scholarly journals Not Only High Number and Specific Comorbidities but Also Age Are Closely Related to Progression and Poor Prognosis in Patients With COVID-19

2022 ◽  
Vol 8 ◽  
Author(s):  
Dafeng Liu ◽  
Yongli Zheng ◽  
Jun Kang ◽  
Dongmei Wang ◽  
Lang Bai ◽  
...  
Keyword(s):  
Clinical Trial ◽  
Disease Progression ◽  
Disease Severity ◽  
Poor Prognosis ◽  
Chronic Obstructive ◽  
Clinical Trial Registry ◽  
Alcoholic Fatty Liver ◽  
Clinical Type ◽  
Conversion Time ◽  
Negative Conversion

Background: Some patients with comorbidities and rapid disease progression have a poor prognosis.Aim: We aimed to investigate the characteristics of comorbidities and their relationship with disease progression and outcomes of COVID-19 patients.Methods: A total of 718 COVID-19 patients were divided into five clinical type groups and eight age-interval groups. The characteristics of comorbidities were compared between the different clinical type groups and between the different age-interval groups, and their relationships with disease progression and outcomes of COVID-19 patients were assessed.Results: Approximately 91.23% (655/718) of COVID-19 patients were younger than 60 years old. Approximately 64.76% (465/718) had one or more comorbidities, and common comorbidities included non-alcoholic fatty liver disease (NAFLD), hyperlipidaemia, hypertension, diabetes mellitus (DM), chronic hepatitis B (CHB), hyperuricaemia, and gout. COVID-19 patients with comorbidities were older, especially those with chronic obstructive pulmonary disease (COPD) and cardiovascular disease (CVD). Hypertension, DM, COPD, chronic kidney disease (CKD) and CVD were mainly found in severe COVID-19 patients. According to spearman correlation analysis the number of comorbidities was correlated positively with disease severity, the number of comorbidities and NAFLD were correlated positively with virus negative conversion time, hypertension, CKD and CVD were primarily associated with those who died, and the above-mentioned correlation existed independently of age. Risk factors included age, the number of comorbidities and hyperlipidaemia for disease severity, the number of comorbidities, hyperlipidaemia, NAFLD and COPD for the virus negative conversion time, and the number of comorbidities and CKD for prognosis. Number of comorbidities and age played a predictive role in disease progression and outcomes.Conclusion: Not only high number and specific comorbidities but also age are closely related to progression and poor prognosis in patients with COVID-19. These findings provide a reference for clinicians to focus on not only the number and specific comorbidities but also age in COVID-19 patients to predict disease progression and prognosis.Clinical Trial Registry: Chinese Clinical Trial Register ChiCTR2000034563.

scholarly journals High number and specific comorbidities independently of age are closely related to progression and poor prognosis in patients with COVID-19

2021 ◽  
Author(s):  
Dafeng Liu ◽  
Yongli Zheng ◽  
Jun Kang ◽  
Dongmei Wang ◽  
Lang Bai ◽  
...  
Keyword(s):  
Clinical Trial ◽  
Disease Progression ◽  
Disease Severity ◽  
Poor Prognosis ◽  
Chronic Obstructive ◽  
Distribution Characteristics ◽  
Alcoholic Fatty Liver ◽  
Clinical Type ◽  
Conversion Time ◽  
Negative Conversion

