of ◽

Hungarian Population ◽

Novel Coronavirus

AbstractBackgroundIn December 2019, pneumonia caused by coronavirus Disease-19 (COVID-19) occurred in Wuhan, Hubei Province, China. Currently, COVID-19 has spread worldwide. In accordance with the restrictions of the Hungarian Government, several epidemic hospitals and centers have been established in Hungary. The first infected patient was detected on 4th March, 2020 in our country, who was not a Hungarian citizen. The first patient died of pneumonia caused by COVID-19 was on 15th March. The Hungarian epidemic curve is flattened and more prolonged. We aimed to report our computer tomography (CT) findings in correlation with clinical status in patients with COVID-19 infection.Material and methodsAll patients with laboratory-identified Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) infection by real-time polymerase chain reaction (PCR) and who underwent chest CT were collected between March 26, 2020, and April 20, 2020, in our hospital. In our centre we had 107 PCR confirmed COVID-19 positive patients in this period. 52 patient (male: female 1:2, average age: 67.94) were admitted to our central epidemic hospital, according to their complains: fever, dyspnoea, hypoxaemia, altered mental status, comorbidity, sepsis or if patient isolation could not be performed. In case of every patient we took blood test, nasopharyngeal sample and a chest CT without contrast agent. In our CT report we used a score system to characterize the severity.ResultsThe majority of infected patients had a history of exposure in nursing homes and mostly presented with fever and cough. The present study confirmed the findings about results of other researches. The COVID-19 pneumonia affected the elderly patients, caused hypoxia, cough and sepsis. On the CT scan, typical signs were seen in the cases of PCR confirmed patients.ConclusionThe limitations of the present study include the low number of patients. Collectively, our results appear consistent with previous studies. Chest CT examination plays an important role in the diagnosis and estimation of the severity of the novel coronavirus pneumonia. Future research should examine strategically the features of the Hungarian population.

A Comparative Study on the Clinical Features of Coronavirus 2019 (COVID-19) Pneumonia With Other Pneumonias

Clinical Infectious Diseases ◽

10.1093/cid/ciaa247 ◽

2020 ◽

Vol 71 (15) ◽

pp. 756-761 ◽

Cited By ~ 95

Author(s):

Dahai Zhao ◽

Feifei Yao ◽

Lijie Wang ◽

Ling Zheng ◽

Yongjun Gao ◽

...

Keyword(s):

Clinical Features ◽

Clinical Symptoms ◽

Severe Pneumonia ◽

Ground Glass Opacity ◽

Chest Ct ◽

Rt Pcr ◽

Bilateral Involvement ◽

Radiological Features ◽

History Of ◽

Novel Coronavirus

Abstract Background A novel coronavirus (COVID-19) has raised world concern since it emerged in Wuhan, China in December 2019. The infection may result in severe pneumonia with clusters of illness onsets. Its impacts on public health make it paramount to clarify the clinical features with other pneumonias. Methods Nineteen COVID-19 and 15 other patients with pneumonia (non-COVID-19) in areas outside of Hubei were involved in this study. Both COVID-19 and non-COVID-19 patients were confirmed to be infected using throat swabs and/or sputa with/without COVID-2019 by real-time RT-PCR. We analyzed the demographic, epidemiological, clinical, and radiological features from those patients, and compared the differences between COVID-19 and non-COVID-19. Results All patients had a history of exposure to confirmed cases of COVID-19 or travel to Hubei before illness. The median (IQR) duration was 8 (6–11) and 5 (4–11) days from exposure to onset in COVID-19 and non-COVID-19 cases, respectively. The clinical symptoms were similar between COVID-19 and non-COVID-19. The most common symptoms were fever and cough. Fifteen (78.95%) COVID-19 but 4 (26.67%) non-COVID-19 patients had bilateral involvement while 17 COVID-19 patients (89.47%) but 1 non-COVID-19 patient (6.67%) had multiple mottling and ground-glass opacity on chest CT images. Compared with non-COVID-19, COVID-19 presents remarkably more abnormal laboratory tests, including AST, ALT, γ-GT, LDH, and α-HBDH. Conclusions The COVID-19 infection has onsets similar to other pneumonias. CT scan may be a reliable test for screening COVID-19 cases. Liver function damage is more frequent in COVID-19 than non-COVID-19 patients. LDH and α-HBDH may be considerable markers for evaluation of COVID-19.

A false alarm of COVID-19 pneumonia in lung cancer: a case report of anti-PD-1 related pneumonitis and literature review

10.21203/rs.3.rs-41095/v1 ◽

2020 ◽

Author(s):

Ying Dai ◽

Sha Liu ◽

Zhiyan Zhao ◽

...

