scholarly journals The characteristics of overseas imported COVID-19 cases and the effectiveness of screening strategy in Beijing, China

2020 ◽  
Author(s):  
Li Li ◽  
Cheng-Jie Ma ◽  
Yu-Fei Chang ◽  
Si-Yuan Yang ◽  
Yun-Xia Tang ◽  
...  
Keyword(s):  
Laboratory Data ◽  
Clinical Manifestations ◽  
Screening Strategy ◽  
Normal Serum ◽  
Initial Presentation ◽  
Screening Tools ◽  
Great Success ◽  
Rt Pcr ◽  
Imported Cases ◽  
Beijing China

Abstract Background While great success in the coronavirus disease 2019 (COVID-19) control has been achieved in China, imported cases have become a major challenge. This study aimed to describe the epidemiological and clinical characteristics of imported COVID-19 cases and to assess the effectiveness of screening strategy in Beijing, China. Methods This retrospective study included all imported COVID-19 cases from Beijing Ditan Hospital from 29 February to 20 March 2020, who were screened by both chest computed tomography (CT) and reverse-transcriptase-polymerase chain reaction (RT-PCR) at initial presentation. Demographic, clinical and laboratory data, in addition to chest CT imaging were were collected and analyzed. Results A total of 71 imported cases were finally diagnosed with laboratory-confirmed COVID-19. The cases were mainly acquired from Europe (63 cases, 88.73%). The main clinical manifestations were fever and cough, which accounted for 30 cases (42.25%) and 35 cases (49.30%), respectively. Only 4 cases (5.63%) had lymphocytopenia and 13 (18.31%) cases demonstrated elevated levels of C-reactive protein (CRP). All cases had normal serum levels of procalcitonin (PCT). 35 cases (49.30%) had abnormal CT findings at initial presentation, whereas 36 cases (50.70%) had a normal CT. Using RT-PCR, 59 cases (83.10%) were tested positive at initial presentation. Conclusions The number of overseas imported COVID-19 cases continues to rise in China. The combination of screening tools, particularly CT and RT-PCR, can detect imported COVID-19 cases efficiently.

scholarly journals The Characteristics of Overseas Imported COVID-19 Cases and the Effectiveness of Screening Strategy in Beijing, China

2020 ◽  
Author(s):  
Li Li ◽  
Cheng-Jie Ma ◽  
Yu-Fei Chang ◽  
Si-Yuan Yang ◽  
Yun-Xia Tang ◽  
...  
Keyword(s):  
Laboratory Data ◽  
Clinical Manifestations ◽  
Screening Strategy ◽  
Normal Serum ◽  
Initial Presentation ◽  
Screening Tools ◽  
Great Success ◽  
Rt Pcr ◽  
Imported Cases ◽  
Beijing China

Abstract Background: In March 2020, the WHO declared the novel coronavirus (COVID-19) outbreak a global pandemic. While great success in the coronavirus disease 2019 (COVID-19) control has been achieved in China, imported cases have become a major challenge. This study aimed to describe the epidemiological and clinical characteristics of imported COVID-19 cases and to assess the effectiveness of screening strategy in Beijing, China.Methods: This retrospective study included all imported COVID-19 cases from Beijing Ditan Hospital from 29 February to 20 March 2020, who were screened by both chest computed tomography (CT) and reverse-transcriptase-polymerase chain reaction (RT-PCR) at initial presentation. Demographic, clinical and laboratory data, in addition to chest CT imaging were collected and analyzed. Results: A total of 71 imported cases were finally diagnosed with laboratory-confirmed COVID-19. The cases were mainly acquired from Europe (63cases, 88.73%). The main clinical manifestations were fever and cough, which accounted for 30 cases (42.25%) and 35 cases (49.30%), respectively. Only 4 cases (5.63%) had lymphocytopenia and 13 (18.31%) cases demonstrated elevated levels of C-reactive protein (CRP). All cases had normal serum levels of procalcitonin(PCT). 35 cases (49.30%) had abnormal CT findings at initial presentation, whereas 36 cases (50.70%) had a normal CT. Using RT-PCR, 59 cases (83.10%) were tested positive at initial presentation.Conclusions: The combination of screening tools, particularly CT and RT-PCR, could be considered to improve the diagnosis in imported COVID-19 cases. Our findings provide the important information and clinical evidence for infection control of imported COVID-19 cases.