Abstract Background— Some patients with comorbidities and rapid disease progression have a poor prognosis.Aim—In this study, we aimed to investigate the distribution characteristics of comorbidities and their relationship with disease progression and outcomes of COVID-19 patients.Methods— A total of 718 COVID-19 patients were divided into five clinical type groups and eight age-interval groups. The distribution characteristics of comorbidities were compared between the different clinical type groups and between the different age-interval groups, and their relationships with disease progression and outcomes of COVID-19 patients were assessed.Results—Approximately 88.62% (637/718) of the COVID-19 patients were twenty to fifty-nine years old. Approximately 65.73% (554/718) had one or more comorbidities, and common comorbidities included non-alcoholic fatty liver disease (NAFLD), hyperlipidaemia, hypertension, diabetes mellitus (DM), chronic hepatitis B (CHB), hyperuricaemia and gout. COVID-19 patients with comorbidities were older, especially those with chronic obstructive pulmonary disease (COPD) and cardiovascular disease (CVD). Hypertension, DM, COPD, chronic kidney disease (CKD) and CVD were mainly found in severe COVID-19 patients. According to spearman and partial correlation analysis the number of comorbidities was correlated positively with disease severity, the number of comorbidities and NAFLD were correlated positively with virus negative conversion time, hypertension, CKD and CVD were primarily associated with those who died, and the above-mentioned correlation existed independently of age. Risk factors included the number of comorbidities and hyperlipidaemia for disease severity, age, the number of comorbidities, hyperlipidaemia, NAFLD and COPD for the virus negative conversion time, and the number of comorbidities and CKD for prognosis. Number of comorbidities played a predictive role in disease progression and outcomes.Conclusions—High number and specific comorbidities independently of age are closely related to progression and poor prognosis in patients with COVID-19. These findings provide a reference for clinicians to focus on the number and specific comorbidities in COVID-19 patients to predict disease progression and prognosis.Clinical Trial Registry: Chinese Clinical Trial Register ChiCTR2000034563A statement about the manuscript in research square This manuscript has been presented as preprint in the research sqaure according to the following link: https://www.researchsquare.com/article/ rs-576949/v2.

scholarly journals Old Age, Number and Specific Comorbidities are Closely Related to Progression and Poor Prognosis in Patients with COVID-19

2021 ◽  
Author(s):  
Dafeng Liu ◽  
Yongli Zheng ◽  
Jun Kang ◽  
Dongmei Wang ◽  
Lang Bai ◽  
...  
Keyword(s):  
Clinical Trial ◽  
Disease Progression ◽  
Poor Prognosis ◽  
Chronic Obstructive ◽  
Distribution Characteristics ◽  
Clinical Trial Registry ◽  
Obstructive Pulmonary Disease ◽  
Alcoholic Fatty Liver ◽  
Clinical Type ◽  
Conversion Time

Abstract Background— Some patients with comorbidities and rapid disease progression have a poor prognosis.Aim—In this study, we aimed to investigate the distribution characteristics of comorbidities and their relationship with disease progression and outcomes of COVID-19 patients.Methods— A total of 718 COVID-19 patients were divided into five clinical type groups and eight age-interval groups. The distribution characteristics of comorbidities were compared between the different clinical type groups and between the different age-interval groups, and their relationships with disease progression and outcomes of COVID-19 patients were assessed.Results—Approximately 88.62% (637/718) of the COVID-19 patients were twenty to fifty-nine years old. Approximately 65.73% (554/718) had one or more comorbidities, and common comorbidities included non-alcoholic fatty liver disease (NAFLD), hyperlipidaemia, hypertension, diabetes mellitus (DM), chronic hepatitis B (CHB), hyperuricaemia and gout. COVID-19 patients with comorbidities were older, especially those with chronic obstructive pulmonary disease (COPD) and cardiovascular disease (CVD). Hypertension, DM, COPD, chronic kidney disease (CKD) and CVD were mainly found in severe COVID-19 patients, and hypertension, CKD and CVD were primarily associated with those who died. Risk factors included the number of comorbidities and hyperlipidaemia for disease severity, age, the number of comorbidities, hyperlipidaemia, NAFLD and COPD for the virus negative conversion time, and the number of comorbidities and CKD for prognosis. Number of comorbidities played a predictive role in disease progression and outcomes.Conclusions—These findings provide a reference for clinicians to focus on the number and specific comorbidities in COVID-19 patients to predict disease progression and prognosis.Clinical Trial Registry: Chinese Clinical Trial Register ChiCTR2000034563

scholarly journals Clinical characteristics of hospitalized mild/moderate COVID-19 patients with a prolonged negative conversion time of SARS-CoV-2 nucleic acid detection

