scholarly journals Comparison of Clinical, Radiological and Laboratory Findings in Discharged and Dead Patients With COVID-19 in Ilam Province, West of Iran

2021 ◽  
Author(s):  
Mohammad Reza Kaffashian ◽  
Maryam Shirani ◽  
Maryam Koupaei ◽  
Nourkhoda Sadeghifard ◽  
Iraj Ahmadi ◽  
...  
Keyword(s):  
Electronic Medical Records ◽  
Medical Records ◽  
Clinical Symptoms ◽  
Rt Pcr ◽  
Laboratory Findings ◽  
Treatment Regimens ◽  
Special Profile ◽  
Radiological Images ◽  
Global Threat ◽  
Underlying Diseases

Abstract Objective: COVID-19 is the last global threat which WHO confirmed it as a pandemic on March 11, 2020. In the Middle East, Iran was the first country where the SARS-Cov-2 was detected. The epidemiological and economic challenges of Iran make this country a particularly relevant subject of study. In the current study, we aimed to evaluate the clinical, radiological and laboratory findings in hospitalized COVID-19 confirmed cases in Ilam province, west of Iran.Material and methods:Overall, 2204 hospitalized RT-PCR confirmed patients with COVID-19 were considered in this study. Electronic medical records, including clinical symptoms, radiological images, laboratory findings, and the comorbidities of patients with COVID-19 were collected and analyzed. In addition, the medication regimens used in these patients were evaluated. The patients were classified in discharged and died groups according to their outcomes. Then, clinical, radiological and laboratory findings as well as treatment regimens and underlying diseases were compared in these two groups.Results:Among the patients, 1209 (54.85%) were male and 995 (45.14%) were female. Pneumonia, dyspnea and cough, were the most common clinical data in both discharged and died groups. Among the comorbidities, COPD, and cancer were significantly more common in the dead patients than in the living. The results of laboratory tests showed that blood creatinine, BUN, ESR, Na+, WBC, and neutrophil count have increased in deceased group compared to the survivors. However, the lymphocyte count decreased in deceased patients. The evaluation of radiographs demonstrated that there were significant correlations between bilateral pneumonia, ground glass opacity, bilateral patchy shadowing, and pleural effusion with death. Conclusion:The current investigation indicated the special profile of COVID-19 in west of Iran. Discharged and dead patients with COVID-19 had distinct clinical, radiological and laboratory features, which were separated by principle component analysis. Identifying these characteristics of the disease would translate into the implementation of practical measures to improve results.

scholarly journals Vestibular migraine: An update on current understanding and future directions

Cephalalgia ◽  
2019 ◽  
Vol 40 (1) ◽  
pp. 107-121 ◽  
Author(s):  
Tzu-Chou Huang ◽  
Shuu-Jiun Wang ◽  
Amir Kheradmand
Keyword(s):  
Clinical Symptoms ◽  
Vestibular Function ◽  
Vestibular Migraine ◽  
Current Understanding ◽  
Laboratory Findings ◽  
Treatment Regimens ◽  
Migraine Headaches ◽  
Narrative Literature ◽  
Vestibular Symptoms ◽  
Narrative Literature Review

Background Vestibular migraine is among the most common causes of recurrent vertigo in the general population. Despite its prevalence and high impact on healthcare cost and utilization, it has remained an under-recognized condition with largely unknown pathophysiology. In the present article, we aim to provide an overview of the current understanding of vestibular migraine. Methods We undertook a narrative literature review on the epidemiology, presentations, clinical and laboratory findings, pathophysiology, and treatments of vestibular migraine. Results Currently, the diagnosis of vestibular migraine relies solely on clinical symptoms since clinical tests of vestibular function are typically normal, or difficult to interpret based on inconsistent results reported in earlier studies. The challenges related to diagnosis of vestibular migraine lie in its relatively broad spectrum of manifestations, the absence of typical migraine headaches with vestibular symptoms, and its very recent definition as a distinct entity. Here, we highlight these challenges, discuss common vestibular symptoms and clinical presentations in vestibular migraine, and review the current aspects of its clinical diagnosis and evaluation. The concepts related to the pathophysiology and treatment of vestibular migraine are also discussed. Conclusion Vestibular migraine is still underdiagnosed clinically. Future studies are needed to address the pathophysiological mechanisms and investigate effective treatment regimens.