Case Report of SLE Patients with Cryptococcosis in Nongkhai Hospital

2021 ◽  
Vol 104 (12) ◽  
pp. 1992-1999
Keyword(s):  
Cryptococcal Meningitis ◽  
Age Of Onset ◽  
Laboratory Data ◽  
Clinical Manifestations ◽  
Case Series ◽  
Screening Tools ◽  
Cns Infection ◽  
High Dose ◽  
Cryptococcal Infection ◽  
Icd 10

Background: Cryptococcal infection, especially cryptococcal meningitis, is the most common cause of central nervous system (CNS) infection with a high mortality rate in patients with systemic lupus erythematosus (SLE). The clinical features of cryptococcal meningitis may be non-specific, which may lead to miss or delay diagnosis and treatment. Objective: To collect the case series of SLE patients with cryptococcosis treated in Nongkhai Hospital between 2013 and 2021 and compared it with other studies. Materials and Methods: The medical records of SLE patients (ICD-10 M320-M329) with cryptococcal infection (ICD-10 B450-B459) treated in Nongkhai Hospital between 2013 and 2021 were reviewed and collected onto a medical record form. The following information were obtained, gender, occupation, age at SLE diagnosis, age of onset, duration of disease, comorbid or risks, previous infection, SLE disease activity, glucocorticoids, and immunosuppressors administered before or at infection diagnosis, cryptococcosis clinical manifestations, laboratory data, Cerebrospinal fluid (CSF) findings, antifungal agents used, and outcomes. Results: Six hundred thirty-six patients with SLE were identified and six patients developed cryptococcosis. Five patients had cryptococcal meningitis and one patient had cryptococcocemia. Fever and headache were the symptoms of all patients. CSF cryptococcal antigen was positive in five patients. Antifungal therapy was initiated as soon as the diagnosis was confirmed in all patients. Five patients (83.3%) recovered completely, and one patient was against the advice. Conclusion: The present study suggested that SLE patients presenting with fever and headache along with a history of moderate to high dose steroids and immunosuppressants administration should always be suspected of cryptococcal infection and cryptococcal meningitis. Meanwhile, CSF cryptococcal antigens are the effective screening tools to establish an early diagnosis. Accordingly, early appropriate treatment is crucial for a favorable outcome. Keywords: Cryptococcal infection; Cryptococcosis; Cryptococcal meningitis; SLE; Lupus

scholarly journals Clinical characteristics of 10 children with COVID-19 outside of Wuhan in Hubei Province

2020 ◽  
Author(s):  
Ming Chen ◽  
Panpan Fan ◽  
Zhi Liu ◽  
Junhua Li ◽  
Shaowu Huang ◽  
...  
Keyword(s):  
Clinical Characteristics ◽  
Laboratory Data ◽  
Clinical Manifestations ◽  
Hubei Province ◽  
Chest Ct ◽  
Rt Pcr ◽  
Short Term ◽  
Radiological Features ◽  
Abnormal Chest ◽  
Familial Clustering

Abstract Background：An outbreak of coronavirus disease 2019 (COVID-19) caused by the Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) began in Wuhan, Hubei Province, China in December 2019. This study aims to report the clinical characteristics of children COVID-19 in Xiangyang, a city outside of Wuhan within Hubei Province.Methods：We retrospectively investigated the clinical manifestations, Chest CT imaging, and laboratory characteristics of confirmed cases of children with COVID-19 with WHO interim guidance in Xiangyang Central Hospital from Feb 1 to Mar 10, 2020. 10 children cases were confirmed by real-time RT-PCR and were analyzed for epidemiological, demographic, clinical, radiological features and laboratory data. Outcomes were followed up until Mar 10, 2020.Results：6 cases (60%) had never been to Wuhan but closely contacted with family members with confirmed COVID-19, and 4 cases (40%) had made short term trips to Wuhan alone without familial clustering. The most common symptoms were cough (50%) followed by fever (40%), 4 cases (40%) showed asymptomatic characteristics including 2 cases (20%) with abnormal chest computed tomograms (CT) image. 9 cases (90%) were mild type, only 1 case (10%) was moderate type, none of them progressed in severe or critical disease. 4 (40%) cases showed leucopenia but none lymphopenia. Abnormalities on chest CT were detected among 8 cases (80%), 2 of 4 cases without obvious symptoms had abnormal chest CT.Conclusions: Children's infection is mainly caused by family clusters. No transmission to other individuals from children was found in our observation. The clinical manifestations in children with COVID-19 are non-specific with milder symptoms and good outcomes.

