scholarly journals Urinary SARS-CoV-2 RNA Is an Indicator for the Progression and Prognosis of COVID-19

Diagnostics ◽  
2021 ◽  
Vol 11 (11) ◽  
pp. 2089
Author(s):  
Lu Zhang ◽  
Maoqing Tian ◽  
Yuan Song ◽  
Wei Liang ◽  
Xiaogang Li ◽  
...  
Keyword(s):  
Clinical Characteristics ◽  
Mathematic Model ◽  
Pcr Analysis ◽  
Histopathological Analysis ◽  
Endothelium Dysfunction ◽  
Risk Of Death ◽  
Positive Rate ◽  
Potential Factors ◽  
Clinical Conditions ◽  
Renal Vascular

Background: We aimed to analyze clinical characteristics and find potential factors to predict poor prognosis in patients with coronavirus disease 2019 (COVID-19). Methods: We analyzed the clinical characteristics and laboratory tests of COVID-19 patients and detected SARS-CoV-2 RNA in urine sediments collected from 53 COVID-19 patients enrolled in Renmin Hospital of Wuhan University from 31 January 2020 to 18 February 2020 with qRT-PCR analysis. Then, we classified those patients based on clinical conditions (severe or non-severe syndrome) and urinary SARS-CoV-2 RNA (URNA− or URNA+). Results: We found that COVID-19 patients with severe syndrome (severe patients) showed significantly higher positive rate (11 of 23, 47.8%) of urinary SARS-CoV-2 RNA than non-severe patients (4 of 30, 13.3%, p = 0.006). URNA+ patients or severe URNA+ subgroup exhibited higher prevalence of inflammation and immune discord, cardiovascular diseases, liver damage and renal dysfunction, and higher risk of death than URNA− patients. To understand the potential mechanisms underlying the viral urine shedding, we performed renal histopathological analysis on postmortems of patients with COVID-19 and found severe renal vascular endothelium lesion characterized by an increase of the expression of thrombomodulin and von Willebrand factor, markers to assess the endothelium dysfunction. We proposed a theoretical and mathematic model to depict the potential factors that determine the urine shedding of SARS-CoV-2. Conclusions: This study indicated that urinary SARS-CoV-2 RNA detected in urine specimens can be used to predict the progression and prognosis of COVID-19 severity.

scholarly journals Urinary SARS-CoV-2 RNA is An Indicator For The Progression and Prognosis of COVID-19 Disease

2021 ◽  
Author(s):  
Maoqing Tian ◽  
Lu Zhang ◽  
Kai Zhu ◽  
Bo Shen ◽  
Gang Wang ◽  
...  
Keyword(s):  
Mathematic Model ◽  
Pcr Analysis ◽  
Histopathological Analysis ◽  
Endothelium Dysfunction ◽  
Risk Of Death ◽  
Positive Rate ◽  
Potential Factors ◽  
Clinical Conditions ◽  
Renal Vascular ◽  
Von Willebrand

Abstract Background: We aimed to analyse clinical characteristics and find potential factors predicting poor prognosis in patients with coronavirus disease 2019 (COVID-19). Methods: We analyzed the demographic and clinical data of COVID-19 patients and detected SARS-CoV-2 RNA in urine sediments collected from 53 COVID-19 patients enrolled in Renmin Hospital of Wuhan University from January 31, 2020 to February 18, 2020 with qRT-PCR analysis, and then classified those patients based on clinical conditions (severe or non-severe syndrome) and urinary SARS-CoV-2 RNA (URNA- or URNA+). Results: We found that COVID-19 patients with severe syndrome (severe patients) showed significantly higher positive rate (11 of 23, 47.8%) of urinary SARS-CoV-2 RNA than non-severe patients (4 of 30, 13.3%, p = 0.006). URNA+ patients or severe URNA+ subgroup exhibited higher prevalence of inflammation and immune discord, cardiovascular diseases, liver damage and renal disfunction, and higher risk of death than URNA- patients. To understand the potential mechanisms underlying the viral urine shedding, we performed renal histopathological analysis on postmortems of patients with COVID-19 and found that severe renal vascular endothelium lesion characterized by increase of the expression of thrombomodulin and von Willebrand factor, markers to assess the endothelium dysfunction. We proposed a theoretical and mathematic model to depict the potential factors determining the urine shedding of SARS-CoV-2. Conclusions: This study indicated that urinary SARS-CoV-2 RNA detected in urine specimens can be used to predict the progression and prognosis of COVID-19 severity.

