scholarly journals Pathogenesis clue from early clinical presentation of 300 hospitalized COVID-19 patients

2020 ◽  
Author(s):  
Feng Yu ◽  
Xuemei Deng ◽  
Li Ni ◽  
Wei Li ◽  
Ping Yan ◽  
...  
Keyword(s):  
Clinical Manifestations ◽  
Alveolar Cells ◽  
Virus Structure ◽  
Multiple Organs ◽  
Interlobular Septum ◽  
Lateral Zone ◽  
Pathological Mechanism ◽  
Global Spread ◽  
Upper Respiratory ◽  
Severity Of The Disease

Abstract The global spread of COVID-19 has been lasted more than half a year. Except for the gene sequence and virus structure of SARS-CoV-2, its clinical characteristics, pathological mechanism and corresponding measures have not been fully revealed. Objective: To speculate the possible pathological mechanism from the early clinical manifestations of the patients with COVID-19. Methods: The onset symptoms, laboratory examination and CT findings on admission of 300 cases in two wards of Wuhan Third Hospital from January 28 to March 15 were analyzed retrospectively. Results: There was no difference in incidence between men and women, but women were hospitalized later after onset. Upper respiratory symptoms and sputum were seldom. The incidence of fever was 71%. Blood lymphocytes count decreased significantly on admission, which was related to the severity of the disease. In the moderate type of patients, who without hypoxia, thrombocytopenia occurred in 12.37%, CRP rose in 64.43 %, BUN elevated in 20.62 %, creatinine rose in 17.53 %, D-dimer elevated in 74.74%, creatine kinase and α-hydroxybutyrate dehydrogenase elevated in 45.36% and 54.12% patients respectively. The early CT showed a small amount of infiltration in the subpleural, the lateral zone of the lung and thickening of the interlobular septum. About 5 days later, infiltration had been worse in a part of the patients, and the affected lung was negatively correlated with the lymphocyte count. Conclusion: There was no gender difference in patients with SARS-CoV-2 invasion. Alveolar cells and T lymphocytes maybe main targets of the virus and apoptosis maybe primary pathogenesis. The virus entering the lung maybe transmitted through lymph or blood channels, rather than direct diffused in the respiratory tract. Early damage of multiple organs maybe caused by immune response.

scholarly journals Pathogenesis Clues from the Early Clinical Presentation of 300 Hospitalized COVID-19 Patients

2020 ◽  
Author(s):  
Feng Yu ◽  
Xuemei Deng ◽  
Li Ni ◽  
Wei Li ◽  
Ping Yan ◽  
...  
Keyword(s):  
Clinical Manifestations ◽  
Alveolar Cells ◽  
Multiple Organs ◽  
Primary Mechanism ◽  
Pathological Mechanism ◽  
Viral Structure ◽  
Global Spread ◽  
Laboratory Examinations ◽  
Upper Respiratory ◽  
Severity Of The Disease

Abstract Background: The global spread of the 2019 coronavirus disease (COVID-19) has lasted more than half a year. Except for the gene sequence and viral structure of SARS-CoV-2, its clinical characteristics, pathological mechanisms and corresponding measures have not been fully revealed. We aimed to speculate about the possible pathological mechanism from the early clinical manifestations of patients with COVID-19. Methods: The onset symptoms, laboratory examinations and CT findings on admission of 300 patients in two wards of Wuhan Third Hospital from January 28 to March 15 were analyzed retrospectively. Results: There was no difference in incidence between men and women, but women were hospitalized later after onset. Upper respiratory symptoms and sputum were rare. The incidence of fever was 71%. Blood lymphocyte counts were decreased significantly on admission and were related to the severity of the disease. In moderate patients without hypoxia, thrombocytopenia occurred in 12.37%, CRP rose in 64.43%, BUN was elevated in 20.62%, creatinine rose in 17.53%, D-dimer was elevated in 74.74%, and creatine kinase and α-hydroxybutyrate dehydrogenase were elevated in 45.36% and 54.12% of patients, respectively. Early CT showed a small amount of infiltration in the subpleural and lateral zones of the lung and thickening of the interlobular septum. Approximately 5 days later, infiltration was worse in some of the patients, and the proportion of involvement of the affected lung was negatively correlated with the lymphocyte count. Conclusions: There was no sex difference in patients with SARS-CoV-2 infection. Alveolar cells and T lymphocytes may be the main targets of the virus, and apoptosis may be the primary mechanism of pathogenesis. The virus entering the lung may be transmitted through lymph or blood vessels rather than directly dispersing through the respiratory tract. Early damage to multiple organs may be caused by the immune response.

