scholarly journals Clinical features, treatments and outcomes of severe and critical severe patients infected with COVID-19: A system review and meta-analysis

2020 ◽  
Author(s):  
Hai-yue Zhang ◽  
Fang-zhou Jiao ◽  
Xiao-jun Wu ◽  
Min Shang ◽  
Yu-chuan Luo ◽  
...  
Keyword(s):  
Clinical Features ◽  
Clinical Laboratory ◽  
Meta Analysis ◽  
Invasive Mechanical Ventilation ◽  
Cardiac Injury ◽  
Fatal Outcome ◽  
Fixed Effect Model ◽  
Utilization Rate ◽  
Imaging Features ◽  
Multiple Organs

Abstract Backgrounds: The outbreak of COVID-19 caused by a novel coronavirus, SARS-CoV-2, has been listed as a public health emergency of international concern by WHO. Most COVID-19 patients presented with a mild infection, but many challenges exist in therapy of severe and critical severe patients. This paper systematically reviewed clinical features, treatments and outcomes of severe and critical severe patients infected COVID-19. Methods: The clinical, laboratory, imaging features, treatment and outcomes of COVID-19 were collected. The data were analyzed by using STATA 15 statistical software to estimate the prevalence and 95% CI in severe and critical severe patients with COVID-19. A random or fixed effect model was used to estimate the prevalence and 95% CI. Results: After screening, 8 studies including a total of 275 patients were included in this meta-analysis. The percentage of severe and critical severe patients in confirmed COVID-19 cases was 25% (95% CI 16-36%). Fever, cough, dyspnea, lymphopenia and bilateral distribution of patchy shadows were the most prevalent findings in these patients. Utilization rate of antiviral drugs, corticosteroid, non-invasive ventilation, invasive mechanical ventilation was high in therapy strategies. The most prevalent complications were ARDS, shock, and acute cardiac injury. Discussion: Severe and critical severe COVID-19 patients usually had complications even a fatal outcome. As vaccines and anti-coronaviral drugs are under development, the principles of treatment for these patients should be focused on improving oxygenation, lung protective and function support of multiple organs.

scholarly journals Clinical, Laboratory and Imaging Features of COVID-19: A Systematic Review and Meta-analysis

2020 ◽  
Author(s):  
Alfonso J. Rodriguez-Morales ◽  
Jaime A. Cardona-Ospina ◽  
Estefanía Gutiérrez-Ocampo ◽  
Rhuvi Villamizar-Peña ◽  
Yeimer Holguin-Rivera ◽  
...  
Keyword(s):  
Observational Studies ◽  
Clinical Laboratory ◽  
Case Reports ◽  
Meta Analysis ◽  
Fatal Outcome ◽  
Clinical Manifestations ◽  
Clinical Infectious Disease ◽  
Imaging Features ◽  
Pooled Prevalence ◽  
Quantitative Analyses

Introduction: An epidemic of Coronavirus Disease 2019 (COVID-19) begun in December 2019 in China, causing a Public Health Emergency of International Concern. Among raised questions, clinical, laboratory, and imaging features have been partially characterized in some observational studies. No systematic reviews have been published on this matter. Methods: We performed a systematic literature review with meta-analysis, using three databases to assess clinical, laboratory, imaging features, and outcomes of confirmed cases of COVID-19. All the observational studies, and also case reports, were included and analyzed separately. We performed a random-effects model meta-analysis to calculate the pooled prevalence and 95% confidence interval (95%CI). Measures of heterogeneity were estimated and reported. Results: 660 articles were retrieved. After screening by abstract and title, 27 articles were selected for full-text assessment. Of them, 19 were finally included for qualitative and quantitative analyses. Additionally, 39 case report articles were included and analyzed separately. For 656 patients, fever (88.7%, 95%CI 84.5-92.9%), cough (57.6%, 40.8-74.4%) and dyspnea (45.6%, 10.9-80.4%) were the most prevalent clinical manifestations. Among the patients, 20.3% (95%CI 10.0-30.6%) required intensive care unit (ICU), with 32.8% presenting acute respiratory distress syndrome (ARDS) (95%CI 13.7-51.8), 6.2% (95%CI 3.1-9.3) with shock and 13.9% (95%CI 6.2-21.5%) with a fatal outcome. Discussion: COVID-19 is a new clinical infectious disease, causing considerable compromise, especially in patients with comorbidities, requiring ICU in at least a fifth of them and sometimes with fatal outcomes. Additional research is needed to elucidate factors that may mediate the pathogenesis of the severe and fatal associated disease.