Keyword(s):

Lung Cancer ◽

Clinical Symptoms ◽

Close Contact ◽

Ct Imaging ◽

Chest Ct ◽

Radiographic Feature ◽

Rt Pcr ◽

Lung Lobe ◽

History Of ◽

Novel Coronavirus

Abstract Background: The fatal toxicity of anti-PD-1/PD-L1 agents is pneumonitis. The diagnosis consists of the history of immunotherapy, clinical symptoms and presentation of computed tomography (CT) imaging. The typical CT findings include ground-glass opacities. Based on the similar radiographic feature with 2019 Novel Coronavirus (COVID-19) pneumonia, clinicians are cautious to evaluate diagnosis especially in COVID-19 epidemic areas. Case presentation: Herein we report a 67-year-old male patient with advanced non-small cell lung cancer developed pneumonitis post Sintilimab injection. The dyspnea appeared at the 15th day of close contact with his son who returned from Wuhan, but not accompanied with fever. The chest CT indicated peripherally subpleural lattice opacities at the inferior right lung lobe and bilateral thoracic infusion. The real-time reverse-transcription polymerase-chain-reaction (RT-PCR) from double swab samples within 72 hours remained negative. The patient was thereafter treated with prednisolone and antibiotics for over two weeks. Thereafter the chest CT demonstrated the former lesion almost absorbed, in line with prominently falling CRP level. The anti-PD-1 related pneumonitis with bacterial infection was diagnosed finally based on the clinical evidence and good response to the prednisolone and antibiotics. Conclusion: Both ani-PD-1 related pneumonitis and COVID-19 pneumonia harbor the common clinical symptom and the varied features of CT imaging. Differential diagnosis was based on the epidemiological and immunotherapy histories, RT-PCR tests. The response to glucocorticoid can indirectly help the diagnosis.

The multicenter study of Chest HRCT imaging characteristics of 2019 Novel Coronavirus (COVID-19) Pneumonia

10.21203/rs.3.rs-20837/v1 ◽

2020 ◽

Author(s):

Zhehao Lyu ◽

Meiji Ren ◽

Lian-Ming Wu ◽

Yuxin Yang ◽

Yi-Bo Lu ◽

...

Keyword(s):

Computed Tomography ◽

Acute Respiratory Distress Syndrome ◽

Distress Syndrome ◽

Chest Ct ◽

Imaging Features ◽

Wholesale Market ◽

High Resolution Computed Tomography ◽

Imaging Characteristics ◽

History Of ◽

Novel Coronavirus

Abstract Background: In December 2019, a cluster of patients with pneumonia of unknown cause was linked to a seafood wholesale market in Wuhan, China. A novel coronavirus was detected, capable of infecting humans, on 6 January 2020 and termed COVID-19. By 16 February 2020, there were 51857 confirmed cases with 2019-nCoV (COVID-19) pneumonia in 25 countries. COVID-19 can also lead to acute respiratory distress syndrome (ARDS).Methods: 149 patients with 2019 Novel Coronavirus (COVID-19)pneumonia(68 males, 81 females, ages 1-89)from 6 research centers in China were diagnosed with positive 2019 Novel Coronavirus(COVID-19)nucleic acids antibodies. And their high-resolution computed tomography(HRCT) imaging datas were evaluated.Results: 136/149(91.3%)patients had a clear history of exposure to Wuhan. Fever (122/149, 81.9%)and cough(83/149, 55.7%)were the most common symptoms. The main imaging characteristics within 4 days of onset included 30(20.13%) cases of pure ground glass opacities (P<0.05), 38(25.50%) cases of GGO with reticulation(P<0.01), 12(8.05%) cases of consolidation(P<0.01). In the 5-8 days group, the main imaging features included 71(47.65%) cases of pGGO(P<0.05), 69(46.31%) cases of GGO with reticulation(P<0.01). In the 9-12 days group, the main feature was 85(57.04%) cases with GGO with reticulation(P<0.01). In the group of 13-16 days group, the main imaging characteristics included 48(32.21%) cases of GGO with reticulation(P < 0.01), 34(22.82%) cases of consolidation(P<0.01).Conclusion: Patients infected with COVID-19 pneumonia show more chest CT characteristics within 5-8 days after the onset of disease. The main manifestations included pGGO, GGO with reticulation, consolidation and GGO with consolidation.