Clinico-Haematological Alterations in Goats Affected with Ruminal Acidosis

2017 ◽  
Vol 13 (02) ◽  
Author(s):  
P. R. Chavelikar ◽  
G. C. Mandali ◽  
D. M. Patel
Keyword(s):  
Clinical Signs ◽  
Clinical Manifestations ◽  
Nasal Discharge ◽  
Mean Values ◽  
Ruminal Acidosis ◽  
Reduced Body ◽  
Muscle Twitching ◽  
Haematological Profile ◽  
The Mean ◽  
Severity Of The Disease

Ruminal acidosis is one of the most important clinical emergencies in sheep and goats resulting into high mortality rate. In the present study, eight healthy farm goats and 24 goats presented to the TVCC of the college with clinical signs of ruminal acidosis like anorexia, tympany, increased pulse and respiratory rate, reduced body temperature, doughy rumen, enteritis, oliguria, grinding of teeth, purulent nasal discharge, muscle twitching, arched back, dehydration and recumbency with rumen liquor pH below 6 were examined for haematological alterations using autohaematoanalyzer. Among various haematological parameters evaluated from acidotic goats, the mean values of Hb (12.21±0.17 vs. 10.86±0.15 g/dl), TEC (14.28±0.16 vs. 12.04±0.36 ×106/ μl), TLC (13.43±0.11 vs. 11.11±0.27 ×103/μl), PCV (36.91±0.53 vs. 29.88±0.55%), neutrophils (64.54±0.93 vs. 28.13±0.92%), MCV (23.38±0.37 vs. 19.38±1.34 fl) and MCH (7.03±0.08 vs. 6.31±0.25 pg) were found significantly increased, while the mean values of lymphocytes (28.00±0.82 vs. 65.38±0.80%) and MCHC (24.55 ±0.26 vs. 34.88±0.97 g/dl) were decreased significantly from the base values of healthy goats. It was concluded that ruminal acidosis induced due to accidental heavy ingestion of readily fermentable carbohydrate rich grains and food waste significantly altered the haematological profile concurrent with clinical manifestations in goats, and hence can be used to assess the severity of the disease.

scholarly journals Temporal association between human upper respiratory and gut bacterial microbiomes during the course of COVID-19 in adults

2021 ◽  
Vol 4 (1) ◽  
Author(s):  
Rong Xu ◽  
Renfei Lu ◽  
Tao Zhang ◽  
Qunfu Wu ◽  
Weihua Cai ◽  
...  
Keyword(s):  
Dynamic Change ◽  
Temporal Association ◽  
Rrna Gene ◽  
Type I ◽  
Dynamic Changes ◽  
Multiple Organs ◽  
Community Types ◽  
Upper Respiratory ◽  
Rrna Gene Sequencing ◽  
16 S Rrna

