Clinical Characteristics of 6 patients with SARS-Cov-2 infected severe pneumonia in Zunyi, China

Abstract Purpose To study the clinical characteristics, laboratory examination, radiological changes and treatments of 6 patients with severe SARS-Cov-2 infected pneumonia in Zunyi City, China.MethodsThe clinical data, laboratory examination, radiological changes and clinical treatment process of 6 patients with severe SARS-Cov-2 infected pneumonia admitted to the Department of Critical Medicine of the Affiliated Hospital of Zunyi Medical University were retrospectively analyzed.Results Four of the six patients were older than 65 years. Two patients had a history of exposure to Wuhan, and four patients had family clustering infection. The most common symptoms at onset of illness were dry cough (4, 66%) and fever (4, 66%). Laboratory tests showed that white blood cell count, neutrophil count, C-reactive protein, IL-6, IL-10, and urea nitrogen elevated. The Total lymphocyte count and T lymphocyte count decreased. All patients received antiviral therapy, blood purification, immunomodulatory therapy, and Chinese herb treatments. One patient was discharged from the hospital, and 5 patients' condition improved significantly. ConclusionT lymphocyte decreased significantly, IL-6 and IL-10 elevated in severe SARS-Cov-2 infected pneumonia patients. Elderly patients with comorbidities appear to be more severe and to recover more slowly. Blood purification can be tried for severe and critically ill patients. Early identification and timely treatment of critical cases is of crucial importance.

Download Full-text

Analysis of clinical characteristics of severe pertussis in infants and children: a retrospective study

BMC Pediatrics ◽

10.1186/s12887-021-02507-4 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Caiying Wang ◽

Huimin Zhang ◽

Yanlan Zhang ◽

Lin Xu ◽

Min Miao ◽

...

Keyword(s):

Retrospective Study ◽

Clinical Characteristics ◽

Severe Disease ◽

Severe Pneumonia ◽

Infants And Children ◽

Critically Ill Children ◽

Young Infants ◽

Incidence And Mortality ◽

Increasing Trend ◽

Medical University

Abstract Background The incidence of pertussis shows an increasing trend in recent years, but some clinicians often lack sufficient understanding of the clinical characteristics and risk factors for severe pertussis, and more effective measures should be taken to reduce the incidence and mortality of pertussis in young infants Methods A retrospective study was conducted, and 184 infants and children with pertussis who had been hospitalized in the Department of Pediatrics of Beijing Ditan Hospital affiliated with Capital Medical University from January 2016 to December 2017 were included. Clinical data of the patients were collected and the clinical characteristics were statistically analyzed Results Among the 184 patients, 41.85% were infants < 3 months of age, and 65.22% of the total patients were not vaccinated against pertussis. There were 22 critically ill children, among whom 4 died, and compared with mild cases, they had a higher proportion of children younger than 3 months of age and infants not vaccinated against pertussis (63.64% vs. 38.89% and 100% vs. 60.49%, respectively); a higher proportion of children with severe pneumonia (100% vs. 0%); higher leukocyte count(× 109/L , 35.80 ± 20.53 vs 19.41 ± 8.59); and a higher proportion of children with severe hyperleukocytosis (18.18% vs. 0%, respectively) (P<0.05) Conclusions 1. Infants aged <3 months not vaccinated for pertussis appear more likely to become infected and have more severe disease. 2. Severe pneumonia and hyperleukocytosis are the main mechanisms underlying severe pertussis.

Download Full-text

Epidemiological characteristics, clinical characteristics, and prognostic factors of children with atopy hospitalised with adenovirus pneumonia

BMC Infectious Diseases ◽

10.1186/s12879-021-06741-0 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Miao Li ◽

Xiao-Hua Han ◽

Li-Yun Liu ◽

Hui-Sheng Yao ◽

Li-Li Yi

Keyword(s):