scholarly journals Clinical Features of Maintenance Hemodialysis Patients with 2019 Novel Coronavirus-Infected Pneumonia in Wuhan, China

2020 ◽  
Vol 15 (8) ◽  
pp. 1139-1145 ◽  
Author(s):  
Jun Wu ◽  
Jushuang Li ◽  
Geli Zhu ◽  
Yanxia Zhang ◽  
Zhimin Bi ◽  
...  
Keyword(s):  
Clinical Features ◽  
Troponin I ◽  
Clinical Laboratory ◽  
Cardiac Injury ◽  
Hemodialysis Patients ◽  
Hospitalized Patients ◽  
Maintenance Hemodialysis ◽  
Computed Tomographic ◽  
Risk Of Death ◽  
Novel Coronavirus

Background and objectivesPrevious reports on the outbreak of coronavirus disease 2019 were on the basis of data from the general population. Our study aimed to investigate the clinical features of patients on maintenance hemodialysis.Design, setting, participants, & measurements In this retrospective, single-center study, we included 49 hospitalized patients on maintenance hemodialysis and 52 hospitalized patients without kidney failure (controls) with confirmed coronavirus disease 2019 at Tongren Hospital of Wuhan University from January 30, 2020 to March 10, 2020. Demographic, clinical, laboratory, and radiologic characteristics and treatment and outcomes data were analyzed. The final date of follow-up was March 19, 2020.ResultsThe median age of 101 patients was 62 years (interquartile range, 49–72). All patients were local residents of Wuhan. In terms of common symptoms, there were differences between patients on hemodialysis and controls (fatigue [59% versus 83%], dry cough [49% versus 71%], and fever [47% versus 90%]). Lymphocyte counts were decreased (0.8×109/L [patients on hemodialysis] versus 0.9×109/L [controls], P=0.02). Comparing patients on hemodialysis with controls, creatine kinase–muscle and brain type, myoglobin, hypersensitive troponin I, B-type natriuretic peptide, and procalcitonin were increased, and the percentage of abnormalities in bilateral lung was higher in computed tomographic scan (82% versus 69%, P=0.15) and unilateral lung was lower (10% versus 27%, P=0.03). Common complications including shock, acute respiratory distress syndrome, arrhythmia, and acute cardiac injury in patients on hemodialysis were significantly higher. Compared with controls, more patients on hemodialysis received noninvasive ventilation (25% versus 6%, P=0.008). As of March 19, 2020, three patients on hemodialysis (6%) were transferred to the intensive care unit and received invasive ventilation. Seven patients on hemodialysis (14%) had died.ConclusionsThe main symptoms of coronavirus disease 2019 pneumonia, including fever and cough, were less common in patients on hemodialysis. Patients on hemodialysis with coronavirus disease 2019 were at higher risk of death.

scholarly journals Clinical, laboratory and imaging features of COVID-19: A systematic review and meta-analysis

2020 ◽  
Vol 34 ◽  
pp. 101623 ◽  
Author(s):  
Alfonso J. Rodriguez-Morales ◽  
Jaime A. Cardona-Ospina ◽  
Estefanía Gutiérrez-Ocampo ◽  
Rhuvi Villamizar-Peña ◽  
Yeimer Holguin-Rivera ◽  
...  
Keyword(s):  
Systematic Review ◽  
Clinical Laboratory ◽  
Meta Analysis ◽  
Imaging Features

scholarly journals CLINICAL PROPERTIES AND DIAGNOSTIC METHODS OF COVID-19 INFECTION IN PREGNANCIES: META-ANALYSIS

2020 ◽  
Author(s):  
Banu Uygun-Can ◽  
Bilge Acar-Bolat
Keyword(s):  
Pregnant Women ◽  
Clinical Features ◽  
Retrospective Studies ◽  
Clinical Symptoms ◽  
Meta Analysis ◽  
Diagnostic Methods ◽  
Imaging Features ◽  
Medical Evidence ◽  
Rt Pcr ◽  
Pcr Diagnosis

