Clinical findings of 35 cases with novel coronavirus pneumonia outside of Wuhan

Abstract Objective: We sought to investigate the clinical characteristics of patients with novel coronavirus pneumonia in Xiamen, which is a city in Fujian Province, China. Methods: From January 20, 2020, to March 4, 2020, the clinical characteristics of all patients confirmed with novel coronavirus pneumonia admitted to the First Affiliated Hospital of Xiamen University, which was the only designated hospital for cases of novel coronavirus pneumonia in Xiamen, were analyzed. Results: A total of 35 cases of novel coronavirus pneumonia were confirmed. Patients were divided into the general-ward admission group and the intensive-care-unit (ICU) admission group. The most commonly observed symptoms were fever (80%), cough (51%), expectoration (28%), and fatigue (23%). Compared with patients in the general-ward group, patients in the ICU group had a higher maximum body temperature, a longer duration of fever after admission, and more symptoms of systemic pain. Considering the laboratory findings, patients in the ICU group exhibited lower peripheral blood lymphocyte ratios and lymphocyte counts but higher C-reactive protein and lactate dehydrogenase levels. All patients were discharged without death, and no patients required invasive ventilation, continuous renal replacement therapy, or extracorporeal membrane oxygenation. Conclusion: Relative to patients with novel coronavirus pneumonia in Wuhan, the cases in Xiamen were less severe.

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Epidemiological and Clinical Characteristics of 17 Hospitalized Patients with 2019 Novel Coronavirus Infections Outside Wuhan, China

10.1101/2020.02.11.20022053 ◽

2020 ◽

Cited By ~ 8

Author(s):

Jie Li ◽

Shilin Li ◽

Yurui Cai ◽

Qin Liu ◽

Xue Li ◽

...

Keyword(s):

Computed Tomography ◽

Clinical Characteristics ◽

National Standards ◽

C Reactive Protein ◽

Protein Levels ◽

Reactive Protein ◽

Computed Tomography Images ◽

Younger Age ◽

Novel Coronavirus ◽

Epidemiologic Characteristics

SUMMARYAn increasing number of cases of novel coronavirus pneumonia (NCP) infected with 2019-nCoV have been identified in Wuhan and other cities in China, since December 2019. We analyzed data on the 17 confirmed cases in Dazhou to provide the epidemiologic characteristics of NCP outside Wuhan. Among them, 12 patients were still quarantined in the hospital, 5 patients were discharged NCP patients according to the national standards. Compared with non-discharged NCP patients, the discharged NCP patients had younger ages. Moreover, discharged NCP patients had higher heart rate, lymphocytes levels and monocytes levels than non-discharged NCP patients on admission to the hospital. Notably, all of 17 patients had abnormal increased C-reactive protein levels, and 16 patients had abnormal computed tomography images. This study provided some information that younger age, higher lymphocytes levels and monocytes levels at the diagnoses of 2019-nCoV may contributed to faster recovery and better therapeutic outcome.

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Clinical characteristics and laboratory biomarkers changes in COVID-19 patients requiring or not intensive or sub-intensive care: a comparative study

BMC Infectious Diseases ◽

10.1186/s12879-020-05647-7 ◽

2020 ◽

Vol 20 (1) ◽

Author(s):

Anna Maria Cattelan ◽

Eugenia Di Meco ◽

Marco Trevenzoli ◽

Alessia Frater ◽

Anna Ferrari ◽

...

Keyword(s):

