scholarly journals Clinical characteristics of a group of deaths with COVID-19 pneumonia in Wuhan, China: retrospective case series

2020 ◽  
Author(s):  
Tao Yao ◽  
Yan Gao ◽  
Qin Cui ◽  
Bo Peng ◽  
Yan Chen ◽  
...  
Keyword(s):  
Control Strategies ◽  
Antiviral Treatment ◽  
Invasive Mechanical Ventilation ◽  
Laboratory Data ◽  
Case Series ◽  
The Elderly ◽  
Retrospective Case ◽  
Initial Symptoms ◽  
Comorbid Diseases ◽  
Death Cases

Abstract Background: With the widespread outbreak of novel coronavirus diseases 2019(COVID-19), more and more death cases were reported, however, limited data are available for the patients who died. We aimed to explore the clinial characteristics of deaths with COVID-19 pneumonia Methods: We abstracted and analyzed epidemiological, demographic, clinical, and laboratory data from 83 death cases with COVID-19 pneumonia in East hospital of Wuhan university Renmin hospital,between January 26, 2020, and February 28, 2020.Results: Of the 83 deaths, none was the medical staff. The mean age was 71.8 years (SD 13.2; range, 34-97 years) and 53(63.9%) were male. The median from onset to admission was 10 days (IQR 7-14: range, 2-43 days), to death was 17days (IQR 14-21: range, 6-54 days). Most deaths (66[80%]) had underlying comorbid diseases, the most of which was hypertension [47(57%)]. The main initial symptoms of these 83 deaths were shortness of breath(98.8%), fever(94%) and myalgia or fatigue(90.4%). Laboratory analyses showed the lymphocytopenia in 69(83%) deaths, hypoalbuminemia in 77(93%) deaths, the elevation of lactate dehydrogenase in 79(95%) deaths, procalcitonin in 69(83%) deaths and C-reactive protein in 79(95%) deaths. All 83 patients received antiviral treatment, 81(97.6%) deaths received antibiotic therapy, and 54(65.1%) deaths received glucocorticoid therapy and 20(24.1%) patients received invasive mechanical ventilation.Conclusion: Most of the deaths with COVID-19 pneumonia were elderly patients with underlying comorbid diseases, especially those over 70 years of age. The time of death was mostly 15-21 days after the onset of the disease. More care should be given to the elderly in the further prevention and control strategies of COVID-19.

scholarly journals Clinical characteristics of a group of deaths with COVID-19 pneumonia in Wuhan, China: a retrospective case series

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Tao Yao ◽  
Yan Gao ◽  
Qin Cui ◽  
Bo Peng ◽  
Yan Chen ◽  
...  
Keyword(s):  
Clinical Characteristics ◽  
Antiviral Treatment ◽  
Invasive Mechanical Ventilation ◽  
Laboratory Data ◽  
Case Series ◽  
The Elderly ◽  
Retrospective Case ◽  
Initial Symptoms ◽  
Comorbid Diseases ◽  
Death Cases

Abstract Background With the widespread outbreak of novel coronavirus diseases 2019(COVID-19), more and more death cases were reported, however, limited data are available for the patients who died. We aimed to explore the clinical characteristics of deaths with COVID-19 pneumonia. Methods We abstracted and analyzed epidemiological, demographic, clinical, and laboratory data from 83 death cases with COVID-19 pneumonia in East Hospital of Wuhan University Renmin Hospital, between January 26, 2020, and February 28, 2020. Results Of the 83 deaths, none was the medical staff. The mean age was 71.8 years (SD 13.2; range, 34–97 years) and 53(63.9%) were male. The median from onset to admission was 10 days (IQR 7–14: range, 2–43 days), to death was 17 days (IQR 14–21: range, 6–54 days). Most deaths (66[80%]) had underlying comorbid diseases, the most of which was hypertension [47(57%)]. The main initial symptoms of these 83 deaths were shortness of breath(98.8%), fever(94%), and myalgia or fatigue(90.4%). Laboratory analyses showed the lymphocytopenia in 69(83%) deaths, hypoalbuminemia in 77(93%) deaths, the elevation of lactate dehydrogenase in 79(95%) deaths, procalcitonin in 69(83%) deaths and C-reactive protein in 79(95%) deaths. All 83 patients received antiviral treatment, 81(97.6%) deaths received antibiotic therapy, 54(65.1%) deaths received glucocorticoid therapy, and 20(24.1%) patients received invasive mechanical ventilation. Conclusion Most of the deaths with COVID-19 pneumonia were elderly patients with underlying comorbid diseases, especially those over 70 years of age. The time of death after the onset of the disease was mostly 15–21 days. More care should be given to the elderly in further prevention and control strategies of COVID-19.

