scholarly journals Clinical course and progression of severe and critically ill patients with corona virus disease 2019

2020 ◽  
Author(s):  
Dan Ding ◽  
Xueying Chen ◽  
Lei Zhang ◽  
Min Zhou ◽  
Yongjian Xu ◽  
...  
Keyword(s):  
Critically Ill ◽  
Critically Ill Patients ◽  
Virus Disease ◽  
Public Health Issue ◽  
Major Public Health Issue ◽  
Reactive Protein ◽  
Corona Virus ◽  
Neutrophil Percentage ◽  
The Mean ◽  
Hs Crp

Abstract Background：The emergence of Corona Virus Disease 2019 (COVID-19) in Wuhan, China at the end of 2019 is a major public health issue, causing to a large global outbreak. However, the information regarding the clinical characteristic and progression of severe and critically ill patients with COVID-19 is scarce.Methods: We conducted a single-center, retrospective, observational study and enrolled 126 severe and critically ill adult patients who were admitted to the intensive care unit (ICU) of Tongji hospital, between Feb 1 and Feb 20, 2020.Results: Of 126 patients, 85 patients with the positive of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) were included. The mean age of 85 patients was 68.3 (SD 10.5) years. More than half were men, 55 (62.4%) had chronic illness. 57 (66.3%) patients had died before Feb 28, 2020. the median duration from onset of illness to death, hospitalization to death and ICU admission to death were 22 (17.0-26.0) days, 9.0 (6.0-13.0) days and 5.0 (2.0-6.0) days, respectively. Compared with survivors, non-survivors were more likely old (69.6 [SD 10.22] vs 65.6 [10.9]). Furthermore, the non-survivors had higher white blood cell (WBC) and neutrophil count, neutrophil percentage, high-sensitive C-reactive protein (hs-CRP) and lower lymphocyte and platelet count, lymphocyte percentage and albumin. Notably, arbidol may improve the survival of severe and critically ill patients.Conclusions: Our study reveals the non-survivors had worse blood routine and other clinical monitors. Additionally, arbidol may play useful role in the survival of severe and critically ill patients, which needs further validation.

scholarly journals The clinical data from 19 critically ill patients with Corona Virus Disease 2019: a single-centered, retrospective, observational study

2020 ◽  
Author(s):  
Jinping Zhang
Keyword(s):  
Critically Ill ◽  
Critically Ill Patients ◽  
Virus Disease ◽  
Ground Glass ◽  
C Reactive Protein ◽  
Reactive Protein ◽  
Corona Virus ◽  
Index Changes ◽  
Hs Crp ◽  
D Dimer

Abstract Background To analyze the clinical features of Corona Virus Disease 2019 (COVID-19) and evaluate the diagnosis and treatment.Methods Making retrospective analysis of the clinical manifestation and auxiliary examination of the 19 patients of COVID-19 which from the Liyuan Hospital ICU between January 16, 2020 and February 20, 2020.Results There were 11 male and 8 female cases among the patients. The median (range) age was 73 (38-91) years. There are 8（42.1%）patients had died , and the median duration from ICU to death was 2 (IQR: 1–10.75) days in non-survivors. Seven patients have the basic diseases which in the dead patients. Auxiliary examination: fever (68.4%), dry cough (15.8%), dyspnea (10.5%), diarrhea (5.3%). 19 cases (100%) showed ground-glass changes on Chest computed tomography. Serum Hypersensitive C-Reactive Protein (hs-CRP) and Serum Amylase A (SAA) were increased obviously of 19 cases (100%); there are 16（84.2%）cases which the total number of lymphocytes decreased; 12 cases (63%) liver function; 11 cases (58%) were deviant in fibrinogen (FIB) and D-dimer, in particular, the D-dimer was significantly higher compared with the non-survivors and survivors.Conclusion More men than women in critically ill patients. All the cases showed ground-glass changes on chest CT, and the vast majority of patients will appear fever and dry cough. Clinical lab index changes obviously, especially the D-dimer in Non-survivors.

scholarly journals Corona Virus Disease 2019 in situ arterial and venous thrombosis in critically ill patients: a case series

2020 ◽  
Author(s):  
Mireya Castro-Verdes ◽  
Antonia Gkouma ◽  
John Wort ◽  
Carole Ridge ◽  
Saeed Mirsadraee ◽  
...  
Keyword(s):  
Critically Ill ◽  
Critically Ill Patients ◽  
Virus Disease ◽  
Case Series ◽  
Bleeding Risk ◽  
Conventional Mechanical Ventilation ◽  
Cross Sectional ◽  
Cardiorespiratory Failure ◽  
Corona Virus