AbstractWe aimed to summarize reliable medical evidence by the meta-analysis of all published retrospective studies that examined data based on the detection of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) by clinical symptoms, molecular (RT-PCR) diagnosis and characteristic CT imaging features in pregnant women. MEDLINE PubMed, SCOPUS, ISI Web of Science, Clinical Key, and CINAHL databases were used to select the studies. Then, 384 articles were received, including the studies until 01/MAY/2020. As a result of the full-text evaluation, 12 retrospective articles covering all the data related were selected. A total of 181 pregnant cases with SARS-CoV-2 infections were included in the meta-analysis within the scope of these articles. According to the results, the incidence of fever was 38.1% (95% CI: 14.2–65%), and cough was 22% (95% CI: 10.8–35.2%) among all clinical features of pregnant cases with SARS-CoV-2 infection. So, fever and cough are the most common symptoms in pregnant cases with SARS-CoV- infection, and 91.8% (95% CI: 76.7–99.9%) of RT-PCR results are positive. Moreover, abnormal CT incidence is 97.9% (95% CI: 94.2–99.9%) positive. No case was death. However, as this virus spreads globally, it should not be overlooked that the incidence will increase in pregnant women and may be in the risky group. RT-PCR and CT can be used together in an accurate and safe diagnosis. In conclusion, these findings will provide important guidance for current studies regarding the clinical features and correct detection of SARS-CoV-2 infection in pregnant women, as well as whether it will create emergency tables that will require the use of a viral drug.

scholarly journals Clinical, laboratory, and radiologic findings associated with mortality in COVID-19: A systematic review and meta-analysis

2020 ◽  
Author(s):  
Hoo Jung Rhim ◽  
Jin Hyun Park ◽  
Yuna Lee ◽  
Seung Chan Kwon ◽  
Min Gyu Yu ◽  
...  
Keyword(s):  
Systematic Review ◽  
Troponin I ◽  
Clinical Laboratory ◽  
Meta Analysis ◽  
Invasive Mechanical Ventilation ◽  
Case Series ◽  
Case Control ◽  
Outcome Analysis ◽  
Cross Sectional ◽  
Case Series Study

Abstract Although there has been a surge in reports on coronavirus disease 2019 (COVID-19), the clinical signs and findings associated with fatal outcomes have rarely been studied. This systematic review and meta-analysis aimed to investigate the clinical, laboratory, and radiologic features associated with mortality in COVID-19. A comprehensive search was performed using PubMed, Embase, Web of Science, and other databases including government sources, for articles and reports published until May 1, 2020. We extracted the number of events (mortality and non-mortality) from case series and case-control and cross-sectional studies. Hazard ratios (HR) of each finding were extracted from studies with time-to-outcome analysis. In total, 23 studies met the inclusion criteria. Of them, 18 studies were case-control, cross-sectional, and case series study. Whereas, only 5 studies included time-to-outcome analysis. Male sex, age over 80 years, dyspnea, cardiovascular disease, chronic kidney disease, increased troponin I level, acute respiratory distress syndrome, acute kidney injury, and need of invasive mechanical ventilation were significantly associated with mortality. The identification of patients at higher risk of mortality has an utmost importance to achieve better treatment outcomes. The findings from our study may aid the prioritization in times of severe shortages of medical resources. Further studies analyzing diverse demographic and geographic populations are needed to generalize the findings from this study.

scholarly journals The Novel Coronavirus Disease (COVID-19): A PRISMA Systematic Review and Meta-Analysis of Clinical and Paraclinical Characteristics

2020 ◽  
Vol 2020 ◽  
pp. 1-16 ◽  
Author(s):  
Hamidreza Hasani ◽  
Shayan Mardi ◽  
Sareh Shakerian ◽  
Nooshin Taherzadeh-Ghahfarokhi ◽  
Parham Mardi
Keyword(s):  
Systematic Review ◽  
Observational Studies ◽  
Clinical Laboratory ◽  
Meta Analysis ◽  
Ct Scanning ◽  
Imaging Features ◽  
The Novel ◽  
Laboratory Findings ◽  
Global Concern ◽  
Novel Coronavirus

An outbreak of pneumonia, caused by a novel coronavirus (SARS-CoV-2), was identified in China in December 2019. This virus expanded worldwide, causing global concern. Although clinical, laboratory, and imaging features of COVID-19 are characterized in some observational studies, we undertook a systematic review and meta-analysis to assess the frequency of these features. We did a systematic review and meta-analysis using three databases to identify clinical, laboratory, and computerized tomography (CT) scanning features of rRT-PCR confirmed cases of COVID-19. Data for 3420 patients from 30 observational studies were included. Overall, the results showed that fever (84.2%, 95% CI 82.6-85.7), cough (62%, 95% CI 60-64), and fatigue (39.4%, 95% CI 37.2-41.6%) are the most prevalent symptoms in COVID-19 patients. Increased CRP level, decreased lymphocyte count, and increased D-dimer level were the most common laboratory findings. Among COVID-19 patients, 92% had a positive CT finding, most prevalently ground-glass opacification (GGO) (60%, 95% CI 58-62) and peripheral distribution opacification (64%, 95% CI 60-69). These results demonstrate the clinical, paraclinical, and imaging features of COVID-19.