Intensive Care ◽

Neutrophil Count ◽

Clinical Characteristics ◽

Primary Outcome ◽

Fatality Rate ◽

C Reactive Protein ◽

Laboratory Findings ◽

Reactive Protein ◽

Group 2 ◽

Group 1

Abstract Background Identifying risk factors for severe novel-coronavirus disease (COVID-19) is useful to ascertain which patients may benefit from advanced supportive care. The study offers a description of COVID-19 patients, admitted to a general ward for a non-critical clinical picture, with the aim to analyse the differences between those transferred to the intensive (ICU) and/or sub-intensive care (SICU) units and those who were not. Methods This observational retrospective study includes all COVID-19 patients admitted to the Infectious Diseases Unit. Clinical, laboratory, radiological and treatment data were collected. The primary outcome was a composite of need of transfer to the ICU and/or SICU during the hospitalization. Patients who did not require to be transferred are defined as Group 1; patients who were transferred to the ICU and/or SICU are defined as Group 2. Demographic, clinical characteristics and laboratory findings at the 1st, 3rd and last measurements were compared between the two groups. Results 303 were included. The median age was 62 years. 69 patients (22.8%) met the primary outcome and were defined as Group 2. The overall fatality rate was 6.8%. Group 2 patients were predominantly male (76.8% vs. 55.1%, p < 0.01), had a higher fatality rate (14.5% vs. 3.8%, p < 0,01), had more hypertension (72.4% vs. 44%, p < 0,01) and diabetes (31.9% vs. 21%, p = 0.04) and were more likely to present dry cough (49.3% vs. 25.2%, p < 0.01). Overall, chest X-ray at admission showed findings suggestive of pneumonia in 63.2%, and Group 2 were more likely to develop pathological findings during the hospitalization (72.7% vs. 17.2%, p = 0.01). At admission, Group 2 presented significantly higher neutrophil count, aspartate-transaminase and C-Reactive-Protein. At the 3rd measurement, Group 2 presented persistently higher neutrophil count, hepatic inflammation markers and C-Reactive-Protein. Group 1 presented a shorter duration from admission to negativization of follow-up swabs (20 vs. 35 days, p < 0.01). Conclusions The presence of comorbidities and the persistent observation of abnormal laboratory findings should be regarded as predisposing factors for clinical worsening.

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Association between clinical characteristics and laboratory findings with outcome of hospitalized COVID-19 patients, a report from northeast of Iran

10.1101/2021.01.23.21250359 ◽

2021 ◽

Author(s):

Sahar Sobhani ◽

Reihaneh Aryan ◽

Elham Kalantari ◽

Salman Soltani ◽

Nafise Malek ◽

...

Keyword(s):

Chest Pain ◽

Medical Records ◽

Clinical Characteristics ◽

C Reactive Protein ◽

Laboratory Findings ◽

Reactive Protein ◽

Level Of Consciousness ◽

Laboratory Features ◽

Duration Of Hospitalization ◽

Male Sex

AbstractCoronavirus disease 2019 (COVID-19) was first discovered in December 2019 in China and has rapidly spread worldwide. Clinical characteristics, laboratory findings, and their association with the outcome of patients with COVID-19 can be decisive in management and early diagnosis. Data were obtained retrospectively from medical records of 397 hospitalized COVID-19 patients between February and May 2020 in Imam Reza hospital, northeast of Iran. Clinical and laboratory features were evaluated among survivors and non-survivors. The correlation between variables and duration of hospitalization and admission to the Intensive Care Unit (ICU) was determined. Male sex, age, hospitalization duration, and admission to ICU were significantly related to mortality rate. Headache was a more common feature in patients who survived (p = 0.017). It was also related to a shorter stay in the hospital (p = 0.032) as opposed to patients who experienced chest pain (p = 0.033). Decreased levels of consciousness and dyspnea were statistically more frequent in non-survivors (p = 0.003 and p = 0.011, respectively). Baseline white blood cell count (WBC), erythrocyte sedimentation rate (ESR), and C-reactive protein (CRP) were significantly higher in non-survivors (p < 0.001). Patients with higher WBC and CRP levels were more likely to be admitted to ICU (p = 0.009 and p = 0.001, respectively). Evaluating clinical and laboratory features can help clinicians find ways for risk stratifying patients and even make predictive tools. Chest pain, decreased level of consciousness, dyspnea, and increased CRP and WBC levels seem to be the most potent predictors of severe prognosis.

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Analysis on the Clinical Characteristics of 36 Cases of Novel Coronavirus Pneumonia in Kunming

10.1101/2020.02.28.20029173 ◽

2020 ◽

Cited By ~ 5

Author(s):

Haiyan Fu ◽

Hongjuan Li ◽

Xiaoqing Tang ◽

Xiang Li ◽

Jie Shen ◽

...

