Clinical Characteristics and Outcomes of 905 COVID-19 Patients Admitted to Imam Khomeini Hospital Complex in the Capital City of Tehran, Iran

Background: We studied the clinical characteristics and outcomes of 905 hospitalized coronavirus disease 2019 (COVID-19) patients admitted to Imam Khomeini Hospital Complex (IKHC), Tehran, Iran. Methods: COVID-19 patients were recruited based on clinical symptoms and patterns of computed tomography (CT) imaging between February 20 and March 19. All patients were tested for the presence of COVID-19 RNA. The Poisson regression model estimated the incidence rate ratio (IRR) for different parameters. Results: The average age (± standard deviation) was 56.9 (±15.7) years and 61.77% were male. The most common symptoms were fever (93.59%), dry cough (79.78%), and dyspnea (75.69%). Only 43.76% of patients were positive for the RT-PCR COVID-19 test. Prevalence of lymphopenia was 42.9% and more than 90% had elevated lactate dehydrogenase (LDH) or C-reactive protein (CRP). About 11% were severe cases, and 13.7% died in the hospital. The median length of stay (LOS) was 3 days. We found higher risks of mortality in patients who were older than 70 years (IRR = 11.77, 95% CI 3.63–38.18), underwent mechanical ventilation (IRR = 7.36, 95% CI 5.06–10.7), were admitted to the intensive care unit (ICU) (IRR = 5.47, 95% CI 4.00–8.38), tested positive on the COVID-19 test (IRR = 2.80, 95% CI 1.64–3.55), and reported a history of comorbidity (IRR = 1.76, 95% CI 1.07–2.89) compared to their corresponding reference groups. Hydroxychloroquine therapy was not associated with mortality in our study. Conclusion: Older age, experiencing a severe form of the disease, and having a comorbidity were the most important prognostic factors for COVID-19 infection. Larger studies are needed to perform further subgroup analyses and verify high-risk groups.

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Evaluating effects of allo-vedic preparation Raj Nirwan Bati on symptomatic cases of COVID-19 at a tertiary level health care facility in rural setting of northern India

International Journal of Research in Medical Sciences ◽

10.18203/2320-6012.ijrms20214411 ◽

2021 ◽

Vol 9 (11) ◽

pp. 3289

Author(s):

Raj Kumar ◽

Ramakant Yadav ◽

Ramakant Rawat ◽

Naresh P. Singh ◽

Indra K. Sharma ◽

...

Keyword(s):

Clinical Symptoms ◽

Care Facility ◽

Health Care Facility ◽

Severe Form ◽

Rural Setting ◽

The Novel ◽

Rt Pcr ◽

Reactive Protein ◽

Northern India ◽

Elevated Lactate

Background: The present pandemic of COVID-19 has created a huge pressure on the current health system of the world as the burden is increasing exponentially day by day. Study evaluated the effect of the novel allo-vedic formulation named Raj Nirwan Bati (RNB) on the clinical symptoms, microbiological, bio-chemical, haematological and radiological profile of patients of COVID-19.Methods: Prospective single arm, non- randomized clinical trial was conducted which enrolled 40 reverse transcriptase-polymerase chain reaction (RT-PCR) confirmed patients of severe acute respiratory syndrome corona virus-2 (SARS-CoV-2). Each patient was given one dosage of RNB twice a day for 10 days. Patients were evaluated on the clinical symptoms, microbiological, bio-chemical, haematological and radiological profile of patients of COVID-19. Cochran’s Q tests was used to assess statistical significance.Results: The study revealed that 31 (77.5%) of the COVID-19 cases were having mild, 6 (15%) moderate and 3 (7.5%) having severe form of illness. The association between absence of clinical symptom (fever, cough, breathlessness, sore throat, fatigue and myalgia) and the day of evaluation (first, fifth and tenth day) after start of RNB intervention was found to be statistically significant (p<0.001, p<0.001, p=0.002, p<0.001, p<0.001 and p<0.001) respectively. Thirty (75.0%) of the cases on RNB intervention became negative for SARS-CoV-2 after day 5 on naso-pharyngeal and oro-pharyngeal RT-PCR testing (p<0.001). Statistically significant association was observed only for changes in proportion of cases with elevated lactate dehydrogenase (LDH) values and C-reactive protein (CRP) positive from day 1 to day 10 of RNB intervention (p<0.001).Conclusions: RNB may be considered a drug to fight against COVID-19.

