scholarly journals An Insight of comparison between COVID-19 (2019-nCoV disease) and SARS in pathology and pathogenesis

2020 ◽  
Author(s):  
Xiaolong Cai
Keyword(s):  
Cd8 T Cells ◽  
Older Patients ◽  
Case Fatality Rate ◽  
Clinical Characteristics ◽  
Case Fatality ◽  
Spike Protein ◽  
Potential Candidate ◽  
Cytokine Release ◽  
Cytokine Release Syndrome ◽  
System Disorder

COVID-19, a novel pathogenic coronavirus (2019-nCoV, now named SARS-CoV2) induced disease, emerged in China and spread globally rapidly. 2019-nCoV(SARS-CoV2) shares above 85% identity in genome with SARS-CoV. Patients infected by 2019-nCoV and SARS-CoV also reveal similar clinical characteristics. Here we compare the clinical and pathological features between patients of COVID-19 and SARS respectively. Conclusions:1. Older patients refer to a higher case fatality rate (CFR) than young. 2. Males show a higher CFR than females, and this difference may converge as age increase.3.COVID-19 may cause a kidney and testis damage. Combined with higher CFR in males, genitourinary system disorder caused by the COVID-19 needs to be cautioned.4. It is critical to control the cytokine release syndrome(CRS) in COVID-19. IL-6, IL-10 and their receptors may be the drugable target.5. Consistently to decrease of CD4+T and CD8+T cells, spleen damage, and lymphocyte depletion may exist inCOVID-19 patients. Approaches for T cell rescued may be considered. 6. Compared with SARS-CoV’s Spike protein, 2019-nCoV(SARS-CoV2) Spike protein present a higher binding affinity to ACE2, which suggests that soluble ACE2 might be a potential candidate for COVID-19 treatment. Other receptors, such as L-SIGN and DC-SIGN, need to be investigated in the future.

scholarly journals Tocilizumab May Be a Key in Therapy for Cytokine Release Syndrome in Older Patients With Severe Symptoms of COVID-19

2020 ◽  
Author(s):  
Xu Lengnan ◽  
Liu Xin ◽  
Zhou Yangwei ◽  
Liu Aihua ◽  
Xu Xiaomao ◽  
...  
Keyword(s):  
Computerized Tomography ◽  
Older Patients ◽  
Severe Disease ◽  
Total Mortality ◽  
High Sensitivity ◽  
Severe Illness ◽  
Therapeutic Effects ◽  
Cytokine Release ◽  
Cytokine Release Syndrome ◽  
Neutrophil Lymphocyte Ratio

Abstract Background Older adults are more susceptible to the novel coronavirus disease 2019 (hereafter, COVID-19) and more likely to develop severe illness. Cytokine release syndrome (CRS) may be an important factor in the development of severe disease in patients with COVID-19. Interleukin-6 (IL-6) is an important cytokine in CRS, and tocilizumab can block the IL-6 receptor. In this study, we analyzed the therapeutic effects and safety of tocilizumab on CRS in older patients with severe COVID-19. Methods Between February 10 and March 21, 2020, a total of 19 patients with severe or critical COVID-19 aged ≥ 60 years met the study inclusion criteria at Tongji hospital in Wuhan city, Hubei Province, China. Patients were divided into two groups: 1. The tocilizumab group, whose IL-6 levels exceeded the upper limit of normal by > 10-fold; and 2. The no tocilizumab group, with 1L-6 levels < 10-fold the upper normal limit. Results Patients in the tocilizumab group were older (73.20 ± 4.44 vs. 66.21 ± 5.06 years, P = 0.014); had lower lymphocyte counts (0.71 ± 0.18 vs. 1.18 ± 0.59 × 109/L, P = 0.016); and higher high-sensitivity C-reactive protein (hsCRP) levels (94.04 ± 57.24 vs. 51.65 ± 45.37 mg/L, P = 0.035). The increases in ferritin (FER) and hsCRP levels in patients in the tocilizumab group were marked. Except in one patient who died, IL-6, FER, and hsCRP levels, and the neutrophil/lymphocyte ratio, in the remaining four patients decreased following treatment with tocilizumab. Further, patient computerized tomography scan results improved after 3–8 days of tocilizumab treatment. Tocilizumab did not cause any serious adverse reactions. There were no differences in mortality or days until lung computerized tomography improvement between the two groups. The total mortality rate was 10.53%. Conclusions Our results support the therapeutic efficacy and safety of tocilizumab on older patients with severe COVID-19.

scholarly journals Regional Differences in Epidemiological and Clinical Characteristics, Treatment, and Clinical Outcomes of COVID-19 in Wuhan and Remote Areas of Hubei Province