Abstract Background Corona Virus Disease 2019 (COVID-19) pneumonitis associated with severe respiratory failure carries a high mortality. Coagulopathy has emerged as a significant contributor to thrombotic complications. Case summary We describe two cases of severe COVID-19 pneumonitis refractory to conventional mechanical ventilation and proning position, transferred to our specialist centre for cardiorespiratory failure. Cross-sectional imaging demonstrated concurrent venous and aortic thrombosis with end-organ ischaemic changes. One patient received thrombolysis with a partial response. This could not be offered to the other patient due to a recent haemorrhagic event. Both patients died of multi-organ failure in the hospital. Discussion Concurrent aortic and venous thromboses are rare. This finding in COVID-19 cases, who were both critically ill patients, likely reflects the strongly thrombogenic nature of this illness which ultimately contributed to poor outcomes. The absence of deep vein thrombosis or a potential systemic source of embolism suggests in situ thrombosis. Further, the management of anticoagulation and thrombolysis is challenging in patients where an attendant bleeding risk exists.

scholarly journals Improved night shift schedule related to the mortality of critically ill patients with Corona Virus Disease 2019

2020 ◽  
Vol 75 ◽  
pp. 354-360
Author(s):  
Sun Zhang ◽  
Yuanda Xu ◽  
Kang Wu ◽  
Tao Wang ◽  
Xiaofen Su ◽  
...  
Keyword(s):  
Critically Ill ◽  
Critically Ill Patients ◽  
Virus Disease ◽  
Night Shift ◽  
Shift Schedule ◽  
Corona Virus

scholarly journals The Efficacy of Convalescent Plasma Use in Critically Ill COVID-19 Patients

Medicina ◽  
2021 ◽  
Vol 57 (3) ◽  
pp. 257
Author(s):  
Livius Tirnea ◽  
Felix Bratosin ◽  
Iulia Vidican ◽  
Bianca Cerbu ◽  
Mirela Turaiche ◽  
...  
Keyword(s):  
Pilot Study ◽  
Critically Ill ◽  
Critically Ill Patients ◽  
Therapeutic Option ◽  
White Blood Cells ◽  
The United States ◽  
Plasma Therapy ◽  
Reactive Protein ◽  
United States Food ◽  
States Food

Background and Objectives: On 24 March 2020, the United States Food and Drug Administration (FDA) announced the approval of convalescent plasma therapy for critically ill patients with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) as an emergency investigational new drug. This pilot study from Romania aimed to determine if convalescent plasma transfusion can be beneficial in the treatment of selected critically ill patients diagnosed with a SARS-CoV-2 infection. Materials and Methods: Donor and receiver eligibility for critically ill coronavirus disease 2019 (COVID-19) patients was based on Romanian guidelines issued at the time of the study. Here, we describe the evolution of a total of five eligible patients diagnosed with COVID-19 who received convalescent plasma (CP) in Romania. Results: In spite of our efforts and convalescent plasma administration, three of the five patients did not survive, while the other two recovered completely. Over the course of our five-day laboratory record, the surviving patients had significantly lower values for C-reactive protein, interleukin-6, and white blood cells. Conclusions: This pilot study provides insufficient evidence to determine the efficacy of convalescent plasma use as a therapeutic option for critically ill COVID-19 patients.

Abstract 15293: Noninvasive Echocardiographic Cardiac Power Output Predicts Mortality in Cardiac Intensive Care Unit Patients

Circulation ◽  
2020 ◽  
Vol 142 (Suppl_3) ◽  
Author(s):  
Barry Burstein ◽  
Vidhu Anand ◽  
Bradley Ternus ◽  
Meir Tabi ◽  
Nandan S Anavekar ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Hospital Mortality ◽  
Critically Ill ◽  
Power Output ◽  
Critically Ill Patients ◽  
Cardiac Intensive Care Unit ◽  
Cardiac Power ◽  
The Mean ◽  
Cardiac Intensive Care

Introduction: A low cardiac power output (CPO), measured invasively, identifies critically ill patients at increased risk of mortality. CPO can also be measured non-invasively with transthoracic echocardiography (TTE), although prognostic data in critically ill patients is not available. Hypothesis: Reduced CPO measured by TTE is associated with increased hospital mortality in cardiac intensive care unit (CICU) patients. Methods: Using a database of CICU patients admitted between 2007 and 2018, we identified patients with TTE within one day (before or after) of CICU admission who had data necessary for calculation of CPO. Multivariable logistic regression determined the relationship between CPO and adjusted hospital mortality. Results: We included 5,585 patients with a mean age of 68.3±14.8 years, including 36.7% females. Admission diagnoses included acute coronary syndrome (ACS) in 57%, heart failure (HF) in 50%, cardiac arrest (CA) in 12%, and cardiogenic shock (CS) in 13%. The mean left ventricular ejection fraction (LVEF) was 47±16%, and the mean CPO was 1.0±0.4 W. CPO was inversely associated with the risk of hospital mortality (Figure A), including among patients with ACS, HF, and CS (Figure B). On multivariable analysis, lower CPO was associated with higher hospital mortality (OR 0.96 per 0.1 W, 95% CI 0.0.93-0.99, p=0.03). Hospital mortality was highest in patients with low CPO coupled with reduced LVEF, increased vasopressor requirements, or higher admission lactate. Hospital mortality was higher among patients with a CPO <0.6 W (adjusted OR 1.57, 95% CI 1.13-2.19, p = 0.007), particularly in the presence of admission lactate level >4 mmol/L (50.9%). Conclusions: Echocardiographic CPO was inversely associated with hospital mortality in CICU patients, particularly among patients with increased lactate and vasopressor requirements. Routine measurement of CPO provides important information beyond LVEF and should be considered in CICU patients.