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Chondrosternal Arthritis in Infant: An Unusual Entity

Case Reports in Orthopedics ◽

10.1155/2014/652539 ◽

2014 ◽

Vol 2014 ◽

pp. 1-4

Author(s):

Athina Nikolarakou ◽

Dana Dumitriu ◽

Pierre-Louis Docquier

Keyword(s):

Clinical Symptoms ◽

Therapeutic Option ◽

White Blood Cells ◽

Laboratory Data ◽

C Reactive Protein ◽

Reactive Protein ◽

History Of ◽

Local Tenderness ◽

Wait And See

Primary arthritis of chondrosternal joint is very rare and occurs in infants less than 18 months of age. Presentation is most often subacute but may be acute. Child presents with a parasternal mass with history of fever and/or local signs of infection. Clinical symptoms vary from a painless noninflammatory to a painful mass with local tenderness and swelling, while fever may be absent. Laboratory data show low or marginally raised levels of white blood cells and C-reactive protein, reflecting, respectively, the subacute or acute character of the infection. It is a self-limiting affection due to the adequate immune response of the patient. Evolution is generally good without antibiotherapy with a progressive spontaneous healing. A wait-and-see approach with close follow-up in the first weeks is the best therapeutic option.

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The preliminary comparative results between Covid-19 and non-Covid-19 patients in Western China

10.21203/rs.3.rs-20178/v1 ◽

2020 ◽

Author(s):

Li Yanzi ◽

Li Hongxia ◽

Han Jianfeng ◽

Yang Lin

Keyword(s):

Clinical Characteristics ◽

White Cell Count ◽

Western China ◽

C Reactive Protein ◽

Reactive Protein ◽

Sputum Production ◽

Familial Clustering ◽

History Of ◽

Comparative Results ◽

Major Adverse Events

Abstract Background: This study aims to investigate the comparative clinical characteristics of Covid-19 and non-Covid-19 patients.Methods: Fifteen Covid-19 and 93 non-Covid-19 patients were included in RNA testing. All epidemiological and clinical data were collected and analyzed, and then comparative results were carried out.Results: Covid-19 patients were older (46.40±18.21 years vs 34.43±18.80 years) and hada higher body weight (70.27±10.67 kg vs 60.54±12.33 kg, P<0.05). The main symptoms that were similar between Covid-19 and non-Covid-19 patients, and Covid-19 patients showed a lower incidence of sputum production (6.67% vs 45.16%, P<0.01) and a lower white-cell count (4.83×109/L vs 7.43×109/L) and lymphocyte count (0.90×109/L vs 1.57×109/L) (P<0.01). Although there were no differences, C-reactive protein and interleukin-6 were elevated in Covid-19 patients. The sensitivity and negative predictive value of CT images were 0.87 and 0.97, respectively. Covid-19 patients showed a higher contact history of Wuhan residents (80% vs 30.11%) and higher familial clustering (53.33% vs 8.60%, P<0.001). Covid-19 patients showed a higher major adverse events (ARDS, 13.33%; death, 6.67%; P<0.05).Conclusion: Our results suggested that Covid-19 patients had a significant history of exposure and familial clustering and a higher rate of severe status; biochemical indicators showed lymphocyte depletion.

