Clinical features of 162 fatal cases of COVID-19: a multi-center, retrospective study

Abstract Understanding the epidemiological and clinical characteristics of fatal cases infected with SARS-CoV-2 is import to develop appropriate preventable intervention programs in hospitals. Demographic data, clinical symptoms, clinical course, co-morbidities, laboratory findings, CT scans, treatments and complications of 162 fatal cases were retrieved from electric medical records in 5 hospitals of Wuhan, China. The median age was 69.5 years old (IQR: 63.0-77.25; range: 29-96). 112 (69.1%) cases were men. Hypertension (45.1%) was the most common co-morbidity, but 59 (36.4%) cases had no co-morbidity. At admission, 131 (81.9%) cases were assessed as severe or critical. However, 39 (18.1%) were assessed as moderate. Moderate cases had a higher prevalence of hypertension and chronic lung disease comparing with severe or critical cases (P<0.05, respectively). 126 (77.8%) and 132 (81.5%) cases received antiviral treatment and glucocorticoids, respectively. 116 (71.6%) cases were admitted to ICU and 137 (85.1%) cases received mechanical ventilation. Respiratory failure or acute respiratory distress syndrome (93.2%) was the most common complication. The young cases of COVID-19, without co-morbidity and in a moderate condition at admission could develop fatal outcome. We need to be more cautious in case management of COVID-19 for preventing the fatal outcomes.

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Az anti-Jo-1-pozitív antiszintetáz szindróma jellegzetességei gondozott betegeink alapján

Orvosi Hetilap ◽

10.1556/650.2016.30400 ◽

2016 ◽

Vol 157 (15) ◽

pp. 575-583 ◽

Cited By ~ 1

Author(s):

Katalin Szabó ◽

Melinda Nagy-Vincze ◽

Levente Bodoki ◽

Katalin Hodosi ◽

Katalin Dankó ◽

...

Keyword(s):

Medical Records ◽

Clinical Laboratory ◽

Clinical Symptoms ◽

Clinical Phenotype ◽

Demographic Data ◽

Clinical Results ◽

C Reactive Protein ◽

Protein Levels ◽

Reactive Protein ◽

Worse Prognosis

Introduction: In idiopathic inflammatory myopathies, the presence of anti-Jo-1 antibody defines a distinct clinical phenotype (myositis, arthritis, interstitial lung disease, Raynaud’s phenomenon fever, mechanic’s hands), called antisynthetase syndrome. Aim: To determine the demographic data as well as clinical, laboratory and terapeutical features of anti-Jo1 positive patients, followed by the department of the authors. Method: The medical records of 49 consecutive anti-Jo1 patients were reviewed. Results: Demographic and clinical results were very similar to those published by other centers. Significant correlation was found between the anti-Jo-1 titer and the creatine kinase and C-reactive protein levels. Distinct laboratory results measured at the time of diagnosis of the disease (C-reactive protein, antigen A associated with Sjogren’s syndrome, positive rheumatoid factor), and the presence of certain clinical symptoms (fever, vasculitic skin) may indicate a worse prognosis within the antisyntetase positive patient group. Conclusion: In the cases above more agressive immunosuppressive therapy may be required. Orv. Hetil., 2016, 157(15), 575–583.

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Abstract 14661: High Sensitive Troponin Elevation Pattern in Covid-19 Era

Circulation ◽

10.1161/circ.142.suppl_3.14661 ◽

2020 ◽

Vol 142 (Suppl_3) ◽

Author(s):

Alessandro Maino ◽

Enrico Di Stasio ◽

Maria Chiara Grimaldi ◽

Luigi Cappannoli ◽

Erica Rocco ◽

...

