scholarly journals Clinical imaging characteristics of inpatients with COVID-19 in Heilongjiang Province, China: a retrospective study

2020 ◽  
Author(s):  
Hao Jiang ◽  
Wei Guo ◽  
Huijie Jiang ◽  
Mingyu Zhang ◽  
Lai Wei ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Clinical Laboratory ◽  
Clinical Symptoms ◽  
Ground Glass Opacity ◽  
Care Group ◽  
Heilongjiang Province ◽  
Care Groups ◽  
Imaging Characteristics ◽  
Lung Lobes

Abstract Objectjve: To investigate the clinical, laboratory, and radiological characteristics of patients with coronavirus disease 2019 (COVID-19) in Heilongjiang Province. Methods: The present study carried out a retrospective analysis of 59 patients with COVID-19, including 44 patients in the intensive care unit (ICU) and 15 patients in the non-intensive care unit. The characteristics of the two groups of patients were compared.Results: ICU care group was older and the incidence was higher than that of non-ICU group. Lymphopenia, neutrophils, and increased D-dimer levels were high-risk causes of COVID-19 patients. Compared to the non-ICU care group, the incidence of pulmonary consolidation and Ground-glass opacity combined consolidation in the ICU care group was significantly higher, all lung lobes were more likely to be involved, and the number of lung lobes involved was greater and the area around the bronchi was more likely to be involved. Of the 59 patients with COVID-19 in this group, 15 received mechanical ventilation. All the intubated patients involved lung lobes, and a large number of lesions were seen in the area around the bronchial vessels. Conclusion: Significant differences were observed in clinical symptoms, laboratory tests, and CT features between the ICU and non-ICU care groups.

scholarly journals Analysis of Clinical Imaging Characteristics of Patients with 2019-nCoV

2020 ◽  
Author(s):  
Hao Jiang ◽  
WEI GUO ◽  
Huijie Jiang ◽  
Ruoshui Zheng ◽  
Ziao Wang ◽  
...  
Keyword(s):  
Transition Period ◽  
Clinical Manifestations ◽  
Ground Glass Opacity ◽  
Ground Glass ◽  
Mediastinal Lymphadenopathy ◽  
Heilongjiang Province ◽  
Amyloid A ◽  
Imaging Characteristics ◽  
The Right ◽  
Lung Lobes

Abstract Background: This article retrospectively analyzed the clinical characteristics and CT characteristics of chest CT of 10 patients with coronavirus disease 2019 (COVID-19) diagnosed in Heilongjiang Province. Methods: A retrospective analysis of 10 COVID-19 patients confirmed by designated hospitals in Heilongjiang Province. Results: The clinical manifestations were mainly fever (80%) and cough (50%). Laboratory tests showed elevated C-reactive protein (70%) and serum amyloid A (80%). CT mainly manifests as ground-glass opacity (100%) in the lung, more than two lung lobes (90%), and the lesions are mostly located in the right upper lobe (80%), and lobular septum thickening (60%) is common.Conclusions: In this group of patients with COVID-19, the typical CT manifestations are double lung sheet ground-glass opacity, which are mainly distributed in the subpleural area, and the range of involvement is more than or equal to two lung lobes, “paving stones” changes; pulmonary lesions were absorbed and fibrous cord foci were formed during the transition period. It is worth noting that hilum, mediastinal lymphadenopathy, and pleural effusion are less common. During the study period, follow-up imaging performed by some patients showed mild / moderate disease progression and gradually dissipating.

scholarly journals Factors Predicting Outcome in Intensive Care Unit-Admitted COVID-19 Patients: Using Clinical, Laboratory, and Radiologic Characteristics

2021 ◽  
Vol 2021 ◽  
pp. 1-7
Author(s):  
Aminreza Abkhoo ◽  
Elaheh Shaker ◽  
Mohammad-Mehdi Mehrabinejad ◽  
Javid Azadbakht ◽  
Nahid Sadighi ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Mortality Rate ◽  
Pericardial Effusion ◽  
Clinical Laboratory ◽  
Vital Signs ◽  
Ground Glass Opacity ◽  
Laboratory Findings ◽  
Radiologic Findings ◽  
Significant Difference