scholarly journals Clinical characteristics and outcomes of people living with HIV hospitalized with COVID-19: a nationwide experience

2021 ◽  
Vol 32 (5) ◽  
pp. 435-443
Author(s):  
Maria Elena Ceballos ◽  
Patricio Ross ◽  
Martin Lasso ◽  
Isabel Dominguez ◽  
Marcela Puente ◽  
...  
Keyword(s):  
Mechanical Ventilation ◽  
Intensive Care ◽  
General Population ◽  
Clinical Characteristics ◽  
Cd4 Count ◽  
People Living With Hiv ◽  
Hiv Diagnosis ◽  
Hiv Viral Load ◽  
Risk Of Death ◽  
Living With Hiv

In this prospective, multicentric, observational study, we describe the clinical characteristics and outcomes of people living with HIV (PLHIV) requiring hospitalization due to COVID-19 in Chile and compare them with Chilean general population admitted with SARS-CoV-2. Consecutive PLHIV admitted with COVID-19 in 23 hospitals, between 16 April and 23 June 2020, were included. Data of a temporally matched-hospitalized general population were used to compare demography, comorbidities, COVID-19 symptoms, and major outcomes. In total, 36 PLHIV subjects were enrolled; 92% were male and mean age was 44 years. Most patients (83%) were on antiretroviral therapy; mean CD4 count was 557 cells/mm3. Suppressed HIV viremia was found in 68% and 56% had, at least, one comorbidity. Severe COVID-19 occurred in 44.4%, intensive care was required in 22.2%, and five patients died (13.9%). No differences were seen between recovered and deceased patients in CD4 count, HIV viral load, or time since HIV diagnosis. Hypertension and cardiovascular disease were associated with a higher risk of death ( p = 0.02 and 0.006, respectively). Compared with general population, the HIV cohort had significantly more men (OR 0.15; IC 95% 0.07–0.31) and younger age (OR 8.68; IC 95% 2.66–28.31). In PLHIV, we found more intensive care unit admission (OR 2.31; IC 95% 1.05–5.07) but no differences in the need for mechanical ventilation or death. In this cohort of PLHIV hospitalized with COVID-19, hypertension and cardiovascular comorbidities, but not current HIV viro-immunologic status, were the most important risk factors for mortality. No differences were found between PLHIV and general population in the need for mechanical ventilation and death.

scholarly journals Clinical characteristics and risk factors for mortality in COVID-19 inpatients in Birjand, Iran: a single-center retrospective study

2021 ◽  
Vol 26 (1) ◽  
Author(s):  
Ghodsiyeh Azarkar ◽  
Freshteh Osmani
Keyword(s):  
Risk Factors ◽  
Platelet Count ◽  
Protein Level ◽  
Clinical Characteristics ◽  
Single Center ◽  
C Reactive Protein ◽  
Reactive Protein ◽  
Risk Of Death ◽  
Survivor Group ◽  
Epidemiological Characteristics