How COVID changed surgical acute inflammatory diseases and surgeons clinical practice during the first wave of COVID-19

10.21203/rs.3.rs-84090/v1 ◽

2020 ◽

Author(s):

Hector Guadalajara ◽

Jose Luis Muñoz de Nova ◽

Saul Fernandez Gonzalez ◽

Marina Yiasemidou ◽

Maria Recarte Rico ◽

...

Keyword(s):

Inflammatory Diseases ◽

Recovery Phase ◽

Control Measures ◽

Future Research ◽

Surgical Services ◽

Infection Control Measures ◽

Number Of Patients ◽

Inflammatory Processes ◽

History Of ◽

The Impact

Abstract BackgroundAnecdotal evidence suggests that community infection control measures during the COVID-19 outbreak have modified the number and natural history of acute surgical inflammatory processes (ASIP - appendicitis, cholecystitis, diverticulitis and perianal abscesses) admissions. This study aims to evaluate the impact of the COVID-19 pandemic on the presentation and treatment ASIP and quantify the effect of COVID-19 infection on the outcomes of ASIP patients. MethodsThis was a multicentre, comparative study, whereby ASIP cases from March 14th to May 2nd 2019 acted as historical controls for the cohort of patients with the same pathology during the COVID-19 pandemic. Data regarding patient and disease characteristics as well as outcomes, were collected from sixteen centres in Madrid, and one in Seville (Spain).ResultsThe number of patients treated for ASIP in 2019 was 822 compared to 521 in 2020. This reduction occurs mainly in patients with mild cases, while the number of severe cases was similar. ConclusionsThe number of ASIP cases treated during the pandemic was reduced by more than one third mainly due to a dramatic reduction in mild cases. This also has represented a selection of severe cases. We also found a more conservative approach to the patients this year, non-justified by clinical circumstances.The positive COVID-19 status itself did not have a direct impact on either morbidity or mortality. This is an interesting finding which if confirmed through future research with a larger sample size of COVID-19 positive patients, can expedite the recovery phase of acute surgical services.

Prerequisites for the creation of an atlas of postcovid inflammation as a way of personalized pharmacotherapy, as well as predicting and preventing organ and systemic dysfunctions

Medical Council ◽

10.21518/2079-701x-2021-12-72-88 ◽

2021 ◽

pp. 72-88

Author(s):

I. V. Kukes ◽

J. M. Salmasi ◽

K. S. Ternovoy ◽

A. N. Kazimirskii ◽

T. E. Obodzinskaya ◽

...

Keyword(s):

Vascular Dysfunction ◽

Clinical Status ◽

Cellular Tissue ◽

Multiple Organ ◽

Metabolic Dysfunction ◽

Persistent Symptoms ◽

Metabolism Disorder ◽

Number Of Patients ◽

Aromatic Amino Acid Metabolism ◽

Novel Coronavirus

SARS-CoV-2 is a novel coronavirus that has been identified as the cause of the 2019 coronavirus infection (COVID-19), which originated at Wuhan city of PRC in late 2019 and widespread worldwide. As the number of patients recovering from COVID-19 continue to grow, it’s very important to understand what health issues they may keep experiencing. COVID-19 is now recognized as an infectious disease that can cause multiple organ diseases of various localization. It is against this background that a new term was introduced: post-acute post-COVID-19 syndrome characterized by several persistent symptoms inherent in the acute phase of the disease, as well as the occurrence of delayed and (or) long-term complications beyond 4 weeks from the onset of the disease. The work reflected in this article revealed a portrait of a patient with post-COVID-19 syndrome, the most common complications of this period, as well as the mechanisms of their development and the resulting metabolic, cellular, tissue disorders leading to the tissue and organ dysfunctions. A comprehensive biochemical and immunological screening was carried out using the example of three clinical cases to identify the most significant disorders in these patients and to correlate with their clinical status over time. In point of fact, such patients were diagnosed with vascular dysfunction factors (development of endothelial dysfunction), metabolic dysfunction factors (metabolic acidosis, mitochondrial dysfunction, carbohydrate metabolism disorder, insulin resistance, altered branched-chain and aromatic amino acid metabolism), neurological disorder factors (neurotoxicity of the resulting metabolites), immunological disorder factors (decreased efficiency of detoxification systems, secondary immunodeficiency, risk of secondary bacterial infection).

Two-year outcomes of more than 30 000 elderly patients with atrial fibrillation: results from the All Nippon AF In the Elderly (ANAFIE) Registry

European Heart Journal - Quality of Care and Clinical Outcomes ◽

10.1093/ehjqcco/qcab025 ◽

2021 ◽

Author(s):

Takeshi Yamashita ◽

Shinya Suzuki ◽

Hiroshi Inoue ◽

Masaharu Akao ◽

Hirotsugu Atarashi ◽

...