scholarly journals Clinical Characteristics of Coronavirus Disease 2019 in Hainan, China

2020 ◽  
Author(s):  
Shijiao Yan ◽  
Xingyue Song ◽  
Feng Lin ◽  
Haiyan Zhu ◽  
Xiaozhi Wang ◽  
...  
Keyword(s):  
Clinical Characteristics ◽  
Early Stage ◽  
Laboratory Data ◽  
Ground Glass Opacity ◽  
The Elderly ◽  
Rt Pcr ◽  
Rapid Spread ◽  
The World ◽  
Imported Cases ◽  
Discharged Patients

AbstractBackgroundSince January 2020, coronavirus disease 2019 (Covid-19) has spread rapidly and developing the pandemic model around the world. Data have been needed on the clinical characteristics of the affected patients in an imported cases as model in island outside Wuhan.MethodsWe conducted a retrospective study included all 168 confirmed cases of Covid-19 in Hainan province from 22 January 2020 to 13 March 2020. Cases were confirmed by real-time RT-PCR and were analysed for demographic, clinical, radiological and laboratory data.ResultsOf 168 patients, 160 have been discharged, 6 have died and 2 remain hospitalized. The median age was 51.0 years and 51.8% were females. 129 (76.8%) patients were imported cases, and 118 (70.2%), 51 (30.4%) and 52 (31%) of patients lived in Wuhan or traveled to Wuhan, had contact with Covid-19 patients, or had contact with Wuhan residents, respectively. The most common symptoms at onset of illness were fever (65.5%), dry cough (48.8%) and expectoration (32.1%). On admission, ground-glass opacity was the most common radiologic finding on chest computed tomography (60.2%). The elderly people with diabetes, hypertension and CVD are more likely to develop severe cases. Follow-up of 160 discharged patients found that 20 patients (12.5%) had a positive RT-PCR test results of pharyngeal swabs or anal swabs or fecal.ConclusionsIn light of the rapid spread of Covid-19 around the world, early diagnosis and quarantine is important to curb the spread of Covid-19 and intensive treatments in early stage is to prevent patients away from critical condition.

scholarly journals Clinical characteristics of 10 children with COVID-19 outside of Wuhan in Hubei Province

2020 ◽  
Author(s):  
Ming Chen ◽  
Panpan Fan ◽  
Zhi Liu ◽  
Junhua Li ◽  
Shaowu Huang ◽  
...  
Keyword(s):  
Clinical Characteristics ◽  
Laboratory Data ◽  
Clinical Manifestations ◽  
Hubei Province ◽  
Chest Ct ◽  
Rt Pcr ◽  
Short Term ◽  
Familial Cluster ◽  
Radiological Features ◽  
Abnormal Chest

Abstract Background: An outbreak of coronavirus disease 2019 (COVID-19) caused by the Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) began in Wuhan, Hubei Province, China in December 2019. This study aims to report the clinical characteristics of children COVID-19 in Xiangyang, a city outside of Wuhan within Hubei Province. Methods: We retrospectively investigated the clinical manifestations, Chest CT imaging, and laboratory characteristics of confirmed cases of children with COVID-19 with WHO interim guidance in Xiangyang Central Hospital from Feb 1 to Mar 10, 2020. 10 children cases were confirmed by real-time RT-PCR, and were analyzed for epidemiological, demographic, clinical, radiological features and laboratory data. Outcomes were followed up until Mar 10, 2020. Results: 6 cases (60%) had never been to Wuhan but closely contacted with family members with confirmed COVID-19, and 4 cases (40%) had made short term trips to Wuhan alone without familial cluster. Most common symptoms was cough (50%) followed by fever (40%), 4 cases (40%) showed asymptomatic characteristics including 2 cases (20%) with abnormal chest CT imag e . 9 cases (90%) were mild type, only 1 case (10%) was moderate type, none of them progressed in severe or critically disease. 4 (40%) cases showed leucopenia but nonelymphopenia. Abnormalities on chest computed tomograms (CT) were detected among 8 cases (80%), 2 of 4 cases without obvious symptoms had abnormal chest CT. Conclusions: Children's infection is mainly caused by family clusters, and COVID-19 seems less likely to spread from children to adults.The clinical manifestations in children with COVID-19 are non-specific with milder symptoms and good outcomes.