scholarly journals Clinical features of 162 fatal cases of COVID-19: a multi-center, retrospective study

2020 ◽  
Author(s):  
Xianlong Zhou ◽  
Guoyong Ding ◽  
Qing Fang ◽  
Jun Guo ◽  
Luyu Yang ◽  
...  
Keyword(s):  
Medical Records ◽  
Distress Syndrome ◽  
Clinical Symptoms ◽  
Demographic Data ◽  
Antiviral Treatment ◽  
Fatal Outcome ◽  
Intervention Programs ◽  
Laboratory Findings ◽  
Co Morbidity ◽  
Moderate Condition

Abstract Understanding the epidemiological and clinical characteristics of fatal cases infected with SARS-CoV-2 is import to develop appropriate preventable intervention programs in hospitals. Demographic data, clinical symptoms, clinical course, co-morbidities, laboratory findings, CT scans, treatments and complications of 162 fatal cases were retrieved from electric medical records in 5 hospitals of Wuhan, China. The median age was 69.5 years old (IQR: 63.0-77.25; range: 29-96). 112 (69.1%) cases were men. Hypertension (45.1%) was the most common co-morbidity, but 59 (36.4%) cases had no co-morbidity. At admission, 131 (81.9%) cases were assessed as severe or critical. However, 39 (18.1%) were assessed as moderate. Moderate cases had a higher prevalence of hypertension and chronic lung disease comparing with severe or critical cases (P<0.05, respectively). 126 (77.8%) and 132 (81.5%) cases received antiviral treatment and glucocorticoids, respectively. 116 (71.6%) cases were admitted to ICU and 137 (85.1%) cases received mechanical ventilation. Respiratory failure or acute respiratory distress syndrome (93.2%) was the most common complication. The young cases of COVID-19, without co-morbidity and in a moderate condition at admission could develop fatal outcome. We need to be more cautious in case management of COVID-19 for preventing the fatal outcomes.

scholarly journals Clinical and Laboratory Findings in Patients with Potential SARS-CoV-2 Reinfection, May–July 2020

2021 ◽  
Author(s):  
James T Lee ◽  
Elisabeth M Hesse ◽  
Heather N Paulin ◽  
Deblina Datta ◽  
Lee S Katz ◽  
...  
Keyword(s):  
Medical Records ◽  
The United States ◽  
Clinical Findings ◽  
Initial Symptom ◽  
Emerging Infections ◽  
Rt Pcr ◽  
Laboratory Findings ◽  
Patient Demographics ◽  
Viral Culture ◽  
Laboratory Test Results

Abstract Background We investigated patients with potential SARS-CoV-2 reinfection in the United States during May–July 2020. Methods We conducted case finding for patients with potential SARS-CoV-2 reinfection through the Emerging Infections Network. Cases reported were screened for laboratory and clinical findings of potential reinfection followed by requests for medical records and laboratory specimens. Available medical records were abstracted to characterize patient demographics, comorbidities, clinical course, and laboratory test results. Submitted specimens underwent further testing, including RT-PCR, viral culture, whole genome sequencing, subgenomic RNA PCR, and testing for anti-SARS-CoV-2 total antibody. Results Among 73 potential reinfection patients with available records, 30 patients had recurrent COVID-19 symptoms explained by alternative diagnoses with concurrent SARS-CoV-2 positive RT-PCR, 24 patients remained asymptomatic after recovery but had recurrent or persistent RT-PCR, and 19 patients had recurrent COVID-19 symptoms with concurrent SARS-CoV-2 positive RT-PCR but no alternative diagnoses. These 19 patients had symptom recurrence a median of 57 days after initial symptom onset (interquartile range: 47 – 76). Six of these patients had paired specimens available for further testing, but none had laboratory findings confirming reinfections. Testing of an additional three patients with recurrent symptoms and alternative diagnoses also did not confirm reinfection. Conclusions We did not confirm SARS-CoV-2 reinfection within 90 days of the initial infection based on the clinical and laboratory characteristics of cases in this investigation. Our findings support current CDC guidance around quarantine and testing for patients who have recovered from COVID-19.