Keyword(s):

Disease Severity ◽

Demographic Data ◽

Fatal Outcome ◽

Treatment Strategies ◽

High Sensitivity ◽

Laboratory Findings ◽

Reference Limit ◽

Care Information ◽

Upper Reference Limit ◽

The Impact

Introduction: Coronavirus disease 2019 (COVID-19) is a pandemic disease that has caused a public health emergency due to its high rapid spread, to the high mortality rate, and the high percentage of patients requiring hospitalization and intensive care . Information regarding the impact of cardiovascular complication on fatal outcome is scarce. Purpose: To compare the levels of hs-Tn between patients affected by SARS-CoV-2 admitted to our hospital in the period February 20-April 9, 2020 versus the general population COVID free. Furthermore, we studied the dependence of hs-Tn levels in SARS-CoV-2 patients on disease severity and on other epidemiological, clinical and laboratory parameters. Methods: This retrospective single-center study analyzed all patients in whom hs-TnI was determined at the Policlinico A.Gemelli (Rome, Italy) from 20 February 2020 to 09 April 2020. One hundred-seventy of these patients received SARS-CoV-2 diagnosis. Demographic data, laboratory findings, comorbidities, and treatments were collected and analyzed in patients with COVID 19. Results: In our study, the population affected by SARS-CoV-2 (n=170) showed a significant association between disease severity and troponin levels (median [range] = 4.0 [<2.4-227.0], 13.5 [<2.4-545.0] and 34.0 [<2.4-45345.0], p<0.001, for mild, severe and critical state, respectively). Moreover, 27 subjects out of 170 (16%) showed high sensitivity troponin values higher than the 99 percentile upper reference limit stratified among previously defined severity classes as follows n=2 (2.4%), n=7 (15.9%) and n=18 (45.0%), respectively. Conclusions: The distribution of the troponin values greater than the cut-off in the SARS-CoV-2 population indicates a myocardial suffering independently related to COVID19 infection. This phenomenon may partially explain the high risk of adverse outcome in COVID-19 patients with underlying CVD. Therefore, it may be reasonable to triage patients with COVID-19 according to the presence of underlying CVD and evidence of myocardial injury for prioritized and personalized treatment strategies.

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Case Series of Dengue Treated with Homoeopathic Intervention

Homœopathic Links ◽

10.1055/s-0039-1688454 ◽

2019 ◽

Vol 32 (01) ◽

pp. 031-035

Author(s):

Padmalaya Rath ◽

Bhopal Singh Arya ◽

Anil Kumar Vichitra ◽

Udaiveer Singh

Keyword(s):

Dengue Virus ◽

Demographic Data ◽

Antiviral Treatment ◽

Case Series ◽

Public Health Problem ◽

Viral Disease ◽

Central Research Institute ◽

Central Research ◽

Laboratory Findings ◽

Eupatorium Perfoliatum

Background Dengue is an infectious mosquito-borne disease in India and is caused by a virus named as dengue virus. It is also known as break bone fever, is a painful and sometimes fatal viral disease characterized by headache, skin rash and debilitating muscle and joint pains. In India, dengue is becoming a public health problem. The predominant dengue virus serotypes during the last few years have been DENV-2 and DENV-3. There is no specific antiviral treatment currently available for dengue fever. Time to time many dengue cases treated with homoeopathic medicine successfully have been reported. Methodology Demographic data, symptoms and laboratory findings were collected from patients with confirmed dengue infections treated from outpatient department and inpatient department of Dr. D. P. R. Central Research Institute for Homoeopathy, Noida, from September 2015 to October 2015. Results Four dengue infected patients were treated successfully by homoeopathic medicine Eupatorium perfoliatum without any complication. Conclusion Dengue requires early diagnosis and treatment. Dengue can be managed with homoeopathy. Further studies are mandatory as evidence-based data in the management of dengue are sparse.

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Clinical and Laboratory Characteristics of COVID-19 Infection in Patients Presenting to A Tertiary Care Hospital

BioMedica ◽

10.51441/biomedica/5-497 ◽

2021 ◽

Vol 37 (3) ◽

pp. 1-17

Author(s):

Huma Batool ◽

Asifa Karamat ◽

Khalid Waheed ◽

Sohail Anwar ◽

Syed Arslan Haider ◽

...