scholarly journals Clinical Characteristics, Treatments and Outcomes of 18 Lung Transplant Recipients with COVID-19

2021 ◽  
Vol 2 (2) ◽  
pp. 229-245
Author(s):  
René Hage ◽  
Carolin Steinack ◽  
Fiorenza Gautschi ◽  
Susan Pfister ◽  
Ilhan Inci ◽  
...  
Keyword(s):  
Lung Transplant ◽  
Clinical Laboratory ◽  
Invasive Mechanical Ventilation ◽  
Case Series ◽  
Outcome Data ◽  
Transplant Recipients ◽  
Retrospective Case ◽  
Laboratory Findings ◽  
Case Series Study ◽  
Lung Transplant Recipients

We report clinical features, treatments and outcomes in 18 lung transplant recipients with laboratory confirmed SARS-CoV-2 infection. We performed a single center, retrospective case series study of lung transplant recipients, who tested positive for SARS-CoV-2 between 1 February 2020 and 1 March 2021. Clinical, laboratory and radiology findingswere obtained. Treatment regimens and patient outcome data were obtained by reviewing the electronic medical record. Mean age was 49.9 (22–68) years, and twelve (67%) patients were male. The most common symptoms were fever (n = 9, 50%), nausea/vomiting (n = 7, 39%), cough (n = 6, 33%), dyspnea (n = 6, 33%) and fatigue (n = 6, 33%). Headache was reported by five patients (28%). The most notable laboratory findings were elevated levels of C-reactive protein (CRP) and lactate dehydrogenase (LDH). Computed Tomography (CT) of the chest was performed in all hospitalized patients (n = 11, 7%), and showed ground-glass opacities (GGO) in 11 patients (100%), of whom nine (82%) had GGO combined with pulmonary consolidations. Six (33%) patients received remdesivir, five (28%) intravenous dexamethasone either alone or in combination with remdesivir, and 15 (83%) were treated with broad spectrum antibiotics including co-amoxicillin, tazobactam-piperacillin and meropenem. Four (22%) patients were transferred to the intensive care unit, two patients (11%) required invasive mechanical ventilation who could not be successfully extubated and died. Eighty-nine percent of our patients survived COVID-19 and were cured. Two patients with severe COVID-19 did not survive.

scholarly journals Calcified Thoracic Disc Herniations in the Elderly: Revisiting the Laminectomy for Single Level Disease

2018 ◽  
Vol 9 (5) ◽  
pp. 527-531 ◽  
Author(s):  
Colby Oitment ◽  
Desmond Kwok ◽  
Chris Steyn
Keyword(s):  
Spinal Injury ◽  
Present Report ◽  
Case Series ◽  
The Elderly ◽  
Retrospective Case ◽  
Disc Space ◽  
Disc Herniations ◽  
Asia Score ◽  
Thoracic Disc ◽  
Clinical Conditions