Abstract Background The coronavirus disease 2019(COVID-19) has affected mortality worldwide. The Cox proportional hazard (CPH) model is becoming more popular in time-to-event data analysis. This study aimed to evaluate the clinical characteristics in COVID-19 inpatients including (survivor and non-survivor); thus helping clinicians give the right treatment and assess prognosis and guide the treatment. Methods This single-center study was conducted at Hospital for COVID-19 patients in Birjand. Inpatients with confirmed COVID-19 were included. Patients were classified as the discharged or survivor group and the death or non-survivor group based on their outcome (improvement or death). Clinical, epidemiological characteristics, as well as laboratory parameters, were extracted from electronic medical records. Independent sample T test and the Chi-square test or Fisher’s exact test were used to evaluate the association of interested variables. The CPH model was used for survival analysis in the COVID-19 death patients. Significant level was set as 0.05 in all analyses. Results The results showed that the mortality rate was about (17.4%). So that, 62(17%) patients had died due to COVID-19, and 298 (83.6%) patients had recovered and discharged. Clinical parameters and comorbidities such as oxygen saturation, lymphocyte and platelet counts, hemoglobin levels, C-reactive protein, and liver and kidney function, were statistically significant between both studied groups. The results of the CPH model showed that comorbidities, hypertension, lymphocyte counts, platelet count, and C-reactive protein level, may increase the risk of death due to the COVID-19 as risk factors in inpatients cases. Conclusions Patients with, lower lymphocyte counts in hemogram, platelet count and serum albumin, and high C-reactive protein level, and also patients with comorbidities may have more risk for death. So, it should be given more attention to risk management in the progression of COVID-19 disease.

scholarly journals Patients Admitted for Variant Alpha COVID-19 Have Poorer Outcomes than Those Infected with the Old Strain

2021 ◽  
Vol 10 (16) ◽  
pp. 3550
Author(s):  
Matteo Vassallo ◽  
Sabrina Manni ◽  
Camille Klotz ◽  
Roxane Fabre ◽  
Paola Pini ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Inflammatory Markers ◽  
Clinical Characteristics ◽  
Clinical Presentation ◽  
Severe Pneumonia ◽  
Demographic Parameters ◽  
Background Characteristics ◽  
Risk Of Death ◽  
Mean Delay ◽  
Diabetes And Obesity

Objectives: The variant alpha COVID-19 rapidly spread across Europe in early 2021. While this variant’s increased infectivity has been proven, little is known of its clinical presentation and outcomes compared to the old strain. Methods: We identified patients admitted to the Cannes General Hospital for variant alpha-related COVID-19 infection from January to April 2021. Their main demographic parameters, inflammatory markers and clinical characteristics were recorded. Patients admitted from October to December 2020 for 20E (EU1) COVID-19 were selected as controls. Differences between groups were analyzed. Results: We included 157 patients (mean age 73 years; 58% men; mean delay of symptoms 6.9 days). Comorbidities were present in 92% (mainly hypertension, diabetes and obesity or overweight). The prevalence of comorbidities did not differ between groups. In 28% of cases, patients either died or required transfer to the Intensive Care Unit (ICU). The cause of death or of transfer to the ICU was presumably associated with severe pneumonia. Variant alpha COVID-19 had 3.8-fold higher risk of death or transfer to the ICU compared to the old strain. Discussion: Patients infected with variant alpha COVID-19, despite similar background characteristics, had a higher risk of unfavorable outcomes than those infected with the old strain, suggesting increased virulence related to this variant.

scholarly journals Comparing the Clinical Characteristics and Mortality of Residential and Non-Residential Older People with COVID-19: Retrospective Observational Study

2022 ◽  
Vol 19 (1) ◽  
pp. 483
Author(s):  
Francesc X. Marin-Gomez ◽  
Jacobo Mendioroz-Peña ◽  
Miguel-Angel Mayer ◽  
Leonardo Méndez-Boo ◽  
Núria Mora ◽  
...  
Keyword(s):  
Risk Factors ◽  
Electronic Medical Records ◽  
Medical Records ◽  
Clinical Characteristics ◽  
Fold Increase ◽  
The Elderly ◽  
Health Administration ◽  
Epidemic Outbreak ◽  
Risk Of Death ◽  
Using Data