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Ya Yang ◽  
Xiaogang Hu ◽  
Lirong Xiong ◽  
Peishu Fu ◽  
Wei Feng ◽  
...  
Keyword(s):  
Disease Progression ◽  
Clinical Symptoms ◽  
Univariate Analysis ◽  
Laboratory Data ◽  
Global Scale ◽  
Viral Rna ◽  
Nucleic Acid Detection ◽  
Conversion Time ◽  
The Impact ◽  
Negative Conversion

Abstract Background The impact of COVID-19 has been devastating on a global scale. The negative conversion time (NCT) of SARS-CoV-2 RNA is closely related to clinical manifestation and disease progression in COVID-19 patients. Our study aimed to predict factors associated with prolonged NCT of SARS-CoV-2 RNA in mild/moderate COVID-19 patients. Methods The clinical features, laboratory data and treatment outcomes of COVID-19 patients were retrospectively analyzed. Then univariate and multivariate analysis were used to screen out risk factors of influencing prolonged NCT of SARS-CoV-2 RNA. Results Thirty-two hospitalized mild/moderate COVID-19 patients were enrolled. The general clinical symptoms were cough (78.1%), fever (75%), diarrhea (68.8%), expectoration (56.3%), and nausea (37.5%). More than 40% of the patients had decreased erythrocyte, hemoglobin and leucocyte and 93.8% patients were detected in abnormalities of chest CT. The median NCT of SARS-CoV-2 RNA was 19.5 days (IQR: 14.25–25). Univariate analysis found fever, nausea, diarrhea and abnormalities in chest CTs were positively associated with prolonged NCT of viral RNA (P< 0.05). The multivariate Cox proportional hazard model revealed that fever [Exp (B), 0.284; 95% CI, 0.114–0.707; P<0.05] and nausea [Exp (B), 0.257; 95%CI, 0.096–0.689; P<0.05] were two significant independent factors. Conclusions Fever and nausea were two significant independent factors in prolonged NCT of viral RNA in mild/moderate COVID-19 patients, which provided a useful references for disease progression and treatment of COVID-19.

scholarly journals Efficacy and Safety of Qushi Huayu Granule For Hyperlipidemia: Study Protocol For a Randomized, Double-Blind, Placebo-Controlled Trial

2021 ◽  
Author(s):  
Yuanlong Sun ◽  
Na Hu ◽  
Gaofeng Chen ◽  
Yanjie Wang ◽  
Yiyang Hu ◽  
...  
Keyword(s):  
Clinical Trial ◽  
Controlled Trial ◽  
Density Lipoprotein ◽  
Efficacy And Safety ◽  
Efficacy Evaluation ◽  
Clinical Trial Registry ◽  
Double Blind ◽  
Alcoholic Fatty Liver ◽  
Double Blind Placebo ◽  
Common Chronic Disease

Abstract Background: Hyperlipidemia has become a common chronic disease worldwide in recent years. Studies shown that hyperlipidemia patients, especially those with a high level of serum low-density lipoprotein cholesterol (LDL-C), have a significantly higher prevalence of atherosclerosis, leading to coronary heart disease. Previous basic experiments and clinical studies have shown that Qushi Huayu granule (QSHY) can reduce blood lipids in patients with non-alcoholic fatty liver disease (NAFLD) accompanied by hyperlipidemia, but lack of clinical efficacy evaluation for patients with hyperlipidemia. This study aims to investigate the efficacy and safety of Qushi Huayu granule for Hyperlipidemia. Methods: This is a randomized, double-blind, placebo-controlled trial. 210 hyperlipidemia participants will be enrolled and randomized into QSHY or placebo granule groups in equal proportions, and receive treatment for 24 weeks. The primary outcome is the percentage change of LDL-C from baseline to week 12. Secondary outcomes are other serum lipid biochemical markers levels, life quality measuring health surveys, and Traditional Chinese Medicine (TCM) Pattern Scale. All related tests will be measured at baseline, week 12 and 24 after enrolment. Adverse events and safety of intervention will be monitored and evaluated.Discussion: We design a clinical trial of hyperlipidemia management with QSHY, a TCM formula. The results of this trial will present the efficacy and safety of QSHY in patients with hyperlipidemia, and provide clinical evidence for the treatment of hyperlipidemia.Trial registration: Chinese Clinical Trial Registry, ID: ChiCTR2000034125. Registered on June 25, 2019.