Study Design: Retrospective case series. Objectives: Calcified thoracic disc herniations in the elderly present with a variety of clinical conditions and the treatment is a source of significant debate. Decompression of the disc space is done through anterior, lateral, posterolateral, and posterior approaches. There is significant morbidity of thoracic disc herniation and associated decompression. Methods: The present report is a case series of 8 elderly patients with calcified discopathy who received a simple laminectomy without decompression of the disc space. Results: Postoperatively, 5 patients mobilized independently, 2 with a walker, and 1 patient was nonambulatory. Two patients improved 1 ASIA (American Spinal Injury Association Impairment Scale) score, 1 patient improved 2 ASIA scores, and 3 patients had no change in ASIA score. Conclusion: In our experience, thoracic disc herniations require a technically difficult decompression and overall the complications are significant. We present a series of 8 patients who generally improved from a simple laminectomy and consider this a viable procedure for patients too unwell to undergo direct disc decompression.

scholarly journals A Retrospective Case Series of Thiamine Deficiency in Non-Alcoholic Hospitalized Veterans: An Important Cause of Delirium and Falling?

2021 ◽  
Vol 10 (7) ◽  
pp. 1449
Author(s):  
Elisabeth Mates ◽  
Deepti Alluri ◽  
Tailer Artis ◽  
Mark S. Riddle
Keyword(s):  
Thiamine Deficiency ◽  
Laboratory Data ◽  
Case Series ◽  
Chronically Ill ◽  
Retrospective Case ◽  
Inflammatory Stress ◽  
Inflammatory Conditions ◽  
Neuropsychiatric Manifestations ◽  
Specific Symptoms ◽  
Thiamine Level

Thiamine deficiency (TD) in non-alcoholic hospitalized patients causes a variety of non-specific symptoms. Studies suggest it is not rare in acutely and chronically ill individuals in high income countries and is underdiagnosed. Our aim is to demonstrate data which help define the risk factors and constellation of symptoms of TD in this population. We describe 36 cases of TD in hospitalized non-alcoholic veterans over 5 years. Clinical and laboratory data were extracted by chart review +/− 4 weeks of plasma thiamine level 7 nmol/L or less. Ninety-seven percent had two or more chronic inflammatory conditions (CICs) and 83% had one or more acute inflammatory conditions (AICs). Of possible etiologies of TD 97% had two or more of: insufficient intake, inflammatory stress, or increased losses. Seventy-five percent experienced 5% or more weight loss. Ninety-two percent had symptoms with the most common being weakness or falling (75%) followed by neuropsychiatric manifestations (72%), gastrointestinal dysfunction (53%), and ataxia (42%). We conclude that TD is underdiagnosed in this population with consequent morbidity and mortality. TD likely develops because of inflammatory stress from CIC’s compounded by AIC’s combined with decreased energy intake or increased nutrient losses.

scholarly journals Varicella Zoster Virus Infections in Canadian Children in the Prevaccine Era: A Hospital-Based Study

1997 ◽  
Vol 8 (6) ◽  
pp. 323-328 ◽  
Author(s):  
Susan Kuhn ◽  
H Dele Davies ◽  
Taj Jadavji
Keyword(s):  
Varicella Zoster Virus ◽  
Antiviral Treatment ◽  
Case Series ◽  
Neurological Complications ◽  
Immunocompetent Patient ◽  
Pulmonary Complications ◽  
Common Reason ◽  
Pediatric Hospital ◽  
Retrospective Case ◽  
Varicella Zoster