Cerebral Amyloid Angiopathy in Combination with Paroxysmal Atrial Fibrillation

2020 ◽  
Vol 25 (4) ◽  
pp. 31-37
Author(s):  
A. A. Kornilova ◽  
O. V. Lagoda ◽  
M. M. Tanashyan
Keyword(s):  
Atrial Fibrillation ◽  
Cerebral Amyloid Angiopathy ◽  
Paroxysmal Atrial Fibrillation ◽  
Past History ◽  
Laboratory Data ◽  
Clinical Manifestations ◽  
Cerebral Haemorrhage ◽  
Exclusion Criterion ◽  
Amyloid Angiopathy ◽  
Cerebral Amyloid

The present article addresses the definition of cerebral amyloid angiopathy (CAA) and its symptoms based on the analysis of the medical case; the issues of diagnosis and treatment of this pathology are discussed. The Boston criteria, which became the basis for diagnosis, study of clinical manifestations and progression of CAA and approaches to its therapy, are presented. Methods and modes of neuroimaging, including magnetic resonance imaging (MRI), which verify micro cerebral haemorrhage, are described. At the same time, the role and significance of cardiac arrhythmias in the genesis of ischemic stroke are discussed, and scales for assessing the risk of its occurrence are presented. The observation of the neurological, somatic, neuroimaging, neuropsychological status of a 62-year-old patient confirms quite rare combination of probable CAA, paroxysmal atrial fibrillation and repeated hemorrhagic functional apoplexy (FA). The relevance of the case described, is a complex clinical dilemma based on mutually exclusive recommendations for the pharmacological correction of such conditions. It is emphasized that in many multicenter clinical studies on the effectiveness of antithrombotic medication (antiaggregants, anticoagulants) in the treatment and prevention of ischaemic functional apoplexy , an important exclusion criterion is a hemorrhagic stroke in past history (including the multiple changes in haemostasis indicators). Taking into account the obtained clinical and laboratory data in the dynamics, the tactics of treating the described patient were determined. The results of studies related to the treatment of comorbid pathology that should become the subject of the development of a personalized algorithm for managing patients in each specific case, are discussed.

scholarly journals A New Multiplatform Model for Outpatient Prenatal and Postpartum Care in a Cohort of COVID-19-Affected Obstetric Patients

2021 ◽  
Vol 18 (10) ◽  
pp. 5144
Author(s):  
Mar Muñoz-Chápuli Gutiérrez ◽  
Ana Durán-Vila ◽  
Javier Ruiz-Labarta ◽  
Pilar Payá-Martínez ◽  
Pilar Pintado Recarte ◽  
...  
Keyword(s):  
Clinical Manifestations ◽  
Specific Treatment ◽  
Rt Pcr ◽  
Good Adherence ◽  
Major Morbidity ◽  
Reference Hospital ◽  
The Mean ◽  
Discharge From Hospital ◽  
Over Time

Spain was one of the epicenters of the first wave of the COVID-19 pandemic. We describe in this article the design and results of a new telephone-and-telematic multiplatform model of systematic prenatal and postpartum follow-up for COVID-19-affected women implemented in a tertiary reference hospital in Madrid. We included patients with RT-PCR-confirmed COVID-19 during pregnancy or delivery from 10 March 2020 to 15 December 2020. We had a total of 211 obstetric patients: 148 (70.1%) were tested at the onset of suspicious clinical manifestations and 62 (29.4%) were tested in the context of routine screening. Of all the patients, 60 women (28.4%) were asymptomatic and 97 (46%) presented mild symptoms. Fifty-one women (24.2%) were admitted to our hospital for specific treatment because of moderate or severe symptoms. We had no missed cases and a good adherence. The mean number of calls per patient was 2.3. We performed 55 in-person visits. We analyzed the complexity of our program over time, showing a two-wave-like pattern. One patient was identified as needing hospitalization and we did not record major morbidity. Telemedicine programs are a strong and reproducible tool to reach to pregnant population affected by COVID-19, to assess its symptoms and severity, and to record for pregnancy-related symptoms both in an outpatient regime and after discharge from hospital.