Abstract 13093: Clinical Features and Prognosis of Acute Cardiac Injury in Hospitalized Patients With Covid-19: A Retrospective Cohort Study

Circulation ◽  
2020 ◽  
Vol 142 (Suppl_3) ◽  
Author(s):  
Mingxing XIE ◽  
Li Zhang ◽  
yanting zhang ◽  
Wei Sun ◽  
CHUN WU ◽  
...  
Keyword(s):  
Hospital Mortality ◽  
Proportional Hazards ◽  
Troponin I ◽  
Clinical Laboratory ◽  
Invasive Mechanical Ventilation ◽  
Cardiac Injury ◽  
High Sensitivity ◽  
Final Analysis ◽  
Cox Proportional Hazards ◽  
Hospitalized Patients

Aims: The fatalities case due to coronavirus disease 2019 (COVID-19) is escalating. However, information on critical complications in hospitalized patients of COVID-19 is scant. We aimed to explore the prevalence of acute cardiac injury and its association with in-hospital mortality in COVID-19 patients. Methods: This retrospective study analyzed COVID-19 patients in Union Hospital (Wuhan, China) from Jan 24 to March 18, 2020. Clinical outcomes (discharge, or death) were monitored to April 9, 2020, the latest date of follow-up. Demographic, clinical, laboratory, echocardiographic data, treatment and prognosis were analyzed. Results: A total of 235 COVID-19 patients were included in the final analysis. Their median age was 66 years (interquartile range 57 - 73), and 131 (55.7%) were men. 98 (41.7%) patients were diagnosed with acute cardiac injury, of whom 60 (61.2%) died. There were more comorbidities in those who with acute cardiac injury than those without. A higher proportion of patients with acute cardiac injury received glucocorticoid therapy (68.0% vs 37.0%; P < 0.001), immunoglobulin (53.1% vs 30.1%; P < 0.001) and invasive mechanical ventilation (40.8% vs 6.6%; P < 0.001) than those without. The percentage of patients who were admitted to intensive care unit (39.8 % vs 8.0%; P < 0.001) or died during hospitalization (61.2% vs 8.0%, P < 0.001) were also higher in those with acute cardiac injury. Plasma high-sensitivity troponin I level correlated significantly with plasma interleukin -6, procalcitonin and C-reactive protein levels in COVID-19 patients. Echocardiography showed that cardiac function was attenuated in acute cardiac injury patients. Multivariable Cox proportional hazards regression analysis showed acute cardiac injury was an independent risk factor for higher in-hospital mortality in COVID-19 patients (HR, 3.393; 95% CI, 1.647- 6.987, P <0.001). Conclusions: Acute cardiac injury is a common condition and may be related to inflammatory response in COVID-19 patients. In addition, our study highlights an association between acute cardiac injury and a higher risk of in-hospital mortality. It is suggested that clinicians should be alert to acute cardiac injury in COVID-19 patients and take prompt treatments to improve outcomes.

scholarly journals Clinical, Laboratory and Imaging Features of COVID-19: A Systematic Review and Meta-analysis

2020 ◽  
Author(s):  
Alfonso J. Rodriguez-Morales ◽  
Jaime A. Cardona-Ospina ◽  
Estefanía Gutiérrez-Ocampo ◽  
Rhuvi Villamizar-Peña ◽  
Yeimer Holguin-Rivera ◽  
...  
Keyword(s):  
Observational Studies ◽  
Clinical Laboratory ◽  
Case Reports ◽  
Meta Analysis ◽  
Case Fatality ◽  
Imaging Features ◽  
Healthcare Facilities ◽  
Qualitative And Quantitative ◽  
Pooled Prevalence ◽  
Quantitative Analyses