AbstractSARS-CoV-2 is the cause of COVID-19. It infects multiple organs including the respiratory tract and gut. Dynamic changes of regional microbiomes in infected adults are largely unknown. Here, we performed longitudinal analyses of throat and anal swabs from 35 COVID-19 and 19 healthy adult controls, as well as 10 non-COVID-19 patients with other diseases, by 16 S rRNA gene sequencing. The results showed a partitioning of the patients into 3-4 categories based on microbial community types (I-IV) in both sites. The bacterial diversity was lower in COVID-19 patients than healthy controls and decreased gradually from community type I to III/IV. Although the dynamic change of microbiome was complex during COVID-19, a synchronous restoration of both the upper respiratory and gut microbiomes from early dysbiosis towards late more diverse status was observed in 6/8 mild COVID-19 adult patients. These findings reveal previously unknown interactions between upper respiratory and gut microbiomes during COVID-19.

scholarly journals Growth Arrest-Specific Factor 6 (GAS6) Is Increased in COVID-19 Patients and Predicts Clinical Outcome

Biomedicines ◽  
2021 ◽  
Vol 9 (4) ◽  
pp. 335
Author(s):  
Albert Morales ◽  
Silvia Rojo Rello ◽  
Helena Cristóbal ◽  
Aida Fiz-López ◽  
Elisa Arribas ◽  
...  
Keyword(s):  
Inflammatory Responses ◽  
Growth Arrest ◽  
Emergency Admission ◽  
Human Macrophage ◽  
Specific Factor ◽  
Alveolar Cells ◽  
Lps Challenge ◽  
Tam Receptors ◽  
Relevant Role ◽  
Severity Of The Disease

Background: Growth arrest-specific factor 6 (GAS6) and the Tyro3, AXL, and MERTK (TAM) receptors counterbalance pro-inflammatory responses. AXL is a candidate receptor for SARS-CoV-2, particularly in the respiratory system, and the GAS6/AXL axis is targeted in current clinical trials against COVID-19. However, GAS6 and TAMs have not been evaluated in COVID-19 patients at emergency admission. Methods: Plasma GAS6, AXL, and MERTK were analyzed in 132 patients consecutively admitted to the emergency ward during the first peak of COVID-19. Results: GAS6 levels were higher in the SARS-CoV-2-positive patients, increasing progressively with the severity of the disease. Patients with initial GAS6 at the highest quartile had the worst outcome, with a 3-month survival of 65%, compared to a 90% survival for the rest. Soluble AXL exhibited higher plasma concentration in deceased patients, without significant differences in MERTK among SARS-CoV-2-positive groups. GAS6 mRNA was mainly expressed in alveolar cells and AXL in airway macrophages. Remarkably, THP-1 human macrophage differentiation neatly induces AXL, and its inhibition (bemcentinib) reduced cytokine production in human macrophages after LPS challenge. Conclusions: Plasma GAS6 and AXL levels reflect COVID-19 severity and could be early markers of disease prognosis, supporting a relevant role of the GAS6/AXL system in the immune response in COVID-19.

scholarly journals Pathobiology of A/Chicken/Hong Kong/220/97 (H5N1) Avian Influenza Virus in Seven Gallinaceous Species

2001 ◽  
Vol 38 (2) ◽  
pp. 149-164 ◽  
Author(s):  
L. E. L. Perkins ◽  
D. E. Swayne
Keyword(s):  
Hong Kong ◽  
Avian Influenza ◽  
Pulmonary Edema ◽  
Multiorgan Failure ◽  
Clinical Manifestations ◽  
Highly Pathogenic ◽  
H5n1 Avian Influenza Virus ◽  
Multiple Organs ◽  
H5n1 Avian Influenza ◽  
Virus Localization