scholarly journals Evaluation of Neurological Complications in Hospitalized COVID-19 Patients: A Cross-Sectional Study 2020

2021 ◽  
Author(s):  
Mojtaba Khazaei ◽  
Fatemeh Feizy ◽  
Salman Khazaei
Keyword(s):  
Electronic Medical Records ◽  
Medical Records ◽  
Neurological Complications ◽  
Cross Sectional Study ◽  
Neurological Symptoms ◽  
Medical Sciences ◽  
Laboratory Findings ◽  
Cross Sectional ◽  
Effective Interventions ◽  
Brain Tissue Damage

Abstract Objective: The coronavirus (COVID-19) has been spreading around the world since December 2019. Neurological symptoms have been reported as a part of the clinical spectrum of the disease. This study aimed to determine the frequency of neurological complications in hospitalized patients with COVID-19.Methods: Electronic medical records in the hospital information system, laboratory findings, and radiological examinations were evaluated for all patients with laboratory-confirmed SARS-CoV-2 infection. The cases were referred to Shahid Beheshti Hospital affiliated to Hamadan University of Medical Sciences from February 20, 2020 to the end of the same year.Results: A total of 477 hospitalized COVID-19 patients were included in the analyses. Based on our results, 105 (22.02%) patients showed neurological manifestations. Ischemic stroke, decreased consciousness, and headache were the most frequent reported neurological symptoms with the rate of 34 (7.13%), 28 (5.88%), and13 (2.72%), respectively. Moreover, 54 (51.43%) cases were male, and the vast majority of the patients (66; 62.86%) had more than 60 years of age. Conclusions: SARS-CoV-2 may involve nervous system and cause brain tissue damage. The findings of this study provide more information on coronavirus disease, contributing to effective interventions for the control of the disease

scholarly journals Clinical Presentation of Iranian Patients Affected with COVID-19: A Thousand Faces Disease

2021 ◽  
Author(s):  
Ali Mostafaei ◽  
Morteza Ghojazadeh ◽  
Sakineh Hajebrahimi ◽  
Nasrin Abolhasanpour ◽  
Hanieh Salehi-Pourmehr
Keyword(s):  
Mortality Rate ◽  
Ct Scan ◽  
Medical Records ◽  
Age Distribution ◽  
Chest Ct ◽  
Hospitalized Patients ◽  
Rt Pcr ◽  
Tertiary Teaching ◽  
Gastrointestinal Problems ◽  
Underlying Diseases