2021 ◽  
Vol 8 ◽  
Author(s):  
Honggang Ren ◽  
Xingyi Guo ◽  
Antonio Palazón-Bru ◽  
Pengcheng Yang ◽  
Nan Huo ◽  
...  
Keyword(s):  
Regional Differences ◽  
Case Fatality Rate ◽  
Clinical Characteristics ◽  
Case Fatality ◽  
Cross Sectional Study ◽  
Hubei Province ◽  
Fatality Rate ◽  
Cross Sectional ◽  
Suburban Areas

Background: The Coronavirus disease 2019 (COVID-19) pandemic has been a major threat to global health. Regional differences in epidemiological and clinical characteristics, treatment and outcomes of patients have not yet been investigated. This study was conducted to investigate these differences amongCOVID-19 patients in Hubei Province, China.Methods: This retrospective cross-sectional study analyzed data on 289 COVID-19 patients from designated hospitals in three regions:Urban (Wuhan Union West Hospital), Suburban areas of Wuhan (Hannan Hospital) and Enshi city, between February 8 and 20, 2020. The final date of follow-up was December 14th, 2020. The outcomes were case fatality rate and epidemiological and clinical data.Results: Urban Wuhan experienced a significantly higher case fatality rate (21.5%) than suburban Wuhan (5.23%) and rural area of Enshi (3.51%). Urban Wuhan had a higher proportion of patients on mechanical ventilation (24.05%) than suburban Wuhan (0%) and rural Enshi (3.57%). Treatment with glucocorticoids was equivalent in urban and suburban Wuhan (46.84 and 45.75%, respectively) and higher than Enshi (25.00%). Urban Wuhan had a higher proportion of patients with abnormal tests including liver function and serum electrolytes and a higher rate of pneumonia (p &lt; 0.01 for all). Urban Wuhan also had a higher incidence of respiratory failure, heart disease, liver disease and shock, compared with the other two regions (all p &lt; 0.05).Conclusions: Our findings revealed that there are regional differences in COVID-19. These findings provide novel insights into the distribution of appropriate resources for the prevention, control and treatment of COVID-19 for the global community.

scholarly journals Clinical characteristics of 50466 patients with 2019-nCoV infection

2020 ◽  
Author(s):  
Pengfei Sun ◽  
Shuyan Qie ◽  
Zongjan Liu ◽  
Jizhen Ren ◽  
Jianing Xi
Keyword(s):  
Case Fatality Rate ◽  
Clinical Characteristics ◽  
Muscle Soreness ◽  
Meta Analysis ◽  
Case Fatality ◽  
Cochrane Library ◽  
Fatality Rate ◽  
Treatment And Prevention ◽  
Abnormal Chest ◽  
Number Of Patients

AbstractObjectiveWe aim to summarize reliable evidences of evidence-based medicine for the treatment and prevention of the 2019 novel coronavirus (2019-nCoV) by analyzing all the published studies on the clinical characteristics of patients with 2019-nCoV.MethodsPubMed, Cochrane Library, Embase, and other databases were searched. Several studies on the clinical characteristics of 2019-nCoV infection were collected for Meta-analysis.ResultsTen studies were included in Meta-analysis, including a total number of 50466 patients with 2019-nCoV infection. Meta-analysis shows that, among these patients, the incidence of fever was 89.1%, the incidence of cough was 72.2%, and the incidence of muscle soreness or fatigue was 42.5%. The incidence of acute respiratory distress syndrome (ARDS) was 14.8%, the incidence of abnormal chest computer tomography (CT) was 96.6%, the percentage of severe cases in all infected cases was 18.1%, and the case fatality rate of patients with 2019-nCoV infection was 4.3%.ConclusionFever and cough are the most common symptoms in patients with 2019-nCoV infection, and most of these patients have abnormal chest CT examination. Several people have muscle soreness or fatigue as well as ARDS. Diarrhea, hemoptysis, headache, sore throat, shock, and other symptoms only occur in a small number of patients. The case fatality rate of patients with 2019-nCoV infection is lower than that of Severe Acute Respiratory Syndrome (SARS) and Middle East Respiratory Syndrome (MERS).

scholarly journals Risk factors for mortality in hospitalized patients with COVID-19 at the start of the pandemic in Belgium: a retrospective cohort study

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Karlijn van Halem ◽  
Robin Bruyndonckx ◽  
Jeroen van der Hilst ◽  
Janneke Cox ◽  
Paulien Driesen ◽  
...  
Keyword(s):  
Risk Factors ◽  
Hospital Mortality ◽  
Case Fatality Rate ◽  
Clinical Characteristics ◽  
Severe Disease ◽  
Univariate Analysis ◽  
Case Fatality ◽  
Fatality Rate ◽  
Risk Of Death ◽  
Increased Risk