Purpose. To investigate the factors contributing to mortality in coronavirus disease 2019 (COVID-19) patients admitted in the intensive care unit (ICU) and design a model to predict the mortality rate. Method. We retrospectively evaluated the medical records and CT images of the ICU-admitted COVID-19 patients who had an on-admission chest CT scan. We analyzed the patients’ demographic, clinical, laboratory, and radiologic findings and compared them between survivors and nonsurvivors. Results. Among the 121 enrolled patients (mean age, 62.2 ± 14.0 years; male, 82 (67.8%)), 41 (33.9%) survived, and the rest succumbed to death. The most frequent radiologic findings were ground-glass opacity (GGO) (71.9%) with peripheral (38.8%) and bilateral (98.3%) involvement, with lower lobes (94.2%) predominancy. The most common additional findings were cardiomegaly (63.6%), parenchymal band (47.9%), and crazy-paving pattern (44.4%). Univariable analysis of radiologic findings showed that cardiomegaly p : 0.04 , pleural effusion p : 0.02 , and pericardial effusion p : 0.03 were significantly more prevalent in nonsurvivors. However, the extension of pulmonary involvement was not significantly different between the two subgroups (11.4 ± 4.1 in survivors vs. 11.9 ± 5.1 in nonsurvivors, p : 0.59 ). Among nonradiologic factors, advanced age p : 0.002 , lower O2 saturation p : 0.01 , diastolic blood pressure p : 0.02 , and hypertension p : 0.03 were more commonly found in nonsurvivors. There was no significant difference between survivors and nonsurvivors in terms of laboratory findings. Three following factors remained significant in the backward logistic regression model: O2 saturation (OR: 0.91 (95% CI: 0.84–0.97), p : 0.006 ), pericardial effusion (6.56 (0.17–59.3), p : 0.09 ), and hypertension (4.11 (1.39–12.2), p : 0.01 ). This model had 78.7% sensitivity, 61.1% specificity, 90.0% positive predictive value, and 75.5% accuracy in predicting in-ICU mortality. Conclusion. A combination of underlying diseases, vital signs, and radiologic factors might have prognostic value for mortality rate prediction in ICU-admitted COVID-19 patients.

scholarly journals Contamination of Healthcare Worker Personal Protective Equipment with MRSA Outside the Intensive Care Unit Setting

2020 ◽  
Vol 41 (S1) ◽  
pp. s27-s28
Author(s):  
Gita Nadimpalli ◽  
Lisa Pineles ◽  
Karly Lebherz ◽  
J. Kristie Johnson ◽  
David Calfee ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Patient Care ◽  
Direct Patient Care ◽  
Care Group ◽  
Surveillance Culture ◽  
Care Hospital ◽  
Contact Precautions ◽  
Patient Interactions ◽  
The Right

Background: Estimates of contamination of healthcare personnel (HCP) gloves and gowns with methicillin-resistant Staphylococcus aureus (MRSA) following interactions with colonized or infected patients range from 17% to 20%. Most studies were conducted in the intensive care unit (ICU) setting where patients had a recent positive clinical culture. The aim of this study was to determine the rate of MRSA transmission to HCP gloves and gown in non-ICU acute-care hospital units and to identify associated risk factors. Methods: Patients on contact precautions with history of MRSA colonization or infection admitted to non-ICU settings were randomly selected from electronic health records. We observed patient care activities and cultured the gloves and gowns of 10 HCP interactions per patient prior to doffing. Cultures from patients’ anterior nares, chest, antecubital fossa and perianal area were collected to quantify bacterial bioburden. Bacterial counts were log transformed. Results: We observed 55 patients (Fig. 1), and 517 HCP–patient interactions. Of the HCP–patient interactions, 16 (3.1%) led to MRSA contamination of HCP gloves, 18 (3.5%) led to contamination of HCP gown, and 28 (5.4%) led to contamination of either gloves or gown. In addition, 5 (12.8%) patients had a positive clinical or surveillance culture for MRSA in the prior 7 days. Nurses, physicians and technicians were grouped in “direct patient care”, and rest of the HCPs were included in “no direct care group.” Of 404 interactions, 26 (6.4%) of providers in the “direct patient care” group showed transmission of MRSA to gloves or gown in comparison to 2 of 113 (1.8%) interactions involving providers in the “no direct patient care” group (P = .05) (Fig. 2). The median MRSA bioburden was 0 log 10CFU/mL in the nares (range, 0–3.6), perianal region (range, 0–3.5), the arm skin (range, 0-0.3), and the chest skin (range, 0–6.2). Detectable bioburden on patients was negatively correlated with the time since placed on contact precautions (rs= −0.06; P < .001). Of 97 observations with detectable bacterial bioburden at any site, 9 (9.3%) resulted in transmission of MRSA to HCP in comparison to 11 (3.6%) of 310 observations with no detectable bioburden at all sites (P = .03). Conclusions: Transmission of MRSA to gloves or gowns of HCP caring for patients on contact precautions for MRSA in non-ICU settings was lower than in the ICU setting. More evidence is needed to help guide the optimal use of contact precautions for the right patient, in the right setting, for the right type of encounter.Funding: NoneDisclosures: None