Keyword(s):

Atrial Fibrillation ◽

Catheter Ablation ◽

Elderly Patients ◽

Major Bleeding ◽

Oral Anticoagulants ◽

Clinical Status ◽

The Elderly ◽

Very Elderly ◽

History Of ◽

Bleeding History

Abstract Aims To clarify the real-world clinical status and prognosis of elderly and very elderly non-valvular atrial fibrillation (NVAF) patients, more than 30 000 elderly patients with NVAF aged ≥75 years were enrolled in the ANAFIE Registry. Methods and Results This multicentre, prospective, observational study followed elderly NVAF patients in Japan for ∼2 years. Among 32 275 patients (mean age 81.5 years; men, 57.3%; mean CHA2DS2-VASc score 4.5), 2445 (7.6%) were not receiving oral anticoagulants (OACs) and 29 830 (92.4%) were given OACs. Of these, 21 585 (66.9%) were receiving direct OACs (DOACs) and 8233 (25.5%), warfarin (mean time in therapeutic range: ∼75%). In total, the 2-year incidence rate was 3.01% for stroke/systemic embolic events (SEE); 2.00%, major bleeding; and 6.95%, all-cause death. As compared with the warfarin group, the DOAC group had a lower hazard ratio (HR) for stroke/SEE, major bleeding, and all-cause death after adjusting for confounders. The group without OACs had a higher HR for stroke/SEE and all-cause death, with a lower HR for major bleeding. History of falls within 1 year at enrolment and of catheter ablation were positive and negative independent risk factors, respectively, for stroke/SEE, major bleeding and all-cause death. Conclusion In Japan, a large proportion of elderly and very elderly NVAF patients were receiving DOACs, which was significantly associated with lower rate of stroke/SEE, major bleeding, and all-cause death vs well-controlled warfarin. History of falls and of catheter ablation were independently associated with stroke/SEE, major bleeding, and all-cause death.

Delivery Routes for COVID-19 Vaccines

Vaccines ◽

10.3390/vaccines9050524 ◽

2021 ◽

Vol 9 (5) ◽

pp. 524

Author(s):

Jang Hyun Park ◽

Heung Kyu Lee

Keyword(s):

Immune Responses ◽

Viral Vector ◽

Future Research ◽

The Novel ◽

Subunit Vaccines ◽

Mucosal Vaccination ◽

The Status ◽

Delivery Routes ◽

History Of ◽

Novel Coronavirus

The novel coronavirus, SARS-CoV-2, which causes COVID-19, has resulted in a pandemic with millions of deaths. To eradicate SARS-CoV-2 and prevent further infections, many vaccine candidates have been developed. These vaccines include not only traditional subunit vaccines and attenuated or inactivated viral vaccines but also nucleic acid and viral vector vaccines. In contrast to the diversity in the platform technology, the delivery of vaccines is limited to intramuscular vaccination. Although intramuscular vaccination is safe and effective, mucosal vaccination could improve the local immune responses that block the spread of pathogens. However, a lack of understanding of mucosal immunity combined with the urgent need for a COVID-19 vaccine has resulted in only intramuscular vaccinations. In this review, we summarize the history of vaccines, current progress in COVID-19 vaccine technology, and the status of intranasal COVID-19 vaccines. Future research should determine the most effective route for vaccine delivery based on the platform and determine the mechanisms that underlie the efficacy of different delivery routes.

The SARS-CoV-2 first wave impact in the acute inflammatory surgical pathologies

Scientific Reports ◽

10.1038/s41598-021-98878-w ◽

2021 ◽

Vol 11 (1) ◽

Author(s):

H. Guadalajara ◽

J. L. Muñoz de Nova ◽

M. Yiasemidou ◽

M. Recarte Rico ◽

L. D. Juez ◽

...