Abstract Background Belgium was among the first countries in Europe with confirmed coronavirus disease 2019 (COVID-19) cases. Since the first diagnosis on February 3rd, the epidemic has quickly evolved, with Belgium at the crossroads of Europe, being one of the hardest hit countries. Although risk factors for severe disease in COVID-19 patients have been described in Chinese and United States (US) cohorts, good quality studies reporting on clinical characteristics, risk factors and outcome of European COVID-19 patients are still scarce. Methods This study describes the clinical characteristics, complications and outcomes of 319 hospitalized COVID-19 patients, admitted to a tertiary care center at the start of the pandemic in Belgium, and aims to identify the main risk factors for in-hospital mortality in a European context using univariate and multivariate logistic regression analysis. Results Most patients were male (60%), the median age was 74 (IQR 61–83) and 20% of patients were admitted to the intensive care unit, of whom 63% needed invasive mechanical ventilation. The overall case fatality rate was 25%. The best predictors of in-hospital mortality in multivariate analysis were older age, and renal insufficiency, higher lactate dehydrogenase and thrombocytopenia. Patients admitted early in the epidemic had a higher mortality compared to patients admitted later in the epidemic. In univariate analysis, patients with obesity did have an overall increased risk of death, while overweight on the other hand showed a trend towards lower mortality. Conclusions Most patients hospitalized with COVID-19 during the first weeks of the epidemic in Belgium were admitted with severe disease and the overall case fatality rate was high. The identified risk factors for mortality are not easily amenable at short term, underscoring the lasting need of effective therapeutic and preventative measures.

scholarly journals Blastomycosis in Northwestern Ontario, 2004 to 2014

2015 ◽  
Vol 26 (5) ◽  
pp. 259-262 ◽  
Author(s):  
Daniel Dalcin ◽  
Syed Zaki Ahmed
Keyword(s):  
Case Fatality Rate ◽  
Clinical Characteristics ◽  
Smoking Status ◽  
Case Fatality ◽  
Invasive Fungal Disease ◽  
Fatality Rate ◽  
Northwestern Ontario ◽  
Number Of Patients ◽  
Canadian Studies ◽  
History Of

Blastomycosis is an invasive fungal disease caused byBlastomyces dermatitidisand the recently discoveredBlastomyces gilchristii. The medical charts of 64 patients with confirmed cases of blastomycosis in northwestern Ontario during a 10-year period (2004 to 2014) were retrospectively reviewed. The number of patients diagnosed with blastomycosis in Ontario was observed to have increased substantially compared with before 1990, when blastomycosis was removed from the list of reportable diseases. Aboriginals were observed to be disproportionately represented in the patient population. Of the patients whose smoking status was known, 71.4% had a history of smoking. 59.4% of patients had underlying comorbidities and a higher comorbidity rate was observed among Aboriginal patients. The case-fatality rate from direct complications of blastomycosis disease was calculated to be 20.3%; this case-fatality rate is the highest ever to be reported in Canada and more than double that of previously published Canadian studies. The clinical characteristics of 64 patients diagnosed with blastomycosis are summarized.

scholarly journals Impact of the COVID-19 pandemic on the epidemiology of out-of-hospital cardiac arrest: A systematic review and meta-analysis

2021 ◽  
Author(s):  
Seth En Teoh ◽  
Yoshio Masuda ◽  
Darren Jun Hao Tan ◽  
Nan Liu ◽  
Laurie J. Morrison ◽  
...  
Keyword(s):  
Cardiac Arrest ◽  
Hospital Admission ◽  
Case Fatality Rate ◽  
Clinical Characteristics ◽  
Case Fatality ◽  
Cochrane Library ◽  
Fatality Rate ◽  
Shockable Rhythm ◽  
The Impact ◽  
Hospital Cardiac Arrest

Abstract Background The coronavirus disease 2019 (COVID-19) pandemic has significantly influenced epidemiology, yet its impact on out-of-hospital cardiac arrest (OHCA) remains unclear. We aimed to evaluate the impact of the pandemic on the incidence and case fatality rate (CFR) of OHCA. We also evaluated the impact on intermediate outcomes and clinical characteristics. Methods PubMed, EMBASE, Web of Science, Scopus, and Cochrane Library databases were searched from inception to May 3, 2021. Studies were included if they compared OHCA processes and outcomes between the pandemic and historical control time periods. Meta-analyses were performed for primary outcomes (annual incidence, mortality, and case fatality rate [CFR]), secondary outcomes (field termination of resuscitation [TOR], return of spontaneous circulation [ROSC]), survival to hospital admission, and survival to hospital discharge), and clinical characteristics (shockable rhythm and etiologies). This study was registered in the International Prospective Register of Systematic Reviews (PROSPERO) (CRD42021253879). Results The COVID-19 pandemic was associated with a 39.5% increase in pooled annual OHCA incidence (p < 0.001). Pooled CFR was increased by 2.65% (p < 0.001), with a pooled odds ratio (OR) of 1.95 for mortality (95% confidence interval [95%CI] 1.51–2.51). There was increased field TOR (OR = 2.46, 95%CI 1.62–3.74). There were decreased ROSC (OR = 0.65, 95%CI 0.55–0.77), survival to hospital admission (OR = 0.65, 95%CI 0.48–0.89), and survival to discharge (OR = 0.52, 95%CI 0.40–0.69). There was decreased shockable rhythm (OR = 0.73, 95%CI 0.60–0.88) and increased asphyxial etiology of OHCA (OR = 1.17, 95%CI 1.02–1.33). Conclusion Compared to the pre-pandemic period, the COVID-19 pandemic period was significantly associated with increased OHCA incidence and worse outcomes.