Keyword(s):

Medical Records ◽

Clinical Symptoms ◽

Wide Spectrum ◽

Severe Disease ◽

Tertiary Care ◽

Care Hospital ◽

Laboratory Findings ◽

Male Predominance ◽

Reactive Protein ◽

Clinical Records

Background and Objective: COVID-19 disease is caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) having a wide variety of clinical features ranging from asymptomatic carriers to respiratory failure requiring mechanical ventilation. The objective of the study was to analyze the spectrum of different symptoms, laboratory findings and complications in patients who were admitted in either COVID ward or intensive care unit (ICU) of a local hospital. Methods: A retrospective cohort study of the medical records of 100 COVID-19 disease patients with PCR detected SARS-CoV-2 infection were collected. Participant information was retrospectively obtained from the hospital medical records which included clinical records and laboratory findings. All statistical analyses were done using Statistical Package for the Social Sciences (SPSS) version 21. Results: The mean age of the patients was 50.8 ±5.86 with male predominance (79%). Most frequent co-morbidities were diabetes mellitus (42%) and hypertension (36%). Most frequent symptoms were fever (95.9%) and fatigue (95.9%) followed by dry cough (86.5%), myalgia (85.1) and shortness of breath (70%). Amongst the patients admitted, leukocyte count was 10.95 x 103, C-reactive protein (CRP) was 12.8mg/dl, ferritin was 730.8ng/ml and Lactate Dehydrogenase (LDH) was found to be 1254.7 U/l. Hepatic and renal functions were borderline deranged. Conclusion: COVID-19 disease has a wide spectrum of clinical symptoms. Patients with raised inflammatory markers have severe disease and are more likely in need of an ICU care. By carefully observing these markers may help in better management of COVID-19 disease.

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Comparison of Clinical, Radiological and Laboratory Findings in Discharged and Dead Patients With COVID-19 in Ilam Province, West of Iran

10.21203/rs.3.rs-1049149/v1 ◽

2021 ◽

Author(s):

Mohammad Reza Kaffashian ◽

Maryam Shirani ◽

Maryam Koupaei ◽

Nourkhoda Sadeghifard ◽

Iraj Ahmadi ◽

...

Keyword(s):

Electronic Medical Records ◽

Medical Records ◽

Clinical Symptoms ◽

Rt Pcr ◽

Laboratory Findings ◽

Treatment Regimens ◽

Special Profile ◽

Radiological Images ◽

Global Threat ◽

Underlying Diseases

Abstract Objective: COVID-19 is the last global threat which WHO confirmed it as a pandemic on March 11, 2020. In the Middle East, Iran was the first country where the SARS-Cov-2 was detected. The epidemiological and economic challenges of Iran make this country a particularly relevant subject of study. In the current study, we aimed to evaluate the clinical, radiological and laboratory findings in hospitalized COVID-19 confirmed cases in Ilam province, west of Iran.Material and methods:Overall, 2204 hospitalized RT-PCR confirmed patients with COVID-19 were considered in this study. Electronic medical records, including clinical symptoms, radiological images, laboratory findings, and the comorbidities of patients with COVID-19 were collected and analyzed. In addition, the medication regimens used in these patients were evaluated. The patients were classified in discharged and died groups according to their outcomes. Then, clinical, radiological and laboratory findings as well as treatment regimens and underlying diseases were compared in these two groups.Results:Among the patients, 1209 (54.85%) were male and 995 (45.14%) were female. Pneumonia, dyspnea and cough, were the most common clinical data in both discharged and died groups. Among the comorbidities, COPD, and cancer were significantly more common in the dead patients than in the living. The results of laboratory tests showed that blood creatinine, BUN, ESR, Na+, WBC, and neutrophil count have increased in deceased group compared to the survivors. However, the lymphocyte count decreased in deceased patients. The evaluation of radiographs demonstrated that there were significant correlations between bilateral pneumonia, ground glass opacity, bilateral patchy shadowing, and pleural effusion with death. Conclusion:The current investigation indicated the special profile of COVID-19 in west of Iran. Discharged and dead patients with COVID-19 had distinct clinical, radiological and laboratory features, which were separated by principle component analysis. Identifying these characteristics of the disease would translate into the implementation of practical measures to improve results.