Keyword(s):

T Cells ◽

Normal Control ◽

Cd8 T Cells ◽

Clinical Characteristics ◽

Normal Control Group ◽

Control Group ◽

C Reactive Protein ◽

Reactive Protein ◽

Hs Crp ◽

Novel Coronavirus

AbstractObjectiveTo analyze the clinical characteristics of patients with novel coronavirus pneumonia in Kunming City, and to study the correlation between nutritional status and immune function.MethodsClinical data of 36 patients with novel coronavirus pneumonia in isolation area of Kunming Third People’s Hospital from January 31 to February 15, 2020 were collected, and the basic situation, clinical characteristics, laboratory examination and CT imaging characteristics were analyzed. Serum albumin (ALB), prealbumin (PAB), hypersensitive c-reactive protein (hs-crp), CD3T cells, CD4T cells, CD8T cells and normal control group were analyzed. A simple linear regression analysis of the relationship between proalbumin and T cell subpopulation counts in the blood of patients.Results(1) The patients with new coronavirus pneumonia in Kunming were mainly of common type. (2) 50% of the patients’ first symptoms were fever and cough; (3) The total number of white blood cells in peripheral blood was normal or decreased in 23 cases (79%), and the lymphocyte count decreased in 5 cases (13.89%), without anemia. Hypersensitive c-reactive protein increased in 19 (52.78%) cases, and procalcitonin increased in 1 case. Albumin decreased in 5 cases (13.89%), proalbumin decreased in 15 cases (41.67%), alanine transaminase increased slightly in 4 cases (11.11%), alanine transaminase increased slightly in 4 cases (11.11%), total bilirubin increased slightly in 11 cases (30.56%), and renal function and blood coagulation were normal. Absolute value of CD3+T cells is with a decrease in 21 cases (58.3%), CD4+T in 28 cases (77.8%), CD8+T in 17 cases (47.2%), and CD4+/ CD8+ inverse in 6 cases (16.7%). (4) The prealbumin, CD3 T cells, CD4 T cells and CD8 T cells in the new coronavirus pneumonia group were significantly lower than those in the normal control group, and the hypersensitive c-reactive protein was higher than that in the normal control group. (5) The levels of PAB in the serum of the patients were linearly correlated with hs-crp, CD3 T cells, CD4 T cells and CD8 T cells, and the correlation coefficients were −0.474, 0.558, 0.467 and 0.613, respectively, showing statistical differences.ConclusionThe clinical characteristics of the novel coronavirus pneumonia in Kunming are different from those in Wuhan. The changes of serum proalbumin and T cell subsets are relatively obvious. Changes in serum proalbumin may contribute to the early warning of novel coronavirus pneumonia. The nutritional status of patients with common and mild pneumonia should be considered.

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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.

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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.

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Anaemia is Associated with Severe Illness in COVID-19: A Retrospective Cohort Study

10.21203/rs.3.rs-39184/v1 ◽

2020 ◽

Author(s):

Zheying Tao ◽

Mingyu Liu ◽

Jingyi Wu ◽

Jing Xu ◽

Wei Chen ◽

...

Keyword(s):