scholarly journals Important updates from the AACR virtual meeting: COVID-19 and cancer

2020 ◽  
pp. FSO630
Author(s):  
Jacob Ripp ◽  
Anup Kasi
Keyword(s):  
Breast Cancer ◽  
Prostate Cancer ◽  
Older Patients ◽  
Cancer Therapeutics ◽  
Hematologic Malignancies ◽  
Phase Iii ◽  
Cytokine Release ◽  
Cytokine Release Syndrome ◽  
Phase Iii Trial ◽  
Virtual Meeting

In this article, we present the pivotal abstracts presented at the ‘AACR Virtual Meeting: COVID-19 and Cancer’ held in July 2020. Much is unknown regarding the effect of COVID-19 on cancer patients, and this conference presented important updates in therapeutics and epidemiology. Specifically, cancer therapeutics have been hypothesized to treat cytokine release syndrome in patients with COVID-19, and the JAK1/2 inhibitor, ruxolitinib, is currently being used in a Phase III trial to assess its efficacy. Additionally, similar to other studies, morbidity and mortality in patients with COVID-19 and cancer appear to be worse in older patients and in males. We also present various COVID-19 data related to breast cancer, lung cancer, hematologic malignancies, melanoma and prostate cancer.

scholarly journals Impact of the COVID-19 pandemic on the epidemiology of out-of-hospital cardiac arrest: a systematic review and meta-analysis

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Seth En Teoh ◽  
Yoshio Masuda ◽  
Darren Jun Hao Tan ◽  
Nan Liu ◽  
Laurie J. Morrison ◽  
...  
Keyword(s):  
Cardiac Arrest ◽  
Hospital Admission ◽  
Case Fatality Rate ◽  
Clinical Characteristics ◽  
Case Fatality ◽  
Cochrane Library ◽  
Fatality Rate ◽  
Shockable Rhythm ◽  
The Impact ◽  
Hospital Cardiac Arrest

Abstract Background The coronavirus disease 2019 (COVID-19) pandemic has significantly influenced epidemiology, yet its impact on out-of-hospital cardiac arrest (OHCA) remains unclear. We aimed to evaluate the impact of the pandemic on the incidence and case fatality rate (CFR) of OHCA. We also evaluated the impact on intermediate outcomes and clinical characteristics. Methods PubMed, EMBASE, Web of Science, Scopus, and Cochrane Library databases were searched from inception to May 3, 2021. Studies were included if they compared OHCA processes and outcomes between the pandemic and historical control time periods. Meta-analyses were performed for primary outcomes [annual incidence, mortality, and case fatality rate (CFR)], secondary outcomes [field termination of resuscitation (TOR), return of spontaneous circulation (ROSC), survival to hospital admission, and survival to hospital discharge], and clinical characteristics (shockable rhythm and etiologies). This study was registered in the International Prospective Register of Systematic Reviews (PROSPERO) (CRD42021253879). Results The COVID-19 pandemic was associated with a 39.5% increase in pooled annual OHCA incidence (p < 0.001). Pooled CFR was increased by 2.65% (p < 0.001), with a pooled odds ratio (OR) of 1.95 for mortality [95% confidence interval (95%CI) 1.51–2.51]. There was increased field TOR (OR = 2.46, 95%CI 1.62–3.74). There were decreased ROSC (OR = 0.65, 95%CI 0.55–0.77), survival to hospital admission (OR = 0.65, 95%CI 0.48–0.89), and survival to discharge (OR = 0.52, 95%CI 0.40–0.69). There was decreased shockable rhythm (OR = 0.73, 95%CI 0.60–0.88) and increased asphyxial etiology of OHCA (OR = 1.17, 95%CI 1.02–1.33). Conclusion Compared to the pre-pandemic period, the COVID-19 pandemic period was significantly associated with increased OHCA incidence and worse outcomes.

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