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Establishment of a Diagnostic Model to Distinguish Coronavirus Disease 2019 From Influenza a Based on Laboratory Findings

10.21203/rs.3.rs-500524/v1 ◽

2021 ◽

Author(s):

Dongyang Xing ◽

Suyan Tian ◽

Yukun Chen ◽

Jinmei Wang ◽

Xuejuan Sun ◽

...

Keyword(s):

Influenza A ◽

Clinical Symptoms ◽

Demographic Data ◽

External Validation ◽

Predictive Performance ◽

Diagnostic Model ◽

Stepwise Logistic Regression ◽

Common Disease ◽

Laboratory Findings ◽

Epidemiological Characteristics

Abstract BackgroundCoronavirus disease 2019 (COVID-19) and Influenza A are common disease caused by viral infection. The clinical symptoms and transmission routes of the two diseases are similar. This study established a model of laboratory findings to distinguish COVID-19 from influenza A perfectly. MethodsIn this study, 56 COVID-19 patients and 54 influenza A patients were included. Laboratory findings, epidemiological characteristics and demographic data were obtained from electronic medical record databases. Elastic network models, followed by a stepwise logistic regression model were implemented to identify indicators capable of discriminating COVID-19 and influenza A. ResultsA monogram is diagramed to show the resulting discriminative model. The majority of hematological and biochemical parameters in COVID-19 patients were significantly different from those in influenza A patients. In the final model, albumin/globulin, total bilirubin and erythrocyte specific volume were selected as predictors. This model has been demonstrated to have a satisfactory predictive performance to discriminate between COVID-19 and influenza A (AUC=0.844) using an external validation set. ConclusionThe establishment of a diagnostic model on laboratory findings is of great significance for the identification of COVID-19 and influenza A.

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Ultrasonography related to clinical and laboratory findings in lymphocytic thyroiditis

Acta Endocrinologica ◽

10.1530/acta.0.1210129 ◽

1989 ◽

Vol 121 (1) ◽

pp. 129-135 ◽

Cited By ~ 89

Author(s):

Rainer Gutekunst ◽

Wiard Hafermann ◽

Thomas Mansky ◽

Peter C Scriba

Keyword(s):

Medical Records ◽

Clinical Symptoms ◽

Clinical Manifestations ◽

Thyroid Volume ◽

Diagnostic Procedures ◽

Needle Aspiration ◽

Epidemiological Studies ◽

Laboratory Findings ◽

Fine Needle ◽

Lymphocytic Thyroiditis

Abstract. The value of ultrasonography compared with established diagnostic procedures was investigated by reviewing medical records of 92 patients (88 women and 4 men, age 11–81 years, mean age 47) with lymphocytic thyroiditis. Clinical manifestations of the disease and serum antimicrosomal antibodies and TSH were determined in all patients. The thyroid was examined by ultrasound. Both lobes were aspirated by a fine needle under sonographic control and smears examined cytologically. A total of 27 (29.3%) patients had no clinical symptoms. Antimicrocosmal antibodies were undetectable in 12 (13%) patients, 16 (17.4%) had low titres 1:32–1:100, and 64 (69.6%) ≥ 1:320. TSH (reference values 0.3–3.9 mU/l) was < 0.3 in 4 (4.3%) 0.3–3.9 in 41 (44.6%), 4–20 in 26 (28.3%), and > 20 in 21 (22.8%) patients. Ultrasound revealed a scattered sonolucent echo in 87 (94.6%) patients, and in 45 (48.9%) a normal thyroid volume (women < 18, men < 25 ml). Cytology alone was diagnostic in 84 (91.3%) patients. In conclusion, ultrasound can suggest lymphocytic thyroiditis. If antimicrosomal antibodies are undetectable or titres are not significant and/or clinical symptoms are uncertain, fine-needle aspiration can confirm the sonographic finding. Epidemiological studies including ultrasonography are necessary to obtain reliable data on the prevalence of lymphocytic thyroiditis.