Risk Factors ◽

Disease Severity ◽

Clinical Characteristics ◽

Severe Infection ◽

Small Airway ◽

Personal History ◽

Factors Associated ◽

History Of ◽

Radiological Changes ◽

Epidemiological Characteristics

Abstract Background Atopy may be associated with disease severity and a poor prognosis of human adenovirus (HAdV) pneumonia in children. Our aim was to observe the clinical characteristics and pulmonary radiological changes in children with atopy and HAdV pneumonia in China. Methods Children hospitalised with HAdV pneumonia from June 2018 to December 2019 were analysed. All children were divided into atopic with HAdV, non-atopic with HAdV, and atopic without HAdV infection group. Each group was further divided into the mild and severe pneumonia groups according to disease severity. Standard treatment was initiated after admission, and regular follow-up evaluations were conducted at 1 month after discharge. Baseline and clinical characteristics and pulmonary radiological changes in children with and without atopy were evaluated. Risk factors associated with small airway lesions in patients with HAdV pneumonia were analysed. Results The eosinophil count in the atopic group was significantly higher than that in the non-atopic group (P < 0.05). Severe coughing, wheezing, and small airway lesions on chest high-resolution computed tomography (HRCT) upon admission, after discharge and 1 month after discharge were significantly higher in the atopic group (with or without HAdV infection) than in the non-atopic group (P < 0.05). There were significant differences in the number of patients with wheezing and small airway lesions during hospitalisation and after discharge among the three groups (P < 0.05). The risks of small airway lesions in children with a family or personal history of asthma, severe infection, atopy, and HAdV infection were 2.1-, 2.7-, 1.9-, 2.1-, and 1.4-times higher than those in children without these characteristics, respectively. Conclusions Children with atopy and HAdV pneumonia may experience severe coughing in mild cases and wheezing in mild and severe cases. Children with atopy are more susceptible to the development of small airway lesions, recurrent wheezing after discharge and slower recovery of small airway lesions as observed on pulmonary imaging than non-atopic children after HAdV infection. A family or personal history of asthma, atopy, severe infection, and HAdV infection are independent risk factors associated with the development of small airway lesion as observed on chest HRCT.

Download Full-text

Retrospective analysis of clinical characteristics of 405 patients with COVID-19

Journal of International Medical Research ◽

10.1177/0300060520949039 ◽

2020 ◽

Vol 48 (8) ◽

pp. 030006052094903 ◽

Cited By ~ 1

Author(s):

Ting Zhan ◽

Meng Liu ◽

Yalin Tang ◽

Zheng Han ◽

Xueting Cheng ◽

...

Keyword(s):

Clinical Characteristics ◽

Severe Disease ◽

Clinical Manifestations ◽

Gastrointestinal Symptoms ◽

Circulatory System ◽

Respiratory Illnesses ◽

Reactive Protein ◽

Circulatory System Diseases ◽

History Of ◽

Abnormal Lymphocyte

Objective This study was performed to investigate the clinical characteristics of patients with coronavirus disease 2019 (COVID-19), which is caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Methods We analyzed the electronic medical records of 405 hospitalized patients with laboratory-confirmed COVID-19 in the Third Hospital of Wuhan. Results The patients’ median age was 56 years, 54.1% were female, 11.4% had a history of smoking, and 10.6% had a history of drinking. All cases of COVID-19 were community-acquired. Fever (76.8%) and cough (53.3%) were the most common clinical manifestations, and circulatory system diseases were the most common comorbidities. Gastrointestinal symptoms were present in 61.2% of the patients, and 2.9% of the patients were asymptomatic. Computed tomography showed ground-glass opacities in most patients (72.6%) and consolidation in 30.9%. Lymphopenia (72.3%) and hypoproteinemia (71.6%) were observed in most patients. About 20% of patients had abnormal liver function. Patients with severe disease had significantly more prominent laboratory abnormalities, including an abnormal lymphocyte count and abnormal C-reactive protein, procalcitonin, alanine aminotransferase, aspartate aminotransferase, D-dimer, and albumin levels. Conclusion SARS-CoV-2 causes a variety of severe respiratory illnesses similar to those caused by SARS-CoV-1. Older age, chronic comorbidities, and laboratory abnormalities are associated with disease severity.