scholarly journals Overall reduced lymphocyte subsets worsening disease severity and prognosis in COVID-19 severe cases with diabetes mellitus in Chengdu, China

2020 ◽  
Author(s):  
Dafeng Liu ◽  
Yong Wang ◽  
Lijuan Lan ◽  
Yaling Liu ◽  
Bennan Zhao ◽  
...  
Keyword(s):  
T Cells ◽  
Critical Illness ◽  
Disease Severity ◽  
Common Type ◽  
Helper T Cells ◽  
Health Clinic ◽  
Comprehensive Treatment ◽  
Cell Percentage ◽  
Conversion Time ◽  
Negative Conversion

Abstract Background The outbreak of coronavirus disease 2019 (COVID-19) is widespread throughout China and the world. Methods Demographic, clinical data of 95 confirmed cases with COVID-19 on admission at the Public and Health Clinic Centre of Chengdu from January 16 to March 16, 2020, were retrospectively collected and analyzed. Of them 76, 19 cases were enrolled in non-DM group (without DM), DM group (with DM), respectively; according to the disease severity 57, 19, 8, 11 cases were further divided into non-severe non-DM subgroup (light and common type and without DM), severe non-DM subgroup (severe and critical illness type and without DM), non-severe DM subgroup (light and common type and with DM), severe DM subgroup (severe and critical illness type and with DM), respectively. The severe rate and the prognosis was compared between two groups. The data of peripheral lymphocyte and subsets, age, glucose metabolism parameters were compared between four subgroups, and its relationship to the disease severity, the viral negative conversion time, and the prognosis were analyzed.Results In this COVID-19 cohort the proportion of DM was 20%. Patients with DM had significantly higher severe rate and worse prognosis than those without DM, the difference was significant (severe rate ,cured, unhealed and death in DM and non-DM groups:61.11%vs.25.00%,26.32%,68.42%;5.26%vs.71.05%,26.32%,2.68%,х2=2.940, 3.394,P=0.003,0.001,respectively),simultaneously the proportion of DM in severe cases was higher than that in non-severe cases, the obvious difference was found (36.67% vs.12.31%,х2=2.744,P=0.006).Severe cases with DM tended to have the lowest lymphocytes count levels and percentage values, as well as the lowest T cells count levels and percentage values, helper T cells count levels and percentage values, suppressor T cells count levels, B cells count levels and percentage values compared with those severe cases without DM and non-severe cases with or without DM. The important influencing factors were that age, DM, lymphocyte percentage values and helper T cells percentage values for the disease severity, lymphocyte percentage values and B cell percentage values for the viral negative conversion time, and age, the disease severity and the viral negative conversion time for the prognosis.Conclusions The COVID-19 severe cases with DM had the lowest lymphocytes count level and percentage value, especially T and B lymphocytes count levels and percentage value. Overall decreased lymphocytes subsets and DM maybe worsen prognosis by worsening the disease severity and prolonging the viral negative conversion time. Combination immunomodulatory therapy based on comprehensive treatment might improve prognosis of the COVID-19 severe cases with DM.

scholarly journals Overall reduced lymphocyte subsets worsening disease severity and prognosis in COVID-19 severe cases with diabetes mellitus in Chengdu, China

2020 ◽  
Author(s):  
Dafeng Liu ◽  
Yong Wang ◽  
Lijuan Lan ◽  
Yaling Liu ◽  
Bennan Zhao ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
T Cells ◽  
Disease Severity ◽  
Helper T Cells ◽  
The Public ◽  
Cell Percentage ◽  
Severe Group ◽  
Conversion Time ◽  
The Difference ◽  
Negative Conversion