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Evaluating the role of high-sensitivity C-reactive protein in asthmatic Iraqi patients and its correlation with parameters of patients’ clinical characteristics and pulmonary function tests

Asian Journal of Medical Sciences ◽

10.3126/ajms.v7i3.13880 ◽

2016 ◽

Vol 7 (3) ◽

pp. 47-53

Author(s):

Muhammed Saleh Najdat ◽

Ahmed M Lutfi

Keyword(s):

Pulmonary Function ◽

Clinical Characteristics ◽

Clinical Symptoms ◽

Pulmonary Function Tests ◽

High Sensitivity ◽

Control Group ◽

Inhaled Corticosteroid ◽

C Reactive Protein ◽

Reactive Protein ◽

Hs Crp

Aims and Objectives: To evaluate the relevance of high-sensitivity assays for C-reactive protein (hs-CRP), as a sensitive marker of inflammation in asthmatic Iraqi patients. Additionally, correlations of serum levels of hs-CRP with patients’ clinical characteristics and pulmonary function tests (PFTs) will be studied in a cross-sectional design.Materials and Methods: A random sample of 58 individuals were divided into a healthy (control) group (n = 12) and two groups of adult patients with chronic stable asthma; (n = 22) patients had been receiving inhaled corticosteroids (inhaled corticosteroid-positive, or ICS+VE, group) for the past 2–3 months, and (n = 24) steroid-naive patients (inhaled corticosteroid-negative, or ICS-VE, group). The selected individuals were subjected to hs-CRP measurement and PFTs.Results: The forced expiratory volume in one second (FEV1)/forced vital capacity (FVC), was measured in all subjects. In the ICS+VE and the ICS-VE groups, there was a significant correlation between the level of hs-CRP and FEV1/FVC with r: ?0.891 and a p-value of < 0.0005 for both groups. In the ICS-VE group, 78.5% had significant clinical symptoms, whereas only 22.7% of the ICS+VE group had significant clinical symptoms. This difference (for the prevalence of clinical symptoms) was significant with a chi-square value of 19.59, degree of freedom (df) = 1, and p < 0.0005.Conclusion: In the ICS-VE group, the level of hs-CRP was significantly higher than in both the ICS+VE group and the control group. The values of the PFTs were significantly lower in the ICS-VE group. The prevalence of clinical features was significantly higher in the ICS-VE group.Asian Journal of Medical Sciences Vol. 7(3) 2016 47-53

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Acute cerebrovascular disease following COVID-19: a single center, retrospective, observational study

Stroke and Vascular Neurology ◽

10.1136/svn-2020-000431 ◽

2020 ◽

Vol 5 (3) ◽

pp. 279-284 ◽

Cited By ~ 106

Author(s):

Yanan Li ◽

Man Li ◽

Mengdie Wang ◽

Yifan Zhou ◽

Jiang Chang ◽

...

Keyword(s):

Risk Factors ◽

Cerebrovascular Disease ◽

Management Strategy ◽

Clinical Characteristics ◽

C Reactive Protein ◽

Laboratory Findings ◽

Reactive Protein ◽

Negative Prognostic Factor ◽

History Of ◽

New Onset

Background and purposeCOVID-19 is an infectious disease caused by Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2). Apart from respiratory complications, acute cerebrovascular disease (CVD) has been observed in some patients with COVID-19. Therefore, we described the clinical characteristics, laboratory features, treatment and outcomes of CVD complicating SARS-CoV-2 infection.Materials and methodsDemographic and clinical characteristics, laboratory findings, treatments and clinical outcomes were collected and analysed. Clinical characteristics and laboratory findings of patients with COVID-19 with or without new-onset CVD were compared.ResultsOf 219 patients with COVID-19, 10 (4.6%) developed acute ischaemic stroke and 1 (0.5%) had intracerebral haemorrhage. COVID-19 with new onset of CVD were significantly older (75.7±10.8 years vs 52.1±15.3 years, p<0.001), more likely to present with severe COVID-19 (81.8% vs 39.9%, p<0.01) and were more likely to have cardiovascular risk factors, including hypertension, diabetes and medical history of CVD (all p<0.05). In addition, they were more likely to have increased inflammatory response and hypercoagulable state as reflected in C reactive protein (51.1 (1.3–127.9) vs 12.1 (0.1–212.0) mg/L, p<0.05) and D-dimer (6.9 (0.3–20.0) vs 0.5 (0.1–20.0) mg/L, p<0.001). Of 10 patients with ischemic stroke; 6 received antiplatelet treatment with aspirin or clopidogrel; and 3 of them died. The other four patients received anticoagulant treatment with enoxaparin and 2 of them died. As of 24 March 2020, six patients with CVD died (54.5%).ConclusionAcute CVD is not uncommon in COVID-19. Our findings suggest that older patients with risk factors are more likely to develop CVD. The development of CVD is an important negative prognostic factor which requires further study to identify optimal management strategy to combat the COVID-19 outbreak.