Nursing homes have accounted for a significant part of SARS-CoV-2 mortality, causing great social alarm. Using data collected from electronic medical records of 1,319,839 institutionalised and non-institutionalised persons ≥ 65 years, the present study investigated the epidemiology and differential characteristics between these two population groups. Our results showed that the form of presentation of the epidemic outbreak, as well as some risk factors, are different among the elderly institutionalised population with respect to those who are not. In addition to a twenty-fold increase in the rate of adjusted mortality among institutionalised individuals, the peak incidence was delayed by approximately three weeks. Having dementia was shown to be a risk factor for death, and, unlike the non-institutionalised group, neither obesity nor age were shown to be significantly associated with the risk of death among the institutionalised. These differential characteristics should be able to guide the actions to be taken by the health administration in the event of a similar infectious situation among institutionalised elderly people.

scholarly journals A Retrospective Cross Sectional Study of Clinical Characteristics and Prognostic Factors of Covid 19 Patients Admitted to a Gambian Teaching Hospital

2021 ◽  
Author(s):  
Sheikh Omar Bittaye ◽  
Abubacarr Jagne ◽  
Abdoulie Badjan ◽  
Babakunta Fofana ◽  
Ebrima Barrow ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Prognostic Factors ◽  
Oxygen Saturation ◽  
Respiratory Rate ◽  
Health Facility ◽  
Teaching Hospital ◽  
Clinical Characteristics ◽  
Risk Of Death ◽  
Increased Risk ◽  
Lower Level Health Facility

Abstract Background: The first case of Novel coronavirus disease (COVID 19) was diagnosed in The Gambia on the 17th March 2020. We therefore investigate the clinical characteristics and prognostic factors of COVID 19 patients admitted at a Gambian teaching Hospital. Method: Out of 407 suspected COVID 19 patients, 137 (33.7%) tested positive for COVID 19 and were recruited. Clinical features, treatment and outcomes were recorded. Univariate and multivariate logistic regression analyses were used to assess prognostic factors of survival in our patients. Results: The median age of our patients was 60 years (19-100) and 86 (62.8%) were men. Eighty nine (64.9%) patients had co-morbidities, mostly Hypertension 51 (37.2%) and Diabetes Mellitus 47 (34.3%). The most common symptoms were cough 71 (51.8%) and dyspnea 53 (38.7%) and majority of patients presented with SPO ≤ 93% 75 (54.7%). Patients with SPO2 ≤ 93% were older 63.2 vs. 53.1 years (p=0.001), more likely to present with dyspnea (p=0.002), Cough (0.035), higher respiratory rate (p<0.001) and co-morbidities (p=0.009) compared to patients with SPO2>93%. Non survivors were older 63.2 vs 53.1 years (p=0.001), more likely to present with higher respiratory rate (p=0.014), lower oxygen saturation (p=<0.001), to be referred from lower level health facility (p=0.012) and to have Diabetes mellitus (p=0.007) as compared to survivors. Our cumulative mortality is 49 (35.8%) and mortality rate of patients referred from lower level heath facilities was 46 % as compared to 25 % for self referred patients. Multivariate analysis showed increasing odds of mortality independently associated with Age≥ 60 years (odd ratio, 2.87: 95% CI, 1.21 to 6.83, p=0.012), Diabetes mellitus (odd ratio, 3.47: 95% CI, 1.44 to 8.36, p=0.006), oxygen saturation ≤ 93% (odd ratio, 3.18: 95% CI, 1.27 to 7.99, p=0.014) and referral from lower level health facility (odd ratio, 2.87: 95% CI, 1.11 to 6.82, p=0.017).Conclusion: Older patients, patients with Diabetes Mellitus, hypoxemia or patients referred from lower level health facilities are at increased risk of death. In resource limited countries where critical care/emergency medicine resources are limited, our results may help guide the clinical management of patients with severe COVID-19.