Clinical Characteristics ◽

Virus Disease ◽

Severe Illness ◽

C Reactive Protein ◽

Severe Condition ◽

Laboratory Findings ◽

Logistic Regression Models ◽

Reactive Protein ◽

The Impact ◽

The Relationship

Abstract Background and objective:Anaemia commonly aggravates the severity of respiratory diseases, whereas thus far, no study has elucidated the impact of anaemiaonCorona Virus Disease 2019(COVID-19). The aim of this study was to evaluate the clinical characteristics of patients with anaemia, and to further explore the relationship between anaemiaand the severity of COVID-19.METHODS:In this single-center, retrospective, observational study, a total of 222 patients were recruited, including 79 patients with anaemia and 143 patients without anaemia. Clinical characteristics, laboratory findings, disease progression and prognosis were collected and analyzed. Risk factors associated with the severe illness in COVID-19were established by univariable and multivariable logistic regression models.Result：In our cohort, compared to patients without anaemia, patients with anaemia were more likely to experience one or more comorbidities and severe COVID-19 illness, as well as higher mortality. More patients demonstrated elevated levels of C-reactive protein (CRP), procalcitonin(PCT) and creatinine in anaemia group. Levels of erythrocyte sedimentation rate(ESR), D-dimer, myoglobin, T-pro brain natriuretic peptide(T-pro-BNP) and urea nitrogen(BUN)in patients with anaemia were significantly higher than those without. In addition,the proportion of patients with dyspnoea，elevated CRP and PCT was positively associated with the severity of anaemia. The Odd Ratio (OR) of anaemia related to the severe condition of COVID-19 was 5.07 (95% CI:1.82-14.18, P=0.002) and 3.47 (95% CI:1.02-11.75, P=0.046) after adjustment for baseline date and laboratory indices, respectively.Conclusion:Anaemia is an independent risk factor associated with the severe illness of COVID-19, and healthcare professionals should be more sensitive to the haemoglobin levels of COVID-19 patients on admission. To avoid rapid deterioration, more intensive care should be given to patients with anaemia.Trial registration: Ethics committee of Wuhan University People's Hospital (wdry2020-k064)

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Clinical characteristics and laboratory biomarkers changes in COVID-19 patients requiring or not intensive or sub-intensive care: a comparative study

10.21203/rs.3.rs-38908/v2 ◽

2020 ◽

Author(s):

Anna Maria Cattelan ◽

Eugenia Di Meco ◽

Marco Trevenzoli ◽

Alessia Frater ◽

Anna Ferrari ◽

...

Keyword(s):

Intensive Care ◽

Neutrophil Count ◽

Clinical Characteristics ◽

Primary Outcome ◽

Clinical Laboratory ◽

C Reactive Protein ◽

Laboratory Findings ◽

Reactive Protein ◽

Group 2 ◽

Group 1

Abstract Background Identifying risk factors for severe novel-coronavirus disease (COVID-19) is useful to ascertain which patients may benefit from advanced supportive care. The study aims to offer a comparative description of the COVID-19 patients, admitted to a general ward for a non-critical clinical picture, who required or not to be transferred to the intensive (ICU) and/or sub-intensive care (SICU) units. Methods This observational retrospective study included all COVID-19 patients admitted to the Infectious Diseases Unit. Clinical, laboratory, radiological and treatment data were collected. The primary outcome was a composite of need of transfer to the ICU and/or SICU during the hospitalization. Patients who did not require to be transferred are defined Group 1; patients who were transferred to the ICU and/or SICU are defined Group 2. Demographic and clinical characteristics were compared between the two groups. Results 303 patients were included. Median age was 62 years. 69 patients (22,8%) met the primary outcome and were defined Group 2. The overall mortality rate was 6.8%. Group 2 were more likely to be men, had a higher mortality (14,5% vs. 3,8%, p<0,01), had more hypertension (72,4% vs. 44%, p<0,01) and diabetes (31,9% vs. 21%, p=0,04) and were more likely to present dry cough (49,3% vs. 25,2%, p<0.01). Overall, chest X-ray at admission showed findings suggestive of pneumonia in 63,2%, and Group 2 were more likely to develop pathological findings during the hospitalization (72,7%vs. 17,2%, p<0,01). At admission, Group 2 presented significantly higher neutrophil count, aspartate-transaminase and C-reactive-protein. At the 3rd measurement, Group 2 presented persistently higher neutrophil count, liver function tests and C-reactive-protein. Group 1 presented a shorter duration from admission to negativization of follow-up swabs (20 vs. 35 days, p<0,01). Conclusions The presence of comorbidities and the persistent observation of abnormal laboratory findings should be regarded as predisposing factors for clinical worsening.

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Clinical characteristics and laboratory biomarkers changes in COVID-19 patients requiring or not intensive or sub-intensive care: a comparative study

10.21203/rs.3.rs-38908/v3 ◽

2020 ◽

Author(s):

Anna Maria Cattelan ◽

Eugenia Di Meco ◽

Marco Trevenzoli ◽

Alessia Frater ◽

Anna Ferrari ◽

...