scholarly journals Association between early mobilization or rehabilitation and intensive care unit acquired weakness: A systematic review and meta-analysis of randomized controlled trials.

2020 ◽  
Author(s):  
Minghang Li ◽  
Mingyue Ding ◽  
Huanzhang Shao ◽  
Bingyu Qin ◽  
Xingwei Wang ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Meta Analysis ◽  
Early Mobilization ◽  
Standard Of Care ◽  
Cochrane Library ◽  
Care Group ◽  
China National Knowledge Infrastructure ◽  
Number Of Patients ◽  
Icu Discharge

Abstract Background The prognosis of intensive care unit acquired weakness (ICUAW) is poor and the treatment effect is not ideal. At present, some effective and safe early prevention means are urgently needed to reduce its incidence.This study evaluated the effectiveness and safety of early activities or rehabilitation in the prevention of ICUAW. Methods We searched for articles in five electronic databases, including PubMed, EMBASE, the Cochrane Library, the China National Knowledge Infrastructure (CNKI) and Wanfang Med Online. All publications until June, 2020 were searched. We have selected trials investigating early mobilization or rehabilitation as compared to standard of care in critically ill adults.The extracted data included adverse events, the number of patients with ICUAW, the length of stay in the ICU (ICU-LOS) the length of mechanical ventilation (MV) etc. Results The final results showed that compared with the usual care group, early mobilization or rehabilitation reduced the prevalence of ICUAW (RR, 0.73; [0.61, 0.87]; I2 = 44%; P = 0.0006), ICU-LOS (MD, − 1.47;[2.83, 0.10]; I2 = 56%; P = 0.04), length of MV (MD, − 1.96; [2.41, 1.51]; I2 = 0%; P = 0.00001), but the mortality (RR, 0.90; [0.62, 1.32]; I2 = 3%; P = 0.60) at ICU discharge was not associated. The subgroup analysis of ICUAW prevalence and ICU-LOS based on the intervention methods showed that early combined rehabilitation could reduce the prevalence of ICUAW (RR, 0.56; [0.43, 0.74]; I2 = 34%; P = 0.0001) and shorten the ICU-LOS (MD, − 2.21; [3.28, 0.97]; I2 = 23%; P = 0.0003). EGDM was not associated with a decrease in ICUAW prevalence (RR, 0.85; [0.65, 1.09]; I2 = 26%; P = 0.20), but it reduced the ICU-LOS (MD, − 2.27; [3.86, 0.68]; I2 = 0%; P = 0.005).Early in-bed cycling was not associated with reduced ICUAW prevalence(RR, 1.25; [0.73, 2.13]; I2 = 0%; P = 0.41) and ICU-LOS(MD, 2.27; [0.27, 4.80]; I2 = 0%; P = 0.08) . Conclusions Early mobilization or rehabilitation was associated with a shorter length of MV and ICU-LOS, but not mortality. Of course, not all early activities or forms of rehabilitation are effective. The early combined rehabilitation model is effective for the prevention of ICUAW. However, EGDM and early in-bed cycling were not effective in preventing ICUAW.