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Role of pulmonary circulation assessment in CT imaging in evaluating the severity and tendency of severe and critical COVID-19 pneumonia

10.21203/rs.3.rs-32243/v1 ◽

2020 ◽

Author(s):

Qiongjie Hu ◽

Yiwen liu ◽

Yueying Pan ◽

Ziyan Sun ◽

Min Xiang ◽

...

Keyword(s):

Pulmonary Circulation ◽

Demographic Data ◽

Pulmonary Veins ◽

Fatal Outcome ◽

Ct Imaging ◽

Cardiac Insufficiency ◽

Imaging Features ◽

Laboratory Findings ◽

Pulmonary Manifestations ◽

Significant Difference

Abstract Objective: To investigate the value of changes of pulmonary circulation in CT imaging in evaluating the severity and tendency of 2019 novel coronavirus disease (COVID-19) pneumonia.Methods: This retrospective study analyzed 99 severe and critical COVID-19 pneumonia patients including the 47 improved cases and 52 dead cases. Demographic data, laboratory findings, comorbidities, and CT imaging features including the diameters of pulmonary vein (PV), pulmonary artery (PA) and ascending aorta were collected and assessed.Results: The PV diameters of the deceased patients were larger than recovered patients in the severe phase. Compared with the severe phase in the improvement group, the diameters of the pulmonary veins during the improved phase were smaller, and the total CT scores were significantly decreased (p < 0.001). Instead, there was no significant difference in the ratio of main PA to aorta diameter between the recovered group and the deceased group, nor did the self control of the recovered group and the deceased group (p > 0.05). Construction of a ROC curve yielded an optimal cut-off value of the PV diameters for prediction of survival (p < 0.05).Conclusion: The changes of the PV diameters might indirectly reflect the activity of pulmonary inflammation and cardiac insufficiency. Pulmonary manifestations of severe and critical COVID-19 pneumonia might be related to myocardial injury and cardiac insufficiency, expecially accompanied by dilated PVs. Evaluation of changes in pulmonary circulation by chest CT images may be considered as a useful tool for determining the severity, fatal outcome and tendency of COVID-19.Key words: COVID-19, pneumonia, pulmonary circulation, Computed Tomography

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Clinical Symptoms and Haematological Characteristics among Male and Female COVID-19 Patients in Rivers State: A Single-center Case Reviews

Asian Journal of Research in Infectious Diseases ◽

10.9734/ajrid/2021/v6i130180 ◽

2021 ◽

pp. 8-16

Author(s):

Alali Dan- Jumbo ◽

Tondor Cleopatra Uzosike ◽

Mary Obidiya Okuku

Keyword(s):