scholarly journals Myocardial amyloidosis following multiple myeloma in a 38-year-old female patient: A case report

Open Medicine ◽  
2020 ◽  
Vol 15 (1) ◽  
pp. 396-402
Author(s):  
Qisi Zhang ◽  
Yingli Qiao ◽  
Dongmei Yan ◽  
Yuhui Deng ◽  
Mengyang Zhang ◽  
...  
Keyword(s):  
Multiple Myeloma ◽  
Plasma Cells ◽  
Laboratory Data ◽  
Young Patients ◽  
Clinical Manifestations ◽  
The Elderly ◽  
First Episode ◽  
Rapid Progression ◽  
Congo Red Staining ◽  
Impaired Cardiac Function

AbstractMultiple myeloma (MM) is an immunoglobulin-producing tumor of plasma cells, which occurs commonly in the elderly. The incidence of myocardial amyloidosis with MM is extremely low and early clinical manifestations are nonspecific. The diversity of clinical manifestations and first episode symptoms often cause misdiagnosis in young patients with myocardial amyloidosis following MM. In this study, we analyzed the clinical data of a young woman with MM and impaired cardiac function combined with echocardiography, electrocardiography (ECG), laboratory data, cell Congo Red staining, and other manifestations to diagnose amyloidosis. Considering the rapid progression, short survival, and poor prognosis in most patients, a clear, definitive, and timely diagnosis is essential for the treatment of patients with MM complicated with myocardial amyloidosis.

scholarly journals Autoimmune encephalitis in a South Asian population

BMC Neurology ◽  
2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Nilanka Wickramasinghe ◽  
Dhanushka Dasanayake ◽  
Neelika Malavige ◽  
Rajiva de Silva ◽  
Thashi Chang
Keyword(s):  
Sri Lanka ◽  
Psychiatric Symptoms ◽  
South Asians ◽  
Laboratory Data ◽  
Clinical Manifestations ◽  
Autoimmune Encephalitis ◽  
Asian Population ◽  
South Asian Population ◽  
Clinical Presentations

Abstract Background Autoimmune encephalitis (AE) is now considered a main, potentially curable cause of encephalitis, but remains conspicuously underreported from South Asia. We studied the clinical characteristics in relation to their antibody status and outcomes of patients presenting with AE in Sri Lanka. Methods Patients admitting to government hospitals who were clinically suspected of AE by an on-site neurologist were prospectively recruited over a period of 12 months. Sera and cerebrospinal fluid were tested for NMDAR, AMPAR1, AMPAR2, LGI1, CASPR2, GABARB1/B2 antibodies (Ab) using commercial cell-based assays. Demographic, clinical and laboratory data were compiled into an investigator-administered proforma. Patients were reviewed at 1 year follow up either in person or via telephone. Results One-hundred and forty-two patients from 21 of 25 districts in Sri Lanka (median age = 20.5 years; range 1–86 years; females = 61.3%) were recruited. Of them, 65 (45.8%; median age = 19 years; range 1–86 years; females = 64.6%) fulfilled diagnostic criteria for probable NMDAR-antibody encephalitis (NMDARE) and 6 (4.2%; median age = 44 years; range 28–71 years; females = 83.3%) limbic encephalitis (LE). Abnormal behaviour (95.3%), seizures (81.5%) and movement disorders (69.2%) were the most frequent clinical manifestations of probable NMDARE. NMDAR-antibodies were detectable in 29 (44.6%) and not detectable in 36 in CSF of probable-NMDARE patients. Abnormal EEG was more frequent (p = 0.003) while a worse outcome (OR = 2.78; 95% CI = 0.88–9.09) and deaths (OR = 2.38; 95% CI = 0.67–8.33) were more likely in antibody-negative than antibody-positive probable-NMDARE. Most patients with LE had amnesia (50%) and/or confusion (100%) with agitation (83.3%) and seizures (100%) but none had detectable antibodies to any of the antigens tested. Conclusions NMDARE is the commonest type of AE among South Asians as is the case worldwide. Clinical presentations of NMDARAb-positive and NMDARAb-negative AE patients do not significantly differ but EEG may be a useful marker of an autoimmune basis for psychiatric symptoms.