Download Full-text

Clinical Analysis of 9 Cases of Neonatal Influenza A

10.21203/rs.3.rs-151767/v1 ◽

2021 ◽

Author(s):

Yanlan Zhang ◽

Lin Xu ◽

Caiying Wang ◽

Lin Pang

Keyword(s):

Influenza A ◽

Nasal Congestion ◽

Antiviral Treatment ◽

Clinical Analysis ◽

Runny Nose ◽

Reactive Protein ◽

Cell Counts ◽

History Of ◽

White Blood Cell Counts ◽

Medical University

Abstract Background: The population is generally susceptible to influenza A, while neonatal cases are relatively rare. The study aims to explore the clinical characteristics, diagnosis, treatment, and prognosis of neonates with influenza A.Methods: The clinical data from neonates with influenza A who were treated in the neonatal department of Beijing Ditan Hospital affiliated with Capital Medical University from November 2017 to January 2019 were retrospectively analyzed.Results: A total of 9 neonates with influenza A were admitted and treated, with a distribution of 7 males and 2 females. The onset was 1.44 ± 1.46 days (mean ± SD), and age at diagnosis was 21.44 ±6. 53 days. All cases had a history of exposure to febrile patients, The main symptoms are fever, nasal congestion, runny nose, sneezing, coughing, other respiratory symptoms and digestive symptoms such as vomiting milk, choking milk, less milk, diarrhea. Laboratory tests showed 7 cases of decreased white blood cell counts, 3 cases of increased plasma C-reactive protein concentrations. All cases were administered antiviral therapy on the day of admission. Eight neonates reverted to a normal temperature within 48 hours after hospitalization, one neonate’s temperature returned to normal after 48 hours of hospitalization, and all cases' symptoms gradually improved.Conclusion: The symptoms of influenza A in neonates are atypical, once a diagnosis is confirmed, the prognosis is likely to be favorable as long as antiviral treatment with antiviral is initiated as soon as possible.

Download Full-text

Clinical characteristics of survivors and non-survivors, medical and non-medical staff members with 2019-nCoV pneumonia in Wuhan, China: a descriptive study

10.21203/rs.3.rs-20714/v1 ◽

2020 ◽

Author(s):

Jiaxun Hu ◽

You Lv ◽

Ying Xu ◽

Yushan Miao ◽

Wei Wang ◽

...

Keyword(s):

Medical Staff ◽

Clinical Characteristics ◽

Severe Pneumonia ◽

Study Data ◽

Disease Classification ◽

Staff Members ◽

Treatment Measures ◽

History Of ◽

Medical Compliance ◽

Novel Coronavirus

Abstract Objectives: In December 2019，the 2019 novel coronavirus ( 2019-nCoV ) emerged in Wuhan, China, leading to a cluster of severe pneumonia cases. Medical staff members on the front line were also infected. We compared the epidemiology, clinical characteristics, and treatment measures of survivors and non-survivors and the different clinical outcomes of medical staff members and non-medical members of the community infected with 2019-nCoV. Methods: We included 81 patients with adult 2019-nCoV in Hankou Hospital from mid-January to mid-February 2020 in this single-center retrospective study. Data were compared between survivors and non-survivors and between medical staff members and non-medical individuals. Results: All 38 medical staff members were infected by patients while working. Only 2 (2.5%) non-medical individuals had a clear history of exposure to 2019-nCoV patients. The median age was 49 years (interquartile range [IQR], 35-59; range, 23-89 years), and 42 (51.9%) were women. We found that the median age,comorbidity, and some laboratory outcomes(lymphocyte count, urea nitrogen, aspartate aminotransferase, lactate dehydrogenase, etc.)differed significantly between survivors and non-survivors. There were also significant differences in the time from onset to admission, disease classification, comorbidity, and prognosis between medical staff members and non-medical individuals. All medical staff members were cured, while 13 (30.2%) non-medical individuals died. Conclusions: Older males with comorbidities are more likely to be affected by 2019-nCoV. Significant changes in some laboratory markers may indicate a poor prognosis. Medical staff members may have had better prognoses due to fewer comorbidities and better medical compliance. Key words: 2019-nCoV; Clinical characteristics; Mortality; comorbidity; Survivors; Non-survivors; Medical Staff

Download Full-text

Analysis of clinical characteristics of severe pertussis in infants and children: a retrospective study

10.21203/rs.3.rs-31604/v4 ◽

2021 ◽

Author(s):

Caiying Wang ◽

Huimin Zhang ◽

Yanlan Zhang ◽

Lin Xu ◽

Min Miao ◽

...