The coronavirus disease 2019 (COVID-19) pandemic in Iran is part of the worldwide pandemic caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). The present study aimed to demonstrate the clinical characteristics of patients affected by COVID-19, in our tertiary teaching hospital. Medical records and compiled data of 668 patients with suspected COVID-19 were obtained retrospectively between January to April 2020. The present study outcomes included demographic features of infected patients, underlying diseases and conditions, the relationship between the results of reverse transcription-polymerase chain reaction (RT-PCR) or CT-scan with the manifestations of the disease, mortality rate, and age distribution of fatalities among men and women. The median age of hospitalized patients was 63 years old (from 18 to 94). The patients’ chief complaints in the admission time were cough, dyspnea, fever, and gastrointestinal problems, respectively. Hospitalized patients' common comorbidities were hypertension (HTN), and cardiovascular disease (CVD) (24%), diabetes mellitus (DM) (21.5%), asthma, or chronic obstructive pulmonary disease (COPD) (6%), or other underlying diseases (15.5%). One-third of patients had no comorbidity according to the data of medical records. In hospitalized patients, 169 (84.5%) had positive RT-PCR, and 156 (78%) had positive chest CT findings. The mortality rate of males was higher than females (66.3% vs. 33.3%) and in patients with positive RT-PCR compared to patients with positive chest CT-scan findings. The majority of deaths had a history of DM or HTN/CVD in their medical records. The chief complaint of patients was cough. DM and HTN or CVD were the common underlying disease related to death in hospitalized cases. Besides, the hospitalization and mortality rate in males was higher than in females. About 87% of dead hospitalized cases had positive RT-PCR results, and this rate was 82% for chest CT results.

scholarly journals Clinical and Laboratory Characteristics of COVID-19 Infection in Patients Presenting to A Tertiary Care Hospital

BioMedica ◽  
2021 ◽  
Vol 37 (3) ◽  
pp. 1-17
Author(s):  
Huma Batool ◽  
Asifa Karamat ◽  
Khalid Waheed ◽  
Sohail Anwar ◽  
Syed Arslan Haider ◽  
...  
Keyword(s):  
Medical Records ◽  
Clinical Symptoms ◽  
Wide Spectrum ◽  
Severe Disease ◽  
Tertiary Care ◽  
Care Hospital ◽  
Laboratory Findings ◽  
Male Predominance ◽  
Reactive Protein ◽  
Clinical Records

<p><strong>Background and Objective:</strong> COVID-19 disease is caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) having a wide variety of clinical features ranging from asymptomatic carriers to respiratory failure requiring mechanical ventilation. The objective of the study was to analyze the spectrum of different symptoms, laboratory findings and complications in patients who were admitted in either COVID ward or intensive care unit (ICU) of a local hospital.</p> <p><strong>Methods:</strong> A retrospective cohort study of the medical records of 100 COVID-19 disease patients with PCR detected SARS-CoV-2 infection were collected. Participant information was retrospectively obtained from the hospital medical records which included clinical records and laboratory findings. All statistical analyses were done using Statistical Package for the Social Sciences (SPSS) version 21.</p> <p><strong>Results:</strong> The mean age of the patients was 50.8 &plusmn;5.86 with male predominance (79%). Most frequent co-morbidities were diabetes mellitus (42%) and hypertension (36%). Most frequent symptoms were fever (95.9%) and fatigue (95.9%) followed by dry cough (86.5%), myalgia (85.1) and shortness of breath (70%). Amongst the patients admitted, leukocyte count was 10.95 x 10<sup>3</sup>, C-reactive protein (CRP) was 12.8mg/dl, ferritin was 730.8ng/ml and Lactate Dehydrogenase (LDH) was found to be 1254.7 U/l. Hepatic and renal functions were borderline deranged.</p> <p><strong>Conclusion:</strong> COVID-19 disease has a wide spectrum of clinical symptoms. Patients with raised inflammatory markers have severe disease and are more likely in need of an ICU care. By carefully observing these markers may help in better management of COVID-19 disease.</p>

scholarly journals Treatment of Six COVID-19 Patients with Convalescent Plasma

2020 ◽  
Author(s):  
Can Jin ◽  
Juan Gu ◽  
Youshu Yuan ◽  
Qinying Long ◽  
Qi Zhang ◽  
...  
Keyword(s):  
Plasma Treatment ◽  
Electronic Medical Records ◽  
Medical Records ◽  
Throat Swab ◽  
Rapid Progression ◽  
Chest Imaging ◽  
Rt Pcr ◽  
Plasma Therapy ◽  
Key Points