Investigation of parasites in the digestive tract of white leg shrimp (Litopenaeus vannamei) cultured at coastal farms in the Mekong Delta

2021 ◽  
Vol 13 (Aquaculture) ◽  
pp. 79-85
Author(s):  
Thi Hoang Oanh Dang ◽  
Thi Nhu Thuy Nguyen ◽  
Ngoc Ut Vu
Keyword(s):  
Gastrointestinal Tract ◽  
Digestive Tract ◽  
Litopenaeus Vannamei ◽  
Developmental Stages ◽  
Slow Growth ◽  
Mekong Delta ◽  
Pcr Analysis ◽  
Histopathological Analysis ◽  
Enterocytozoon Hepatopenaei

A total of 291 white leg shrimp samples were collected from 70 cultured ponds in Soc Trang, Bac Lieu and Ca Mau provinces in the Mekong Delta and subjected to endoparasitic detection in the digestive tract. Collected shrimps displayed unhealthy behaviors such as stop or less feeding and lethagic swimming. Pathological signs in the gastrointestinal tract include (1) empty midgut and stomach together with pale and atrophy hepatopancreas; (2) empty, little or discontinued food in the midgut; (3) slow growth and variation in sizes; and (4) white feces. The results from fresh and Giemsa stained smears methods revealed that 96.5% of sampled shrimps were infected by gregarine parasite at different developmental stages. A prevalence infection of 24.7% was recorded with Vermiform present in the hepatopancreas by fresh smear and histology. Histopathological analysis noted that 7.9% of collected shrimp samples had Enterocytozoon hepatopenaei (EHP) spores in hepatopancreas and midgut and confirmed by PCR analysis.

Neurologist, 30 years’ experience, Italy

2020 ◽  
pp. 257-259
Author(s):  
Markus Reuber ◽  
Gregg H. Rawlings ◽  
Steven C. Schachter
Keyword(s):  
At Risk ◽  
Clinical Practice ◽  
Case Reports ◽  
Epileptic Seizures ◽  
Correct Treatment ◽  
Risk Of Death ◽  
Convulsive Seizures ◽  
Clinical Conditions

This chapter assesses how, in clinical practice, the diagnostic and therapeutic borders between epileptic and Psychogenic Non-Epileptic Seizures (PNES) are ill-defined and sometimes contrast with the schematic views offered by scientific reports. It specifically considers two case reports that illustrate how it is difficult to distinguish the two clinical conditions at the time of the diagnosis and, when the diagnosis is apparently clear, to start the correct treatment. The first patient was referred with seizures characterized by “convulsions” accompanied by loss of awareness. His seizures started when he was caught in an emergency and was at risk of death. The second patient, a 24-year-old girl, was hospitalized because she had experienced “convulsive” seizures. She received contrasting opinions regarding her diagnosis.

scholarly journals Distinct Clinical Characteristics and Risk Factors for Mortality in Female Inpatients With Coronavirus Disease 2019 (COVID-19): A Sex-stratified, Large-scale Cohort Study in Wuhan, China

2020 ◽  
Author(s):  
Jing Chen ◽  
Hualin Bai ◽  
Jia Liu ◽  
Ge Chen ◽  
Qiuyue Liao ◽  
...  
Keyword(s):  
Risk Factors ◽  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Clinical Characteristics ◽  
Large Scale ◽  
Cardiac Injury ◽  
Laboratory Data ◽  
Coagulation Disorder ◽  
Risk Of Death ◽  
Initial Symptoms