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Clinical Characteristics, Management, and Natural History of Chronic Inducible Urticaria in a Pediatric Cohort

International Archives of Allergy and Immunology ◽

10.1159/000514757 ◽

2021 ◽

pp. 1-8

Author(s):

Laura May Miles ◽

Sofianne Gabrielli ◽

Michelle Le ◽

Elena Netchiporouk ◽

Sharon Baum ◽

...

Keyword(s):

Natural History ◽

Clinical Characteristics ◽

Pediatric Patients ◽

C Reactive Protein ◽

Protein Levels ◽

Reactive Protein ◽

Protocol Population ◽

Chronic Inducible Urticaria ◽

Inducible Urticaria ◽

History Of

Background: Some forms of chronic urticaria (CU) can be specifically attributed to a response to a definite trigger, referred to as chronic inducible urticaria (CIndU). We aimed to assess the demographics, clinical characteristics, comorbidities, natural history, and management of pediatric patients with CIndU. Methods: Over a 6-year period, children presenting to the allergy clinic at the Montreal Children’s Hospital (MCH) with CIndU were prospectively recruited. CU was defined as the presence of wheals and/or angioedema, occurring for at least 6 weeks. A standardized diagnostic test was used to establish the presence of a specific form of urticaria. Resolution was defined as the absence of hives for 1 year without treatment. Results: Sixty-four patients presented with CIndU, of which 51.6% were male, with a median age of 12.5 (interquartile range 7.3, 15.9) years. Cold CU and cholinergic CU were the most common subtypes (60.3 and 41.3%, respectively). Basophil counts were undetectable in 48.4% of the cases, and C-reactive protein levels were elevated in 7.8% of patients. Of all cases, 71.4% were controlled with second-generation antihistamines. The resolution rate was of 45.3% (95% confidence interval 33.1–57.5%), based on per-protocol population within the 6-year course of the study. Resolution was more likely in patients who presented with well-controlled urticaria control test scores and elevated CD63 counts and in those suffering from thyroid comorbidity. Conclusion: The natural history of CIndU resolution in pediatric patients was relatively low and was associated with elevated CD63 levels, as well as thyroid comorbidity.

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C-reactive protein or procalcitonin combined with rhinorrhea for discrimination of viral from bacterial infections in hospitalized adults in non-intensive care units with lower respiratory tract infections

BMC Pulmonary Medicine ◽

10.1186/s12890-021-01672-7 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Shengchen Duan ◽

Xiaoying Gu ◽

Guohui Fan ◽

Fei Zhou ◽

Guangfa Zhu ◽

...