Direct bird-to-human transmission, with the production of severe respiratory disease and human mortality, is unique to the Hong Kong-origin H5N1 highly pathogenic avian influenza (HPAI) virus, which was originally isolated from a disease outbreak in chickens. The pathobiology of the A/chicken/Hong Kong/ 220/97 (H5N1) (HK/220) HPAI virus was investigated in chickens, turkeys, Japanese and Bobwhite quail, guinea fowl, pheasants, and partridges, where it produced 75-100% mortality within 10 days. Depression, mucoid diarrhea, and neurologic dysfunction were common clinical manifestations of disease. Grossly, the most severe and consistent lesions included splenomegaly, pulmonary edema and congestion, and hemorrhages in enteric lymphoid areas, on serosal surfaces, and in skeletal muscle. Histologic lesions were observed in multiple organs and were characterized by exudation, hemorrhage, necrosis, inflammation, or a combination of these features. The lung, heart, brain, spleen, and adrenal glands were the most consistently affected, and viral antigen was most often detected by immunohistochemistry in the parenchyma of these organs. The pathogenesis of infection with the HK/220 HPAI virus in these species was twofold. Early mortality occurring at 1-2 days postinoculation (DPI) corresponded to severe pulmonary edema and congestion and virus localization within the vascular endothelium. Mortality occurring after 2 DPI was related to systemic biochemical imbalance, multiorgan failure, or a combination of these factors. The pathobiologic features were analogous to those experimentally induced with other HPAI viruses in domestic poultry.

POLYNEURITIS IN CHILDREN

PEDIATRICS ◽  
1958 ◽  
Vol 22 (5) ◽  
pp. 972-990
Author(s):  
Niels L. Low ◽  
Julia Schneider ◽  
Sidney Carter
Keyword(s):  
Clinical Picture ◽  
Cranial Nerve ◽  
Clinical Manifestations ◽  
Signs And Symptoms ◽  
Severity Of The Disease ◽  
Clinical Records

Polyneuritis in children is becoming more common. The clinical picture is variable; it may be manifested by motor and sensory findings, or by a combination of peripheral and cranial nerve signs and symptoms. The etiology is usually obscure. The pathologic picture varies with the severity of the disease and differs according to the stage at which the patient dies, but all fatal cases show the same main characteristic changes. Clinical records of 30 cases, 17 boys and 13 girls from 17 months to 16 years of age, are reviewed. The clinical manifestations, course and treatment are described.

scholarly journals Propéptido natriurético tipo B N-terminal en adultos mayores ecuatorianos

2020 ◽  
Vol 4 (1) ◽  
pp. 9
Author(s):  
Rubí Eliana Bermello Zamora ◽  
Yury Jordano Sanclemente Núñez ◽  
Ivón Howland Álvarez
Keyword(s):  
Heart Failure ◽  
Healthcare Expenditure ◽  
Clinical Manifestations ◽  
Clinical Importance ◽  
The Elderly ◽  
Comprehensive Health Care ◽  
Palabras Clave ◽  
Insuficiencia Cardiaca ◽  
Comprehensive Health ◽  
Severity Of The Disease