Abstract 16541: Clinical and Imaging Phenotypes From a Registry of Segmental Arterial Mediolysis

Circulation ◽  
2020 ◽  
Vol 142 (Suppl_3) ◽  
Author(s):  
Arvind K Pandey ◽  
Marie Gerhard-Herman
Keyword(s):  
Risk Score ◽  
Clinical Laboratory ◽  
Clinical Symptoms ◽  
Intramural Hematoma ◽  
Arterial Dissection ◽  
Aged Patients ◽  
Male Predominance ◽  
Imaging Characteristics ◽  
Vascular Segment

Background: Segmental arterial mediolsyis (SAM) is a non-inflammatory arteriopathy that is increasingly being recognized; however, its clinical characteristics and natural history remain poorly defined. Methods: A retrospective, single-institution review of 20 patients presenting with arterial dissection, intramural hematoma, aneurysm, or occlusion between 2015 and 2020 was performed. To establish a non-invasive diagnosis of SAM, patients with FMD, inflammatory, or genetic arteriopathy were excluded by clinical, laboratory, and imaging criteria according to multidisciplinary guidelines. Patient demographics, clinical features, imaging findings, and management were assessed. Results: The average age of patients was 56 years; 75% were male. CAD was present in 15% of patients and 45% had hypertension; 55% were current or prior smokers. In patients without diagnosed CAD, the 10-year ASCVD risk score was 8.7% and the Framingham risk score was 6.8%. The average hemoglobin A1c was 5.6%. Acute onset abdominal pain (70%) was the most frequent presenting symptom. On average, two different arterial beds were affected at the time of diagnosis, most often in the abdomen. Arterial dissection was present in 75% of patients, and intramural hematoma was seen in 35% of cases. The most affected vessel was the superior mesenteric artery (50%), followed by the celiac, renal, and iliac arteries (35% each). Over a mean follow-up period of 20 months, all patients survived; two patients required intervention due to worsening clinical symptoms. Anticoagulation (AC) was utilized in 50% of cases, most commonly for one month. Long-term follow-up imaging was available in 11 patients; 3 patients (27%) had progression in lesion size over the first month. By 1 year, only 1 patient continued to show enlargement, with all others showing regression. Conclusions: This cohort provides longitudinal follow-up on both clinical and imaging characteristics of non-invasively diagnosed SAM. The condition shows a male predominance, typically manifesting in middle-aged patients with low to intermediate cardiovascular risk. While a subset of patients shows growth in size of the affected vascular segment over the first month, longer follow-up imaging demonstrates regression.

scholarly journals CLINICAL CHARACTERISTICS OF 28 PATIENTS WITH DIABETES AND COVID-19 IN WUHAN, CHINA

2020 ◽  
Vol 26 (6) ◽  
pp. 668-674 ◽  
Author(s):  
Feng Wang ◽  
Yan Yang ◽  
Kun Dong ◽  
Yongli Yan ◽  
Shujun Zhang ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Brain Natriuretic Peptide ◽  
Natriuretic Peptide ◽  
Clinical Characteristics ◽  
Troponin I ◽  
Clinical Laboratory ◽  
Invasive Mechanical Ventilation ◽  
Icu Patients ◽  
Patients With Diabetes

Objective: Previous studies on coronavirus disease 2019 (COVID-19) were based on information from the general population. We aimed to further clarify the clinical characteristics of diabetes with COVID-19. Methods: Twenty-eight patients with diabetes and COVID-19 were enrolled from January 29, 2020, to February 10, 2020, with a final follow-up on February 22, 2020. Epidemiologic, demographic, clinical, laboratory, treatment, and outcome data were analyzed. Results: The average age of the 28 patients was 68.6 ± 9.0 years. Most (75%) patients were male. Only 39.3% of the patients had a clear exposure of COVID-19. Fever (92.9%), dry cough (82.1%), and fatigue (64.3%) were the most common symptoms, followed by dyspnea (57.1%), anorexia (57.1%), diarrhea (42.9%), expectoration (25.0%), and nausea (21.4%). Fourteen patients were admitted to the intensive care unit (ICU). The hemoglobin A1c level was similar between ICU and non-ICU patients. ICU patients had a higher respiratory rate, higher levels of random blood glucose, aspartate transaminase, bilirubin, creatine, N-terminal prohormone of brain natriuretic peptide, troponin I, D-dimers, procalcitonin, C-reactive protein, ferritin, interleukin (IL)-2R, IL-6, and IL-8 than non-ICU patients. Eleven of 14 ICU patients received noninvasive ventilation and 7 patients received invasive mechanical ventilation. Twelve patients died in the ICU group and no patients died in the non-ICU group. Conclusion: ICU cases showed higher rates of organ failure and mortality than non-ICU cases. The poor outcomes of patients with diabetes and COVID-19 indicated that more supervision is required in these patients. Abbreviations: COVID-19 = coronavirus disease 2019; ICU = intensive care unit; MERS-CoV = middle East respiratory syndrome-related coronavirus; 2019- nCoV = 2019 novel coronavirus; NT-proBNP = N-terminal prohormone of brain natriuretic peptide; SARS-CoV = severe acute respiratory syndrome-related coronavirus