Keyword(s):

Retrospective Study ◽

Clinical Characteristics ◽

Severe Disease ◽

Severe Pneumonia ◽

Infants And Children ◽

Critically Ill Children ◽

Young Infants ◽

Incidence And Mortality ◽

Increasing Trend ◽

Medical University

Abstract Background: The incidence of pertussis shows an increasing trend in recent years, but some clinicians often lack sufficient understanding of the clinical characteristics and risk factors for severe pertussis, and more effective measures should be taken to reduce the incidence and mortality of pertussis in young infants. Methods: A retrospective study was conducted, and 184 infants and children with pertussis who had been hospitalized in the Department of Pediatrics of Beijing Ditan Hospital affiliated with Capital Medical University from January 2016 to December 2017 were included. Clinical data of the patients were collected and the clinical characteristics were statistically analyzed. Results: Among the 184 patients, 41.85% were infants < 3 months of age, and 65.22% of the total patients were not vaccinated against pertussis. There were 22 critically ill children, among whom 4 died, and compared with mild cases, they had a higher proportion of children younger than 3 months of age and infants not vaccinated against pertussis (63.64% vs. 38.89% and 100% vs. 60.49%, respectively); a higher proportion of children with severe pneumonia (100% vs. 0%); higher leukocyte count(× 109/L , 35.80 ± 20.53 vs 19.41 ± 8.59); and a higher proportion of children with severe hyperleukocytosis (18.18% vs. 0%, respectively) (P<0.05). Conclusions: 1. Infants aged <3 months not vaccinated for pertussis appear more likely to become infected and have more severe disease. 2. Severe pneumonia and hyperleukocytosis are the main mechanisms underlying severe pertussis.

Download Full-text

Epidemiology, Clinical Characteristics, and Prognostic Factors of Atopic Children Hospitalised for Adenovirus Infection: A Single Institutional Study in Shenyang, China

10.21203/rs.3.rs-51134/v1 ◽

2020 ◽

Author(s):

Miao Li ◽

Xiao-Hua Han ◽

Li-Yun Liu ◽

Hui-Sheng Yao ◽

Li-Li Yi

Keyword(s):

Clinical Characteristics ◽

Severe Infection ◽

Airway Disease ◽

Small Airway ◽

Personal History ◽

Factors Associated ◽

Small Airway Disease ◽

Number Of Patients ◽

History Of ◽

Radiological Changes

Abstract Background: Atopy may be associated with the severity of disease and poor prognosis after adenovirus (Adv) infection in children. Our aim was to observe the clinical characteristics and pulmonary radiological changes in atopic children with Adv pneumonia in China.Methods: Children hospitalised for Adv pneumonia from June 2018 to Dec 2019 were analysed. All children were divided into three groups: atopic with Adv, non-atopic with Adv, and atopic without Adv infection. Each group was further divided into mild or severe infection groups according to disease severity. Standard treatment was initiated after admission and regular follow-up evaluations were conducted at 1 month after discharge. Baseline and clinical characteristics, and pulmonary radiological changes of atopic and non-atopic children were collected. Risk factors associated with small airway diseases in Adv pneumonia patients were analyzed.Results: Compared with non-atopic children with Adv infection, the cases of eosinophilic granulocyte count were significantly higher in atopic children than non-atopic children (P<0.05). Among children with mild and severe infection, the number of patients with wheezing and small airway disease as observed by high-resolution computed tomography (HRCT) was significantly higher in atopic children than non-atopic children (P<0.05). Furthermore, coughing was more severe in atopic children than non-atopic children (P<0.05). A family history of asthma (OR 2.1 [95% CI 1.8–3.0]), personal history of asthma (OR 2.7 [95% CI 2.1–3.1]), atopy (OR 2.1 [95% CI 1.8–3.2]), severe infection (OR 1.9 [95% CI 1.0–2.7]), and Adv infection (OR 1.4, [95% CI 0.9–2.0]) were independent factors associated with the development of small airway disease, both after admission and a month after discharge. Conclusions: Atopic children with Adv infection experience more severe coughing during hospitalisation and are prone to wheezing and small airway disease on the HRCT. Family and personal history of asthma, atopy, severe infection, and Adv infection were independent factors associated with the development of small airway disease on the chest HRCT scan.