AbstractObjectiveTo describe the efficacy of convalescent plasma transfusion for COVID-19 patients.MethodsThis is a retrospective study of 6 COVID-19 patients with convalescent plasma at Guizhou Provincial Jiangjunshan Hospital – a tertial hospital, in Guiyang, Guizhou, China, from January 29, to April 30, 2020; final data of follow-up was May 12, 2020. Through the review of the electronic medical records of Guizhou Jiangjunshan Hospital, clinical data of 6 patients were obtained. Three patients with worsening symptoms after empirical treatment with antivirals were transfused convalescent plasma therapy for the first treatment, while the other three severe or critical COVID-19 patients with rapid progression were transfused. The efficacy of convalescent plasma depends on the relief of symptoms, changes in laboratory indicators and chest imaging abnormalities.ResultsThe PaO2 / FiO2 and lymphocyte count of patients 1, 2 and 3 treated with convalescent plasma treatment for the first treatment period were changed from abnormal to normal. The levels of inflammation markers CRP and IL-6 of the patients decreased significantly. Chest imaging examination showed that the lung lesions gradually subsided. The relapsed patients (No. 4 and No. 6), after using convalescent plasma therapy, turned negative on two consecutive throat swab tests on Day 24 and Day 3, respectively.ConclusionsConvalescent plasma treatment of COVID-19 is beneficial for those patients with be difficult to turn to negative or re-positive RT-PCR.Key PointsConvalescent plasma treatment of COVID-19 is beneficial for those patients with be difficult to turn to negative or re-positive RT-PCR.

scholarly journals Trying to Find the Answer for Two Questions in Patients with COVID-19: 1. Is pulmonary infiltrate of COVID-19 infective or inflammatory in nature (Pneumonia or Pneumonitis)? 2. Is Hydroxychloroquine plus Azithromycin or Favipiravir plus Dexamethasone more effective in the COVID-19 treatment?

2020 ◽  
Author(s):  
Adem Dirican ◽  
Tugce Uzar ◽  
Irem Karaman ◽  
Aziz Uluisik ◽  
Sevket Ozkaya
Keyword(s):  
Clinical Symptoms ◽  
Severe Pneumonia ◽  
Pulmonary Infiltrate ◽  
Biologic Agent ◽  
Great Effort ◽  
Rt Pcr ◽  
Radiological Findings ◽  
First Line ◽  
Radiological Images ◽  
Hrct Finding

Background: During the current pandemic, a great effort is made to understand the COVID-19 and find an effective treatment. As of 17 August 2020, there is no specific drug or biologic agent which have been approved by the FDA for the prevention or treatment of COVID-19. Methods: We retrospectively analyzed the clinical and radiological findings of 211 COVID-19 in-patients that were treated between March - August 2020. Confirmation of a COVID-19 diagnosis was made according to a positive RT-PCR result with a consistent high-resolution-CT (HRCT) finding. Radiological images and the rate of clinical response of patients were investigated. Result: While 128 patients (58.7) did not develop pneumonia, the mild, moderate and severe pneumonia ratios were 28(13.2%), 31(18.7%) and 27(22.9%). 72 patients (34.1%) whose PCR tests were positive did not show any symptom and they were followed in isolation without treatment. 52 patients (24.6%) received hydroxychloroquine plus azithromycin, 57 patients (27%) received favipiravir and 30 patients (14.2%) received favipiravir plus dexamethasone as the first line of treatment. 63.1% of pneumonia patients who received hydroxychloroquine plus azithyromycine, 28.3% of patients who received favipiravir and 10% of patients who received favipiravir plus dexamethasone showed a failure of treatment. Conclusion: The pulmonary infiltrates of COVID-19 are not infective; therefore, the characteristic of the disease should be described as COVID-19 pneumonitis instead of pneumonia. The favipiravir plus dexamethasone seems to be the only drug combination to achieve the improvement of radiological presentation and clinical symptoms in COVID-19 pneumonia patients.

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