Keyword(s):

Intensive Care ◽

Respiratory Tract ◽

Bacterial Infection ◽

Lower Respiratory Tract ◽

Bacterial Infections ◽

Clinical Characteristics ◽

Clinical Symptoms ◽

C Reactive Protein ◽

Reactive Protein ◽

Tract Infections

Abstract Background Whether procalcitonin (PCT) or C-reactive protein (CRP) combined with certain clinical characteristics can better distinguish viral from bacterial infections remains unclear. The aim of the study was to assess the ability of PCT or CRP combined with clinical characteristics to distinguish between viral and bacterial infections in hospitalized non-intensive care unit (ICU) adults with lower respiratory tract infection (LRTI). Methods This was a post-hoc analysis of a randomized clinical trial previously conducted among LRTI patients. The ability of PCT, CRP and PCT or CRP combined with clinical symptoms to discriminate between viral and bacterial infection were assessed by portraying receiver operating characteristic (ROC) curves among patients with only a viral or a typical bacterial infection. Results In total, 209 infected patients (viral 69%, bacterial 31%) were included in the study. When using CRP or PCT to discriminate between viral and bacterial LRTI, the optimal cut-off points were 22 mg/L and 0.18 ng/mL, respectively. When the optimal cut-off for CRP (≤ 22 mg/L) or PCT (≤ 0.18 ng/mL) combined with rhinorrhea was used to discriminate viral from bacterial LRTI, the AUCs were 0.81 (95% CI: 0.75–0.87) and 0.80 (95% CI: 0.74–0.86), which was statistically significantly better than when CRP or PCT used alone (p < 0.001). When CRP ≤ 22 mg/L, PCT ≤ 0.18 ng/mL and rhinorrhea were combined, the AUC was 0.86 (95% CI: 0.80–0.91), which was statistically significantly higher than when CRP (≤ 22 mg/L) or PCT (≤ 0.18 ng/mL) was combined with rhinorrhea (p = 0.011 and p = 0.021). Conclusions Either CRP ≤ 22 mg/L or PCT ≤ 0.18 ng/mL combined with rhinorrhea could help distinguish viral from bacterial infections in hospitalized non-ICU adults with LRTI. When rhinorrhea was combined together, discrimination ability was further improved.

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Characteristics and outcomes of coronavirus disease 2019 (COVID-19) patients with cancer: A single-center retrospective observational study in Tokyo, Japan

10.21203/rs.3.rs-39157/v1 ◽

2020 ◽

Author(s):

Shohei Nakamura ◽

Yusuke Kanemasa ◽

Yuya Atsuta ◽

Sho Fujiwara ◽

Masaru Tanaka ◽

...

Keyword(s):

Clinical Characteristics ◽

Rest Period ◽

C Reactive Protein ◽

Illness Onset ◽

Viral Shedding ◽

Patients With Cancer ◽

Reactive Protein ◽

Median Period ◽

History Of ◽

Univariate Analyses

Abstract BackgroundAlthough severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has caused an international outbreak of coronavirus disease 2019 (COVID-19), data on the clinical characteristics of COVID-19 patients with cancer are limited. This study aimed to evaluate the clinical characteristics and outcomes including mortality and viral shedding period in COVID-19 patients with cancer in Japan.MethodsWe retrospectively analyzed 32 patients with a history of cancer who were referred to our hospital between January 31, 2020 and May 25, 2020. We evaluated the association between clinical outcomes and potential prognostic factors using univariate analyses.ResultsThe median age was 74.5 (range, 24–90) years and 22 patients (69%) were men. A total of 11 patients (34%) died. Our analyses demonstrated that the mortality was significantly associated with lymphocyte count, albumin, lactate dehydrogenase, serum ferritin, and C-reactive protein on admission. The median period between illness onset and the first effective negative SARS-CoV-2 PCR result was 22 days (interquartile range, 18–25) in survivors. Of four patients with hematological malignancy who developed COVID-19 within the rest period of chemotherapy, three died and the other patient, who received bendamustine plus rituximab therapy, had the longest duration of viral shedding (56 days).ConclusionOur study suggested that the risk factors for mortality previously reported in general COVID-19 patients, including lymphocytopenia, were also effective in cancer patients. Patients who received cytotoxic chemotherapy recently or were treated with chemotherapy, which can lead to lymphocyte reduction, had poor prognosis and prolonged periods of viral shedding.