Introduction: An epidemic of Coronavirus Disease 2019 (COVID-19) begun in December 2019 in China, causing a Public Health Emergency of International Concern. Among raised questions, clinical, laboratory, and imaging features have been partially characterized in some observational studies. No systematic reviews have been published on this matter. Methods: We performed a systematic literature review with meta-analysis, using three databases to assess clinical, laboratory, imaging features, and outcomes of COVID-19 confirmed cases. Observational studies, and also case reports, were included and analyzed separately. We performed a random-effects model meta-analysis to calculate the pooled prevalence and 95% confidence interval (95%CI). Results: 660 articles were retrieved (1/1/2020-2/23/2020). After screening by abstract/title, 27 articles were selected for full-text assessment. Of them, 19 were finally included for qualitative and quantitative analyses. Additionally, 39 case report articles were included and analyzed separately. For 656 patients, fever (88.7%, 95%CI 84.5-92.9%), cough (57.6%, 40.8-74.4%) and dyspnea (45.6%, 10.9-80.4%) were the most prevalent manifestations. Among the patients, 20.3% (95%CI 10.0-30.6%) required intensive care unit (ICU), with 32.8% presenting acute respiratory distress syndrome (ARDS) (95%CI 13.7-51.8), 6.2% (95%CI 3.1-9.3) with shock and 13.9% (95%CI 6.2-21.5%) of hospitalized patients with fatal outcomes (case fatality rate, CFR).Conclusion: COVID-19 brings a huge burden to healthcare facilities, especially in patients with comorbidities. ICU was required for approximately 20% of polymorbid, COVID-19 infected patients and this group was associated with a CFR of over 13%. As this virus spreads globally, countries need to urgently prepare human resources, infrastructure, and facilities to treat severe COVID-19.

Abstract 15633: Clinical Features and Prognosis of Acute Cardiac Injury in Hospitalized Patients With Covid-19: A Retrospective Cohort Study

Circulation ◽  
2020 ◽  
Vol 142 (Suppl_3) ◽  
Author(s):  
Mingxing XIE ◽  
Li Zhang ◽  
Yuji Xie ◽  
yanting zhang ◽  
Wei Sun ◽  
...  
Keyword(s):  
Hospital Mortality ◽  
Proportional Hazards ◽  
Troponin I ◽  
Clinical Laboratory ◽  
Invasive Mechanical Ventilation ◽  
Cardiac Injury ◽  
Final Analysis ◽  
Cox Proportional Hazards ◽  
Hospitalized Patients ◽  
High Flow Oxygen

Background: The number of fatalities due to coronavirus disease 2019 (COVID-19) is escalating. However, information on critical complications in hospitalized patients of COVID-19 is scant. We aimed to explore the prevalence of acute cardiac injury and its association with in-hospital mortality in COVID-19 patients. Method: This retrospective study analyzed patients confirmed with COVID-19 in Union Hospital (Wuhan, China) from Jan 24 to March 18, 2020. Clinical outcomes (discharge, or death) were monitored to April 9, 2020, the latest date of follow-up. Demographic, clinical, laboratory, echocardiographic data as well as treatment and prognosis were analyzed. Comparisons were made between patients with acute cardiac injury and those without. An association of acute cardiac injury and in-hospital mortality was identified. Results: A total of 235 COVID-19 patients were included in the final analysis. Their median age was 66 years (interquartile range 57 - 73 years), and 131 (55.7%) were men. 98 (41.7%) patients were diagnosed with acute cardiac injury, of whom 60 (61.2%) died. There were more comorbidities in those who had acute cardiac injury than those who did not have. A higher proportion of patients with acute cardiac injury received glucocorticoid therapy (68.0% vs 37.0%; P < 0.001), immunoglobulin (53.1% vs 30.1%; P < 0.001), high-flow oxygen (79.6% vs 43.1%; P < 0.001), and invasive mechanical ventilation (40.8% vs 6.6%; P < 0.001) than those without acute cardiac injury. The percentage of patients who were admitted to intensive care unit (39.8 % vs 8.0%; P < 0.001) or died during hospitalization (61.2% vs 8.0%, P < 0.001) were also higher in those with acute cardiac injury. Plasma high-sensitivity troponin I levels correlated significantly with plasma interleukin -6, procalcitonin and C-reactive protein levels in COVID-19 patients. Echocardiography showed the cardiac function was attenuated in acute cardiac injury patients. Multivariable Cox proportional hazards regression analysis showed acute cardiac injury was an independent risk factor for higher in-hospital mortality in COVID-19 patients (HR, 3.393; 95% CI, 1.647- 6.987, P <0.001).

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