Keyword(s):

Intensive Care ◽

Neutrophil Count ◽

Clinical Characteristics ◽

Primary Outcome ◽

Fatality Rate ◽

C Reactive Protein ◽

Laboratory Findings ◽

Reactive Protein ◽

Group 2 ◽

Group 1

Abstract Background Identifying risk factors for severe novel-coronavirus disease (COVID-19) is useful to ascertain which patients may benefit from advanced supportive care. The study offers a description of COVID-19 patients, admitted to a general ward for a non-critical clinical picture, with the aim to analyse the differences between those transferred to the intensive (ICU) and/or sub-intensive care (SICU) units and those who were not.Methods This observational retrospective study includes all COVID-19 patients admitted to the Infectious Diseases Unit. Clinical, laboratory, radiological and treatment data were collected. The primary outcome was a composite of need of transfer to the ICU and/or SICU during the hospitalization. Patients who did not require to be transferred are defined as Group 1; patients who were transferred to the ICU and/or SICU are defined as Group 2. Demographic, clinical characteristics and laboratory findings at the 1st, 3rd and last measurements were compared between the two groups. Results 303 patients were included. The median age was 62 years. 69 patients (22.8%) met the primary outcome and were defined as Group 2. The overall fatality rate was 6.8%. Group 2 patients were predominantly male (76.8% vs. 55.1%, p<0.01), had a higher fatality rate (14.5% vs. 3.8%, p<0,01), had more hypertension (72.4% vs. 44%, p<0,01) and diabetes (31.9% vs. 21%, p=0.04) and were more likely to present dry cough (49.3% vs. 25.2%, p<0.01). Overall, chest X-ray at admission showed findings suggestive of pneumonia in 63.2%, and Group 2 were more likely to develop pathological findings during the hospitalization (72.7% vs. 17.2%, p=0.01). At admission, Group 2 presented significantly higher neutrophil count, aspartate-transaminase and C-reactive-protein. At the 3rd measurement, Group 2 presented persistently higher neutrophil count, hepatic inflammation markers and C-reactive-protein. Group 1 presented a shorter duration from admission to negativization of follow-up swabs (20 vs. 35 days, p<0.01). Conclusions The presence of comorbidities and the persistent observation of abnormal laboratory findings should be regarded as predisposing factors for clinical worsening.

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Clinical characteristics of children infected with SARS-CoV-2 in Italy

Italian Journal of Pediatrics ◽

10.1186/s13052-021-01045-0 ◽

2021 ◽

Vol 47 (1) ◽

Author(s):

Isabella Tarissi De Jacobis ◽

Rosa Vona ◽

Camilla Cittadini ◽

Alessandra Marchesi ◽

Laura Cursi ◽

...

Keyword(s):

Electronic Medical Records ◽

Medical Records ◽

Clinical Characteristics ◽

Pediatric Population ◽

C Reactive Protein ◽

Normal Range ◽

Laboratory Findings ◽

Reactive Protein ◽

Males And Females ◽

D Dimer

Abstract Background Since December 2019 coronavirus disease (COVID-19) emerged in Wuhan and spread rapidly worldwide. Despite the high number of people affected, data on clinical features and prognostic factors in children and adolescents are limited. We propose a retrospective study aimed to evaluate clinical characteristics of children infected with SARS-CoV-2 in Italy. Methods A pediatric population admitted with COVID-19 to Bambino Gesù Children’s Hospital of Rome (Italy) in the period from the end of February to July 2020 has been studied. Medical history, comorbidities, symptoms and laboratory findings were obtained from patients’ electronic medical records. Results In 66 patients (35 males and 31 females) we found that: i) fever and cough were the dominant symptoms, while vomit and convulsions were rare symptoms; and ii) all ages of childhood were susceptible to COVID-19. Furthermore, we found that, compared to females, males with COVID-19, although not significantly, had higher values of inflammatory markers such as C-reactive protein (CRP) and ESR. Conversely, we found that COVID-19 positive females were older than males and required more days of hospitalization. Both males and females COVID-19 positives had procalcitonin values within the normal range and D-Dimer values slightly higher than the normal range. With regard to this latter marker, the value measured in females, although not significant, was higher than that measured in males. Interestingly, the presence of leukopenia was found in both sexes. Conclusions Compared to the adults we found that COVID-19 infection in children is a non-severe inflammatory disease in both males and females. In any case, many detailed studies should be conducted.

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