OBJECTIVE: To describe the clinical course of children admitted for varicella zoster virus (VZV) infections to a pediatric hospital before the release of VZV vaccine in Canada.DESIGN: Retrospective case series.SETTING: Tertiary pediatric hospital. Population studied was children aged 18 years or younger admitted to hospital between 1983 and 1992 who were discharged with a diagnosis of varicella or zoster. Of the 201 children who were identified, 36 were excluded, leaving 165 for analysis.RESULTS: There was a male:female ratio of 1.5:1 and a median age of 5.3 years (range two weeks to 18 years). The group included those who were previously healthy (70, 42.4%), immunocompromised (60, 36.4%), and those with nonimmunocompromising conditions (35, 21.2%). Comparison of immunocompetent and immunocompromised children revealed that complication of VZV infection was a more common reason for admission among the former (86 of 105, 81.9%, P<0.001), whereas treatment with acyclovir to limit dissemination was the most common reason in the latter (53 of 60, 88.3%, P<0.001). Skin and soft tissue infections were the most common complications in immunocompetent children (36 of 98) and those younger than five years (26 of 53), whereas pulmonary complications predominated among immunocompromised patients (eight of 98) and neurological complications in five- to 10-year-olds (16 of 36). Only one death (0.6%) occurred in an immunocompetent patient. Group A beta-hemolytic streptococci andStaphylococcus aureuscaused equal numbers of secondary infections (92% of all isolates).CONCLUSIONS: Complications of VZV infections and secondary prophylactic antiviral treatment of immunocompromised children explain the majority of hospitalizations in this institution, and can be monitored after VZV vaccine introduction. Complications vary significantly with underlying healthy status and age.

scholarly journals Approaching Otolaryngology Patients During the COVID-19 Pandemic

2020 ◽  
Vol 163 (1) ◽  
pp. 121-131 ◽  
Author(s):  
Chong Cui ◽  
Qi Yao ◽  
Di Zhang ◽  
Yu Zhao ◽  
Kun Zhang ◽  
...  
Keyword(s):  
Infection Control ◽  
Control Strategies ◽  
Nasal Congestion ◽  
Case Series ◽  
Retrospective Case ◽  
Protective Measures ◽  
Air Supply ◽  
Risk Of Exposure ◽  
Protective Strategies ◽  
Nose And Throat

Objective. To describe coronavirus disease 2019 (COVID-19) patient presentations requiring otolaryngology consultation and provide recommendations for protective measures based on the experience of ear, nose, and throat (ENT) departments in 4 Chinese hospitals during the COVID-19 pandemic. Study Design. Retrospective case series. Setting. Multicenter. Subjects and Methods. Twenty hospitalized COVID-19 patients requiring ENT consultation from 3 designated COVID-19 hospitals in Wuhan, Shanghai, and Shenzhen were identified. Data on demographics, comorbidities, COVID-19 symptoms and severity, consult reason, treatment, and personal protective equipment (PPE) use were collected and analyzed. Infection control strategies implemented for ENT outpatients and emergency room visits at the Eye and ENT Hospital of Fudan University were reported. Results. Median age was 63 years, 55% were male, and 95% were in severe or critical condition. Six tracheotomies were performed. Posttracheotomy outcomes were mixed (2 deaths, 2 patients comatose, all living patients still hospitalized). Other consults included epistaxis, pharyngitis, nasal congestion, hyposmia, rhinitis, otitis externa, dizziness, and tinnitus. At all hospitals, powered air-supply filter respirators (PAPRs) were used for tracheotomy or bleeding control. PAPR or N95-equivalent masks plus full protective clothing were used for other complaints. No inpatient ENT providers were infected. After implementation of infection control strategies for outpatient clinics, emergency visits, and surgeries, no providers were infected at the Eye and ENT Hospital of Fudan University. Conclusions and Relevance. COVID-19 patients require ENT consultation for many reasons, including tracheotomy. Otolaryngologists play an indispensable role in the treatment of COVID-19 patients but, due to their work, are at high risk of exposure. Appropriate protective strategies can prevent infection of otolaryngologists.

scholarly journals The spectrum of kidney biopsies in hospitalized patients with COVID-19, acute kidney injury and/or proteinuria