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Radiological and clinical characteristics of 22 suspected COVID-19 patients with multiple negative RT-PCR testing

10.21203/rs.3.rs-27135/v1 ◽

2020 ◽

Author(s):

Wenjun Wu ◽

Heshui Shi ◽

Bo Liang ◽

Feihong Wu ◽

Dongqiao Xiang ◽

...

Keyword(s):

Clinical Characteristics ◽

Clinical Symptoms ◽

Lower Lobe ◽

Ground Glass Opacity ◽

Pulmonary Involvement ◽

Active Management ◽

Rapid Progression ◽

Rt Pcr ◽

Reactive Protein ◽

Group 2

Abstract This study aims to investigate radiological and clinical characteristics of suspected COVID-19 patients with negative RT-PCR testing. 22 suspected COVID-19 patients with 2-5 negative RT-PCR testing were enrolled. The most common symptoms at onset included fever (18[81.8%] patients), fatigue (16[72.7%]) and cough (12[54.5%]). 20(90.9%) patients were with normal or decreased Leukocyte count, 17 (77.3%) with decreased Lymphocyte count, 16 (72.7%) and 18 (81.8%) with increased level of C-reactive protein and D-dimers, respectively. Ground-glass opacity (GGO) (22[100]), reticular/interlobular septal thickening (11 [50%]) and consolidation (14 [63.6%)) with predominantly bilateral and peripheral distribution were typical findings at initial CT scan. The CT score of right lower lobe was significantly higher than right upper lobe (P=0.042). The total CT scores of group 2, 3, 4 (2nd week, 3rd week, 4th week and after) were significantly higher than group 1 (1st week) (P＜0.01,for all). After rapid progression at first week, the most extensive pulmonary involvement emerged at second week after symptom onset, then the involvement gradually decreased. Given the clinical symptoms, laboratory results and typical radiological manifestations, even suspected COVID-19 patients with multiple negative RT-PCR testing deserve great concern for active management.

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The preliminary comparative results between Covid-19 and non-Covid-19 patients in Western China

BMC Infectious Diseases ◽

10.1186/s12879-020-05680-6 ◽

2020 ◽

Vol 20 (1) ◽

Author(s):

Yanzi Li ◽

Hongxia Li ◽

Jianfeng Han ◽

Lin Yang

Keyword(s):

Clinical Characteristics ◽

White Cell Count ◽

Western China ◽

C Reactive Protein ◽

Reactive Protein ◽

Sputum Production ◽

Familial Clustering ◽

History Of ◽

Comparative Results ◽

Major Adverse Events

Abstract Background This study aims to investigate the comparative clinical characteristics of Covid-19 and non-Covid-19 patients. Methods Fifteen Covid-19 and 93 non-Covid-19 patients were included in RNA testing. All epidemiological and clinical data were collected and analyzed, and then comparative results were carried out. Results Covid-19 patients were older (46.40 ± 18.21 years vs 34.43 ± 18.80 years) and had a higher body weight (70.27 ± 10.67 kg vs 60.54 ± 12.33 kg, P < 0.05). The main symptoms that were similar between Covid-19 and non-Covid-19 patients, and Covid-19 patients showed a lower incidence of sputum production (6.67% vs 45.16%, P < 0.01) and a lower white-cell count (4.83 × 109/L vs 7.43 × 109/L) and lymphocyte count (0.90 × 109/L vs 1.57 × 109/L, P < 0.01). Although there were no differences, C-reactive protein and interleukin-6 were elevated in Covid-19 patients. The sensitivity and negative predictive value of CT images were 0.87 and 0.97, respectively. Covid-19 patients showed a higher contact history of Wuhan residents (80% vs 30.11%) and higher familial clustering (53.33% vs 8.60%, P < 0.001). Covid-19 patients showed a higher major adverse events (ARDS, 13.33%; death, 6.67%; P < 0.05). Conclusion Our results suggested that Covid-19patients had a significant history of exposure and familial clustering and a higher rate of severe status; biochemical indicators showed lymphocyte depletion.

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