scholarly journals Analysis clinical features of COVID-19 infection in secondary epidemic area and report potential biomarkers in evaluation

Author(s):  
Weiping Ji ◽  
Gautam Bishnu ◽  
Xian Shen ◽  
Zhenzhai Cai

Abstract Objective: Based on the clinical characteristics of infected patients with novel coronavirus in secondary epidemic areas, we aimed to identify potential biomarkers for the evaluation of novel coronavirus-infected patients, guide the diagnosis and treatment of this disease in secondary epidemic areas and provide a reference for the clinical prevention and control of this epidemic situation.Methods: The clinical data of 33 patients with respiratory symptoms caused by the novel coronavirus in Wenzhou city from January 15 to February 12, 2020, were thoroughly reviewed. At the onset of the disease, we found that the primary symptoms were fever, cough, fatigue, chest tightness, chest pain and specific blood test results. According to the patients’ histories, the patients were divided into two groups: those who spent time in the main epidemic area and those who did not spend time in the main epidemic area. The differences in the clinical manifestations between these two groups were analyzed.Results: The main clinical symptoms of patients infected with novel coronavirus in the secondary epidemic area were respiratory tract ailments and systemic symptoms. After grouping patients based on the presence or absence of residency in or travel history to the main epidemic area, there was no significant difference between the baseline data of these two groups, and there were no significant differences in symptoms and signs between the two groups (P>0.05). Some patients had abnormally increased serum amyloid protein A (SAA). There were statistically significant differences in the leukocyte count/C-reactive protein, monocyte ratio/C-reactive protein, neutrophil count/C-reactive protein, monocyte count/C-reactive protein and hemoglobin/C-reactive protein values between the two groups (P < 0.05).Conclusion: Respiratory tract ailments and systemic symptoms were the primary symptoms of novel coronavirus infection in the secondary epidemic area; these symptoms are not typical. The abnormal increase in serum amyloid protein (SAA) may be used as an auxiliary index for diagnosis and treatment. CRP changes before other blood parameters and thus may be an effective evaluation index for patients with COVID-19 infection.

2020 ◽  
Author(s):  
Weiping Ji ◽  
Gautam Bishnu ◽  
Zhenzhai Cai ◽  
Xian Shen

AbstractObjectiveBased on the clinical characteristics of infected patients with novel coronavirus in secondary epidemic areas, we aimed to identify potential biomarkers for the evaluation of novel coronavirus-infected patients, guide the diagnosis and treatment of this disease in secondary epidemic areas and provide a reference for the clinical prevention and control of this epidemic situation.MethodsThe clinical data of 33 patients with respiratory symptoms caused by the novel coronavirus in Wenzhou city from January 15 to February 12, 2020, were thoroughly reviewed. At the onset of the disease, we found that the primary symptoms were fever, cough, fatigue, chest tightness, chest pain and specific blood test results. According to the patients’ histories, the patients were divided into two groups: those who spent time in the main epidemic area and those who did not spend time in the main epidemic area. The differences in the clinical manifestations between these two groups were analyzed.ResultsThe main clinical symptoms of patients infected with novel coronavirus in the secondary epidemic area were respiratory tract ailments and systemic symptoms. After grouping patients based on the presence or absence of residency in or travel history to the main epidemic area, there was no significant difference between the baseline data of these two groups, and there were no significant differences in symptoms and signs between the two groups (P>0.05). Some patients had abnormally increased serum amyloid protein A (SAA). There were statistically significant differences in the leukocyte count/C-reactive protein, monocyte ratio/C-reactive protein, neutrophil count/C-reactive protein, monocyte count/C-reactive protein and hemoglobin/C-reactive protein values between the two groups (P < 0.05).ConclusionRespiratory tract ailments and systemic symptoms were the primary symptoms of novel coronavirus infection in the secondary epidemic area; these symptoms are not typical. The abnormal increase in serum amyloid protein (SAA) may be used as an auxiliary index for diagnosis and treatment. CRP changes before other blood parameters and thus may be an effective evaluation index for patients with COVID-19 infection.


2020 ◽  
Author(s):  
Yong-Tao Li ◽  
Mei-Lian Peng ◽  
Jia-dan Fu ◽  
Li Liu ◽  
Yong-zheng Guo ◽  
...  