scholarly journals AB0533 ANTI-NEUTROPHIL CYTOPLASMIC ANTIBODY (ANCA) IN GENERAL POPULATION WITHOUT ANCA ASSOCIATED VASCULITIS

2020 ◽  
Vol 79 (Suppl 1) ◽  
pp. 1563.3-1563
Author(s):  
H. Tamaki ◽  
S. Fukui ◽  
T. Nakai ◽  
G. Kidoguchi ◽  
S. Kawaai ◽  
...  
Keyword(s):  
Risk Factors ◽  
Autoimmune Disease ◽  
General Population ◽  
Granulomatosis With Polyangiitis ◽  
Dietary Habits ◽  
Laboratory Data ◽  
Clinical Manifestations ◽  
Anca Associated Vasculitis ◽  
The Mean

Background:Currently it is hypothesized that many systemic autoimmune diseases occur due to environmental risk factors in addition to genetic risk factors. Anti-Neutrophil Cytoplasmic Antibody (ANCA) is mainly associated with three systemic autoimmune disease including granulomatosis with polyangiitis (GPA), microscopic polyangiitis (MPA), eosinophilic granulomatosis with polyangiitis (EGPA). It is known that ANCA can be positive before clinical symptoms in patients with known diagnosis of GPA and ANCA titers rise before clinical manifestations appear. However, prevalence of ANCA among general population is not well known. It has not been described as well how many of people with positive ANCA eventually develop clinical manifestations of ANCA associated Vasculitis.Objectives:This study aims to estimate prevalence of ANCA in general population without ANCA associated Vasculitis. It also describes natural disease course of people with positive ANCA without ANCA associated Vasculitis. Risk factors for positive ANCA are also analyzed.Methods:This is a single center retrospective study at Center for Preventive Medicine of St. Luke’s International Hospital in Tokyo. ANCA was checked among the patients who wished to between 2018 and 2019. St. Luke’s Health Check-up Database (SLHCD) was utilized to collect the data. The patients whose serum was measured for ANCA were identified. The data for basic demographics, social habits, dietary habits and laboratory data were extracted. The charts of the patients with positive ANCA were reviewed.Results:Sera of total 1204 people were checked for ANCA. Of these 1204 people, 587 (48.8%) are male and the mean age was 55.8 years (32.6 to 79). There were total 11 patients with positive ANCA. Myeloperoxidase ANCA (MPO-ANCA) was positive for 3 patients and proteinase 3 ANCA (PR3-ANCA) was positive for 8 patients. Of these 11 patients, 5 were male (45.5%) and the mean age was 54.6 years. Two patients had history of autoimmune disease (primary biliary cirrhosis and ulcerative colitis). Five patients were evaluated by rheumatologists with the median follow-up period of 274 days. None of them developed clinical signs and symptoms of ANCA associated Vasculitis. Four out of five patients had ANCA checked later, two of which turned negative. The prevalence of ANCA in this cohort was 0.9% (95% confidence interval [95% CI]: 0.5% to 1.6%). Univariate analysis was performed to identify risk factors of positive ANCA. The variables analyzed include age, gender, body mass index (BMI), smoking habits, alcohol intake, dietary habits (fruits, fish, red meat), hypertension, dyslipidemia, and laboratory data. None of these variables demonstrated statistically significant differences except for positive rheumatoid factor (ANCA positive group: 33 % vs ANCA negative group: 9.1%, p value = 0.044).Conclusion:The prevalence of ANCA in this cohort was 0.9% (95% CI: 0.5% to 1.6%). None of them who had a follow-up developed ANCA associated Vasculitis during the follow-up period. Longer follow-up and more patients are necessary to determine natural course of people with positive ANCA.Disclosure of Interests:None declared

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