2021 ◽  
Author(s):  
Sophie Ferlicot ◽  
Matthieu Jamme ◽  
François Gaillard ◽  
Julie Oniszczuk ◽  
Aymeric Couturier ◽  
...  
Keyword(s):  
Acute Kidney Injury ◽  
Kidney Biopsy ◽  
Case Series ◽  
Kidney Injury ◽  
Tubular Injury ◽  
Glomerular Injury ◽  
Retrospective Case ◽  
Risk Variants ◽  
Initial Symptoms ◽  
Almost All

Abstract Background The coronavirus disease 2019 (COVID-19) may be associated with kidney injury, which may impact patient's prognosis. Methods We report a multicentric retrospective case series of patients with COVID-19 who developed acute kidney injury (AKI) and/or proteinuria and underwent a kidney biopsy in Paris and its metropolitan area. Results Forty-seven patients (80.9% men) with COVID-19 who underwent a kidney biopsy between 8 March and 19 May 2020 were included. The median age was 63 years (interquartile range 52–69). Comorbidities included hypertension (66.0%), diabetes mellitus (27.7%), obesity (27.7%), history of chronic kidney disease (25.5%), cardiac diseases (38.6%) and respiratory diseases (27.3%). Initial symptoms were fever (85.1%), cough (63.8%), shortness of breath (55.3%) and diarrhoea (23.4%). Almost all patients developed AKI (97.9%) and 63.8% required renal replacement therapy. Kidney biopsy showed two main histopathological patterns, including acute tubular injury in 20 (42.6%) patients, and glomerular injury consisting of collapsing glomerulopathy (CG) and focal segmental glomerulosclerosis in 17 (36.2%) patients. Two (4.3%) patients had acute vascular nephropathy, while 8 (17%) had an alternative diagnosis most likely unrelated to COVID-19. Acute tubular injury occurred almost invariably in the setting of severe forms of COVID-19, whereas patients with glomerular injury had various profiles of COVID-19 severity and CG was only observed in patients harbouring a combination of APOL1 risk variants. At the last follow-up, 16 of the 30 patients who initially required dialysis were still on dialysis, and 9 had died. Conclusions This study describes the spectrum of kidney lesions in patients with COVID-19. While acute tubular injury is correlated with COVID-19 severity, the pattern of glomerular injury is intimately associated with the expression of APOL1 risk variants.

scholarly journals Complex Spinal Dorso-Ventral Stabilization in the Elderly – Is Age a Limiting Factor? Retrospective Case Series of 53 patients

2020 ◽  
pp. 1-9
Author(s):  
Christian Ewelt ◽  
Murat Yavuz ◽  
Nils Warneke ◽  
Michael Schwake ◽  
Juliane Schröteler ◽  
...  
Keyword(s):  
Case Series ◽  
Length Of Hospital Stay ◽  
The Elderly ◽  
Neurological Deficits ◽  
Motor Deficit ◽  
Control Group ◽  
Limiting Factor ◽  
Retrospective Case ◽  
Medical Progress ◽  
Duration Of Surgery

Objective: Medical progress is increasingly confronting us with the question of whether complex surgical spinal care can be performed safely, even in older patients. This study is intended to contribute to the clarification of this question. Methods: 53 patients with a minimum age of 70 years at time of surgery were retrospectively enrolled in a single center setting. All patients were treated with complex dorsoventral instrumentation and corpectomy due to different pathologies. Because of neurological deficits and untreatable pain, no control group of patients could be defined in advanced age by withholding necessary surgery. The ethical committee would not accept this. Results: Most patients benefited from the procedure with regard to pain (97%), sensori-motor deficit (89%), and finally, immobility (82%). The duration of surgery, the amount of transfused red blood cell concentrates, and the length of hospital stay were not predictors of a poor overall outcome. It was shown that the risk of postoperative complications increased due to the number of preoperative secondary diagnoses. Conclusion: Therefore, not the patients’ age alone is of prime importance for individual surgical treatment decisions, but the number of secondary diagnoses plays a more important role. Especially in that older population, patients benefit from surgical therapy; regardless, it could be complex.

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