Keyword(s):

Laparoscopic Approach ◽

Recovery Phase ◽

Control Measures ◽

Future Research ◽

Wave Impact ◽

Infection Control Measures ◽

Number Of Patients ◽

Inflammatory Processes ◽

History Of ◽

The Impact

AbstractAnecdotal evidence suggests that community infection control measures during the COVID-19 outbreak have modified the number and natural history of acute surgical inflammatory processes (ASIP—appendicitis, cholecystitis, diverticulitis and perianal abscesses) admissions. This study aims to evaluate the impact of the COVID-19 pandemic on the presentation and treatment ASIP and quantify the effect of COVID-19 infection on the outcomes of ASIP patients. This was a multicentre, comparative study, whereby ASIP cases from 2019, 2020 and 2021 (March 14th to May 2nd) were analyzed. Data regarding patient and disease characteristics as well as outcomes, were collected from sixteen centres in Madrid, and one in Seville (Spain). The number of patients treated for ASIP in 2019 was 822 compared to 521 in 2020 and 835 in 2021. This 1/3rd reduction occurs mainly in patients with mild cases, while the number of severe cases was similar. Surgical standards suffered a step back during the first wave: Lower laparoscopic approach and longer length of stay. We also found a more conservative approach to the patients this year, non-justified by clinical circumstances. Luckily these standards improved again in 2021. The positive COVID-19 status itself did not have a direct impact on mortality. Strikingly, none of the 33 surgically treated COVID positive patients during both years died postoperatively. This is an interesting finding which, if confirmed through future research with a larger sample size of COVID-19 positive patients, can expedite the recovery phase of acute surgical services.

Impact of public sentiments on the transmission of COVID-19 across a geographical gradient

10.1101/2021.01.29.21250655 ◽

2021 ◽

Author(s):

Folashade B. Agusto ◽

Eric Numfor ◽

Karthik Srinivasan ◽

Enahoro Iboi ◽

Alexander Fulk ◽

...

Keyword(s):

Disease Burden ◽

Public Perception ◽

Belief System ◽

Early Discharge ◽

Epidemic Curve ◽

Public Sentiment ◽

Number Of Factors ◽

History Of ◽

Media Platform ◽

Novel Coronavirus

AbstractCOVID-19 is a respiratory disease caused by a recently discovered, novel coronavirus, SARS-COV2. The disease has led to over 81 million confirmed cases of COVID-19, with close to 2 million deaths. In the current social climate, the risk of COVID-19 infection is driven by individual and public perception of risk and sentiments. A number of factors influences public perception, including an individual’s belief system, prior knowledge about a disease and information about a disease. In this paper, we develop a model for COVID-19 using a system of ordinary differential equations following the natural history of the infection. The model uniquely incorporates social behavioral aspects such as quarantine and quarantine violation. The model is further driven by people’s sentiments (positive and negative) which accounts for the influence of disinformation. People’s sentiments were obtained by parsing through and analyzing COVID-19 related tweets from Twitter, a social media platform across six countries. Our results show that our model incorporating public sentiments is able to capture the trend in the trajectory of the epidemic curve of the reported cases. Furthermore, our results show that positive public sentiments reduce disease burden in the community. Our results also show that quarantine violation and early discharge of the infected population amplifies the disease burden on the community. Hence, it is important to account for public sentiment and individual social behavior in epidemic models developed to study diseases like COVID-19.

Combination of chest CT and clinical features for diagnosis of 2019 novel coronavirus pneumonia

Open Medicine ◽

10.1515/med-2020-0107 ◽

2020 ◽

Vol 15 (1) ◽

pp. 723-727

Author(s):

Xin Wang ◽

Peng Wen ◽

Zhi-Gang Sun ◽

Chun-Yan Xing ◽

Yun Li

Keyword(s):

Nucleic Acid ◽

Clinical Features ◽

Comprehensive Evaluation ◽

High Sensitivity ◽

Chest Ct ◽

Nucleic Acid Test ◽

First Case ◽

History Of ◽

Novel Coronavirus ◽

Acid Test

AbstractIn December 2019, novel coronavirus pneumonia-19 (COVID-19) was discovered in the viral pneumonia cases that occurred in Wuhan, China, and then quickly spread around the world. This report described the clinical course of two COVID-19 patients and the purpose of the study was to discuss the combination of chest CT and clinical features for diagnosis of COVID-19. The first case was a typical COVID-19 case. A 66-year-old female presented to our hospital with a 3-day history of fever. She had contact with a COVID-19 patient. Chest CT showed a typical COVID-19 appearance. She was diagnosed with COVID-19 by a positive nucleic acid test. The second case was a 50-year-old male with a 2-day history of fever. He denied having been to Wuhan. Chest CT also showed typical features of COVID-19 pneumonia. COVID-19 nucleic acid tests were repeated up to seven times and the results remained controversial. Eventually, he was diagnosed with COVID-19. Our study shows that chest CT has high sensitivity for diagnosis of COVID-19 in clinical practice, particularly when the nucleic acid test is negative. The chest CT should be considered as a diagnostic tool for the COVID-19 screening, comprehensive evaluation, and follow-up and patients would benefit from effective treatments in time.