scholarly journals Anticipation of High-Sensitivity C-Reactive Protein Effect on Post Myocardial Infarction Depression Disorder

2021 ◽  
Vol 10 ◽  
pp. e1512
Author(s):  
Parichehr Alizadeh ◽  
Ehsan Bahramali ◽  
Arvin Hedayati ◽  
Azizallah Dehghan
Keyword(s):  
Myocardial Infarction ◽  
High Sensitivity ◽  
Intima Media Thickness ◽  
Public Health Issue ◽  
C Reactive Protein ◽  
Mild Depression ◽  
Reactive Protein ◽  
Depressed Patients ◽  
Inflammatory State ◽  
Hs Crp

Background: The natural history of acute myocardial infarction (AMI) as the most prevalent public health issue in Iran has changed with the introduction of novel therapeutic strategies that have reduced its mortality significantly. Major depressive disorder (MDD) is a prevalent and disabling psychiatric disorder and frequently co-exist with AMI. There are proposed pathophysiological links between the two diseases among which inflammation is the most important. With more patients surviving a myocardial infarction (MI) event, post-MI depression has become an important determinant of disability and mortality. Materials and Methods: In this study we defined a 1-month post-MI depressive scale of 200 patients using Beck’s inventory questionnaire II and measured serum high Sensitivity C-Reactive Protein (hs-CRP) and carotid intima-media thickness (CIMT) to look for the association between inflammatory state and atherosclerosis in different depression score categories. Results: Minimum and maximum Beck scores were 1 and 43, respectively with a mean of 13±8. The mean CIMT was 0.77±0.26 mm. Serum hs-CRP level was measured with a mean of 1.51±1.6 mg/L. According to BDI-II scores, 44.2% of patients 1-month post-MI suffered from more than mild depression. Being affected was not correlated with either the level of hs-CRP or CIMT. Nearly 44 percent of patients suffered more than mild depression. There was a negative association between serum hs-CRP level and CIMT as a measure of atherosclerosis in groups of depressed versus non-depressed patients. This may indicate that the extent of atherosclerosis is not correlated with the inflammatory state after MI in depressed versus non-depressed patients. Conclusions: The results of this study indicate that the extent of atherosclerosis is not correlated with the inflammatory state after MI in depressed versus non-depressed patients. Nonetheless, the prognostic indications of increased hs-CRP and depression after AMI remains to be investigated further. [GMJ.2021;10:e1512]

scholarly journals Early Fever Is Associated With Clinical Outcomes in Patients With Coronavirus Disease

2021 ◽  
Vol 9 ◽  
Author(s):  
Feng-ming Ding ◽  
Yun Feng ◽  
Lei Han ◽  
Yan Zhou ◽  
Yong Ji ◽  
...  
Keyword(s):  
Clinical Outcomes ◽  
Critically Ill ◽  
Symptom Onset ◽  
Critically Ill Patients ◽  
Severe Disease ◽  
Multivariable Analysis ◽  
Reactive Protein ◽  
Increased Temperature ◽  
Kaplan Meier ◽  
Image Improvement

Fever is one of the typical symptoms of coronavirus disease (COVID-19). We aimed to investigate the association between early fever (EF) and clinical outcomes in COVID-19 patients. A total of 1,014 COVID-19 patients at the Leishenshan Hospital were enrolled and classified into the EF and non-EF groups based on whether they had fever within 5 days of symptom onset. Risk factors for clinical outcomes in patients with different levels of disease severity were analyzed using multivariable analyses. Time from symptom onset to symptom alleviation, CT image improvement, and discharge were longer for patients with moderate and severe disease in the EF group than in the non-EF group. Multivariable analysis showed that sex, EF, eosinophil number, C-reactive protein, and IL-6 levels were positively correlated with the time from symptom onset to hospital discharge in moderate cases. The EF patients showed no significant differences in the development of acute respiratory distress syndrome, compared with the non-EF patients. The Kaplan–Meier curve showed no obvious differences in survival between the EF and non-EF patients. However, EF patients with increased temperature showed markedly lower survival than the non-EF patients with increased temperature. EF had no significant impact on the survival of critically ill patients, while an increase in temperature was identified as an independent risk factor. EF appears to be a predictor of longer recovery time in moderate/severe COVID-19 infections. However, its value in predicting mortality needs to be considered for critically ill patients with EF showing increasing temperature.

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