Data Collection ◽

Clinical Symptoms ◽

Blood Pressure Level ◽

Healthcare Personnel ◽

Laboratory Findings ◽

Systolic Blood Pressure Level ◽

Presenting Symptoms ◽

Co Morbidity ◽

Males And Females ◽

Rivers State

Objectives: The study seeks to assess the sex differences in reported clinical symptoms and haematological parameters of hospitalized COVID-19 cases. Study Design: A retrospective descriptive cross-sectional study. Place and Duration of Study: Covid-19 Treatment Centre, Rivers State, between May 2020 and July 2020. Methodology: Descriptive data collection for patients diagnosed of COVID-19 was employed within the months of May to July 2020. A comparison of demographic profile, presenting symptoms, comorbidities and laboratory findings between males and females was analyzed using SPSS version 25. Ethical approval was obtained prior to commencing data collection. Results: In this study, data of 56 patients were analyzed of which 31 (55.4%) were males and 25 (44.6%) were females. The mean age for all patients was 36 years and males had a higher mean age (40 ± 12.6) compared to females (31 ± 8.8). Twelve patients (21.4%) reported pre-existing co-morbidities and Hypertension 11 (19.6%) was the prevalent co-morbidity followed by peptic ulcer 2 (3.6%) and Diabetes 2 (3.6%) and these were more common among males. Triglyceride level was significantly higher among females (p= 0.028) and low-density lipoprotein (LDL) level was significantly lower among females (p= 0.044) while systolic blood pressure level was significantly higher among males (p= 0.011). Conclusion: Though similar symptoms and haematological findings occur in males and females, specific disparities in some parameters were observed. We recommend healthcare personnel to consider these differences when caring for patients hospitalized for COVID-19.

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Clinical Characteristics and Cardiovascular Implications of 116 Hospitalized Patients with COVID-19 in Wuhan, China: A single-Centered, Retrospective, Observational Study

10.21203/rs.3.rs-26358/v1 ◽

2020 ◽

Author(s):

Shiqiang Xiong ◽

Lin Liu ◽

Feng Lin ◽

Jinhu Shi ◽

Lei Han ◽

...

Keyword(s):

Cardiovascular Diseases ◽

Clinical Symptoms ◽

Virus Disease ◽

Demographic Data ◽

Case Fatality ◽

Outcome Data ◽

Hospitalized Patients ◽

Laboratory Findings ◽

Aged Population ◽

New Onset

Abstract Background Corona Virus Disease 2019 (COVID-19) caused by 2019 novel coronavirus (SARS-CoV-2), has become a global pandemic. Aged population with cardiovascular diseases are more likely be to infected with SARS-CoV-2 and result in more severe outcomes and elevated case-fatality rate. Meanwhile, cardiovascular diseases have a high prevalence in the middle-aged and elderly population. However, despite of several researches in COVID-19, cardiovascular implications related to it still remains largely unclear. Methods 116 patients with laboratory-confirmed COVID-19 were enrolled, who admitted to the General Hospital of Central Theater Command (Wuhan, China) from January 20 to March 8, 2020. The demographic data, underlying comorbidities, clinical symptoms and signs, laboratory findings, chest computed tomography, treatment measures, and outcome data were collected from electronic medical records. Data were compared between non-severe and severe cases.Results Of 116 hospitalized patients with COVID-19, the median age was 58.5 years (IQR, 47.0-69.0), and 36 (31.0%) were female. Hypertension (45 [38.8%]), diabetes (19 [16.4%]), and coronary heart disease (17 [14.7%]) were the most common coexisting conditions. Common symptoms included fever [99 (85.3%)], dry cough (61 [52.6%]), fatigue (60 [51.7%]), dyspnea (52 [44.8%]), anorexia (50 [43.1%]), and chest discomfort (50 [43.1%]). Lymphopenia (lymphocyte count, 1.0 × 109/L [IQR, 0.7-1.3]) was observed in 66 patients (56.9%), and elevated lactate dehydrogenase (245.5 U/L [IQR, 194.3-319.8]) in 69 patients (59.5%). Compared with non-severe cases, severe cases were older (64.0 years [IQR, 53.0-76.0] vs 56.0 years [IQR, 37.0-64.0]), more likely to have comorbidities (35 [63.6%] vs 24 [39.3%]), and more likely to develop acute cardiac injury (19 [34.5%] vs 4 [6.6%]), acute heart failure (18 [32.7%] vs 3 [4.9%]), and ARDS (20 [36.4%] vs 0 [0%]). During hospitalization, the prevalence of new onset hypertension was significantly higher in severe patients (55.2% vs 19.0%) than in non-severe ones. Conclusions We found that the infection of SARS-CoV-2 was more likely to occur in aged population with cardiovascular comorbidities. Cardiovascular complications, including new onset hypertension and heart injury were common in severe patients. More detailed researches in cardiovascular involvement in COVID-19 are urgently needed to further understand the disease.

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