Download Full-text

The preliminary comparative results between Covid-19 and non-Covid-19 patients in Western China

10.21203/rs.3.rs-20178/v1 ◽

2020 ◽

Author(s):

Li Yanzi ◽

Li Hongxia ◽

Han Jianfeng ◽

Yang Lin

Keyword(s):

Clinical Characteristics ◽

White Cell Count ◽

Western China ◽

C Reactive Protein ◽

Reactive Protein ◽

Sputum Production ◽

Familial Clustering ◽

History Of ◽

Comparative Results ◽

Major Adverse Events

Abstract Background: This study aims to investigate the comparative clinical characteristics of Covid-19 and non-Covid-19 patients.Methods: Fifteen Covid-19 and 93 non-Covid-19 patients were included in RNA testing. All epidemiological and clinical data were collected and analyzed, and then comparative results were carried out.Results: Covid-19 patients were older (46.40±18.21 years vs 34.43±18.80 years) and hada higher body weight (70.27±10.67 kg vs 60.54±12.33 kg, P<0.05). The main symptoms that were similar between Covid-19 and non-Covid-19 patients, and Covid-19 patients showed a lower incidence of sputum production (6.67% vs 45.16%, P<0.01) and a lower white-cell count (4.83×109/L vs 7.43×109/L) and lymphocyte count (0.90×109/L vs 1.57×109/L) (P<0.01). Although there were no differences, C-reactive protein and interleukin-6 were elevated in Covid-19 patients. The sensitivity and negative predictive value of CT images were 0.87 and 0.97, respectively. Covid-19 patients showed a higher contact history of Wuhan residents (80% vs 30.11%) and higher familial clustering (53.33% vs 8.60%, P<0.001). Covid-19 patients showed a higher major adverse events (ARDS, 13.33%; death, 6.67%; P<0.05).Conclusion: Our results suggested that Covid-19 patients had a significant history of exposure and familial clustering and a higher rate of severe status; biochemical indicators showed lymphocyte depletion.

Download Full-text

Clinical characteristics of imported and second-generation coronavirus disease 2019 (COVID-19) cases in Shaanxi outside Wuhan, China: a multicentre retrospective study

Epidemiology and Infection ◽

10.1017/s0950268820002332 ◽

2020 ◽

Vol 148 ◽

Cited By ~ 1

Author(s):

Puyu Shi ◽

Guoxia Ren ◽

Jun Yang ◽

Zhiqiang Li ◽

Shujiao Deng ◽

...

Keyword(s):

Pulmonary Fibrosis ◽

Lymphocyte Count ◽

Clinical Characteristics ◽

Second Generation ◽

C Reactive Protein ◽

Laboratory Findings ◽

Reactive Protein ◽

Computed Tomography Images ◽

Death Case ◽

Very High

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.

Download Full-text

Acute cerebrovascular disease following COVID-19: a single center, retrospective, observational study

Stroke and Vascular Neurology ◽

10.1136/svn-2020-000431 ◽

2020 ◽

Vol 5 (3) ◽

pp. 279-284 ◽

Cited By ~ 106

Author(s):

Yanan Li ◽

Man Li ◽

Mengdie Wang ◽

Yifan Zhou ◽

Jiang Chang ◽

...

Keyword(s):

Risk Factors ◽

Cerebrovascular Disease ◽

Management Strategy ◽

Clinical Characteristics ◽

C Reactive Protein ◽

Laboratory Findings ◽

Reactive Protein ◽

Negative Prognostic Factor ◽

History Of ◽

New Onset

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.

Download Full-text