Abstract BackgroundIn early December 2019 the outbreak of coronavirus disease 2019 (COVID-19) is widespread from Wuhan throughout China and the world.MethodsDemographic, clinical data of 95 confirmed cases with COVID-19 on admission at the Public and Health ClinicCentre of Chengdu from January 16 to March 16, 2020, were collected and analyzed. The data ofperipheral lymphocyte and subsetswere compared between severe and non-severe patients with or without diabetes mellitus (DM), and its relationship to the disease severity, the viral negative conversion time, and the prognosis were analyzed.ResultsIn this COVID-19cohort the prevalence of DM was 20%. Patients with DM had significantly higher severe rate and worseprognosis than those without DM, the difference was significant(severe rate ,cured, unhealed and death in DM and non-DM groups:61.11%vs.25.00%,26.32%,68.42%,5.26%vs.71.05%,26.32%,2.68%,х2=2.940,3.394,P=0.003,0.001,respectively),simultaneously the prevalence of DM in severe cases was higher than that in non-severe group,the obvarious difference was found(36.67% vs.12.31%,х2=2.940,P=0.003). Severe cases with DM tended to have the lowest lymphocytes count levels and percentage values,as well as the lowest T cells count levels, helper T cells count levels, suppressor T cells count levels and B(CD19+) count levelscompared with those severe cases without DM and non-severe cases with or without DM. The important influencing factorswere that age,DM, lymphocyte percentage values and helper T cells percentage values for the disease severity, lymphocyte percentage values andB(CD19+) cell percentage values for the viral negative conversion time, and age, the disease severity and the viral negative conversion time for the prognosis.ConclusionsThe COVID-19 severe cases with DMhad the lowest lymphocytes count levels, especially T lymphocytescount levels and B lymphocytes count levels. Overall decreased lymphocytes subsets and DM maybe worsen prognosis by worseningthe disease severity and prolonging the viral negative conversion time.Combinationimmunomodulatory therapy based on comprehensive treatmentmight improveprognosisof the COVID-19 severe cases with DM.

Vitamin D levels are not associated with non-alcoholic fatty liver disease severity in a Brazilian population

2020 ◽  
pp. 1-8
Author(s):  
Jeniffer Danielle M. Dutra ◽  
Quelson Coelho Lisboa ◽  
Silvia Marinho Ferolla ◽  
Carolina Martinelli M. L. Carvalho ◽  
Camila Costa M. Mendes ◽  
...  
Keyword(s):  
Vitamin D ◽  
Liver Disease ◽  
Fatty Liver ◽  
Disease Severity ◽  
Fatty Liver Disease ◽  
Hypovitaminosis D ◽  
Alcoholic Fatty Liver ◽  
Vitamin D Levels ◽  
The Mean ◽  
Alcoholic Fatty Liver Disease

Abstract. Some epidemiological evidence suggests an inverse correlation between non-alcoholic fatty liver disease (NAFLD) frequency and vitamin D levels. Likewise, a beneficial effect of vitamin D on diabetes mellitus (DM) and insulin resistance has been observed, but this is an unsolved issue. Thus, we aimed to investigate the prevalence of hypovitaminosis D in a NAFLD Brazilian population and its association with disease severity and presence of comorbidities. In a cross-sectional study, the clinical, biochemical and histological parameters of 139 NAFLD patients were evaluated according to two different cut-off points of serum 25-hydroxyvitamin D levels (20 ng/mL and 30 ng/mL). The mean age of the population was 56 ± 16 years, most patients were female (83%), 72% had hypertension, 88% dyslipidemia, 46% DM, 98% central obesity, and 82% metabolic syndrome. Serum vitamin D levels were < 30 ng/mL in 78% of the patients, and < 20 ng/mL in 35%. The mean vitamin D level was 24.3 ± 6.8 ng/mL. The comparison between the clinical, biochemical and histological characteristics of the patients according to the levels of vitamin D showed no significant difference. Most patients with NAFLD had hypovitaminosis D, but low vitamin D levels were not related to disease severity and the presence of comorbidities.

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