scholarly journals Gambaran Penyakit Jantung Bawaan di Neonatal Intensive Care Unit RSUP Prof. Dr. R. D. Kandou Manado Periode 2013 - 2017

e-CliniC ◽  
2018 ◽  
Vol 6 (2) ◽  
Author(s):  
Berry R. Manopo ◽  
Erling D. Kaunang ◽  
Adrian Umboh
Keyword(s):  
Intensive Care Unit ◽  
Congenital Heart Disease ◽  
Intensive Care ◽  
Heart Disease ◽  
Neonatal Intensive Care Unit ◽  
Neonatal Intensive Care ◽  
Congenital Heart ◽  
Septal Defect ◽  
Clinical Symptoms ◽  
Shortness Of Breath

Abstract: Congenital heart disease (CHD) is a structural heart defect that results from abnormal embryological heart development, or persistence of some parts of the fetal circulation at birth. Congenital heart disease is divided into two categories, namely non-cyanotic congenital heart disease and cyanotic congenital heart disease. Congenital heart disease is caused by interactions between predisposing exogenous factors and endogenous factors. This study was aimed to obtain the profile of CHD in the Neonatal Intensive Care Unit (NICU) of Prof. Dr. R. D. Kandou Hospital Manado in the period 2013 - 2017. This was a retrospective descriptive study using medical record data of patients suffering from CHD in NICU from 2013 to 2017. The results showed that there were 27 patients suffering from CHD consisting of 24 non-cyanotic CHD patients (88.89%) and 3 cyanotic CHD patients (11.11%), and the highest incidence was Atrial Septal Defect (ASD) as many as 17 babies (62.96%). Congenital heart disease was more common in males as many as 18 babies (66.67%). In this study, the clinical symptoms oftenly found was shortness of breath (48.15%) and the most common diagnosis was pneumonia (48.15%). Conclusion: The most common CHD was non-cyanotic CHD. The most commonly found defect was ASD. Clinical symptoms that often arised was shortness of breath, pneumonia was the most common comorbid diagnosis, and the dominant gender of CHD was male.Keywords: non-cyanotic CHD, cyanotic CHD, atrial septal defect Abstrak: Penyakit jantung bawaan (PJB) merupakan defek jantung struktural yang terjadi akibat perkembangan jantung embriologis yang abnormal, atau persistensi dari beberapa bagian dari sirkulasi fetus saat lahir. Penyakit ini dibagi menjadi dua kategori yaitu penyakit jantung bawaan non sianosis dan yang sianosis. Penyakit jantung bawaan disebabkan oleh interaksi antara predisposisi faktor eksogen dan faktor endogen. Penelitian ini bertujuan untuk mendapatkan gambaran penyakit jantung bawaan di Neonatal Intensive Care Unit (NICU) RSUP Prof. Dr. R. D. Kandou Manado periode 2013-2017. Jenis penelitian ialah deskriptif retrospektif dengan menggunakan data rekam medik pasien yang menyandang penyakit jantung bawaan di NICU periode 2013-2017. Hasil penelitian mendapatkan dari 27 pasien dengan PJB, ditemukan PJB non sianotik berjumlah 24 bayi (88,89%) dan PJB sianotik berjumlah 3 bayi (11,11%) dengan angka kejadian terbanyak pada atrial septal defek (ASD) berjumlah 17 bayi (62,96%). Penyakit jantung bawaan paling banyak terjadi pada bayi yang berjenis kelamin laki-laki yaitu berjumlah 18 bayi (66,67%). Gejala klinis yang sering muncul ialah sesak napas (48,15%) dan diagnosis penyerta terbanyak yaitu pnemonia (48,15%). Simpulan: Penyakit jantung bawaan non sianosis merupakan diagnosis terbanyak, jenis ASD, dengan gejala klinis yang sering muncul yaitu sesak napas. Pneumonia merupakan diagnosis penyerta terbanyak. PJB tersering pada jenis kelamin laki-laki.Kata kunci: PJB sianotik, PJB, non sianotik, atrial septal defek

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