Abstract Background As the coronavirus disease 2019 (COVID-19) outbreak accelerates worldwide, it is important to evaluate sex-specific clinical characteristics and outcomes, which may affect public health policies. Methods Patients with COVID-19 admitted to Tongji Hospital between 18 January and 27 March 2020 were evaluated. Clinical features, laboratory data, complications, and outcomes were compared between females and males. Risk factors for mortality in the whole population, females, and males were determined respectively. Results There were 1667 (50.38%) females among the 3309 patients. The mortality rate was 5.9% in females but 12.7% in males. Compared with males, more females had no initial symptoms (11.1% vs 8.3%, P = .008). Complications including acute respiratory distress syndrome, acute kidney injury, septic shock, cardiac injury, and coagulation disorder were less common in females; critical illness was also significantly less common in females (31.1% vs 39.4%, P &lt; .0001). Significantly fewer females received antibiotic treatment (P = .001), antiviral therapy (P = .025), glucocorticoids treatment (P &lt; .0001), mechanical ventilation (P &lt; .0001), and had intensive care unit admission (P &lt; .0001). A lower risk of death was found in females (OR, .44; 95% CI, .34–.58) after adjusting for age and coexisting diseases. Among females, age, malignancy, chronic kidney disease, and days from onset to admission were significantly associated with mortality, while chronic kidney disease was not a risk factor in males. Conclusions Significantly milder illness and fewer deaths were found in female COVID-19 inpatients and risk factors associated with mortality varied among males and females.

scholarly journals Clinical characteristics and outcomes of patients with severe covid-19 with diabetes

2020 ◽  
Vol 8 (1) ◽  
pp. e001343 ◽  
Author(s):  
Yongli Yan ◽  
Yan Yang ◽  
Fen Wang ◽  
Huihui Ren ◽  
Shujun Zhang ◽  
...  
Keyword(s):  
Mechanical Ventilation ◽  
Clinical Characteristics ◽  
Cox Regression ◽  
Survival Curve ◽  
High Sensitivity ◽  
Severe Case ◽  
Lactic Dehydrogenase ◽  
Survival Duration ◽  
Risk Of Death ◽  
Patients With Diabetes

ObjectiveThis study explores the clinical characteristics of patients with diabetes with severe covid-19, and the association of diabetes with survival duration in patients with severe covid-19.Research design and methodsIn this single-center, retrospective, observational study, the clinical and laboratory characteristics of 193 patients with severe covid-19 were collected. 48 patients with severe covid-19 had diabetes, and 145 patients (ie, the controls) did not have diabetes. A severe case was defined as including at least one of the following criteria: (1) Respiratory rate >30/min. (2) Oxygen saturation ≤93%. (3) PaO2/FiO2≤300 mm Hg. (4) Patients, either with shock or respiratory failure, requiring mechanical ventilation, or combined with other organ failure, requiring admission to intensive care unit (ICU).ResultsOf 193 patients with severe covid-19, 48 (24.9%) had diabetes. Compared with patients with severe covid-19 without diabetes, patients with diabetes were older, susceptible to receiving mechanical ventilation and admission to ICU, and had higher mortality. In addition, patients with severe covid-19 with diabetes had higher levels of leukocyte count, neutrophil count, high-sensitivity C reaction protein, procalcitonin, ferritin, interleukin (IL) 2 receptor, IL-6, IL-8, tumor necrosis factor α, D-dimer, fibrinogen, lactic dehydrogenase and N-terminal pro-brain natriuretic peptide. Among patients with severe covid-19 with diabetes, more non-survivors were men (30 (76.9%) vs 9 (23.1%)). Non-survivors had severe inflammatory response, and cardiac, hepatic, renal and coagulation impairment. Finally, the Kaplan-Meier survival curve showed a trend towards poorer survival in patients with severe covid-19 with diabetes than patients without diabetes. The HR was 1.53 (95% CI 1.02 to 2.30; p=0.041) after adjustment for age, sex, hypertension, cardiovascular disease and cerebrovascular disease by Cox regression. The median survival durations from hospital admission in patients with severe covid-19 with and without diabetes were 10 days and 18 days, respectively.ConclusionThe mortality rate in patients with severe covid-19 with diabetes is considerable. Diabetes may lead to an increase in the risk of death.

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