  La insuficiencia cardiaca (IC) es un trastorno progresivo y letal que constituye la primera causa de ingreso hospitalario en las personas mayores de 65 años. Se ha demostrado la utilidad del NT-proBNP para su diagnóstico; sin embargo, los valores de estos marcadores difieren según las características de los pacientes y la severidad de la enfermedad. El objetivo de este estudio consistió en determinar la utilidad de la medición de NT-proBNP para diagnosticar el riesgo de padecer IC en adultos mayores. Se realizaron análisis de NT-proBNP, creatinina, urea, hemoglobina, glucosa y sodio en 47 muestras sanguíneas de pacientes de un centro gerontológico de Manabí en el periodo octubre a diciembre 2017. Se analizaron los valores y la posible asociación a otras enfermedades. Se compararon los valores de variables demográficas, analíticas y clínicas. Se analizaron las manifestaciones clínicas y antecedentes patológicos personales asociados al riesgo de IC. El valor NT-proBNP se asoció con la presencia de anemia, creatinina mayor de 2 mg/dL e hiponatremia. La edad media de los pacientes fue de 79 años, de predominio masculino, con comorbilidad asociada y cierto grado de dependencia, aunque la edad no fue un factor que influyó en la probabilidad de tener elevación en el valor plasmático de NT-proBNP y por lo tanto del riesgo latente de padecer o no IC. El valor de NT-proBNP mostró ser un analito complementario de gran importancia clínica para la evaluación y el cuidado integral de salud del anciano.   Palabras clave: NT-proBNP, insuficiencia cardiaca, adultos mayores.   Abstract Heart failure (HF) is a progressive and lethal disorder that constitutes the first cause of hospital admission in people over 65 years of age and represents just over 2% of national healthcare expenditure. The usefulness of NT-proBNP for its diagnosis has been demonstrated, however, the values of these markers differ according to the characteristics of the patients and the severity of the disease. The objective of this study is to determine the NT-proBNP usefullness to diagnose risk of HF in older adults. NT-proBNP, creatinine, urea, hemoglobin, glucose and sodium were analyzed in 47 blood samples of patients from the gerontological center from October to December 2017. The values and the possible association to other diseases were analyzed. The values of demographic, analytical and clinical variables were compared. The clinical manifestations and personal pathological background associated with the risk of HF were analyzed. The NT-proBNP value was associated with the presence of anemia, creatinine greater than 2 mg/dL and hyponatremia. The average age of the patients was 79 years, predominantly male, with associated comorbidity and a certain degree of dependence, although age was not a factor that influenced the probability of having an elevated plasma NT-proBNP value and therefore both of the latent risk of suffering or not IC. The value of NT-proBNP was shown to be a complementary analyte of great clinical importance for the evaluation and comprehensive health care of the elderly.   Keywords: NT-proBNP, heart failure, elderly.

scholarly journals Clinical Characteristics and CT Manifestations of 143 Patients With 2019 Novel Coronavirus Disease (COVID-19) in Taizhou City, Zhejiang, China

2020 ◽  
Author(s):  
Yani Kuang ◽  
Susu He ◽  
Shuangxiang Lin ◽  
Rui Zhu ◽  
Rongzhen Zhou ◽  
...  
Keyword(s):  
Clinical Symptoms ◽  
Protein A ◽  
Clinical Manifestations ◽  
Imaging Features ◽  
First Case ◽  
Severe Group ◽  
Laboratory Examinations ◽  
The Difference ◽  
Severity Of The Disease ◽  
Novel Coronavirus

Abstract Background: In December 2019, the first case of pneumonia associated with the SARS-CoV-2 was found in Wuhan and rapidly spread throughout China, so data are needed on the affected patients. The purpose of our study was to find the clinical manifestations and CT features of COVID-19.Methods: All patients with COVID-19 in Taizhou city were retrospectively included and divided into non-severe group and severe group according to the severity of the disease. The clinical manifestations, laboratory examinations and imaging features of COVID-19 patients were analyzed, and the differences between the two groups were compared.Results: A total of 143 laboratory-confirmed cases were included in the study, including 110 non-severe patients and 33 severe patients. The median age of patients was 47 (range 4–86 years). Fever (73.4%) and cough (63.6%) were the most common initial clinical symptoms. Between two groups of cases, the results of aspartate transaminase, creatine kinase and lactate dehydrogenase, serum albumin, CR, glomerular filtration rate, amyloid protein A, fibrinogen, calcitonin level and oxygen partial pressure, IL – 10, absolute value of CD3, CD4, CD8 were different, and the difference was statistically significant (P < 0.05). Therefore, these quantitative indicators can be used to help assess the severity. On admission, the CT showed that the lesions were mostly distributed in the periphery of the lung or subpleural (135 cases (98%)), and most of lesions presented as patchy (81%), mixed density (63%) shadow. Consolidation (68% vs 41%), bronchial inflation signs (59% vs 41%), and bronchiectasis (71% vs 39%) were more common in the severe group.Conclusions: Most of the cases of COVID-19 in Taizhou have mild symptoms and no death. In addition to clinical symptoms, some laboratory tests (such as absolute values of CD4 and CD8) and CT findings can be used to assess the severity of the disease.

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