scholarly journals Severe Community-acquired Pneumonia Caused by Type 7 Human Adenovirus in Immuno competent Adults

2020 ◽  
Author(s):  
Qin Gu ◽  
Ying Xu ◽  
Ran Ming Shao ◽  
Ning Liu ◽  
Jiang Dan Dong ◽  
...  
Keyword(s):  
Early Stage ◽  
Laboratory Data ◽  
Human Adenovirus ◽  
Community Acquired Pneumonia ◽  
High Fever ◽  
C Reactive Protein ◽  
Illness Onset ◽  
Reactive Protein ◽  
Severe Community Acquired Pneumonia ◽  
Immunocompetent Adults

Abstract Background Severe community-acquired pneumonia (SCAP) caused by human adenovirus type 7 (HAdV-7) in immunocompetent adults has been of increasing concern recently. Clinical understanding of SCAP caused by HAdV-7 in adults remains limited, though the pathogen has been adequately identified by metagenomic next-generation sequencing (mNGS). Methods We conducted a retrospective review of all patients with SCAP caused by HAdV-7 in immunocompetent adults admitted to Nanjing Drum Tower Hospital, a tertiary hospital in Nanjing, China, between July 2017 and April 2020. Clinical manifestation, laboratory findings, serial radiological characteristics, mNGS results, treatments and outcomes of these patients were collected and analyzed. Results A total of 7 SCAP patients with confirmed HAdV-7 infections were included. All patients were positive for HAdV-7 DNA fragments by mNGS for BALF and blood specimens. The median of the identified reads of two groups were 2783 and 1038, and the median coverage rates were 99.3% and 97.7%, respectively. All the patients were male and the median age was 23 years. High fever (100%), cough (57.14%) and dyspnea (100%) were the most frequent symptoms at admission. Laboratory data showed slightly decreased leucocytes but high procalcitonin and C-reactive protein levels. At early stage, with median 5 days from onset of illness, consolidation (85.71%) and patchy ground-glass opacity (GGOs) (85.71%) in unilateral lung were the most common findings in severe HAdV CAP. Within median 8 days after illness onset into progressive stage, consolidation developed and was the predominant finding in all patients, and 6 patients (85.71%) showed bilateral consolidations. In convalescent stage with median 18 days after illness onset, the parenchymal abnormalities began to absorb. Conclusions MNGS of blood or BALF could identify HAdV-7 infection accurately. Doctors should be aware of SCAP caused by HAdV-7 infection and perform mNGS as soon as possible when patients had persistent high fever, cough,decreased WBC༌high C-reactive protein and consolidation and GGO in unilateral or bilateral lungs shown by chest CT scan.

scholarly journals C-Reactive Protein Level May Predict the Risk of COVID-19 Aggravation

2020 ◽  
Vol 7 (5) ◽  
Author(s):  
Guyi Wang ◽  
Chenfang Wu ◽  
Quan Zhang ◽  
Fang Wu ◽  
Bo Yu ◽  
...  
Keyword(s):  
Early Stage ◽  
Characteristic Curve ◽  
Laboratory Data ◽  
Area Under The Curve ◽  
Threshold Value ◽  
Clinical Findings ◽  
Optimal Threshold ◽  
C Reactive Protein ◽  
Related Factors ◽  
Reactive Protein

Abstract Background Clinical findings indicated that a fraction of coronavirus disease 2019 (COVID-19) patients diagnosed as mild early may progress to severe cases. However, it is difficult to distinguish these patients in the early stage. The present study aimed to describe the clinical characteristics of these patients, analyze related factors, and explore predictive markers of the disease aggravation. Methods Clinical and laboratory data of nonsevere adult COVID-19 patients in Changsha, China, were collected and analyzed on admission. A logistic regression model was adopted to analyze the association between the disease aggravation and related factors. The receiver operating characteristic curve (ROC) was utilized to analyze the prognostic ability of C-reactive protein (CRP). Results About 7.7% (16/209) of nonsevere adult COVID-19 patients progressed to severe cases after admission. Compared with nonsevere patients, the aggravated patients had much higher levels of CRP (median [range], 43.8 [12.3–101.9] mg/L vs 12.1 [0.1–91.4] mg/L; P = .000). A regression analysis showed that CRP was significantly associated with aggravation of nonsevere COVID-19 patients, with an area under the curve of 0.844 (95% confidence interval, 0.761–0.926) and an optimal threshold value of 26.9 mg/L. Conclusions CRP could be a valuable marker to anticipate the possibility of aggravation of nonsevere adult COVID-19 patients, with an optimal threshold value of 26.9 mg/L.

scholarly journals Clinical and CT Characteristics of Medical Personnel with the Coronavirus Disease-2019 (COVID-19) in Wuhan

2020 ◽  
Author(s):  
Ying Xiong ◽  
Qiang Zhang ◽  
Dong Sun ◽  
Xiaoming Li ◽  
Wenzhen Zhu
Keyword(s):  
Clinical Laboratory ◽  
Early Stage ◽  
Medical Personnel ◽  
C Reactive Protein ◽  
Illness Onset ◽  
Reactive Protein ◽  
Erythrocyte Sedimentation ◽  
Clinical Laboratory Test ◽  
Ct Features

Abstract Objectives: To investigate the clinical and chest CT characteristics of medical personnel infected with the Coronavirus Disease-2019 (COVID-19).Methods: The clinical, laboratory test and computed tomography (CT) features of 30 medical personnel (MP group, 26-65 years, 16 males) with COVID-19 were retrospectively analyzed, and compared to 33 non-medical related patients (non-MP group, 26-74 years, 19 males). Follow-up CT characteristics were analyzed to assess the changes of the COVID-19 infection in the period of hospitalization.Results: At admission, the main complaints of MP group, including fever (86.7%), fatigue (53.3%) and cough (43.3%), were similar to the non-MP group; the C-reactive protein, erythrocyte sedimentation rate and lactate dehydrogenase levels of the non-MP group (55.6±45.9mg/L, 34.7±26.3mm/H and 321±117U/L) were higher than that of the MP group (17.8±19.9mg/L, 18.6±21.3mm/H and 219±54.2U/L, respectively, all p<0.05). Ground-grass opacities, consolidation, interstitial thickening were common CT features of both groups. The days from illness onset to the first CT exam, and the severity of opacities on initial CT were less in the MP group than that of the non-MP group (p<0.05). However, the days from onset to observation of the most obvious pulmonary opacities, according to CT findings, were similar in the MP group (11.5±5.9 days) and the non-MP group (12.2±3.1 days, p=0.55).Conclusions: Like the general population, medical personnel are also susceptible to the COVID-19, although with more professional knowledge and protective equipment. Occupational exposure is a very important factor. Medical personnel have a higher vigilance about the infection in the early stage of the disease.

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