Abstract Objective: The novel coronavirus pneumonia (COVID-19) has spread rapidly across the globe with the movement of people. How to diagnose COVID-19 quickly and accurately is a concern for all. We retrospectively assessed the clinical characteristics of patients with COVID-19 detected by outpatient screening in areas outside Wuhan, China, to guide early screening outside the epidemic area, to isolate and treat COVID-19-positive patients, and to control the spread of this virus in the region.Results: Among the 213 patients treated in the fever clinic of our hospital, 41 tested positive for novel coronavirus (2019-nCoV) and 172 were negative. Among the positive patients, 13 (31.7%) of the patients had been to Wuhan, while 28 (68.3%) had not been to Wuhan. There were 4 cases of clustering occurrence. The main symptoms exhibited by COVID-19-positive patients were fever (87.8%), cough (68.3%), and expectoration (34.1%). The C-reactive protein (CRP) levels were increased in 35 (85.3%) positive patients; the hydroxybutyrate dehydrogenase in the myocardial zymogram was increased in 22 positive patients (53.6%) and 38 negative patients (22.1%); computed tomography (CT) findings revealed lung lesions in all 41 positive patients (100%).Conclusion: We classified the patient population and analyzed the data to understand the early clinical performance of COVID-19. Our research illustrate that screening for COVID-19 outside Wuhan should focus on early symptoms such as fever and cough, in combination with lung CT findings, epidemiological history, and sputum pathogen detection to determine whether patients need further isolation.


1993 ◽  
Vol 39 (2) ◽  
pp. 293-297 ◽  
Author(s):  
T Nakayama ◽  
S Sonoda ◽  
T Urano ◽  
T Yamada ◽  
M Okada

Abstract We examined serum amyloid protein A (SAA) and C-reactive protein (CRP) as inflammatory markers of viral and bacterial infections. Both acute-phase reactants increased in the acute stage and thereafter decreased in the convalescent stage. In viral infections, the mean serum concentrations of SAA during the acute stage were 141 mg/L in infections with adenovirus, 77 mg/L with measles virus, 63 mg/L with influenza virus, 55 mg/L with parainfluenza virus, 31 mg/L with respiratory syncytial virus, and 31 mg/L in aseptic meningitis. The mean serum concentration of CRP was 19 mg/L for adenovirus infection and &lt; 7 mg/L in all other viral infections. The SAA concentrations were 5- to 11-fold greater than the CRP concentrations. Both the SAA and the CRP concentrations were higher in bacterial infections than in viral infections. Changes in the concentrations of serum SAA paralleled those in serum CRP in bacterial infection; during the course of viral infection, however, serum SAA tended to disappear more quickly than CRP did. SAA appears to be a clinically useful marker of inflammation in acute viral infections, with or without significant changes in the CRP concentration.


Author(s):  
Rohit S Loomba ◽  
Enrique G Villarreal ◽  
Juan S Farias ◽  
Gaurav Aggarwal ◽  
Saurabh Aggarwal ◽  
...  

Background There is limited information regarding the role of biomarker levels at predicting mortality in patients with the novel coronavirus pandemic (Covid-19). The purpose of this study is to determine the differences in serum biomarker levels in adults with Covid-19 who survived hospitalization from those who did not. Methods A comprehensive search was completed on PubMed, EMBASE, and Cochrane libraries to identify studies of interest. Endpoints of interest were blood counts, hepatic function test, acute phase reactants, cytokines and cardiac biomarkers. Results A total of 10 studies with 1,584 patients were included in the pooled analyses. Biomarkers that were noted to be significantly higher in those who died from Covid-19 (coronavirus disease 2019) included: white blood cell count, neutrophil count, C-reactive protein, high sensitivity C-reactive protein, procalcitonin, ferritin, D-dimer, interleukins 6, lactate dehydrogenase, creatine kinase, prothrombin time, aspartate aminotransferase, alanine aminotransferase, total bilirubin, and creatinine. Lymphocyte count, platelet count, and albumin were significantly lower in patients who died. Conclusion This pooled analysis of 10 studies including 1,584 patients identified significant differences in biomarkers on admission in patients who survived from those who did not. Further research is needed to develop risk stratification models to help with judicious use of limited healthcare resources.


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